CARRIAGE OF ADHESIVE ESCHERICHIA-COLI AFTER RESTORATIVE PROCTOCOLECTOMY AND POUCH-ANAL ANASTOMOSIS - RELATION WITH FUNCTIONAL OUTCOME AND INFLAMMATION

Restorative proctocolectomy with pelvic ileal reservoir is a well acce pted option for the surgical treatment of ulcerative colitis. Acute po uchitis is a common complication and resembles acute ulcerative coliti s. Patients with ulcerative colitis carry Escherichia coli that adhere to epithelial cells and thus this study examined whether acute pouchi tis is associated with the carriage of adhesive E coli. E coli isolate d from stool samples from 24 patients (median age 34 years, range 16-6 4; 13 men, 11 women) who had had restorative proctocolectomy with pelv ic ileal reservoir were examined by means of the buccal epithelial cel l adhesion assay. Patients were studied at a median of 12 months (rang e 7-21) after operation. Eight of 24 patients had acute pouchitis at t he time of study. Adhesive E coli were detected in nine of 24 patients with a pelvic ileal reservoir compared with none of 12 controls (p<0. 05). The buccal epithelial cell adhesion index was inversely related t o the degree of acute pouchitis (r(s)=-0.46, p=0.024) and to the funct ional outcome (r(s)=-0.49, p=0.022). Carriage of adhesive E coli was n ot related to the design of the reservoir. By contrast with ulcerative colitis, acute pouchitis is not associated with the carriage of adhes ive E coli.