Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative Colitis
Background/Aims: The study investigated the incidence, risk factors, and clinical outcomes of chronic antibiotic-refractory pouchitis (CARP) in Korean patients with ulcerative colitis (UC). Methods: This single-center retrospective study included patients with UC who underwent total proctocolectomy...
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Gastroenterology Council for Gut and Liver
2025-05-01
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| Series: | Gut and Liver |
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| Online Access: | http://gutnliver.org/journal/view.html?doi=10.5009/gnl240226 |
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| author | Ji Eun Baek Jung-Bin Park June Hwa Bae Min Hyun Kim Seung Wook Hong Sung Wook Hwang Jong Lyul Lee Yong Sik Yoon Dong-Hoon Yang Byong Duk Ye Jeong-Sik Byeon Seung-Jae Myung Chang Sik Yu Suk-Kyun Yang Sang Hyoung Park |
| author_facet | Ji Eun Baek Jung-Bin Park June Hwa Bae Min Hyun Kim Seung Wook Hong Sung Wook Hwang Jong Lyul Lee Yong Sik Yoon Dong-Hoon Yang Byong Duk Ye Jeong-Sik Byeon Seung-Jae Myung Chang Sik Yu Suk-Kyun Yang Sang Hyoung Park |
| author_sort | Ji Eun Baek |
| collection | DOAJ |
| description | Background/Aims: The study investigated the incidence, risk factors, and clinical outcomes of chronic antibiotic-refractory pouchitis (CARP) in Korean patients with ulcerative colitis (UC). Methods: This single-center retrospective study included patients with UC who underwent total proctocolectomy with ileal pouch-anal anastomosis at the Asan Medical Center in Korea between January 1987 and December 2022. The primary outcomes were endoscopic remission and pouch failure. The Cox’s proportional hazard model was used to identify the risk factors for CARP. Results: The clinical data of 232 patients were analyzed. The most common cause of surgery was steroid refractoriness (50.9%), followed by dysplasia/colorectal cancer (26.7%). Among 74 patients (31.9%) with chronic pouchitis (CP), 31 (13.4%) had CARP, and 43 (18.5%) had chronic antibiotic-dependent pouchitis (CADP). The most frequent endoscopic phenotype was focal inflammation of the pouch (CP, 47.3%; CARP, 35.5%; CADP, 55.8%). Patients with CARP were less likely to use concomitant probiotics than patients with CADP (29.0% vs 72.1%, p<0.01). The endoscopic remission rate of CP, CARP, and CADP was 14.9%, 9.7%, and 18.6%, respectively. The pouch failure rate associated with CP, CARP, and CADP was 13.5%, 16.1%, and 11.6%, respectively. Current smoking status (adjusted hazard ratio [aHR], 2.96; 95% confidence interval [CI], 1.27 to 6.90; p=0.01) and previous use of biologics/small molecules (aHR, 2.40; 95% CI, 1.05 to 5.53; p=0.04) were significantly associated with CARP development. Conclusions: UC patients who were current smokers and previously used biologics/small molecules had a higher risk of developing CARP. Concomitant use of probiotics was less likely to be associated with CARP development. |
| format | Article |
| id | doaj-art-fb84f6757487412b9c653d03e30e8743 |
| institution | Kabale University |
| issn | 1976-2283 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Gastroenterology Council for Gut and Liver |
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| series | Gut and Liver |
| spelling | doaj-art-fb84f6757487412b9c653d03e30e87432025-08-20T03:52:57ZengGastroenterology Council for Gut and LiverGut and Liver1976-22832025-05-0119338839710.5009/gnl240226gnl240226Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative ColitisJi Eun Baek0Jung-Bin Park1June Hwa Bae2Min Hyun Kim3Seung Wook Hong4Sung Wook Hwang5Jong Lyul Lee6Yong Sik Yoon7Dong-Hoon Yang8Byong Duk Ye9Jeong-Sik Byeon10Seung-Jae Myung11Chang Sik Yu12Suk-Kyun Yang13Sang Hyoung Park14Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDivision of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDivision of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDivision of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDivision of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground/Aims: The study investigated the incidence, risk factors, and clinical outcomes of chronic antibiotic-refractory pouchitis (CARP) in Korean patients with ulcerative colitis (UC). Methods: This single-center retrospective study included patients with UC who underwent total proctocolectomy with ileal pouch-anal anastomosis at the Asan Medical Center in Korea between January 1987 and December 2022. The primary outcomes were endoscopic remission and pouch failure. The Cox’s proportional hazard model was used to identify the risk factors for CARP. Results: The clinical data of 232 patients were analyzed. The most common cause of surgery was steroid refractoriness (50.9%), followed by dysplasia/colorectal cancer (26.7%). Among 74 patients (31.9%) with chronic pouchitis (CP), 31 (13.4%) had CARP, and 43 (18.5%) had chronic antibiotic-dependent pouchitis (CADP). The most frequent endoscopic phenotype was focal inflammation of the pouch (CP, 47.3%; CARP, 35.5%; CADP, 55.8%). Patients with CARP were less likely to use concomitant probiotics than patients with CADP (29.0% vs 72.1%, p<0.01). The endoscopic remission rate of CP, CARP, and CADP was 14.9%, 9.7%, and 18.6%, respectively. The pouch failure rate associated with CP, CARP, and CADP was 13.5%, 16.1%, and 11.6%, respectively. Current smoking status (adjusted hazard ratio [aHR], 2.96; 95% confidence interval [CI], 1.27 to 6.90; p=0.01) and previous use of biologics/small molecules (aHR, 2.40; 95% CI, 1.05 to 5.53; p=0.04) were significantly associated with CARP development. Conclusions: UC patients who were current smokers and previously used biologics/small molecules had a higher risk of developing CARP. Concomitant use of probiotics was less likely to be associated with CARP development.http://gutnliver.org/journal/view.html?doi=10.5009/gnl240226ulcerative colitis; pouchitis; proctocolectomyrestorative; korea |
| spellingShingle | Ji Eun Baek Jung-Bin Park June Hwa Bae Min Hyun Kim Seung Wook Hong Sung Wook Hwang Jong Lyul Lee Yong Sik Yoon Dong-Hoon Yang Byong Duk Ye Jeong-Sik Byeon Seung-Jae Myung Chang Sik Yu Suk-Kyun Yang Sang Hyoung Park Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative Colitis Gut and Liver ulcerative colitis; pouchitis; proctocolectomy restorative; korea |
| title | Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative Colitis |
| title_full | Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative Colitis |
| title_fullStr | Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative Colitis |
| title_full_unstemmed | Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative Colitis |
| title_short | Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative Colitis |
| title_sort | incidence risk factors and outcomes of chronic antibiotic refractory pouchitis in korean patients with ulcerative colitis |
| topic | ulcerative colitis; pouchitis; proctocolectomy restorative; korea |
| url | http://gutnliver.org/journal/view.html?doi=10.5009/gnl240226 |
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