Primary Sclerosing Cholangitis and Extraintestinal Manifestations in Patients with Ulcerative Colitis and Ileal Pouch–Anal Anastomosis

Objective The aim of this study was to assess complications and functional outcomes in patients having ileal pouch–anal anastomosis for ulcerative colitis with or without primary sclerosing cholangitis or extraintestinal manifestations and to assess if primary sclerosing cholangitis is a risk factor for pouchitis. Materials and methods From 1984 to 2007, 289 patients underwent proctocolectomy with ileal pouch–anal anastomosis for ulcerative colitis. Mean follow-up time was 12 years and data was recorded prospectively. Eleven patients had primary sclerosing cholangitis, six had pyoderma gangrenosum, and 12 had arthritis or ankylosing spondylitis. Results Early complications were similar for patients with or without extraintestinal manifestations. Functional outcomes were similar, but more incontinence among patients with sclerosing cholangitis was found. These patients had more frequent pouchitis, 5.25 vs. 2.72 average episodes of pouchitis ( p = 0.048), and more chronic pouchitis, 4/11 vs. 17/260 ( p