Role of oxygen free radicals in the etiology of pouchitis

Kenneth E. Levin, John H. Pemberton, Sidney F. Phillips, Alan R. Zinsmeister, Michael E. Pezim

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Transient mucosal ischemia may cause oxygen-derived free radical production by xanthine oxidase, precipitating pouchitis after ileal pouch-anal anastomosis. Our aim, therefore, was to determine the effect of allopurinol, a xanthine oxidase inhibitor, in patients with acute and chronic pouchitis. Acute pouchitis was characterized clinically by sporadic episodes of increased frequency and decreased viscosity of stools, hematochezia, fever, malaise, and pelvic pain, which resolved promptly with treatment. Chronic pouchitis patients required continuous treatment to remain asymptomatic and invariably developed the signs and symptoms of pouchitis within one week following cessation of therapy. Eight patients with acute pouchitis were treated with allopurinol (300 mgp.o. b.i.d.)during the episode. Fourteen patients with chronic pouchitis had their standard antibiotic therapy discontinued while still asymptomatic; they were then given allopurinol (300 mgp.o. b.i.d.)for 28 days. Acute pouchitis resolved promptly in four of eight patients. Seven of the 14 patients with chronic pouchitis responded completely with no recurrence of symptoms during treatment. Allopurinol either terminated an episode of acute pouchitis or prevented pouchitis from recurring in 50 percent of patients. These data support a role for mucosal ischemia and oxygen free radical production in the etiology of pouchitis.

Original languageEnglish (US)
Pages (from-to)452-456
Number of pages5
JournalDiseases of the Colon & Rectum
Volume35
Issue number5
DOIs
StatePublished - May 1992

Fingerprint

Pouchitis
Free Radicals
Reactive Oxygen Species
Allopurinol
Xanthine Oxidase
Ischemia
Therapeutics
Colonic Pouches
Pelvic Pain
Gastrointestinal Hemorrhage
Viscosity
Signs and Symptoms

Keywords

  • Chronic ulcerative colitis
  • Familial adenomatous polyposis
  • Ileal pouch-anal anastomosis
  • Oxygen free radicals
  • Pouchitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Levin, K. E., Pemberton, J. H., Phillips, S. F., Zinsmeister, A. R., & Pezim, M. E. (1992). Role of oxygen free radicals in the etiology of pouchitis. Diseases of the Colon & Rectum, 35(5), 452-456. https://doi.org/10.1007/BF02049401

Role of oxygen free radicals in the etiology of pouchitis. / Levin, Kenneth E.; Pemberton, John H.; Phillips, Sidney F.; Zinsmeister, Alan R.; Pezim, Michael E.

In: Diseases of the Colon & Rectum, Vol. 35, No. 5, 05.1992, p. 452-456.

Research output: Contribution to journalArticle

Levin, KE, Pemberton, JH, Phillips, SF, Zinsmeister, AR & Pezim, ME 1992, 'Role of oxygen free radicals in the etiology of pouchitis', Diseases of the Colon & Rectum, vol. 35, no. 5, pp. 452-456. https://doi.org/10.1007/BF02049401
Levin KE, Pemberton JH, Phillips SF, Zinsmeister AR, Pezim ME. Role of oxygen free radicals in the etiology of pouchitis. Diseases of the Colon & Rectum. 1992 May;35(5):452-456. https://doi.org/10.1007/BF02049401
Levin, Kenneth E. ; Pemberton, John H. ; Phillips, Sidney F. ; Zinsmeister, Alan R. ; Pezim, Michael E. / Role of oxygen free radicals in the etiology of pouchitis. In: Diseases of the Colon & Rectum. 1992 ; Vol. 35, No. 5. pp. 452-456.
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