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Sample records for bowel preparation one-center

  1. Physiologic effects of bowel preparation

    DEFF Research Database (Denmark)

    Holte, Kathrine; Nielsen, Kristine Grubbe; Madsen, Jan Lysgård;

    2004-01-01

    PURPOSE: Despite the universal use of bowel preparation before colonoscopy and colorectal surgery, the physiologic effects have not been described in a standardized setting. This study was designed to investigate the physiologic effects of bowel preparation. METHODS: In a prospective study, 12...... preparation has significant adverse physiologic effects, which may be attributed to dehydration. The majority of these findings is small and may not be of clinical relevance in otherwise healthy patients undergoing bowel preparation and following recommendations for oral fluid intake....

  2. Bowel preparation for CT colonography

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    Neri, Emanuele, E-mail: emanuele.neri@med.unipi.it [Diagnostic and Interventional Radiology, University of Pisa (Italy); Lefere, Philippe; Gryspeerdt, Stefaan [Department of Radiology, Stedelijk Ziekenhuis, Roeselare (Belgium); Bemi, Pietro; Mantarro, Annalisa; Bartolozzi, Carlo [Diagnostic and Interventional Radiology, University of Pisa (Italy)

    2013-08-15

    Bowel preparation represents an essential part of CT colonography, as the accuracy of the exam is strongly related to the adequacy of colonic cleansing, and a poor bowel preparation may compromise the diagnostic quality even despite optimization of all other acquisition parameters. Residual stool and fluid in the large bowel may affect the interpretation of the exam and may increase the number of false positives and false negatives. In this regard, the majority of patients having undergone CT colonography state that bowel preparation is the most unpleasant part. Unfortunately, to date no definite consensus has been reached about the ideal bowel preparation technique, and there is great variability in preparation strategies across diagnostic centers. The purpose of this review article is to describe the development and evolution of bowel preparation techniques in order to choose the best approach for optimizing the diagnostic quality of CT colonography in each patient.

  3. Optimal Bowel Preparation for Video Capsule Endoscopy

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    Hyun Joo Song

    2016-01-01

    Full Text Available During video capsule endoscopy (VCE, several factors, such as air bubbles, food material in the small bowel, and delayed gastric and small bowel transit time, influence diagnostic yield, small bowel visualization quality, and cecal completion rate. Therefore, bowel preparation before VCE is as essential as bowel preparation before colonoscopy. To date, there have been many comparative studies, consensus, and guidelines regarding different kinds of bowel cleansing agents in bowel preparation for small bowel VCE. Presently, polyethylene glycol- (PEG- based regimens are given primary recommendation. Sodium picosulphate-based regimens are secondarily recommended, as their cleansing efficacy is less than that of PEG-based regimens. Sodium phosphate as well as complementary simethicone and prokinetics use are considered. In this paper, we reviewed previous studies regarding bowel preparation for small bowel VCE and suggested optimal bowel preparation of VCE.

  4. Mechanical bowel preparation for elective colorectal surgery

    DEFF Research Database (Denmark)

    Güenaga, Katia F; Matos, Delcio; Wille-Jørgensen, Peer

    2011-01-01

    The presence of bowel contents during colorectal surgery has been related to anastomotic leakage, but the belief that mechanical bowel preparation (MBP) is an efficient agent against leakage and infectious complications is based on observational data and expert opinions only.An enema before the...

  5. Mechanical bowel preparation for elective colorectal surgery

    DEFF Research Database (Denmark)

    Güenaga, Katia F; Matos, Delcio; Wille-Jørgensen, Peer

    2011-01-01

    The presence of bowel contents during colorectal surgery has been related to anastomotic leakage, but the belief that mechanical bowel preparation (MBP) is an efficient agent against leakage and infectious complications is based on observational data and expert opinions only.An enema before the r...

  6. Mechanical bowel preparation for elective colorectal surgery

    DEFF Research Database (Denmark)

    Guenaga, Katia K F G; Matos, Delcio; Wille-Jørgensen, Peer

    2009-01-01

    BACKGROUND: The presence of bowel contents during surgery has been related to anastomotic leakage, but the belief that mechanical bowel preparation (MBP) is an efficient agent against leakage and infectious complications is based on observational data and expert opinions only. OBJECTIVES: To dete......BACKGROUND: The presence of bowel contents during surgery has been related to anastomotic leakage, but the belief that mechanical bowel preparation (MBP) is an efficient agent against leakage and infectious complications is based on observational data and expert opinions only. OBJECTIVES......: To determine the security and effectiveness of MBP on morbidity and mortality in colorectal surgery. SEARCH STRATEGY: Publications describing trials of MBP before elective colorectal surgery were sought through searches of MEDLINE, EMBASE, LILACS, and The Cochrane Library; by handsearching relevant medical...... journals and conference proceedings, and through personal communication with colleagues.Searches were performed March 13, 2008. SELECTION CRITERIA: Randomised controlled trials (RCTs) including participants submitted for elective colorectal surgery. Eligible interventions included any type of MBP compared...

  7. Factors influencing quality of bowel preparation for colonoscopy.

    Science.gov (United States)

    Romero, Ronald V; Mahadeva, Sanjiv

    2013-02-16

    Recent technological advances in colonoscopy have led to improvements in both image enhancement and procedural performance. However, the utility of these technological advancements remain dependent on the quality of bowel preparation during colonoscopy. Poor bowel preparation has been shown to be associated with lower quality indicators of colonoscopy performance, such as reduced cecal intubation rates, increased patient discomfort and lower adenoma detection. The most popular bowel preparation regimes currently used are based on either Polyethylene glycol-electrolyte, a non-absorbable solution, or aqueous sodium phosphate, a low-volume hyperosmotic solution. Statements from various international societies and several reviews have suggested that the efficacy of bowel preparation regimes based on both purgatives are similar, although patients' compliance with these regimes may differ somewhat. Many studies have now shown that factors other than the type of bowel preparation regime used, can influence the quality of bowel preparation among adult patients undergoing colonoscopy. These factors can be broadly categorized as either patient-related or procedure-related. Studies from both Asia and the West have identified patient-related factors such as an increased age, male gender, presence of co-morbidity and socio-economic status of patients to be associated with poor bowel preparation among adults undergoing routine out-patient colonoscopy. Additionally, procedure-related factors such as adherence to bowel preparation instructions, timing of bowel purgative administration and appointment waiting times for colonoscopy are recognized to influence the quality of colon cleansing. Knowledge of these factors should aid clinicians in modifying bowel preparation regimes accordingly, such that the quality of colonoscopy performance and delivery of service to patients can be optimised.

  8. Effect of small bowel preparation with simethicone on capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    You-hong FANG; Chun-xiao CHEN; Bing-ling ZHANG

    2009-01-01

    Background: Capsule endoscopy is a novel non-invasive method for visualization of the entire small bowel. The diagnostic yield of capsule endoscopy depends on the quality of visualization of the small bowel mucosa and its complete passage through the small bowel. To date, there is no standardized protocol for bowel preparation before capsule endoscopy. The addition ofsimethicone in the bowel preparation for the purpose of reducing air bubbles in the intestinal lumen had only been studied by a few investigators. Methods: Sixty-four participants were randomly divided into two groups to receive a bowel preparation of polyethylene glycol (PEG) solution (Group 1) and both PEG solution and simethicone (Group 2). The PEG solution and sime-thicone were taken the night before and 20 min prior to capsule endoscopy, respectively. Frames taken in the small intestine were examined and scored for luminal bubbles by two professional capsule endoscopists. Gastric emptying time and small bowel transit time were also recorded. Results: Simethicone significantly reduced luminal bubbles both in the proximal and distal small intes-tines. The mean time proportions with slight bubbles in the proximal and distal intestines in Group 2 were 97.1% and 99.0%, respectively, compared with 67.2% (P<0.001) and 68.8% (P<0.001) in Group 1. Simethicone had no effect on mean gastric emptying time, 32.08 min in Group 2 compared with 30.88 min in Group 1 (P=0.868), but it did increase mean small intestinal transit time from 227.28 to 281.84 min (P=0.003). Conclusion: Bowel preparation with both PEG and simethicone significantly reduced bubbles in the intestinal lumen and improved the visualization of the small bowel by capsule endoscopy without any side effects observed.

  9. The evolution of bowel preparation and new developments.

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    Park, Jeong Bae; Lee, Yong Kook; Yang, Chang Heon

    2014-05-01

    Bowel preparation is essential for successful colonoscopy examination, and the most important factor is the bowel preparation agent used. However, selection of a bowel preparation agent invariably involves compromise. Originally, bowel preparation was performed for radiologic and surgical purposes, when the process involved dietary limitations, cathartics, and enemas, which had many side effects. Development of polyethylene glycol (PEG) solution led to substantive advancement of bowel preparation; however, despite its effectiveness and safety, the large volume involved, and its salty taste and unpleasant odor reduce compliance. Accordingly, modified PEG solutions requiring consumption of lower volumes and sulfate-free solutions were developed. Aqueous sodium phosphate is more effective and better tolerated than PEG solutions; however, fatal complications have occurred due to water and electrolyte shifts. Therefore, aqueous sodium phosphate was withdrawn by the US Food and Drug Administration, and currently, only sodium phosphate tablets remain available. In addition, oral sulfate solution and sodium picosulfate/magnesium citrate are also available, and various studies have reported on adjunctive preparations, such as hyperosmolar or stimulant laxatives, antiemetics, and prokinetics, which are now in various stages of development.

  10. Modified Bowel Preparation to Reduce Infection after Prostate Biopsy

    OpenAIRE

    Yun-Ching Huang; Dong-Ru Ho; Ching-Fang Wu; Jia-Jen Shee; Wei-Yu Lin; Chih-Shou Chen

    2006-01-01

    Background: Infectious complications after ultrasound guided prostate biopsy are animportant issue of concern. We found a higher infection rate with traditionalbowel preparation, the phosphate enema, for prostate biopsy and so we modifiedour technique. In addition, we tried to assess the efficacy of this modifiedmethod for aged patients in an agricultural area who have poor complianceor inaccuracy when self-administering bowel preparations.Methods: Between April 2002 and May 2005, all patient...

  11. Improving the Quality of Colonoscopy Bowel Preparation Using an Educational Video

    OpenAIRE

    Prakash, Sateesh R; Verma, Siddharth; McGowan, John; Smith, Betsy E.; Shroff, Anjali; Gibson, Gregory H; Cheng, Michael; Lowe, DouglasII; Gopal, Kavitha; Mohanty, Smruti R

    2013-01-01

    Colonoscopy is the preferred modality for colon cancer screening. A successful colonoscopy requires proper bowel preparation. Adequate bowel preparation continues to remain a limiting factor. One hundred thirty-three patients scheduled for an outpatient colonoscopy were prospectively randomized in a single-blinded manner to video or nonvideo group. In addition to written bowel preparation instructions, patients in the video group viewed a brief instructional video. Quality of colon preparatio...

  12. Efficiency of bowel preparation for capsule endoscopy examination:A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Yaron Niv

    2008-01-01

    Good preparation before endoscopic procedures is essential for successful visualization.The small bowel is difficult to evaluate because of its length and complex configuration.A meta-analysis was conducted of studies comparing small bowel visualization by capsule endoscopy with and without preparation.Medical data bases were searched for all studies investigating the preparation for capsule endoscopy of the small bowel up to July 31,2007.Studies that scored bowel cleanness and measured gastric and small bowel transit time and rate of cecum visualization were included.The primary endpoint was the quality of bowel visualization.The secondary endpoints were transit times and proportion of examinations that demonstrated the cecum,with and without preparation.Meta-analysis was performed with StatDirect Statistical software,version 2.6.1 (http://statsdirect.com).Eight studies met the inclusion criteria.Bowel visualization was scored as "good" in 78% of the examinations performed with preparation and 49% performed without (P<0.0001).There were no significant differences in transit times or in the proportion of examinations that demonstrated the cecum with and without preparation.Capsule endoscopy preparation improves the quality of small bowel visualization,but has no effect on transit times,or demonstration of the cecum.

  13. Coffee enema for preparation for small bowel video capsule endoscopy: a pilot study.

    Science.gov (United States)

    Kim, Eun Sun; Chun, Hoon Jai; Keum, Bora; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang

    2014-07-01

    Coffee enemas are believed to cause dilatation of bile ducts and excretion of bile through the colon wall. Proponents of coffee enemas claim that the cafestol palmitate in coffee enhances the activity of glutathione S-transferase, an enzyme that stimulates bile excretion. During video capsule endoscopy (VCE), excreted bile is one of the causes of poor preparation of the small bowel. This study aimed to evaluate the feasibility and effect of coffee enema for preparation of the small bowel during VCE. In this pilot study, 17 of 34 patients were assigned to the coffee enema plus polyethylene glycol (PEG) 2 L ingestion group, whereas the 17 remaining control patients received 2 L of PEG only. The quality of bowel preparation was evaluated in the two patient groups. Bowel preparations in the proximal segments of small bowel were not differ between two groups. In the mid and distal segments of the small intestine, bowel preparations tend to be better in patients who received coffee enemas plus PEG than in patients who received PEG only. The coffee enema group did not experience any complications or side effects. Coffee enemas may be a feasible option, and there were no clinically significant adverse events related to coffee enemas. More prospective randomized studies are warranted to improve small bowel preparation for VCE.

  14. Oral sodium phosphate for bowel preparation in endoscopic submucosal dissection training in a pig model: A pilot study

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    Chien-Yuan Hung

    2015-03-01

    Conclusion: The use of oral sodium phosphate is easy and safe in porcine bowel preparation for ESD training. Bowel preparation using a split dose of 2 mL/kg or 4 mL/kg sodium phosphate produces an adequate bowel cleansing. The optimal dosage still needs to be established in a large-scale study.

  15. DOUBLE-BLIND PROSPECTIVE RANDOMIZED STUDY COMPARING POLYETHYLENE GLYCOL TO LACTULOSE FOR BOWEL PREPARATION IN COLONOSCOPY

    OpenAIRE

    MENACHO, Aline Moraes; REIMANN, Adriano; HIRATA, Lie Mara; GANZERELLA, Caroline; IVANO, Flavio Heuta; SUGISAWA, Ricardo

    2014-01-01

    Background Colonoscopy is the most frequent exam used to evaluate colonic mucosa, allowing the diagnosis and treatment of many diseases. The appropriate bowel preparation is indispensable for the realization of colonoscopy. Therefore, it is necessary the use of laxative medications, preferentially by oral administration. Aim To compare two medications used in bowel preparation in adult patients going to ambulatory colonoscopy and to analyze the patients' profile. Methods A double-blind prospe...

  16. Impact of Educational Cartoon on Pediatric Bowel Preparation Quality at Time of Colonoscopy

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    Elizabeth Maxwell MD

    2014-08-01

    Full Text Available Objective: To evaluate if addition of educational cartoon to pediatric bowel preparation instructions improves the quality of bowel preparation and patient experience. Methods: Patients were randomized to control group receiving standard bowel preparation instructions or intervention group receiving additional educational cartoon. To objectively rate bowel preparation, a blinded endoscopist completed numeric Ottawa score (0-14, with 0 being best. The family also completed a questionnaire rating the bowel preparation process. Results: Data from 23 patients were analyzed. Mean Ottawa score in the intervention group compared with controls was not significantly different (mean scores 3.73 and 3.33, respectively; P = .384. Level of education was significantly correlated with better Ottawa score in the overall population (ρ = −.462, P = .026 and within the control group (ρ = −.658, P = .02. Both groups of patients reported positive experience with bowel preparation. Conclusion: There may be benefit to further investigation of this educational cartoon in parents with less than college level education or non-English-speaking families in larger population of patients.

  17. The Effectiveness of Short Message Service to Assure the Preparation-to-Colonoscopy Interval before Bowel Preparation for Colonoscopy.

    Science.gov (United States)

    Park, Jongha; Kim, Tae-Oh; Lee, Nae-Young; Kim, Hyoungjun; Seo, Eun Hee; Heo, Nae-Yun; Park, Seung Ha; Moon, Young-Soo

    2015-01-01

    Background/Aims. The preparation-to-colonoscopy (PC) interval is one of several important factors for the bowel preparation. Short message service (SMS) reminder from a cellular phone has been suggested to improve compliance in various medical situations. We evaluated the effectiveness of SMS reminders to assure the PC interval for colonoscopy. Methodology. This prospective randomized study was investigator blinded. In the No-SMS group, patients took the first 2 L polyethylene glycol (PEG) between 6 and 8 PM on the day before colonoscopy and the second 2 L PEG approximately 6 hours before the colonoscopy without SMS. In the SMS group, patients took first 2 L PEG in the same manner as the No-SMS group and the second 2 L PEG after receiving an SMS 6 hours before the colonoscopy. Results. The SMS group had a lower score than the No-SMS group, according to the Ottawa Bowel Preparation Scale (P < 0.001). Multivariate logistic regression analysis showed that compliance with diet instructions (odds ratio (OR) 2.109; 95% confidence interval (CI), 1.11-3.99, P = 0.022) and intervention using SMS ((OR) 2.329; 95% (CI), 1.34-4.02, P = 0.002) were the independent significant factors for satisfactory bowel preparation. Conclusions. An SMS reminder to assure PC interval improved the bowel preparation quality for colonoscopy with bowel preparation. PMID:25792978

  18. The Effectiveness of Short Message Service to Assure the Preparation-to-Colonoscopy Interval before Bowel Preparation for Colonoscopy

    Directory of Open Access Journals (Sweden)

    Jongha Park

    2015-01-01

    Full Text Available Background/Aims. The preparation-to-colonoscopy (PC interval is one of several important factors for the bowel preparation. Short message service (SMS reminder from a cellular phone has been suggested to improve compliance in various medical situations. We evaluated the effectiveness of SMS reminders to assure the PC interval for colonoscopy. Methodology. This prospective randomized study was investigator blinded. In the No-SMS group, patients took the first 2 L polyethylene glycol (PEG between 6 and 8 PM on the day before colonoscopy and the second 2 L PEG approximately 6 hours before the colonoscopy without SMS. In the SMS group, patients took first 2 L PEG in the same manner as the No-SMS group and the second 2 L PEG after receiving an SMS 6 hours before the colonoscopy. Results. The SMS group had a lower score than the No-SMS group, according to the Ottawa Bowel Preparation Scale (P<0.001. Multivariate logistic regression analysis showed that compliance with diet instructions (odds ratio (OR 2.109; 95% confidence interval (CI, 1.11–3.99, P=0.022 and intervention using SMS ((OR 2.329; 95% (CI, 1.34–4.02, P=0.002 were the independent significant factors for satisfactory bowel preparation. Conclusions. An SMS reminder to assure PC interval improved the bowel preparation quality for colonoscopy with bowel preparation.

