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Differential diagnosis of DP from the underlying disease in patients with inflammatory bowel diseases (IBD) is often unclear. As a result, it might be difficult to undertake any specific treatment. We aimed to systematically review the literature evidence on DP in IBD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For this qualitative systematic review, we searched PubMed, EMBASE and Scopus to identify all studies published until July 2021 including IBD patients affected by DP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 37 papers published between 1982 and 2021 were included. A total of 1.211 IBD patients were included: 613 UC (50.6%), 524 CD (43.3%), 66 IBD\u2010unclassified (IBD\u2010U) (5.4%), 8 unspecified patients (0.7%). Most patients with DP are asymptomatic, although inflammation is detectable in almost all patients with a rectal stump. Reduced short\u2010chain fatty acids and an altered microbiome, may trigger mucosal inflammation and have been proposed as causing factors. An increased risk of developing cancer on DP has been reported in patients with a history of previous dysplasia\/cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The etiopathogenesis of DP is still unknown. The efficacy of mesalamine, corticosteroids or short\u2010chain fatty acids has not been proven by randomized trials yet. Since the incidence of cancer of the rectal stump can reach 4.5 per 1.000 diverted patients\u2010year, IBD patients undergoing subtotal colectomy with end\u2010ileostomy should undergo close endoscopic surveillance, being eventually counseled for surgery with or without the restoration of the intestinal continuity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12175","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T16:37:08Z","timestamp":1638290228000},"page":"1157-1167","source":"Crossref","is-referenced-by-count":25,"title":["Diversion proctocolitis and the problem of the forgotten rectum in inflammatory bowel diseases: A systematic review"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-4355","authenticated-orcid":false,"given":"Arianna","family":"Dal Buono","sequence":"first","affiliation":[{"name":"IBD Center Department of Gastroenterology Humanitas Research Hospital \u2013 IRCCS  Rozzano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Carvello","sequence":"additional","affiliation":[{"name":"Colon and Rectal Surgery Division Humanitas Research Hospital \u2013 IRCCS  Rozzano Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Pieve Emanuele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Sachar","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Spinelli","sequence":"additional","affiliation":[{"name":"Colon and Rectal Surgery Division Humanitas Research Hospital \u2013 IRCCS  Rozzano Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Pieve Emanuele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Danese","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Roda","sequence":"additional","affiliation":[{"name":"IBD Center Department of Gastroenterology Humanitas Research Hospital \u2013 IRCCS  Rozzano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i16.1734"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(81)90003-2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(84)90547-X"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2000.11753522"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-017-4618-7"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13356"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjx009"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjw040"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamasurg.325"},{"issue":"3","key":"e_1_2_10_11_1","first-page":"173","article-title":"Indeterminate colitis \u2013 definition, diagnosis, characteristics and management","volume":"21","author":"Telakis E","year":"2008","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-006-0127-4"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02049711"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjx008"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2013.10.008"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i4.542"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2018.05.010"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.01.010"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izy253"},{"key":"e_1_2_10_20_1","volume-title":"Cochrane handbook for systematic reviews of interventions","author":"Higgins JPT","year":"2020"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2385"},{"key":"e_1_2_10_22_1","unstructured":"Anon. 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