Bertucci Zoccali M, Hyman N, Skowron KB, et al. - Researchers examined if prior exposure to biologics influences the development of pouchitis in patients who have ulcerative colitis. In this retrospective case-control study, they included 417 patients with ulcerative colitis who underwent IPAA. Pouchitis occurred in 40.4% of the cases. Anti-tumor necrosis factor exposure was identified to be the only independent risk factor for the development of pouchitis. These agents seemed to alter the microbiome and/or local host immunity of the terminal ileum and thereby may “precondition” the pouch to develop pouchitis.