Synonyms
Nonspecific colitis of the excluded colonic segment
Definition
Diversion colitis is an inflammatory process occurring in an empty colon or rectum after surgical diversion of the fecal stream. It was first recognized in patients with chronic inflammatory bowel disease (IBD). It is still more common in these patients, although it has been reported with other, non-inflammatory conditions. Most patients have mild to moderate symptoms, typically tenesmus and diarrhea which may be mucous or bloody. Rare cases present with fulminant colitis. It is commonly believed that diversion colitis starts in the mucosa, with damage to the colonic epithelium. The colonocytes use mainly luminal short-chain fatty acids (SCFAs) as nutrients. SCFAs are metabolites of carbohydrate and peptide fermentation by obligate anaerobic bacteria. The number of these bacteria is reduced in an excluded colon.
Clinical Features
Incidence
The incidence and prevalence of this disease are difficult to estimate since...
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References and Further Reading
Cook, S. I., & Sellin, J. H. (1998). Review article: Short chain fatty acids in health and disease. Alimentary Pharmacology and Therapeutics, 12, 499–507.
Edwards, C. M., George, B., & Warren, B. (1999). Diversion colitis – New light through old windows. Histopathology, 1999(34), 1–5.
Haas, P. A., Fox, T. A., Jr., & Szilagy, E. J. (1990). Endoscopic examination of the colon and rectum distal to a colostomy. The American Journal of Gastroenterology, 85, 850–854.
Ma, C. K., Gottlieb, C., & Haas, P. A. (1990). Diversion colitis: A clinicopathologic study of 21 cases. Human Pathology, 21, 429–436.
Schmit, A., Van Gossum, A., Carol, M., et al. (2000). Diversion of intestinal flow decreases the numbers of interleukin 4 secreting and interferon gamma secreting T lymphocytes in small bowel mucosa. Gut, 46, 40–45.
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De Hertogh, G. (2017). Diversion Colitis. In: Carneiro, F., Chaves, P., Ensari, A. (eds) Pathology of the Gastrointestinal Tract. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-40560-5_1436
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DOI: https://doi.org/10.1007/978-3-319-40560-5_1436
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Publisher Name: Springer, Cham
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