A 32-year-old man presents 2 years after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis. He reports increased stool frequency (12/day from baseline 5), urgency, cramping, low-grade fever, and minor rectal bleeding. Pouchoscopy shows diffuse erythema, granularity, friability, and superficial ulcerations confined to the pouch; biopsies confirm acute and chronic inflammation with a Pouchitis Disease Activity Index (PDAI) of 9. This is his first episode of pouchitis. Which of the following management approaches, marked **B** in the algorithm, is most appropriate for this acute presentation?
Ready to test yourself?
Test your Surgery knowledge with AI-powered MCQs and detailed explanations — no signup required to try.
Sign up free and practice all 1 Pouchitis after IPAA MCQs with AI-powered explanations tailored to your performance.
Create Free Account