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At least 109 records · Page 6Linked to original sources
PubMed2003

Quality of life before and after proctocolectomy and IPAA in patients with ulcerative proctocolitis--a prospective study.

OBJECTIVE: The principal aim of the present investigation was to study the general QoL and disease-specific adjustment before, and one-year after, operation with an ileal pouch anal-anastomosis (IPAA) in a consecutive series of patients with ulcerative colitis (UC). PATIENTS AND METHOD: Eleven patients were medically treated and 31 patients underwent colectomy with ileostomy. The patients were interviewed before the IPAA operation and again one-year after closure of the covering loop ileostomy. General quality of life was estimated with a Swedish instrument (according to Kajandi, score range 16-96) and a VA-scale. The instrument for disease-specific adjustment contained specific questions with five factors (score range 34-204). Open questions about quality of life were used to identify areas of concern, which were not included in the other instruments. Postoperative function was described in terms of a functional score (score range 0-15). RESULTS: The results of the general quality of life assessments did not differ significantly when comparing pre-operative to postoperative values. Disease-specific adjustment showed that the medically treated patients had a score of 162; interquartile range (IQR) 145-176. The patients with ileostomy scored 164; IQR 141-180. Postoperatively there was a statistically significant improvement in both groups to 189 (IQR 172-199), an increase of 15%. The open questions revealed restrictions in daily life for both patient groups pre-operatively with improvements after IPAA. The median grading of functional outcome according to the score system was 2. The most frequent problems were: patients who had occasional bowel movements at night, 40%; intermittent perianal soreness, 51%; antidiarrhoeal medication use, 61%. CONCLUSION: General QoL did not change after IPAA. The bowel-specific adjustment in most factors improved in the majority of patients after IPAA. However, half of the IPAA patients had occasional bowel movements at night perianal soreness, and used antidiarrhoeal medication.

Adult↗
PubMed1992

Epidemiological study of ulcerative proctocolitis in Indian migrants and the indigenous population of Leicestershire.

A retrospective epidemiological study of ulcerative colitis (UC) and proctitis was performed in Leicestershire from 1972-89. Potential cases were identified from hospital departments of pathology, endoscopy, and medical records and from general practitioners. The county population includes more than 93,000 South Asians. There were 573 cases of UC and 286 of proctitis in Europeans and 115 cases of UC and 29 of proctitis in South Asians. The standardised incidence of UC in Europeans and South Asians was stable, except in Sikhs in whom it had increased rapidly. The relative risk of UC to South Asians was 2.45. The standardised incidences of UC in South Asians during the 1980s were: 10.8/10(5)/year in Hindus (95% confidence interval (CI) 7.4-14.1 cases/10(5)/year) 16.5/10(5)/year in Sikhs (95% CI 7.9-25.2 cases/10(5)/year), and 6.2/10(5)/year in Muslims (95% CI 1.6-10.9 cases/10(5)/year). There was no difference in incidence between Asians from East Africa and India. The standardised incidence of UC in Europeans was 5.3/10(5)/year (95% CI 4.3-6.3 cases/10(5)/year). The standardised incidences of proctitis were 3.1/10(5)/year (95% CI 1.9-2.5 cases/10(5)/year) in South Asians and 2.3/10(5)/year (95% CI 1.8-2.4 cases/10(5)/year) in Europeans. Ethnic groups had a similar disease distribution, except Sikhs in whom it was less extensive. Despite the similar disease distribution, South Asians had fewer operations and complications from UC than Europeans. There was a bimodal age specific incidence in Europeans, but not in other ethnic groups. First and second generation South Asians were at similar risk. Hindus and Sikhs have a significantly higher incidence of UC than Europeans in Leicestershire.

Adolescent↗
PubMed1999

[Surgical treatment of hemorrhagic proctocolitis].