  19. BOWEL PREPARATION BEFORE COLONOSCOPY FOR CHILDREN: comparison of efficacy of three different methods

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    Seyed Mohsen DEHGHANI

    2015-12-01

    Full Text Available Background - Colonoscopy is an important diagnostic and therapeutic procedure. Adequate bowel preparation is mandatory. Several regimens were discussed in the literature. Among the drugs which has recently used, polyethylene glycol is one of the most popular agents. Objectives - The aim of this study was to compare efficacy of three different methods for 1 day preparation before colonoscopy. Methods - This study included children with the range of ages (2-21 who had an indication of colonoscopy. Exclusion criteria were based on the history of previous surgery, parental disagreement, and patients who did not use preparation protocol. Three methods for bowel preparation were studied: 1- Polyethylene glycol only; 2- Polyethylene glycol and bisacodyl suppositories; 3- Polyethylene glycol plus normal saline enema. Boston Bowel Preparation Score was used for evaluation of preparation. SPSS version 16.0 (Chicago, IL, USA were used for data analysis. Results - In this study 83 cases completed the bowel preparation completely. Acceptable bowel preparation was seen in 24 (85.71%, 36 (94.73%, and 14 (82.35% of cases in PEG, PEG + bisacodyl, and PEG + normal saline enema groups respectively. PEG + bisacodyl suppositories was more effective than PEG + normal saline for the preparation of the first segment ( P=0.05. For second and third segment of colon, BPPS score was higher in PEG + bisacodyl suppositories compared to other regimens, but this difference was not statistically significant. Conclusion - There was no significant difference between 1 day colonoscopy regimens in terms of bowel preparation score. Lowest score was seen in PEG + enema group compared to other group.

  20. A Comparison of the Efficacy of Castor Oil and Senagroph Herbal Extract in Patients' Bowel Preparation

    OpenAIRE

    Karim Ghazikanlou Sani; Mahmoodreza Jafari; Hasan Gheshlaghi

    2011-01-01

    Background/Objective: Bowel preparation has been"nconsidered necessary in radiologic examinations of the"nabdominal region to improve the diagnostic quality and"naccuracy. This study compares the effectiveness, side"neffects and patient tolerance of two bowel preparation"nregimens with castor oil and Senagraph herbal extract"nin bowel preparation of outpatients for intravenous"nurography (IVU)."nPatients and Methods: One-hundred fourteen"nconsecuti...

  1. Bowel cleansing before CT colonography: comparison between two minimal-preparation regimens

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    Iafrate, F.; Iannitti, M.; Ciolina, M.; Baldassari, P.; Pichi, A.; Laghi, A. [University of Rome, Department of Radiological Oncological and Pathological Sciences, Rome (Italy)

    2015-01-15

    To compare two regimens of reduced bowel preparation and faecal tagging for CT colonography. Single centre, prospective, randomized, noninferiority study, in which 52 consecutive adults underwent routine CT colonography. Patients, following a three-day low-fibre diet, received one of the two reduced preparations: 1-L polyethylene glycol and four tablets of bisacodyl in association with 90 mL of Iopamidol for faecal tagging administered on the same day as CTC examination (group 1); or a standard ''iodine-only'' preparation, consisting in 180 ml of Iopamidol the day before the examination (group 2). Primary outcome was the overall quality of bowel preparation. Twenty-six patients per group were included. Per segment analysis showed preparation of diagnostic quality in 97.4 % of segments in group 1 and in 95.5 % in group 2 (p = ns). Per-patient analysis showed optimal quality of preparation in 76.9 % of patients in group 1 and in 84.6 % in group 2 (p = ns). Patient tolerability to both preparations was not different. A limited bowel preparation consisting of 1-L PEG and four tablets of bisacodyl in association with 90 mL of Iodine for faecal tagging administered on the same day as CTC examination is feasible and offers bowel cleansing comparable to ''iodine-only'' preparation. (orig.)

  2. Improved Bowel Preparation with Multimedia Education in a Predominantly African-American Population: A Randomized Study

    Science.gov (United States)

    Garg, Shashank; Girotra, Mohit; Chandra, Lakshya; Verma, Vipin; Kaur, Sumanjit; Allawy, Allawy; Secco, Alessandra; Anand, Rohit; Dutta, Sudhir K.

    2016-01-01

    Background and Aim. Inadequate bowel preparation is a major impediment in colonoscopy quality outcomes. Aim of this study was to evaluate the role of multimedia education (MME) in improving bowel preparation quality and adenoma detection rate. Methods. This was an IRB-approved prospective randomized study that enrolled 111 adult patients undergoing outpatient screening or surveillance colonoscopy. After receiving standard colonoscopy instructions, the patients were randomized into MME group (n = 48) and control group (n = 46). The MME group received comprehensive multimedia education including an audio-visual program, a visual aid, and a brochure. Demographics, quality of bowel preparation, and colonoscopy findings were recorded. Results. MME group had a significantly better bowel preparation in the entire colon (OR 2.65, 95% CI 1.16–6.09) and on the right side of the colon (OR 2.74, 95% CI 1.12–6.71) as compared to control group (p 1 cm) were found more frequently in the MME group (11/31, 35.5% versus 0/13; p < 0.05). More polyps and adenomas were detected in MME group (57 versus 39 and 31 versus 13, resp.) but the difference failed to reach statistical significance. Conclusion. MME can lead to significant improvement in the quality of bowel preparation and large adenoma detection in a predominantly African-American population. PMID:27006590

  3. One-day bowel preparation in children with colostomy using normal saline

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    Emmanuel A Ameh

    2011-01-01

    Full Text Available Background: Colonic and colorectal surgery frequently requires bowel preparation. This is an evaluation of the use of normal saline for one-day bowel preparation in children with colostomy. Patients and Methods:A prospective study of 55 children with colostomy who had one-day bowel preparation for colonic and colorectal surgical procedures in a 3-year period. The information, along with clinical data was recorded on a structured proforma. Data were analysed using SPSS version 11.0. Results:There were 33 boys and 22 girls. The median age was 4 years (range, one month - 13 years. The primary diagnosis were as follows: Anorectal malformation, 24 (44%; Hirschsprung`s disease, 24 (44%; Faecal incontinence- post-abdominoperineal pull-through, 2 (4%; Penetrating rectal injury, 1 (2%; others, 4(8%. Intraoperative bowel luminal fluid cleanliness was assessed as clear in 36 (62% and contaminated in 21 (38%. Overall, postoperatively, superficial surgical site infection occurred in 6 (10.9% patients (2 had clean intraoperative colonic fluid, 5.9%. Conclusion:One-day bowel preparation using normal saline is effective and safe in children with colostomy.

  4. Low-Fiber Diet in Limited Bowel Preparation for CT Colonography: Influence on Image Quality and Patient Acceptance

    NARCIS (Netherlands)

    M.H. Liedenbaum; M.J. Denters; A.H. de Vries; V.F. van Ravesteijn; S. Bipat; F.M. Vos; E. Dekker; J. Stoker

    2010-01-01

    OBJECTIVE. The purpose of this study was to determine whether a low-fiber diet is necessary for optimal tagging-only bowel preparation for CT colonography. SUBJECTS AND METHODS. Fifty consecutively enrolled patients received an iodine bowel preparation: 25 patients used a low-fiber diet and 25 used

  5. Revisiting the potential signs of colorectal cancer on contrast-enhanced computed tomography without bowel preparation.

    Science.gov (United States)

    Naqvi, Jawad; Hosmane, Sharath; Lapsia, Snehal

    2015-10-01

    Colorectal cancer (CRC) is the second most common cause of cancer death in the US. Earlier detection can allow treatment with curative intent and improve prognosis. Optical and virtual colonoscopy are widely used in screening for colonic polyps and in the investigation of suspected CRC. However, contrast-enhanced computed tomography (CT) is still performed to investigate various non-specific abdominal complaints. Hence, a significant number of CRC are identified on contrast-enhanced CT without bowel preparation. We describe several signs, which when present in tandem, raise suspicion of CRC, and may warrant further investigation with optical colonoscopy. These include an intraluminal mass, eccentric or circumferential wall thickening >3 mm, focal wall enhancement, pericolic fat stranding, a cluster of >3 local lymph nodes, and enlarged lymph nodes >10 mm in short axis. Multiplanar evaluation of the bowel should be performed on all CT abdominal studies, including those without bowel preparation, to identify subtle features of CRC. PMID:26194811

  6. Characteristics associated with suboptimal bowel preparation prior to colonoscopy: Results of a national survey

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    Corey H Basch

    2014-01-01

    Conclusions: This study indicates the potential value of a personalized approach to bowel preparation, which addresses the specific needs of an individual patient like chronic constipation and diabetes and those with poor literacy skills or poor fluency in English. Development and evaluation of educational interventions to address these factors warrants investment.

  7. CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation

    International Nuclear Information System (INIS)

    The purpose of this study was to prospectively compare participant experience and preference of limited preparation computed tomography colonography (CTC) with full-preparation colonoscopy in a consecutive series of patients at increased risk of colorectal cancer. CTC preparation comprised 180 ml diatrizoate meglumine, 80 ml barium and 30 mg bisacodyl. For the colonoscopy preparation 4 l of polyethylene glycol solution was used. Participants' experience and preference were compared using the Wilcoxon signed rank test and the chi-squared test, respectively. Associations between preference and experience parameters for the 173 participants were determined by logistic regression. Diarrhoea occurred in 94% of participants during CTC preparation. This side effect was perceived as severely or extremely burdensome by 29%. Nonetheless, the total burden was significantly lower for the CTC preparation than for colonoscopy (9% rated the CTC preparation as severely or extremely burdensome compared with 59% for colonoscopy; p<0.001). Participants experienced significantly more pain, discomfort and total burden with the colonoscopy procedure than with CTC (p<0.001). After 5 weeks, 69% preferred CTC, 8% were indifferent and 23% preferred colonoscopy (p<0.001). A burdensome colonoscopy preparation and pain at colonoscopy were associated with CTC preference (p<0.04). In conclusion, participants' experience and preference were rated in favour of CTC with limited bowel preparation compared with full-preparation colonoscopy. (orig.)

  8. CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation

    Energy Technology Data Exchange (ETDEWEB)

    Jensch, Sebastiaan [University of Amsterdam, Department of Radiology, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Bipat, Shandra; Vries, Ayso H. de; Heutinck, Anneke; Stoker, Jaap [University of Amsterdam, Department of Radiology, Amsterdam (Netherlands); Peringa, Jan; Montauban van Swijndregt, Alexander D. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Dekker, Evelien [University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam (Netherlands); Baak, Lubbertus C. [Onze Lieve Vrouwe Gasthuis, Department of Gastroenterology, Amsterdam (Netherlands)

    2010-01-15

    The purpose of this study was to prospectively compare participant experience and preference of limited preparation computed tomography colonography (CTC) with full-preparation colonoscopy in a consecutive series of patients at increased risk of colorectal cancer. CTC preparation comprised 180 ml diatrizoate meglumine, 80 ml barium and 30 mg bisacodyl. For the colonoscopy preparation 4 l of polyethylene glycol solution was used. Participants' experience and preference were compared using the Wilcoxon signed rank test and the chi-squared test, respectively. Associations between preference and experience parameters for the 173 participants were determined by logistic regression. Diarrhoea occurred in 94% of participants during CTC preparation. This side effect was perceived as severely or extremely burdensome by 29%. Nonetheless, the total burden was significantly lower for the CTC preparation than for colonoscopy (9% rated the CTC preparation as severely or extremely burdensome compared with 59% for colonoscopy; p<0.001). Participants experienced significantly more pain, discomfort and total burden with the colonoscopy procedure than with CTC (p<0.001). After 5 weeks, 69% preferred CTC, 8% were indifferent and 23% preferred colonoscopy (p<0.001). A burdensome colonoscopy preparation and pain at colonoscopy were associated with CTC preference (p<0.04). In conclusion, participants' experience and preference were rated in favour of CTC with limited bowel preparation compared with full-preparation colonoscopy. (orig.)

  9. Commonly used bowel preparations have significant and different effects upon cell proliferation in the colon: a pilot study

    Directory of Open Access Journals (Sweden)

    Riley Stuart A

    2008-11-01

    Full Text Available Abstract Background Markers of crypt cell proliferation are frequently employed in studies of the impact of genetic and exogenous factors on human colonic physiology. Human studies often rely on the assessment of tissue acquired at endoscopy. Modulation of cell proliferation by bowel preparation with oral laxatives may confound the findings of such studies, but there is little data on the impact of commonly used bowel preparations on markers of cell proliferation. Methods Crypt length, crypt cellularity and crypt cell proliferation were assessed in biopsies acquired after preparation with either Klean-Prep or Picolax. Crypt cell proliferation was assessed by whole-mount mitotic figure count, and by two different immunohistochemical (IHC labelling methods (Ki-67 and pHH3. Subsequent biopsies were obtained from the same patients without bowel preparation and similarly assessed. Parameters were compared between groups using analysis of variance and paired t-tests. Results There were significant differences in labelling indices (LI between biopsies taken after Klean-prep and those taken after Picolax preparation, for both Ki67 (p = 0.019 and pHH3 (p = 0.017. A similar trend was seen for whole-mount mitotic figure counts. Suppression or elevation of proliferation parameters by bowel preparation may mask any effect due to an intervention or disease. Conclusion Commonly used bowel preparations may have significant and different effects on crypt cell proliferation. This should be taken into account when designing studies and when considering the findings of existing studies.

  10. Analysis of YouTube~TM videos related to bowel preparation for colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Corey; Hannah; Basch; Grace; Clarke; Hillyer; Rachel; Reeves; Charles; E; Basch

    2014-01-01

    AIM: To examine YouTubeTM videos about bowel preparation procedure to better understand the quality of this information on the Internet. METHODS: YouTubeTM videos related to colonoscopy preparation were identified during the winter of 2014; only those with ≥ 5000 views were selected for analysis(n = 280). Creator of the video, length, date posted, whether the video was based upon personal experience, and theme was recorded. Bivariate analysis was conducted to examine differences between consumers vs healthcare professionals-created videos. RESULTS: Most videos were based on personal experience. Half were created by consumers and 34% were ≥ 4.5 min long. Healthcare professional videos were viewed more often(> 19400, 59.4% vs 40.8%,P = 0.037, for healthcare professional and consumer, respectively) and more often focused on the purgative type and completing the preparation. Consumer videos received more comments(> 10 comments, 62.2% vs 42.7%, P = 0.001) and more often emphasized the palatability of the purgative, disgust, and hunger during the procedure. Content of colonoscopy bowel preparation YouTube? videos is influenced by who creates the video and may affect views on colon cancer screening. CONCLUSION: The impact of perspectives on the quality of health-related information found on the Internet requires further examination.

  11. Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation

    Institute of Scientific and Technical Information of China (English)

    Sasinee Tongprasert; Abhasnee Sobhonslidsuk; Sasivimol Rattanasiri

    2009-01-01

    AIM: To evaluate the effectiveness of simethicone in enhancing visibility and efficacy during colonoscopy. METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted. One hundred and twenty-four patients were allocated to receive 2 doses of sodium phosphate plus 240 mg of tablet simethicone or placebo as bowel preparation. Visibility was blindly assessed for the amount of air bubbles and adequacy of colon preparation. Total colonoscopic time, side effects of the medication, endoscopist and patient satisfaction were also compared. RESULTS: Sodium phosphate plus simethicone, compared to sodium phosphate plus placebo, improved visibility by diminishing air bubbles (100.00% vs 42.37%, P < 0.0001) but simethicone failed to demonstrate improvement in adequacy of colon preparation (90.16% vs 81.36%, P = 0.17). Endoscopist and patient satisfaction were increased significantly in the simethicone group. However, there was no difference in the total duration of colonoscopy and side effects of the medication. CONCLUSION: The addition of simethicone is of benefit for colonoscopic bowel preparation by diminishing air bubbles, which results in enhanced visibility. Endoscopist and patient satisfaction is also increased.

  12. Polyethylene glycol plus ascorbic acid for bowel preparation in chronic kidney disease.

    Science.gov (United States)

    Lee, Jae Min; Keum, Bora; Yoo, In Kyung; Kim, Seung Han; Choi, Hyuk Soon; Kim, Eun Sun; Seo, Yeon Seok; Jeen, Yoon Tae; Chun, Hoon Jai; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck; Kim, Myung Gyu; Jo, Sang Kyung

    2016-09-01

    The safety of polyethylene glycol plus ascorbic acid has not been fully investigated in patients with renal insufficiency. High-dose ascorbic acid could induce hyperoxaluria, thereby causing tubule-interstitial nephritis and renal failure. This study aims to evaluate the safety and efficacy of polyethylene glycol plus ascorbic acid in patients with chronic kidney disease.We retrospectively reviewed prospectively collected data on colonoscopy in patients with impaired renal function. Patients were divided into 2 groups: 2 L polyethylene glycol plus ascorbic acid (n = 61) and 4 L polyethylene glycol (n = 80). The safety of the 2 groups was compared by assessing the differences in laboratory findings before and after bowel cleansing.The laboratory findings were not significantly different before and after the administration of 2 L polyethylene glycol plus ascorbic acid or 4 L polyethylene glycol. In both groups, the estimated glomerular filtration rate was not influenced by the administration of the bowel-cleansing agent. Patients' reports on tolerance and acceptability were better in the 2 L polyethylene glycol plus ascorbic acid group than in the 4 L polyethylene glycol group.The 2 L polyethylene glycol plus ascorbic acid solution is a safe choice for bowel preparation before colonoscopy in patients with impaired renal function. PMID:27603372

  13. Beverage intake preference and bowel preparation laxative taste preference for colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Adeyinka; O; Laiyemo; Clinton; Burnside; Maryam; A; Laiyemo; John; Kwagyan; Carla; D; Williams; Kolapo; A; Idowu; Hassan; Ashktorab; Angesom; Kibreab; Victor; F; Scott; Andrew; K; Sanderson

    2015-01-01

    AIM: To examine whether non-alcoholic beverage intake preferences can guide polyethylene glycol(PEG)-based bowel laxative preparation selection for patients.METHODS: We conducted eight public taste test sessions using commercially procured(A) unflavored PEG,(B) citrus flavored PEG and(C) PEG with ascorbate(Moviprep). We collected characteristics of volunteers including their beverage intake preferences. The volunteers tasted the laxatives in randomly assigned orders and ranked the laxatives as 1st, 2nd, and 3rd based on their taste preferences. Our primary outcome is the number of 1st place rankings for each preparation. RESULTS: A total of 777 volunteers completed the study. Unflavored PEG was ranked as 1st by 70(9.0%), flavored PEG by 534(68.7%) and PEG with ascorbate by173(22.3%) volunteers. Demographic, lifestyle characteristics and beverage intake patterns for coffee, tea, and carbonated drinks did not predict PEG-based laxative preference.CONCLUSION: Beverage intake pattern was not a useful guide for PEG-based laxative preference. It is important to develop more tolerable and affordable bowel preparation laxatives for colonoscopy. Also, patients should taste their PEG solution with and without flavoring before flavoring the entire gallon as this may give them more opportunity to pick a pattern that may be more tolerable.

