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. 2022 Dec;20(4):564-581.
doi: 10.1007/s11938-022-00405-x. Epub 2022 Dec 6.

Ileal Pouch-Anal Anastomosis in the Older Adult: a Review of Postoperative Outcomes and Pouchitis Treatment

Sabrina L Chen  1 , Adam S Faye  1 , Shannon Chang  1
Affiliations

Ileal Pouch-Anal Anastomosis in the Older Adult: a Review of Postoperative Outcomes and Pouchitis Treatment

Sabrina L Chen et al. Curr Treat Options Gastroenterol. 2022 Dec.

Abstract

Purpose of review: Ileal pouch-anal anastomosis (IPAA) has become the preferred surgical treatment for patients with medically refractive ulcerative colitis (UC). Previous studies have suggested that outcomes of this procedure may be worse in older patients; however, more recent reports have suggested that IPAA in select patients is safe, feasible, and results in good quality of life. In this review, we discuss the recent literature surrounding clinical considerations and treatment management of IPAA in older adults.

Recent findings: IPAA complication rates and adverse events are similar in the older adult population, as compared to the younger adult patient population. Although fecal urgency and incontinence may be more common among older adults, chronological age alone is not a contraindication for IPAA surgery, as good quality of life can still be achieved. In this review, we will also discuss the development of pouchitis after IPAA, particularly among older adults, as the emergence of newer biologic drugs has shifted the treatment landscape.

Summary: IPAA can be a safe and effective treatment modality for older adults with UC, with high self-reported patient satisfaction. Patient optimization and careful case selection are vital to achieving these outcomes, and specialized preoperative assessments and counseling can help facilitate the proper treatment.

Keywords: IPAA; Older adults; Proctocolectomy; Ulcerative colitis.

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Conflict of interest statement

Conflict of Interest Sabrina L. Chen declares that she has no conflict of interest. Adam S. Faye declares that he has no conflict of interest. Shannon Chang declares that she has no conflict of interest.

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