Which statement best describes an essential qualification for IPAA?

• A. The GI tract is free of disease from mouth to end of small bowel
• B. A portion of distal rectum and anal canal is disease free
• C. Both statements A and B are true
• D. The stomach must be disease-free

Answer: (C)

For IPAA, you want to ensure that the tissues involved in the surgery are free of disease so the pouch can function reliably and heal well. The first important point is that there should be no inflammatory disease anywhere along the upper GI tract—essentially from the mouth through the end of the small bowel—because disease in these areas, such as Crohn’s disease, can threaten the ileal pouch and lead to complications. The second crucial point is that the portion of distal rectum and anal canal that will work with the pouch must be disease-free, so the anastomosis to the anal canal is healthy and continence can be preserved.

The stomach being disease-free is not a separate, standalone requirement beyond this broader upper GI criterion. So both conditions being true accurately describes the essential qualifications for IPAA.