  14. Medicare Under Age 65 and Medicaid Patients Have Poorer Bowel Preparations: Implications for Recommendations for an Early Repeat Colonoscopy.

    Directory of Open Access Journals (Sweden)

    Bryan B Brimhall

    Full Text Available Colonoscopy is performed on patients across a broad spectrum of demographic characteristics. These characteristics may aggregate by patient insurance provider and influence bowel preparation quality and the prevalence of adenomas. The purpose of this study was to evaluate the association of insurance status and suboptimal bowel preparation, recommendation for an early repeat colonoscopy due to suboptimal bowel preparation, adenoma detection rate (ADR, and advanced ADR (AADR.This is a cohort study of outpatient colonoscopies (n = 3113 at a single academic medical center. Patient insurance status was categorized into five groups: 1 Medicare < 65y; 2 Medicare ≥ 65y; 3 Tricare/VA; 4 Medicaid/Colorado Indigent Care Program (CICP; and 5 commercial insurance. We used multivariable logistic or linear regression modeling to estimate the risks for the association between patient insurance and suboptimal bowel preparation, recommendation for an early repeat colonoscopy due to suboptimal bowel preparation, ADR, and AADR. Models were adjusted for appropriate covariates.Medicare patients < 65y (OR 4.91; 95% CI: 3.25-7.43 and Medicaid/CICP patients (OR 4.23; 95% CI: 2.65-7.65 were more likely to have a suboptimal preparation compared to commercial insurance patients. Medicare patients < 65y (OR 5.58; 95% CI: 2.85-10.92 and Medicaid/CICP patients (OR 3.64; CI: 1.60-8.28 were more likely to receive a recommendation for an early repeat colonoscopy compared to commercial insurance patients. Medicare patients < 65y had a significantly higher adjusted ADR (OR 1.50; 95% CI: 1.03-2.18 and adjusted AADR (OR 1.99; 95% CI: 1.15-3.44 compared to commercial insurance patients.Understanding the reasons for the higher rate of a suboptimal bowel preparation in Medicare < 65y and Medicaid/CICP patients and reducing this rate is critical to improving colonoscopy outcomes and reducing healthcare costs in these populations.

  15. Case of inappropriate ADH syndrome: hyponatremia due to polyethylene glycol bowel preparation.

    Science.gov (United States)

    Ko, Sun-Hye; Lim, Chul-Hyun; Kim, Jae-Young; Kang, Seung Hun; Baeg, Myong Ki; Oh, Hyun Jin

    2014-09-14

    Colonoscopic screening has been reported to reduce deaths from colorectal cancer. Adequate bowel preparation is essential for this and safety is an important issue in choosing the methods. Polyethylene glycol (PEG) is regarded as a safe method for cleansing, especially compared with oral sodium phosphate. Here, we present a case of hyponatremia caused by the syndrome of inappropriate antidiuretic hormone (ADH) syndrome after PEG precolonoscopic cleansing resulting in generalized tonic-clonic seizures. A 62-year-old women had ingested PEG for precolonoscopic bowel cleansing. While waiting for the colonoscopy, she developed a stuporous mentality and generalized tonic-clonic seizures, which did not correlate with brain magnetic resonance imaging. Her serum sodium level was 113 mEq per liter and laboratory analyses were consistent with inappropriate ADH syndrome. Her thyroid and adrenal functions were normal. There were no malignancies, infections, respiratory disorders or central nervous disorders and she had no history of taking either diuretics or other medications, which might have caused inappropriate ADH syndrome. She was treated with 3% hypertonic saline and showed a complete neurological recovery as her sodium levels recovered. Follow-up visits showed the patient to have a normal sodium level without neurologic deficits. This case shows that inappropriate ADH syndrome can be caused by PEG preparation, which implies that physicians have to be aware of the possible side effects of this colonic cleansing approach and mindful of the possible ensuing symptoms.

  16. Comorbid Illness, Bowel Preparation, and Logistical Constraints Are Key Reasons for Outpatient Colonoscopy Nonattendance

    Directory of Open Access Journals (Sweden)

    Deepti Chopra

    2016-01-01

    Full Text Available Background. Colonoscopy nonattendance is a challenge for outpatient clinics globally. Absenteeism results in a potential delay in disease diagnosis and loss of hospital resources. This study aims to determine reasons for colonoscopy nonattendance from a Canadian perspective. Design. Demographic data, reasons for nonattendance, and patient suggestions for improving compliance were elicited from 49 out of 144 eligible study participants via telephone questionnaire. The 49 nonattenders were compared to age and sex matched controls for several potential contributing factors. Results. Nonattendance rates were significantly higher in winter months; the OR of nonattendance was 5.2 (95% CI, 1.6 to 17.0, p<0.001 in winter versus other months. Being married was positively associated with attendance. There was no significant association between nonattendance and any of the other variables examined. The top 3 reasons for nonattendance were being too unwell to attend the procedure, being unable to complete bowel preparation, or experiencing logistical challenges. Conclusions. Colonoscopy attendance rates appear to vary significantly by season and it may be beneficial to book more colonoscopies in the summer or overbook in the winter. Targets for intervention include more tailored teaching sessions, reminders, taxi chits, and developing a hospital specific colonoscopy video regarding procedure and bowel preparation requirements.

  17. A Comparison of the Efficacy, Adverse Effects, and Patient Compliance of the Sena-Graph®Syrup and Castor Oil Regimens for Bowel Preparation

    OpenAIRE

    Ghazikhanlou Sani, Karim; Jafari, Mahmood-Reza; Shams, Safar

    2010-01-01

    Sena-Graph syrup has recently been formulated by an Iranian pharmaceutical company for being used in bowel evacuation before radiography, colonoscopy and surgery. This study compares the efficacy, adverse effects and patient compliance of two bowel preparation regimens with castor oil and Sena-Graph syrup in of outpatients for Intravenous Urography (IVU). One hundred and fourteen consecutive outpatients were randomized to receive either the standard bowel preparation with 60 mL of castor oil ...

  18. Magnesium citrate with a single dose of sodium phosphate for colonoscopy bowel preparation

    Institute of Scientific and Technical Information of China (English)

    Yong Sung Choi; Jung Pil Suh; Jong Kyu Kim; In Taek Lee; Eui Gon Youk; Doo Seok Lee; Do Sun Kim; Doo Han Lee

    2011-01-01

    AIM: To evaluate the efficacy and acceptability of magnesium citrate and a single dose of oral sodium phosphate (45 mL) solution for morning colonoscopy bowel preparation.METHODS: A total of 159 patients were randomly assigned to receive two split doses of 90 mg of sodium phosphate (Group Ⅰ, n = 79) or magnesium citrate (250 mL,the day before the procedure) followed by 45 mL of sodium phosphate (the day of procedure, Group Ⅱ, n =80). The quality of bowel cleansing and the acceptability of each regimen were compared, including the satisfaction,taste, willing to repeat and adverse effects of each regimen.RESULTS: The quality of bowel cleansing of Group Ⅱ was as good as that of Group Ⅰ (An Aronchick scale score of good or excellent: 70.9% vs 81.0%, respectively,P = 0.34; the Ottawa system score: 4.4 ± 2.6 vs 3.8± 3.0, respectively, P = 0.76). There was no statistically significant difference between both groups with regard to acceptability, including the satisfaction, taste and willingness to repeat the regimen. A significantly greater number of older patients (over 65 years old) in Group Ⅱ graded the overall satisfaction as satisfactory (48.1%vs 78.1%, respectively; Group Ⅰ vs Group Ⅱ, P = 0.01).There were no significant adverse reactions. CONCLUSION: Magnesium citrate and a single dose of sodium phosphate was as effective and tolerable as the conventional sodium phosphate regimen and is a satisfactory option.

  19. Serious Events in Older Ontario Residents Receiving Bowel Preparations for Outpatient Colonoscopy with Various Comorbidity Profiles: A Descriptive, Population-Based Study

    Directory of Open Access Journals (Sweden)

    Joanne M Ho

    2012-01-01

    Full Text Available BACKGROUND: Polyethylene glycol-based bowel preparations (PEGBPs and sodium picosulfate (NaPS are commonly used for bowel cleansing before colonoscopy. Little is known about adverse events associated with these preparations, particularly in older patients or patients with medical comorbidities.

  20. CT colonography with reduced bowel preparation after incomplete colonoscopy in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Iafrate, F.; Stagnitti, A. [University of Rome, Department of Radiological Sciences, Rome (Italy); Hassan, C.; Zullo, A. [Hospital-Rome, Gastroenterology and Digestive Endoscopy Unit, Rome (Italy); Spagnuolo, A. [Univeristy of Rome, I.C.O.T, Department of Radiological Sciences, Latina (Italy); Ferrari, R.; Laghi, A.

    2008-07-15

    We prospectively assessed the feasibility and acceptance of computerized tomographic colonography (CTC) without bowel cathartic preparation in elderly patients after incomplete colonoscopy. A total of 136 patients underwent CTC without cathartic preparation. The time delay between conventional colonoscopy and CTC ranged between 3 and 20 days, depending on the clinical situation. Before CTC, fecal tagging was achieved by adding diatrizoate meglumine and diatrizoate sodium to regular meals. CTCs were interpreted using a primary two-dimensional (2D) approach and 3D images for further characterization. Patients were interviewed before and 2 weeks after CTC to assess preparation acceptance. CTC was feasible and technically successful in all the 136 patients. Fecal tagging was judged as excellent in 113 (83%) patients and sufficient in 23 (17%). Average CT image interpretation time was 14.8 min. Six (4.4%) cases of colorectal cancer and nine (6.6%) large polyps were detected, as well as 23 (11.3%) extracolonic findings of high clinical importance. No major side effect occurred, although 25% patients reported minor side effects, especially diarrhea. Overall, 76/98 patients replied that they would be willing to repeat the test if necessary. CTC without cathartic preparation is a technically feasible and safe procedure to complete a colonic study in the elderly, prompting its use in clinical practice. (orig.)

  1. Comorbid Illness, Bowel Preparation, and Logistical Constraints Are Key Reasons for Outpatient Colonoscopy Nonattendance.

    Science.gov (United States)

    Chopra, Deepti; Hookey, Lawrence C

    2016-01-01

    Background. Colonoscopy nonattendance is a challenge for outpatient clinics globally. Absenteeism results in a potential delay in disease diagnosis and loss of hospital resources. This study aims to determine reasons for colonoscopy nonattendance from a Canadian perspective. Design. Demographic data, reasons for nonattendance, and patient suggestions for improving compliance were elicited from 49 out of 144 eligible study participants via telephone questionnaire. The 49 nonattenders were compared to age and sex matched controls for several potential contributing factors. Results. Nonattendance rates were significantly higher in winter months; the OR of nonattendance was 5.2 (95% CI, 1.6 to 17.0, p video regarding procedure and bowel preparation requirements. PMID:27478818

  2. Magnetic resonance colonography with a limited bowel preparation and automated carbon dioxide insufflation in comparison to conventional colonoscopy: Patient burden and preferences

    Energy Technology Data Exchange (ETDEWEB)

    Paardt, M.P. van der, E-mail: m.p.vanderpaardt@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Boellaard, T.N., E-mail: t.n.boellaard@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Zijta, F.M., E-mail: fmzijta@yahoo.com [Department of Radiology, Medisch Centrum Haaglanden, Den Haag (Netherlands); Baak, L.C., E-mail: l.c.baak@olvg.nl [Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Depla, A.C.T.M., E-mail: actm.depla@slz.nl [Department of Gastroenterology and Hepatology, Slotervaartziekenhuis, Amsterdam (Netherlands); Dekker, E., E-mail: e.dekker@amc.uva.nl [Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Nederveen, A.J., E-mail: a.j.nederveen@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Bipat, S., E-mail: s.bipat@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Stoker, J., E-mail: j.stoker@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands)

    2015-01-15

    Highlights: • MR colonography with a limited bowel preparation and automated carbon dioxide insufflation demonstrated less burden compared to colonoscopy. • When discarding the bowel preparation, the examinations were rated equally burdensome. • The majority of patients preferred MR colonography over colonoscopy for their future examination of the bowel. - Abstract: Objectives: To evaluate patient burden and preferences for MR colonography with a limited bowel preparation and automated carbon dioxide insufflation in comparison to conventional colonoscopy. Methods: Symptomatic patients were consecutively recruited to undergo MR colonography with automated carbon dioxide insufflation and a limited bowel preparation followed within four weeks by colonoscopy with a standard bowel cleansing preparation. Four questionnaires regarding burden (on a five-point scale) and preferences (on a seven-point scale) were addressed after MR colonography and colonoscopy and five weeks after colonoscopy. Results: Ninety-nine patients (47 men, 52 women; mean age 62.3, SD 8.7) were included. None of the patients experienced severe or extreme burden from the MR colonography bowel preparation compared to 31.5% of the patients for the colonoscopy bowel preparation. Colonoscopy was rated more burdensome (25.6% severe or extreme burden) compared to MR colonography (5.2% severe or extreme burden) (P < 0.0001). When discarding the bowel preparations, the examinations were rated equally burdensome (P = 0.35). The majority of patients (61.4%) preferred MR colonography compared to colonoscopy (29.5%) immediately after the examinations and five weeks later (57.0% versus 39.5%). Conclusion: MR colonography with a limited bowel preparation and automated carbon dioxide insufflation demonstrated less burden compared to colonoscopy. The majority of patients preferred MR colonography over colonoscopy.

  3. Bowel preparation in CT colonography: electrolyte and renal function disturbances in the frail and elderly patient

    Energy Technology Data Exchange (ETDEWEB)

    Mc Laughlin, Patrick; Mc Sweeney, Sean; Mc Williams, Sebastian; O' Regan, Kevin; Kelly, Denis; Maher, Michael M. [Cork University Hospital, Department of Radiology, Cork (Ireland); Eustace, Joseph; O' Connor, Michael [Cork University Hospital, Department of Medicine, Cork (Ireland)

    2010-03-15

    Elderly patients are at increased risk of biochemical disturbances secondary to cathartic medications. This study investigates the renal function, electrolyte and clinical disturbances associated with CT colonography (CTC) with sodium picosulphate-magnesium citrate (SPS-MC) in a subgroup of frail, elderly patients. Patients aged over 70 years considered at risk of complication during SPS-MC administration by a physician specialised in care of the elderly were included in this retrospective study. Biochemical parameters pre- and post-CTC and the presence of co-morbidities were recorded. Imaging findings and quality of bowel preparation at CTC were graded by consensus by two radiologists. Of the 72 patients 56% had co-morbidities that caution the use of SPS-MC. No significant changes in serum urea, sodium, potassium or estimated glomerular filtration rate (eGFR) occurred post-CTC (p > 0.10). Serum magnesium increased by 0.11 mmol/L in 14 patients (p = 0.03) without clinical sequelae. Good overall preparation was achieved in 88% of patients, allowing confident identification of signs of colonic neoplasia in 20 patients (27%). A mild increase in serum magnesium but no other significant biochemical disturbance was observed. In our group CTC with SPS-MC was safe and effective; however, we advise an alternate preparation be considered in patients with decreased renal function due to decreased magnesium clearance. (orig.)

  4. CT colonography with minimal bowel preparation: evaluation of tagging quality, patient acceptance and diagnostic accuracy in two iodine-based preparation schemes

    NARCIS (Netherlands)

    M.H. Liedenbaum; A.H. de Vries; C.I.B.F. Gouw; A.F. van Rijn; S. Bipat; E. Dekker; J. Stoker

    2010-01-01

    PURPOSE: The aim of this study was to compare a 1-day with a 2-day iodine bowel preparation for CT colonography in a positive faecal occult blood test (FOBT) screening population. MATERIALS AND METHODS: One hundred consecutive patients underwent CT colonography and colonoscopy with segmental unblind

  5. Bowel preparation for colonoscopy using standard vs reduced doses of sodium phosphate: A single-blind randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    Tatsuya; Koshitani; Mayumi; Kawada; Toshikazu; Yoshikawa

    2014-01-01

    AIM: To evaluate the efficacy of a colonoscopy prepa-ration that utilizes a reduced dose of sodium phosphate(NaP) and an adjunct.METHODS: Sixty-two patients requiring screening colonoscopies were studied. Each patient was randomly allocated to receive either 50 NaP tablets(50 g) or 30 NaP tablets(30 g) with 10 mL of 0.75% sodium pico-sulfate for bowel preparation. NaP was administered at a rate of five tablets(5 g) or three tablets(3 g) every 15 min with 200 mL of water, beginning five to six hours before colonoscopy. The sodium picosulfate was administered with 200 mL of water on the night before the procedure. Both groups were compared in term of the efficacies of colonic cleansing, the time required for completion of the bowel preparation, and acceptability of the preparation.RESULTS: Sixty patients(n = 30 for each group) were analyzed. The cleansing efficacy tended to be higher in the 30 g NaP plus sodium picosulfate group as as-sessed by the mean total Ottawa scale score(50 g NaP6.70 ± 1. 42 vs 30 g NaP plus sodium picosulfate 6.17 ± 1.18 P = 0.072). The mean time for bowel prepara-tion tended to be shorter in the 30 g NaP plus sodium picosulfate group(50 g NaP 189.9 ± 64.0 min vs 30 g NaP plus sodium picosulfate 161.8 ± 57.6 min, P = 0.065). There were no significant differences between the two groups in the acceptability of the preparations(50 g NaP 83.3% vs 30 g NaP plus sodium picosulfate 86.7%, P = 0.500). There were no adverse events re-lated to bowel preparation in either of the groups.CONCLUSION: The colonoscopy preparation that uti-lized 30 g NaP with sodium picosulfate was comparable to that utilizing 50 g NaP. This novel bowel preparation might be useful before colonoscopy.

  6. A comparison of the efficacy, adverse effects, and patient compliance of the sena-graph®syrup and castor oil regimens for bowel preparation.

