Long-Term Adjustment to Living With an Ileal Pouch-Anal Anastomosis

Abstract

Most participants had adjusted well to life with an ileal pouch-anal anastomosis and considered life to be normal. Good public restrooms were important for quality of life. Improving pouch function may help patients adjust to the postoperative state, but deeper understanding of reasons for poor adjustment despite good pouch function is needed.

Chronic Illness and Disordered Eating: A Discussion of the Literature

“…For instance, many patients with an ileal pouch-anal anastomosis reported food restrictions and complained about "being unable to eat different kinds of food, having to bring their own food outside the home, worrying about food making them ill, and having to eat often to feel well" (73). Patients also reported avoiding certain foods such as milk and onions that had the potential to cause a blockage (73).…”

“…"The chronic, unpredictable gastrointestinal symptoms and complications that occur with IBD, along with the required treatments, all impose psychological and social stresses on young patients" (72). A qualitative content analysis of young patients with an ileal pouch-anal anastomosis revealed that living a "normal" life, physical limitations, food restrictions, availability of restrooms in social situations, and being dependent on medical care were emergent themes (73). For instance, many patients with an ileal pouch-anal anastomosis reported food restrictions and complained about "being unable to eat different kinds of food, having to bring their own food outside the home, worrying about food making them ill, and having to eat often to feel well" (73).…”

“…A qualitative content analysis of young patients with an ileal pouch-anal anastomosis revealed that living a "normal" life, physical limitations, food restrictions, availability of restrooms in social situations, and being dependent on medical care were emergent themes (73). For instance, many patients with an ileal pouch-anal anastomosis reported food restrictions and complained about "being unable to eat different kinds of food, having to bring their own food outside the home, worrying about food making them ill, and having to eat often to feel well" (73). Patients also reported avoiding certain foods such as milk and onions that had the potential to cause a blockage (73).…”

“…Eating disorder screening tools used in the general population have the potential to misclassify eating disorder risk in those with chronic illness due to (70,73) Weight and shape concerns (e.g., weight gain from steroid treatments) (70) Poor body image (i.e., presence of cushingoid features) (75,78) Poor emotional well-being (e.g., depression, self-esteem) (72) Disease severity (e.g., need surgery to remove part of the intestinal tract) (78) Body shame (e.g., use of colostomy or ileostomy bag) (78) Limited social functioning (70) Impaired interpersonal relationships (peers and significant others) (72) Physical limitations (decreased energy levels) (70) the nature of the questions possibly reflecting skills and attitudes learned as part of disease management. For instance, a question such as "Have you tried to follow definite rules regarding your eating?"…”

Quality of life after surgery in individuals with familial colorectal cancer: does extended surgery have an adverse impact?

“…Low anterior resection with total mesorectal excision may be associated with a high rate of functional disability, particularly if radiation is given . Ileal pouch anal anastomosis also carries a significant rate of bowel dysfunction and risk of episodic pouchitis . Although there is little data available, it is likely that pouch dysfunction would be compromised further by neoadjuvant or especially adjuvant radiation.…”