Management of pouch related symptoms in patients who underwent ileal pouch anal anastomosis surgery for adenomatous polyposis

Table 1 Baseline characteristics of study participants, n (%)

Characteristics	Data
Sex, male	14 (42.4)
Mean age at surgery, years (mean ± SD)	33.2 ± 11.2
Ethnicity, Ashkenazi	11 (33.3)
Genetic diagnosis
FAP	26 (78.7)
Attenuated FAP	3 (9.1)
Polymerase proofreading polyposis	1 (3)
MUTYH	3 (9.1)
mean age at study enrollment, years (mean ± SD)	47.6 ± 12.8
mean time from surgery to enrollment, years (mean ± SD)	14.4 ± 6.9
mean time from pre-treatment endoscopy to clinic visit, months (mean ± SD)	9.6 ± 8.7
mean time from clinic visit to post-treatment endoscopy, months (mean ± SD)	6.5 ± 6.8
Patients undergoing single stage pouch surgery	9 (27.2)
Treatments
Diet	30 (90.9)
Probiotics	21 (63.6)
Loperamide	14 (42.4)
Bismuth	6 (18.1)
Mebeverine	6 (18.1)
Antibiotics	9 (27.2)
5-ASA	5 (15.1)
Topical steroids	1 (3.0)
Patients with desmoid tumor	13 (39.4)

5-ASA: 5-aminosalicylic acid, FAP: Familial adenomatous polyposis.

Table 2 Effects of different treatment modalities on clinical outcome and Pouchitis disease activity index scores

Treatment	All (n = 33)		Diet (n = 30)		Probiotics (n = 21)		Loperamide (n = 14)		Bismuth (n = 6)		Antibiotics (n = 9)		Mebeverine (n = 6)		5-ASA (n = 5)
	Data	P value	Data	P value	Data	P value	Data	P value	Data	P value	Data	P value	Data	P value	Data	P value
Mean BM		0.003a		0.003a		0.007a		0.027a		0.18		0.042a		0.1		0.066
Before treatment	10.3 ± 4.3		10.5 ± 4.4		10.2 ± 3.8		9.4 ± 3.2		9.0 ± 3.3		9.7 ± 5.1		11.8 ± 5.4		11.2 ± 5.01
After treatment	9.3 ± 4.1		9.3 ± 4.2		8.8 ± 3.2		8.14 ± 2.47		8.3 ± 2.4		7.6 ± 3.4		10.0 ± 5.3		8.6 ± 3.9
Patients with bloody stools		0.62		1		0.5		1		1		1		1		1
Before treatment	3 (9.1)		3 (10)		2 (9.5)		1 (7.1)		0		1 (11.1)		1 (16.67)		1 (20)
After treatment	2 (6.06)		2 (6.67)		0		0		0		0		0		0
Patients with abdominal pain		0.016a		0.016a		0.12		0.25		1		0.5		0.5		1
Before treatment	16 (48.4)		13 (43.3)		11 (52.3)		7 (50)		4 (66.6)		4 (44.4)		4 (66.7)		2 (40)
After treatment	9 (27.2)		6 (20)		7 (33.3)		4 (28.5)		3 (50)		2 (22.2)		2 (33.3)		1 (20)
Mean clinical PDAI		0.004a		0.004a		0.01a		0.024a		0.15		0.066		0.1		0.1
Before treatment	1.3 ± 1.1		1.3 ± 1.2		1.38 ± 1.11		1.5 ± 1.28		1.5 ± 1.2		1.67 ± 1.2		1.83 ± 1.32		2.2 ± 0.8
After treatment	0.87 ± 0.89		0.86 ± 0.93		0.80 ± 0.74		0.85 ± 0.77		1.1 ± 0.75		0.8 ± 0.7		0.83 ± 0.75		1.0 ± 1.0
Mean endoscopic PDAI		0.86		0.79		0.95		0.059		0.31		0.19		0.41		0.45
Before treatment	0.65 ± 0.97		0.65 ± 1.0		0.80 ± 1.12		0.57 ± 1.08		0		1.3 ± 1.2		0.83 ± 1.16		1.6 ± 1.5
After treatment	0.6 ± 1.1		0.66 ± 1.15		0.80 ± 1.32		0.92 ± 1.26		0.16 ± 0.40		1.7 ± 1.5		1.16 ± 1.16		2.2 ± 1.7
Mean histologic PDAI		0.60		0.66		0.77		0.31		1		0.1		0.7		0.7
Before treatment	0.76 ± 1.0		0.68 ± 1.04		0.83 ± 1.04		0.5 ± 0.84		0.16 ± 0.40		1.0 ± 1.06		1.16 ± 0.98		1.6 ± 1.3
After treatment	0.46 ± 0.76		0.51 ± 0.78		0.55 ± 0.82		0.64 ± 0.92		0.16 ± 0.40		1.1 ± 0.99		1.0 ± 1.2		1.0 ± 0.8
Mean overall PDAI		0.01a		0.04a		0.032a		1		0.56		0.48		0.059		0.25
Before treatment	2.51 ± 2.38		2.46 ± 2.48		2.9 ± 2.54		2.42 ± 2.44		1.67 ± 1.2		3.8 ± 2.6		3.83 ± 2.78		5.4 ± 2.7
After treatment	1.93 ± 2.01		2.03 ± 2.09		2.1 ± 2.2		2.42 ± 2.37		1.50 ± 1.04		3.6 ± 2.6		3.0 ± 2.6		4.0 ± 2.9

^aP < 0.05 was considered statistically significant for all analyses.

Data are present as mean ± SD or n (%). 5-ASA: 5-aminosalicylic acid, BM: Bowel movements (per day), PDAI: Pouchitis disease activity index.