Large Intestine: Diversion Colitis

Diversion Colitis

Basics

  • Inflammation of a Defunctionalized-Bypassed Segment of Colon After Surgical Diversion
  • Caused by Short-Chain Fatty Acid (SCFA) Deficiency – Primary Colonocyte Nutrient

Symptoms

  • Mostly Asymptomatic
  • Tenesmus
  • Bleeding
  • Mucus Discharge
  • Pain

Diagnosis

  • Diagnosis of Exclusion

Treatment

  • Preferred Tx: Surgical Reanastomosis
  • If Unable to Reanastomose: SCFA Enema
    • Consider Topical Anti-Inflammatory (5-ASA/Steroids)

Diversion Colitis, Before (Left) & After (Right) Enema Treatments 1

References

  1. Matsumoto S, Mashima H. Efficacy of Combined Mesalazine Plus Corticosteroid Enemas for Diversion Colitis after Subtotal Colectomy for Ulcerative Colitis. Case Rep Gastroenterol. 2016 May 9;10(1):157-60.(License: CC BY-NC-4.0)