Intestinal Research

Review

IBD

The evolving understanding of histology as an endpoint in ulcerative colitis: Shintaro Akiyama, Yusuke Miyatani, David T. Rubin; Intest Res 2024;22(4):389-396. Published online March 13, 2024; DOI: https://doi.org/10.5217/ir.2023.00120

A therapeutic goal for patients with ulcerative colitis (UC) is deep remission including clinical remission and mucosal healing. Mucosal healing was previously defined by endoscopic appearance, but recent studies demonstrate that histological improvements can minimize the risks of experiencing clinical relapse after achieving endoscopic remission, and there is growing interest in the value and feasibility of histological targets of treatment in inflammatory bowel disease, and specifically UC. In this review article, we identify remaining challenges and discuss an evolving role of histology in the management of UC.

Citations

Citations to this article as recorded by

Claudin-2 simplifies histological assessment of activity/remission of ulcerative colitis in real-life daily practice
Gabrio Bassotti, Rachele Del Sordo, Francesco Lanzarotto, Sara Mino, Chiara Ricci, Vincenzo Villanacci
European Journal of Gastroenterology & Hepatology.2025; 37(4): 409. CrossRef
Patients with ulcerative colitis who have normalized histology are clinically stable after de-escalation of therapy
Shintaro Akiyama, Joëlle St-Pierre, Cindy Traboulsi, Alexa Silfen, Victoria Rai, Tina G. Rodriguez, Amarachi I. Erondu, Joshua M. Steinberg, Seth R. Shaffer, Britt Christensen, David T. Rubin
npj Gut and Liver.2024;[Epub] CrossRef

4,863 View
373 Download
2 Web of Science
2 Crossref

Original Article

IBD

Association of colonic metaplasia of goblet cells and endoscopic phenotypes of the J pouch in patients with ulcerative colitis: a retrospective pilot study: Shintaro Akiyama, Tsubasa Onoda, Shoko Moue, Noriaki Sakamoto, Taku Sakamoto, Hideo Suzuki, Tsuyoshi Enomoto, Daisuke Matsubara, Tatsuya Oda, Kiichiro Tsuchiya; Intest Res 2024;22(1):92-103. Published online January 29, 2024; DOI: https://doi.org/10.5217/ir.2023.00105

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Mucosal adaptation of the ileum toward colonic epithelium has been reported in pouchitis in ulcerative colitis (UC); however, the clinical characteristics, endoscopic findings, and outcomes in patients with pouchitis with ileal mucosal adaptation are poorly understood.
Methods
This was a single-center retrospective study comprising UC patients treated by proctocolectomy with ileal pouch-anal anastomosis who had undergone pouchoscopy at the University of Tsukuba Hospital between 2005 and 2022. Endoscopic phenotypes were evaluated according to the Chicago classification. High-iron diamine staining (HID) was performed to identify sulfomucin (colon-type mucin)-producing goblet cells (GCs) in pouch biopsies. We compared clinical data between patients with (high HID group) and without > 10% sulfomucin-producing GCs in at least one biopsy (low HID group).
Results
We reviewed 390 endoscopic examination reports from 50 patients. Focal inflammation was the most common phenotype (78%). Five patients (10%) required diverting ileostomy. Diffuse inflammation and fistula were significant risk factors for diverting ileostomy. The median proportion of sulfomucin-producing GCs on histological analysis of 82 pouch biopsies from 23 patients was 9.9% (range, 0%–93%). The duration of disease was significantly greater in the high HID group compared to the low HID group. The median percentage of sulfomucin-producing GCs was significantly higher in patients with diffuse inflammation or fistula compared to other endoscopic phenotypes (14% vs. 6.0%, P= 0.011).
Conclusions
Greater proportions of sulfomucin-producing GCs were observed in endoscopic phenotypes associated with poor outcomes in UC, indicating patients with pouchitis showing colonic metaplasia of GCs may benefit from early interventions.

