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Diversion colitis and pouchitis: A mini-review

Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a sub...

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Autores principales: Tominaga, Kentaro, Kamimura, Kenya, Takahashi, Kazuya, Yokoyama, Junji, Yamagiwa, Satoshi, Terai, Shuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922993/
https://www.ncbi.nlm.nih.gov/pubmed/29713128
http://dx.doi.org/10.3748/wjg.v24.i16.1734
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author Tominaga, Kentaro
Kamimura, Kenya
Takahashi, Kazuya
Yokoyama, Junji
Yamagiwa, Satoshi
Terai, Shuji
author_facet Tominaga, Kentaro
Kamimura, Kenya
Takahashi, Kazuya
Yokoyama, Junji
Yamagiwa, Satoshi
Terai, Shuji
author_sort Tominaga, Kentaro
collection PubMed
description Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion. Surgical closure of the stoma, with reestablishment of gut continuity, is the only curative intervention available for patients with diversion disease. Pharmacologic treatments using short-chain fatty acids, mesalamine, or corticosteroids are reportedly effective for those who are not candidates for surgical reestablishment; however, there are no established assessment criteria for determining the severity of diversion colitis, and no management strategies to date. Therefore, in this mini-review, we summarize and review various recently-reported treatments for diversion disease. We are hopeful that the information summarized here will assist physicians who treat patients with diversion colitis and pouchitis, leading to better case management.
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spelling pubmed-59229932018-04-30 Diversion colitis and pouchitis: A mini-review Tominaga, Kentaro Kamimura, Kenya Takahashi, Kazuya Yokoyama, Junji Yamagiwa, Satoshi Terai, Shuji World J Gastroenterol Minireviews Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion. Surgical closure of the stoma, with reestablishment of gut continuity, is the only curative intervention available for patients with diversion disease. Pharmacologic treatments using short-chain fatty acids, mesalamine, or corticosteroids are reportedly effective for those who are not candidates for surgical reestablishment; however, there are no established assessment criteria for determining the severity of diversion colitis, and no management strategies to date. Therefore, in this mini-review, we summarize and review various recently-reported treatments for diversion disease. We are hopeful that the information summarized here will assist physicians who treat patients with diversion colitis and pouchitis, leading to better case management. Baishideng Publishing Group Inc 2018-04-28 2018-04-28 /pmc/articles/PMC5922993/ /pubmed/29713128 http://dx.doi.org/10.3748/wjg.v24.i16.1734 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Minireviews
Tominaga, Kentaro
Kamimura, Kenya
Takahashi, Kazuya
Yokoyama, Junji
Yamagiwa, Satoshi
Terai, Shuji
Diversion colitis and pouchitis: A mini-review
title Diversion colitis and pouchitis: A mini-review
title_full Diversion colitis and pouchitis: A mini-review
title_fullStr Diversion colitis and pouchitis: A mini-review
title_full_unstemmed Diversion colitis and pouchitis: A mini-review
title_short Diversion colitis and pouchitis: A mini-review
title_sort diversion colitis and pouchitis: a mini-review
topic Minireviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922993/
https://www.ncbi.nlm.nih.gov/pubmed/29713128
http://dx.doi.org/10.3748/wjg.v24.i16.1734
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