Pouchitis Pouchitis is characterized by increased stool frequency and lower abdominal cramping in patients with a history of ulcerative colitis who have had either an ileoanal pouch or Koch pouch surgery. The diagnosis of pouchitis requires endoscopy of the pouch with pouch biopsy. These idiopathic inflammatory disorders of the colon cause watery diarrhea typically in middle-aged or older individuals. They have a relatively benign natural history and do not lead to other forms of colitis or to colon dysplasia or malignancy. The diagnosis is dependent upon colonoscopic biopsies.
Treatment is empiric.
Bismuth in the form of Pepto-Bismol is effective in many patients. Other inflammatory medications such as sulfasalazine or prednisone may be required in some patients. A subgroup of patients seem to respond to cholestyramine. This study is to determine if there is a difference between CellCept and Azathioprine in the percentage of patients with chronic active Crohn's disease achieving remission within 24 weeks and in the time course for induction of remission. Mayo Foundation for Medical Education and Research.