Pouchitis: Symptoms, Treatment & Prevention
The most common pouch complication and how to manage it.
What Is Pouchitis?
Pouchitis is inflammation of the J-pouch lining. It is the most common complication after pouch surgery and many pouch patients experience it at some point. The good news: it’s usually treatable and manageable.
Symptoms to Watch For
- Increased number of bowel movements
- More urgent need to go
- Watery or bloody stool
- Cramping or abdominal pain
- Fever (in more severe cases)
- Feeling unwell or fatigued
How Is It Treated?
- Antibiotics are the first-line treatment. Your doctor will prescribe the specific antibiotic and length of course based on your situation
- Most episodes respond well to a single course of antibiotics
- For recurring pouchitis, your doctor may try longer antibiotic courses, probiotics, or other medications
- Rarely, pouchitis that doesn’t respond to standard treatment may need stronger immunosuppressive medications
Can You Prevent It?
Some patients benefit from daily probiotics. Specific formulations have been studied for pouchitis prevention. Staying well-hydrated, eating a balanced diet, and managing stress may also help. Talk to your gastroenterologist about whether a prevention strategy makes sense for you.
When to Call Your Doctor
Contact your doctor if you notice a significant increase in bowel frequency, blood in your stool, fever, or symptoms that don’t improve within a few days. Early treatment leads to faster recovery.