For which of the following patients is an IPAA not recommended?

An ileal pouch-anal anastomosis (IPAA) is a surgical procedure often considered for patients with certain inflammatory bowel diseases, particularly ulcerative colitis, to create a pouch from the small intestine to restore bowel function after the removal of the colon. However, this procedure is not recommended for patients with Crohn's disease, as this condition can involve the entire gastrointestinal tract, and particularly the anal region, causing complications that may arise post-surgery.

Patients with Crohn's may experience ongoing inflammation, frequent bowel obstructions, or possible anal fistulas. The existence of these conditions could complicate the healing process or lead to poor surgical outcomes after an IPAA. Consequently, the risk of complications is significantly heightened for these patients, making the procedure inappropriate.

In contrast, individuals with ulcerative colitis, prior surgeries (barring serious complications that directly affect pouch creation), and familial polyposis are generally considered more suitable candidates for an IPAA, presuming they meet other health criteria.