title: Quality of life, social impact and functional outcome following ileal pouch-anal anastomosis for ulcerative colitis and familial adenomatous polyposis.
abstract: This study aims to assess quality of life (QoL), functional outcome, and social impact following ileal pouch anal anastomosis (IPAA) for ulcerative colitis (UC) and familial adenomatous polyposis (FAP) since Indian data is limited. Data was collected prospectively from patients who underwent IPAA for UC or FAP from 2004 to 2013. QoL and functional outcome at 1, 3, and 5 years after surgery, return to work, and change of job (social impact) were documented. QoL was assessed using the validated Cleveland Global Quality of Life (CGQL) score, the normal score being 1.0. Twenty-five patients were analyzed. Mean CGQL scores before surgery and at 1, 3, and 5 years were 0.5, 0.63, 0.73, and 0.8, respectively. FAP patients had better scores at 3 and 5 years. Only 40 % returned to same job. Sixty-four percent returned to work within a year. The median number of bowel movements per 24 h was less for FAP patients at 3 and 5 years. UC patients on long-term steroids had poorer function at 3 years. Long-term QoL and functional outcomes following IPAA are acceptable. Initial deterioration in QoL, mainly in FAP and long-term adverse social impact in both groups should not be underestimated. UC patients on long-term steroids showed delayed improvement in pouch function.
authors.affiliation: Department of Surgical Gastroenterology, Medical College, Trivandrum, 695 011, India, drravirams@rediffmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Raviram
authors.forename: Ramesh
authors.initials: R
authors.lastname: Rajan
authors.forename: R S
authors.initials: RS
authors.lastname: Sindhu
authors.forename: N
authors.initials: N
authors.lastname: Bonny
authors.forename: A P
authors.initials: AP
authors.lastname: Kuruvilla
authors.forename: N
authors.initials: N
authors.lastname: Subhalal
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D000328:Adult; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods; D003093:Colitis, Ulcerative / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000379:methods* / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D012917:Social Adjustment; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult