What rheumatic disorders have been associated with pouchitis Microscopic colitis?
Pouchitis is inflammation of the ileal pouch following colectomy for UC. It occurs in up to 40% to 60% of patients undergoing this surgery. Patients present with watery or bloody diarrhea. Treatment includes metronidazole and ciprofloxacin, but some patients develop antibiotic-refractory disease requiring immunosuppression. Surgical revision may be necessary in treatment-resistant cases. Some develop SpA similar to UC-associated disease.
Microscopic colitis includes both LC and CC. Patients present with watery diarrhea and may develop arthritic manifestations (10%–20%) or autoimmune thyroiditis. Patients aged >65 years (80%) and women (60%) are most commonly affected. The diagnosis is made by tissue histology obtained by colonoscopy. Budesonide is effective in inducing and maintaining clinical and histologic remission for CC and LC, and loperamide may ameliorate diarrhea. Evidence for benefit of bismuth subsalicylate and mesalamine with or without cholestyramine for treatment of CC or LC is weak.
