Two examples of patient conditions that qualify for IPAA (Ileal reservoir) are which of the following?

• A. Chronic ulcerative colitis and familial adenomatous polyposis
• B. Crohn's disease and ulcerative colitis
• C. Irritable bowel syndrome and diverticulitis
• D. Colon cancer with liver metastasis

Answer: (A)

IPAA is used when removing the colon and rectum is indicated and preserving a functioning outlet for stool is desirable. Chronic ulcerative colitis and familial adenomatous polyposis fit this scenario well. In ulcerative colitis, disease is limited to the colon/rectum, and removing those segments with an ileal pouch–anal anastomosis can cure the diseased tissue while maintaining continence. In familial adenomatous polyposis, there is a near-certain cancer risk from numerous polyps, so prophylactic colectomy with IPAA offers cancer prevention while preserving bowel continuity and function. Crohn’s disease, especially with small-bowel or perianal involvement, often leads to pouch inflammation or failure, so it’s not a typical indication. Irritable bowel syndrome and diverticulitis do not generally require this kind of reconstruction, making them unsuitable indications. Metastatic colon cancer reflects systemic disease and isn’t an automatic or primary reason to perform IPAA.