Presented to the Surgical Research Society, Oxford, UK, January 1996 and published in abstract form as Br J Surg 1996; 83: 693
Immunoglobulin G and albumin levels in whole gut lavage fluid provide an objective measure of pouch ileitis†
Article first published online: 6 DEC 2002
© 2000 British Journal of Surgery Society Ltd
British Journal of Surgery
Volume 87, Issue 6, pages 808–813, June 2000
How to Cite
Evgenikos, N., Bartolo, D. C. C., Hamer-Hodges, D. W. and Ghosh, S. (2000), Immunoglobulin G and albumin levels in whole gut lavage fluid provide an objective measure of pouch ileitis. Br J Surg, 87: 808–813. doi: 10.1046/j.1365-2168.2000.01424.x
- Issue published online: 6 DEC 2002
- Article first published online: 6 DEC 2002
- Manuscript Accepted: 10 DEC 1999
Gut protein loss is a characteristic of inflammatory bowel disease (IBD), and immunoglobulin (Ig) G, albumin and α1-antitrypsin concentrations in whole gut lavage fluid (WGLF) correlate with clinical disease activity. If inflammation in ileoanal pouches is similar to IBD, then measurement of protein-losing enteropathy by analysis of WGLF may provide an objective assessment of disease activity in pouches.
Forty-two patients who had restorative proctocolectomy for ulcerative colitis underwent whole gut lavage with a polyethylene glycol–electrolyte solution. The first clear effluent was filtered, processed by the addition of protease inhibitors and stored at −70°C. IgG, albumin and α1-antitrypsin were assayed in WGLF. The Pouchitis Disease Activity Index (PDAI) was calculated after pouchoscopy and biopsy; the Moskowitz criteria for pouchitis were also applied.
There was a significant correlation of the pouchoscopy score and the PDAI with the concentration of WGLF IgG. All patients with ‘pouchitis’ according to the Moskowitz criteria had a WGLF IgG concentration greater than 10 μg/ml. The WGLF albumin level also showed a significant correlation with the PDAI, but α1-antitrypsin concentration did not.
Analysis of WGLF for IgG and albumin may be useful in the assessment of disease activity in pouch inflammation. © 2000 British Journal of Surgery Society Ltd