Inflammatory pouch disease: The spectrum of pouchitis

Table 2 The variety of idiopathic pouchitis classifications

Activity

Active

Inactive

Presentation

Acute < 4 wk duration

Chronic > 4 wk duration

Clinical pattern

Single episode

Infrequent < 4 episodes a year

Relapsing > 4 episodes a year

Continuous

Response to treatment

Responsive

Refractory

Response to antibiotics

Antibiotic-responsive:

Infrequent episodes (< 4 episodes per year) responding to a 2-wk course of a single antibiotic

Antibiotic-dependent

Frequent episodes or persistent episodes of pouchitis requiring long-term, continuous therapy for maintaining remission

Chronic antibiotic-refractory

Not responding to a 4-wk course of metronidazole or ciprofloxacin, requiring prolonged therapy of ≥ 4 wk consisting of 2 or more antibiotics, oral or topical 5-ASA, corticosteroids, AZA/6-MP, or biologics