engleski

Prevention of diversion colitis

Background: diversion of the faecal stream by colostomy leads to inflammation in the defunctioned segment, known as diversion colitis. Colostomy closure has a high rate of stricture formation and needs to be delayed in these patients. Diversion colitis represents an inflammatory state resulting from a nutritional deficiency in the lumen of the colonic epithelium. Therefore, it can potentially benefit significantly from local application of polysaccharide fibers. Objectives and research questions: determine whether the enema with polysaccharide fibers is effective in preventing the development of diversion colitis. Design: prospective multicentre randomised controlled trial. Inclusion Criteria: patients >18 years old who have undergone colostomy formation will be randomized to treatment with fiber enema or placebo. Exclusion criteria: patients with IBD ; patients allergic to any of the preparations used in the study. Primary outcome parameters: incidence of diversion colitis after colostomy formation evaluated by endoscopic biopsies. Secondary outcome parameters: postoperative complications after colostomy closure. Group size calculation: to show a 30% reduction of incidence rate in the group treated with fiber enema, with an 80% power and p<0.05, 58 patients per group will be necessary. Time frame: patients will be recruited within 2 years and outcome evaluated until one year after colostomy closure.

diversion colitis

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