Does a defunctionalized colon develop colitis?
- Although controversial, some patients with a portion or the entire colon out of the fecal stream develop an inflammation difficult to distinguish from ulcerative colitis on biopsy.
- The diagnosis of diversion colitis is suggested when bloody mucopus is passed from the separate colorectal segment . The colon may be isolated by diverting ileostomy, end or loop colostomy, mucous fistula, or Hartmann procedure.
- It is believed that short-chain fatty acids normally produced by anaerobic bacteria serve as a trophic factor for the colonocytes.
- The diversion colitis quickly resolves on restoration of intestinal continuity; when restoration is not possible, the administration of short-chain fatty acid enemas is beneficial.
