| Surgical anastomosis |
[2, 4, 3,
21, 22] |
1981 |
Mobilization of both ends of the bowel with either
sutured or stapled anastomosis. |
This is the most effective method of alleviating the
signs and symptoms. |
| Corticosteroids |
[23, 24] |
1987 |
Hydrocortisone (100 mg per 60 mL bottle) enema is
administered once daily for up to 3 weeks. |
Response to treatment is generally seen in
3 to 5 days. |
| Occasional treatment may be given for 2 to 3 months
depending on clinical response. |
| Short-chain-fatty acids (SCFAs) |
[10, 26, 28,29,30] |
1989 |
SCFA enema rectally twice a day for 2 weeks, and then
tapered according to response over 2 to 4 weeks. |
Varying effect. |
| 5-aminosalicylic acid (5ASA) enemas |
[31,32,33] |
1991 |
4 g mesalamine in 60 ml suspension, administered
rectally once-daily for 4 to 5 weeks. |
Varying effect. |
| Irrigation with Fibers |
[35, 36] |
2004 |
Solution containing 5% Fibers (10 g/day) for 7
days. |
The endoscopic score, used to quantify the intensity
of the imflammation of the mucosa at the diverted colon, diminished after
treatment. |
| Leukocytapheresis |
[37] |
2014 |
Leukocytapheresis, at a flow rate of 40 mL/min for 60
min, once weekly for 5 weeks; following low dose of metronidazole and
ciprofloxacin, another set of weekly leukocytapheresis was added. |
Signficant improvement in pouchitis disease activity
index (PDAI) from 14 to 1. |
| Autologous fecal transplantation |
[55,56,57,58,59] |
2015 |
Feces were collected from the colostomy
bag, diluted with 600 mL of sterile saline (0.9 %), stirred, and filtered three
times using an ordinary coffee filter, and irrigation was done
endoscopically. |
All symptoms improved dramatically within 5 days after
the first treatment. |
| Colonoscopy performed at 28 days after the first
treatment showed no major signs of inflammation in the colonic stump. |
| This procedure was repeated 3 times within 4 weeks (on
Days 0, 10, and 28). |
|
| Dextrose (hypertonic glucose) spray |
[7] |
2017 |
Endoscopically sprayed with 150 mL of 50% dextrose via
a catheter. |
Follow-up pouchoscopy 2 weeks after the dextrose spray
showed normal pouch mucosa with no evidenceof bleeding or mucosal friability. |
| Infliximab |
[42] |
2021 |
The infliximab dose was 5 mg/kg, repeated
at 2 and 6 weeks after the initial dose. |
This therapy dramatically improved the colonic
inflammation and alleviated the patient’s symptoms. |
| Total colonoscopy performed at 4 weeks after
initiating this protocol showed almost complete resolution of the
inflammation. |
| Elemental diet |
[45] |
2021 |
An exclusive elemental diet and the low-fibre,
fat-limited exclusion (LOFFLEX) diet. |
Significant improvement in symptoms with a decrease in
bowel motions, rectal discharge, and pain few weeks after employing an elemental
diet. |
| Probiotics |
[50, 51] |
2021 |
Slow infusion of a solution of 4.5 mg of probiotics
diluted in 250 mL of 0.9% physiological saline for 20–30 min. |
A significant decrease in endoscopic pathological
findings (mucosal friability, mucous erosions, polyps, edema, erythema and
stenosis) and in histological findings (follicular hyperplasia, eosinophils,
cryptic abscesses, lymphocyte infiltration, plasma cell infiltration and
architecture distortion) was observed in a group stimulated with probiotics
(p<0.001). |
| Coconut oil |
[52] |
2022 |
Daily local administration of 100 mL
prewarmed coconut oil as a rectal enema. |
One week after initiation of daily coconut oil
administrations, the patient reported reduced abdominal pain and mucus secretions.
|
| After another 6 weeks of continuous therapy,
hematochezia and mucus secretion completely stopped. |
| In a sigmoidoscopy performed after 8 weeks of daily
therapy, clear improvement of endoscopic and histologic signs of inflammation were
observed. |
