Patients Undergoing Ileoanal Pouch Surgery Experience a Constellation of Symptoms and Consequences Representing a Unique Syndrome

Abstract

This brief discusses the definition of nominal group technique; how to prepare for it; the four-step process to conduct it; when to use it; and the disadvantages and advantages of its use.

Defining normal pouch function in patients with ileal pouch‐anal anastomosis: a pilot study

“…Complicating this is the variability in how functional outcomes after IPAA are defined and the lack of standardisation in which symptoms are reported. 7,8 Functional disorders of the pouch include irritable pouch syndrome and pouch evacuation disorders such as dyssynergic defecation of the pouch. 9 Analogous to patients with an intact colon and rectum, impaired pouch evacuation may be driven by paradoxical contraction or inadequate relaxation of pelvic floor muscles (i.e., dyssynergic defecation of the pouch) and/or reduced propulsive forces during attempted defecation.…”

“…While much is known regarding the diagnosis and management of postoperative and inflammatory complications of the pouch, including pouchitis, functional pouch disorders remain largely undefined and poorly understood. Complicating this is the variability in how functional outcomes after IPAA are defined and the lack of standardisation in which symptoms are reported 7,8 . Functional disorders of the pouch include irritable pouch syndrome and pouch evacuation disorders such as dyssynergic defecation of the pouch 9 .…”

Editorial: what is normal function of a pelvic pouch?

“…However, to truly get the whole picture physiology findings also needs to be correlated to specific symptoms. 3 Second, it is difficult to define the healthy pouch. Out of the 25 patients with self-reported normal function only 14 were asymptomatic and/or without abnormalities on MR imaging.…”

“…This spotlights that previous quantifications of pouch function may have been biased by our perceptions as clinicians. Importantly, based on patient‐reported outcomes after pouch surgery and patient involvement, a Delphi process has recently come up with a consensus definition of an ileoanal pouch syndrome, 3 with an intent to eventually provide a clinically useful scoring for pouch dysfunction.…”

“…The study by Quinn et al, 1 makes it obvious that we could—and should—aim for adding objective functional data as physiology and dynamic MR may augment, and complement, self‐reported function scores. However, to truly get the whole picture physiology findings also needs to be correlated to specific symptoms 3 …”