Ileoanal pouch function is related to postprandial pouch tone

Background: Functional impairments are frequently observed in patients with an ileoanal pouch. Meal ingestion increases pouch tone and motility. Littl e is known, however, about the influence of meal-stimulated pouch character istics on pouch function. The aim was to characterize basal and postprandia l pouch motor and sensory characteristics in relation to clinical pouch fun ction in patients with an ileoanal pouch. Methods: Nineteen patients with an ileoanal pouch, without faecal incontine nce but with either a high stool frequency (n=8) or an adequate stool frequ ency (n=11), underwent pressure distension of the pouch, by which pouch com pliance and sensitivity characteristics were assessed using an electronic b arostat. A set pressure procedure was performed to assess the influence of a meal on pouch tone and motility. Results: Mean(s.d.) compliance was 10(6) and 11(4) ml/mmHg in the groups wi th poor and adequate pouch function respectively (P not significant). Mean( s.d.) visual analogue scale scores (0-10 cm) for urge at the highest pressu re of 28 mmHg were 2.3(1.0) versus 2.3(2.4) cm respectively (P not signific ant); those for pain were 0.8(1.0) versus 0.5(0.7) (P not significant). Pos tprandially mean(s.d.) pouch volume decreased by 70(24) per cent in the gro up with poor pouch function and 29(25) per cent in the group with adequate pouch function (P<0.01). The frequency and amplitude of phasic pouch contra ctions increased significantly postprandially, but no differences in motili ty characteristics were observed between the two groups. Conclusion: In patients with uniform pouch design and follow-up after pouch construction, pouch compliance and sensitivity were no different between p atients with normal and high stool frequency; however, postprandial pouch t one was increased significantly in patients with a high stool frequency.