scholarly journals Efficacy of Combined Mesalazine Plus Corticosteroid Enemas for Diversion Colitis after Subtotal Colectomy for Ulcerative Colitis

2016 ◽  
Vol 10 (1) ◽  
pp. 162-165 ◽  
Author(s):  
Satohiro Matsumoto ◽  
Hirosato Mashima
Keyword(s):  
Ulcerative Colitis ◽  
Sodium Phosphate ◽  
Subtotal Colectomy ◽  
Ileal Pouch ◽  
Mucosal Inflammation ◽  
Diversion Colitis ◽  
Once Daily ◽  
Endoscopic Findings ◽  
Old Japanese ◽  
Diverting Colostomy

Diversion colitis is a benign inflammatory process that occurs in any part of the large bowel excluded from the fecal stream by a diverting colostomy. While most of the patients with diversion colitis usually are asymptomatic, a minority has abdominal pain and rectal discharge of blood or mucus. A 65-year-old Japanese man was diagnosed as having diversion colitis with ulcerative colitis at 4 months after subtotal colectomy. Corticosteroid and mesalazine enemas were started nonsynchronously. A proctoscopy after 2 months showed no response. Prednisolone injections were started at 1.0 mg/kg daily, but the mucosal inflammation still failed to improve. A combined mesalazine 1 g plus prednisolone sodium phosphate 20 mg enema was started once daily. The rectal bleeding and endoscopic findings improved. Finally proctectomy and ileal pouch-anal anastomosis were successfully performed. A combined mesalazine plus corticosteroid enema may be effective in patients with diversion colitis associated with ulcerative colitis.

Minimally Invasive Subtotal Colectomy and Ileal Pouch-Anal Anastomosis for Fulminant Ulcerative Colitis

2009 ◽  
Vol 52 (2) ◽  
pp. 187-192 ◽  
Author(s):  
Stefan D. Holubar ◽  
David W. Larson ◽  
Eric J. Dozois ◽  
Jirawat Pattana-arun ◽  
John H. Pemberton ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Minimally Invasive ◽  
Subtotal Colectomy ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Anal Anastomosis ◽  
Fulminant Ulcerative Colitis

Volvulus of an ileal pouch-rectal anastomosis after subtotal colectomy for ulcerative colitis: report of a case

Surgery Today ◽  
2013 ◽  
Vol 44 (12) ◽  
pp. 2382-2384 ◽  
Author(s):  
Kota Arima ◽  
Masayuki Watanabe ◽  
Masaaki Iwatsuki ◽  
Satoshi Ida ◽  
Takatsugu Ishimoto ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Subtotal Colectomy ◽  
Ileal Pouch ◽  
Rectal Anastomosis

scholarly journals The Impact of Rectal Stump Inflammation After Subtotal Colectomy on Pouch Outcomes in Ulcerative Colitis Patients

2020 ◽  
Author(s):  
Karin A Wasmann ◽  
Eline M van der Does de Willebois ◽  
Lianne Koens ◽  
Marjolijn Duijvestein ◽  
Willem A Bemelman ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Subtotal Colectomy ◽  
Rectal Stump ◽  
Distal Margin ◽  
Diversion Colitis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Active Inflammation ◽  
The Impact ◽  
Pouch Surgery

Abstract Background and Aims Proctitis after subtotal colectomy with ileostomy for ulcerative colitis [UC] is common, but its impact on short- and long-term outcome after pouch surgery is unknown. The aim of this study was to determine the incidence of proctitis after subtotal colectomy and its impact on postoperative morbidity and pouchitis. Methods The distal margin of the rectal stump of all consecutive patients undergoing completion proctectomy and pouch procedure for UC, between 1999 and 2017, was revised and scored for active inflammation according to the validated Geboes score, and for diversion proctitis. Pathological findings were correlated to complications after pouch surgery and pouchitis [including therapy-refractory] using multivariate analyses. Results Out of 204 included patients, 167 [82%] had active inflammation in the rectal stump and diversion colitis was found in 170 specimens [83%]. Overall postoperative complications and anastomotic leakage rates were not significantly different between patients with and without active inflammation in the rectal stump [34.7% vs 32.4%, p = 0.79, and 10.2% vs 5.4%, p = 0.54, respectively]. Active inflammation of the rectal stump was significantly associated with the development of pouchitis [54.3% vs 25.5%, plog = 0.02], as well as with therapy refractory pouchitis [14% vs 0%, plog = 0.05]. Following multivariate analysis, active inflammation was an independent predictor for the development of pouchitis. Diversion proctitis showed no association with these outcome parameters. Conclusions Active inflammation in the rectal stump after subtotal colectomy occurs in 80% of UC patients and is a predictor for the development of pouchitis and therapy-refractory pouchitis.

