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Refractory pouchitis is just pouchitis that won’t respond to treatment. It shouldn’t be diagnosed until all reasonable treatments have been tried. The only remaining definitive treatment at that point would be pouch removal, but that would depend on the severity of the symptoms. “Antibiotic refractory pouchitis” is just unresponsive to antibiotics, but in lots of those cases biologics will do the trick.

Scott F

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