Pouchitis can occur after IPAA within which time frame?

• A. Immediately after IPAA
• B. 3-6 months after IPAA
• C. 6 months to 2.5 years after IPAA
• D. 5-10 years after IPAA

Answer: (C)

Pouchitis after IPAA most often shows up in the early to mid postoperative period. The ileal pouch can become inflamed months after surgery, with many cases presenting around 6 to 12 months, though it can occur later as well. The window of six months to about two and a half years after IPAA captures this common onset period, making it the best choice. Returning to surgery immediately after the procedure is not typical for pouchitis, which relies on postoperative healing and evolving pouch biology, while waiting five to ten years tends to miss the usual timeframe for initial pouchitis onset. In short, pouchitis most commonly develops within 6 months to 2.5 years after IPAA.