Relationship between diversion colitis and quality of life in rectal cancer

Dong Nyoung Son, Dong Jin Choi, Si Uk Woo, Jin Kim, Bo Ra Keom, Chul Hwan Kim, Se Jin Baek, Seon Hahn Kim

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24 Citations (Scopus)

Abstract

AIM: To investigated the incidence of diversion colitis (DC) and impact of DC symptoms on quality of life (QoL) after ileostomy reversal in rectal cancer. METHODS: We performed a prospective study with 30 patients who underwent low anterior resection and the creation of a temporary ileostomy for the rectal cancer between January 2008 and July 2009 at the Department of Surgery, Korea University Anam Hospital. The participants totally underwent two rounds of the examinations. At first examination, endoscopies, tissue biopsies, and questionnaire survey about the symptom were performed 3-4 mo after the ileostomy creations. At second examination, endoscopies, tissue biopsies, and questionnaire survey about the symptom and QoL were performed 5-6 mo after the ileostomy reversals. Clinicopathological data were based on the histopathological reports and clinical records of the patients. RESULTS: At the first examination, all of the patients presented with inflammation, which was mild in 15 (50%) patients, moderate in 11 (36.7%) and severe in 4 (13.3%) by endoscopy and mild in 14 (46.7%) and moderate in 16 (53.3%) by histology. At the second examination, only 11 (36.7%) and 17 (56.7%) patients had mild inflammation by endoscopy and histology, respectively. There was no significant difference in DC grade between the endoscopic and the histological findings at first or second examination. The symptoms detected on the first and second questionnaires were mucous discharge in 12 (40%) and 5 (17%) patients, bloody discharge in 5 (17%) and 3 (10%) patients, abdominal pain in 4 (13%) and 2 (7%) patients and tenesmus in 9 (30%) and 5 (17%) patients, respectively. We found no correlation between the endoscopic or histological findings and the symptoms such as mucous discharge, bleeding, abdominal pain and tenesmus in both time points. Diarrhea was detected in 9 patients at the second examination; this number correlated with the severity of DC (0%, 0%, 66.7%, 33.3% vs 0%, 71.4%, 23.8%, 4.8%, P = 0.001) and the symptom-related QoL (r = -0.791, P < 0.001). CONCLUSION: The severity of DC is related to diarrhea after an ileostomy reversal and may adversely affect QoL.

Original languageEnglish
Pages (from-to)542-549
Number of pages8
JournalWorld journal of gastroenterology
Volume19
Issue number4
DOIs
Publication statusPublished - 2013

Keywords

  • Diarrhea
  • Diversion colitis
  • Ileostomy
  • Quality of life
  • Rectal cancer

ASJC Scopus subject areas

  • Gastroenterology

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  • Cite this

    Son, D. N., Choi, D. J., Woo, S. U., Kim, J., Keom, B. R., Kim, C. H., Baek, S. J., & Kim, S. H. (2013). Relationship between diversion colitis and quality of life in rectal cancer. World journal of gastroenterology, 19(4), 542-549. https://doi.org/10.3748/wjg.v19.i4.542