Diversion colitis: A cause of abdominal discomfort in spinal cord injury patients with colostomy

Jenny Lai, Tien Yow Chuang, Gerard E. Francisco, Jonathan R. Strayer

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Diversion colitis is thought to result from nutritional deficiencies secondary to fecal diversion. Symptoms include hemorrhagic purulent rectal discharge, abdominal pain, and tenesmus. 5-Aminosalicylic acid (5-ASA) and N- butyrate enemas have been reported to help this condition in non-spinal cord injury (SCI) patients. We report the case of a 49-year-old C6 ASIA B tetraplegic man who had received colostomy because of intractable ileus 10 years earlier. He presented with a 2-week history of rectal pain and bleeding. Abdominal and rectal examination on admission were unremarkable. Colonoscopy showed a partial stricture 70cm proximally to the rectum. The colonic mucosa appeared granular and friable with evidence of linear ulceration. Histopathologic study was consistent with colitis. The patient developed fever, abdominal distention, and extensive retroperitoneal air after endoscopy, suggesting colonic perforation. He was treated with daily 5- ASA suppository and total parenteral nutrition for the presumed diagnosis of diversion colitis, and intravenous antibiotics for perforated colon. After 6 weeks of treatment with 5-ASA, the patient had decreased rectal pain and bleeding. This experience suggests that diversion colitis may be a cause of abdominal discomfort in SCI patients and that 5 ASA may be used in the management of diversion colitis.

Original languageEnglish (US)
Pages (from-to)670-671
Number of pages2
JournalArchives of Physical Medicine and Rehabilitation
Volume78
Issue number6
DOIs
StatePublished - Jan 1 1997

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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