INDETERMINATE COLITIS - LONG-TERM OUTCOME IN PATIENTS AFTER ILEAL POUCH-ANAL ANASTOMOSIS

Uncertainty persists concerning the long-term results of ileal pouch-a nal anastomosis performed for indeterminate colitis. PURPOSE: This stu dy was designed to compare functional outcomes of ileal pouch-anal ana stomosis in patients with typical chronic ulcerative colitis and indet erminate colitis. METHOD: Seventy-one ileoanal pouch patients were ide ntified with a diagnosis of indeterminate colitis. Mean follow-up was 56 months. Outcomes were compared with 1,232 chronic ulcerative coliti s patients after ileal pouch-anal anastomosis. Mean follow-up was GO m onths. RESULTS: (mean +/- SD) There was no difference in the frequency of daily bowel movements (indeterminate colitis, 7 +/- 3, vs. chronic ulcerative colitis, 7 +/- 2). Daytime and nighttime incontinence rate s were likewise similar. Prevalence of pouchitis was identical (33 per cent). However, failure rate was higher in the indeterminate colitis g roup (indeterminate colitis, 19 percent, vs. chronic ulcerative coliti s, 8 percent; (P = 0.03)). CONCLUSIONS: At a mean of nearly five years after surgery, failure appears to occur more frequently in patients w ith indeterminate colitis than in patients with chronic ulcerative col itis. However, the great majority of indeterminate colitis patients (> 80 percent) have long-term functional results identical to those of pa tients with chronic ulcerative colitis.