    Science.gov (United States)

    Ghazikhanlou Sani, Karim; Jafari, Mahmood-Reza; Shams, Safar

    2010-01-01

    Sena-Graph syrup has recently been formulated by an Iranian pharmaceutical company for being used in bowel evacuation before radiography, colonoscopy and surgery. This study compares the efficacy, adverse effects and patient compliance of two bowel preparation regimens with castor oil and Sena-Graph syrup in of outpatients for Intravenous Urography (IVU). One hundred and fourteen consecutive outpatients were randomized to receive either the standard bowel preparation with 60 mL of castor oil or the test method with 60 mL of Sena-Graph syrup before IVU examination. Demographic data of patients and their prior bowel preparation experience were collected before the examination. Two radiologists, blinded to the method of bowel preparation, reviewed the radiographs and graded the bowel preparation. The compliance and acceptability of both regimens were assessed by using structured questionnaires filled by the patients. The Numbers, ages, weights and gender distribution of patients and their prior bowel preparation experience in the two groups did not differ significantly. The cleanliness scores for the castor oil and Sena-Graph group were 3.97 ± 0.971 and 4.87 ± 0.917, respectively. The results indicated that Sena-Graph syrup causes a better bowel cleansing compared castor oil. Adverse effects in Sena-Graph groups were significantly lower than the castor oil group. Acceptability of the regimen in patients who used Sena-Graph was higher than the other group. The Sena-Graph regimen is significantly more effective and better tolerated than of Castor oil regimen in bowel cleansing. The incidence and severity of the adverse effects from Castor oil was higher than Sena-Graph.

  7. Bowel Preparation for Colonoscopy with Sodium Phosphate Solution versus Polyethylene Glycol-Based Lavage: A Multicenter Trial

    Directory of Open Access Journals (Sweden)

    S. Schanz

    2008-01-01

    Full Text Available Background: Adequate bowel preparation is essential for accurate colonoscopy. Both oral sodium phosphate (NaP and polyethylene glycol-based lavage (PEG-ELS are used predominantly as bowel cleansing modalities. NaP has gained popularity due to low drinking volume and lower costs. The purpose of this randomized multicenter observer blinded study was to compare three groups of cleansing (NaP, NaP + sennosides, PEG-ELS + sennosides in reference to tolerability, acceptance, and cleanliness. Patient and Methods: 355 outpatients between 18 and 75 years were randomized into three groups (A, B, C receiving NaP = A, NaP, and sennosides = B or PEG-ELS and sennosides = C. Gastroenterologists performing colonoscopies were blinded to the type of preparation. All patients documented tolerance and adverse events. Vital signs, premedication, completeness, discomfort, and complications were recorded. A quality score (0–4 of cleanliness was generated. Results: The three groups were similar with regard to age, sex, BMI, indication for colonoscopy, and comorbidity. Drinking volumes (L (A = 4.33 + 1.2, B = 4.56 + 1.18, C = 4.93 + 1.71 were in favor of NaP (P = .005. Discomfort from ingested fluid was recorded in A = 39.8% (versus C: P = .015, B = 46.6% (versus C: P = .147, and C = 54.6%. Differences in tolerability and acceptance between the three groups were statistically not significant. No differences in adverse events and the cleanliness effects occurred in the three groups (P = .113. The cleanliness quality scores 0–2 were calculated in A: 77.7%, B: 86.7%, and C: 85.2%. Conclusions: These data fail to demonstrate significant differences in tolerability, acceptance, and preparation quality between the three types of bowel preparation for colonoscopy. Cleansing with NaP was not superior to PEG-ELS.

  8. CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation

    NARCIS (Netherlands)

    S. Jensch; S. Bipat; J. Peringa; A.H. de Vries; A. Heutinck; E. Dekker; L.C. Baak; A.D. Montauban van Swijndregt; J. Stoker

    2010-01-01

    The purpose of this study was to prospectively compare participant experience and preference of limited preparation computed tomography colonography (CTC) with full-preparation colonoscopy in a consecutive series of patients at increased risk of colorectal cancer. CTC preparation comprised 180 ml di

  9. Contrasting Perspectives of Anesthesiologists and Gastroenterologists on the Optimal Time Interval between Bowel Preparation and Endoscopic Sedation

    Directory of Open Access Journals (Sweden)

    Deepak Agrawal

    2015-01-01

    Full Text Available Background. The optimal time interval between the last ingestion of bowel prep and sedation for colonoscopy remains controversial, despite guidelines that sedation can be administered 2 hours after consumption of clear liquids. Objective. To determine current practice patterns among anesthesiologists and gastroenterologists regarding the optimal time interval for sedation after last ingestion of bowel prep and to understand the rationale underlying their beliefs. Design. Questionnaire survey of anesthesiologists and gastroenterologists in the USA. The questions were focused on the preferred time interval of endoscopy after a polyethylene glycol based preparation in routine cases and select conditions. Results. Responses were received from 109 anesthesiologists and 112 gastroenterologists. 96% of anesthesiologists recommended waiting longer than 2 hours until sedation, in contrast to only 26% of gastroenterologists. The main reason for waiting >2 hours was that PEG was not considered a clear liquid. Most anesthesiologists, but not gastroenterologists, waited longer in patients with history of diabetes or reflux. Conclusions. Anesthesiologists and gastroenterologists do not agree on the optimal interval for sedation after last drink of bowel prep. Most anesthesiologists prefer to wait longer than the recommended 2 hours for clear liquids. The data suggest a need for clearer guidelines on this issue.

  10. What Level of Bowel Prep Quality Requires Early Repeat Colonoscopy: Systematic Review and Meta-Analysis of the Impact of Preparation Quality on Adenoma Detection Rate

    Science.gov (United States)

    Clark, Brian T.; Rustagi, Tarun; Laine, Loren

    2015-01-01

    OBJECTIVES Current guidelines recommend early repeat colonoscopy when bowel preparation quality is inadequate, defined as inability to detect polyps > 5 mm, but no data link specific bowel preparation categories or scores to this definition. Nevertheless, most physicians use a shortened screening/surveillance interval in patients with intermediate-quality preparation. We determined whether different levels of bowel preparation quality are associated with differences in adenoma detection rates (ADRs: proportion of colonoscopies with ≥1 adenoma) to help guide decisions regarding early repeat colonoscopy—with primary focus on intermediate-quality preparation. METHODS MEDLINE and Embase were searched for studies with adenoma or polyp detection rate stratified by bowel preparation quality. Preparation quality definitions were standardized on the basis of Aronchick definitions (excellent/good/fair/poor/insufficient), and primary analyses of ADR trichotomized bowel preparation quality: high quality (excellent/good), intermediate quality (fair), and low quality (poor/insufficient). Dichotomized analyses of adequate (excellent/good/fair) vs. inadequate (poor/insufficient) were also performed. RESULTS Eleven studies met the inclusion criteria. The primary analysis, ADR with intermediate- vs. high-quality preparation, showed an odds ratio (OR) of 0.94 (0.80–1.10) and absolute risk difference of −1% (−3%, 2%). ADRs were significantly higher with both intermediate-quality and high-quality preparation vs. low-quality preparation: OR = 1.39 (1.08–1.79) and 1.41 (1.21–1.64), with absolute risk increases of 5% for both. ADR and advanced ADR were significantly higher with adequate vs. inadequate preparation: OR = 1.30 (1.19–1.42) and 1.30 (1.02–1.67). Studies did not report other relevant outcomes such as total adenomas per colonoscopy. CONCLUSIONS ADR is not significantly different with intermediate-quality vs. high-quality bowel preparation. Our results confirm

  11. Comparison of split-dosing vs non-split(morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Hardik; Shah; Devendra; Desai; Hrishikesh; Samant; Sandeep; Davavala; Anand; Joshi; Tarun; Gupta; Philip; Abraham

    2014-01-01

    AIM: To compare(using the Ottawa Bowel Preparation Scale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the optimal preparation-to-colonoscopy interval.METHODS: Single-centre, prospective, randomized, investigator-blind stud in an academic tertiarycare centre. Two hundred patients requiring elective colonoscopy were assigned to receive one of the two preparation regimens(split vs morning) prior to colonoscopy. Main outcome measurements were bowel preparation quality and patient tolerability.RESULTS: Split-dose regimen resulted in better bowel preparation compared to morning regimen [Ottawascore mean 5.52(SD 1.23) vs 6.02(1.34); P = 0.017]. On subgroup analysis, for afternoon procedures, both the preparations were equally effective(P = 0.756). There was no difference in tolerability and compliance between the two regimens.CONCLUSION: Overall, previous evening- same morning split-dosing regimen results in better bowel cleansing for colonoscopy compared to morning preparation. For afternoon procedures, both schedules are equally effective; morning preparation may be more convenient to the patient.

  12. Can the localization of primary colonic tumors be improved by staging CT without specific bowel preparation compared to optical colonoscopy?

    Energy Technology Data Exchange (ETDEWEB)

    Feuerlein, Sebastian; Grimm, Lars J.; Davenport, Matthew S.; Haystead, Clare M.; Miller, Chad M.; Neville, Amy M. [Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC 27710 (United States); Jaffe, Tracy A., E-mail: tracy.jaffe@duke.edu [Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC 27710 (United States)

    2012-10-15

    Objectives: To investigate the ability of staging computed tomography (CT) without bowel preparation to accurately localize colonic tumors compared to optical colonoscopy. Methods: The local institutional review board approved this retrospective and HIPAA-compliant study. Forty-six patients with colonic adenocarcinoma, preoperative colonoscopy, and staging CT within 60 days of resection were included. Patients underwent contrast enhanced CT imaging without bowel preparation or oral contrast. The colon was divided into four segments with the operative reports used as the standard. Rectal and cecal cancers were excluded. CT scans were reviewed by 5 readers in a segmental binary fashion using a 5-point confidence scale in two sessions blinded and unblinded to the colonoscopy report. Results: At surgery 49 tumors were found in 46 patients. Readers detected 86.1%, 74.3%, and 66.9% of lesions with 92.0%, 94.1%, and 95.4% accuracy for confidence scores of ≥3, ≥4, and 5. CT interobserver agreement was good (κ = 0.82) for the unblinded and moderate (κ = 0.60) for the blinded read. Colonoscopic localization was only 78.7% accurate with 2 tumors undiscovered. Colonoscopic accuracy was low in the descending colon (57.1%) and the transverse colon (55.6%). Conclusions: Preoperative staging CT is more accurate than colonoscopy in the localization of colonic tumors.

  13. Polyethylene Glycol Electrolyte Lavage Solution versus Colonic Hydrotherapy for Bowel Preparation before Colonoscopy: A Single Center, Randomized, and Controlled Study.

    Science.gov (United States)

    Cao, Yan; Zhang, Kai-Yuan; Li, Jiao; Lu, Hao; Xie, Wan-Ling; Liao, Sheng-Tao; Chen, Dong-Feng; Zeng, Deng-Feng; Lan, Chun-Hui

    2014-01-01

    This single center, randomized, and controlled study aimed to compare the effectiveness and safety of polyethylene glycol electrolyte lavage (PEG-EL) solution and colonic hydrotherapy (CHT) for bowel preparation before colonoscopy. A total of 196 eligible outpatients scheduled for diagnostic colonoscopy were randomly assigned to the PEG-EL (n = 102) or CHT (n = 94) groups. Primary outcome measures included colonic cleanliness and adverse effects. Secondary outcome measures were patient satisfaction and preference, colonoscopic findings, ileocecal arrival rate, examiner satisfaction, and cecal intubation time. The results show that PEG-EL group was associated with significantly better colonic cleanliness than CHT group, fewer adverse effects, and increased examiner satisfaction. However, the CHT group had higher patient satisfaction and higher diverticulosis detection rates. Moreover, the results showed the same ileocecal arrival rate and patient preference between the two groups (P > 0.05). These findings indicate that PEG-EL is the preferred option in patients who followed the preparation instructions completely.

  14. Effects of first-dose volume and exercise on the efficacy and tolerability of bowel preparations for colonoscopy in Chinese people

    Directory of Open Access Journals (Sweden)

    Qin Y

    2016-04-01

    Full Text Available Ying Qin, Wei Liu, Songbai Lin, Xiangfeng Li International Medical Services, Peking Union Medical College Hospital, Beijing, People’s Republic of China Aim: This study was designed to compare the efficacy and tolerability of bowel preparations with and without the higher first-dose volume of polyethylene glycol (PEG solution or exercise after drinking PEG solution in Chinese people. Methods: A total of 330 participants who had a colonoscopy done in Peking Union Medical College Hospital were randomly and evenly assigned to three groups. Participants in Group A ingested 1 L PEG solution and then ingested 2 L PEG solution at a rate of 250 mL every 15 minutes. Participants in Group B ingested 3 L PEG solution at a rate of 250 mL every 15 minutes and then exercised more than 10 minutes after ingesting each liter of PEG solution. Participants in Group C ingested 3 L PEG solution at a rate of 250 mL every 15 minutes. Experienced gastrointestinal endoscopists rated the efficacy of bowel preparations based on the Boston Bowel Preparation Scale score. A questionnaire regarding participants’ symptoms associated with bowel preparations was administered to evaluate participants’ tolerability. Results: The three groups had insignificant difference in the percentages of participants’ symptoms including dizziness, nausea, stomach ache, bloating, and asthenia. However, the percentages of participants having hunger sensation, sleep disturbance, and anal discomfort were significantly higher in groups with the higher first-dose volume of PEG solution or exercise after drinking PEG solution than without them. The three groups had insignificant difference in the Boston Bowel Preparation Scale score. Conclusion: Whether to add the higher first-dose volume of PEG solution and exercise after drinking PEG solution or not, all participants achieved a similar quality of bowel preparations. Bowel preparations without the additional first-dose volume of PEG

  15. A Randomized Prospective Study of Bowel Preparation for Colonoscopy with Low-Dose Sodium Phosphate Tablets versus Polyethylene Glycol Electrolyte Solution

    Directory of Open Access Journals (Sweden)

    Erina Kumagai

    2014-01-01

    Full Text Available Optimal bowel preparation is essential for the safety and outcome of colonoscopy. A solution containing polyethylene glycol (PEG is often used as a bowel cleansing agent, but some patients are intolerant of PEG, and this may lead to discontinuation of colonoscopy. Sodium phosphates (NaP tablets are designed to improve patient acceptance and compliance. The objective of this study was to compare bowel preparation efficiency and patient acceptance of a 30 NaP tablet preparation (L-NaP and a 2 L PEG preparation. Patients were randomized into either the L-NaP or PEG group. The primary endpoint was the efficiency of colon cleansing as assessed by a validated four-point scale according to the Aronchick scale by endoscopists and was verified by blinded investigators. The secondary endpoints were patients’ tolerability and acceptance. Colon-cleansing efficiency was not significantly different between the two preparations. However, patients’ overall judgment was significantly in favor of L-NaP, reflecting better acceptance of L-NaP than PEG. Additionally, more patients favored L-NaP over PEG in a hypothetical future occasion requiring colonoscopy.

  16. 'Pico-Bello-Klean study': effectiveness and patient tolerability of bowel preparation agents sodium picosulphate-magnesium citrate and polyethylene glycol before colonoscopy. A single-blinded randomized trial

    NARCIS (Netherlands)

    Munsterman, I.D.; Cleeren, E.; Ploeg, T. van der; Brohet, R.; Hulst, R van der

    2015-01-01

    OBJECTIVES: Adequate bowel preparation is an important step for an effective colonoscopy. Polyethylene glycol solution (Kleanprep) and sodium picosulphate with a magnesium citrate solution (Picoprep) are bowel cleansing agents registered and available for this purpose. So far, the results of studies

  17. Polyethylene Glycol Electrolyte Lavage Solution versus Colonic Hydrotherapy for Bowel Preparation before Colonoscopy: A Single Center, Randomized, and Controlled Study

    Directory of Open Access Journals (Sweden)

    Yan Cao

    2014-01-01

    Full Text Available This single center, randomized, and controlled study aimed to compare the effectiveness and safety of polyethylene glycol electrolyte lavage (PEG-EL solution and colonic hydrotherapy (CHT for bowel preparation before colonoscopy. A total of 196 eligible outpatients scheduled for diagnostic colonoscopy were randomly assigned to the PEG-EL (n=102 or CHT (n=94 groups. Primary outcome measures included colonic cleanliness and adverse effects. Secondary outcome measures were patient satisfaction and preference, colonoscopic findings, ileocecal arrival rate, examiner satisfaction, and cecal intubation time. The results show that PEG-EL group was associated with significantly better colonic cleanliness than CHT group, fewer adverse effects, and increased examiner satisfaction. However, the CHT group had higher patient satisfaction and higher diverticulosis detection rates. Moreover, the results showed the same ileocecal arrival rate and patient preference between the two groups (P>0.05. These findings indicate that PEG-EL is the preferred option in patients who followed the preparation instructions completely.

  18. CT colonography with minimal bowel preparation: evaluation of tagging quality, patient acceptance and diagnostic accuracy in two iodine-based preparation schemes

    Energy Technology Data Exchange (ETDEWEB)

    Liedenbaum, Marjolein H. [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Academic Medical Center, Amsterdam (Netherlands); Vries, A.H. de; Bipat, S.; Stoker, J. [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Gouw, C.I.B.F. [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Gelre Hospitals, Department of Radiology, Apeldoorn (Netherlands); Rijn, A.F. van; Dekker, E. [Academic Medical Centre, Department of Gastroenterology and Hepatology, Amsterdam (Netherlands)

    2010-02-15

    The aim of this study was to compare a 1-day with a 2-day iodine bowel preparation for CT colonography in a positive faecal occult blood test (FOBT) screening population. One hundred consecutive patients underwent CT colonography and colonoscopy with segmental unblinding. The first 50 patients (group 1) ingested 7*50 ml iodinated contrast starting 2 days before CT colonography. The latter 50 patients (group 2) ingested 4*50 ml iodinated contrast starting 1 day before CT colonography. Per colonic segment measurements of residual stool attenuation and homogeneity were performed, and a subjective evaluation of tagging quality (grade 1-5) was done. Independently, two reviewers performed polyp and carcinoma detection. The tagging density was 638 and 618 HU (p = 0.458) and homogeneity 91 and 86 HU for groups 1 and 2, respectively (p = 0.145). The tagging quality was graded 5 (excellent) in 90% of all segments in group 1 and 91% in group 2 (p = 0.749). Mean per-polyp sensitivity for lesions {>=}10 mm was 86% in group 1 and 97% in group 2 (p = 0.355). Patient burden from diarrhoea significantly decreased for patients in group 2. One-day preparation with meglumine ioxithalamate results in an improved patient acceptability compared with 2-day preparation and has a comparable, excellent image quality and good diagnostic performance. (orig.)

  19. Regime for Bowel Preparation in Patients Scheduled to Colonoscopy: Low-Residue Diet or Clear Liquid Diet? Evidence From Systematic Review With Power Analysis.

