Improved physical performance and increased lean tissue and fat mass in patients with ulcerative colitis four to six years after ileoanal anastomosis with a J-pouch.

Abstract

This study was designed to examine the long-term changes in physical performance, body composition, and bone mineral density in patients with ulcerative colitis undergoing ileoanal anastomosis with J-pouch. Patients were also screened for abnormalities in blood biochemistry. Maximal isometric strength (sum of pinching, hand grip, arm flexion, and knee extension), work capacity (ergometer test at 1.5 W/kg), pulmonary function, body composition (dual-energy x-ray absorptiometry scan), and fatigue level were assessed before surgery and four to six years later. Of 24 patients examined preoperatively, 12 females and 8 males were retested. At follow-up, their mean age +/- standard deviation was 38 +/- 9 years, weight was 76 +/- 14 kg, and height was 173 +/- 7 cm. Compared with preoperative assessments, muscular strength had increased 10.6 +/- 17.2 percent (P = 0.015), work capacity 10.4 +/- 13.3 percent (P = 0.003), total tissue mass 4.6 +/- 5.4 kg (P = 0.001), lean tissue mass 2.3 +/- 2.2 kg (P < 0.001), fat mass 2.2 +/- 3.7 kg (P = 0.014), and bone mineral density 1.6 +/- 2.4 percent (P = 0.008). Seventeen of 20 patients had biochemical abnormalities. After ileoanal anastomosis with J-pouch, muscular strength and work capacity improved concomitant with an increase in total tissue mass, lean tissue mass, fat mass, and bone mineral density. Biochemical abnormalities were common.