The Optimal Ileal Pouch: Physiologic Parameters Significantly Correlate with Overall Pouch Function

Melvin, Joseph C.; Harms, Bruce A.; Heise, Charles P.; Leverson, Glen; Carchman, Evie H.

doi:10.1007/s11605-020-04617-3

“…Optimal function and QoL depend in part on maintaining optimal pouch compliance and pressure differentials between the pouch and anal canal, defined by the pouch-anal pressure gradient. 38…”

Section: Discussionmentioning

confidence: 99%

“…Optimal function and QoL depend in part on maintaining optimal pouch compliance and pressure differentials between the pouch and anal canal, defined by the pouch-anal pressure gradient. 38 As the first patient-centered report on the outcomes of pouch surgery, IPS can accurately and comprehensively reflect the bowel function of patients after pouch operation. However, the scope of symptoms and consequences included in IPS is not clearly defined, and fortunately, work is underway.…”

Section: Discussionmentioning

confidence: 99%

Ileoanal Pouch Syndrome Is Common and Associated With Significant Disability in Patients With Ulcerative Colitis Undergoing IPAA

Li

¹

,

Ding

²

,

Zhu

³

et al. 2022

Diseases of the Colon &Amp; Rectum

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“…In a similar study, Melvin et al 3 defined “ideal” pouch function as 6 or fewer bowel movements per 24 hours, with no nighttime bowel movements and no incontinence, day or night. They measured a variety of physiological parameters to define a dysfunctional pouch scientifically.…”

Section: Methodsmentioning

confidence: 99%

Functional Disorders of the Ileal–Anal Pouch: A Systematic Review

Church

2024

Diseases of the Colon &Amp; Rectum

1

0

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BACKGROUND: The ileal pouch-anal anastomosis is a boon to patients needing proctocolectomy but maintains per anal function through anatomic and physiologic compromises. The state of pouch function is hard to define as pouch anatomy is not normal and pouch physiology is a distortion of normal defecation. Patients with pouches develop multiple symptoms; some expected, some disease related, and some the result of surgical complications. It is important to understand the cause of pouch related symptoms so that the appropriate management is offered. OBJECTIVES: Review pouch symptoms and discuss their likely cause. Review the literature on pouch function and dysfunction and provide clarity to the confusion. DATA SOURCES: PubMed and Cochrane database search using the terms “ileoanal pouch function” and “ileoanal pouch dysfunction.” STUDY SELECTION: A total of 553 articles from 1983 to 2023 from “ileoanal pouch function” and 178 from “ileoanal pouch dysfunction” were reviewed. Nine studies appeared under both headings. Case studies, duplicate publications, and articles concerning pouch diseases were excluded. MAIN OUTCOME MEASURES: Definitions of pouch function and dysfunction, methods of describing and scoring symptoms, understanding of expected changes in pouch function given the nature of the surgery. RESULTS: Twenty-seven studies were reviewed from the ileoanal pouch dysfunction search, and 38 from ileoanal pouch function. 3 studies tried to define normal pouch function, 10 attempted to measure pouch function, and 4 aimed at scoring pouch function. Only 3 papers addressed pouch physiology. CONCLUSIONS: Most studies of pouch function and dysfunction don’t consider expected changes in the physiology of defecation that follow restorative proctocolectomy. This means that most studies of pouch function produce conclusions that lack an important dimension. See symposium video.

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Patient-reported Outcome Measures in Ileoanal Pouch Surgery: a Systematic Review

Warsop,

Manzo,

Yu

et al. 2023

Journal of Crohn's and Colitis

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Objective To summarize frequency, type, and heterogeneity of Patient Reported Outcomes Measures (PROMs) in papers reporting on outcomes after Ileal Pouch Anal Anastomosis (IPAA). Background Prevalence of Ulcerative Colitis (UC) has risen in Western Countries, and 1 in 3 patients requires surgery. IPAA is a frequently performed procedures for UC, and a lack of standardization is manifest in reporting outcomes for Inflammatory Bowel Disease (IBD) despite the clear need for inclusion of PROMs as primary outcomes in IBD trials. Methods Scopus, Pubmed and Web of Science databases were searched from January 2010 to January 2023 for studies investigating outcomes in IPAA surgery. The primary outcome was the proportion of studies reporting outcomes for IPAA surgery for UC which included PROMs. Results The search identified a total of 8028 studies which, after deduplication and exclusion, were reduced to 79 articles assessing outcomes after IPAA surgery. 44 (55.7%) reported PROMs, with 23 including validated questionnaires and 21 papers using authors’ questions. 22 different PROMs were identified, with bowel function as the mostly investigated item. Majority of studies (67/79, 85%) were retrospective, only 14/79 (18%) prospective papers and only 2 (2.5%) randomized controlled trials. Conclusions Only half of the papers reviewed used PROMs. The main reported item is bowel function, whilst urogenital, social, and psychological function are the most neglected. There is lack of standardisation for use of PROMs in IPAA. Complexity of UC and of outcomes after IPAA demands a change in clinical practice and follow up given how crucial PROMs are, compared to their non-routinary use.

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The Optimal Ileal Pouch: Physiologic Parameters Significantly Correlate with Overall Pouch Function

Cited by 4 publications

References 15 publications

Ileoanal Pouch Syndrome Is Common and Associated With Significant Disability in Patients With Ulcerative Colitis Undergoing IPAA

Ileoanal Pouch Syndrome Is Common and Associated With Significant Disability in Patients With Ulcerative Colitis Undergoing IPAA

Functional Disorders of the Ileal–Anal Pouch: A Systematic Review

Patient-reported Outcome Measures in Ileoanal Pouch Surgery: a Systematic Review

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