Sandborn et al developed a Pouchitis Disease Activity Index to describe the severity of inflammation in an ileoanal pouch. This can be helpful for making the initial diagnosis and for monitoring the response to therapy.
Parameters:
(1) stool frequency
(2) rectal bleeding
(3) fecal urgency and/or abdominal cramping
(4) fever
(5) endoscopic features (6, see below)
(6) histologic features (2, see below)
|
Parameter |
Finding |
Points |
|---|---|---|
|
stool frequency |
usual postoperative frequency |
0 |
|
|
1 to 2 stools per day in excess of usual postoperative frequency |
1 |
|
|
3 or more stools per day in excess of usual postoperative frequency |
2 |
|
rectal bleeding |
none |
0 |
|
|
rare |
0 |
|
|
present daily |
1 |
|
urgency, abdominal cramping |
none |
0 |
|
|
occasional |
1 |
|
|
usual |
2 |
|
fever (temperature > 100.5°F) |
absent |
0 |
|
|
present |
1 |
|
Endoscopic Parameter |
Finding |
Points |
|---|---|---|
|
edema |
absent |
0 |
|
|
present |
1 |
|
granularity |
absent |
0 |
|
|
present |
1 |
|
friability |
absent |
0 |
|
|
present |
1 |
|
loss of vascular pattern |
absent |
0 |
|
|
present |
1 |
|
mucus exudates |
absent |
0 |
|
|
present |
1 |
|
ulceration |
absent |
0 |
|
|
present |
1 |
|
Histologic Parameter |
Finding |
Points |
|---|---|---|
|
polymorph infiltration |
none |
0 |
|
|
mild |
1 |
|
|
moderate with crypt abscesses |
2 |
|
|
severe with crypt abscesses |
3 |
|
ulceration per low power field |
none |
0 |
|
|
1 - 24% |
1 |
|
|
25 - 50% |
2 |
|
|
51 - 100% |
3 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• A score >= 7 indicates pouchitis is present.
Purpose: To evaluate a patient with an ileoanal pouch for pouchitis using the Pouchitis Disease Activity Index of Sandborn et al.
Specialty: Gastroenterology
Objective: severity, prognosis, stage, complications, disease progression, complication detection
ICD-10: K91,
