Long-term clinical outcome and anemia after restorative proctocolectomy for ulcerative colitis

Background: The purpose of this study was to evaluate long-term outcome and hematologic data after restorative proctocolectomy (RPC) and mucosectomy w ith hand-sewn J-pouch-anal anastomosis for ulcerative colitis (UC). Methods : Forty-eight (75%) out of 64-consecutive patients operated on during the p eriod 1985-1990 participated in a long-term follow-up in 1998. Study visits involved an interview according to a 23-item functional questionnaire, pou ch endoscopy and blood samples. Pre- and postoperative data on these patien ts were reviewed at our own database covering all operations performed for UC at our institute. Results: Functional disturbances were common and uncha nged during long-term follow-up, Minor incontinence occurred in 37.5% and o utlet difficulties in 10.5% of patients. Bowel obstruction occurred in 16.7 % and usually needed operative treatment. Twenty-four (50.0%) patients had had at least one episode of pouchitis and chronic or severe pouchitis occur red in 18 (37.5%) cases, Males seem to have chronic pouchitis more often. T en (20.8%) patients had anemia during follow-up. Recurrent bleeding from th e pelvic pouch and chronic pouchitis exposed to the anemia. Conclusions: Mi nor morbidity is common after RPC. Pouchitis occurred in half of our patien ts during long-term follow-up. There may be a risk of anemia with chronic p ouchitis and bleeding from the pelvic pouch mucosa.