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Diversion colitis and pouchitis: A mini-review
#MMPMID29713128
Tominaga K
; Kamimura K
; Takahashi K
; Yokoyama J
; Yamagiwa S
; Terai S
World J Gastroenterol
2018[Apr]; 24
(16
): 1734-1747
PMID29713128
show ga
Diversion colitis is characterized by in?ammation of the mucosa in the
defunctioned segment of the colon after colostomy or ileostomy. Similar to
diversion colitis, diversion pouchitis is an in?ammatory disorder occurring in
the ileal pouch, resulting from the exclusion of the fecal stream and a
subsequent lack of nutrients from luminal bacteria. Although the vast majority of
patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it
has been reported that diversion colitis and pouchitis might occur in almost all
patients with diversion. Surgical closure of the stoma, with reestablishment of
gut continuity, is the only curative intervention available for patients with
diversion disease. Pharmacologic treatments using short-chain fatty acids,
mesalamine, or corticosteroids are reportedly effective for those who are not
candidates for surgical reestablishment; however, there are no established
assessment criteria for determining the severity of diversion colitis, and no
management strategies to date. Therefore, in this mini-review, we summarize and
review various recently-reported treatments for diversion disease. We are hopeful
that the information summarized here will assist physicians who treat patients
with diversion colitis and pouchitis, leading to better case management.
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