Whats an Ileoanal Anastomosis, or Ileoanal Pull-Through?
Since UC inflames only the innermost layer of the colon, the rectum can be stripped of this layer and attached to the ileum after the colon is removed. Early attempts to perform this surgery were frustrating as patients predictably suffered from incapacitating diarrhea. The operation was modified in 1980, adding an S or J shaped pouch just above the rectum and patients achieved continence. The patient can then pass stools normally, though bowel movements are more frequent and watery than in an otherwise healthy individual without IBD. Like the Kock pouch, eight to ten bowel movements a day are typical immediately after the surgery. The pouch continues to stretch for several years and eventually it’s only necessary to have four or five bowel movements a day. In rare cases (around 5% when the surgery is performed by an appropriately trained surgeon) when other complications, such as infection occur, the pouch may need to be converted to an ileostomy.
