BACKGROUND: Crohn's disease (CD) of the pouch can occur in patients with restorative proctocolectomy and ileal pouch-anal anastomosis originally performed for a preoperative diagnosis of ulcerative colitis (UC). CD of the pouch was often observed in patients with a family history of CD. The purpose was to determine whether the family history of CD increased the risk for CD of the pouch in patients who underwent restorative proctocolectomy. METHODS: A total of 558 eligible patients seen in the Pouchitis Clinic were enrolled, including 116 patients with CD of the pouch and 442 patients with a normal pouch or other pouch disorders. Demographic and clinical variables were included in the study. Multivariable logistic regression analyses were performed. RESULTS: The adjusted multivariate logistic analyses revealed that the risk for CD of the pouch was increased in patients with a family history of CD, with an odds ratio (OR) of 3.22 (95% confidence interval [CI] 1.56-6.67), or with a first-degree relative with CD (OR = 4.18, 95% CI, 1.48-11.8), or with a greater number of family members with CD (OR = 2.00 per family member, 95% CI, 1.19-3.37), adjusting for age, gender, smoking status, duration of IBD, duration of having a pouch, and a preoperation diagnosis of indeterminate colitis or CD. In addition, patients of younger age and longer duration of having a pouch had a higher risk for CD of the pouch. A diagnosis of CD of the pouch was associated with a poor outcome, with a greater than 5-fold estimated increased odds of pouch failure (OR = 5.58, 95% CI, 2.74-11.4). CONCLUSIONS: The presence of a family history of CD is associated with an increased risk for CD of the pouch, which in turn has a high risk for pouch failure.
BACKGROUND:Crohn's disease (CD) of the pouch can occur in patients with restorative proctocolectomy and ileal pouch-anal anastomosis originally performed for a preoperative diagnosis of ulcerative colitis (UC). CD of the pouch was often observed in patients with a family history of CD. The purpose was to determine whether the family history of CD increased the risk for CD of the pouch in patients who underwent restorative proctocolectomy. METHODS: A total of 558 eligible patients seen in the Pouchitis Clinic were enrolled, including 116 patients with CD of the pouch and 442 patients with a normal pouch or other pouch disorders. Demographic and clinical variables were included in the study. Multivariable logistic regression analyses were performed. RESULTS: The adjusted multivariate logistic analyses revealed that the risk for CD of the pouch was increased in patients with a family history of CD, with an odds ratio (OR) of 3.22 (95% confidence interval [CI] 1.56-6.67), or with a first-degree relative with CD (OR = 4.18, 95% CI, 1.48-11.8), or with a greater number of family members with CD (OR = 2.00 per family member, 95% CI, 1.19-3.37), adjusting for age, gender, smoking status, duration of IBD, duration of having a pouch, and a preoperation diagnosis of indeterminate colitis or CD. In addition, patients of younger age and longer duration of having a pouch had a higher risk for CD of the pouch. A diagnosis of CD of the pouch was associated with a poor outcome, with a greater than 5-fold estimated increased odds of pouch failure (OR = 5.58, 95% CI, 2.74-11.4). CONCLUSIONS: The presence of a family history of CD is associated with an increased risk for CD of the pouch, which in turn has a high risk for pouch failure.
Authors: J P Hugot; M Chamaillard; H Zouali; S Lesage; J P Cézard; J Belaiche; S Almer; C Tysk; C A O'Morain; M Gassull; V Binder; Y Finkel; A Cortot; R Modigliani; P Laurent-Puig; C Gower-Rousseau; J Macry; J F Colombel; M Sahbatou; G Thomas Journal: Nature Date: 2001-05-31 Impact factor: 49.962
Authors: Y Ogura; D K Bonen; N Inohara; D L Nicolae; F F Chen; R Ramos; H Britton; T Moran; R Karaliuskas; R H Duerr; J P Achkar; S R Brant; T M Bayless; B S Kirschner; S B Hanauer; G Nuñez; J H Cho Journal: Nature Date: 2001-05-31 Impact factor: 49.962
Authors: Victor W Fazio; Paris P Tekkis; Feza Remzi; Ian C Lavery; Elena Manilich; Jason Connor; Miriam Preen; Conor P Delaney Journal: Ann Surg Date: 2003-10 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: Edward L Barnes; Joshua Hudson; Scott Esckilsen; Bharati Kochar; Michael D Kappelman; Millie D Long; Mark Koruda; Robert S Sandler; Hans H Herfarth Journal: Inflamm Intest Dis Date: 2021-10-07
Authors: Adam Truong; Karen N Zaghiyan; James Mirocha; Gil Y Melmed; Dermot P B McGovern; Gaurav Syal; Christina Y Ha; Stephan R Targan; Phillip R Fleshner Journal: Colorectal Dis Date: 2021-07-16 Impact factor: 3.917