Ileoanal pull-through: a new surgical alternative to ileostomy and a new challenge in diet therapy

Colectomy mucosal proctectomy, and endorectal ileoanal pull-through is presently considered the best alternative for many patients with chronic ulcerative colitis, familial polyposis, and Gardner's syndrome. Although continence is achieved in nearly all patients who undergo the operation, high stool frequency and poor stool consistency are not infrequently encountered, particularly in the early postoperative period. Dietary control plays a likely role in postoperative management. At present, however, there are no published data to support specific dietary interventions. On the basis of our clinical experience and some preliminary study results, we have developed a comprehensive dietary regimen which is outlined in Table 1. Many questions in regard to the optimal diet for this patient population are presently unanswered, thus opening an exciting new area of nutrition research.