Scintigrapfic evaluation of pouch function in patients with ulcerative colitis

Bidragets oversatte titel: Skintigrafisk evaluering af pouch funktion hos patienter med colitis ulcerosa

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskning

Resumé

Introduction
The function of an ileal pouch–anal anastomosis (IPAA) has high impact on the patients’ quality of life (QoL), and, hence, objective methods for examination of the function are warranted for a better understanding of the functional result and possible treatment of dysfunction. Studies on defecography and pouch function have shown ambiguous results. Intestinal transit time could theoretically affect pouch function but reports in patients with an IPAA are rare.
The objective of this study was to evaluate scintigraphic intestinal transit time, scintigraphic defecography and any association with QoL and pouch function.

Method
It is a cross-sectional study including 20 patients with ulcerative colitis and an IPAA. Scintigraphic transit time was determined after oral administration of a Tc-99m-labelled omelette. Defecography was performed with instillation of a radioactive labelled paste. Ejection fraction (EF) was measured after defecation and one hour later. QoL was estimated by the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Pouch function in terms of bowel movements, pouch volume, and incontinence were self-reported on a separate questionnaire. Pouchitis was evaluated by endoscopy and pouch biopsy.

Results
We included 9 men and 12 women with a median age of 41 yrs [26-68]. Median BMI was 24 [19-36] and follow-up was 932 days [481-3491]. A median daily stool frequency of 8.5 [4-25] was reported and 3 (15%) patients suffered from incontinence. No patients had symptomatic or endoscopic pouchitis; however, the histology showed inflammation in 15 (71%) patients. Median pouch volume was 222 mL [100-360] and SIBDQ score 55 [22-67]. Median transit time was 180 min [80-365]. Median EF at first defecation was 49% [8-75] and 66% [27-97] at the second.

We found a slower transit time in patients with high BMI (p = 0.006), but no correlation between transit time and pouch function. We found no association with EF.

Conclusion
Intestinal transit time and defecography are feasible methods in patients with IPAA, and allows estimation of pouch volume and EF. In this small series, intestinal transit time was associated to BMI, but there was no association between clinical symptoms and objective measurements of pouch function.
OriginalsprogEngelsk
Publikationsdato14. nov. 2013
Antal sider1
StatusUdgivet - 14. nov. 2013
BegivenhedDansk Kirurgisk Selskabs Årsmøde - Crown Plaza, København, Danmark
Varighed: 14. nov. 201316. nov. 2013

Konference

KonferenceDansk Kirurgisk Selskabs Årsmøde
LokationCrown Plaza
LandDanmark
ByKøbenhavn
Periode14/11/201316/11/2013

Citer dette

Kjær, M. D., Hvidsten, S., Simonsen, J. A., Kjeldsen, J., & Qvist, N. (2013). Scintigrapfic evaluation of pouch function in patients with ulcerative colitis. Poster session præsenteret på Dansk Kirurgisk Selskabs Årsmøde, København, Danmark.
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title = "Scintigrapfic evaluation of pouch function in patients with ulcerative colitis",
abstract = "IntroductionThe function of an ileal pouch–anal anastomosis (IPAA) has high impact on the patients’ quality of life (QoL), and, hence, objective methods for examination of the function are warranted for a better understanding of the functional result and possible treatment of dysfunction. Studies on defecography and pouch function have shown ambiguous results. Intestinal transit time could theoretically affect pouch function but reports in patients with an IPAA are rare. The objective of this study was to evaluate scintigraphic intestinal transit time, scintigraphic defecography and any association with QoL and pouch function. MethodIt is a cross-sectional study including 20 patients with ulcerative colitis and an IPAA. Scintigraphic transit time was determined after oral administration of a Tc-99m-labelled omelette. Defecography was performed with instillation of a radioactive labelled paste. Ejection fraction (EF) was measured after defecation and one hour later. QoL was estimated by the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Pouch function in terms of bowel movements, pouch volume, and incontinence were self-reported on a separate questionnaire. Pouchitis was evaluated by endoscopy and pouch biopsy.Results We included 9 men and 12 women with a median age of 41 yrs [26-68]. Median BMI was 24 [19-36] and follow-up was 932 days [481-3491]. A median daily stool frequency of 8.5 [4-25] was reported and 3 (15{\%}) patients suffered from incontinence. No patients had symptomatic or endoscopic pouchitis; however, the histology showed inflammation in 15 (71{\%}) patients. Median pouch volume was 222 mL [100-360] and SIBDQ score 55 [22-67]. Median transit time was 180 min [80-365]. Median EF at first defecation was 49{\%} [8-75] and 66{\%} [27-97] at the second.We found a slower transit time in patients with high BMI (p = 0.006), but no correlation between transit time and pouch function. We found no association with EF.ConclusionIntestinal transit time and defecography are feasible methods in patients with IPAA, and allows estimation of pouch volume and EF. In this small series, intestinal transit time was associated to BMI, but there was no association between clinical symptoms and objective measurements of pouch function.",
author = "Kj{\ae}r, {Mie Dilling} and Svend Hvidsten and Simonsen, {Jane Angel} and Jens Kjeldsen and Niels Qvist",
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Kjær, MD, Hvidsten, S, Simonsen, JA, Kjeldsen, J & Qvist, N 2013, 'Scintigrapfic evaluation of pouch function in patients with ulcerative colitis', Dansk Kirurgisk Selskabs Årsmøde, København, Danmark, 14/11/2013 - 16/11/2013.

