Effect of small bowel obstruction on functional outcome and quality of life in patients with ileal pouch‐anal anastomosis: 10‐year follow‐up study

Abstract

Medical management of SBO is associated with an increase in two symptoms, but QOL is comparable with surgical management.

Gender of the patient may influence perioperative and long‐term complications after restorative proctocolectomy

“…The finding of a greater incidence of small bowel obstruction in female patients had been reported in a previous study from this institution [24] and also in other centres [25,26]. It has been suggested that this might be due to the effect of oestrogens on the formation of abdominal adhesions [27].…”

Functional Outcome and Quality of Life after Ileal Pouch-Anal Anastomosis within a Defined Population in Sweden

“…Another explanation might be that this finding is a type I error. This explanation is supported by a large study by Erkek et al [60] showing no difference in HRQOL between patients with no SBO episodes, patients who had one or more SBO episodes treated medically, and patients who had one or more SBO episodes, at least one of which was treated surgically.…”

Intraoperative, postoperative and reoperative problems with ileoanal pouches

“…Small bowel obstruction is the most common complication after IPAA. Most large studies report an incidence of between 13 and 25 per cent35, 36, which increases as follow‐up lengthens. A previous colectomy with avoidance of the use of a temporary ileostomy at IPAA reduces, but does not eliminate, the problem.…”

“…Most episodes respond to conservative management—intestinal rest, nasogastric suction and intravenous fluids—whereas about 25 per cent require operation35. Patients who have had episodes of small bowel obstruction treated conservatively have more bowel movements per day than those who either have never had small bowel obstruction or were treated surgically36.…”