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Diversion colitis 25 years later: the phenomenon of the disease

BACKGROUND: Diversion colitis (DC) seems to be common in stoma patients, and the restoration of the continuity of the digestive tract is crucial for relief from the inflammatory process. No prospective studies of the late effects of DC on the lower gastrointestinal (GI) tract mucosa and the clinical...

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Autores principales: Szczepkowski, Marek, Banasiewicz, Tomasz, Kobus, Adam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522524/
https://www.ncbi.nlm.nih.gov/pubmed/28357500
http://dx.doi.org/10.1007/s00384-017-2802-z
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author Szczepkowski, Marek
Banasiewicz, Tomasz
Kobus, Adam
author_facet Szczepkowski, Marek
Banasiewicz, Tomasz
Kobus, Adam
author_sort Szczepkowski, Marek
collection PubMed
description BACKGROUND: Diversion colitis (DC) seems to be common in stoma patients, and the restoration of the continuity of the digestive tract is crucial for relief from the inflammatory process. No prospective studies of the late effects of DC on the lower gastrointestinal (GI) tract mucosa and the clinical condition of patients have been reported. METHODS: Data from 23 patients who underwent stoma creation were analysed during the reversal period (A) and at an average of 3 months (B1) and 5.6 years (B2) after restoration of GI tract continuity. Every monitoring visit included endoscopy, histology and assessment of the clinical condition of patients. RESULTS: Shortly after GI tract restoration (B1), a significant decrease in inflammation was observed. The Ki67 positivity percentage increased, but this was not significant. At an average of 5.6 years after restoration (group B2), the clinical symptoms were mild. More patients presented with endoscopically detected inflammation of the mucosa, but its severity was not significantly higher than that at 3 months after reversal. Histological inflammation was more common, and its severity was significantly higher than that shortly after reversal but similar to that before reversal. The Ki67 positivity percentage decreased at the last examination (B2). CONCLUSIONS: The results of this study show a complex recurrence of histological inflammation several years after GI tract restoration but without clinical and endoscopic inflammation and with good clinical condition. DC can potentially have a late influence on the rectal mucosa, even after stoma closure.
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spelling pubmed-55225242017-08-07 Diversion colitis 25 years later: the phenomenon of the disease Szczepkowski, Marek Banasiewicz, Tomasz Kobus, Adam Int J Colorectal Dis Original Article BACKGROUND: Diversion colitis (DC) seems to be common in stoma patients, and the restoration of the continuity of the digestive tract is crucial for relief from the inflammatory process. No prospective studies of the late effects of DC on the lower gastrointestinal (GI) tract mucosa and the clinical condition of patients have been reported. METHODS: Data from 23 patients who underwent stoma creation were analysed during the reversal period (A) and at an average of 3 months (B1) and 5.6 years (B2) after restoration of GI tract continuity. Every monitoring visit included endoscopy, histology and assessment of the clinical condition of patients. RESULTS: Shortly after GI tract restoration (B1), a significant decrease in inflammation was observed. The Ki67 positivity percentage increased, but this was not significant. At an average of 5.6 years after restoration (group B2), the clinical symptoms were mild. More patients presented with endoscopically detected inflammation of the mucosa, but its severity was not significantly higher than that at 3 months after reversal. Histological inflammation was more common, and its severity was significantly higher than that shortly after reversal but similar to that before reversal. The Ki67 positivity percentage decreased at the last examination (B2). CONCLUSIONS: The results of this study show a complex recurrence of histological inflammation several years after GI tract restoration but without clinical and endoscopic inflammation and with good clinical condition. DC can potentially have a late influence on the rectal mucosa, even after stoma closure. Springer Berlin Heidelberg 2017-03-29 2017 /pmc/articles/PMC5522524/ /pubmed/28357500 http://dx.doi.org/10.1007/s00384-017-2802-z Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Szczepkowski, Marek
Banasiewicz, Tomasz
Kobus, Adam
Diversion colitis 25 years later: the phenomenon of the disease
title Diversion colitis 25 years later: the phenomenon of the disease
title_full Diversion colitis 25 years later: the phenomenon of the disease
title_fullStr Diversion colitis 25 years later: the phenomenon of the disease
title_full_unstemmed Diversion colitis 25 years later: the phenomenon of the disease
title_short Diversion colitis 25 years later: the phenomenon of the disease
title_sort diversion colitis 25 years later: the phenomenon of the disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522524/
https://www.ncbi.nlm.nih.gov/pubmed/28357500
http://dx.doi.org/10.1007/s00384-017-2802-z
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