{
  "abstract": "Background: Pouchitis is the most frequent long-term complication after ileal pouch–anal anastomosis (IPAA) for ulcerative colitis. This study aimed to describe current international practices, definitions, and treatment strategies among experienced clinicians.\n\nMethods: An international web-based survey was conducted in 2025, following CROSS guidelines, exploring diagnostic, monitoring, and therapeutic practices. Responses were anonymized and analyzed descriptively.\n\nResults: A total of 412 physicians from 49 countries completed the survey, mostly gastroenterologists involved in IBD care (362/412, 87.8%). Most clinicians (156/412, 37.9%) estimated a pouchitis prevalence of 26%-50% among patients with IPAA, typically occurring within the first postoperative year. Follow-up was scheduled every 3-6 months by 164/412 (39.8%) physicians, with nearly half (47.6%) reporting the use of the pouch disease activity index (PDAI). Fecal calprotectin was the preferred non-invasive monitoring tool (326/412, 79.1%), whereas intestinal ultrasound was selected by 130/412 respondents (31.69%). Endoscopy was the primary diagnostic and follow-up modality (398/412, 96.6%), with biopsies routinely taken (364/412, 88%), although 46.7% of respondents reported not using a standardized histological scoring system. Prophylactic therapy was prescribed by 222/412 (53.9%), mainly probiotics (27.7%) and rectal mesalazine (18.2%). In acute pouchitis, ciprofloxacin plus metronidazole was the preferred first-line regimen (218/412, 52.9%). For chronic antibiotic-dependent or refractory pouchitis, advanced therapies were the predominant first-line option (254/412, 61.7%), with vedolizumab (198/412, 48.1%), and infliximab (170/412, 41.3%) most frequently selected. Ustekinumab, selective IL-23 inhibitors, JAK inhibitors and S1P receptor modulators were increasingly used in refractory cases. Treatment targets were primarily clinical (156/412, 37.9%) and endoscopic (124/412, 30.1%) remission, and most respondents (246/396, 62.1%) reported performing endoscopic assessment within 3-6 months after advanced treatment initiation.\n\nConclusions: This international survey demonstrates substantial heterogeneity in pouchitis diagnosis, monitoring, and treatment, highlighting important gaps in standardized disease assessment and treatment strategies. The findings support the need for consensus-based approaches and prospective, pouch-specific studies to improve the standardization of pouchitis care.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "Fabrizio Fanizzi",
      "orcid": "0009-0005-1198-6121"
    },
    {
      "name": "Ferdinando D’Amico"
    },
    {
      "name": "Maria Galbiati",
      "orcid": "0009-0009-0721-3766"
    },
    {
      "name": "Vipul Jairath",
      "orcid": "0000-0002-1092-0033"
    },
    {
      "name": "Laurent Peyrin-Biroulet",
      "orcid": "0000-0003-2536-6618"
    },
    {
      "name": "Silvio Danese",
      "orcid": "0000-0001-7341-1351"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ahevs40e2r9tg.bib",
  "cited_by": 0,
  "doi": "10.1093/crocol/otag114",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13700064/",
  "id": "ahevs40e2r9tg",
  "issns": [
    "2631-827X"
  ],
  "landing_url": "https://doi.org/10.1093/crocol/otag114",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00260"
    ],
    [
      "heading",
      "AcademicSubjects/MED00760"
    ],
    [
      "heading",
      "AcademicSubjects/MED00972"
    ],
    [
      "heading",
      "Observations and Research"
    ],
    [
      "openalex",
      "1311|Inflammatory Bowel Disease"
    ]
  ],
  "openalex": "W7223683326",
  "pdf_url": "https://europepmc.org/articles/PMC13700064?pdf=render",
  "pmcid": "PMC13700064",
  "pmid": "42936095",
  "published": "2026-10-12",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/ahevs40e2r9tg.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:34Z",
      "native_id": "PMC13700064",
      "source": "pmc",
      "url": "https://doi.org/10.1093/crocol/otag114"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42936095",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42936095"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:1311|Inflammatory Bowel Disease",
      "subfield": "genetics-genomics"
    }
  ],
  "title": "International practice patterns in the management of pouchitis: results from a global survey",
  "title_text": "International practice patterns in the management of pouchitis: results from a global survey",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:36:32Z",
  "url": "https://research.draconitic.com/paper/ahevs40e2r9tg",
  "venue": "Crohn's & Colitis 360",
  "versions": []
}