Assessment of Dietary Intake and Trace Element Status in Patients with Ileal Pouch-Anal Anastomosis

• Published in: Diseases of the colon & rectum Vol. 50; no. 10; pp. 1553 - 1557
• Main Authors: El Muhtaseb, Mohammad Sami H., Duncan, Andrew, Talwar, Dinesh K., O'Reilly, Denis St. J., McKee, Ruth F., Anderson, John H., Finlay, Ian G.
• Format: Journal Article
• Language: English
• Published: Secaucus, NJ Springer 01.10.2007; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adenomatous Polyposis Coli - blood; Adenomatous Polyposis Coli - surgery; Adult; Aged; Biological and medical sciences; Case-Control Studies; Colitis, Ulcerative - blood; Colitis, Ulcerative - surgery; Colonic Pouches; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Medical sciences; Middle Aged; Nutritional Status; Other diseases. Semiology; Proctocolectomy, Restorative; Selenium - blood; Stomach, duodenum, intestine, rectum, anus; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Trace Elements - blood; Transition Elements - blood; Human; Toxicity; Polyposis; Inflammatory disease; Ileal pouch-anal anastomosis; Trace element; Treatment; Surgery; Ileal pouch; Digestive diseases; Intestinal disease; Intake; Trace elements; Manganese; Ulcerative colitis
• ISSN: 0012-3706; 1530-0358
• DOI: 10.1007/s10350-007-9003-8

Panproctocolectomy and ileal pouch-anal anastomosis is the operation of choice for patients with ulcerative colitis and familial polyposis. The long-term nutritional consequences after pouch surgery are unknown. We have assessed the nutritional status of the essential trace elements-zinc, copper, manganese, and selenium-in patients several years (median, 10 (range, 2-15) years) after surgery. Fifty-five patients with uncomplicated ileal pouch-anal anastomosis and 46 healthy control subjects were studied. A dietary assessment of trace element intake was undertaken by using a semiquantitative food frequency questionnaire. The patients' trace elements status for zinc, copper, manganese, and selenium was assessed by measuring their concentrations in blood. The dietary intake of individual trace elements was similar in both groups (all P values > 0.4). There was no significant difference in the concentrations of plasma copper, zinc, and selenium between patients and healthy control subjects (all P values > 0.07). The concentration of whole blood manganese was significantly higher (P = 0.004) in patients (median, 178.5 nmol/l; range, 59-478 nmol/l) compared with healthy control subjects (median, 140 nmol/l; range, 53-267 nmol/l). Four (7 percent) patients had manganese concentrations more than three standard deviations of the mean of control group (>255 nmol/l). This study shows that patients who have had uncomplicated pouch surgery have a normal dietary intake of trace elements and do not develop deficiencies in copper, zinc, manganese, and selenium. However, these patients may be at increased risk of manganese toxicity.