Chronic Use of PPI and H2 Antagonists Decreases the Risk of Pouchitis After IPAA for Ulcerative Colitis

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• 作者：Lisa S. Poritz (1)
  Rishabh Sehgal (1)
  Arthur S. Berg (2)
  Lacee Laufenberg (1)
  Christine Choi (1)
  Emmanuelle D. Williams (3)
  
• 关键词：Pouchitis ; Proton pump inhibitors ; H2 blockers ; Ileal pouch anal anastomosis ; Ulcerative colitis
• 刊名：Journal of Gastrointestinal Surgery
• 出版年：2013
• 出版时间：June 2013
• 年：2013
• 卷：17
• 期：6
• 页码：1027-1031
• 全文大小：129KB
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• 作者单位：Lisa S. Poritz (1)
  Rishabh Sehgal (1)
  Arthur S. Berg (2)
  Lacee Laufenberg (1)
  Christine Choi (1)
  Emmanuelle D. Williams (3)
  
  1. Division of Colon and Rectal Surgery, Department of Surgery, Penn State Milton S. Hershey Medical Center, H137, 500 University Drive, Hershey, 17033, PA, USA
  2. Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
  3. Division of Gastroenterology, Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
  

文摘

Introduction Bacteria have been implicated in the development of pouchitis after ileal pouch anal anastomosis. The change in gastric pH with the use of proton pump inhibitors and H2 antagonists may lead to alteration of enteric bacteria. We hypothesized that chronic use of these medications would decrease the incidence of pouchitis. Methods Patients who had undergone ileal pouch anal anastomosis for ulcerative colitis were classified by history of pouchitis. Patients were further classified by their use of proton pump inhibitors, H2 blockers, antacids, and other known risk factors for pouchitis. Results Eighty-five patients were identified. There was a statistically significant increase in the use of daily acid suppression in patients without pouchitis. There was also a statistically significant increase in the use of antacids in patients without pouchitis. Occasional use of acid suppression did not alter the rate of pouchitis. Conclusions Our data suggest that the daily use of proton pump inhibitors, H2 antagonists, or antacids is associated with a decreased risk of pouchitis in ulcerative colitis. Occasional use of these agents did not seem to afford the same protection. These data suggest that altering the pH of the gastrointestinal tract may influence the development of pouchitis.