Change in the bacterial flora of pouchitis.

BACKGROUND/AIMS: Pouchitis is the most frequent complication of ileal pouch-anal anastomosis for patients with ulcerative colitis. While the mechanism of pouchitis is still unknown, a role involving the bacterial flora is suspected. The aim of the present study is to investigate the association between pouchitis and change in the bacterial flora. METHODOLOGY: This study included 22 patients who underwent ileal pouch-anal anastomosis in our department to treat ulcerative colitis. The mean age was 46.2 years. The male-to-female ratio was 10:12. The mean interval between surgery and this study was 95.6 months. Collected feces was serially diluted 10-fold to 10-8 and each solution was cultured. We diagnosed pouchitis using the pouchitis disease activity index. RESULTS: Nine of the 22 patients were diagnosed as having pouchitis. In the obligate anaerobes, the numbers of Bacteroidaceae and Bifidobacterium were significantly lower in the pouchitis group (P<0.01 and P<0.001). In the facultative anaerobic bacteria, the number of Lactobacillus was significantly lower in the pouchitis group (P<0.05). CONCLUSIONS: The numbers of Bacteroidaceae, Bifidobacterium and Lactobacillus were significantly lower in the bacterial flora of the pouchitis group. Our findings suggest that there is an association between change in the bacterial flora and pouchitis.