One of the greatest advances in colorectal surgery has been the development of restorative proctocolectomy for patients with inflammatory colitides and familial adenomatous polyposis. The construction of pelvic pouch allows the entire excision of the colon while maintaining transanal fecal continence. When this procedure became first the standard of care, little was known about the short- versus long-term metabolic consequences of this operation. We began prospective studies investigating surgical complications, function of the pouches, consequences of the pouch mucosa in the presence of pouch inflammation, new trends for ileal reservoir construction and health related quality of life. We also made several laboratory tests to detect possible metabolic effects. The fruit of these analyses is this book. The patient's quality of life and satisfaction is high and functional outcome is excellent. Our goal is to continuing a successful surveillance on the restorative proctocolectomy effects and establishes a feasibility of identifying a panel of deficient biochemical variables that may be considered for institutional correctional view point.