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Long-Term Outcome After Ileal Pouch-Anal Anastomosis: Function and Health-Related Quality of Life

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Diseases of the Colon & Rectum

Purpose

This study was designed to investigate long-term pouch function and health-related quality of life in a single, large cohort of patients with ileal pouch-anal anastomosis for ulcerative colitis.

Methods

Data from 370 patients were included in the study. Thirty-nine patients (11 percent) did not have a functioning pouch (failures) but were included in the health-related quality of life analyses. Pouch function (Öresland score) and health-related quality of life (Short Form-36) were evaluated by postal questionnaires. A total of 88 percent of the patients with a functioning ileal pouch-anal anastomosis returned the questionnaires vs. 76 percent of the failures. Median follow-up time after ileal pouch-anal anastomosis was 15 years vs. 11 years after failure. An age-matched and gender-matched reference sample (n = 286) was randomly drawn from the Swedish Short Form-36 database.

Results

Median bowel frequency was six per 24 hours: 76 percent emptied the reservoir at night, 23 percent had urgency, 12 percent had evacuation difficulties, and 17 percent experienced soiling during the day. Fifty-two percent of the males and 32 percent of the females suffered from soiling at night. More than one-half of the patients had occasional perianal soreness, 6 percent considered the pouch to be a social handicap, and 94 percent were satisfied with their pouch. Patients with a functioning ileal pouch-anal anastomosis did not differ from the reference sample on any Short Form-36 domain, except for a reduced score in General Health (P = 0.02). Pouch function was positively correlated to health-related quality of life. Patients with pouch failure had reduced health-related quality of life in most domains.

Conclusions

Patients’ satisfaction is high and functional outcome is good after ileal pouch-anal anastomosis. Poor pouch function affects health-related quality of life negatively. Patients with failure after ileal pouch-anal anastomosis are substantially limited in a variety of health-related quality of life domains.

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Acknowledgment

The authors thank Charles Taft, Ph.D., Health Care Research Unit, Sahlgrenska University Hospital for providing the SF-36 normative sample.

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Authors and Affiliations

  1. The Colorectal Unit, Sahlgrenska University Hospital/Östra, S-416 85, Göteborg, Sweden

    Ina Berndtsson Ph.D., Elisabet Lindholm M.S., Tom Öresland Ph.D. & Lars Börjesson Ph.D.

Authors
  1. Ina Berndtsson Ph.D.
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  2. Elisabet Lindholm M.S.
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  3. Tom Öresland Ph.D.
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  4. Lars Börjesson Ph.D.
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Corresponding author

Correspondence to Ina Berndtsson Ph.D..

Additional information

Supported by the Department of Surgery, Sahlgrenska University Hospital, and by the Anna-Lisa and Bror Björnsson Foundation.

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Berndtsson, I., Lindholm, E., Öresland, T. et al. Long-Term Outcome After Ileal Pouch-Anal Anastomosis: Function and Health-Related Quality of Life. Dis Colon Rectum 50, 1545–1552 (2007). https://doi.org/10.1007/s10350-007-0278-6

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  • DOI: https://doi.org/10.1007/s10350-007-0278-6

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