Pathogenesis and progress in diagnosis and treatment of diversion colitis after colorectal cancer surgery
10.3760/cma.j.cn441530-20250326-00125
- VernacularTitle:结直肠癌术后转流性结肠炎的发病机制与诊治进展
- Author:
Ziwei ZHANG
1
;
Yingjiang YE
1
;
Zhanlong SHEN
1
Author Information
1. 北京大学人民医院胃肠外科 北京大学人民医院外科肿瘤研究室 北京市结直肠癌诊疗研究重点实验室，北京 100044
- Publication Type:Journal Article
- Keywords:
Colorectal neoplasms, postoperative;
Diversion colitis;
Diagnosis;
Treatment
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(6):627-632
- CountryChina
- Language:Chinese
-
Abstract:
Diversion colitis (DC) is a non-specific inflammation caused by the lack of fecal flow stimulation in the distal intestine after intestinal diversion surgery. It is mainly related to factors such as intestinal flora imbalance, deficiency of short-chain fatty acid (SCFA) and immune abnormalities. The clinical manifestations of diversion colitis include abdominal pain, mucus and bloody stools, diarrhea and other symptoms, but most patients may have no obvious symptoms. Diagnosis mainly relies on endoscopic examination and pathological characteristics. Common endoscopic findings include mucosal congestion, edema, and increased fragility, and the histological manifestation is mainly lymphoid follicle hyperplasia. Other intestinal inflammatory diseases need to be excluded. The treatment options include surgical and conservative medical therapies, among which stoma reversal is the most effective treatment to restore intestinal continuity. Conservative treatments such as SCFA, 5-aminosalicylic acid (5-ASA), steroid or cellulose solution enema, leukocyte removal therapy and fecal microbiota transplantation (FMT) can be used for those who cannot undergo surgery, combined with diet and lifestyle support to improve symptoms. This article summarized the pathogenesis, status, clinical features, diagnostic strategy and treatment progress of DC, hoping to provide reference for the diagnosis and treatment of DC.
