Ileostomy and colostomy are both surgical procedures to create an opening in the abdomen to reroute the gastrointestinal (GI) tract. Diversion colitis (DC) is a condition that causes a part of the colon to become inflamed after these procedures.

Colostomy and ileostomy both involve rerouting the GI tract through an opening in the abdomen. This opening is called a stoma.

A person then wears a collection bag over the stoma. This bag collects the digestive waste that no longer passes through the digestive system.

DC is a possible complication of these procedures. It can cause a person to experience abdominal pain and rectal bleeding among other symptoms.

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DC is an inflammatoryTrusted Source disease. It affects the area of the colon that no longer functions after a colostomy or ileostomy.

DC occurs when this part of the colon becomes inflamed.

Studies show that DC occurs in almost all patients who undergo surgery to divert their GI tract. However, the vast majority of these people will experience no symptoms.

Medical professionals often associate DC with inflammatory bowel disease (IBD). This is because colostomies often take place as a treatment for this condition.

However, DC can also occur after surgical treatment for a number of other conditions, such as:

The majority of people with DC will experience no symptoms.

However, DC can cause a variety of symptoms in some people. These include:

  • abdominal pain and discomfort
  • the feeling of needing a bowel movement despite having empty bowels
  • anus or rectum pain
  • rectal bleeding
  • mucus discharge

Medical professionals refer toTrusted Source the procedure of creating a stoma as an ostomy. The name of the ostomy surgery depends on which part of the GI tract the surgeon uses to create the stoma.

Colostomy

During a colostomy, a surgeon creates an openingTrusted Source through the skin in the abdomen and then inserts the colon through the opening.

The surgeon then connects the colon to the skin on the outside of the body, creating a stoma.

Then, they make an opening so that the contents of the colon can leave the body through the stoma.

Ileostomy

An ileostomy is very similar to a colostomy. However, during an ileostomy, a surgeon creates a stoma usingTrusted Source a section of the small intestine rather than the colon.

DC occurs in people who have undergoneTrusted Source colostomy or ileostomy surgery. However, medical professionals do not fully understand what causes DC.

Possible theories about what may cause DC include:

  • changes to the gut microbiome
  • overgrowth of certain bacteria
  • the presence of harmful bacteria
  • nutritional deficiencies
  • toxins
  • disturbance in the relationship between luminal bacteria and the mucosal layer of the colon

More research is needed to determine what causes DC to develop.

When diagnosing DC, a doctor often starts by taking a person’s medical history and discussing their symptoms. They may then perform a physical examination.

A medical professional might perform an endoscopy or colonoscopy to look for inflammation in the GI tract.

An endoscopy is a test that a medical professional performs to examine the internal organs. It involves using a thin tube with a camera inside called an endoscope.

During the endoscopy for DC, a medical professional passes the endoscope through a person’s mouth and into their body, down to their GI tract.

A colonoscopy is similar to an endoscopy. During a colonoscopy, a medical professional will passTrusted Source an endoscope through a person’s anus. They can then use this to look inside the rectum and colon.

A doctor may also carry out blood tests to look for signs of inflammation.

Ileostomy and colostomy surgery may also cause other complicationsTrusted Source around the stoma as well as skin complications.

Possible stoma complications include:

  • bleeding from the stoma
  • stoma retraction, where the stoma sinks below the level of the skin
  • stoma separation, where the stoma separates from the skin surrounding it
  • a lack of blood supply to the stoma causing death of stoma tissue
  • stoma hernia
  • stoma prolapse

Possible skin complications include:

  • bacterial or fungal infections of the skin around the stoma
  • irritation, if intestinal contents touch the skin
  • irritation due to applying or changing the ostomy pouch

Other possible complications include:

  • dehydration
  • issues absorbing nutrients
  • intestinal obstruction

Below are some of the possible treatments for DC.

Surgery

In some severe cases, a person with DC may require surgery to treat their condition. The surgical procedure that halts DC symptoms is called reanastomosis.

Reanastomosis is the process of reattaching the bowel so waste continues to pass through the colon once again. This can cause problems, as it may lead to the symptoms of the underlying condition that led to the initial colostomy returning.

Another possible surgical treatment for DC is a resection. Some medical professionals refer to a resection of the colon as a colectomy. During this procedure, a surgeon will removeTrusted Source all or part of the colon.

Enemas

During an enema, a medical professional will injectTrusted Source liquid through the anus so it travels into the colon.

They may use enemas containing certain substances to reduce inflammation in people with DC.

Possible enemas for treating DC include:

  • short-chain fatty acids, including butyrate
  • 5-aminosalicylic acid
  • corticosteroids

Autologous fecal transplantation

Autologous fecal transplantation is a procedure that involves transferring stool from a healthy donor to the patient’s colon.

This procedure is an effective treatment for certain colon diseases, including Crohn’s disease and recurrent Clostridium difficile infections.

Studies suggest that autologous fecal transplantation may also be an effective and safe option for treating DC if standard therapies fail. This may be due to the interruption of the fecal stream playing a role in the development of DC.

More research is required to determine if this treatment is effective for DC.

DC is an inflammatory condition affecting the inactive section of the colon following a colostomy or ileostomy. While nearly all patients undergoing GI diversion develop DC, most remain asymptomatic.

Possible symptoms of DC may include abdominal pain, rectal discomfort, bleeding, mucus discharge, and the sensation of incomplete bowel movements.

The exact cause of DC is unclear, but theories suggest changes in the gut microbiome, bacterial imbalances, nutritional deficiencies, or disruptions in gut bacteria may cause the condition.

Treatment options for DC include surgery, such as reanastomosis or resection, or enemas containing anti-inflammatory substances. Possible substances include corticosteroids or short-chain fatty acids.

Autologous fecal transplantation may be another possible treatment for DC. This procedure involves transferring stool from a healthy donor to the patient’s colon.