Skip to main content
NCBI home page
Gut logoLink to Gut
. 1991 Jan;32(1):61–65. doi: 10.1136/gut.32.1.61

Mucosal characteristics of pelvic ileal pouches.

H J de Silva 1, P R Millard 1, M Kettlewell 1, N J Mortensen 1, C Prince 1, D P Jewell 1
PMCID: PMC1379215  PMID: 1846839

Abstract

This study aimed to investigate the degree of colonic metaplasia in ileo - anal pouches. Biopsy specimens from 25 patients with functioning pouches, eight of whom had pouchitis, were studied using routine histology, mucosal morphometry, mucin histochemistry, and immunoperoxidase staining with monoclonal antibodies directed towards a 40kD colonic protein and a small bowel specific disaccharidase-sucrase isomaltase. Thirteen patients (including all eight with pouchitis) had subtotal or total villous atrophy and crypt hyperplasia. In this group, nine had colorectal type sulphomucin and the 40kD colonic protein was detected in two. These changes were not observed in patients with less severe villous abnormalities. Sucrase-isomaltase activity was, however, present in all 25 pouch specimens. We conclude that although some ileal pouches acquire certain colonic characteristics, complete colonic metaplasia does not occur.

Full text

PDF
61

Images in this article

63Figure 1
on p.63
64Figure 2
on p.64

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Corazza G. R., Frazzoni M., Dixon M. F., Gasbarrini G. Quantitative assessment of the mucosal architecture of jejunal biopsy specimens: a comparison between linear measurement, stereology, and computer aided microscopy. J Clin Pathol. 1985 Jul;38(7):765–770. doi: 10.1136/jcp.38.7.765. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Das K. M., Sakamaki S., Vecchi M., Diamond B. The production and characterization of monoclonal antibodies to a human colonic antigen associated with ulcerative colitis: cellular localization of the antigen by using the monoclonal antibody. J Immunol. 1987 Jul 1;139(1):77–84. [PubMed] [Google Scholar]
  3. Dozois R. R., Goldberg S. M., Rothenberger D. A., Utsunomiya J., Nicholls R. J., Cohen Z., Hultén L. A., Moskowitz R. L., Williams N. S. Restorative proctocolectomy with ileal reservoir. Int J Colorectal Dis. 1986 Jan;1(1):2–19. doi: 10.1007/BF01648830. [DOI] [PubMed] [Google Scholar]
  4. Ehsanullah M., Filipe M. I., Gazzard B. Mucin secretion in inflammatory bowel disease: correlation with disease activity and dysplasia. Gut. 1982 Jun;23(6):485–489. doi: 10.1136/gut.23.6.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fleshman J. W., Cohen Z., McLeod R. S., Stern H., Blair J. The ileal reservoir and ileoanal anastomosis procedure. Factors affecting technical and functional outcome. Dis Colon Rectum. 1988 Jan;31(1):10–16. doi: 10.1007/BF02552562. [DOI] [PubMed] [Google Scholar]
  6. Fonkalsrud E. W. Endorectal ileoanal anastomosis with isoperistaltic ileal reservoir after colectomy and mucosal proctectomy. Ann Surg. 1984 Feb;199(2):151–157. doi: 10.1097/00000658-198402000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gadacz T. R., Kelly K. A., Phillips S. F. The continent ileal pouch: absorptive and motor features. Gastroenterology. 1977 Jun;72(6):1287–1291. [PubMed] [Google Scholar]
  8. Go P. M., Lens J., Bosman F. T. Mucosal alterations in the reservoir of patients with Kock's continent ileostomy. Scand J Gastroenterol. 1987 Nov;22(9):1076–1080. doi: 10.3109/00365528708991961. [DOI] [PubMed] [Google Scholar]