Is fecal diversion necessary during ileal pouch creation after initial subtotal colectomy in pediatric ulcerative colitis?

2019 ◽  
Vol 35 (4) ◽  
pp. 443-448 ◽  
Author(s):  
Y. Julia Chen ◽  
Robert Grant ◽  
Erika Lindholm ◽  
Aaron Lipskar ◽  
Stephen Dolgin ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Subtotal Colectomy ◽  
Ileal Pouch ◽  
Fecal Diversion

scholarly journals Gut Microbiome Alterations In Ulcerative Colitis And After Moxibustion Intervention

2021 ◽  
Author(s):  
Qin Qi ◽  
Ya-Nan Liu ◽  
Si-Yi Lv ◽  
Huan-Gan Wu ◽  
Lin-Shuang Zhang ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Gut Microbiota ◽  
Metabolic Pathways ◽  
High Throughput Sequencing ◽  
Male Rats ◽  
Mucosal Inflammation ◽  
Acupuncture Points ◽  
Once Daily ◽  
Microbial Dysbiosis ◽  
And Function

Abstract Background: Recent studies have shown that the pathogenesis of ulcerative colitis (UC) is closely related to the gut microbiota. Moxibustion, a common treatment in traditional Chinese medicine, is the burning of the herb moxa over acupuncture points. Moxibustion has been used to improve the inflammation and gastrointestinal dysfunctions in gastrointestinal disorders such as UC. In this study, we investigated whether moxibustion could improve the gut microbial dysbiosis induced by dextran sulphate sodium (DSS).Methods: Twenty-five male rats were randomly assigned into five groups: normal (NG), UC model (UC), moxibustion (UC+MOX), mesalazine (UC+MES), and normal rats with moxibustion (NG+MOX). The UC rat model was established by administering DSS solution. The rats in the UC+MOX and NG+MOX groups were treated with moxibustion at Tianshu (bilateral, ST25) points once daily for 7 consecutive days, and the UC+MES group rats were treated with mesalazine once daily for 7 consecutive days. After intervention, gut microbiota profiling was conducted by metagenomic high throughput sequencing technology. The gut microbiota composition, diversity and function were analyzed and compared using metagenomics methodologies.Results: The most abundant phyla of five groups were Bacteroidetes, Firmicutes, Proteobacteria and Actinobacteria. Moxibustion treatment increased abundance levels of Bacteroidetes, Actinobacteria, Ascomycota, Synergistetes and decreased abundance of Firmicutes, Proteobacteria. At the genus level, the abundance of Bacteroides, Bacteroides_bacterium_M7, Prevotella, Bacteroidales_bacterium_H2, were increased and Bacteroides_bacterium_H3, Parabacteroides, Porphyromonas, Alistipes, Parasutterella were decreased in the UC group in comparsion with those in the NG group. Moxibustion increased the abundance of Bacteroides and Bacteroides_bacterium_H3 and decreased Bacteroides_bacterium_M7, Prevotella, Bacteroidales_bacterium_H2. In addition, compare with the NG group, genes involved in certain metabolic pathways, such as energy production and conversion, amino acid transport and metabolism, nucleotide transport and metabolism, carbohydrate transport and metabolism, replication, recombination and repair, were under-represented in the UC group, and these changes in the metabolic pathways could be reversed by moxibustion treatment and mesalazine treatment.Conclusion: Our findings suggest that moxibustion treatment may protect the host from mucosal inflammation by modulating the intestinal microbiota community.

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