    Science.gov (United States)

    Song, Guo-Min; Tian, Xu; Ma, Li; Yi, Li-Juan; Shuai, Ting; Zeng, Zi; Zeng, Xian-Tao

    2016-01-01

    Clear liquid diet (CLD) is used to perform bowel preparation before colonoscopy traditionally, but several clinical studies indicated that low-residue diet (LRD) generates equal effects to CLD and a conclusive conclusion has not yet been yielded. The systematic review was performed to address this conflict and facilitate informed decision-making eventually. To capture randomized controlled trials (RCTs) comparing LRD with CLD in terms of bowel preparation, a search was performed in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, recent conference abstracts, Google Scholar, and Clinicaltrials.gov through May 2015. We performed all meta-analyses based on fixed- or random-effects model, which is generated from clinical characteristics and methodology. Moreover, the G*Power software was adopted to achieve statistical power for each outcome. In total, we captured 109 potential citations at initial search stage and 2 topic-related articles were included through other sources. After critical appraisal, 7 RCTs were eligible for our inclusion criteria. Meta-analyses generated similar effects in bowel preparation quality, efficacy of colon cleansing, and compliance with recommended dietary regime when LRD versus CLD regime, but patients who were prescribed to receive LRD have slightly better tolerance (RR, 1.06; 95% CI, 1.02-1.11) and tended to repeat the same preparation regime in future (RR, 1.17; 95% CI, 1.09-1.26) relative to patients in CLD. Importantly, both regimes resulted in similar adverse events (AEs). With the best available evidence, LRD could be recommended to be as standard regime for bowel preparation prior to colonoscopy. PMID:26735547

  20. On effectiveness in colorectal surgery : mechanical bowel preparation or not in elective colonic surgery and treatment options for elderly patients with rectal cancer

    OpenAIRE

    Jung, Bärbel

    2008-01-01

    The management of patients undergoing colorectal surgery has changed in recent decades. Efforts have been made to show that perioperative physiological stress to the patient can be minimised with standardised care programmes and thus improve short term outcome after colorectal surgery. Mechanical bowel preparation (MBP), for instance, has been questioned as part of standard management. There are studies highlighting the effect of cancer treatment and its side effects in the elderly, showing t...

  1. Induction of potentially lethal hypermagnesemia, ischemic colitis, and toxic megacolon by a preoperative mechanical bowel preparation: report of a case.

    Science.gov (United States)

    Sugiyama, Masahiko; Kusumoto, Eiji; Ota, Mitsuhiko; Kimura, Yasue; Tsutsumi, Norifumi; Oki, Eiji; Sakaguchi, Yoshihisa; Kusumoto, Tetsuya; Ikejiri, Koji; Maehara, Yoshihiko

    2016-12-01

    A 67-year-old man was diagnosed with rectal cancer. The tumor invaded the subserosal layer, but it was not large, and there was no sign of obstruction. Neo-adjuvant chemotherapy reduced the size of the tumor. The patient was admitted to our hospital for surgery. For mechanical bowel preparation, he ingested 34 g of magnesium citrate (Magcorol P®), but then developed severe shock, a disturbance of consciousness, and acidemia, and he required catecholamines and mechanical ventilation. X-ray, CT, and laboratory tests revealed ischemic colitis, toxic megacolon, and hypermagnesemia (16.3 mg/dL). After 2 days of temporary hemodialysis and an enema to reduce his blood magnesium concentration, he recovered and left the intensive care unit. However, the left side of his colon had suffered ischemic damage and become irreversibly atrophied. One month later, he underwent laparoscopic abdominoperineal resection and left-side colectomy for the rectal cancer and severe ischemic colitis of the left side of the colon. Histopathology confirmed the rectal cancer with a grade 2 chemotherapeutic effect and severe ischemic colitis of the left side of the colon. Hence, the present case suggests that severe ischemic colitis, toxic megacolon, and hypermagnesemia can occur after taking a magnesium laxative without obstruction of the intestine. PMID:26943694

  2. Preoperative mechanical bowel preparation in elective colorectal surgery: an update of systematic review of the literature and meta-analysis

    Directory of Open Access Journals (Sweden)

    Katia Ferreira Güenaga

    2012-03-01

    Full Text Available The belief that mechanical bowel preparation is related to the reduction of complications in elective colorectal surgery is based on observational studies and expert opinion. This question led the authors to a systematic literature review, with the completion of meta-analysis, followed by three updates. METHOD: The sources of information were EMBASE, LILACS, MEDLINE, IBECS, the Cochrane Controlled Trials Register and letters to the authors. The studies were included according to the randomization criteria. The studied variables were: anastomotic dehiscence, mortality and operatory wound infection. The analysis was divided into two comparisons: one group with mechanical preparation (Group A compared with a group without preparation (Group B (Comparison I and a group submitted to rectal enema (Comparison II. RESULTS: We analyzed 5,805 patients in 20 clinical trials. In comparison I, anastomotic leak occurred in 4.4% (101/2,275 patients in Group A and 4.5% (103/2,258 patients in Group B. In comparison II, anastomotic leak occurred in 4.4% (27/601 patients in Group A and 3.4% (21/609 patients in Group B. CONCLUSION: Despite the inclusion of more studies, evidences found in studies did not show any benefit obtained from the use of preoperative mechanical bowel preparation or rectal cleansing enemas in elective colorectal surgery.A crença de que o preparo mecânico do cólon está relacionado à diminuição de complicações na cirurgia colorretal eletiva é baseada em estudos observacionais e opinião de especialistas. Seu questionamento motivou os autores na busca sistemática da literatura, com a realização de meta-análise, seguida de três atualizações. MÉTODO: Fontes de informação foram EMBASE, LILACS, MEDLINE, IBECS, Registros de Ensaios Clínicos Casualizados da Colaboração Cochrane e cartas para os autores. Os estudos foram incluídos de acordo com os critérios de casualização. Os desfechos clínicos estudados foram: deisc

  3. Estudo comparativo entre manitol e polietilenoglicol no preparo intestinal para colonoscopia Manitol versus polyethylene glycol in bowel preparation for colonoscopy

    Directory of Open Access Journals (Sweden)

    Marcelo Alexandre Pinto de Britto

    2009-06-01

    Full Text Available OBJETIVOS: O estudo visa comparar o preparo intestinal para colonoscopia com manitol a 10%, com o uso de polietilenoglicol (PEG. Levou-se em conta o custo de cada preparo, tolerabilidade, eficácia, e alterações bioquímicas causadas pela administração. MÉTODOS: Desenvolveu-se um ensaio clínico randomizado, duplo-cego, unicêntrico. Pacientes que já haviam feito o exame foram excluídos. Fez-se a dosagem de hematócrito, sódio, potássio e cloretos antes e depois do preparo. Escalas de sintomatologia e eficácia foram utilizadas. O custo foi calculado pelo volume médio necessário para obter-se evacuação com líquido claro sem resíduos. RESULTADOS: Foi necessário um litro a mais de solução de PEG para o preparo. Apesar disso, a tolerabilidade desta solução foi melhor. Na avaliação do colonoscopista sobre a qualidade do preparo, o manitol obteve vantagem. Não houveram alterações bioquímicas significativas, e o custo foi comparável. CONCLUSÃO: O manitol, apesar de parecer provocar mais sintomatologia nos pacientes, é mais eficaz na limpeza do cólon. Apesar de não ter seu uso endossado pelos últimos consensos internacionais, mostra-se seguro e eficaz. O PEG torna-se de custo vantajoso quando comprado pelo paciente, porém o manitol é mais barato em ambiente hospitalar.OBJECTIVES: The present study aims to analyze bowel preparation for colonoscopy with mannitol compared to polyethylene glycol (PEG. Variables were the cost of preparation, patient acceptance, efficacy, and biochemical imbalances due to the use. METHODS: A randomized, double-blind, unicentric clinical trial was designed. Patients already submitted to colonoscopies were excluded. Haematocrit, sodium, potassium, and chloride were evaluated before and after the administration. Symptom and efficacy scores were determined, and the cost was calculated by the average volume of solution necessary to produce a clear-liquid passage. RESULTS: It took one liter more

  4. Bowel incontinence

    Science.gov (United States)

    ... which adds bulk to stools. Bowel retraining and pelvic floor exercises. These methods can help you control your ... provider can show you exercises to strengthen the pelvic floor and anal muscles. Bowel retraining involves trying to ...

  5. Analysis of a grading system to assess the quality of small-bowel preparation for capsule endoscopy: in search of the Holy Grail

    Science.gov (United States)

    Goyal, Jatinder; Goel, Anshum; McGwin, Gerald; Weber, Frederick

    2014-01-01

    Background: The diagnostic yield of capsule endoscopy is vulnerable to inadequate visualization related to residual bile or chyme remaining in the lumen despite intestinal lavage. It has been challenging to determine the optimal lavage preparation of the bowel and patient diet before capsule endoscopy, as well as the timing of the procedure, because no well-accepted, validated grading system for assessing the quality of intestinal lavage before capsule endoscopy is available. There remains no consensus on the reliability of qualitative, quantitative, or computer-derived assessments of the quality of preparation for capsule endoscopy. This study evaluates intra-observer and interobserver agreement for a previously validated scale. Materials and methods: The digital images of 34 patients who underwent capsule endoscopy were independently reviewed by two blinded physicians according to a previously validated grading scale. One of the physicians reviewed and graded the patients a second time. The quality of the bowel luminal preparation was assessed with a qualitative parameter (fluid transparency) and a more quantitative parameter (mucosal invisibility) for each of three small-intestinal segments, and an overall small-bowel score for each parameter was assigned as well. A weighted kappa coefficient was used to calculate intra-observer (observer 1A and 1B) and interobserver (observer 1A and observer 2) agreement. A kappa value of 0.60 or more suggests strong agreement, 0.40 to 0.60 moderate agreement, and less than 0.40 poor agreement. Results: The intra-observer weighted kappa index for both fluid transparency and mucosal visibility was 0.52, which is consistent with moderate agreement. The interobserver weighted kappa indices for fluid transparency and mucosal invisibility were 0.29 and 0.42, respectively, demonstrating suboptimal interobserver agreement. The individual segment interobserver kappa indices were better for mucosal visibility (0.52, 0.39, and 0.47 for

  6. The timing of bowel preparation before colonoscopy determines the quality of cleansing, and is a significant factor contributing to the detection of flat lesions: A randomized study

    Institute of Scientific and Technical Information of China (English)

    Adolfo Parra-Blanco; David Nicolás-Pérez; Antonio Gimeno-García; Bego(n)a Grosso; Alejandro Jiménez; Juan Ortega; Enrique Quintero

    2006-01-01

    AIM: To compare the cleansing quality of polyethylene glycol electrolyte solution and sodium phosphate with different schedules of administration, and to evaluate whether the timing of the administration of bowel preparation affects the detection of polyps.METHODS: One hundred and seventy-seven consecutive outpatients scheduled for colonoscopy were randomized in one of four groups to receive polyethylene glycol electrolyte solution or oral sodium phosphate with two different timing schedules. Quality of cleansing, polyp detection, and tolerance were evaluated.RESULTS: Patients receiving polyethylene glycol or sodium phosphate on the same day as the colonoscopy,obtained good to excellent global cleansing scores more frequently than patients who received polyethylene glycol or sodium phosphate on the day prior to the procedure (P< 0.001). Flat lesions, but not flat adenomas, were more frequent in patients prepared on the same day (P = 0.02).CONCLUSION: The quality of colonic cleansing and the detection of flat lesions are significantly improved when the preparation is taken on the day of the colonoscopy.

  7. Bowel disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008069 The application of Montreal classification in inflammatory bowel disease. YANG Chuanhua(杨川华), et al. Renji Hosp, Shanghai Instit, Shanghai Jiaotong Univ Med Coll, Shanghai 200001. Chin J Intern Med 2008;47(1):7-10. Objective To investigate the clinical features of Crohn′s disease (CD) and ulcerative colitis (UC) according to the Montreal classification. Methods The clinical data of 110 cases of CD or UC were reviewed. The age at

  8. Preparo intestinal para colonoscopia com picossulfato sódico e citrato de magnésio em crianças e adolescentes Bowel preparation for colonoscopy with sodium picosulphate and magnesium citrate in children and adolescents

    Directory of Open Access Journals (Sweden)

    Elisabete Kawakami

    2004-03-01

    Full Text Available RACIONAL: A eficácia do exame colonoscópico depende diretamente da limpeza colônica. Ao contrário do paciente adulto, há poucos relatos na literatura sobre preparo colônico em crianças. OBJETIVO: Avaliar a eficácia do preparo colônico à base de picossulfato sódico e citrato de magnésio em crianças e adolescentes. PACIENTES E MÉTODOS: Realizou-se estudo aberto, prospectivo e consecutivo em crianças maiores de 1 ano, de ambos os sexos, que realizaram colonoscopia por diferentes indicações. Os pacientes receberam a medicação associada à dieta líquida e pastosa sem resíduos no dia anterior ao exame. A eficácia do preparo foi classificada em: Grau I: ótimo; Grau II: bom; Grau III: regular; Grau IV: ruim. RESULTADOS: A idade variou de 12 meses a 16 anos e 1 mês (mediana: 6 anos e 6 meses, sendo 54,3% do sexo masculino. O preparo foi feito conforme a orientação em 37/46 (80,4% dos pacientes, sendo que 9 não fizeram a dieta adequadamente e 22/46 (47,8% referiram efeitos colaterais. A eficácia do preparo foi: GI em 41,3%, GII em 52,2%, GIII em 6,5% e GIV em 0%. CONCLUSÃO: Preparo intestinal com picossulfato sódico e citrato de magnésio é eficiente e prático, podendo ser recomendado de rotina nos exames de colonoscopia em crianças e adolescentes.BACKGROUND: The efficacy of colonoscopic examination depends directly on bowel cleasing preparation. There are few studies in the medical literature about bowel preparation in children. AIM: To determinate the efficacy of picosulphate sodium with magnesium citrate as a bowel preparation in children and adolescents. PATIENTS AND METHODS: In an open prospective and consecutive trial, we included all children above 1 year of age submitted to colonoscopy for different indications. All patients received the drug the day before the procedure and was allowed no solid food but a liberal intake of clear fluids. The adequacy of the preparation was graded as follows: gI - excellent, g

  9. Narcotic Bowel Syndrome

    Science.gov (United States)

    ... Intolerance Malabsorption Narcotic Bowel Syndrome Radiation Therapy Injury Short Bowel Syndrome Symptoms & Causes Treatments Nutrition and Diet Managing Secondary Effects Medications Surgery Daily Living with SBS Resources SMA Syndrome Volvulus ...

  10. Large bowel resection - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100089.htm Large bowel resection - Series To use the sharing features ... 6 out of 6 Normal anatomy Overview The large bowel [large intestine or the colon] is part ...

  11. Large bowel resection - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000151.htm Large bowel resection - discharge To use the sharing features ... surgery to remove all or part of your large intestine (large bowel). You may also have had ...

  12. Affect of periampullary structure display for three kinds of bowel preparation methods%3种肠道准备方法对十二指肠壶腹周围结构显示的影响

    Institute of Scientific and Technical Information of China (English)

    陈清生; 蔡吉勇; 陶锐; 胡薇; 魏梅

    2015-01-01

    目的:对比肌内注射(肌注)低张药物、口服阴性对比剂及肌注低张药物结合口服阴性对比剂3种方法进行肠道准备后对正常十二指肠壶腹及周围解剖结构显示的差异。方法将健康体检者60例随机分为3组各20例,分别采用肌注消旋山茛菪碱(654-2肌注组)、饮温开水(饮水组)和肌注654-2注射液结合饮温开水(654-2肌注+饮水组)进行肠道准备。3组体检者分别行肠道准备后壶腹部CT扫描。结果3种肠道准备后CT扫描图像对十二指肠肠腔扩张度,胆总管下段、壶腹部、十二指肠乳头及十二指肠黏膜显示差异有统计学意义(P<0.05),654-2肌注+饮水组十二指肠、壶腹部解剖结构的显示结果最佳。结论肌注低张药物结合口服阴性对比剂肠道准备后CT扫描有利于正常十二指肠、壶腹部周围解剖结构的显示,为最优肠道准备方法。%Objective To observe the differences of the normal duodenal ampulla and surrounding anatomical struc -tures display by intramuscular injection hypotonic drugs ,negative oral contrast agent ,intramuscular injection of hypotonic drugs with negative oral contrast agent three kinds of methods of bowel preparation .Methods 60 cases of healthy people were ran-domly divided into A group,B group and C group,each of 20 people,bowel preparation were given with intremuscular injected 654-2 injection ,drunk warm water ,and injecting 654-2 injection combined with drunk warm water respectively .3 groups health-y people were performed CT examination after bowel preparation .Results 3 kinds of bowel preparation for CT scan images of the duodenum lumen expansion,common bile duct,ampulla,duodenal mucosa and duodenal showed statistically significant differences(P<0.05).Intramuscular 654-2 combined water duodenum,ampulla anatomy showed the best results .Conclusion The best bowel preparation of injected 654-2,drunk warm water,before CT

  13. The Effects Observed of Small Doses of Senna Immersion in the Capsule Endoscopy Bowel Preparation%小剂量番泻叶浸液在胶囊内镜肠道准备中的效果观察

    Institute of Scientific and Technical Information of China (English)

    杨院平; 黄若

    2013-01-01

      Objective To observe the different methods of cleaning effect of bowel preparation before capsule endoscopy. Methods Divided into 40 patients with bowel cleansing method random level magnesium sulfate group (at 4 p.m. of the day before capsule endoscopy drinking 50% magnesium sulfate 25g soluble in water a little firstly, then drinking 500 mL of water within half an hour later, the next day at 5 a.m drinking 50% magnesium sulfate 50g soluble in water a little firstly, then drinking more than 1000 mL of water within half an hour later) and senna-magnesium sulfate group (eating less residue diet two days ago before capsule endoscopy, senna daily 2-3g soaked with water 300 mL after 15 minutes, then drinking the senna immersion replace tea until 12h before check, then like the former group taking the magnesium sulfate). Results Magnesium sulfate group and senna-magnesium group patients all could tolerate the bowel preparation, bowel cleansing excellent rate the magnesium sulfate group of patients was 70%, senna-magnesiu sulfate group was 90%. Conclusion The small dose of senna immersion plus magnesium sulfate oral as bowel preparation method in capsule endoscopy can effectively improve the images clarity and lesion detection rate, worth in clinical popularize.%  目的观察不同方法对胶囊内镜检查前肠道准备的清洁效果。方法将40例患者按肠道清洁方法随机平分为硫酸镁组(检查前1d 下午4点将50%硫酸镁25g 溶于清水少许中饮完,其后半小时内饮水500mL,当日早晨5点50%硫酸镁50g 溶于清水少许中饮完,其后半小时内饮水1000mL 以上)及番泻叶-硫酸镁组(检查前2d 进食少渣饮食,每日番泻叶2~3g 用开水300mL 浸泡15min 后当茶饮用,检查前12h 停服番泻叶,按照前组办法服用硫酸镁)。结果硫酸镁组及番泻叶-硫酸镁组患者均能耐受肠道准备。肠道清洁评分显示硫酸镁组患者优良率为65%,番泻

  14. The application of sodium phosphate combined with simethicone emulsion for bowel preparation of patients before undergoing colonoscopy examination%西甲硅油去泡剂在磷酸钠盐肠道准备中的应用

    Institute of Scientific and Technical Information of China (English)

    洪鑫芳; 杨丽

    2012-01-01

    Objective To evaluate the simethicone emulsion combined with Sodium phosphate for bowel preparation of patients before undergoing eolonoscopy examination. Methods 160 patients who would accept colonoscopy were randomized to three groups: control group, simethicone emulsion group 1 and simethicone emulsion group 2. Patients in control group were given warm water as placebo. Patients in simethicone emulsion group 1 were given 30 mg simethicone emulsion and 30 mg warm water. Patients in simethicone emulsion group 2 were given 60 mg simethicone emulsion. The foams and the pictures quality in the intestinal were compared among the three groups. Results The simethicone emulsion group 1 and group 2 had less foams in the intestine and better pictures quality than control group (P<0.05). But there was no statistic difference between the simethicone emulsion groupl and group 2. There was no adverse effect among the three groups. Conclusions Less foams and better pictures quality could be achieved by simethicone emulsion combined with Sodium phosphate for bowel preparation. And 30 mg simethicone emulsion may be enough for one bowel preparation.%目的 观察西甲硅油在磷酸钠盐肠道准备中祛泡应用效果.方法 160例行肠镜检查患者随机分为对照组(检查前1h口服安慰剂60 mg,安慰剂即为温纯净水),药物组一(检查前1h口服西甲硅油30 mg+温纯净水30 ml),药物组二(检查前1h口服西甲硅油60 mg),比较3组大肠肠道内所含气泡量,同时观察有无不良反应.结果 与对照组相比,2个药物组大肠内的气泡较少、图像清晰度较好,差异有统计学意义(P<0.05),但2个药物组比较,差别无统计学意义.3组均没有出现明显不良反应.结论 西甲硅油能够祛除肠道内的气泡,30 mg剂量即可,加大剂量对于效果改善不明显.

