Long-term effects on diet after proctocolectomy for ulcerative colitis

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doi:10.1016/j.amjsurg.2007.12.023 Copyright © 2008 Elsevier Inc. All rights reserved.

The Midwest Surgical Association

Long-term effects on diet after proctocolectomy for ulcerative colitis

C. Max Schmidt M.D., Ph.D., a, , Chad A. Wiesenauer M.D.a and V. Sitzmann M.D.a aDepartment of Surgery, Indiana University School of Medicine, 1044 W. Walnut St., R4-039, Indianapolis, IN 46202, USA Received 26 November 2007; revised 13 December 2007. Available online 4 March 2008.

Abstract

Background

Patients with ulcerative colitis (UC) often report dietary intolerances. Our aim was to assess the effects of proctocolectomy (PC) for UC on dietary intolerances. Methods

A novel disease-specific questionnaire was used. Results

Eighty-seven percent of patients reported 338 dietary intolerances. Of 225 preoperative dietary intolerances, 151 (67%) resolved/improved, 56 (25%) were unchanged, and 18 (8%) were exacerbated after PC. A total of 113 dietary intolerances developed only after PC. The incidence of specific dietary intolerances in patients 10 years and older post-PC was similar to patients younger than 10 years post-PC except for a lower incidence of caffeinated beverage (P = .01) dietary intolerances 10 years or more post-PC. Intestinal symptoms, bowel function, and activities of daily living largely improved after PC. Extraintestinal UC symptoms worsened or failed to improve in 74%. Conclusions

PC for UC frequently improves preoperative dietary intolerances. Some patients, however, are at risk for onset of new dietary intolerances after PC. Studies examining traditional symptoms in UC patients pre-PC and post-PC may be enhanced by examining effects on specific dietary intolerances.

Keywords: Ulcerative colitis; Proctocolectomy; Dietary intolerance; Diet

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The American Journal of Surgery Volume 195, Issue 3, March 2008, Pages 353-357