Citations

Citations to this article as recorded by

Endoscopic assessment of the J pouch in ulcerative colitis: A narrative review
Shintaro Akiyama, Edward L Barnes, Tsubasa Onoda, Naoki Ishikawa, Mamiko Shiroyama, Yuka Ito, David T Rubin, Kiichiro Tsuchiya
DEN Open.2025;[Epub] CrossRef
Prevalence and predictability of the Chicago Classification of Pouchitis in ulcerative colitis: a multicenter study in Japan
Shintaro Akiyama, Ryohei Hayashi, Takeshi Takasago, Kurando Kusunoki, Hiroki Ikeuchi, Kento Takenaka, Kazuhiro Watanabe, Kazutaka Koganei, Nobuhiro Ueno, Mikihiro Fujiya, Naoki Hosoe, Fumikazu Koyama, Yasuhisa Sakata, Motohiro Esaki, Ken Takeuchi, Makoto
Journal of Gastroenterology.2025;[Epub] CrossRef
A Comparative Analysis of Clinical Symptoms and Modified Pouchitis Disease Activity Index Among Endoscopic Phenotypes of the J Pouch in Patients With Inflammatory Bowel Disease
Shintaro Akiyama, Nathaniel A Cohen, Jacob E Ollech, Cindy Traboulsi, Tina Rodriguez, Victoria Rai, Laura R Glick, Yangtian Yi, Joseph Runde, Russell D Cohen, Kinga B Skowron, Roger D Hurst, Konstantin Umanskiy, Benjamin D Shogan, Neil H Hyman, Michele A
Crohn's & Colitis 360.2024;[Epub] CrossRef

3,097 View
155 Download
3 Web of Science
3 Crossref

Review

IBD

Pouchitis in inflammatory bowel disease: a review of diagnosis, prognosis, and treatment: Shintaro Akiyama, Victoria Rai, David T. Rubin; Intest Res 2021;19(1):1-11. Published online November 5, 2020; DOI: https://doi.org/10.5217/ir.2020.00047

Abstract PDF PubReader ePub

Patients with inflammatory bowel disease (IBD) occasionally need a restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) because of medically refractory colitis or dysplasia/cancer. However, pouchitis may develop in up to 70% of patients after this procedure and significantly impair quality of life, more so if the inflammation becomes a chronic condition. About 10% of patients with IBD who develop pouchitis require pouch excision, and several risk factors of the failure have been reported. A phenotype that has features similar to Crohn’s disease may develop in a subset of ulcerative colitis patients following proctocolectomy with IPAA and is the most frequent reason for pouch failure. In this review, we discuss the diagnosis and prognosis of pouchitis, risk factors for pouchitis development, and treatment options for pouchitis, including the newer biological agents.

