Diversion colitis is a common inflammatory condition of the large intestine (colon) that sometimes occurs aftercolostomyorileostomysurgery.
Studies estimate that between 13% and 37% of people with IBD have a fecal diversion.
There are two common types of ostomy surgery.
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Ileostomy
An opening is made in the last section of the small intestine, called the ileum.
This procedure can be done as an end colostomy or a loop colostomy; like an ileostomy.
Cause
Its not known exactly what causes diversion colitis.
However, it’s thought that because the ostomy diverts undigested food, it changes the gut microbiome.
Your gut microbiome contains trillions of bacteria important for proper digestion.
They work to digest fiber and carbohydrates to make short-chain fatty acids (SCFAs).
These acids help to keep the colon lining healthy.
The diverted part of the colon has lower levels of SCFAs to maintain the lining, leading to inflammation.
Risk Factors
Its unclear how many people who have diversion surgeries develop diversion colitis.
However, its more common in people who have had surgery for IBD.
Symptoms
Not everyone will experience symptoms.
Complications
Serious complications can occur with diversion colitis.
Treatments
There is no standard treatment for diversion colitis but there are several effective solutions.
Reconnection could also occur when the part of the colon bypassed through the diversion has fully healed from surgery.
When and how the reversal takes place is individualized for every person.
Enemas
Some people are not candidates for surgical reconnection.
One study showed that applying these enemas twice daily resolved symptoms within four to six weeks.
Remission of symptoms lasted up to 14 months with daily or twice-a-week use.
There were no adverse events and the treatment is inexpensive.
Summary
Diversion colitis is common but may not cause any symptoms.
It usually reverses after the intestine is surgically reconnected.
Yet, in some cases, symptoms can be severe and cause complications that may require further treatments.
It’s important to consult your healthcare provider to learn which treatment is best suited for you.
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