Pouchitis is described as which of the following?

• A. Bacterial overgrowth causing obstruction
• B. Nonspecific inflammatory condition of the ileal pouch
• C. Crohn's disease affecting the pouch
• D. Obstruction of the pouch

Answer: (B)

Pouchitis is best described as a nonspecific inflammatory condition of the ileal pouch. This means the lining of the pouch becomes inflamed without being tied to a single defined disease process like obstruction or Crohn’s disease. It’s a common inflammatory change seen after ileal pouch-anal anastomosis, rather than a mechanical blockage or a Crohn’s-specific pouch involvement.

In this sense, the inflammation is of the pouch mucosa itself and not caused by a wandering pathogen that produces obstruction, and it isn’t the same as Crohn’s disease affecting the pouch, which would involve a different pattern of inflammation. Clinically, patients may have increased stool frequency and urgency, and diagnosis is typically supported by endoscopic or histologic evidence of pouch mucosal inflammation and response to antibiotic therapy.