• EL Barnes, M Agrawal et al. Gastroenterol 2024; 166: 59-85. Open Access! AGA Clinical Practice Guideline on the Management of Pouchitis and Inflammatory Pouch Disorders
• Gastroenterol 2024; 166: 86. Open Access! Decision-support tool (1 page summary)
• Gastroenterol 2024; 166: 87. Open Access! Spotlight (1 page summary)

Key recommendations

• AGA recommends metronidazole and/or ciprofloxacin as preferred treatment of pouchitis with duration of treatment 2-4 weeks.
• For Crohn’s-like disease of the pouch, AGA guideline recommends using either ileal-release budesonide or advanced immunosuppressive agents (eg. Biological therapies and small molecule therapies)
• “In patients with cuffitis, topical therapies should be the first-line therapy, such as mesalamine suppositories, corticosteroid suppositories, or corticosteroid ointment applied directly to the cuff. Biological therapies and small molecule therapies are recommended in refractory cases

Related blog posts:

• Endoscopy of the Ileal Pouch Anal Anastomosis
• Chicago Classification of J Pouch Outcomes
• Vedolizumab for Chronic Pouchitis
• Vancomycin for Chronic Pouchitis & ASPEN Infant Formula Resources
• IBD Updates: Built-in Infliximab Dosing, Pouchitis in kids, PIBD Symposium & Aspen Meeting