PDF(Pubmed)
Abstract：
Diversion colitis (DC) is characterized by mucosal inflammation in the defunctioned segment of the colon following a colostomy or ileostomy. The major causes of DC are an increase in the number of aerobic bacteria, a lack of short-chain fatty acids (SCFAs), and immune disorders in the diverted colon. However, its exact pathogenesis remains unknown. Various treatment strategies for DC have been explored, although none have been definitively established. Treatment approaches such as SCFAs, 5-aminosalicylic acid enemas, steroid enemas, and irrigation with fibers have been attempted, yielding various degrees of efficacies in mitigating mucosal inflammation. However, only individual case reports demonstrating the limited effect of the following therapies have been published: leukocytapheresis, dextrose (hypertonic glucose) spray, infliximab, an elemental diet, and coconut oil. The usefulness of probiotics for treating DC has recently been reported. Furthermore, fecal microbiota transplantation (FMT) has emerged as a promising treatment for DC. This review provides an update on the treatment strategies of DC, with a particular focus on FMT and its relationship with the intestinal microbiota. FMT may become the first choice of treatment for some patients in the future because of its low medical costs, ease of use, and minimal side effects. Furthermore, FMT can also be used for postoperative DC prophylaxis.
摘要：
转移性结肠炎（DC）的特征是结肠造口术或回肠造口术后结肠功能衰竭段的粘膜炎症。DC的主要原因是需氧细菌数量的增加，缺乏短链脂肪酸（SCFA），和转移结肠的免疫紊乱。然而,其确切的发病机制尚不清楚。已经探索了DC的各种治疗策略，虽然还没有确定。SCFA等治疗方法，5-氨基水杨酸灌肠剂，类固醇灌肠,并尝试用纤维灌溉，在减轻粘膜炎症方面产生不同程度的功效。然而,仅发表了证明以下疗法效果有限的个别病例报告：白细胞分离术，葡萄糖（高渗葡萄糖）喷雾剂，英夫利昔单抗,基本的饮食，和椰子油。最近已经报道了益生菌用于治疗DC的有用性。此外，粪便微生物移植（FMT）已成为DC的有希望的治疗方法。这篇综述提供了DC治疗策略的最新信息，特别关注FMT及其与肠道微生物群的关系。FMT因其低廉的医疗费用,未来可能成为部分患者的首选治疗方案,易用性,和最小的副作用。此外，FMT也可用于术后DC预防。