  15. Short bowel syndrome

    International Nuclear Information System (INIS)

    This thesis describes some aspects of short bowel syndrome. When approximately 1 m or less small bowel is retained after extensive resection, a condition called short bowel syndrome is present. Since the advent of parenteral nutrition, the prognosis of patients with a very short bowel has dramatically improved. Patients with 40 to 100 cm remaining jejunum and/or ileum can generally be maintained with oral nutrition due to increased absorption of the small bowel remnant as result of intestinal adaptation. This study reports clinical, biochemical and nutritional aspects of short bowel patients on oral or parenteral nutrition, emphasizing data on absorption of various nutrients and on bone metabolism. Furthermore, some technical apsects concerning long-term parenteral nutrition are discussed. (Auth.)

  16. Functional bowel disease

    DEFF Research Database (Denmark)

    Rumessen, J J; Gudmand-Høyer, E

    1988-01-01

    Twenty-five patients with functional bowel disease were given fructose, sorbitol, fructose-sorbitol mixtures, and sucrose. The occurrence of malabsorption was evaluated by means of hydrogen breath tests and the gastrointestinal symptoms, if any, were recorded. One patient could not be evaluated...... with functional bowel disease. The findings may have direct influence on the dietary guidance given to a major group of patients with functional bowel disease and may make it possible to define separate entities in this disease complex....

  17. Short Bowel Syndrome

    Science.gov (United States)

    ... may include nutritional support medications surgery intestinal transplant Nutritional Support The main treatment for short bowel syndrome is nutritional support, which may include the following: Oral rehydration. Adults ...

  18. Small Bowel Bleeding

    Science.gov (United States)

    ... ACG on Facebook About ACG ACG Store ACG Patient Education & Resource Center Home GI Health and Disease Recursos en Español What is a Gastroenterologist? Podcasts and Videos GI Health Centers Colorectal Cancer Hepatitis C Inflammatory Bowel Disease Irritable Bowel Syndrome Obesity © ...

  19. Pediatric inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Karen A Diefenbach; Christopher K Breuer

    2006-01-01

    Inflammatory bowel disease is an important cause of gastrointestinal pathology in children and adolescents.The incidence of pediatric inflammatory bowel disease is increasing; therefore, it is important for the clinician to be aware of the presentation of this disease in the pediatric population. Laboratory tests, radiology studies,and endoscopic procedures are helpful in diagnosing inflammatory bowel disease and differentiating between Crohn's disease and ulcerative colitis. Once diagnosed,the goal of medical management is to induce remission of disease while minimizing the side effects of the medication. Specific attention needs to be paid to achieving normal growth in this susceptible population.Surgical management is usually indicated for failure of medical management, complication, or malignancy.Algorithms for diagnostic evaluation and treatment of pediatric inflammatory bowel disease are presented.The specific psychosocial issues facing these patients are also discussed in this review as are the future goals of research in the complex problem of pediatric inflammatory bowel disease.

  20. Small Bowel Review: Part I

    Directory of Open Access Journals (Sweden)

    ABR Thomson

    2000-01-01

    Full Text Available In the past year, there have been many advances in the area of small bowel physiology and pathology. More than 1500 papers were assessed in preparation for this review. Some were selected and reviewed, with a particular focus on presenting clinically useful information for the practising gastroenterologist. Relevant review articles have been highlighted, and important clinical learning points have been stressed. The topics are varied in scope, and wherever possible show a logical progression from basic physiology to pathophysiology to clinical disorders and management.

  1. Quantitative Risk-Benefit Analysis of Probiotic Use for Irritable Bowel Syndrome and Inflammatory Bowel Disease.

    Science.gov (United States)

    Bennett, William E

    2016-04-01

    Probiotics have seen widespread use for a variety of gastrointestinal problems, especially in two common disorders: irritable bowel syndrome and inflammatory bowel disease. Since a wide variety of probiotic preparations has been used, and despite a large number of studies performed, a great deal of heterogeneity exists among them. Straightforward evidence-based recommendations for the use of probiotics in irritable bowel syndrome and inflammatory bowel disease have thus been difficult to formulate. In an effort to improve understanding of the risk-benefit balance of probiotics in these conditions, this study (1) queried the US FDA Adverse Event Reporting System (FAERS) database for all reported adverse drug events related to probiotics in 2013, and (2) constructed risk-benefit planes for both irritable bowel syndrome and inflammatory bowel disease using a geometric approximation of the confidence region between risk and benefit. The results show that adverse events from probiotics vary widely by disease, and when they occur, they are mild and may be difficult to distinguish from the natural history of the underlying disorders they are used to treat. The risk-benefit plane for irritable bowel syndrome straddles the risk-benefit threshold, so patients can expect a balance between a low chance of risk and also a low chance of benefit. The risk-benefit plane for inflammatory bowel disease largely lies above the risk-benefit threshold, so patients may expect more benefit than risk in most cases. More standardized and high-quality research is needed to improve our understanding of risk and benefit for these complex biopharmaceuticals. PMID:26467550

  2. Irritable Bowel Syndrome

    Science.gov (United States)

    ... foods are linked to other digestive conditions like lactose intolerance or celiac disease , though, so it's important to ... MORE ON THIS TOPIC Gastroesophageal Reflux Disease (GERD) Lactose Intolerance Inflammatory Bowel Disease Ulcers Digestive System Eating Well ...

  3. Small bowel resection - discharge

    Science.gov (United States)

    ... incision is red, warm, swollen, or more painful Short of breath or chest pain Swollen legs or pain in your calves Alternative Names Small intestine surgery - discharge; Bowel resection - small intestine - discharge; Resection of ...

  4. Prevalence of Bowel Incontinence

    Science.gov (United States)

    ... Incontinence and Aging Managing Incontinence Managing Incontinence: A Survey The Patient's Perspective Barriers on ... is the word used to describe loss of control over when and where we go to the bathroom. It is also called accidental bowel leakage, or ...

  5. Small bowel bacterial overgrowth

    Science.gov (United States)

    ... Surgical procedures that create a loop of small intestine where excess bacteria can grow. An example is a Billroth II type of stomach removal ( gastrectomy ). Some cases of irritable bowel syndrome (IBS) Symptoms The most common symptoms are: Abdominal ...

  6. Irritable bowel syndrome.

    OpenAIRE

    Beck, E.; Hurwitz, B

    1992-01-01

    1. Irritable bowel syndrome is a functional disorder of the lower intestinal tract affecting approximately 10% of the population and causing a wide range of symptoms. 2. Most cases of irritable bowel syndrome can be diagnosed in general practice on the basis of the presenting history and clinical examination but some patients may need to be referred to a gastro-enterologist for further assessment including sigmoidoscopy and barium enema. 3. The clinical picture may include symptoms of abdomin...

  7. 复方枸橼酸阿尔维林用于结肠镜检查前肠道准备144例%Application of Compound Alverine Citrate in Bowel Preparation before Colonoscopic Examination in 144 Cases

    Institute of Scientific and Technical Information of China (English)

    黄旻

    2015-01-01

    Objective To investigate the application and value of compound alverine citrate in the bowel preparation for colonoscopic ex-amination. Methods 288 patients requiring for colonoscopic examination were randomly divided into the experimental group and the control group. Before examination, the control group used sodium phosphate oral solution for cleaning the bowel, while on this basis the experimental group was added with oral compound alverine citrate. Results The intestinal bubble remaining of the experimental group was less than that of the control group ( P ﹤ 0. 05 ) , the patient ’ s tolerance degree in the observation group was higher than that in the control group ( P ﹤ 0. 05 ) , and the intestinal cleanliness had no statistically significant difference between the two groups ( P ﹥ 0. 05 ) . Conclusion Using compound alverine citrate before colonoscopic examination could mitigate discomfort degrees such as abdominal pain and abdominal distension, improves tolerance, reduces intestinal bubble remaining and is worthy of being clinically promoted and applied.%目的:探讨复方枸橼酸阿尔维林在结肠镜检查前肠道准备中的应用及价值。方法将288例需行结肠镜检查的患者随机均分为试验组和对照组,检查前对照组用磷酸钠盐口服溶液清洗肠道,试验组在此基础上加用复方枸橼酸阿尔维林。结果试验组肠道气泡存留少于对照组( P﹤0.05),患者检查耐受程度大于对照组( P﹤0.05),两组肠道清洁度无明显差异( P﹥0.05)。结论行结肠镜检查前应用复方枸橼酸阿尔维林,能减轻患者腹痛、腹胀等不适程度而提高耐受性,可减少肠道气泡存留,值得临床推广。

  8. Bowel vaginoplasty in children

    Directory of Open Access Journals (Sweden)

    Sarin Yogesh

    2006-01-01

    Full Text Available OBJECTIVES: To describe our experience with bowel vaginoplasty done in children. MATERIALS AND METHODS: This is a retrospective study of eight children aged 10 months to 8 years, who underwent bowel vaginoplasty over a period of 5 years (2000-2005. The indications of bowel vaginoplasty included anorectovestibular fistula (ARVF associated with Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome (n=6 and cloaca (n=2. The bowel segment used for vaginoplasty included colon (n=3, ileum (n=2 and duplicated rectum (n=1. In two patients of ARVF associated with uterovaginal agenesis, the distal- most part of ARVF was transected at the level of peritoneal reflection and left as neovagina, whereas the proximal bowel was pulled through at the proposed neo-anal site. All the patients were advised daily home dilatation of the neo vaginal orifice with Hegar′s dilators, for a period of six weeks. RESULTS: Bowel vaginoplasty was done in eight patients. None had any significant per-operative complication. Two patients had abdominal wound dehiscence, requiring secondary suturing. Two patients had mucosal prolapse of the neovagina, which required trimming. One patient died two months after discharge, because of meningitis. Out of the eight patients, seven are in regular follow-up. Six patients have neovagina, cosmetically acceptable to the parents; all have been radiologically proven to have adequate length. One patient had unacceptable perineal appearance with nipple-like vaginal orifice and scarred perineal wound, that merits a revision. None of the patients had vaginal stenosis and excessive mucus discharge, during follow-up visits. Although post surgical results are acceptable to the parents cosmetically, the sexual and psychological outcome is yet to be assessed. Conclusions: Bowel vaginoplasty is a safe and acceptable procedure to treat the pediatric patients of uterovaginal agenesis and cloaca.

  9. Ostomy Surgery of the Bowel

    Science.gov (United States)

    ... sustain life. Diarrhea is the main symptom of short bowel syndrome. Other symptoms may include cramping bloating heartburn weakness and fatigue vomiting excessive gas foul-smelling stool Short bowel syndrome is uncommon and can occur with Crohn’s ...

  10. Inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Kottler, R.E.; Freson, M. (Groote Schuur Hospital, Cape Town (South Africa). Dept. of Radiology)

    1985-06-01

    Radiology is of considerable value in all forms of inflammatory bowel disease to establish its presence and extent, and to differentiate lesions. The most common inflammatory bowel diseases are Crohn's disease and ulcerative colitis. Crohn's disease may occur anywhere in the disgestive tract, but is most common in the terminal ileum. Since there is no practical endoscopic method of examining the small bowel, barium studies of the latter are most important. Modern radiological techniques, especially the double contrast barium enema, show excellent correlation between the macroscopic changes and the radiological features. Radiology alone does not provide the answers and the radiological features must be interpreted in conjunction with clinical investigation.

  11. Anastomotic disruption after large bowel resection

    Institute of Scientific and Technical Information of China (English)

    Mohammad U NasirKhan; Farshad Abir; Walter Longo; Robert Kozol

    2006-01-01

    Anastomotic disruption is a feared and serious complication of colon surgery. Decades of research have identified factors favoring successful healing of anastomoses as well as risk factors for anastomotic disruption. However, some factors, such as the role of mechanical bowel preparation, remain controversial.Despite proper caution and excellent surgical technique,some anastomotic leaks are inevitable. The rapid identification of anastomotic leaks and the timely treatment in these cases are paramount.

  12. Anastomotic disruption after large bowel resection

    OpenAIRE

    NasirKhan, Mohammad U; Abir, Farshad; Longo, Walter; Kozol, Robert

    2006-01-01

    Anastomotic disruption is a feared and serious complication of colon surgery. Decades of research have identified factors favoring successful healing of anastomoses as well as risk factors for anastomotic disruption. However, some factors, such as the role of mechanical bowel preparation, remain controversial. Despite proper caution and excellent surgical technique, some anastomotic leaks are inevitable. The rapid identification of anastomotic leaks and the timely treatment in these cases are...

  13. PPH术前三种肠道准备效果的对比研究%Comparative study on the effect of PPH pre - operative bowel preparation

    Institute of Scientific and Technical Information of China (English)

    杨萌

    2012-01-01

    目的:对比观察口服甘露醇、清洁灌肠和结肠水疗在PPH术前清洁肠道的效果.方法:将531例患者随机分为A、B、C三组,A组口服甘露醇,B组清洁灌肠,C组综合结肠水疗(结肠水疗配合开塞露塞肛、音乐疗法及腹部按摩),比较三组患者舒适度、肠道清洁度、肠道清洁所需时间、首次排便时间.结果:与A组、B组相比,C组患者舒适度、肠道清洁度、术后首次排便时间控制最佳(P<0.05),A、B两组在肠道灌洗时间、术后首次排便时间差异无统计学意义(P>0.05).结论:综合结肠水疗可能是PPH术目前一种最佳的肠道准备方法.但特殊患者可根据患者个体情况选择合适的肠道清洁方法.%Objective: To observe the effects of the three ways of he intestinal tract preparation before procedure for prolapse hemorrhoids (PPH) : oral Man-nitol,cleaning enema and colon spa hydrotherapy. Methods:Chose the 531 samples of sufferer and divide them into three parts;the group A was oral mannitol,the group B was cleaning enema ,the group C was colon hydrotherapy, then we compare the sufferer's comfortness, cleanness of enena, the spending time of clean enema, and the time of first defecating. Results: The group C was more superior than group A and group B in enema cleanness obviously and the time was longer than group A and group B(P 0.05). Conclusion:Colon spa hydrotherap may be PPH art a the best of current intestinal preparation,but some special sufferers appropriate enema cleanness technic according to the individual's status.

  14. Different types of diets on the effect observation of bowel preparation before gynecological laparoscopic surgery%妇科腹腔镜手术前不同类型饮食对肠道准备的效果观察

    Institute of Scientific and Technical Information of China (English)

    兰香; 夏利花; 徐金贵; 李锦; 舒俊英; 黄美珍

    2014-01-01

    Objective]To investigate the effects of having different types of diets on bowel preparation before gynecological la-paroscopic surgery .[Method]To select 110 cases from patients who will take Laparoscopic operation in Department of gynecol-ogy in our Hospital from 2013 January to 2013 June .According to their surgery date ,they were divided into two groups as ob-servation group (n=57)(odd-numbered days) and control group (n=53) (even-numbered days) .The day before surgery , the observation group patients ate full food at noon and started eating semi liquid diet from dinner ;and the control group started eating semi liquid diet from lunch .After taking oral enema ,we compare the following phenomenon between two types of diets:the first defecation time ,4H defecation frequency ,fecal contamination rate during operation ,also the incidence rate of hypo-glycemia reaction .[Result]The first defecation time ,4H defecation frequency and fecal contamination rate during operation of two groups had no significant difference ( P>0.05 ) ,The observation group has lower incidence rate of hypoglycemia reaction than the control group( P<0.05) .[Conclusion]Before taking oral enema to clean intestine ,eating full diet has no significant effect on bowel preparation ,but the incidence rate of hypoglycemia ,dizziness ,palpitation ,abnormal sweating due to general debility ,weakness is obviously lower in the observation group than the control group ,also the patients has higher comfort lev-els .%目的:探讨妇科腹腔镜手术前不同类型饮食对肠道准备的影响。方法:选择2013年1-6月在我院妇科腹腔镜手术治疗患者110例,单号手术日患者57例设为观察组,双号手术日的患者53例设为对照组。对照组患者术前1d中餐、晚餐均半流质饮食;观察组患者术前1d中餐普食,晚餐半流质饮食。比较2组不同类型饮食患者口服复方聚乙二醇电解质散后首次排便时间、4h内排

  15. Effects of Different Preoperative Bowel Preparations on Intestinal Cleansing among Patients with Bladder Cancer%不同肠道准备方法对膀胱癌患者术前肠道清洁效果的影响

    Institute of Scientific and Technical Information of China (English)

    刘亚珍; 姜岩; 申海燕; 刘星

    2012-01-01

    目的 探讨术前不同肠道准备方法对腹腔镜下根治性膀胱切除联合全去带乙状结肠原位新膀胱术患者肠道清洁效果的影响.方法 便利抽样法选择2009年6月至2011年7月在南方医科大学珠江医院泌尿外科行腹腔镜下根治性膀胱切除联合全去带乙状结肠原位新膀胱术患者60例为研究对象,按随机数字表法将其分成对照组和观察组,每组均30例.观察组患者术前口服聚乙二醇电解质+蓖麻油后灌肠,对照组患者术前口服蓖麻油后灌肠.比较两组患者肠道的清洁度、不良反应以及患者服药依从性情况.结果 与对照组比较,观察组患者肠道清洁情况较好,不良反应发生少且依从性强,差异有均有统计学意义(均P<0.05).结论 口服聚乙二醇电解质+蓖麻油后灌肠能提高患者的肠道准备效果,可减少不良反应,更有利于保证手术的顺利进行.%Objective To discuss the effects of different preoperative bowel preparations on patients with intestinal cleaning for laparoscopic radical cystectomy with complete detenial sigmoid colon orthotopic neo-bladder reconstruction. Methods From Jun. 2009 to Jul. 2011,60 patients undergoing laparoscopic radical cystectomy with complete detenial sigmoid colon orthotopic neobladder reconstruction in the hospital were randomly divided into experimental group(n = 30) and control group(n = 30). The patients in the experi-mental group and in the control group were administrated with polyethylene glycol electrolytes powder±castor oil and castor oil+cleansing before enema respectively. The intestinal cleanliness,adverse reactions and compliance of the two groups were compared. Results Compared with the control group,significantly increased intestinal cleanliness,decreased adverse reactions and better compliance in the experimental group were observed(P<0. 05). Conclusion The bowel preparation method with polyethylene glycol electrolytes powder±castor oil before

  16. Inflammatory bowel disease epidemiology

    DEFF Research Database (Denmark)

    Burisch, Johan; Munkholm, Pia

    2013-01-01

    The occurrence of inflammatory bowel disease (IBD) is increasing worldwide, yet the reasons remain unknown. New therapeutic approaches have been introduced in medical IBD therapy, but their impact on the natural history of IBD remains uncertain. This review will summarize the recent findings...... in the epidemiology of IBD....

