Cuffitis
Cuffitis is inflammation at the anal transition zone or “cuff” created as a result of ileal pouch-anal anastomosis (IPAA).[1] It is considered a variant form of ulcerative colitis that occurs in the rectal cuff.[2] Cuffitis is a common complication of IPAA, particularly when a stapled anastomosis without mucosectomy procedure has been used.[2]
Signs and symptoms[edit | edit source]
Symptoms of cuffitis mimic those of pouchitis.[2] In addition, patients with cuffitis often present with small volume bloody bowel movements.[2] Often, cuffitis can produce the appearance of bright red blood on tissue.[1]
Complications[edit | edit source]
Surgery-associated ischemia may contribute inflammation at the anal transitional zone.[2]
Patients whose cuffitis is refractory to mesalamine and/or corticosteroids should be evaluated for other disease in the cuff area, such as fistula or anastomotic leaks.[2] Cuffitis that is refractory to medication can also be a sign of Crohn's disease of the pouch.[2]
Chronic cuffitis can also contribute to the development of anastomotic stricture.[2]
Cuffitis that is refractory, Crohn's-related, or is associated with surgical complications can contribute to pouch failure.[2]
Diagnosis[edit | edit source]
Definitive diagnose of cuffitis is obtained by endoscopy.[2]
Treatment[edit | edit source]
Cuffitis is treated with mesalamine suppositories or topical application of lidocaine or corticosteroid medications.[2] Systemic medications are rarely used.[2]
References[edit | edit source]
External links[edit | edit source]
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Contributors: Prab R. Tumpati, MD
