THE INFLUENCE OF ILEAL POUCH-ANAL ANASTOMOSIS FOR ULCERATIVE-COLITIS ON ILEAL GLYCOPROTEIN-SYNTHESIS

Restorative proctocolectomy and ileal pouch-anal anastomosis are frequ ently associated with the onset of low-grade inflammation, colonic met aplasia, and pouchitis. The influence of intestinal adaptation and inf lammatory activity on ileal glycoprotein synthesis (GS) has been asses sed. Ileal GS activity in controls (n = 13, 28.9 +/- 3.6) was similar to that of patients with ulcerative colitis (n = 18, 26.4 +/- 3.6) irr espective of the presence of backwash ileitis (n = 6, 22.0 +/- 4.0). I leoanal pouch construction was not associated with a significant chang e in ileal GS activity regardless of the presence of low-grade inflamm ation (n = 19, 25.9 +/- 2.2), frank pouchitis (n = 5, 24.4 +/- 4.6), o r transformation to a colonic type of mucosa (n = 6, 25.4 +/- 5.2). Th e transformation of ileal mucosa from an absorptive to a storage funct ion is associated with characteristic morphologic and inflammatory cha nges but does not produce a protective response mediated by increased GS.