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Management of pouch related symptoms in patients who underwent ileal pouch anal anastomosis surgery for adenomatous polyposis

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World Journal of Clinical Cases 2021年第32期9卷 9847-9856页

作者： Ophir Gilad Guy Rosner Eli Brazowski Revital Kariv Nathan Gluck hana strul Department of Gastroenterology and Hepatology Tel-Aviv Sourasky Medical CenterTel Aviv 6423906Israel Department of Pathology Tel-Aviv Sourasky Medical CenterTel Aviv 6423906Israel

BACKGROUND Adenomatous polyposis syndromes(APS)patients with ileal pouch anal anastomosis(IPAA)suffer frequent symptoms with scarce signs of inflammation,distinct from ulcerative colitis *** the management of pouchitis in ulcerative colitis patients is well established,data regarding response to treatment modalities targeting pouch-related disorders in APS patient population is *** To assess clinical,endoscopic and histologic response to various treatment modalities employed in the therapy of pouch related *** APS patients who underwent IPAA between 1987-2019 were followed every 6-12 mo and pouch-related symptoms were recorded at every *** endoscopy was performed annually,recording features of the pouch,cuff and terminal ileum.A dedicated gastrointestinal pathologist reviewed biopsies for signs and severity of *** current study,files were retrospectively reviewed for initiation and response to various treatment modalities between *** included dietary modifications,probiotics,loperamide,antibiotics,bismuth subsalicylate,mebeverine hydrochloride,5-aminosalicylic acid compounds and topical rectal *** and endoscopic and histologic signs of inflammation before and after treatment were *** disease activity index(PDAI)and its subscores was *** of variables before and after therapy was assessed using Wilcoxon signed rank test for continuous variables and using McNemar's test for categorical *** Thirty-three APS patients after IPAA were *** treatment,16 patients(48.4%)suffered from abdominal pain and 3(9.1%)from bloody *** number of daily bowel movement was *** 4 patients(12.1%)had a PDAI≥*** baseline PDAI was 2.5±***,intervention was associated with symptomatic relief,mainly decreasing abdominal pain(from 48.4%to 27.2%of patients,P=0.016).Daily bowel movements decreased from a mean of 10.3 to 9.3(P=0.003).Mean ov

关键词： Familial adenomatous polyposis Adenomatous polyposis syndromes Ileal pouch anal anastomosis

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