title: The effect of ageing on function and quality of life in ileal pouch patients: a single cohort experience of 409 patients with chronic ulcerative colitis.
abstract: OBJECTIVE
  To evaluate in what manner ageing affects functional outcome and quality of life (QoL) in patients with chronic ulcerative colitis (CUC) after ileal pouch-anal anastomosis (IPAA).
  
  
  BACKGROUND
  Short-term function and QoL after IPAA is good. However, patients are usually young, and little is known about the influence of time and ageing on long-term outcomes after IPAA.
  
  
  METHODS
  Using a standardized questionnaire, functional outcome, QoL, and complications were assessed prospectively in a cohort of 409 patients followed annually for 15 years after IPAA.
  
  
  RESULTS
  Follow-up was complete in the single cohort of 409 patients and functional and QoL outcomes summarized at 5, 10, and 15 years. Daytime stool frequency changed little (mean 6), while nighttime frequency increased from 1 stool to 2 stools. Incontinence for gas and stool increased from 1% to 10% during the day and from 2% to 24% at night over 15 years. The cumulative probability of pouchitis increased from 28% at 5 years to 38% at 10 years and to 47% at 15 years. Bowel obstruction and stricture were other principal long-term complications. At 15 years, 91% of patients had kept the same job. Work was not affected by the surgery in 83%, while social activities, sports, traveling, and sexual life all improved after surgery and did not deteriorate over time.
  
  
  CONCLUSIONS
  These long-term results in a single cohort of 409 IPAA patients are unique and are likely a more accurate reflection of long-term outcome than has been previously reported. These data support the conclusion that IPAA is a durable operation for patients requiring proctocolectomy for CUC; functional and QoL outcomes are good, predictable, and stable for 15 years after operation.
authors.affiliation: Division of Colon and Rectal Surgery, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: Dieter
authors.initials: D
authors.lastname: Hahnloser
authors.forename: John H
authors.initials: JH
authors.lastname: Pemberton
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Wolff
authors.forename: Dirk R
authors.initials: DR
authors.lastname: Larson
authors.forename: Brian S
authors.initials: BS
authors.lastname: Crownhart
authors.forename: Roger R
authors.initials: RR
authors.lastname: Dozois
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology*; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000601:surgery*; D003108:Colonic Diseases / Q000209:etiology; D039021:Colonic Pouches / Q000502:physiology*; D003251:Constriction, Pathologic / Q000209:etiology; D003672:Defecation / Q000502:physiology; D004651:Employment; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019449:Pouchitis / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome