Implications of Pouchitis on the Functional Results Following Stapled Restorative Proctocolectomy
Bibliographic record
Abstract
PURPOSE: Pouchitis is the most frequent long-term complication of restorative proctocolectomy; its long-term consequences are inadequately described. This prospective study evaluates the effect of pouchitis on the functional results, general health perception, and patient satisfaction. METHODS: A total of 100 consecutive patients who underwent stapled restorative proctocolectomy for ulcerative colitis were divided into three groups: no pouchitis, acute pouch-itis and chronic pouchitis. Functional results, general health perception, and satisfaction of each group at the latest review were compared only when patients were not symptomatic of active pouchitis. RESULTS: Pouchitis occurred in 33 patients (17 acute and 16 chronic). There were no significant differences in the long-term functional results between the no pouchitis and acute pouchitis groups. Patients who experienced chronic pouchitis had a significant increase in bowel movements, looseness of stools, urgency, nocturnal seepage, perianal excoriation, and dietary restrictions (P < 0.05). They also had a worse perception of their general health (P < 0.05). Previous chronic pouchitis had no effect on continence, daytime soilage, or gas-feces discrimination. Most patients were satisfied, despite pouchitis, and would recommend the operation to someone else with ulcerative colitis. CONCLUSIONS: Acute pouchitis is easily treated and results in minimal functional consequences. Even in the absence of clinically active pouchitis, patients who had suffered from chronic pouchitis had poorer functional results and general health perception. This may overshadow the benefits of restorative proctocolectomy. This finding suggests that acute and chronic pouchitis are distinct disease entities and chronic pouchitis may represent a persistent condition that displays episodic symptomatic exacerbation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".