Comprehensive Evaluation of Inflammatory and Noninflammatory Sequelae of Ileal Pouch-Anal Anastomoses

Abstract

Symptoms largely overlapped among the disease groups of IPAA. Endoscopy is valuable for diagnosis. Inflammatory or noninflammatory sequelae of IPAA adversely affected patients' QOL.

Pouchitis

“…Pouchitis, a nonspecific inflammatory condition at the ileal pouch reservoir, is the most common long-term complication in patients with IPAA which significantly affects patients' quality of life [2] . Reported cumulative frequency rates of pouchitis 10-11 years after IPAA surgery range from 23% to 46% [3,4] .…”

Both Preoperative Perinuclear Antineutrophil Cytoplasmic Antibody and Anti-CBir1 Expression in Ulcerative Colitis Patients Influence Pouchitis Development After Ileal Pouch–Anal Anastomosis

“…For patients with persistent symptoms, studies were done to exclude mechanical complications of surgery such as an anal stricture or partial small bowel obstruction. Patients in whom the ileostomy was not closed, those who did not consent to have blood drawn for research purposes and those using nonsteroidal anti-inflammatory drugs (17) were excluded from analysis. CD after IPAA was diagnosed when mucosal inflammation involved the small bowel mucosa proximal to the ileal pouch or when a pouch fistula or other perianal complication developed more than 3 months after ileostomy closure.…”

Natural history of Crohn’s disease in patients who underwent intentional restorative proctocolectomy with ileal pouch‐anal anastomosis

“…32 Risks and benefits of IPAA for these patients should carefully be balanced. 33 There are limitations to this historical cohort study. There might have been referral bias as all patients were evaluated and managed at our tertiary subspecialty Pouchitis Clinic.…”