Document Detail


Functional assessment of bacterial colonization in patients with ileal pouch-anal anastomosis and Brooke ileostomy.
MedLine Citation:
PMID:  15484354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study was designed to determine whether patients with an ileal pouch-anal anastomosis have increased gastrointestinal bacterial colonization as assessed functionally compared with patients with Brooke ileostomy and to determine the effect of pouch bacterial colonization on pouch function. METHODS: Gastrointestinal bacterial colonization in 27 patients with an ileal pouch-anal anastomosis and 20 patients with a Brooke ileostomy was assessed using the 14C-glycocholate and glucose-hydrogen breath tests. Bacterial colonization was correlated with pouch function and pouch satisfaction. RESULTS: Patients with ileal pouch-anal anastomosis had increased levels of gastrointestinal bacterial colonization as measured using the 14C-glycocholate method compared with patients with Brooke ileostomy (P = 0.03). Only three patients had a positive result on the glucose hydrogen breath test, two patients with ileal pouch-anal anastomosis, and one with ileostomy; however, the ileal pouch-anal anastomosis patients did have higher levels on this test. Pouch satisfaction and pouch symptoms of urgency were not correlated with levels of bacterial colonization, whereas there was a nonsignificant trend with continence. CONCLUSIONS: We showed increased levels of gastrointestinal bacterial colonization with ileal pouch-anal anastomosis compared with Brooke ileostomy. The increase in bacteria is not limited to the pouch but also are found in the proximal small bowel. There was no correlation between bacterial colonization and urgency, continence, and pouch satisfaction. Reasons for this are discussed.
Authors:
Steven Kelly; James Yeo; Greg M Robertson; Bruce Chapman; J Elisabeth Wells; Frank A Frizelle
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  47     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-10-14     Completed Date:  2004-10-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1386-9     Citation Subset:  IM    
Affiliation:
Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
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MeSH Terms
Descriptor/Qualifier:
Anal Canal / surgery
Anastomosis, Surgical
Bacteria / growth & development*
Breath Tests
Carbon Radioisotopes / diagnostic use
Cholagogues and Choleretics / diagnostic use
Colonic Pouches / microbiology*
Digestive System / microbiology*
Fecal Incontinence
Glycocholic Acid / diagnostic use
Humans
Hydrogen / analysis
Ileostomy*
Prospective Studies
Chemical
Reg. No./Substance:
0/Carbon Radioisotopes; 0/Cholagogues and Choleretics; 1333-74-0/Hydrogen; 475-31-0/Glycocholic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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