Family history of Crohn's disease is associated with an increased risk for Crohn's disease of the pouch

Bo Shen, Feza H. Remzi, Jeffrey P. Hammel, Bret A. Lashner, Charles L Bevins, Ian C. Lavery, Jan Wehkamp, Victor W. Fazio

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Background: Crohn's disease (CD) of the pouch can occur in patients with restorative proctocolectomy and ileal pouch-anal anastomosis originally performed for a preoperative diagnosis of ulcerative colitis (UC). CD of the pouch was often observed in patients with a family history of CD. The purpose was to determine whether the family history of CD increased the risk for CD of the pouch in patients who underwent restorative proctocolectomy. Methods: A total of 558 eligible patients seen in the Pouchitis Clinic were enrolled, including 116 patients with CD of the pouch and 442 patients with a normal pouch or other pouch disorders. Demographic and clinical variables were included in the study. Multivariable logistic regression analyses were performed. Results: The adjusted multivariate logistic analyses revealed that the risk for CD of the pouch was increased in patients with a family history of CD, with an odds ratio (OR) of 3.22 (95% confidence interval [CI] 1.56-6.67), or with a first-degree relative with CD (OR = 4.18, 95% CI, 1.48-11.8), or with a greater number of family members with CD (OR = 2.00 per family member, 95% CI, 1.19-3.37), adjusting for age, gender, smoking status, duration of IBD, duration of having a pouch, and a preoperation diagnosis of indeterminate colitis or CD. In addition, patients of younger age and longer duration of having a pouch had a higher risk for CD of the pouch. A diagnosis of CD of the pouch was associated with a poor outcome, with a greater than 5-fold estimated increased odds of pouch failure (OR = 5.58, 95% CI, 2.74-11.4). Conclusions: The presence of a family history of CD is associated with an increased risk for CD of the pouch, which in turn has a high risk for pouch failure.

Original languageEnglish (US)
Pages (from-to)163-170
Number of pages8
JournalInflammatory Bowel Diseases
Volume15
Issue number2
DOIs
StatePublished - 2009
Externally publishedYes

Keywords

  • Crohn's disease
  • Family history
  • Ileal pouch
  • Inflammatory bowel disease
  • Pouchitis
  • Restorative proctocolectomy
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

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    Shen, B., Remzi, F. H., Hammel, J. P., Lashner, B. A., Bevins, C. L., Lavery, I. C., Wehkamp, J., & Fazio, V. W. (2009). Family history of Crohn's disease is associated with an increased risk for Crohn's disease of the pouch. Inflammatory Bowel Diseases, 15(2), 163-170. https://doi.org/10.1002/ibd.20646