Gut Liver.
2014 Mar;8(2):170-176.
Relationship between the Severity of Diversion Colitis and the Composition of Colonic Bacteria: A Prospective Study
- Affiliations
-
- 1Department of Surgery, Korea University College of Medicine, Seoul, Korea. drkimsh@korea.ac.kr
- 2Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea.
- 3Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
- 4Department of Pathology, Korea University College of Medicine, Seoul, Korea.
Abstract
- BACKGROUND/AIMS
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.
METHODS
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.
RESULTS
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).
CONCLUSIONS
The colonic microflora differed significantly between the diversion and control groups. Bifidobacterium was negatively correlated with the severity of diversion colitis.
MeSH Terms
-
Aged
Aged, 80 and over
Case-Control Studies
Colitis/*microbiology
Colon/*microbiology
Female
Gram-Negative Bacteria/isolation & purification
Gram-Positive Bacteria/isolation & purification
Humans
Ileostomy
Male
Middle Aged
Polymerase Chain Reaction
Pouchitis/*microbiology
Prospective Studies
Rectal Neoplasms/microbiology/surgery
