Relationship between the Severity of Diversion Colitis and the Composition of Colonic Bacteria: A Prospective Study

• Published in: Gut and liver Vol. 8; no. 2; pp. 170 - 176
• Main Authors: Baek, Se-Jin, Kim, Seon-Hahn, Lee, Chang-Kyu, Roh, Kyoung-Ho, Keum, Bora, Kim, Chul-Hwan, Kim, Jin
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Pancreatobiliary Association; Korean Society of Gastrointestinal Cancer 01.03.2014; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Aged; Aged, 80 and over; Case-Control Studies; Colitis - microbiology; Colon - microbiology; colonic bacteria; diversion colitis; Female; Gram-Negative Bacteria - isolation & purification; Gram-Positive Bacteria - isolation & purification; Humans; Ileostomy; Male; Middle Aged; Original; Polymerase Chain Reaction; Pouchitis - microbiology; Prospective Studies; rectal neoplasms; Rectal Neoplasms - microbiology; Rectal Neoplasms - surgery; 내과학; Polymerase chain reaction; Rectal neoplasms; Colonic bacteria; Diversion colitis
• ISSN: 1976-2283; 2005-1212; 2005-1212
• DOI: 10.5009/gnl.2014.8.2.170

Diversion colitis is the inflammation of the excluded segment of the colon in patients undergoing ostomy. It has been suggested that a change in colonic flora may lead to colitis; however, direct evidence for this disease progression is lacking. The aim of this study was to evaluate the relationship between the severity of diversion colitis and the composition of colonic bacteria. We used culture methods and polymerase chain reaction to analyze the colonic microflora of patients who underwent rectal cancer resection with or without diversion ileostomy. In the diversion group, we also evaluated the severity of colonoscopic and pathologic colitis before reversal. This study enrolled 48 patients: 26 in the diversion group and 22 in the control group. Significant differences were observed between the two groups in the levels of Staphylococcus (p=0.038), Enterococcus (p<0.001), Klebsiella (p<0.001), Pseudomonas (p=0.015), Lactobacillus (p=0.038), presence of anaerobes (p=0.019), and Bifidobacterium (p<0.001). A significant correlation between the severity of colitis and bacterial composition was only observed for Bifidobacterium (p=0.005, correlation coefficient=-0.531). The colonic microflora differed significantly between the diversion and control groups. Bifidobacterium was negatively correlated with the severity of diversion colitis.