VITAMINS IN PATIENTS WITH THE MAINZ-POUCH -I

For the creation of the Mainz-Pouch-I reservoir, 24-36 cm of the termi nal ileum and 12 cm of the colon ascendens including the ileocecal val ve are required. As a consequence thereof, a portion of the resorption area for vitamins, trace elements and bile acid is removed. In 137 pa tients, the levels of the vitamins A, B-1, B-2, B-6, B-12, D, E, folic and bile acid, and ammonia were examined and a red blood cell count p erformed. Since 1992 we have also determined the intracorpuscular vita min B-12 and folic acid levels. The patients were divided into 3 group s (less than or equal to 2 years, > 2 -less than or equal to 4 years a nd > years after operation), as well as in children and adults. In all patients the vitamin A, B-1, B-2, B-6, D, E levels, folic and bile ac id, the red blood cell count and ammonia levels were within normal ran ges. In the group of children (n = 51), there was no significant drop of vitamin Bit serum levels after the operation. The intracorpuscular vitamin B-12 level, examined in 20 children, also showed no significan t decrease over time. In the adult group (n = 86), vitamin B-12 in the serum dropped from 402 +/- 182 ng/l during the first two years after the operation and to 292 +/- 204 ng/l after the 4(th) year. The decrea se was statistically significant, however, levels remained within the normal range (normal = 240 to 1100). In 64 adults there was no signifi cant drop in the intracorpuscular vitamin B-12 level from the first to the 4(th) year after operation. Beside regular check-ups, determinati on of the vitamin B-12 level after the 4(th) year of operation is mand atory. It still remains unclear if substitution may become necessary. However, substitution is easily performed and even cheaper than the ro utine determination of vitamin B-12.