Maximizing Outcomes for Pouch Disorders Patients

Cleveland Clinic’s Center for Ileal Pouch Disorders (CIPD) was the first multidisciplinary facility of its kind in the world, and is currently the largest. CIPD gastroenterologists and colorectal surgeons see the nation’s highest volumes of both initial and reoperative J-pouch cases, with more than 5,000 initial and 500 reoperative pouch surgeries, including pouches that have failed either from disease or complications related to prior surgical procedures.

Ileal pouch surgery has revolutionized the care offered today. Ileal pouch patients have significantly improved quality of life; they do not need to carry a permanent stoma bag. The operative success rates at Cleveland Clinic are 96 percent in ulcerative colitis patients for initial pouches and 85 percent for redo pouches or pouch revision surgery. Yet the pouch procedure is technically challenging and can result in various mechanical and inflammatory conditions, including strictures, anastomotic leaks and pouchitis.

Fine-tuning diagnoses

“Pouchitis used to be a mixed bag of everything together,” says Bo Shen, MD, one of the nation’s first gastroenterologists specializing in pouch disorders. “Now, we subclassify them based on etiology, disease mechanism, clinical presentation and disease course. If we have the correct classification, here’s the proper solution. It’s a much more analytical approach.”

The CIPD is home to the majority of the original pouchitis research done in the United States, including studies of:

• The pouch microbiome
• Genetic profiles of pouch disorders patients
• The association of hepatobiliary disorders, autoimmune disorders and autoinflammatory disorders and pouchitis
• Diagnosis and management of Crohn disease of the pouch
• New endoscopic therapies for mechanical pouch complications
• Assessment and management of cancer risk in pouch patients
• Adverse metabolic consequences of pouches and pouchitis
• Health disparities in pouch disorders patients
• New surgical techniques to salvage ileal pouches

For more information, please contact Dr. Shen at 216.444.9252 or shenb@ccf.org.