Medical management of patients with ileal pouch anal anastomosis after restorative procto-colectomy.
Restorative procto-colectomy with ileal pouch anal anastomosis has become the most common elective surgical procedure for patients with ulcerative colitis and is becoming popular in those with familial adenomatous polyposis coli. The procedure itself is primarily carried out in specialist surgical centres but an increasing number are being performed and followed up in district general hospitals. These patients are now filtering through general surgical and gastroenterology clinics and are frequently seen in primary care. Pouchitis, an inflammatory condition of the ileal pouch, has become the third most important form of inflammatory bowel disease. As research develops in this area, other complications are being found. The aim of this review is to provide an up-to-date, evidence-based approach to the clinical management of these patients.
Johnson
Matthew W
MW
Gastroenterology Surgical Department, St. Mark's Hospital, Northwick Park, Harrow, Middlesex, UK.
Das
Partha
P
Dewar
David H
DH
Forbes
Alastair
A
Ciclitira
Paul J
PJ
Nicholls
Richard J
RJ
D011125:Adenomatous Polyposis Coli / Q000601:surgery; D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000209:etiology; D003093:Colitis, Ulcerative / Q000601:surgery; D039021:Colonic Pouches; D005260:Female; D006801:Humans; D008286:Malabsorption Syndromes / Q000209:etiology; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology; D019449:Pouchitis / Q000188:drug therapy* / Q000209:etiology; D016737:Proctocolectomy, Restorative; D012008:Recurrence; D012735:Sexual Dysfunction, Physiological / Q000209:etiology
D000900:Anti-Bacterial Agents