title: Comparison of micronutrients in patients having had panproctocolectomy and either ileal pouch anal anastomosis or Brooke ileostomy for chronic ulcerative colitis (UC).
abstract: OBJECTIVE
  Patients having panproctocolectomy undergo major metabolic changes. A recent study suggested that patients who have had a panproctocolectomy and ileal pouch-anal anastomosis (IPAA) may be trace element-deficient, while other recent evidence has suggested a gradual decrease in vitamin B12. This study was undertaken to compare patients who had a panproctocolectomy for UC in combination with either an IPAA or a Brooke ileostomy (BI), and to determine whether the type of surgery post-proctocolectomy influences the absorption of trace elements, as well as comparing the levels after both operations with the normal population values.
  
  
  METHODS
  One hundred randomly selected patients who had had a panproctocolectomy for UC (50 IPAA, 50 BI) were invited to take part in the study by letter. The patients who consented had blood taken for haemoglobin, serum iron, ferritin, serum folate, red cell folate, vitamin B12, insulin-like growth factor-1 (IGF-1), albumin, and the trace elements copper, magnesium, manganese, selenium, and zinc.
  
  
  RESULTS
  Of the 100 patients, 46 consented to participate in the study (23 IPAA, 23 BI). The age of the BI group was significantly higher than those of the IPAA group (mean age IPAA 44 years, BI 52 years, P < 0.05). There was no significant difference between the two groups with respect to time since operation, mean levels of haemoglobin, iron indices, albumin, serum and red cell folate, vitamin B12, or any of the trace elements examined. Plasma IGF-1 was higher in the IPAA group, but this was no longer significant when adjusted for age.
  
  
  CONCLUSIONS
  No difference was found in trace element status in patients who had had a panproctocolectomy for UC with either an IPAA or BI. Furthermore, no difference existed between these two groups.
authors.affiliation: Departments of Surgery, Endocrinology, and Pathology, Christchurch Hospital, Christchurch, New Zealand.
authors.forename: E
authors.initials: E
authors.lastname: Whineray
authors.forename: W J
authors.initials: WJ
authors.lastname: Inder
authors.forename: D
authors.initials: D
authors.lastname: Roche
authors.forename: B R
authors.initials: BR
authors.lastname: Dobbs
authors.forename: F A
authors.initials: FA
authors.lastname: Frizelle