[Functional results of ileo-anal anastomosis. The point of view of the gastroenterologist]

Ulcerative colitis is an illness that occurs unexpectedly in a young patient, with a generally unpredictable prognosis, and there is no medication to cure it. This illness profoundly impairs the patient's professional life, family life, sex life, leading to an overall change in lifestyle, most particularly in cases of pancolitis. The majority of patients who benefit from a total colectomy for their ulcerative colitis, are those whose cases are severe, chronic, incapacitating, and who respond poorly to prolonged, appropriately administered medical treatment, mainly continuous steroid therapy. After the surgical procedure, the average number of defecations is from 5 to 6 evacuations in 24 hours, and the anal continence is good. Around 5% of patients have nocturnal leakage requiring to wear a protecting fad. Globally 9 out 10 patients are satisfied with their surgery and ileal pouch-anal anastomosis is the procedure of choice for the treatment of ulcerative colitis in subjects under 60 years of age, with a normal anal sphincter function and without neoplastic complication of the lower rectum.