Relationship between the Severity of Diversion Colitis and the Composition of Colonic Bacteria: A Prospective Study.
- Author:
Se Jin BAEK
1
;
Seon Hahn KIM
;
Chang Kyu LEE
;
Kyoung Ho ROH
;
Bora KEUM
;
Chul Hwan KIM
;
Jin KIM
Author Information
1. Department of Surgery, Korea University College of Medicine, Seoul, Korea. drkimsh@korea.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Diversion colitis;
Colonic bacteria;
Rectal neoplasms;
Polymerase chain reaction
- MeSH:
Aged;
Aged, 80 and over;
Case-Control Studies;
Colitis/*microbiology;
Colon/*microbiology;
Female;
Gram-Negative Bacteria/isolation & purification;
Gram-Positive Bacteria/isolation & purification;
Humans;
Ileostomy;
Male;
Middle Aged;
Polymerase Chain Reaction;
Pouchitis/*microbiology;
Prospective Studies;
Rectal Neoplasms/microbiology/surgery
- From:Gut and Liver
2014;8(2):170-176
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Diversion colitis is the inflammation of the excluded segment of the colon in patients undergoing ostomy. It has been suggested that a change in colonic flora may lead to colitis; however, direct evidence for this disease progression is lacking. The aim of this study was to evaluate the relationship between the severity of diversion colitis and the composition of colonic bacteria. METHODS: We used culture methods and polymerase chain reaction to analyze the colonic microflora of patients who underwent rectal cancer resection with or without diversion ileostomy. In the diversion group, we also evaluated the severity of colonoscopic and pathologic colitis before reversal. RESULTS: This study enrolled 48 patients: 26 in the diversion group and 22 in the control group. Significant differences were observed between the two groups in the levels of Staphylococcus (p=0.038), Enterococcus (p<0.001), Klebsiella (p<0.001), Pseudomonas (p=0.015), Lactobacillus (p=0.038), presence of anaerobes (p=0.019), and Bifidobacterium (p<0.001). A significant correlation between the severity of colitis and bacterial composition was only observed for Bifidobacterium (p=0.005, correlation coefficient=-0.531). CONCLUSIONS: The colonic microflora differed significantly between the diversion and control groups. Bifidobacterium was negatively correlated with the severity of diversion colitis.
