Simple radiographic evaluation of ileoanal pouch volume

C. Maximillian Schmidt, Karen M. Horton, James V. Sitzmann, Bronwyn Jones, Theodore Bayless

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

PURPOSE: Total colectomy and mucosal proctectomy with ileal reservoir and anal pull-through is used in the treatment of ulcerative colitis or familial polyposis, with one complication being frequent bowel movements. A simple radiographic test to predict frequency of bowel movements and measure spasticity was evaluated. METHODS: Fourteen patients underwent evaluation after ileal reservoir and anal pull-through J-pouch construction. Barium sulfate suspension was instilled into the pouch via the anus in the standing position until reflux flowed into the small intestine proximal to the pouch and patients felt the urge to defecate. Total volume infused (VOLtot), volume to reflux (VOLrflx), and volume voided (VOLvoid) were measured. RESULTS: VOLvoid and the 'voiding efficiency' (VOLvoid/VOLtot) correlated significantly with stool frequency (R = -0.744, P < 0.002 and R = -0.754, P < 0.002, respectively). Time from operation was correlated with VOLvoid and stool frequency (R = -0.723, P < 0.003 and R0.573, P < 0.032, respectively). CONCLUSIONS: The addition of quantitative measurements to this radiographic test gives useful information about pouch performance. Furthermore, the data imply that spasticity, as measured by voiding quantum and efficiency, rather than actual pouch volume is a major determinant of bowel movement frequency.

Original languageEnglish (US)
Pages (from-to)66-73
Number of pages8
JournalDiseases of the Colon and Rectum
Volume39
Issue number1
DOIs
StatePublished - Jan 1 1996

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Keywords

  • Colectomy
  • Familiar polyposis
  • Ileal-anal pull- through
  • Radiography
  • Spastic bowel
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

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