Meta-analysis of the association of extraintestinal manifestations with the development of pouchitis in patients with ulcerative colitis

Background The presence of extraintestinal manifestations may be associated with the development of pouchitis in patients with ulcerative colitis after ileal pouch-anal anastomosis. The aim of this study was to assess this correlation. Methods A systematic literature search was performed using MEDLINE and the Cochrane Library. Studies published in English up to 22 May 2017 investigating the association between extraintestinal manifestations and development of pouchitis in adults with ulcerative colitis were included. Case reports were excluded. The association of extraintestinal manifestations with the development of overall and chronic pouchitis was investigated using a random-effects model. Results Of 1010 citations identified, 22 observational studies comprising 5128 patients were selected for analysis. The presence of extraintestinal manifestations was significantly associated with both chronic pouchitis (odds ratio 2.28, 95 per cent c.i. 1.57 to 3.32; P = 0.001) and overall pouchitis (odds ratio 1.96, 1.49 to 2.57; P < 0.001). Conclusion The presence of extraintestinal manifestations is associated with development of pouchitis after ileal pouch-anal anastomosis. Presented in part to the Annual ScientificMeeting of the American Society of Colon and Rectal Surgeons, Los Angeles, California, USA, April/May 2016; published in abstract form as Dis Colon Rectum 2016;59:e178