Pouchitis
Pouchitis is inflammation of the ileal pouch — a surgically created reservoir made from the small intestine, usually performed after removal of the colon in ulcerative colitis or familial adenomatous polyposis.
Overview
Pouchitis is inflammation of the ileal pouch — a surgically created reservoir made from the small intestine, usually performed after removal of the colon in ulcerative colitis or familial adenomatous polyposis. It is the most common complication after this surgery, with up to 50% of patients developing it within 10 years (thelancet.com). If untreated, pouchitis can cause chronic diarrhoea, abdominal pain, and in severe cases, pouch failure.
Common Misunderstandings
Patients sometimes assume pouchitis is inevitable after surgery, but it can be preventable and manageable. Others mistake symptoms for “normal post-surgery changes” and delay seeking help. Frequent antibiotic courses can be frustrating and may lead to further microbiome disruption.
How is Pouchitis Linked to Your Microbiome?
- People with pouchitis often have reduced microbial diversity and a shift towards pro-inflammatory bacteria (gut.bmj.com).
- Beneficial species such as F. prausnitzii are commonly reduced, while certain Proteobacteria increase.
- Dysbiosis may both trigger and sustain inflammation in the pouch.
- Probiotic and postbiotic use (particularly multi-strain, high-potency blends) has been shown to help maintain remission in some patients (gut.bmj.com).
Symptoms
Increased stool frequency or looseness
Urgency and abdominal cramping
Blood or mucus in stool
Fatigue
Fatigue in acute cases
The Microbiome Clinic™
Our treatment approach for Pouchitis includes:
Gut Microbiome Test
Profile the gut to identify dysbiosis that may be affecting symptoms or treatment using the Gut Microbiome Test.
Targeted Antimicrobial Strategies
Antibiotics and plant-based or pharmaceutical antimicrobials (where appropriate) to reduce the overgrown population of unwanted bacteria in the gut.
Probiotics and Prebiotics
Targeted probiotics and prebiotics are introduced slowly to restore balance and biodiversity of microbes in the gut without fuelling overgrowth.
Individualised Nutrition Plans
Nutrition strategies to support recovery and enhance your overall health such as a tailored low-FODMAP diet or fibre consumptions strategies.
Suspect you might have Pouchitis?