Surgical treatment of chronic ulcerative colitis requires restorative proctocolectomy with ilial pouch-anal anastomosis to remove all the disease bowel and provide cure. A one-stage or two-stage procedure can be performed after subtotal colectomy with ileostomy and colostomy. Restorative proctocolectomy is not advised for very old patients or patients with anal sphincter insufficiency. In such cases, total colectomy with ileo-rectal anastomosis is proposed. The rectal stump must be examined regularly by rectoscopy because of the risk of cancer. A proctocolectomy with definitive ileostomy is proposed after pouch-anal excision for pelvic septic complications (5% of ileal pouch-anal anastomoses). Surgical treatment of chronic ulcerative colitis is indicated when medical treatment fails, at onset of fulminant acute colitis, or because of colorectal dysplasia.

Aged↗
PubMedDate not supplied

[Surgical treatment of ulcerative rectocolitis: technical aspects of total restorative proctocolitis with S pouch].

Restorative proctocolectomy with an ileal-pouch-anal anastomosis seems to be the treatment of choice for ulcerative colitis. The aim of this study was to discuss a number of technical and functional aspects of the procedure that still appear to be controversial such as the shape of the pouch, the mucosectomy and the type of anastomosis. The authors report on their experience with the surgical treatment of ulcerative colitis with an "S" pouch. The technique reported, however, differs from the original method proposed by Parks and Nicholls in 1978 and the reasons for this surgical choice are discussed. A six-year experience (1993-1999) regarding 35 patients undergoing this approach is reported. No perioperative deaths were observed. The early and long-term complication rates were 8.5% and 11.4%, respectively. The average number of daily evacuations was 4. Mucosectomy affords complete resolution of the disease, while the particular shape of the pouch guarantees good functional results.

Adolescent↗
PubMed1990

Acute ulcerative proctocolitis associated with primary cytomegalovirus infection.

The case is reported of a 39-year-old pregnant woman who presented with fever, abdominal complaints, and diarrhea. Laboratory investigation revealed mononucleosis in the peripheral blood. All microbiological studies were negative, with the exception of finding cytomegalovirus (CMV). Seroconversion was documented; the virus was cultured from urine and subsequently was demonstrated to be present in the inflamed mucosa of the rectum and distal sigmoid, which was found at sigmoidoscopy. This woman was delivered of a neonate with congenital CMV infection but without apparent malformations. The patient experienced recurrences of the bowel disease, in the first of which CMV could still be cultured from a biopsy specimen. In the follow-up period, an otherwise aspecific chronic inflammatory bowel disease remained present. No immunological abnormalities were found, and antibodies to human immunodeficiency virus were negative. This case demonstrates that inflammatory bowel disease can develop as a result of primary infection with CMV.

Acute Disease↗
PubMed1989

[Surgical treatment of ulcerative proctocolitis with total colectomy, resection of rectal mucosa and continent reconstruction with a ileoanal pouch anastomosis].

Between 1984 and 1988, 10 patients with ulcerative colitis underwent surgery involving total colectomy and ileoanal reconstruction with a J-pouch. In 8 of the 10 we selected the three-stage surgical procedure: 1. total colectomy, 2. proctomucosectomy, ileoanal pouch anastomosis and double path protective ileostomy, 3. ileostomy closure. In 2 patients colectomy and pouch-anal anastomosis were performed at the same time. In 3 of 10 patients postoperative complications occurred (1 pelvic abscess, 1 abdominal abscess, 1 ileus) after total colectomy. Complications after pouch-anal anastomosis occurred in 2 of 10 patients (1 abscess formation lateral to pouch, 1 entero-vaginal fistula). Follow-up in all 6 patients in whom ileostomy closure had already been possible showed that an average of 16 months (2-44 months) after restoration of continuity 5 (of 6) patients were fully continent for stool and 1 woman patient was slightly incontinent for thin stool. With an average of 4.2 stool evacuations during the day and 1 defecation at night, all 6 patients expressed a high degree of satisfaction with the operative result.

Adolescent↗