Pouchitis Disease Activity Index

Clinical indication

Diagnosis of pouchitis after ileal pouch-anal anastomosis, combining symptom, endoscopic and histological subscores.

What is scored

The calculator collects 12 items:

• Stool Frequency
• Rectal Bleeding
• Faecal Urgency or Abdominal Cramps
• Fever
• Endoscopy: Mucosal Edema
• Endoscopy: Mucosal Granularity
• Endoscopy: Contact Friability
• Endoscopy: Loss of Vascular Pattern
• Endoscopy: Mucosal Exudate
• Endoscopy: Discrete Ulcerations
• Histology: Polymorphonuclear Leukocyte Infiltration
• Histology: Mucosal Ulceration Extent

Any item left blank stops the score being calculated — an incomplete form never reports as remission.

Interpretation

Bands as implemented in IBD Care. A band is a description of the score, not an instruction.

Limitations

Needs both pouchoscopy and histology, so it cannot be completed on symptoms alone — and symptoms correlate poorly with inflammation after IPAA. It does not distinguish pouchitis from cuffitis, Crohn's disease of the pouch, or a structural or functional pouch disorder, each of which needs a different response.

References

• Sandborn WJ, Tremaine WJ, Batts KP, Pemberton JH, Phillips SF. Pouchitis after ileal pouch-anal anastomosis: a Pouchitis Disease Activity Index. Mayo Clin Proc 1994;69:409-15. PMID 8170189. doi:10.1016/s0025-6196(12)61634-6

Content last reviewed 2026-10-10. References were resolved against PubMed, a service of the US National Library of Medicine, which does not endorse this site.

Use the calculator

Pouchitis Disease Activity Index is implemented as an interactive calculator in IBD Care, with its full guidance and scoring bands.