Quality of life in patients
with ileal pouch-anal anastomosis
Bortlík M.1, Ďuricová D.2, Donoval R.2, Šváb J.3, Krška Z.3, Lukáš M.1
1Klinické a výzkumné centrum IBD, ISCARE Lighthouse, Praha, Vedoucí: prof. MUDr. Milan Lukáš, CSc. 24. interní klinika VFN a 1. LF UK, Praha Přednosta: prof. MUDr. Aleš Žák, DrSc. 31. chirurgická klinika VFN a 1. LF UK, Praha Přednosta: doc. MUDr. Jan Šváb, CSc. |
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Summary:
Introduction: Proctocolectomy with ileal pouch-anal anastomosis
(IPAA) is thought to be the best option for patients
with intractable ulcerative colitis (UC).
Aims and methods: In this retrospective study we aimed at
assessing the functional status and quality of life in the
group of 20 patients with IPAA. We looked at the course of
the disease prior to and after IPAA and assess the functionality
of the pouch and quality of life (QOL) in all patients
using standardized questionaires.
Results: The reason for surgery was corticodependency or
corticorezistency in all cases. Fourty percent of our patients
experienced at least one course of pouchitis. The mean
number of soft stools was 6 during the day and 2 at the
night, with rare incontinency but frequent difficulty to differentiate
between the stool and gas when urgency occurs.
Most patients had to modify their activities according to
the intensity of bowel problems, more than one third use
regularly the antidiarrheals. Evaluation of the quality of
life assessed by the Cleveland Global Quality of Life
(CGQL) questionaire revealed in our patients the mean
score of 0.73. It is obviously higher than CGQL score described
in UC patients with intractable UC pre-operatively.
Conclusions: Proctocolectomy with IPAA improves the
quality of life, but does not cure UC without functional consequences.
Most patients had to modify their life in accordance
with the intensity of their bowel problems. These
results should be considered when deciding on therapeutic
modality in UC patient.
Key words:
ulcerative colitis, ileo pouch-anal anastomosis,
quality of life
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