  9. Go P. M., van Dieijen-Visser M. P., Davies B. I., Lens J., Brombacher P. J. Microbial flora and bile acid metabolism in patients with an ileal reservoir. Scand J Gastroenterol. 1988 Mar;23(2):229–236. doi: 10.3109/00365528809103973. [DOI] [PubMed] [Google Scholar]
  10. Hauri H. P., Sterchi E. E., Bienz D., Fransen J. A., Marxer A. Expression and intracellular transport of microvillus membrane hydrolases in human intestinal epithelial cells. J Cell Biol. 1985 Sep;101(3):838–851. doi: 10.1083/jcb.101.3.838. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Heimann T. M., Gelernt I., Salky B., Bauer J., Greenstein A., Beck A. R. Familial polyposis coli. Results of mucosal proctectomy with ileoanal anastomosis. Dis Colon Rectum. 1987 Jun;30(6):424–427. doi: 10.1007/BF02556489. [DOI] [PubMed] [Google Scholar]
  12. Jagenburg R., Kock N. G., Philipson B. Vitamin B12 absorption in patients with continent ileostomy. Scand J Gastroenterol. 1975;10(2):141–144. [PubMed] [Google Scholar]
  13. Jass J. R., England J., Miller K. Value of mucin histochemistry in follow up surveillance of patients with long standing ulcerative colitis. J Clin Pathol. 1986 Apr;39(4):393–398. doi: 10.1136/jcp.39.4.393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Klein K., Stenzel P., Katon R. M. Pouch ileitis: report of a case with severe systemic manifestations. J Clin Gastroenterol. 1983 Apr;5(2):149–153. [PubMed] [Google Scholar]
  15. Knobler H., Ligumsky M., Okon E., Ayalon A., Nesher R., Rachmilewitz D. Pouch ileitis--recurrence of the inflammatory bowel disease in the ileal reservoir. Am J Gastroenterol. 1986 Mar;81(3):199–201. [PubMed] [Google Scholar]
  16. Lerch M. M., Braun J., Harder M., Hofstădter F., Schumpelick V., Matern S. Postoperative adaptation of the small intestine after total colectomy and J-pouch-anal anastomosis. Dis Colon Rectum. 1989 Jul;32(7):600–608. doi: 10.1007/BF02554181. [DOI] [PubMed] [Google Scholar]
  17. Moskowitz R. L., Shepherd N. A., Nicholls R. J. An assessment of inflammation in the reservoir after restorative proctocolectomy with ileoanal ileal reservoir. Int J Colorectal Dis. 1986 Jul;1(3):167–174. doi: 10.1007/BF01648445. [DOI] [PubMed] [Google Scholar]
  18. Naim H. Y., Roth J., Sterchi E. E., Lentze M., Milla P., Schmitz J., Hauri H. P. Sucrase-isomaltase deficiency in humans. Different mutations disrupt intracellular transport, processing, and function of an intestinal brush border enzyme. J Clin Invest. 1988 Aug;82(2):667–679. doi: 10.1172/JCI113646. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Nasmyth D. G., Godwin P. G., Dixon M. F., Williams N. S., Johnston D. Ileal ecology after pouch-anal anastomosis or ileostomy. A study of mucosal morphology, fecal bacteriology, fecal volatile fatty acids, and their interrelationship. Gastroenterology. 1989 Mar;96(3):817–824. [PubMed] [Google Scholar]
  20. Nasmyth D. G., Johnston D., Williams N. S., King R. F., Burkinshaw L., Brooks K. Changes in the absorption of bile acids after total colectomy in patients with an ileostomy or pouch-anal anastomosis. Dis Colon Rectum. 1989 Mar;32(3):230–234. doi: 10.1007/BF02554535. [DOI] [PubMed] [Google Scholar]
