Diversion colitis is an
inflammation
Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...
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.
It also occurs frequently in a
neovagina
Vaginoplasty is any surgical procedure that results in the construction or reconstruction of the vagina. It is a type of genitoplasty. Pelvic organ prolapse is often treated with one or more surgeries to repair the vagina. Sometimes a vaginoplas ...
created by
colovaginoplasty
Vaginoplasty is any surgical procedure that results in the construction or reconstruction of the vagina. It is a type of genitoplasty. Pelvic organ prolapse is often treated with one or more surgeries to repair the vagina. Sometimes a vaginoplas ...
, with varying delay after the original procedure.
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,
mucous discharge and rectal bleeding that develops from the inflamed
mucosa
A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is ...
of the distal, unused colon.
Diagnosis
Diagnosis is aided by knowing the full clinical history.
Treatment
In many milder cases after
ileostomy or colostomy, diversion colitis is left untreated and disappears naturally. Possible pharmacologic treatments include
short-chain fatty acid irrigation,
steroid
A steroid is a biologically active organic compound with four rings arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter membrane fluidity; and a ...
enemas and
mesalazine
Mesalazine, also known as mesalamine or 5-aminosalicylic acid (5-ASA), is a medication used to treat inflammatory bowel disease, including ulcerative colitis and Crohn's disease. It is generally used for mildly to moderately severe disease. It ...
.
For surgical candidates,
reanastomosis
A surgical anastomosis is a surgical technique used to make a new connection between two body structures that carry fluid, such as blood vessels or bowel. For example, an Artery, arterial anastomosis is used in vascular bypass and a Colon (anatom ...
is a reversal procedure carried out to restore bowel continuity that effectively halts the symptoms of diversion colitis.
References
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Colitis
Diseases of intestines
Gastrointestinal tract disorders