Pouchitis

Diagnosis

Mayo Clinic has the expertise and tools to distinguish pouchitis from other possible causes of symptoms. Most of the time, suspected pouchitis can be accurately diagnosed with the following combination of methods:

• Medical history of symptoms
• Physical examination
• Endoscopic examination of the pouch
• Biopsy of tissue from the lining of the pouch

The endoscopic exam can also detect cuffitis — an inflammation of the connection created between the intestinal tissue and the rectum. Cuffitis is a recurrence of the ulcerative colitis in the original tissue that remains after the ileoanal anastomosis procedure.

X-rays and a pelvic MRI may be needed to detect other possible causes of symptoms, such as pouch leak, Crohn's disease, an abscess or a fistula (an abnormal opening).

After diagnosis, additional testing may be needed to monitor the disease, its complications or the side effects of medications. Some people may also be monitored for precancerous changes.