Ileoanal Reservoir - operation

Ileoanal Reservoir - operation

Ileoanal Reservoir - an operation to connect the ILEUM, the final segment of the SMALL INTESTINE, directly with the anal canal (a short tract immediately before the ANUS) as an alternative to ILEOSTOMY when it is necessary to remove the entire COLON. The surgery may take place in one OPERATION or, more commonly, in two operations. First the surgeon removes the colon, leaving the anal canal, anus, and surrounding muscles intact. Then the surgeon uses the last 18 to 20 inches of the ileum to structure a pouch that replaces the RECTUM, and attaches it to the anal canal. The front end of the ileum remains as part of the small intestine. To allow these changes to heal the surgeon creates a temporary ileostomy, cutting the ileum and bringing the open end through an opening (stoma) in the abdominal wall. The ileostomy allows digestive waste, which, coming from the small intestine is fairly watery, to empty outside the body. When the ileoanal reservoir has healed, the surgeon performs a second operation to reconnect the ends of the ileum within the abdominal cavity and close the ileostomy.

With ileoanal reservoir the person retains control of the anal sphincter and has bowel movements, though stools are soft and bowel movements more frequent (7 to 10 per day). Bulking agents such as methylcellulose (Citrucel) or psyllium (Metamucil) help to solidify the stool. Foods that add bulk to the stool include bananas and rice. Risks of ileoanal reservoir include chronic INFECTION of the pouch, FECAL INCONTINENCE and stool leakage, and the need to make dietary changes (such as cutting out CAFFEINE and milk, which often cause diarrhea). Most people who undergo ileoanal reservoir surgery return to a satisfactory QUALITY OF LIFE.

See also COLOSTOMY; FAMILIAL ADENOMATOUS POLYPOSIS; INFLAMMATORY BOWEL DISEASE (IBD).

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The Gastrointestinal System

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