What is the typical time interval from IPAA to development of a pouch inlet stricture

What is known

- Symptomatic fibrotic strictures at the ileoanal anastomosis or proximal J pouch develop in 9–16% of patients, usually within 6–9 months of surgery, but this describes IPAA/anastomotic, not inlet, strictures. ¹ - Anastomotic strictures may occur early but typically present 6–9 months post-op; inlet strictures are described as a distinct, less common entity. ^2,3 - Pouch inlet strictures are often secondary to a Crohn's phenotype / pre-pouch ileitis, whose median time to diagnosis is ~12–36 months (reported range 9–22 months to 4.5 years). ^3–5

What is unknown / caveats

- No excerpt reports a time interval specific to pouch inlet strictures - The 6–9 month figures pertain to IPAA anastomotic strictures, a distinct entity from inlet strictures - The corpus here does not isolate a dedicated onset interval for inlet strictures. Timing is inferred from the underlying Crohn's/pre-pouch ileitis etiology.

## References

1. Mahgerefteh S, Pikarsky A, Bloom AI. Image-guided sharp recanalization of a benign J pouch anastomotic occlusion facilitates surgical repair. J Vasc Interv Radiol. 2014;25:646-9. PMID: 24674221.

2. Wahbeh GT, Suskind DL, Lee SD, Waldhausen JT, Murray KF. The pediatric pouch in inflammatory bowel disease: a primer for the gastroenterologist. Expert Rev Gastroenterol Hepatol. 2013;7(3):215-23. PMID: 23445231.

3. Ream J, Costello M, Baker M. Imaging of the J-pouch. Radiol Clin North Am. 2025;63:331-344. PMID: 40221178.

4. Shen B. Pouchitis: what every gastroenterologist needs to know. Clin Gastroenterol Hepatol. 2013;11(12):1538-49. PMID: 23602818.

5. Connelly TM, Lincango E, Holubar SD. Crohn's of the Pouch: Now What?. Clin Colon Rectal Surg. 2022;35(6):475-486. PMID: 36591396.

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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._