PTU-258 Prevalence and severity of pre-pouch ileitis: a distinct disease entity or a manifestation of refractory pouchitis?
Bibliographic record
Abstract
Introduction Pre-pouch ileitis (PI) is a complication that can occur after panproctocolectomy and ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). It is characterised by inflammation of pre-pouch ileum in the afferent limb of the pouch. Our aims were to assess the prevalence of PI as well as to identify predictive factors and investigate the medications needed for its management. Method Data on 546 patients who underwent IPAA for UC was retrospectively collected from three tertiary inflammatory bowel disease (IBD) referral centres. Data was collected from sites in the Netherlands (Academic Medical Centre, Amsterdam), Belgium (Leuven University Hospital) and England (University College London Hospital). PI was considered present if there was endoscopic, as well as histological inflammation in the afferent limb. Results PI was present in 33/546 (6%) UC patients, all of these had concurrent pouchitis. 144 (26%) patients had pouchitis without PI. 369 (68%) patients did not have any inflammatory pouch problems. Rates of requiring potent immunosupressive treatment were higher amongst patients with PI than those with pouchitis alone. Patients who went on to develop PI were significantly younger at the time of their UC diagnosis. PSC was significantly more common in patients with PI than those with pouchitis alone. Conclusion PI is a much less common and more treatment refractory condition than pouchitis alone. Pouchoscopy should be considered in any patient with symptoms of pouchitis. This should include careful endoscopic evaluation of the afferent pouch limb as well as biopsies of the pre-pouch ileum. Once a diagnosis of PI is made, clinicians should commence immunomodulatory therapy early in the disease course and consider escalating to an anti-TNF if this proves ineffective. Disclosure of interest None Declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".