Diagnosis of Pouch Disorders: Laboratory Tests

Abstract

Abstract Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) remains the surgical treatment of choice for patients with medically refractory ulcerative colitis (UC) or UC with dysplasia. There are risks for the development of complications following IPAA, including pouchitis. There are limited data available on laboratory markers in the evaluation and diagnosis of pouch disorders. Immunogenotypic markers such as genetic polymorphisms of IL-1 receptor antagonist, NOD2/CARD15, toll-like receptor, and tumor necrosis factor-α, are found to be associated with the risk of developing pouchitis. Fecal markers including lactoferrin and calprotectin are useful to diagnose inflammatory conditions affecting the pouch. Laboratory evaluation has provided information on the etiology and pathogenesis of pouchitis and also helps practicing clinicians for accurate diagnosis, differential diagnosis, disease stratification, and management of ileal pouch disorders.