Adalimumab in the Treatment of Chronic Pouchitis

Inclusion Criteria: * Operated with proctocolectomy and construction of an IPAA * Prior to surgery diagnosed with ulcerative colitis according to established clinically, radiologic, endoscopic and histological criteria. * Diagnosed with chronic pouchitis as defined above * PDAI ≥ 7, with the clinically part of PDAI \>2 and the endoscopic part of PDAI \>3 * Age \>18 years * Negative stool cultures for bacterial bowel pathogens and negative stool microscopy for parasites * Serology negative for chronic hepatitis B * Negative examination for tuberculosis (including x-ray of thorax and a interferon gamma test) * Signed informed consent Exclusion Criteria: * Treatment with glucocorticoids within the last 4 weeks * Diagnosed with Crohn's disease * Need of an interpreter or if patients do not understand oral or written information. * Surgical complications as anal stenosis, leak of the anastomosis, or fistula arising from the pouch * Abuse of medicine, alcohol or drugs * Ongoing treatment with NSAID (non steroid anti inflammatory drug) * Pregnancy or nursing * A diverting stoma * Malignancy or other severe chronic disease or expected longevity less than one year * Patients diagnosed with immune deficiency * Ongoing infectious disease * Contraindications against treatment with tumor necrosis factor-alpha antibody, such as heart disease, former cancer disease, in vivo vaccination within the last 4 weeks