Pouch dynamics--a simple test of ileo-anal pouch evacuation.
A simple technique for quantifying ileo-anal pouch evacuation has been used to compare patients with good pouch function and fully spontaneous defaecation (n = 10) to patients with a symptomatic disorder of pouch evacuation (n = 10), usually due to a pouch-anal stricture (n = 7). Pouch emptying was significantly less efficient in those with disordered evacuation (median 54% evacuated) than in those with good function (median 98% evacuated, p = 0.02) and significantly slower (median 22.4 sec vs 5.2 sec to evacuate 75% of instilled barium, p less than 0.02) even when of comparable efficiency. Testing of four further patients with high stool frequency but neither stenosis nor symptomatic difficulty with evacuation excluded a significant disorder of evacuation in three but identified inefficient emptying in the fourth. This test may prove useful in the investigation of patients with poor pouch function of uncertain origin.
Levitt
M D
MD
St. Mark's Hospital, London, UK.
Kamm
M A
MA
Nicholls
R J
RJ
D000328:Adult; D001003:Anal Canal / Q000503:physiopathology; D001464:Barium; D003672:Defecation / Q000502:physiology*; D005260:Female; D006801:Humans; D007082:Ileum / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative
D001464:Barium