Nutrition considerations surrounding restorative proctocolectomy.
Restorative proctocolectomy with ileal pouch-anal anastomosis has become the surgical treatment of choice for patients with ulcerative colitis and familial polyposis coli syndromes. Pouch construction uses the distal 30-40 cm of ileum, and there exists a potential for postoperative nutrition consequences. These include vitamin B(12) deficiency, iron deficiency, bile acid malabsorption, and abnormalities of trace elements, fluids, and electrolytes. Patients who have undergone an ileal pouch-anal anastomosis procedure often describe specific food sensitivities that may require diet alteration, even more so than do patients with permanent ileostomy. There may be roles for postoperative probiotic supplementation in an attempt to decrease the rate of "pouchitis" and appropriate preoperative nutrition support to minimize the risk of perioperative complications.
Buckman
Sara A
SA
University of Wisconsin School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Madison, WI, USA.
Heise
Charles P
CP
D011125:Adenomatous Polyposis Coli / Q000601:surgery; D001003:Anal Canal / Q000601:surgery; D018798:Anemia, Iron-Deficiency / Q000209:etiology; D003093:Colitis, Ulcerative / Q000601:surgery; D039021:Colonic Pouches / Q000009:adverse effects*; D004032:Diet; D019587:Dietary Supplements; D004573:Electrolytes / Q000493:pharmacokinetics; D006801:Humans; D007081:Ileostomy; D007408:Intestinal Absorption; D052756:Nutritional Sciences; D009752:Nutritional Status; D011183:Postoperative Complications; D019449:Pouchitis / Q000209:etiology / Q000517:prevention & control; D019936:Probiotics; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D014131:Trace Elements / Q000493:pharmacokinetics; D014806:Vitamin B 12 Deficiency / Q000209:etiology
D004573:Electrolytes; D014131:Trace Elements