Motility of the Small Intestine after Proctocolectomy and Heal Pouch-Anal Anastomosis

Publisher Website
Google Scholar
Abstract
Though the mechanisms of continence after proctocolectomy and ileal pouch-anal anastomosis were studied, functions of the small intestine received little attention. Frequent stools and urgency plaque some patients who are otherwise quite continent. Motility of the jejunum and ileum was assessed in 8 patients with ulcerative colitis who were studied 4-24 mo. after proctocolectomy and ileal pouch-anal anastomosis; these findings were compared to those in 6 healthy volunteers. Continuous manometric recordings from the small bowel were obtained in both groups for 16-23 h of fasting; postprandial recordings were made for 6 h following a mixed meal (800 kcal, 20% protein, 40% fat, 40% carbohydrate) in the ileoanal patients. The duration, velocity of propagation, and periodicity of the migrating motor complex did not differ between the groups (P > 0.05). Discrete bursts of clustered contractions were recorded from all of the controls and in 5 of 8 patients. From all controls and 5 of 8 patients large amplitude, prolonged waves of pressure which propagated distally were recorded. In controls these large amplitude waves were confined to the terminal ileum, but in patients these were detected in the jejunoileum, up to 125 cm proximal to the ileal pouch. Jejunoileal motility is not greatly altered by proctocolectomy with ileal pouch-anal anastomosis. The appearance of the large amplitude, rapidly propagating waves in the proximal jejunoileum after operation may be a response to increased storage within and distention of the distal bowel.