Citations

Citations to this article as recorded by

Endoscopic assessment of the J pouch in ulcerative colitis: A narrative review
Shintaro Akiyama, Edward L Barnes, Tsubasa Onoda, Naoki Ishikawa, Mamiko Shiroyama, Yuka Ito, David T Rubin, Kiichiro Tsuchiya
DEN Open.2025;[Epub] CrossRef
Crohn's-like Ileal Pouch Illness and Ileal Pouch Salvage Strategies
Alex L. Huang, Marnie Abeshouse, Katherine C. Lee, Emily Rinebold, Maia Kayal, Michael C. Plietz
Clinics in Colon and Rectal Surgery.2025; 38(02): 160. CrossRef
Treatment of Chronic Pouchitis With JAK Inhibitors: Results from A Large Multicenter Database
Saqr Alsakarneh, Aakash Desai, Gursimran S Kochhar, Francis A Farraye, Jana G Hashash
Inflammatory Bowel Diseases.2025; 31(2): 597. CrossRef
Endoscopic Normalization and Transition of J-Pouch Phenotypes Over Time in Patients With Inflammatory Bowel Disease
Shintaro Akiyama, Jacob E Ollech, Nathaniel A Cohen, Cindy Traboulsi, Victoria Rai, Laura R Glick, Yangtian Yi, Joseph Runde, Russell D Cohen, Kinga B Skowron Olortegui, Roger D Hurst, Konstantin Umanskiy, Benjamin D Shogan, Neil H Hyman, Michele A Rubin,
Inflammatory Bowel Diseases.2025; 31(1): 63. CrossRef
Efficacy and Safety of Janus Kinase Inhibitors in Chronic Inflammatory Pouch Conditions: A Systematic Review and Meta-analysis
Saqr Alsakarneh, Fouad Jaber, Sandesh Parajuli, Yazan Abboud, Mohamed Abuelazm, Jana G. Hashash
American Journal of Therapeutics.2025; 32(2): e164. CrossRef
In Vitro Preliminary Evaluation of a New Rifamycin In Situ Gelling Formulation for Pouchitis Treatment
Caterina Aiello, Cinzia Quattrocchi, Rosario Musumeci, Daria Nicolosi, Giulio Petronio Petronio, Roberto Di Marco
Microbiology Research.2025; 16(2): 44. CrossRef
Pouchitis unveiled: exploring clinical features, diagnosis, and cutting-edge treatments
Francesca Lusetti, Camilla Almeida Martins Helfenberger, Munique Kurtz de Mello, Natália Sousa Freitas Queiroz
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Risk factors associated with the development of chronic pouchitis following ileal-pouch anal anastomosis surgery for ulcerative colitis
Emi Khoo, Robert Gilmore, Alison Griffin, Gerald Holtmann, Jakob Begun
World Journal of Meta-Analysis.2025;[Epub] CrossRef
Prevalence and predictability of the Chicago Classification of Pouchitis in ulcerative colitis: a multicenter study in Japan
Shintaro Akiyama, Ryohei Hayashi, Takeshi Takasago, Kurando Kusunoki, Hiroki Ikeuchi, Kento Takenaka, Kazuhiro Watanabe, Kazutaka Koganei, Nobuhiro Ueno, Mikihiro Fujiya, Naoki Hosoe, Fumikazu Koyama, Yasuhisa Sakata, Motohiro Esaki, Ken Takeuchi, Makoto
Journal of Gastroenterology.2025;[Epub] CrossRef
Treatment of Antibiotic Refractory Chronic Pouchitis With JAK Inhibitors and S1P Receptor Modulators: An ECCO CONFER Multicentre Case Series
Davide Giuseppe Ribaldone, Giulia Testa, Bram Verstockt, Tamas Molnar, Edoardo Savarino, Carsten Schmidt, Sophie Vieujean, Niels Teich, Corina Meianu, Pascal Juillerat, Nathan Grellier, Triana Lobaton
Journal of Crohn's and Colitis.2024; 18(5): 720. CrossRef
Association of colonic metaplasia of goblet cells and endoscopic phenotypes of the J pouch in patients with ulcerative colitis: a retrospective pilot study
Shintaro Akiyama, Tsubasa Onoda, Shoko Moue, Noriaki Sakamoto, Taku Sakamoto, Hideo Suzuki, Tsuyoshi Enomoto, Daisuke Matsubara, Tatsuya Oda, Kiichiro Tsuchiya
Intestinal Research.2024; 22(1): 92. CrossRef
Diagnosis and Medical Treatment of Acute and Chronic Idiopathic Pouchitis in Inflammatory Bowel Disease
Corina Meianu, Tudor Stroie, Doina Istratescu, Carmen Monica Preda, Mihai Mircea Diculescu
Medicina.2024; 60(6): 979. CrossRef
Mucosal Single-Cell Profiling of Crohn’s-Like Disease of the Pouch Reveals Unique Pathogenesis and Therapeutic Targets
Siyan Cao, Khai M. Nguyen, Kaiming Ma, Xiaotang Du, Xiuli Liu, Alina Ulezko Antonova, Richard P. Rood, Anas Gremida, Chien-Huan Chen, Alexandra Gutierrez, Deborah C. Rubin, Martin H. Gregory, Mate Gergely, Guadalupe Oliva Escudero, Katherine Huang, Natali
Gastroenterology.2024; 167(7): 1399. CrossRef
A Comparative Analysis of Clinical Symptoms and Modified Pouchitis Disease Activity Index Among Endoscopic Phenotypes of the J Pouch in Patients With Inflammatory Bowel Disease
Shintaro Akiyama, Nathaniel A Cohen, Jacob E Ollech, Cindy Traboulsi, Tina Rodriguez, Victoria Rai, Laura R Glick, Yangtian Yi, Joseph Runde, Russell D Cohen, Kinga B Skowron, Roger D Hurst, Konstantin Umanskiy, Benjamin D Shogan, Neil H Hyman, Michele A
Crohn's & Colitis 360.2024;[Epub] CrossRef
Ileoanal Pouch–Related Fistulas: A Narrative Review