  21. Nicholls R. J., Belliveau P., Neill M., Wilks M., Tabaqchali S. Restorative proctocolectomy with ileal reservoir: a pathophysiological assessment. Gut. 1981 Jun;22(6):462–468. doi: 10.1136/gut.22.6.462. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. O'Connell P. R., Rankin D. R., Weiland L. H., Kelly K. A. Enteric bacteriology, absorption, morphology and emptying after ileal pouch-anal anastomosis. Br J Surg. 1986 Nov;73(11):909–914. doi: 10.1002/bjs.1800731121. [DOI] [PubMed] [Google Scholar]
  23. Oresland T., Fasth S., Nordgren S., Hultén L. The clinical and functional outcome after restorative proctocolectomy. A prospective study in 100 patients. Int J Colorectal Dis. 1989;4(1):50–56. doi: 10.1007/BF01648551. [DOI] [PubMed] [Google Scholar]
  24. Pemberton J. H., Kelly K. A., Beart R. W., Jr, Dozois R. R., Wolff B. G., Ilstrup D. M. Ileal pouch-anal anastomosis for chronic ulcerative colitis. Long-term results. Ann Surg. 1987 Oct;206(4):504–513. doi: 10.1097/00000658-198710000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Pescatori M., Mattana C., Castagneto M. Clinical and functional results after restorative proctocolectomy. Br J Surg. 1988 Apr;75(4):321–324. doi: 10.1002/bjs.1800750410. [DOI] [PubMed] [Google Scholar]
  26. Philipson B., Brandberg A, Jagenburg R., Kock N. G., Lager I., Ahrén C. Mucosal morphology, bacteriology, and absorption in intra-abdominal ileostomy reservoir. Scand J Gastroenterol. 1975;10(2):145–153. [PubMed] [Google Scholar]
  27. SPICER S. S. DIAMINE METHODS FOR DIFFERENTIALING MUCOSUBSTANCES HISTOCHEMICALLY. J Histochem Cytochem. 1965 Mar;13:211–234. doi: 10.1177/13.3.211. [DOI] [PubMed] [Google Scholar]
  28. Scott A. D., Phillips R. K. Ileitis and pouchitis after colectomy for ulcerative colitis. Br J Surg. 1989 Jul;76(7):668–669. doi: 10.1002/bjs.1800760705. [DOI] [PubMed] [Google Scholar]
  29. Scott B. B., Losowsky M. S. Patchiness and duodenal-jejunal variation of the mucosal abnormality in coeliac disease and dermatitis herpetiformis. Gut. 1976 Dec;17(12):984–992. doi: 10.1136/gut.17.12.984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Shepherd N. A., Jass J. R., Duval I., Moskowitz R. L., Nicholls R. J., Morson B. C. Restorative proctocolectomy with ileal reservoir: pathological and histochemical study of mucosal biopsy specimens. J Clin Pathol. 1987 Jun;40(6):601–607. doi: 10.1136/jcp.40.6.601. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Stryker S. J., Carney J. A., Dozois R. R. Multiple adenomatous polyps arising in a continent reservoir ileostomy. Int J Colorectal Dis. 1987 Feb;2(1):43–45. doi: 10.1007/BF01648998. [DOI] [PubMed] [Google Scholar]
  32. Taylor B. A., Dozois R. R. The J ileal pouch-anal anastomosis. World J Surg. 1987 Dec;11(6):727–734. doi: 10.1007/BF01656595. [DOI] [PubMed] [Google Scholar]
  33. Tytgat G. N., van Deventer S. J. Pouchitis. Int J Colorectal Dis. 1988 Nov;3(4):226–228. doi: 10.1007/BF01660720. [DOI] [PubMed] [Google Scholar]
  34. Wolfstein I. H., Bat L., Neumann G. Regeneration of rectal mucosa and recurrent polyposis coli after total colectomy and ileoanal anastomosis. Arch Surg. 1982 Sep;117(9):1241–1242. doi: 10.1001/archsurg.1982.01380330095024. [DOI] [PubMed] [Google Scholar]
  35. Zweibaum A., Triadou N., Kedinger M., Augeron C., Robine-Léon S., Pinto M., Rousset M., Haffen K. Sucrase-isomaltase: a marker of foetal and malignant epithelial cells of the human colon. Int J Cancer. 1983 Oct 15;32(4):407–412. doi: 10.1002/ijc.2910320403. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES