Pouchitis and irritable pouch syndrome are 2 of the most frequent sequelae of ileal pouch-anal anastomosis after restorative proctocolectomy in patients with ulcerative colitis.
These complications can compromise the gain in health-related quality of life substantially.
|Mucosal proinflammatory gene transcripts differentiate the syndrome from pouchitis|
|Inflammatory Bowel Diseases|
The pathophysiological mechanisms underlying irritable pouch syndrome, and the predictors of health-related quality of life in irritable pouch syndrome have not been studied so far.
Dr Carsten Schmidt and colleagues from Germany assessed 10 ileal pouch-anal anastomosis patients in remission, 18 patients with pouchitis, and 15 patients with irritable pouch syndrome symptoms.
Endoscopical and histological patterns, anxiety and depressiveness, and health-related quality of life scores were measured.
The team used the Hospital Anxiety and Depression Scale, and the Inflammatory Bowel Disease Questionnaire.
The team quantified mucosal expression of 5 proinflammatory gene transcripts using real-time polymerase chain reaction.
The research team found that clinical symptoms and health-related quality of life differed between patients in remission and those with pouchitis or irritable pouch syndrome.
However, between irritable pouch syndrome and pouchitis no such differences could be found.
The team observed that depressiveness scores differed between irritable pouch syndrome and patients in remission.
Health-related quality of life in irritable pouch syndrome was predicted by depressiveness.
The researchers noted that cytokine transcripts discriminated between pouchitis and irritable pouch syndrome.
The research team did not find differences between irritable pouch syndrome patients and asymptomatic patients.
Dr Schmidts' team concluded, "Patients with irritable pouch syndrome and pouchitis cannot be differentiated by clinical symptoms or health-related quality of life, which is associated with depressiveness in irritable pouch syndrome patients."
"Irritable pouch syndrome is a noninflammatory sequela in ileal pouch-anal anastomosis patients that shares clinical features with IBD."
"Quantification of mucosal proinflammatory gene transcripts differentiates objectively and simply between irritable pouch syndrome and pouchitis."