36 yr old female presented with rectal bleeding, tensmus and mucus discharge 3 yrs after temporary loop ileostomy for refractory CD. Inicially she managed well with medical therapy. stomoscopy was normal. Flex sigi found diversion colitis.
what is the treatment :
1-Mesalasines
2-Acetrasol supp
3-steroids supp
4-refer to surgery
5-Short-chain fatty acid enema
Diversion colitis is inflammation in the defunctional loop of a colostomy.
It usually occur within few months or after long delay following diversion.
it is thought to result form deficiency of short-chain fatty acids.
Not mandatory to have histological evidence and not all those with histological evidence have symptoms.
Usually respond to SCFA enemas, steroid amd meslasines enamas has a role.
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