Relationship Between Diversion Colitis and Quality of Life in Rectal Cancer

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2013 Feb 6

PMID 23382634

Citations 19

Authors

Dong Nyoung Son

Dong Jin Choi

Si Uk Woo

Jin Kim

Bo Ra Keom

Chul Hwan Kim

Se Jin Baek

Seon Hahn Kim

Affiliations

Soon will be listed here.

Abstract

Aim: To investigated the incidence of diversion colitis (DC) and impact of DC symptoms on quality of life (QoL) after ileostomy reversal in rectal cancer.

Methods: We performed a prospective study with 30 patients who underwent low anterior resection and the creation of a temporary ileostomy for the rectal cancer between January 2008 and July 2009 at the Department of Surgery, Korea University Anam Hospital. The participants totally underwent two rounds of the examinations. At first examination, endoscopies, tissue biopsies, and questionnaire survey about the symptom were performed 3-4 mo after the ileostomy creations. At second examination, endoscopies, tissue biopsies, and questionnaire survey about the symptom and QoL were performed 5-6 mo after the ileostomy reversals. Clinicopathological data were based on the histopathological reports and clinical records of the patients.

Results: At the first examination, all of the patients presented with inflammation, which was mild in 15 (50%) patients, moderate in 11 (36.7%) and severe in 4 (13.3%) by endoscopy and mild in 14 (46.7%) and moderate in 16 (53.3%) by histology. At the second examination, only 11 (36.7%) and 17 (56.7%) patients had mild inflammation by endoscopy and histology, respectively. There was no significant difference in DC grade between the endoscopic and the histological findings at first or second examination. The symptoms detected on the first and second questionnaires were mucous discharge in 12 (40%) and 5 (17%) patients, bloody discharge in 5 (17%) and 3 (10%) patients, abdominal pain in 4 (13%) and 2 (7%) patients and tenesmus in 9 (30%) and 5 (17%) patients, respectively. We found no correlation between the endoscopic or histological findings and the symptoms such as mucous discharge, bleeding, abdominal pain and tenesmus in both time points. Diarrhea was detected in 9 patients at the second examination; this number correlated with the severity of DC (0%, 0%, 66.7%, 33.3% vs 0%, 71.4%, 23.8%, 4.8%, P = 0.001) and the symptom-related QoL (r = -0.791, P < 0.001).

Conclusion: The severity of DC is related to diarrhea after an ileostomy reversal and may adversely affect QoL.

Citing Articles

An updated review on the treatment for diversion colitis and pouchitis, with a focus on the utility of autologous fecal microbiota transplantation and its relationship with the intestinal microbiota.

Tominaga K, Kojima Y, Kawata Y, Takahashi K, Sato H, Tsuchiya A Biosci Microbiota Food Health. 2024; 43(3):162-169.

PMID: 38966047 PMC: 11220330. DOI: 10.12938/bmfh.2024-014.

Successful allogeneic fecal microbiota transplantation for severe diversion colitis: a case report.

Cheng C, Wang X, Fan L, Lv Y, Xiong K, Jiang Z J Int Med Res. 2024; 52(5):3000605241241000.

PMID: 38749910 PMC: 11107325. DOI: 10.1177/03000605241241000.

The Quality of Life of Patients with Surgically Treated Colorectal Cancer: A Narrative Review.

Swiatkowski F, Gornicki T, Buldys K, Chabowski M J Clin Med. 2022; 11(20).

PMID: 36294531 PMC: 9604858. DOI: 10.3390/jcm11206211.

Diversion proctocolitis and the problem of the forgotten rectum in inflammatory bowel diseases: A systematic review.

Dal Buono A, Carvello M, Sachar D, Spinelli A, Danese S, Roda G United European Gastroenterol J. 2021; 9(10):1157-1167.

PMID: 34845854 PMC: 8672074. DOI: 10.1002/ueg2.12175.

Low anterior resection syndrome: can it be prevented?.

Annicchiarico A, Martellucci J, Solari S, Scheiterle M, Bergamini C, Prosperi P Int J Colorectal Dis. 2021; 36(12):2535-2552.

PMID: 34409501 DOI: 10.1007/s00384-021-04008-3.

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