The resident gut microbiota is essential for physiological processes.
The disturbance of its balance is linked to intestinal inflammation.
The ileoanal pouch is a model for the study of intestinal inflammation, as inflammation of the pouch is common and mostly develops within 12 months following ileostomy closure.
This allows the longitudinal study of the microbiota, giving insight into the microbiota changes during transition from a normal to an inflamed pouch.
Dr Segal and colleagues explored the literature on the microbiota of the ileoanal pouch in health and disease.
|Anerobic bacteria are the abundant species in the ileoanal pouch|
|Alimentary Pharmacology & Therapeutics|
The research team performed a systematic computer search of the on-line bibliographic databases MEDLINE and EMBASE between 1966 and 2017.
The team included randomized controlled trials, cohort studies and observational studies.
Studies were included if they reported microbiota analysis on faecal samples or tissue from the ileoanal pouch.
The researchers identified 26 papers that were eligible.
Following ileostomy closure, the team found that anerobic bacteria are the abundant species in the ileoanal pouch with presence of a diverse microbiota key to maintaining a healthy ileoanal pouch.
The researchers observed that acute pouchitis is associated with an increase in Clostridia species, while chronic pouchitis is associated with an increase in Staphylococcus aureus.
In the treatment of pouchitis, the team noted that a decrease in Clostridia species appears to be associated with treatment response.
Dr Segal's team comments, "The microbiota plays an important role in both the inflamed and the healthy ileoanal pouch."
"A direct causal relationship between individual microbiota changes and inflammation has not yet been established, but manipulation of the ileoanal pouch microbiota may be a novel therapeutic avenue to explore."