View source for Medicine:Diversion colitis

{{Infobox medical condition (new)
| name            = Diversion colitis
| synonyms        =
| image           = Diversion proctitis - intermed mag.jpg
| width           =
| caption         = [[Micrograph]] showing colonic-type mucosa with follicular lymphoid hyperplasia, as is seen in diversion colitis. H&E stain.
| pronounce       =
| field           = [[Medicine:Gastroenterology|Gastroenterology]]
| symptoms        =
| complications   =
| onset           =
| duration        =
| types           =
| causes          = Surgery with diversion of colon (ileostomy or colostomy)
| risks           =
| diagnosis       =
| differential    =
| prevention      =
| treatment       = Short-chain fatty acid enemas
| medication      = [[Chemistry:Mesalazine|Mesalazine]]
| prognosis       =
| frequency       =
| deaths          =
}}
'''Diversion colitis''' is an [[Medicine:Inflammation|inflammation]] of the colon which can occur as a complication of ileostomy or colostomy, where symptoms may occur between one month and three years following surgery.<ref name="pmid29713128">{{cite journal | vauthors = Tominaga K, Kamimura K, Takahashi K, Yokoyama J, Yamagiwa S, Terai S | title = Diversion colitis and pouchitis: A mini-review | journal = World Journal of Gastroenterology | volume = 24 | issue = 16 | pages = 1734–1747 | date = April 2018 | pmid = 29713128 | pmc = 5922993 | doi = 10.3748/wjg.v24.i16.1734 | doi-access = free }}</ref> It also occurs frequently in a neovagina created by colovaginoplasty, with varying delay after the original procedure.<ref name="pmid26632208">{{cite journal | vauthors = van der Sluis WB, Bouman MB, Meijerink WJ, Elfering L, Mullender MG, de Boer NH, van Bodegraven AA | title = Diversion neovaginitis after sigmoid vaginoplasty: endoscopic and clinical characteristics | journal = Fertility and Sterility | volume = 105 | issue = 3 | pages = 834–839.e1 | date = March 2016 | pmid = 26632208 | doi = 10.1016/j.fertnstert.2015.11.013 | doi-access=free }}</ref> Despite the presence of a variable degree of inflammation the most suggestive histological feature remains the prominent lymphoid aggregates.

==Symptoms and signs==
People may be asymptomatic but common symptoms are abdominal discomfort, anorectal pain, [[Medicine:Rectal discharge|mucous discharge]] and rectal bleeding that develops from the inflamed mucosa of the distal, unused colon.<ref name="pmid29713128"/>

==Diagnosis==
Diagnosis is aided by knowing the full clinical history.<ref name="pmid23577987">{{cite journal | vauthors = Haboubi, Haboubi | title = Reporting colonic mucosal biopsies in inflammatory conditions: a new approach | journal = Colorectal Disease | volume = 2 | issue = 2 | pages = 66–72 | date = April 2000 | pmid = 23577987 | doi = 10.1046/j.1463-1318.2000.00104.x| s2cid = 40271111 }}</ref>

==Treatment==
In many milder cases after ileostomy or colostomy, diversion colitis is left untreated and disappears naturally. Possible pharmacologic treatments include [[Chemistry:Short-chain fatty acid|short-chain fatty acid]] irrigation, [[Biology:Corticosteroid|steroid]] [[Biology:Enema|enema]]s and [[Chemistry:Mesalazine|mesalazine]].<ref>{{cite journal |doi=10.1136/gut.32.9.1020|vauthors=Geraghty JM, Talbot IC |title=Diversion colitis: histological features in the colon and rectum after defunctioning colostomy |journal=Gut |volume=32 |issue=9 |pages=1020–3 |date=September 1991 |pmid=1916483 |pmc=1379042 |url=}}</ref> For surgical candidates, [[Biology:Surgical anastomosis|reanastomosis]] is a reversal procedure carried out to restore bowel continuity that effectively halts the symptoms of diversion colitis.<ref name="pmid29713128"/>

== References ==
{{reflist}}


[[Category:Colitis]]
[[Category:Diseases of intestines]]

{{Sourceattribution|Diversion colitis}}