Assessment of dietary intake and trace element status in patients with ileal pouch-anal anastomosis.
OBJECTIVE
Panproctocolectomy and ileal pouch-anal anastomosis is the operation of choice for patients with ulcerative colitis and familial polyposis. The long-term nutritional consequences after pouch surgery are unknown. We have assessed the nutritional status of the essential trace elements-zinc, copper, manganese, and selenium-in patients several years (median, 10 (range, 2-15) years) after surgery.


METHODS
Fifty-five patients with uncomplicated ileal pouch-anal anastomosis and 46 healthy control subjects were studied. A dietary assessment of trace element intake was undertaken by using a semiquantitative food frequency questionnaire. The patients' trace elements status for zinc, copper, manganese, and selenium was assessed by measuring their concentrations in blood.


RESULTS
The dietary intake of individual trace elements was similar in both groups (all P values > 0.4). There was no significant difference in the concentrations of plasma copper, zinc, and selenium between patients and healthy control subjects (all P values > 0.07). The concentration of whole blood manganese was significantly higher (P = 0.004) in patients (median, 178.5 nmol/l; range, 59-478 nmol/l) compared with healthy control subjects (median, 140 nmol/l; range, 53-267 nmol/l). Four (7 percent) patients had manganese concentrations more than three standard deviations of the mean of control group (>255 nmol/l).


CONCLUSIONS
This study shows that patients who have had uncomplicated pouch surgery have a normal dietary intake of trace elements and do not develop deficiencies in copper, zinc, manganese, and selenium. However, these patients may be at increased risk of manganese toxicity.
El Muhtaseb
Mohammad Sami H
MS
Department of Coloproctology, Lister Department of Surgery, Glasgow Royal Infirmary, Glasgow, G31 2ER, United Kingdom. muhtaseb11@hotmail.com
Duncan
Andrew
A
Talwar
Dinesh K
DK
O'Reilly
Denis St J
DS
McKee
Ruth F
RF
Anderson
John H
JH
Finlay
Ian G
IG
D011125:Adenomatous Polyposis Coli / Q000097:blood* / Q000601:surgery; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000097:blood* / Q000601:surgery; D039021:Colonic Pouches; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D016737:Proctocolectomy, Restorative; D012643:Selenium / Q000097:blood; D014131:Trace Elements / Q000097:blood*; D028561:Transition Elements / Q000097:blood
D014131:Trace Elements; D028561:Transition Elements; D012643:Selenium