Absorption studies after ileal J-pouch anastomosis for ulcerative colitis. A prospective study

Scand J Gastroenterol. 1991 Jan;26(1):65-72. doi: 10.3109/00365529108996485.

Abstract

Absorption studies were performed in 17 patients with ulcerative colitis operated on with colectomy and an ileal two-limbed J-pouch anastomosis. The patients were studied 3 and greater than or equal to 18 months after closure of the temporary ileostomy. Increased stool mass (median, 609 g/24 h) was found in all patients and was unchanged with time. Moderate steatorrhoea was present in 29% of the patients 3 months postoperatively, but faecal fat excretion normalized with time. Calcium absorption was normal in all but one patient regardless of time after operation. An abnormal bacterial deconjugation, evaluated by a 14C-glycocholic acid breath test was present in 27% of the patients and increased significantly with time. Forty per cent of the patients had increased faecal bile acid excretion. B12 malabsorption was present in 29-35% of the patients. In conclusion, ileal J-pouch anastomosis for ulcerative colitis causes increased stool mass in all patients and produces moderate bile acid deconjugation and malabsorption in about one-third to half. Substitution therapy with vitamin B12 is necessary in about one-third of the patients. Intestinal adaptation as far as absorption is concerned is minimal after the first 3 postoperative months.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anal Canal / surgery
  • Anastomosis, Surgical / methods
  • Bile Acids and Salts / metabolism
  • Calcium / metabolism
  • Colitis, Ulcerative / metabolism
  • Colitis, Ulcerative / physiopathology
  • Colitis, Ulcerative / surgery*
  • Female
  • Humans
  • Ileum / surgery*
  • Intestinal Absorption*
  • Lipid Metabolism
  • Male
  • Middle Aged
  • Prospective Studies

Substances

  • Bile Acids and Salts
  • Calcium