The following is the summary of “Ileoanal Pouch Syndrome Is Common and Associated With Significant Disability in Patients With Ulcerative Colitis Undergoing IPAA” published in December 2022 issue of Diseases of the Colon & Rectum by Li, et al.

After ileoanal pouch surgery, a new syndrome called ileoanal pouch syndrome (IPS) has been postulated and described based on a set of symptoms and complications experienced by the patient. The goal of this research was to find out how frequent IPS is in  Ulcerative Colitis (UC) patients who are receiving ileal pouch-anal anastomosis (IPAA), and how much it affects their quality of life after the procedure. This research design was a cross-sectional analysis. The researchers in this study chose to conduct their work in a tertiary care facility. From October 2014 through May 2021, information on 128 IPAA was collected relating to UC.

Primary outcomes were the frequency with which IPS was seen. The median postoperative follow-up time for the 138 patients recruited was 2.64 (interquartile range [IQR]: 1.31-3.80) years. Long-term follow-up after ileostomy reversal is associated with a decreased incidence of IPS and its symptoms and complications. Pad use and fecal incontinence affected 29% and 31% of patients in terms of quality of life. The IBD-Disability Index was considerably greater in the IPS group (27.25 vs. 12.15, P<0.001) than in the non-IPS group. 4 symptoms (fecal incontinence, clustering, fragmentation, incomplete evacuation, and nocturnal symptoms) and 2 outcomes (pad usage, negative mental modifications) were associated with a higher IBD-Disability Index (P<0.05) in a multivariate analysis. 

Multivariate analysis revealed that male gender (OR, 4.485; 95% CI, 1.354-14.857; P=0.014), preoperative disease duration (OR, 1.013; 95% CI, 1.001-1.025; P=0.031), and postoperative follow-up (OR, 0.462; 95% CI, 0.244-0.876; P=0.049) were independently associated with IPS for patients followed for more than 2 years.  Unlike future large-scale multi-site longitudinal studies, this one only involved a single center. IPS is a prevalent problem that has a detrimental impact on the quality of life for patients with ulcerative colitis having IPAA, but its rate has decreased over time once ileal pouch surgery was implemented.