Cuffitis

Cuffitis is inflammation at the anal transition zone, sometimes called the cuff, that is created as a byproduct of ileal pouch-anal anastomosis, a surgical procedure abbreviated IPAA in which a pouch made from the small intestine is connected to the anus, most often to treat ulcerative colitis after the diseased colon has been removed. The condition represents a variant of ulcerative colitis itself, affecting the small strip of original rectal tissue, the cuff, that is deliberately left behind during a stapled anastomosis performed without the additional step of mucosectomy, the removal of the lining of that residual tissue. Because this residual cuff tissue is the same tissue type that was originally affected by ulcerative colitis, it remains susceptible to the same inflammatory disease even after the rest of the colon has been surgically removed, which is why cuffitis is understood as a continuation of the original disease rather than a wholly separate complication. Patients typically experience small-volume bloody bowel movements and may notice bright red blood on toilet tissue, symptoms that closely resemble pouchitis, a related but distinct complication affecting the surgically constructed pouch itself rather than the cuff, making careful clinical distinction between the two conditions important for correct treatment.