Ileoanal pouch function and release of peptide YY.
OBJECTIVE
This study evaluates peptide tyrosine-tyrosine (PYY), intestinal transit, fecal retention time, and anal sphincter manometry in colectomized patients with ileal pouch-anal anastomosis.


METHODS
Plasma and pouch PYY, mouth-to-pouch transit time, fecal retention time, and anal canal pressures were studied in 27 patients with ileoanal pouches a mean of 50 (range, 3-84) months after loop ileostomy closure.


RESULTS
Basal and peak postprandial plasma PYY were significantly reduced in patients with pouches compared with controls (P < 0.0001). Pouch PYY was decreased compared with control ileal PYY (P = 0.0003). No significant correlation was noted between intestinal transit and total integrated PYY response in patients with pouches (r=0.36; P=0.06). Fecal retention time was related to postprandial total integrated response of plasma PYY (r=0.43; P=0.02), mouth-to-pouch transit (r=0.87; P < 0.0001), and resting (r=0.44; P=0.02) and squeeze (r=0.62; P=0.0006) anal sphincter pressures.


CONCLUSIONS
Colectomized ileoanal patients with pouches showed decreased plasma and pouch PYY compared with controls. Intestinal transit was not significantly related to PYY release. However, prolonged pouch fecal retention was associated with greater PYY release, mouth-to-pouch transit, and anal sphincter pressures.
Section of Colon and Rectal Surgery, Creighton University School of Medicine, Omaha, Nebraska 68131, USA.
C A
CA
Ternent
P
P
Staab
A G
AG
Thorson
G J
GJ
Blatchford
M A
MA
Christensen
J S
JS
Thompson
S J
SJ
Lanspa
P G
PG
Meade
R A
RA
Cali
P M
PM
Falk
S M
SM
Sentovich
T E
TE
Adrian
D000293:Adolescent; D000328:Adult; D001944:Breath Tests; D003093:Colitis, Ulcerative / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008875:Middle Aged; D019894:Peptide YY / Q000097:blood / Q000378:metabolism*; D011184:Postoperative Period; D016737:Proctocolectomy, Restorative
D019894:Peptide YY