Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) proposed for the first time by Parks in 1978 [1], represents nowadays the surgical treatment of choice for the management of patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC) [2, 3]. This procedure allows the removal of the whole diseased colorectal mucosal and has the great advantage of preserving the anal sphincter function. Most patients undergoing IPAA for severe colitis or for chronic continuous disease will achieve excellent functional results and physical well-being. In a prospective evaluation of health related quality of life (HRLQ) after IPAA, a significant improvement of HRQL has been shown, assessed with both generic and disease-specific measures, with many patients experiencing improvements as early as 1 month postoperatively [4]. However pouchitis, a non-specific (idiopathic) inflammation of the ileal reservoir, is the most common long-term complication after pouch surgery for UC [5].

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