Clinical Approaches to Ileal Pouch Dysfunction

Inclusion Criteria

• •Having a history of UC and more than 1 year from TPC/IPAA
• •Meet diagnostic criteria of IPS, i.e.
• •Symptoms of diarrhea and abdominal pain, with PDAI symptoms score \> (range 2-6).
• •Duration of symptoms \> 12 weeks in the preceding 12-months period
• •Pouch endoscopy shows no evidence of inflammation of the ileal pouch and rectal cuff
• •No antibiotic therapy, aspirin, or non-steriodal anti-inflammatory drugs for 2 weeks prior to entry into the study; no antidepressant and or anti-anxiety medicines for at least 4 weeks.