  17. Small bowel obstruction- a surprise.

    Science.gov (United States)

    Mathew, Jeffrey Daniel; Cp, Ganesh Babu; M, Balachandar; M, Ramanathan

    2015-01-01

    Trans - omental hernia is very rare, accounting to 1-4% of all internal hernias which is an unusual cause of small bowel obstruction. Here we present a case report of a small bowel obstruction in a female due to trans - omental hernia presenting with central abdominal pain, distension and bilious vomiting. She had no previous history of trauma, surgery. Plain X-ray abdomen erect showed multiple air fluid levels with dilated small bowel loops. Emergency laparotomy revealed a segment of congested small bowel loop (ileum) through a defect in greater omentum. On table the herniated bowel loop was reduced and the defect in greater omentum was closed primarily. There was no necessity for bowel resection as it regained normal colour after reduction. Postoperative period was uneventful with complete resolution of symptoms. This case is presented for its rarity and its importance in clinical differential diagnosis of acute abdomen due to small bowel obstruction.

  18. Application of intestinal microecological preparations to preoperative bowel preparation for patients with radical resection of colon cancer%肠道微生态制剂在结肠癌根治术前肠道准备中的应用

    Institute of Scientific and Technical Information of China (English)

    杨丽; 周军

    2014-01-01

    Objective:To study the application effect of intestinal microecological preparations to preoperative bowel preparation for pa-tients with radical resection of colon cancer.Methods:180 patients with radical resection of colon cancer were randomly divided into the control group and the observation group(90 cases in each group).The bowel preparation was made by using the conventional method in the control group and the patients in the observation group were given ecoimmunonutrition.The number of intestinal flora,postoperative recov-ery and immune function indexes were compared between the two groups.Results:On the 7th day after operation,the number of bifidobacte-rium,lactobacillus and enterococcus was more in the observation group than the control group;the number of escherichia coli,staphylococ-cus and yeast was less in the observation group than the control group(P<0.05);the postoperative anal exhaust time,the time of taking liquid food,the time in bed and hospitalization time was earlier and shorter in the observation group than the control group( P<0.05);the level of IgG,IgM and IgA was higher in the observation group than the control group(P<0.05).Conclusion:Application of intestinal mi-croecological preparations for preoperative bowel preparation is conducive to increasing probiotics,controlling pathogenic bacteria and pro-moting the recovery of body function and immune function in patients with radical resection of colon cancer.%目的:探讨肠道微生态制剂在结肠癌根治术前肠道准备中的应用效果。方法:将180例结肠癌根治术患者随机分为对照组和观察组各90例,对照组按照传统方法进行肠道准备,观察组给予免疫微生态营养。比较两组患者肠道菌群数目、术后恢复情况及免疫功能指标。结果:术后7d时,观察组患者双歧杆菌、乳酸杆菌、肠球菌数目高于对照组,大肠杆菌、葡萄球菌、酵母菌数目低于对照组(P<0.05);观察组患

  19. Preparo do intestino grosso para a coloscopia: usos, abusos e idéias controversas Bowel preparation for colonoscopy: myths and misconceptions

    Directory of Open Access Journals (Sweden)

    Julio César M Santos Jr

    2010-09-01

    determinar seus usos indiscriminados para propiciar as melhores condições para os mais adequados exames. Estamos diante de um impasse: o manitol, mundialmente proscrito, continua sendo indicado entre nós, sem causar problemas, num esquema posológico diferente do que foi usado no passado e que influenciou os acidentes. Por outro lado, a industria farmacêutica não conseguiu popularizar o PEG; o NaP, fabricado para uso retal, substituiu os antecessores com limpeza eficiente, mas com ações lesivas significativas, principalmente renais. Assim, o que nos resta é resgatar o manitol - demonstrar por meio de um estudo prospectivo, casualizado, que o manitol a 10% ingerido pelo menos até 4 horas antes da coloscopia é totalmente inócuo para o procedimento de diagnóstico e de terapêutica.The routine of the colonoscopic examination for therapeutic evaluation, for diagnosis, and management of the diseases of the colon and of the rectum, as well as for screening and prevention of the colorectal cancer in young patients bearing premalignant diseases or in those above 50 years of age, as well as for screening and prevention of the colorectal cancer in young patients bearing premalignant diseases or in those above 50 years of age, "has been one of the most successful public health projects worldwide71". The easy acceptance is due to three principal factors: first, to the technical adaptation and evolution of the instruments, and the safety of the examination; second one, to the practical development of the examiner skills, and, thirdly, to the magnificence of the image revealing broad access to the fine structures of the mucous membrane, with a large criteria for the diagnosis. In this context, the necessary preparation became the worst part or less tolerable of the colonoscopy. For this reason, it is necessary to look for a method of preparation, quick, efficient, cheap, pleasant, and safe. In the last 40 years, between the commentaries on mechanical and pharmacological methods

  20. Inflammatory bowel disease in pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Charron, M. [Children`s Hospital of Pittsburgh, Pittsburgh (United States). Dept. of Radiology

    1997-12-01

    Optimal management of chronic idiopathic inflammatory bowel disease requires determination of disease localization and intensity. Scintigraphy with the use of {sup 99m}Tc - HMPAO- White Bloods Cells ({sup 99m}Tc - HMPAO-WBC) is a relatively new noninvasive nuclear medicine procedure. They have evaluated more than 230 children and have found a high correspondence between the disease distribution shown by the {sup 99m}Tc - HMPAO- WBC scan and that shown by endoscopic, radiologic, or surgical methods. Additionally the {sup 99m}Tc - HMPAO-WBC scan has the ability of identifying extra intestinal site of inflammation, such as appendicitis and others. The {sup 99m}Tc - HMPAO-WBC scan is reliable in differentiating Crohn`s disease from ulcerative colitis. Some patients because of unequivocal demonstrable small bowel uptake are reclassified from ulcerative colitis to Crohn`s disease. The medication regimen is frequently altered because of the intensity of uptake displayed by the {sup 99m}Tc - HMPAO-WBC scan. It is a practical and safe study even in an acutely ill patient who may not tolerate endoscopic or radiological study. At their institution, the {sup 99m}Tc - HMPAO-WBC scan is now part of the initial evaluation, and follow-up of patients with inflammatory bowel disease. In conclusion the {sup 99m}Tc - HMPAO-WBC is excellent for the detection, localization and characterization of inflammatory bowel disease in children. Compared with the other methods of investigation this study requires no bowel preparation, is noninvasive and has excellent diagnostic accuracy.

  1. Small Bowel Hamartoma: A Huge Diverticulum of Small Bowel

    Directory of Open Access Journals (Sweden)

    Hamdi Ebdewi

    2013-01-01

    Full Text Available A-20-year old male, with no significant medical history, presented with clinical features mimicking a perforated acute appendicitis. Because of features of peritonitis, a laparotomy was performed which showed a segment of small bowel with multiple large diverticula and mesenteric cysts. A segmental small bowel resection was performed. The patient made an uneventful recovery from surgery. Histology revealed features of a small bowel hamartoma.

  2. Irritable bowel syndrome, inflammatory bowel disease and the microbiome

    OpenAIRE

    Major, Giles; Robin C. Spiller

    2014-01-01

    Purpose of review The review aims to update the reader on current developments in our understanding of how the gut microbiota impact on inflammatory bowel disease and the irritable bowel syndrome. It will also consider current efforts to modulate the microbiota for therapeutic effect. Recent findings Gene polymorphisms associated with inflammatory bowel disease increasingly suggest that interaction with the microbiota drives pathogenesis. This may be through modulation of the immune response,...

  3. Short bowel syndrome.

    LENUS (Irish Health Repository)

    Donohoe, Claire L

    2012-02-01

    The short bowel syndrome (SBS) is a state of malabsorption following intestinal resection where there is less than 200 cm of intestinal length. The management of short bowel syndrome can be challenging and is best managed by a specialised multidisciplinary team. A good understanding of the pathophysiological consequences of resection of different portions of the small intestine is necessary to anticipate and prevent, where possible, consequences of SBS. Nutrient absorption and fluid and electrolyte management in the initial stages are critical to stabilisation of the patient and to facilitate the process of adaptation. Pharmacological adjuncts to promote adaptation are in the early stages of development. Primary restoration of bowel continuity, if possible, is the principle mode of surgical treatment. Surgical procedures to increase the surface area of the small intestine or improve its function may be of benefit in experienced hands, particularly in the paediatric population. Intestinal transplant is indicated at present for patients who have failed to tolerate long-term parenteral nutrition but with increasing experience, there may be a potentially expanded role for its use in the future.

  4. Bowel disease after radiotherapy

    International Nuclear Information System (INIS)

    The clinical presentation, operative findings and outcome in 40 patients who required surgery for bowel disease after radiotherapy are presented. The type of presentation varied according to the time after radiotherapy. In the first month, many patients had a proctitis but none required surgery. Five patients were operated on within one month, 2 for radiation-induced acute ileitis and 3 for exacerbations of pre-existing disease (diverticular disease 2, ulcerative colitis 1). The commonest time of presentation was between 3 and 18 months after radiotherapy, when 20 patients needed surgery for bowel disease caused by radiation-induced local ischaemia. Twelve of these patients had chronic perforation, 6 had severe rectal bleeding and 2 had painful anorectal ulceration. Fifteen patients presented between 2 and 24 years after radiotherapy, usually with incomplete intestinal obstruction due to a fibrous stricture, but 2 patients had rectal carcinoma. Wide resection of the involved bowel was the principal method of treatment but any anastomosis was protected by a proximal defunctioning stoma. There was no operative mortality but 10 patients have died subsequently. The danger of dismissing these patients as having incurable malignancy is stressed because, although the condition is infrequent, it is usually amenable to adequate surgery. (author)

  5. Small bowel imaging of inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Emanuele; Casciani; Chiara; De; Vincentiis; Gianfranco; Gualdi

    2015-01-01

    The study of the small bowel(SB) has always beenchallenging both for clinicians and radiologist. It is a long and tortuous tube that can be affected by various pathologies whose signs and symptoms are usually non specific and can mimic other acute abdominal disorders. For these reasons, imaging plays a central role in the diagnosis of the different pathological conditions that can occur. They are important also in the management and follow up of chronic diseases. We expose and evaluate all the radiological methods that are now available for the study of the SB with particular emphasis on the technological improvement of cross-sectional imaging, such as computed tomography(CT) and magnetic resonance imaging(MRI). These techniques have, infact, highly improved in terms of execution times(fast acquisitions images), patients discomfort and radiation dose, for CT, with consequent reduced biological risks. Moreover, the new post-processing options with multiplanar reconstruction and isotropic images have made significant changes in the evaluation of the exams. Especially MRI scans have been improved by the advent of new sequences, such as diffusion weighted imaging and cine-MRI, parallel imaging and breath-hold sequences and can provide excellent soft-tissue contrast without the use of ionizing radiations.

  6. [Diagnosis of functional bowel diseases].

    Science.gov (United States)

    Kruis, W

    2007-02-28

    Functional bowel disorders cause frequent doctor visits. The term comprises various disease entities. Most frequent are the irritable bowel syndrome, functional constipation and functional diarrhea. An exact history plays an outstanding role for the diagnosis of all these entities. History either confirms a positive diagnosis or initiates some complementary investigations. Redundant and dangerous technical procedures should be avoided in the diagnostic work up.

  7. Diagnosis of Irritable Bowel Syndrome

    Science.gov (United States)

    ... your anus. The doctor will fill your large intestine with barium . You may be asked to change positions several times during the test. ​​​​​ ​February 23, 2015​​​​ Previous: Symptoms and Causes of Irritable Bowel Syndrome Next: Treatment for Irritable Bowel Syndrome Digestive Disease ...

  8. Small bowel transplantation: An overview

    NARCIS (Netherlands)

    R.W.F. de Bruin (Ron); E. Heineman (Erik); R.L. Marquet (Richard)

    1994-01-01

    textabstractSmall bowel transplantation (SBT) would, in theory, be the treatment of choice for patients suffering from the short bowel syndrome. Although SBT has been done with a considerable degree of success in some centers [36,145], it is by no means an established or widely applicable therapy fo

  9. Inflammatory bowel disease unclassified

    Institute of Scientific and Technical Information of China (English)

    Ning ZHOU; Wei-xing CHEN; Shao-hua CHEN; Cheng-fu XU; You-ming LI

    2011-01-01

    Objective: Inflammatory bowel diseases (IBDs) are idiopathic, chronic, and inflammatory intestinal disorders. The two main types, ulcerative colitis (UC) and Crohn's disease (CD), sometimes mimic each other and are not readily distinguishable. The purpose of this study was to present a series of hospitalized cases, which could not initially be classified as a subtype of IBD, and to try to note roles of the terms indeterminate colitis (IC) and inflammatory bowel disease unclassified (IBDU) when such a dilemma arises. Methods: Medical records of 477 patients hospitalized due to IBD, during the period of January 2002 to April 2009, were retrospectively studied in the present paper. All available previous biopsies from endoscopies of these patients were reanalyzed. Results: Twenty-seven of 477 IBD patients (5.7%) had been initially diagnosed as having IBDU. Of them, 23 received colonoscopy and histological examinations in our hospital. A total of 90% (9/10) and 66.7% (4/6) of patients, respectively, had a positive finding via wireless capsule endoscopy (CE) and double-balloon enteroscopy (DBE). The barium-swallow or small bowel follow-through (SBFT) was performed on 11 patients. Positive changes were observed under computer tomographic (CT) scanning in 89.5% (17/19) of patients. Reasonable treatment strategies were employed for all patients. Conclusions: Our data indicate that IBDU accounts for 5.7% of initial diagnoses of IBD. The definition of IBDU is valuable in clinical practice. For those who had no clear clinical, endoscopic, histological, or other features affording a diagnosis of either UC or CD,IBDU could be used parenthetically.

  10. Kirsner's inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    R Balfour Sarto; William J Sandborn

    2005-01-01

    @@ Very few medical textbooks have so thoroughly dominated,and even defined a field, as has Inflammatory Bowel Diseases by Joe Kirsner. Originally co-edited with Roy Shorter of Mayo Clinic, this book, beginning with its first edition in 1975, encapsulated the science and art of caring for patients with Crohn's disease and ulcerative colitis. Thus it is with considerable respect, and indeed some awe and trepidation,that we eagerly embraced the opportunity to assume the editorship of this preeminent textbook and the obligation to transition it to reflect the changing, increasingly complex pathophysiology and treatment of these diseases.

  11. INFLAMMATORY BOWEL DISEASE

    Directory of Open Access Journals (Sweden)

    I Gusti Ayu Mahaprani Danastri

    2013-02-01

    Full Text Available Crohn disease (CD and ulcerative colitis (UC is an chronic inflammation in the gastrointestinal tract. Colecctively, they are called inflammatory bowel disease (IBD, and about 1,5 millions people in America suffering from UC and CD. The cause of UC and CD is unknown, but the expert believe that UC and CD are caused by a disturbed immune response in someone who has a genetic predisposition. UC and CD have a significant recurrency  and remission rate. Surgery in UC is a curative treatment for colon’s disease and a potentially colon’s malignancy, but it is not a curative treatment for CD.

