The authors present a revision of diversion colitis. It is an inflammatory disorder that occurs in the colorectum segment after a diverting colostomy. The main features of this disease are: colon or rectum disfunction; no previous intestinal inflammatory disorder; it never attacks the colon upper colostomy; after intestinal transit restoration, the inflammatory process is solved. Many hypothesis are postulated to explain its occurrance. They include: fecal stasis; changes in the bacterial population of colon; nutritional deficiency of colonic epithelium due to the absence of short chain fatty acids in the defunctionalized segment is the most accepted nowadays. The absence of fatty acids produces energetic defficiency in colon mucosa, reduced electrolite absorption and secretion, and reduced mucus production. The patients have abdominal pain, mucus diarrhoea and bleeding. Histopathological features include chronical inflamation of colon wall, vascular congestion and changes in mucosa cripts. Lynphoid hiperplasy of mucosa and submucosa are common. The diagnosis is done by endoscopy, radiology, pathology and laboratory data. Surgery is considered the best treatment and when the intestinal continuity is restored the patients get cured. The topical use of short chain fatty acids by enema have had good results in some cases. As diversion colitis results in many assimptomatic patients, its incidence is understimated and more attention is needed always when a colostomy is done.
Derivation colitis; Short-chain fatty acids; Intestinal mucosa