Pouchitis is an acute or chronic inflammatory disease of the ileal reservoir. It is common after restorative proctocolectomy with ileal pouch–anal anastomosis, and treatment of chronic antibiotic-refractory pouchitis has proven challenging. Most cases of acute pouchitis evolve into chronic pouchitis. The aetiology of acute pouchitis is likely to be partly related to the gut microbiota, whereas the pathophysiology of chronic pouchitis involves abnormal interactions between genetic disposition, faecal stasis, the gut microbiota, dysregulated host immunity, surgical techniques, ischaemia and mesentery-related factors. Pouchoscopy with biopsy is the most valuable modality for diagnosis, disease monitoring, assessment of treatment response, dysplasia surveillance and delivery of endoscopic therapy. Triggering or risk factors, such as Clostridioides difficile infection and use of non-steroidal anti-inflammatory drugs, should be modified or eradicated. In terms of treatment, acute pouchitis usually responds to oral antibiotics, whereas chronic antibiotic-refractory pouchitis often requires induction and maintenance therapy with integrin, interleukin or tumour necrosis factor inhibitors. Chronic pouchitis with ischaemic features, fistulae or abscesses can be treated with hyperbaric oxygen therapy.

储袋炎是回肠储库的一种急性或慢性炎症性疾病。这种情况在恢复性直肠结肠切除术联合回肠贮袋-肛门吻合术后很常见，并且慢性抗生素难治性贮袋炎的治疗已被证明具有挑战性。大多数急性储袋炎病例会演变成慢性储袋炎。急性储袋炎的病因可能部分与肠道微生物群有关，而慢性储袋炎的病理生理学涉及遗传倾向、粪便瘀滞、肠道微生物群、宿主免疫失调、手术技术、缺血和肠系膜相关因素之间的异常相互作用。储袋镜活检和活检是诊断、疾病监测、治疗反应评估、发育不良监测和内镜治疗最有价值的方法。应改变或消除触发因素或危险因素，例如艰难梭菌感染和使用非甾体抗炎药。在治疗方面，急性储袋炎通常对口服抗生素有反应，而慢性抗生素难治性储袋炎通常需要整合素、白细胞介素或肿瘤坏死因子抑制剂的诱导和维持治疗。具有缺血特征、瘘管或脓肿的慢性储袋炎可以用高压氧疗法治疗。