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News

Mucosal morphology in patients with ileal pouch-anal anastomosis

A higher load of bacterial flora is associated with the degree of colonic metaplasia, villous atrophy, and inflammation after surgery for ulcerative colitis, find physicians in Diseases of the Colon and Rectum.

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Pouchitis has been associated with abnormal bacterial flora responding to antibiotics.

It is possible that dietary factors may play a role in modifying the microflora.

In this study, physicians from Finland evaluated the interactions between nutritional factors, fecal and mucosal bacterial flora, and mucosal morphology in patients with a history of pouchitis.

The team compared these patients with those who had optimal outcome for at least 5 years after ileal pouch-anal anastomosis for ulcerative colitis.

There were 32 patients were enrolled in the study. Of these, 11 had optimal outcome and 21 a history of pouchitis.

The patients recorded a 7-day food diary.
Low lactose intake is associated with sulfomucin predominance.
Diseases of the Colon and Rectum

The team then performed an endoscopy and biopsies. In addition, the team cultured fecal samples, and analyzed fecal bile acids using gas-liquid chromatography.

The physicians found no differences in mean nutrient intake, composition of fecal bile acids, or microbial tissue biopsy cultures between the 2 patient groups.

The patients with optimal outcome tended to have a more benign course of ulcerative colitis than patients with pouchitis.

The team determined that fecal concentrations of anaerobes and aerobes were significantly higher in patients with a history of pouchitis.

They also found that the degree of villous atrophy and colonic metaplasia were both associated with fecal anaerobic flora.

In addition, a low intake of lactose was associated with sulfomucin predominance.

The physicians identified a negative correlation existed between fecal aerobes and dietary lactose consumption.

Dr Kuisma's team concluded, "A higher total load of fecal anaerobic bacterial flora is strongly associated with degree of colonic metaplasia, villous atrophy, and inflammation activity after surgery for ulcerative colitis".

"An association existed between dietary lactose, fecal bacteria, and pouch morphology".

"Lactose may have prebiotic properties".

Dis Colon Rectum 2003; 46(11): 1476-83
18 November 2003

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