Long-term Clinical Outcome and Anemia after Restorative Proctocolectomy for Ulcerative Colitis

Abstract

Minor morbidity is common after RPC. Pouchitis occurred in half of our patients during long-term follow-up. There may be a risk of anemia with chronic pouchitis and bleeding from the pelvic pouch mucosa.

Risk Factors for Anemia in Patients with Ileal Pouch-Anal Anastomosis

“…Severe or chronic pouchitis seemed to predispose to anemia, and eight of ten anemic patients had chronic pouchitis. 9 A third study with 83 patients who underwent IPAA reported only 4 percent with low Hgb values (< 13 g/dl males, < 11.5 g/dl females) at 12-month follow-up after surgery. 10 The anemia prevalence in that study was much higher before the colectomy, which may be attributed to hematochezia.…”

“…Only a few studies in the past have addressed the long-term morbidity in patients after restorative proctocolectomy. Previous 9 and a median follow-up after surgery of 9.8 (range, 7.8-11.9) years reported 10 patients (20.8 percent) with anemia (Hgb < 13 g/dl males, and Hgb < 12 g/dl females). 9 Two patients required vitamin B 12 supplement therapy, whereas iron deficiency anemia was present in five patients (1 female and 4 males).…”

“…Previous 9 and a median follow-up after surgery of 9.8 (range, 7.8-11.9) years reported 10 patients (20.8 percent) with anemia (Hgb < 13 g/dl males, and Hgb < 12 g/dl females). 9 Two patients required vitamin B 12 supplement therapy, whereas iron deficiency anemia was present in five patients (1 female and 4 males). 9 Among those patients, two had ulceration in the pelvic pouch, one had Crohn_s disease of the pouch, and one had bleeding from the pelvic pouch mucosa.…”

“…9 Two patients required vitamin B 12 supplement therapy, whereas iron deficiency anemia was present in five patients (1 female and 4 males). 9 Among those patients, two had ulceration in the pelvic pouch, one had Crohn_s disease of the pouch, and one had bleeding from the pelvic pouch mucosa. Severe or chronic pouchitis seemed to predispose to anemia, and eight of ten anemic patients had chronic pouchitis.…”

“…[8][9][10][11] The identification of underlying causes in IPAA patients can be challenging. Demographic and clinical features of IPAA patients with anemia have not been systematically evaluated.…”