Chyme reinfusion to test previously complicated ileoanal pouch prior to restoration of bowel continuity

Complications following ileoanal pouch surgery, including anastomotic leak and pouch-related fistula, carry significant morbidity and a high risk of failure following ileostomy reversal. Standard radiological and endoscopic assessments may not reliably reflect the biological and functional integrity of a defunctioned pouch. We describe a novel application of chyme reinfusion through a diverting ileostomy as a dynamic functional stress test of ileoanal pouch integrity, and as a means of bowel rehabilitation prior to stoma reversal, in three patients with complex pouch-related complications. In all cases, the technique was technically feasible, well tolerated, and provided functional information beyond that afforded by conventional imaging. No procedure-related complications were observed. Chyme reinfusion may complement standard assessment tools and help prepare the bowel for future reversal surgery.