The Influence of Ileal Pouch-Anal Anastomosis for Ulcerative Colitis on Ileal Glycoprotein Synthesis

Abstract

Restorative proctocolectomy and ileal pouch-anal anastomosis are frequently associated with the onset of low-grade inflammation, colonic metaplasia, and pouchitis. The influence of intestinal adaptation and inflammatory activity on ileal glycoprotein synthesis (GS) has been assessed. Ileal GS activity in controls (n = 13, 28.9 ± 3.6) was similar to that of patients with ulcerative colitis (n = 18, 26.4 ± 3.6) irrespective of the presence of backwash ileitis (n = 6, 22.0 ± 4.0). Ileoanal pouch construction was not associated with a significant change in ileal GS activity regardless of the presence of low-grade inflammation (n = 19, 25.9 ± 2.2), frank pouchitis (n = 5, 24.4 ± 4.6), or transformation to a colonic type of mucosa (n = 6, 25.4 ± 5.2). The transformation of ileal mucosa from an absorptive to a storage function is associated with characteristic morphologic and inflammatory changes but does not produce a protective response mediated by increased GS.

Key Words:

• Crohn's disease
• ileal pouch-anal anastomosis
• restorative proctocolectomy
• ulcerative colitis