title: Diversion colitis 25 years later: the phenomenon of the disease.
abstract: BACKGROUND
  Diversion colitis (DC) seems to be common in stoma patients, and the restoration of the continuity of the digestive tract is crucial for relief from the inflammatory process. No prospective studies of the late effects of DC on the lower gastrointestinal (GI) tract mucosa and the clinical condition of patients have been reported.
  
  
  METHODS
  Data from 23 patients who underwent stoma creation were analysed during the reversal period (A) and at an average of 3 months (B1) and 5.6 years (B2) after restoration of GI tract continuity. Every monitoring visit included endoscopy, histology and assessment of the clinical condition of patients.
  
  
  RESULTS
  Shortly after GI tract restoration (B1), a significant decrease in inflammation was observed. The Ki67 positivity percentage increased, but this was not significant. At an average of 5.6 years after restoration (group B2), the clinical symptoms were mild. More patients presented with endoscopically detected inflammation of the mucosa, but its severity was not significantly higher than that at 3 months after reversal. Histological inflammation was more common, and its severity was significantly higher than that shortly after reversal but similar to that before reversal. The Ki67 positivity percentage decreased at the last examination (B2).
  
  
  CONCLUSIONS
  The results of this study show a complex recurrence of histological inflammation several years after GI tract restoration but without clinical and endoscopic inflammation and with good clinical condition. DC can potentially have a late influence on the rectal mucosa, even after stoma closure.
authors.affiliation: Clinical Department of General and Colorectal Surgery, Bielanski Hospital, Warsaw, Poland.|Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Szczepkowski
authors.affiliation: Department of General, Endocrynological Surgery and Gastrointestinal Oncology, Poznan University of Medical Sciences, ul. Przybyszewskiego 49, 60-355, Poznań, Poland. tbanasiewicz@op.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Banasiewicz
authors.affiliation: Clinical Department of General and Colorectal Surgery, Bielanski Hospital, Warsaw, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Kobus
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003092:Colitis / Q000473:pathology*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D007413:Intestinal Mucosa / Q000473:pathology; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged
chemical_list: D019394:Ki-67 Antigen
keywords: Diversion colitis; Inflammation; Mucosal proliferation; Rectal stump