The true incidence is still difficult to determine, depending on the diagnostic criteria used to define the syndrome, the accuracy of the evaluation and, particularly, on the duration of the follow-up. Reported incidence rates vary between 10 and 59%; most patients experience their first episode of acute pouchitis within 12 months after surgery, but some may suffer their first attack some years later [6]. Recently, Simchuk et al. performed a retrospective review of patients who underwent IPAA with a mean follow-up of 3 years: the incidence of pouchitis was 59%, but it increased with the duration of follow-up [7].

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