Which condition is most likely indicated by a patient reporting pelvic discomfort, low-grade fever, diarrhea, and anorexia six months after IPAA surgery?

The most likely condition indicated by a patient experiencing pelvic discomfort, low-grade fever, diarrhea, and anorexia six months after an ileal pouch-anal anastomosis (IPAA) surgery is pouchitis. Pouchitis is an inflammation of the ileal pouch created during the surgical procedure, commonly seen in individuals who underwent IPAA for ulcerative colitis or familial adenomatous polyposis.

The symptoms presented—pelvic discomfort, low-grade fever, diarrhea, and anorexia—are classic signs of pouchitis. Inflammation can lead to increased bowel movements and abdominal discomfort, as well as systemic symptoms like fever. Anorexia can occur due to the discomfort associated with the condition and the gastrointestinal disturbances.

Other conditions, while they might share some symptoms, are less consistent with the typical post-operative timeline or symptom profile for a patient who has undergone IPAA. For instance, a Clostridium difficile infection might cause similar gastrointestinal symptoms but would typically be more acute and occurs after antibiotic use, making it a different diagnostic consideration. Recurrent inflammatory bowel disease could present, but it generally would manifest with more severe symptoms and may not typically result in pouch-specific complaints in such a timeframe. Dehydration, while a potential consequence of