Sergio Bronze, Maia Kayal, Maria Manuela Estevinho, Sue Hahn, Sergey Khaitov, Jean-Frederic Colombel, Serre-Yu Wong
Inflammatory Bowel Diseases.2024;[Epub] CrossRef
Complicaciones asociadas al reservorio ileal en colitis ulcerativa versus poliposis familiar adenomatosa: Impacto en la calidad de vida del paciente
Rodrigo Castaño Llano, Sandra Patricia Molina Meneses, Juan Darío Puerta, René Marcelo Escobar, Santiago Salazar Ochoa, Juan Esteban Puerta, Manuel Barreiro-de Acosta
Gastroenterología y Hepatología.2023; 46(1): 39. CrossRef
Antibiotics in the pathogenesis of diabetes and inflammatory diseases of the gastrointestinal tract
Aline C. Fenneman, Melissa Weidner, Lea Ann Chen, Max Nieuwdorp, Martin J. Blaser
Nature Reviews Gastroenterology & Hepatology.2023; 20(2): 81. CrossRef
Treatment of Chronic Inflammatory Pouch Conditions With Tofacitinib: A Case Series From 2 Tertiary IBD Centers in the United States
Shintaro Akiyama, Nathaniel A Cohen, Maia Kayal, Marla C Dubinsky, Jean-Frederic Colombel, David T Rubin
Inflammatory Bowel Diseases.2023; 29(9): 1504. CrossRef
Ileal reservoir-associated complications in ulcerative colitis versus familial adenomatous polyposis: Impact on patient quality of life
Rodrigo Castaño Llano, Sandra Patricia Molina Meneses, Juan Darío Puerta, René Marcelo Escobar, Santiago Salazar Ochoa, Juan Esteban Puerta, Manuel Barreiro-de Acosta
Gastroenterología y Hepatología (English Edition).2023; 46(1): 39. CrossRef
Effectiveness and safety of tofacitinib in patients with chronic pouchitis multirefractory to biologics
Mathieu Uzzan, Maria Nachury, Aurélien Amiot, Laurent Peyrin-Biroulet, Julien Kirchgesner, Yoram Bouhnik
Digestive and Liver Disease.2023; 55(8): 1158. CrossRef
Prioritization in inflammatory bowel disease therapy
Klaus R. Herrlinger, Eduard F. Stange
Expert Review of Gastroenterology & Hepatology.2023; 17(8): 753. CrossRef
Cannabis Improves Clinical Outcomes and Quality of Life in Patients With Chronic Pouchitis
Timna Naftali, Lihi Bar-Lev Schleider, Hen Kayless, Zohar Bromberg, Iris Dotan, Efrat Broide
ACG Case Reports Journal.2023; 10(8): e01131. CrossRef
Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study
Ronaldo Paolo Panganiban, Alyssa Tuan, Maxwell Hart, Mathew Pelton, Daniella Mikhail, Sarah Akhtar, Kaleb Bogale, Susan Deiling, Shouhao Zhou, Mathew D Coates, Gregory S Yochum, Walter Koltun
Crohn's & Colitis 360.2023;[Epub] CrossRef
Endoscopy of the Ileal Pouch Anal Anastomosis
Athos Bousvaros, Jill M. Zalieckas, Lori Zimmerman
Journal of Pediatric Gastroenterology & Nutrition.2023; 77(6): 691. CrossRef
Sampling and Reporting of Inflammatory Bowel Disease
Ian S. Brown, Cheng Liu, Gregory C. Miller
Advances in Anatomic Pathology.2022; 29(1): 25. CrossRef
Time to Revisit Disease Classification in Inflammatory Bowel Disease: Is the Current Classification of Inflammatory Bowel Disease Good Enough for Optimal Clinical Management?
Bram Verstockt, Brian Bressler, Helena Martinez-Lozano, Dermot McGovern, Mark S. Silverberg
Gastroenterology.2022; 162(5): 1370. CrossRef
Histopathology of Colectomy Specimens Predicts Endoscopic Pouch Phenotype in Patients with Ulcerative Colitis
Shintaro Akiyama, Jacob E. Ollech, Cindy Traboulsi, Victoria Rai, Laura R. Glick, Yangtian Yi, Joseph Runde, Andrea D. Olivas, Christopher R. Weber, Russell D. Cohen, Kinga B. Skowron Olortegui, Roger D. Hurst, Konstantin Umanskiy, Benjamin D. Shogan, Mic
Digestive Diseases and Sciences.2022; 67(8): 4020. CrossRef
Network meta-analysis: efficacy of treatment for acute, chronic, and prevention of pouchitis in ulcerative colitis
Stephanie Poo, Danujan Sriranganathan, Jonathan P Segal
European Journal of Gastroenterology & Hepatology.2022; 34(5): 518. CrossRef
When pouches cannot empty: a cohort study of the symptoms this causes, the reasons it's happening, and the treatments needed
Emmeline Nugent, James M. Church
ANZ Journal of Surgery.2022; 92(12): 3237. CrossRef
Diagnostic and Management Considerations for the IPAA With Crohn’s Disease-Like Features
Shintaro Akiyama, Emma C. Dyer, David T. Rubin
Diseases of the Colon & Rectum.2022; 65(S1): S77. CrossRef
Ileal Pouch-Anal Anastomosis in the Older Adult: a Review of Postoperative Outcomes and Pouchitis Treatment
Sabrina L. Chen, Adam S. Faye, Shannon Chang
Current Treatment Options in Gastroenterology.2022; 20(4): 564. CrossRef
Recent Advance in the Management of Dysplasia in the Ulcerative Colitis
Dong-Hoon Yang
Journal of Digestive Cancer Reports.2021; 9(2): 50. CrossRef

11,002 View
476 Download
31 Web of Science
32 Crossref

First
Prev
Page of 1
Next
Last

Search