Edward L Barnes1,2,3, Kimberly Darlington4, Hans H Herfarth4,5,6. 1. Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Campus Box #7080 130 Mason Farm Road, 27599-7080, Chapel Hill, NC, USA. edward_barnes@med.unc.edu. 2. Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. edward_barnes@med.unc.edu. 3. Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. edward_barnes@med.unc.edu. 4. Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Campus Box #7080 130 Mason Farm Road, 27599-7080, Chapel Hill, NC, USA. 5. Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 6. Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Abstract
PURPOSE OF REVIEW: Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis has been associated with multiple short- and long-term complications. In this review, we examine the role of biomarkers, imaging, and pouchoscopy in the assessment of patients after ileal pouch-anal anastomosis, with a particular focus on the emergence of novel biomarkers and techniques for evaluating and risk stratifying patients after this procedure in the hopes of improving outcomes in this specific population. RECENT FINDINGS: There are indications that that the incidence of pouchitis may be increasing in recent decades. Calprotectin and other non-invasive imaging tests such as ultrasound may offer advantages in distinguishing patients with inflammatory conditions of the pouch from other etiologies. In the search for other biomarkers that may identify patients at risk for inflammatory conditions of the pouch, the stool microbiota and metabolomics may play a key role in identifying those patients at greatest risk for complications. Advances in biomarkers, imaging, and standardized pouchoscopy scoring offer immediate improvements in clinical care and will prompt future research efforts.
PURPOSE OF REVIEW: Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis has been associated with multiple short- and long-term complications. In this review, we examine the role of biomarkers, imaging, and pouchoscopy in the assessment of patients after ileal pouch-anal anastomosis, with a particular focus on the emergence of novel biomarkers and techniques for evaluating and risk stratifying patients after this procedure in the hopes of improving outcomes in this specific population. RECENT FINDINGS: There are indications that that the incidence of pouchitis may be increasing in recent decades. Calprotectin and other non-invasive imaging tests such as ultrasound may offer advantages in distinguishing patients with inflammatory conditions of the pouch from other etiologies. In the search for other biomarkers that may identify patients at risk for inflammatory conditions of the pouch, the stool microbiota and metabolomics may play a key role in identifying those patients at greatest risk for complications. Advances in biomarkers, imaging, and standardized pouchoscopy scoring offer immediate improvements in clinical care and will prompt future research efforts.
Authors: Alexandra D Frolkis; Jonathan Dykeman; María E Negrón; Jennifer Debruyn; Nathalie Jette; Kirsten M Fiest; Talia Frolkis; Herman W Barkema; Kevin P Rioux; Remo Panaccione; Subrata Ghosh; Samuel Wiebe; Gilaad G Kaplan Journal: Gastroenterology Date: 2013-07-27 Impact factor: 22.682
Authors: Edward L Barnes; Hans H Herfarth; Robert S Sandler; Wenli Chen; Elizabeth Jaeger; Van M Nguyen; Amber R Robb; Michael D Kappelman; Christopher F Martin; Millie D Long Journal: Inflamm Bowel Dis Date: 2017-07 Impact factor: 5.325
Authors: Edward L Barnes; Yue Jiang; Michael D Kappelman; Millie D Long; Robert S Sandler; Alan C Kinlaw; Hans H Herfarth Journal: Inflamm Bowel Dis Date: 2020-07-17 Impact factor: 5.325
Authors: Victor Warren Fazio; Ravi P Kiran; Feza H Remzi; John Calvin Coffey; Helen Mary Heneghan; Hasan Tarik Kirat; Elena Manilich; Bo Shen; Sean T Martin Journal: Ann Surg Date: 2013-04 Impact factor: 12.969
Authors: Marco Bertucci Zoccali; Neil H Hyman; Kinga B Skowron; Michele Rubin; Lisa M Cannon; Roger D Hurst; Konstantin Umanskiy; David T Rubin; Benjamin D Shogan Journal: Dis Colon Rectum Date: 2019-11 Impact factor: 4.585
Authors: Amy L Lightner; Kellie L Mathis; Eric J Dozois; Dieter Hahnsloser; Edward V Loftus; Laura E Raffals; John H Pemberton Journal: Inflamm Bowel Dis Date: 2017-05 Impact factor: 5.325
Authors: Edward L Barnes; Hans H Herfarth; Michael D Kappelman; Xian Zhang; Amy Lightner; Millie D Long; Robert S Sandler Journal: Clin Gastroenterol Hepatol Date: 2020-06-22 Impact factor: 13.576
Authors: Lester Tsai; Christopher Ma; Parambir S Dulai; Larry J Prokop; Samuel Eisenstein; Sonia L Ramamoorthy; Brian G Feagan; Vipul Jairath; William J Sandborn; Siddharth Singh Journal: Clin Gastroenterol Hepatol Date: 2020-10-27 Impact factor: 13.576