Search

The aim of the study was to review the principal effects of probiotics on pouchitis and identify their mechanisms of action.The study was based on a review of all relevant studies published in the literature on the effects of probiotics in pouchitis and their possible mechanisms of action.Pouchitis is the major long-term complication after ileal pouch anal anstomosis for ulcerative colitis. The cause is still unknown but is likely to be multifactorial. An imbalance in the usual fecal flora was recently suggested. Most patients with symptoms of pouchitis respond promptly to antibiotics. However, 5-10% of them develop rapidly relapsing symptoms that required protacted therapy. Porbiotics are living microorganisms that ingested in adequate amounts exert beneficial effects. Promising results have been obtained with probiotics mainly in maintenance of remission of chronic pouchitis and also as induction of remission.These results suggest that restoring the microbial imbalance may offer an effective therapeutic alternative to patients with pouchitis.

The pathogenic role of certain microorganism of intestinal flora has been demonstrated in experimental colitis in animals and strongly suspected in inflammatory bowel disease in human, especially in Crohn's disease and pouchitis. Probiotics are living non pathogenic microorganisms that, upon oral ingestion exert benefits on human health by modulating enteric flora or by stimulation of local immune system. The aim of this article is to remind the role of intestinal flora in inflammatory bowel disease, the mechanism of inflammation induced by this flora and to review through the literature, the different clinical studies performed with probiotics in human.

DEFINITION AND FREQUENCY: An ileoanal anastomosis with creation of an ideal pouch is proposed as the treatment for familial adenomatous polyposis and ulcerative hemorrhagic rectocolitis. The ideal pouch may become inflammatory in 10 to 30% of the cases. The diagnosis of pouchitis is based on a clinical, endoscopid and histological criteria.Pouchitis is a late complication, mainly after ileoanal anastomosis for ulcerative rectocolitis. The pathogenic mechanism is a subject of debate. Fecal stasis, bacterial pollution, mucine secretion and the underlying inflammatory disease could be involved.Antibiotics active against anaerobic bacteria, such as metronidazole, are generally given. In case of failure, common antiinflammatory agents used in inflammatory bowel disease are indicated.