The role of pouch compliance measurement  in the management of pouch dysfunction.
OBJECTIVE
Ileal pouch anal anastomosis is an established option for patients who require total proctocolectomy and restoration of bowel continuity. However, the functional results are not always good and low pouch compliance has been suggested as one possible cause. We aimed to review the results of pouch compliance tests over 11 years to assess whether measuring pouch compliance is a useful diagnostic tool to guide management of pouch dysfunction.


METHODS
The results of pouch compliance tests performed between 1996 and 2007 together with the details of symptoms, treatments and outcome were reviewed.


RESULTS
One hundred and forty-one pouch compliance tests were performed. There was no difference in pouch compliance between those with overt pathology (pouchitis, pelvic sepsis or anastomotic stricture) and those with idiopathic pouch dysfunction. In this second group, there was no difference in pouch compliance between patients with and without each of the symptoms of increased defaecatory frequency, incontinence and evacuation difficulties. The results of the compliance testing did not influence the clinical decision making on idiopathic pouch dysfunction (p=0.77) nor diverted pouches (p=0.07).


CONCLUSIONS
Measuring pouch compliance does not offer new information accounting for idiopathic pouch dysfunction and has little influence on the clinical management.
Maeda
Yasuko
Y
St Mark's Hospital, Harrow, UK.
Molina
María Elena
ME
Norton
Christine
C
McLaughlin
Simon D
SD
Vaizey
Carolynne J
CJ
Laurberg
Søren
S
Clark
Susan K
SK
D000328:Adult; D000368:Aged; D039021:Colonic Pouches / Q000592:standards*; D019468:Disease Management; D005260:Female; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D034161:Pelvic Infection; D019449:Pouchitis; D016737:Proctocolectomy, Restorative / Q000592:standards*; D012189:Retrospective Studies; D018805:Sepsis; D017211:Treatment Failure; D016896:Treatment Outcome