The etiology is still unknown and is likely to be mul-tifactorial; a variety of hypotheses have been suggested, including bacterial overgrowth due to faecal stasis, mucosal ischemia of the pouch, missed diagnosis of Crohn's disease, recurrence of UC and a novel form of IBD. Most likely pouchitis is the results of the interaction of a genetical and immunological susceptibility and an ileal mucosa that has adapted from its absorptive function to a new role of that of a reservoir with a colon-like morphology in response to faecal stasis [21].

Table 1. Pouchitis: predictive factors

Positive Association

Extra-intestinal manifestations Primary sclerosing cholangitis

Antineutrophil cytoplasmic antibody with a perinuclear staining pattern (p-ANCA) Extent of preoperative UC Negative Association Smoking

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