Recovery from Recurrence of Post-operative Pouchitis Due to Ulcerative Colitis through Daitokato

MATSUURA Keiko, TOKUNAGA Hideaki, IMAZU Yoshihiro, NISHIMURA Ko, AKIBA Tetsuo, WATANABE Kenji

doi:10.3937/kampomed.62.713

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Other Title

大桃花湯が潰瘍性大腸炎術後の繰り返す回腸嚢炎に対し有効であった1症例
臨床報告大桃花湯が潰瘍性大腸炎術後の繰り返す回腸嚢炎に対し有効であった1症例
リンショウホウコクダイトウカユガカイヨウセイダイチョウエンジュツゴノクリカエスカイチョウノウエンニタイシユウコウデアッタ 1 ショウレイ

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Description

Pouchitis is the most common complication following ileal pouch-anal anastomosis in patients with ulcerative colitis and is strongly correlated with the risk of pouch failure and malignant mucosal transformation in the pouch. Here we report a case treated successfully with the Kampo decoction, daitokato. A 41-year-old male treated with ileal pouch-anal anastomosis due to severe ulcerative colitis suffered from repeated pouchitis and stenosis of the ileal pouch post-operatively. He complained of general fatigue, chills, continuous lower abdominal pain and discomfort, and severe pain with evacuation. Initial treatment with antibiotics and painkillers was ineffective, so the patient came to our hospital's Kampo clinic, where he was initially prescribed the decoction, shokenchuto. This proved ineffective at resolving his fatigue. Subsequent treatment with ogikenchuto improved physical strength but was ineffective for pouchitis. Antibiotic resistant pouchitis occurred afterwards and we attempted treatment with saikokeishito decoction and the extracts, hochuekkito and juzentaihoto, which similarly improved fatigue but not pouchitis. Following administration of daitokato, instances of pouchitis were reduced with no recurrence 6 months post-treatment. This case illustrates the therapeutic efficacy of daitokato in improving ileal pouch disorders resistant to treatment with Western medicine.

Journal

Kampo Medicine

Kampo Medicine 62 (6), 713-717, 2011

The Japan Society for Oriental Medicine

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