BACKGROUND & AIMS: Pouchitis often is diagnosed based on symptoms alone. In this study, we evaluate whether symptoms correlate with endoscopic and histologic findings in patients with ulcerative colitis and an ileal pouch-anal anastomosis. METHODS: Symptoms, endoscopy, and histology were assessed in 46 patients using Pouchitis Disease Activity Index (PDAI). Patients were classified as either having pouchitis (PDAI score > or =7; N = 22) or as not having pouchitis (PDAI score <7; N = 24). RESULTS: Patients with pouchitis had significantly higher mean total PDAI scores, symptom scores, endoscopy scores, and histology scores. There was a similar magnitude of contribution of each component score to the total PDAI for the pouchitis group. Of note, 25% of patients with symptoms suggestive of pouchitis did not meet the PDAI diagnostic criteria for pouchitis. In both groups, the correlation coefficients between symptom, endoscopy, and histology scores were near zero (range, -0.26 to 0.20; P > 0.05). CONCLUSIONS: The symptom, endoscopy, and histology scores each contribute to the PDAI and appear to be independent of each other. Symptoms alone do not reliably diagnose pouchitis.
BACKGROUND & AIMS:Pouchitis often is diagnosed based on symptoms alone. In this study, we evaluate whether symptoms correlate with endoscopic and histologic findings in patients with ulcerative colitis and an ileal pouch-anal anastomosis. METHODS: Symptoms, endoscopy, and histology were assessed in 46 patients using Pouchitis Disease Activity Index (PDAI). Patients were classified as either having pouchitis (PDAI score > or =7; N = 22) or as not having pouchitis (PDAI score <7; N = 24). RESULTS:Patients with pouchitis had significantly higher mean total PDAI scores, symptom scores, endoscopy scores, and histology scores. There was a similar magnitude of contribution of each component score to the total PDAI for the pouchitis group. Of note, 25% of patients with symptoms suggestive of pouchitis did not meet the PDAI diagnostic criteria for pouchitis. In both groups, the correlation coefficients between symptom, endoscopy, and histology scores were near zero (range, -0.26 to 0.20; P > 0.05). CONCLUSIONS: The symptom, endoscopy, and histology scores each contribute to the PDAI and appear to be independent of each other. Symptoms alone do not reliably diagnose pouchitis.
Authors: Tracy C Grikscheit; Erin R Ochoa; Anthony Ramsanahie; Eben Alsberg; David Mooney; Edward E Whang; Joseph P Vacanti Journal: Ann Surg Date: 2003-07 Impact factor: 12.969
Authors: Linda Y Tang; Hui Cai; Udayakumar Navaneethan; James H Boone; Sarah J Rhodes; Lauren Moore; Hyunjin Rho; Carol de La Motte; Elaine Queener; Bo Shen Journal: Int J Colorectal Dis Date: 2012-03-20 Impact factor: 2.571
Authors: Jan Wehkamp; Nita H Salzman; Edith Porter; Sabine Nuding; Michael Weichenthal; Robert E Petras; Bo Shen; Elke Schaeffeler; Matthias Schwab; Rose Linzmeier; Ryan W Feathers; Hiutung Chu; Heriberto Lima; Klaus Fellermann; Tomas Ganz; Eduard F Stange; Charles L Bevins Journal: Proc Natl Acad Sci U S A Date: 2005-12-05 Impact factor: 11.205