Lymphocytic Colitis Treated with Proctocolectomy and Ileal J-Pouch-Anal Anastomosis

Abstract

We present a case of severe diarrhea caused by lymphocytic colitis and concurrent celiac sprue in a patient who did not respond to maximal medical therapy and required surgery. The patient was initially treated with fecal diversion via an end ileostomy. Six months later, she underwent colectomy and one-stage ileal J-pouch-anal anastomosis. Notably, the characteristic microscopic changes of lymphocytic colitis were still present at the time of colectomy despite diversion. Colectomy with continent reconstruction is an option for treatment of patients with lymphocytic colitis refractory to medical therapy.