Pouchitis developing after surgery for ulcerative colitis (UC) is associated with changes in gene expression, which increase along with disease severity, reports a study in Inflammatory Bowel Diseases, official journal of the Crohn’s & Colitis Foundation of America (CCFA).
“Gene alterations in pouch inflammation and Crohn’s disease overlap, suggesting that inflammatory bowel disease is a spectrum, rather than distinct diseases,” according to the new research by Dr. S. Ben Shachar and colleagues of Tel Aviv University, Israel. They believe the occurrence and progression of gene changes in previously normal intestine after UC surgery provides a useful model for studying the development of inflammatory bowel disease (IBD).
The researchers analyzed gene expression changes in different groups of patients who had undergone “pouch” surgery for UC. In this procedure (restorative proctocolectomy), the entire large intestine is removed and a portion of small intestine (the ileum) is used to create a reservoir, or pouch, to restore bowel function.
Because of unmanageable disease or complications, up to one-fourth of patients with UC need surgery. Surgery is effective, but has a substantial rate of complications– especially the development of inflammation in the newly created pouch, called pouchitis.
By definition, the small intestine is normal in UC– in contrast to Crohn’s disease (CD), which can affect any part of the gastrointestinal tract. The development of pouchitis after UC surgery thus provides an opportunity