From the Research
Diversion colitis is a non-specific inflammation of a de-functioned segment of intestine after diversion of the faecal stream, characterized by symptoms such as tenesmus, rectal discharge, bleeding per rectum, and abdominal pain, and can be treated with short chain fatty acid enemas, restoration of bowel continuity, or surveillance for asymptomatic patients. The definition of diversion colitis is based on the study by 1, which reviewed the current literature on the pathophysiology, clinical presentation, and management of diversion colitis. Some key points about diversion colitis include:
- It is invariably present in all diverted segments of the colon, but is usually asymptomatic 1
- Major macroscopic changes include mucosal nodularity, erythema, and friability, while microscopic features are predominantly those of lymphoid follicular hyperplasia, apthous ulceration, and chronic inflammatory changes, mostly limited to submucosa 1
- Treatment modalities include surveillance for asymptomatic patients, restoration of bowel continuity for severely symptomatic cases, and the use of short chain fatty acid (SCFA) enemas in selected cases 1
- In symptomatic patients, short chain fatty acid enema may help, as shown in the study by 1
- A combined mesalazine plus corticosteroid enema may be effective in patients with diversion colitis associated with ulcerative colitis, as reported in the study by 2