DIVERSION COLITIS - MINI REVIEW

Diversion colitis refers to inflammatory condition of the defunctionalized colon or rectum following fecal diversion, with possible clinical significance primarily for surgical practice. To review current understanding of diversion colitis from a surgical point of view, emphasizing on pathophysiology, clinical presentation, diagnostic approach and therapeutic strategy. Incidence is high histologically whereas less than half of patients become symptomatic. In the center of pathogenesis are loss of short-chain fatty acids and microbiome disruption. Endoscopy with biopsy confirms diagnosis. Ostomy reversal remains the most definitive treatment. Short chain fatty acids enemas and topical agents are alternatives for patient not suited for surgery. Diversion colitis highlights the importance of intraluminal nutrition for colorectal mucosal integrity and supports timely restoration of continuity when feasible.