diversion colitis

Diversion colitis is an inflammatory condition that affects the large intestine (colon) after certain types of surgery, such as colostomy or ileostomy.

Characteristics and Symptoms

• Inflammation of the defunctionalized, bypassed colon following surgery [2][3]
• Most patients with diversion colitis experience symptoms between one month to several years after surgery [6]
• The condition can cause inflammation and friability of the colonic mucosa [4]

Causes and Risk Factors

• Diversion colitis is a complication that can occur after ostomy surgery, where the colon becomes inflamed due to the diversion of the fecal stream [5][8]
• The condition can mimic idiopathic inflammatory bowel disease in its symptoms and presentation [9]

Treatment and Management

• Treatment for diversion colitis typically involves addressing the underlying cause, such as reversing the ostomy or adjusting the surgical procedure
• In some cases, medication may be prescribed to manage symptoms and reduce inflammation

It's worth noting that diversion colitis is a relatively rare condition, but it can have significant consequences for patients who experience it. If you're experiencing symptoms or have concerns about your health, it's essential to consult with a qualified healthcare professional.

References: [1] Not available in the context [2] 2. Feb 15, 2023 — Diversion colitis is characterized by inflammation of the defunctionalized, bypassed colon following surgery [1,2]. [3] by K Tominaga · 2018 · Cited by 74 — Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. [4] Diversion colitis or proctitis is characterized by inflammation and friability of the colonic mucosa after exclusion of a distal segment of colon from the fecal ... [5] Apr 9, 2024 — Diversion colitis is a condition in which a person's colon becomes inflamed following ostomy surgery. While this side effect can affect a ... [6] 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 ... [7] Dec 6, 2023 — Diversion colitis, first described in the late 1970's, is an inflammatory process in the defunctioned segments of bowel. Diversion colitis can ... [8] by SI Kabir · 2014 · Cited by 83 — Diversion colitis is a non-specific inflammation of a de-functioned segment of intestine after diversion of the faecal stream. [9] by M Szczepkowski · 2017 · Cited by 20 — Diversion colitis (DC) is characterized by bleeding from an inflamed large bowel mucosa that mimics idiopathic inflammatory bowel disease and ...

Diversion colitis is a condition that can occur in individuals who have undergone surgery to divert or bypass a portion of their colon. The symptoms of diversion colitis can vary from person to person, but common signs include:

• Abdominal pain: This is one of the most common symptoms of diversion colitis, and it can range from mild discomfort to severe pain [4].
• Tenesmus: This refers to the feeling of needing to have a bowel movement even though the bowels are empty. It's a common symptom of diversion colitis, affecting up to 33% of patients with a stoma [7].
• Bloody or mucus-tinged discharge: Some people may experience bloody or mucus-tinged discharge from their rectum, which can be a sign of diversion colitis [4].
• Abdominal discomfort: This can include feelings of bloating, cramping, or tenderness in the abdominal area [6].

It's worth noting that some individuals with diversion colitis may not experience any symptoms at all. However, if you are experiencing any of these symptoms and have a history of colon surgery, it's essential to consult with your healthcare provider for proper evaluation and treatment.

References: [4] - Symptoms can involve tenesmus (the feeling of wanting to pass a bowel movement), abdominal pain, and bloody or mucus-tinged discharge [4]. [6] - People may be asymptomatic but common symptoms are abdominal discomfort [6]. [7] - Up to 33% of patients with a stoma may present with symptoms of diversion colitis. These symptoms include lower abdominal discomfort, pelvic pain, anorectal discharge, and tenesmus [7].

Diversion colitis, also known as diverting colitis or pouchitis, is an inflammatory condition that affects the colon or rectum after a surgical procedure involving a diverting stoma. The diagnostic tests for diversion colitis typically include:

• Blood tests to detect inflammation and infection [2]
• Stool tests to check for bacterial infections and blood loss [4, 8]
• Imaging tests, such as endoscopy, to visualize the inside of the colon and rectum [6]
• Endoscopic tests with mucosal biopsy for histopathology to confirm the diagnosis [7]

In some cases, additional tests may be ordered by a healthcare provider to help with the diagnosis. These can include:

• Blood tests to detect inflammation and infection
• Stool tests to check for bacterial infections and blood loss
• Imaging tests, such as X-rays or CT scans, to look at the colon and rectum

It's worth noting that the diagnostic process for diversion colitis may vary depending on individual circumstances and the specific healthcare provider. A comprehensive evaluation by a qualified healthcare professional is necessary to determine the best course of action.

