Table of Contents
ISRN Gastroenterology
Volume 2011 (2011), Article ID 430171, 8 pages
http://dx.doi.org/10.5402/2011/430171
Clinical Study

Long-Term Followup of Patients with Active J-Reservoirs after Restorative Proctocolectomy for Ulcerative Colitis with regard to Reservoir Function, Mucosal Changes, and Quality of Life

1Department of Gastrointestinal Surgery, Akershus University Hospital, 1478 Lørenskog, Norway
2Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
3Department of Surgery, Diakonissehjemmet Hospital, Haraldsplass, 5021 Bergen, Norway
4Department of Surgery, Haukeland University Hospital, 5021 Bergen, Norway
5Centre for Clinical Research, Haukeland University Hospital, 5021 Bergen, Norway
6Research Group on Lifestyle Epidemiology, Department of Public Health and Primary Health Care, University of Bergen, 5020 Bergen, Norway
7Department of Pathology, Ullevaal University Hospital, 0424 Oslo, Norway

Received 18 May 2011; Accepted 15 June 2011

Academic Editor: J. M. Pajares

Copyright © 2011 Ola Røkke et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Study the functional results and mucosal changes in the ileal pouch after restorative proctocolectomy with J-reservoir for ulcerative colitis. Material and Methods. Followup study of 125 patients with J-reservoir with one disease-specific- and one general (SF-36) quality of life-questionnaire, rectoscopy with biopsies, and stool samples to evaluate inflammation, dysplasia, presence of Helicobacter pylori and calprotectin level. Results. Fourteen J-reservoirs were removed or deactivated, leaving 111 patients for followup. The followup time was 6.8 (1–15) years. 87.4% of the patients were satisfied. 93.1% had some kind of functional restriction: food- (75.5%), social- (28.9%), physical- (37%) or sexual restriction (15.3%). 18.6% had often or sometimes faecal incontinence. Low daytime faecal frequency was associated with good quality of life. 13 patients (12.6%) had a less favourable result. There was no pouch-dysplasia. Calprotectin levels were increased in patients with visible pouch inflammation or history of pouchitis. HP was diagnosed by RUT in 42.3%, but was not associated with inflammation or pouchitis. Conclusions. Most patients were satisfied with the J-reservoir in spite of a high frequency of various restrictions. 12.6% (13 patients) had a less favourable functional result, partly due to a high frequency of defecations, pain, pouchitis and inflammation.