Functional outcome after restorative proctocolectomy

Incontinence and pouchitis are complications that affect most patients who have undergone restorative proctocolectomy. Incontinence, with particular regard to night leakage, is related to the combination of poorly functioning ileal reservoir and poor anal sphincter function. Pouchitis, the major late complication of restorative proctocolectomy, is quite similar to the previous inflammatory bowel disease. Pouchitis has an important impact on functional results after restorative proctocolectomy, causing a significant increase in defecation frequency, pain on evacuation, urgency, watery bowel movements, bloody diarrhea, anal irritation and stool leakage. In particular, chronic pouchitis can cause distress, anxiety and disappointment for patients needing continuous treatment. The influence of anal sphincter and ileal pouch function on clinical outcome after ileal pouch-anal anastomosis (IPAA) is reviewed, together with the correlation between ileal pouch function and pouchitis. The possible correlation between pouchitis and long-term functional outcome after restorative proctocolectomy is examined. Received: 28 May 1998 / Accepted in revised form: 22 September 1999