The Continent Ileal Pouch: Absorptive and Motor Features

In 8 patients, 6 to 40 months after proctocolectomy and construction of a continent ileal pouch, selected absorptive and motor functions of the pouch were assessed. Test solutions of 100 or 200 ml, containing a nonabsorbable marker, were placed in the pouch and sampled serially for 1 hr; an oro-intestinal tube was used to prevent contamination of the pouch by endogenous secretions. Sodium, chloride, and water were absorbed in a fashion similar to that reported previously for normal ileum. Similarly, the resting mucosal potential difference and its response to glucose were like those of normal ileum. The pouch also absorbed vitamin B12 that was instilled together with intrinsic factor. The distribution of primary and secondary bile acids in duodenal content suggested that decreased dehydroxylation of bile acids, also seen after conventional ileostomines, occurs in pouch patients. The pattern of motility in pouches was consistent with that reported previously for normal ileum. Thus, the functions of the mucosa and smooth muscle of the continent ileal pouch are quite similar to those of normal ileum.