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Effectiveness of vedolizumab treatment in two different anti-tumor necrosis factor alpha refractory pouchitis: A case report

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World Journal of Clinical Cases 2019年第16期7卷 2316-2321页

作者： Ozlem Ozer Cakir Department of Gastroenterology and Hepatology Alanya Alaaddin Keykubat University School of Medicine

BACKGROUND refractory pouchitis is a common cause of pouch failure,which may require surgical excision of the pouch or permanent *** aimed to show the effect of vedolizumab on treatment of the patient with refractory *** SUMMARY A 32-year-old male with pancolonic ulcerative colitis since the age of 25 with primary failure of infliximab and mesalamine and intolerance of azathioprine,underwent a total proctocolectomy with ileal pouch-anal anastomosis in *** developed chronic diarrhea in 2014,which was watery,30 per day and accompanied with blood and mucus affecting his quality of *** Vedolizumab is safe and effective in the management of anti-tumor necrosis factor alpha refractory pouchitis.

关键词： Anti-tumor necrosis factor alpha refractory pouchitis Vedolizumab Ulcerative colitis

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Successful treatment of severe pouchitis with rebamipide refractory to antibiotics and corticosteroids:A case report

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World Journal of Gastroenterology 2006年第4期12卷 656-658页

作者： MitsukiMiyata ToshihiroKonagaya ShinitiKakumu TakeshiMori Department of Gastroenterology Aichi Medical University School of MedicineNagokute-choAichi 480-1195Japan

The antibiotics, metronidazole and ciprofloxacin, are the first-line treatment for pouchitis. Patients who do not respond to antibiotics or conventional medications represent a major challenge to therapy. In this report, we have described a successful treatment of severe refractory pouchitis with a novel agent, rebamipide, known to promote epithelial cell regeneration and angiogenesis. A 27-year-old male with ileo-anal pouch surgery presented with worsening anal pain, diarrhea, and abdominal pain. The patient was diagnosed to have pouchitis and was given metronidazole together with betamethasone enema （3.95 rag/dose）. However, despite this intensive therapy, the patient did not improve. On endoscopy, ulceration and inflammation were seen in the ileal pouch together with contact bleeding and mucous discharge. The patient was treated with rebamipide enema （150 rag/close） twice a clay for 8 wk without additional drug therapy. Two weeks after the rebamipide therapy, stool frequency started to decrease and fecal hemoglobin became negative at the 4^th wk. At the end of the therapy, endoscopy revealed that ulcers in the ileal pouch had healed with no obvious inflammation. The effect of rebamipide enema was dramatic and was maintained throughout the ll-mo follow-up. The patient continued to be in remission. No adverse effects were observed during the treatment or the follow-up period. The sustained response seen in this case with severe and refractory pouchitis indicates that agents, which promote epithelial cell growth, angiogenesis and mucosal tissue regeneration, are potential therapeutic agents for the treatment of refractory colorectal lesions.

关键词： refractory pouchitis Rebamipide enema Ileo-anal pouch Epithelial cells

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Hyperbaric oxygen therapy for chronic antibioticrefractory ischemic pouchitis

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Gastroenterology Report 2017年第4期5卷 320-321,I0003页

作者： Custon T.Nyabanga Geeta Kulkarni Bo Shen Cleveland Clinic Lerner College of Medicine of Case Western Reserve University ClevelandOHUSA Department of Gastroenterology/Hepatology Cleveland ClinicClevelandOHUSA

Hyperbaric oxygen therapy(HBOT)has been shown to be efficacious in treating various conditions,including perianal Crohn’s *** we present a case of a 59-year-old male with a history of ulcerative colitis,who underwent a total proctocolectomy and two-stage J-pouch *** later developed chronic antibiotic-refractory pouchitis with endoscopic features of *** the completion of HOBT-a total of 20 sessions of 100%oxygen at 2.5-3.0 atmospheres absolute for 60-90 minutes per session-a repeat pouchoscopy showed marked improvement of endoscopic mucosal *** is known to increase tissue oxygenation,reduce tissue hypoxia,alter inflammatory pathways and promote tissue *** case demonstrated the therapeutic role of HBOT as well as the possible disease mechanism in chronic antibiotic-refractory pouchitis.

关键词： hyperbaric oxygen therapy refractory pouchitis ischemic pouchitis

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