In pouchitis treatment, which non-antibiotic option is listed?

• A. Probiotics
• B. Antifungal cream
• C. Acupuncture
• D. Osteopathy

Answer: (A)

Probiotics are used in pouchitis to help restore the balance of the gut microbiota and reduce inflammation, offering a non-antibiotic approach to management. After ileal pouch-anal anastomosis, antibiotics are commonly used for active flare-ups, but probiotics can be considered for maintenance or to help lower relapse risk by introducing beneficial bacteria that compete with harmful microbes, support the mucosal barrier, and modulate immune responses. Evidence from studies suggests some patients experience fewer symptoms and fewer relapses with probiotic use, though results can vary.

The other options aren’t standard therapies for pouchitis: antifungal cream targets fungal skin or mucosal infections rather than the intestinal inflammation seen in pouchitis; acupuncture and osteopathy lack robust, disease-specific evidence for pouchitis management.