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Defining normal pouch function in patients with ileal pouch-anal anastomosis: a pilot study
Kevin P Quinn1, Irene A Busciglio2, Duane D Burton2
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Alimentary Pharmacology & Therapeutics
|March 11, 2022
Summary
Many patients with ileal pouch-anal anastomosis (IPAA) have asymptomatic pouch abnormalities. This study defines normal objective parameters for ano-pouch function in healthy IPAA patients, aiding in diagnosing defecation disorders.
Area of Science:
- Gastroenterology and surgical outcomes
- Anorectal physiology and imaging
Background:
- Ileal pouch-anal anastomosis (IPAA) is common for ulcerative colitis.
- Most patients report good functional outcomes post-IPAA.
Purpose of the Study:
- To assess objective anorectal function in asymptomatic IPAA patients.
- To identify normal parameters for defecation tests in this population.
Main Methods:
- Recruited 18-65 year old patients with self-reported healthy pouch function.
- Excluded patients with pouchitis, Crohn's, or strictures.
- Utilized high-resolution ano-pouch manometry, balloon expulsion test, pouch barostat, and MR defecography.
Main Results:
- 14 asymptomatic patients completed testing; 6 were excluded for abnormalities.
- Defined mean pressures, balloon expulsion time, and MR defecography findings.
- Established reference values for objective anorectal tests in healthy IPAA patients.
Conclusions:
- A significant number of asymptomatic IPAA patients have underlying pouch abnormalities.
- Proposed normal parameters for key anorectal tests in asymptomatic IPAA patients.
- Aids in diagnosing defecation disorders in the IPAA population.
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