Long term metabolic consequences of ileal pouch-anal anastomosis for ulcerative colitis

Kuisma, Juha; Nuutinen, Hannu; Luukkonen, Pekka; Järvinen, Heikki; Kahri, Arvi; Färkkilä, M.

doi:10.1111/j.1572-0241.2001.05256.x

Cited by 29 publications

(40 citation statements)

References 32 publications

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“…However, the invasive nature and cost of endoscopy, and frequent episodes in some patients with pouchitis, may prevent its routine use in every episode of symptom flare-ups. Laboratory testing in these patients may offer alternatives to endoscopy [43].…”

Section: Laboratory Testsmentioning

confidence: 99%

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Diagnosis and Management of Pouchitis and Ileoanal Pouch Dysfunction

Navaneethan

Shen

2010

Curr Gastroenterol Rep

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Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the surgical treatment of choice for patients with medically refractory ulcerative colitis (UC) or UC with dysplasia and for the majority of patients with familial adenomatous polyposis. However, UC patients with IPAA are susceptible to inflammatory and noninflammatory sequelae, such as pouchitis, Crohn's disease of the pouch, cuffitis, and irritable pouch syndrome, in addition to common surgery-associated complications, which adversely affect the surgical outcome and compromise health-related quality of life. Pouchitis is the most frequent long-term complication of IPAA in patients with UC, with a cumulative prevalence of up to 50%. Pouchitis may be classified based on the etiology into idiopathic and secondary types, and the management is often different. Pouchoscopy is the most important tool for the diagnosis and differential diagnosis in patients with pouch dysfunction. Antibiotic therapy is the mainstay of treatment for active pouchitis. Some patients may develop dependency on antibiotics, requiring long-term maintenance therapy. Although management of antibiotic-dependent or antibiotic-refractory pouchitis has been challenging, secondary etiology for pouchitis should be evaluated and modified, if possible.

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Section: Laboratory Testsmentioning

confidence: 99%

“…Fecal inflammatory markers reflect closely the presence of intestinal inflammation [43]. Fecal pyruvate kinase (PK) has been investigated in IPAA patients, who had significantly higher levels of fecal PK in pouchitis than did patients with normal pouch [47].…”

Section: Laboratory Testsmentioning

confidence: 99%

Diagnosis and Management of Pouchitis and Ileoanal Pouch Dysfunction

Navaneethan

Shen

2010

Curr Gastroenterol Rep

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“…[3][4][5][6] This may explain why patients with pouches develop vitamin B 12 deficiency and bile salt malabsorption. [7][8][9] Despite the fact that many thousands of pouch operations have been performed worldwide, little is known about the longterm nutritional sequelae of ileal pouch reconstruction.…”

mentioning

confidence: 99%

Assessment of Dietary Intake and Trace Element Status in Patients with Ileal Pouch-Anal Anastomosis

Muhtaseb

Duncan

Talwar

et al. 2007

Diseases of the Colon &Amp; Rectum

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“…Bei Patienten mit IPS ist diese eingeschränkte Lebensquali- Da die klinische Differenzierung im Einzelfall manchmal schwierig ist, kann eine morphometrische Erfassung der Krypten-/Zottenhöhe in der Pouchmukosa zur Beschreibung der mukosalen Transformation hilfreich sein. Nur bei Patienten mit chronischer Pouchitis findet sich eine (nahezu) komplette Zottenatrophie, deren Nachweis letztlich dieses Patientenkollektiv definiert [12,27,30,32].…”

Section: Komplikationen Und Probleme Mit Dem Pouchunclassified

Ileoanale Pouch-Operation

Stallmach

Schmidt

2007

Internist

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Restorative proctocolectomy with an ileal pouch-anal anastomosis is the treatment of choice in patients with ulcerative colitis (UC) and familial adenomatous polyposis requiring surgical therapy. Pouchitis is the most frequent complication, occurring in up to 50% of patients with underlying UC. Clinical symptoms of the disease are non-specific. Moreover, surgical complications must be differentiated from idiopathic pouchitis using pouchoscopy, endoscopic ultrasound or MRI of the pelvis in certain cases. The therapy for idiopathic pouchitis, its etiology and pathophysiology being unclear, is based on antibiotic treatment, usually with metronidazole or ciprofloxacin. Probiotics such as VSL#3 can be used to prevent relapse. In summary, the clinical and functional outcomes are excellent and stable for 20 years after surgery.

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Long term metabolic consequences of ileal pouch-anal anastomosis for ulcerative colitis

Abstract: Metabolic consequences after IPAA are associated with pouchitis, grade of villous atrophy, and extent of inflammation in the remaining ileum. Patients with active chronic inflammation need long term follow-up.

Cited by 29 publications

References 32 publications

Diagnosis and Management of Pouchitis and Ileoanal Pouch Dysfunction

Diagnosis and Management of Pouchitis and Ileoanal Pouch Dysfunction

Assessment of Dietary Intake and Trace Element Status in Patients with Ileal Pouch-Anal Anastomosis

Ileoanale Pouch-Operation

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