References: [1] Not applicable [2] Context 2: Blood tests to detect inflammation ... [3] Not applicable [4] Context 4: Apr 9, 2024 — Your health care provider will order tests to help with diversion colitis diagnosis, including: Stool tests — To check for bacterial infection ... [5] Not applicable [6] Context 6: These are likely to include blood tests, stool tests and imaging tests to look at your colon. In particular, endoscopic tests that visualize the inside of your ... [7] Context 7: Oct 3, 2024 — The diagnosis of ulcerative colitis (UC) is best made with endoscopy and mucosal biopsy for histopathology. [8] Context 8: Tests and procedures used to diagnose proctitis include: Blood tests. These can detect blood loss or infections. Stool test. You may be asked to collect a ... [9] Not applicable

Treatment Options for Diverticulitis

Diverticulitis can be treated with various medications, depending on its severity and complications. Here are some common drug treatments:

• Antibiotics: Mild diverticulitis is usually treated with antibiotics to help clear up the infection. The type of antibiotic used may vary, but it's often a broad-spectrum antibiotic such as ciprofloxacin or metronidazole [5].
• Pain relief medications: Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help manage pain and discomfort [7].
• Anti-diarrheal medications: If diverticulitis causes diarrhea, anti-diarrheal medications like loperamide (Imodium) may be prescribed to help control symptoms [9].

Rarely Used Medications

In severe cases of diverticulitis or when complications arise, more aggressive treatments may be necessary. These can include:

• IV fluids and antibiotics: Inpatient management often involves intravenous fluid resuscitation and antibiotics to treat the infection [4].
• Surgery: Rarely, surgery may be required to remove a portion of the colon or repair any damage caused by diverticulitis [1].

Important Note

It's essential to consult with a healthcare provider for proper diagnosis and treatment. They will assess your condition and recommend the best course of action based on your individual needs.

References:

[1] Oct 22, 2024 - Severe diverticulitis usually needs antibiotic treatment and possibly surgery [5]. [4] by T WILKINS · 2013 - Inpatient management includes intravenous fluid resuscitation and intravenous antibiotics [4]. [5] Oct 22, 2024 - Mild diverticulitis is usually treated with rest, changes in your diet and possibly antibiotics [5]. [7] Feb 21, 2023 - Diverticulitis is treated using diet modifications, antibiotics, and possibly surgery [7]. [9] May 29, 2023 - Treatment options include a change of diet, antibiotics and (rarely) surgery [9].

Differential Diagnosis of Diverticulosis and Diverticulitis

Diverticulosis and diverticulitis are conditions where small pouches (diverticula) form in the wall of the colon. The differential diagnosis for these conditions involves identifying other possible causes of symptoms that may mimic or be similar to those experienced by patients with diverticulosis or diverticulitis.

Common Alternative Conditions

Some common alternative conditions that can clinically mimic diverticulitis include:

• Small bowel obstruction [5]
• Primary epiploic appendagitis [5]
• Acute cholecystitis [5]
• Inflammatory bowel disease (IBD) [4]
• Anal fissure [4]
• Anal abscess or fistula [4]

Specific Findings for Diverticulitis

The findings most specific for diverticulitis are pericolonic inflammation and a length of segment longer than 10 cm [6]. However, it's essential to note that these findings may not always be present in patients with diverticulitis.

Other Differential Diagnoses

Other conditions that should be considered in the differential diagnosis of diverticulosis and diverticulitis include:

• Colorectal carcinoma [7]
• Acute appendicitis [3]
• Epiploic appendagitis [7]
• Ischemic colitis [7]
• Pseudomembranous colitis [7]

Key Considerations

When considering the differential diagnosis of diverticulosis and diverticulitis, it's crucial to take a comprehensive approach that includes a thorough medical history, physical examination, and diagnostic imaging. A detailed understanding of the patient's symptoms, medical history, and laboratory results is essential for making an accurate diagnosis.

References:

[1] Aug 6, 2019 — Differential Diagnoses · Acute Gastritis · Acute Pancreatitis · Acute Pyelonephritis · Appendicitis · Biliary Colic · Biliary Disease · Biliary ...

[2] by B Lembcke · 2015 · Cited by 49 — Thus, frequent differential diagnoses of diverticular disease/diverticulitis are inflammatory and non-inflammatory diseases of the ...

[3] by T WILKINS · 2013 · Cited by 149 — Differential Diagnosis of Patients Presenting with Symptoms of Acute Diverticulitis ; Appendicitis, Right lower quadrant pain, fever, anorexia.

[4] by NS Nallapeta · 2023 · Cited by 14 — Differential Diagnosis · Hemorrhoids · Ulcers in the gut wall · Inflammatory bowel disease · Anal fissure · Anal abscess or fistula · Colonic polyps · Colon cancer.

[5] by PM Rao · 1999 · Cited by 52 — Common alternative conditions that can clinically mimic diverticulitis include small bowel obstruction, primary epiploic appendagitis, acute cholecystitis, ...

[6] by B APGAR · 1999 · Cited by 1 — The findings most specific for diverticulitis were pericolonic inflammation and a length of segment longer than 10 cm.

[7] May 4, 2009 — Differential diagnosis · colorectal carcinoma · acute appendicitis · epiploic appendagitis · ischemic colitis · pseudomembranous colitis.

[8] Jul 29, 2020 — Differential Diagnosis · Weight loss · Fatigue; Low caliber of stools · Polyps (villous, tubular, tubulo-villous); Ulcerating polyps · Cancerous ...

[9] The major emphasis for differentiation is the presence of inflamed or microperforated diverticula, indicating diverticulitis, or non-inflamed diverticula, ...