Association Between Pouchitis and Ulcerative Colitis-Related Gastroduodenitis After Restorative Proctocolectomy

Background: Ulcerative colitis (UC)-related disorders, which include pouchitis and gastroduodenitis (GDUC), can develop even after restorative proctocolectomy (RPC). However, the etiology of and predictive factors for these disorders remain unclear. Aim: We analyzed the incidence and associations between pouchitis and GDUC. Methods: UC patients who underwent RPC at the Hyogo College of Medicine between 2009 and 2012 were included in this study. The postoperative results of examinations and the clinical courses were analyzed. Results: A total of 122 patients examined by endoscopy after RPC out of 188 patients who underwent follow-up at the outpatient clinic were included. Pouchitis developed in 56 of 188 patients. The cumulative incidence of pouchitis was 32.1% at 5 years. GDUC was identified in 14 of 122 patients. In the Cox regression analyses, GDUC was selected as an independent predictive factor for pouchitis (hazard ratio, 2.32; P = 0.025). Conclusion: An association between GDUC and pouchitis after RPC was found. However, this association should be evaluated in a further study because both complications might exist coincidentally as components of a systemic immune disorder, and the etiology of each complication should be determined.