Diversion procto-colitis: Response to treatment with short-chain fatty acids

Background/Purpose: Diversion procto-colitis (DPC) results from a deficienc y of luminal short-chain fatty acids (SCFAs). Endoscopic and histopathologi c features of the disorder are almost universally present in defunctioned b owel, but symptomatic DPC is less common. Methods: Five children with symptomatic DPC underwent endoscopy and rectosi gmoid biopsies. An endoscopic index (El) was used to quantify disease sever ity. An SCFA mixture was administered into the defunctioned bowel. Results: A good clinical response and improvement in the endoscopic index o ccurred in all children. Undiversion or rectal excision was carried out in 4 and was curative in each case. One child is awaiting a redo pull through. Conclusions: DPC should be considered in children with a defunctioned colon presenting with evidence of colitis. Histopathology provides supportive ev idence and SCFAs may provide effective relief of symptoms. Stoma reversal o r rectal excision is curative. Copyright (C) 2001 by W B. Saunders Company.