Definition A condition characterised by inflammation of surgically bypassed segments of the colon and rectum, typically seen in patients with ulcerative colitis after surgical diversion of the faecal stream, which occurs long–years–after diversion
Clinical findings Asymptomatic or bloody discharge, colicky anorectal pain, tenesmus, purulent or haemorrhagic discharge
Endoscopy Friable, erythematous and granular mucosa mimicking Crohn’s disease and ulcerative colitis
Pathogenesis Possibly due to local nutritional deficiency of mucosa
Differential diagnosis Ulcerative colitis, Crohn’s disease (diversion colitis closely mimics Crohn’s disease), diverticular disease
Management Topical use of short-chain fatty acids, butyrate enemas, restoration of faecal flow.
Synonyms Diversion proctitis, diversion proctocolitis, exclusion colitis, exclusion proctitis, exclusion proctocolitis
References Gut. Sep 1991; 32(9): 1020–1023