Pouch pressures and motility in relation to functional results of the ileal pouch-anal anastomosis

Abstract:

The aim of the present study was to evaluate pouch motility and sphincter function in relation to longterm functional outcome in ileal pouch patients. Nineteen patients with restorative proctocolectomy for ulcerative colitis were divided into two functional groups (good vs poor) on the basis of the frequency of defaecation and symptoms of soiling and faecal leakage, no patient used a pad during daytime. Ambulatory manometry with double-sensor micro-transducer was used to measure the pouch and sphincter pressures simultaneously in different postures during fasting (after defaecation), after a standardized meal and until desire for defaecation. There was no difference in sphincter pressures between the groups. Poor function was characterized by a higher resting pouch pressure in the lying position both after defaecation and at desire for defaecation. The resting pouch pressure was significantly higher in standing than in lying position in both groups. The median amplitude of pouch contraction pressure was higher in the group with poor than with good function. In conclusion functional disturbances in our patient population may be related to changes in the resting pouch pressure and motility.