Diversion colitis occurs commonly in the large bowel remnant after diversion of the fecal stream. Several experimental models of colitis have been described, but none examine the inflammatory alterations that can occur in experimentally defunctioned colons. This characterization could be useful in understanding pathophysiological aspects of diversion colitis, and in developing future therapeutic strategies. Thus, we evaluated the temporal inflammatory alterations in the defunctioned colon of rats by analyzing the histological results, infiltrating neutrophils, pro-inflammatory markers such as cyclooxygenase (COX)-2 and inducible nitric oxide synthase (iNOS), and DNA damage in isolated colonocytes. We compared the obtained data with those from hapten-induced colitis. The experimental diversion of the colon fecal stream induces diversion colitis characterized by an early inflammatory process with increased neutrophil infiltrate, and COX-2 and iNOS expression that resembles, in some aspects, the inflammatory characteristics of chemically induced colitis. After acute inflammation resolution, there was an increase in COX-2 and iNOS expression and the presence of lymphoid follicular hyperplasia and ulcerations, suggesting that diversion colitis can be experimentally established and useful for studying different pathophysiological aspects of this condition.
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http://dx.doi.org/10.3109/00365520903471572 | DOI Listing |
Introduction: Gastroenterocolitis is one of the adverse events related to immune checkpoint inhibitors. However, inflammation of the intestinal lesion used for urinary diversion is not well known as an adverse event related to their use.
Case Presentation: A patient with metastatic bladder cancer was administered pembrolizumab as second-line treatment.
Cureus
November 2024
Gastroenterology, Barts Health NHS Trust, London, GBR.
Ulcerative colitis (UC) is a chronic immune-mediated intestinal condition. This case report describes an 82-year-old woman who was newly diagnosed with UC. Two years prior, she had multiple admissions for abdominal pain and rectal bleeding, initially diagnosed as diverticulitis.
View Article and Find Full Text PDFBMJ Case Rep
November 2024
Gastroenterology, Southport and Ormskirk Hospital NHS Trust, Southport, UK.
Diversion colitis is a common phenomenon affecting patients after defunctioning ileostomy. We present a complex case of diversion colitis where the patient was deemed unsuitable for restorative surgery due to multiple areas of stricturing in a long defunctioned colonic segment. Despite initial treatments with rectally administered topical mesalazine, butyrate enemas and topical steroid therapy, the patient remained symptomatic with rectal bleeding and mucus discharge.
View Article and Find Full Text PDFBiomed Mater
November 2024
Core Labs, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia.
This study aimed to optimize mesalamine (MES)-nanoparticles (NPs) using Box Behnken Design and investigate itsantioxidant potential in colon drug targeting. The formulation was prepared using oil/water (O/W) emulsion solvent evaporation technique for time dependent colonic delivery. The optimal formulation with the following parameters composition was selected: polymer concentration (% w/w) (A) = 0.
View Article and Find Full Text PDFAm Surg
October 2024
Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Introduction: The impact of diverting ileostomy in adults with ulcerative colitis (UC) undergoing ileal pouch-anal anastomosis (IPAA) is unclear. This study uses a novel approach with population-level data to identify patients with diverting ileostomy at the time of IPAA and determine the impact of diverting ileostomy on postoperative outcomes.
Methods: Using the International Business Machines (IBM) MarketScan® database, adults (18-64 years old) with a diagnosis of UC who underwent IPAA between 2000 and 2019 were examined.
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