Scintigrapfic evaluation of pouch function in patients with ulcerative colitis. / Kjær, Mie Dilling; Hvidsten, Svend; Simonsen, Jane Angel; Kjeldsen, Jens; Qvist, Niels.

2013. Poster session præsenteret på Dansk Kirurgisk Selskabs Årsmøde, København, Danmark.

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskning

TY - CONF

T1 - Scintigrapfic evaluation of pouch function in patients with ulcerative colitis

AU - Kjær, Mie Dilling

AU - Hvidsten, Svend

AU - Simonsen, Jane Angel

AU - Kjeldsen, Jens

AU - Qvist, Niels

PY - 2013/11/14

Y1 - 2013/11/14

N2 - IntroductionThe function of an ileal pouch–anal anastomosis (IPAA) has high impact on the patients’ quality of life (QoL), and, hence, objective methods for examination of the function are warranted for a better understanding of the functional result and possible treatment of dysfunction. Studies on defecography and pouch function have shown ambiguous results. Intestinal transit time could theoretically affect pouch function but reports in patients with an IPAA are rare. The objective of this study was to evaluate scintigraphic intestinal transit time, scintigraphic defecography and any association with QoL and pouch function. MethodIt is a cross-sectional study including 20 patients with ulcerative colitis and an IPAA. Scintigraphic transit time was determined after oral administration of a Tc-99m-labelled omelette. Defecography was performed with instillation of a radioactive labelled paste. Ejection fraction (EF) was measured after defecation and one hour later. QoL was estimated by the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Pouch function in terms of bowel movements, pouch volume, and incontinence were self-reported on a separate questionnaire. Pouchitis was evaluated by endoscopy and pouch biopsy.Results We included 9 men and 12 women with a median age of 41 yrs [26-68]. Median BMI was 24 [19-36] and follow-up was 932 days [481-3491]. A median daily stool frequency of 8.5 [4-25] was reported and 3 (15%) patients suffered from incontinence. No patients had symptomatic or endoscopic pouchitis; however, the histology showed inflammation in 15 (71%) patients. Median pouch volume was 222 mL [100-360] and SIBDQ score 55 [22-67]. Median transit time was 180 min [80-365]. Median EF at first defecation was 49% [8-75] and 66% [27-97] at the second.We found a slower transit time in patients with high BMI (p = 0.006), but no correlation between transit time and pouch function. We found no association with EF.ConclusionIntestinal transit time and defecography are feasible methods in patients with IPAA, and allows estimation of pouch volume and EF. In this small series, intestinal transit time was associated to BMI, but there was no association between clinical symptoms and objective measurements of pouch function.

AB - IntroductionThe function of an ileal pouch–anal anastomosis (IPAA) has high impact on the patients’ quality of life (QoL), and, hence, objective methods for examination of the function are warranted for a better understanding of the functional result and possible treatment of dysfunction. Studies on defecography and pouch function have shown ambiguous results. Intestinal transit time could theoretically affect pouch function but reports in patients with an IPAA are rare. The objective of this study was to evaluate scintigraphic intestinal transit time, scintigraphic defecography and any association with QoL and pouch function. MethodIt is a cross-sectional study including 20 patients with ulcerative colitis and an IPAA. Scintigraphic transit time was determined after oral administration of a Tc-99m-labelled omelette. Defecography was performed with instillation of a radioactive labelled paste. Ejection fraction (EF) was measured after defecation and one hour later. QoL was estimated by the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Pouch function in terms of bowel movements, pouch volume, and incontinence were self-reported on a separate questionnaire. Pouchitis was evaluated by endoscopy and pouch biopsy.Results We included 9 men and 12 women with a median age of 41 yrs [26-68]. Median BMI was 24 [19-36] and follow-up was 932 days [481-3491]. A median daily stool frequency of 8.5 [4-25] was reported and 3 (15%) patients suffered from incontinence. No patients had symptomatic or endoscopic pouchitis; however, the histology showed inflammation in 15 (71%) patients. Median pouch volume was 222 mL [100-360] and SIBDQ score 55 [22-67]. Median transit time was 180 min [80-365]. Median EF at first defecation was 49% [8-75] and 66% [27-97] at the second.We found a slower transit time in patients with high BMI (p = 0.006), but no correlation between transit time and pouch function. We found no association with EF.ConclusionIntestinal transit time and defecography are feasible methods in patients with IPAA, and allows estimation of pouch volume and EF. In this small series, intestinal transit time was associated to BMI, but there was no association between clinical symptoms and objective measurements of pouch function.

M3 - Poster

ER -

Kjær MD, Hvidsten S, Simonsen JA, Kjeldsen J, Qvist N. Scintigrapfic evaluation of pouch function in patients with ulcerative colitis. 2013. Poster session præsenteret på Dansk Kirurgisk Selskabs Årsmøde, København, Danmark.