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Diversion colitis is an inflammation 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.[1] It also occurs frequently in a neovagina created by colovaginoplasty, with varying delay after the original procedure.[2] Despite the presence of a variable degree of inflammation the most suggestive histological feature remains the prominent lymphoid aggregates.
| Diversion colitis | |
|---|---|
 | |
| Micrograph showing colonic-type mucosa with follicular lymphoid hyperplasia, as is seen in diversion colitis. H&E stain. | |
| Specialty | Gastroenterology |
| Causes | Surgery with diversion of colon (ileostomy or colostomy) |
| Treatment | Short-chain fatty acid enemas |
| Medication | Mesalazine |
People may be asymptomatic but common symptoms are abdominal discomfort, anorectal pain, mucous discharge and rectal bleeding that develops from the inflamed mucosa of the distal, unused colon.[1]
Diagnosis is aided by knowing the full clinical history.[3]
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 enemas and mesalazine.[4] For surgical candidates, reanastomosis is a reversal procedure carried out to restore bowel continuity that effectively halts the symptoms of diversion colitis.[1]
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