Pouchitis seldom occurs after IPAA and is usually easily resolved with topical therapy and antibiotics, but doubts should arise in case of poor response and a tendency to chronicity. IPAA fails in 8% of patients with evident differences in the different groups: 6.5-19% in indeterminate colitis, 15-43% in CD and 1.4-8% in UC [16-18]. Only close collaboration between the gastroenterologist and the surgeon during the follow-up of pouchitis can evaluate the results of conservative therapy and decide the right time for revision of the pouch, which shows good clinical outcome in up to two thirds of patients [19, 20].

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