Mayo Clinic has the expertise and tools to diagnose pouchitis. In part, the diagnosis involves ruling out other possible causes of signs and symptoms. Most of the time, suspected pouchitis can be accurately diagnosed with the following combination of methods:
- Medical history of signs and symptoms
- Physical examination
- Stool tests to exclude infections as the cause of signs and symptoms
- Endoscopic examination of the pouch, in which the doctor will insert a tube containing a light and a tiny camera to view the inflamed area
- Biopsy of tissue from the lining of the pouch
- Abdominal and pelvic imaging, which may include X-rays, computed tomography enterography (CTE) or magnetic resonance enterography (MRE)
- Water-soluble contrast pouchogram (Gastrografin enema)
These tests and procedures will rule out, among other conditions:
- Cuffitis, an inflammation of the connection created between the intestinal tissue and the anus. Cuffitis is a recurrence of the ulcerative colitis in the small amount of original colon tissue that remains in most people after the ileoanal anastomosis procedure.
- Pouch leak
- Crohn's disease, in which a new occurrence of the disease develops in the pouch
- Abscess, opening (sinus), or abnormal connection between tissue or organs (fistula)
- Infectious diarrhea
- Irritable pouch syndrome
After a diagnosis of pouchitis, you may need additional testing to monitor the disease, its complications or the side effects of medications. Some people may also be monitored for precancerous changes.
June 11, 2015
- Chowdhry S, et al. Update on the pathogenesis and management of pouchitis. Current Infectious Disease Reports. 2014;16:442.
- Feldman, M, et al. Ileostomy, colostomy, and pouches. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed April 9, 2015.
- Batista D, et al. Role of intestinal bacteria in the pathogenesis of pouchitis. Inflammatory Bowel Diseases. 2014;20:1481.
- Shen B. Pouchitis: Epidemiology, clinical manifestations, and diagnosis. http://www.uptodate.com/home. Accessed April 9, 2015.
- Shen B. Pouchitis: Management. http://www.uptodate.com/home. Accessed April 9, 2015.
- Corticosteroids. Crohn's & Colitis Foundation of America. http://www.ccfa.org/resources/corticosteroids.html. Accessed April 13, 2015.
- Golden AK. Decision Support System. Mayo Clinic, Rochester, Minn. April 9, 2015.