  12. Irritable bowel syndrome.

    Science.gov (United States)

    Enck, Paul; Aziz, Qasim; Barbara, Giovanni; Farmer, Adam D; Fukudo, Shin; Mayer, Emeran A; Niesler, Beate; Quigley, Eamonn M M; Rajilić-Stojanović, Mirjana; Schemann, Michael; Schwille-Kiuntke, Juliane; Simren, Magnus; Zipfel, Stephan; Spiller, Robin C

    2016-01-01

    Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with a high population prevalence. The disorder can be debilitating in some patients, whereas others may have mild or moderate symptoms. The most important single risk factors are female sex, younger age and preceding gastrointestinal infections. Clinical symptoms of IBS include abdominal pain or discomfort, stool irregularities and bloating, as well as other somatic, visceral and psychiatric comorbidities. Currently, the diagnosis of IBS is based on symptoms and the exclusion of other organic diseases, and therapy includes drug treatment of the predominant symptoms, nutrition and psychotherapy. Although the underlying pathogenesis is far from understood, aetiological factors include increased epithelial hyperpermeability, dysbiosis, inflammation, visceral hypersensitivity, epigenetics and genetics, and altered brain-gut interactions. IBS considerably affects quality of life and imposes a profound burden on patients, physicians and the health-care system. The past decade has seen remarkable progress in our understanding of functional bowel disorders such as IBS that will be summarized in this Primer. PMID:27159638

  13. Comparação entre as soluções orais de manitol a 10% e bifosfato de sódio no preparo mecânico do cólon Comparison between sodium biphosphate and 10% oral mannitol solutions for mechanical bowel preparation

    Directory of Open Access Journals (Sweden)

    Marssoni Deconto Rossoni

    2008-10-01

    Full Text Available OBJETIVO: Comparar o uso das soluções orais de manitol a 10% e de bifosfato de sódio no preparo mecânico do cólon quanto a qualidade da limpeza, a tolerabilidade e as alterações hidroeletrolíticas e da osmolaridade plasmática. MÉTODO: Foram analisados 60 pacientes de modo randomizado, duplo-cego e prospectivo, com indicação de colonoscopia. A qualidade da limpeza intestinal foi analisada pelo examinador através da classificação de Beck. A tolerabilidade à ingestão baseou-se na pesquisa do gosto, presença ou não de desconforto, aparecimento de efeitos adversos e a quantidade da solução ingerida. Foram dosados o sódio, potássio, cálcio, magnésio, fósforo, uréia, creatinina, glicose, hematócrito, hemoglobina e calculado a osmolaridade plasmática, antes e após a ingestão da solução oral de preparo inestinal. RESULTADOS: Ambas as soluções atingiram qualidade de preparo classificado como bom ou superior em mais de 80% dos pacientes. O uso do bifosfato de sódio determinou menor desconforto e melhor tolerância, apesar de não ter sido superior ao manitol quanto à análise do gosto e presença de efeitos adversos. O bifosfato induziu ao aumento e o manitol a uma redução da osmolaridade, reflexo do que ocorreu com o sódio plasmático nos dois grupos respectivamente. O bifosfato ainda determinou alteração significativa dos níveis séricos de fósforo, cálcio, magnésio e potássio, sem repercussões clínicas. CONCLUSÃO: Ambos os tipos de preparo intestinal determinaram qualidade de limpeza adequada. O bifosfato de sódio, apesar de melhor tolerado, determina maior quantidade de alterações hidroeletrolíticas.BACKGROUND: To compare the use of sodium biphosphate and 10% mannitol solutions for mechanical bowel preparation in terms of cleansing quality, tolerability, disorder in water and electrolyte balance, and plasma osmolality. METHOD: Sixty patients who had been referred for colonoscopy were analyzed in a

  14. International bowel function extended spinal cord injury data set

    DEFF Research Database (Denmark)

    Krogh, K; Perkash, I; Stiens, S A;

    2008-01-01

    STUDY DESIGN: International expert working group.Objective:To develop an International Bowel Function Extended Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of an extended amount of information on bowel function. SETTING: Working group...... consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS). METHODS: A draft prepared by the working group was reviewed by Executive Committee of the International SCI Standards and Data Sets and later by the ISCoS Scientific Committee...... or segmental colorectal transit times. CONCLUSION: An International Bowel Function Extended SCI Data Set has been developed. This Data Set is mainly for research purposes and it should be used in combination with the information obtained from the International SCI Core Data Set and the International...

  15. Irritable Bowel Syndrome in Children

    Science.gov (United States)

    ... KB)​​​​​ Alternate Language URL Irritable Bowel Syndrome in Children Page Content On this page: What is irritable ... GI tract [ Top ] How common is IBS in children? Limited information is available about the number of ...

  16. Sleep and Irritable Bowel Syndrome

    Science.gov (United States)

    ... Bruce D. Naliboff, PhD, Clinical Professor of Medical Psychology in the Dept. of Psychiatry and Biobehavioral Sciences, ... Gynecological Aspects of Irritable Bowel Syndrome Symptom Diary Testing in IBS Changes You Should Not Ignore if ...

  17. Inflammatory Bowel Disease (For Teens)

    Science.gov (United States)

    ... Just like other organs in your body, the intestines can develop problems or diseases. IBD (which is not the same thing as irritable bowel syndrome, or IBS), can cause more serious problems than ...

  18. Diet in irritable bowel syndrome

    OpenAIRE

    El-Salhy, Magdy; Gundersen, Doris Irene

    2015-01-01

    Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that is characterized by intermittent abdominal pain/discomfort, altered bowel habits and abdominal bloating/distension. This review aimed at presenting the recent developments concerning the role of diet in the pathophysiology and management of IBS. There is no convincing evidence that IBS patients suffer from food allergy/intolerance, and there is no evidence that gluten causes the debated new diagnosis of non-coel...

  19. Small Bowel Review - Part I

    OpenAIRE

    Thomson, ABR; Wild, G.

    1997-01-01

    Significant advances have been made in the study of the small bowel. Part I of this two-part review of the small bowel examines carbohydrates, including brush border membrane hydrolysis and sugar transport; amino acids, dipeptides, proteins and food allergy, with a focus on glutamine, peptides and macromolecules, and nucleosides, nucleotides and polyamines; salt and water absorption, and diarrhea, including antidiarrheal therapy and oral rehydration treatment; lipids (digestion and absorption...

  20. Oral mannitiol solution for bowel preparation before gynecologic surgery Clinical Observation and nursing care%口服甘露醇溶液用于妇科术前肠道准备临床疗效观察及护理

    Institute of Scientific and Technical Information of China (English)

    李恩芝; 石祥奎

    2012-01-01

    Objective To compared with clinical effects of oral mannitol solution and magnesium sulfate solution for bowel preparation before gynecologic surgery, so as to clinical selection. Methods Solution by observing the use of oral mannitol group and the control efficacy of oral administration of magnesium sulfate group and adverse reactions. Results Two groups of intestinal cleanliness, frequency of defecation was not statistically significant ( P>0. 05); two nausea, vomiting, stomach pain, bloating, abdominal pain, anal stimulation no significant side effects; Time after discharge, dizziness, headache, no significant adverse effects (P>0. 05); mannitol taste, easy to use. Magnesium sulfate bitter, easy to grow bacteria. Conclusion The therapeutic effect with no significant adverse reactions difference, can be used as bowel preparation before gynecologic surgery using drugs, but mannitol and easy to use, easy to save, taste, and can be used in place of magnesium sulfate bowel preparation before gynecologic surgery.%目的 比较口服甘露醇溶液与硫酸镁溶液用于妇科术前肠道准备临床疗效,以便临床选择使用.方法 通过观察使用口服甘露醇溶液组与口服硫酸镁组进行对照疗效与不良反应.结果 两组肠道清洁度、排便次数无统计学意义(P>0.05);两组恶心、呕吐、胃痛、腹胀、腹痛、肛门刺激不良反应无统计学意义:术后排气时间、头晕、头痛不良反应无统计学意义(P>0.05);甘露醇口感好,使用方便.硫酸镁味苦,易长菌.结论 两组疗效与不良反应无显著性差异,均可作为妇科术前肠道准备使用药物,但甘露醇使用方便,易保存,口感好,可代替硫酸镁广泛用于妇科手术前肠道准备.

  1. Small bowel faeces sign in patients without small bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Jacobs, S.L. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States)]. E-mail: stacylynnjacobs@yahoo.com; Rozenblit, A. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States); Ricci, Z. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States); Roberts, J. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States); Milikow, D. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States); Chernyak, V. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States); Wolf, E. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States)

    2007-04-15

    Aim: To evaluate frequency and clinical relevance of the 'small bowel faeces' sign (SBFS) on computed tomography (CT) in patients with and without small bowel obstruction (SBO) presenting with acute abdominal or acute abdominal and flank pain. Methods: Abdominal CTs of consecutive patients presenting to the emergency department with abdominal or flank pain over a 6 month period were retrospectively reviewed by six radiologists, independently, for the presence of the SBFS. Examinations with positive SBFS were further evaluated in consensus by three radiologists, blinded to the final diagnosis. The small bowel was graded as non-dilated (<2.5 cm) and mildly (2.5-2.9 cm), moderately (3-4 cm) or severely (>4 cm) dilated. The location of SBFS and presence of distal small bowel collapse indicative of SBO was recorded. Imaging findings were subsequently correlated with the final diagnosis via chart review and compared between patients with and without SBO. Results: Of 1642 CT examinations, a positive SBFS was found in 100 (6%) studies. Of 100 patients with a positive SBFS, 32 (32%) had documented SBO. The remaining 68 patients had other non-obstructive diagnoses. SBFS was located in proximal, central, distal and multisegmental bowel loops in one (3.1%), eight (25.0%), 21 (65.6%) and two (6.3%) patients with SBO, and in zero (0%), 10 (14.7%), 53 (77.9%) and five (7.4%) of patients without SBO (p < 0.273). The small bowel was non-dilated and mildly, moderately or severely dilated in one (3%), five (16%), 20 (62%) and six (19%) patients with SBO, and in 61(90%), seven (10%), zero (0%) and zero (0%) patients without SBO. Normal or mildly dilated small bowel was seen in all (100%) patients without SBO, but only in six (19%) of 32 patients with SBO (p < 0.0001). Moderate or severe small bowel dilatation was seen in 26 (81%) patients with SBO (p < 0.0001), but it was absent in patients without SBO. Distal small bowel collapse was found in 27 (84.4%) of 32 patients with

  2. Outcomes of bowel program in spinal cord injury patients with neurogenic bowel dysfunction

    Institute of Scientific and Technical Information of China (English)

    Zuhal Ozisler; Kurtulus Koklu; Sumru Ozel; Sibel Unsal-Delialioglu

    2015-01-01

    In this study, we aimed to determine gastrointestinal problems associated with neurogenic bowel dysfunction in spinal cord injury patients and to assess the efifcacy of bowel program on gas-trointestinal problems and the severity of neurogenic bowel dysfunction. Fifty-ifve spinal cord injury patients were included in this study. A bowel program according to the characteristics of neurogenic bowel dysfunction was performed for each patient. Before and after bowel program, gastrointestinal problems (constipation, dififcult intestinal evacuation, incontinence, abdominal pain, abdominal distension, loss of appetite, hemorrhoids, rectal bleeding and gastrointestinal induced autonomic dysrelfexia) and bowel evacuation methods (digital stimulation, oral med-ication, suppositories, abdominal massage, Valsalva maneuver and manual evacuation) were determined. Neurogenic bowel dysfunction score was used to assess the severity of neurogenic bowel dysfunction. At least one gastrointestinal problem was identiifed in 44 (80%) of the 55 patients before bowel program. Constipation (56%, 31/55) and incontinence (42%, 23/55) were the most common gastrointestinal problems. Digital rectal stimulation was the most common method for bowel evacuation, both before (76%, 42/55) and after (73%, 40/55) bowel program. Oral medication, enema and manual evacuation application rates were signiifcantly decreased and constipation, dififcult intestinal evacuation, abdominal distention, and abdominal pain rates were signiifcantly reduced after bowel program. In addition, mean neurogenic bowel dysfunction score was decreased after bowel program. An effective bowel program decreases the severity of neurogenic bowel dysfunction and reduces associated gastrointestinal problems in patients with spinal cord injury.

  3. Outcomes of bowel program in spinal cord injury patients with neurogenic bowel dysfunction

    Directory of Open Access Journals (Sweden)

    Zuhal Ozisler

    2015-01-01

    Full Text Available In this study, we aimed to determine gastrointestinal problems associated with neurogenic bowel dysfunction in spinal cord injury patients and to assess the efficacy of bowel program on gastrointestinal problems and the severity of neurogenic bowel dysfunction. Fifty-five spinal cord injury patients were included in this study. A bowel program according to the characteristics of neurogenic bowel dysfunction was performed for each patient. Before and after bowel program, gastrointestinal problems (constipation, difficult intestinal evacuation, incontinence, abdominal pain, abdominal distension, loss of appetite, hemorrhoids, rectal bleeding and gastrointestinal induced autonomic dysreflexia and bowel evacuation methods (digital stimulation, oral medication, suppositories, abdominal massage, Valsalva maneuver and manual evacuation were determined. Neurogenic bowel dysfunction score was used to assess the severity of neurogenic bowel dysfunction. At least one gastrointestinal problem was identified in 44 (80% of the 55 patients before bowel program. Constipation (56%, 31/55 and incontinence (42%, 23/55 were the most common gastrointestinal problems. Digital rectal stimulation was the most common method for bowel evacuation, both before (76%, 42/55 and after (73%, 40/55 bowel program. Oral medication, enema and manual evacuation application rates were significantly decreased and constipation, difficult intestinal evacuation, abdominal distention, and abdominal pain rates were significantly reduced after bowel program. In addition, mean neurogenic bowel dysfunction score was decreased after bowel program. An effective bowel program decreases the severity of neurogenic bowel dysfunction and reduces associated gastrointestinal problems in patients with spinal cord injury.

  4. Preoperative mechanical preparation of the colon: the patient's experience

    Directory of Open Access Journals (Sweden)

    Arodell Malin

    2007-05-01

    Full Text Available Abstract Background Preoperative mechanical bowel preparation can be questioned as standard procedure in colon surgery, based on the result from several randomised trials. Methods As part of a large multicenter trial, 105 patients planned for elective colon surgery for cancer, adenoma, or diverticulitis in three hospitals were asked to complete a questionnaire regarding perceived health including experience with bowel preparation. There were 39 questions, each having 3 – 10 answer alternatives, dealing with food intake, pain, discomfort, nausea/vomiting, gas distension, anxiety, tiredness, need of assistance with bowel preparation, and willingness to undergo the procedure again if necessary. Results 60 patients received mechanical bowel preparation (MBP and 45 patients did not (No-MBP. In the MBP group 52% needed assistance with bowel preparation and 30% would consider undergoing the same preoperative procedure again. In the No-MBP group 65 % of the patients were positive to no bowel preparation. There was no significant difference between the two groups with respect to postoperative pain and nausea. On Day 4 (but not on Days 1 and 7 postoperatively patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02. Time to intake of fluid and solid food did not differ between the two groups. Bowel emptying occurred significantly earlier in the No-MBP group than in the MBP group, p = 0.03. Conclusion Mechanical bowel preparation is distressing for the patient and associated with a prolonged time to first bowel emptying.

  5. Tumours in the Small Bowel

    Directory of Open Access Journals (Sweden)

    N. Kurniawan

    2014-01-01

    Full Text Available Small bowel tumours are rare and originate from a wide variety of benign and malignant entities. Adenocarcinomas are the most frequent primary malignant small bowel tumours. Submucosal tumours like gastrointestinal stromal tumours (GIST or neuroendocrine tumours (NET may show a central umbilication, pathologic vessels, bridging folds or an ulceration of the overlying mucosa. These signs help to differentiate them from harmless bulges caused by impression from outside, e.g. from other intestinal loops. Sarcomas of the small bowel are rare neoplasias with mesenchymal origin, sometimes presenting as protruding masses. Benign tumours like lipoma, fibrolipoma, fibroma, myoma, and heterotopias typically present as submucosal masses. They cannot be differentiated endoscopically from those with malignant potential as GIST or NET. Neuroendocrine carcinomas may present with diffuse infiltration, which may resemble other malignant tumours. The endoscopic appearance of small bowel lymphomas has a great variation from mass lesions to diffuse infiltrative changes. Melanoma metastases are the most frequent metastases to the small bowel. They may be hard to distinguish from other tumours when originating from an amelanotic melanoma.

  6. /sup 111/In autologous leucocytes in the diagnosis and assessment of inflammatory bowel disease. [Tropolone

    Energy Technology Data Exchange (ETDEWEB)

    Saverymuttu, S.H.; Peters, A.M.; Chadwick, V.S.; Hodgson, H.J.; Lavender, J.P. (Hammersmith Hospital, London (UK))

    1982-01-01

    Indium-111 autologous leukocyte scanning is now established as an effective method of localising sepsis (Ascher and others, 1980). In view of the extensive leucocyte infiltration of the intestinal wall in inflammatory bowel disease, the authors have prospectively studied the use of indium-111 labelled white cells in a variety of inflammatory bowel disorders. Leukocytes were labelled in 68 patients using /sup 111/In acetylacetonate and in 18 patients /sup 111/In tropolone. Crude mixed leukocytes preparations were used in 74 patients and pure neutrophil preparation used in 12 patients. Gamma scans over the abdomen were performed from 40 min later after re-injection of the labelled cells and assessed. /sup 111/In-tropolone labelling appeared to offer the advantage over /sup 111/In-acac labelling in localising inflamed bowel earlier. The technique of /sup 111/In-leukocyte scanning offers several advantages over the alternative technique of imaging diseased bowel using gallium-67 citrate. Indium-111 leukocyte scanning provides a novel approach to the problem of diagnosis and assessment of inflammatory bowel disease. It is non-invasive, requires no bowel preparation and this is safe in the acutely sick patient where conventional radiological imaging methods may be hazardous. /sup 111/In faecal excretion provides an objective assessment of disease activity which should prove useful in evaluating treatment regimes.

  7. Clostridium difficile and inflammatory bowel disease.

    OpenAIRE

    Greenfield, C.; Aguilar Ramirez, J R; Pounder, R E; Williams, T.; Danvers, M; Marper, S R; Noone, P

    1983-01-01

    Stools from 109 patients with inflammatory bowel disease (13.4%) contained Clostridium difficile or its toxin, an incidence similar to the stools of 99 control patients with diarrhoea (11.9%), but significantly higher than the stools of 77 control patients with a normal bowel habit (1.4%). Sixty-six per cent of the diarrhoea controls, but only 11% of the inflammatory bowel disease patients, reported recent antibiotic use: however, 67% of inflammatory bowel disease patients were taking sulphas...

  8. Fecal calprotectin in inflammatory bowel disease

    OpenAIRE

    Walsham NE; Sherwood RA

    2016-01-01

    Natalie E Walsham,1 Roy A Sherwood2 1Department of Clinical Biochemistry, University Hospital Lewisham, Lewisham, 2Department of Clinical Biochemistry, Viapath at King’s College Hospital NHS Foundation Trust, London, UK Abstract: Inflammatory bowel disease (IBD) and irritable bowel syndrome share many symptoms. While irritable bowel syndrome is a functional bowel disorder for which no specific treatment is available, the range of effective therapies for IBD is evolving rapidly. Acc...

  9. Small Bowel Imaging: an Update.

    Science.gov (United States)

    Rimola, Jordi; Panés, Julián

    2016-07-01

    Bowel imaging had experienced relevant technical advances during the last decade. The developments in the field of cross-sectional imaging had a particular impact on the assessment of Crohn's disease. The purpose of this manuscript is to provide a review of the main progress of cross-sectional imaging in the assessment of Crohn's disease and other small bowel diseases with relevance in clinical practice and in research. Also, we outline the technical advances, trends, and potential contributions of new technological cross-sectional imaging improvements that may have potential impact and contribution in the near future. PMID:27315216

  10. An unusual white blood cell scan in a child with inflammatory bowel disease: a case report.

    Science.gov (United States)

    Porn, U; Howman-Giles, R; O'Loughlin, E; Uren, R; Chaitow, J

    2000-10-01

    Technetium-99m-labeled leukocyte (WBC) imaging is a valuable screening method for inflammatory bowel disease, especially in children, because of its high rate of sensitivity, low cost, and ease of preparation. A 14-year-old girl is described who had juvenile arthritis and iritis complicated by inflammatory bowel disease. She was examined for recurrent abdominal pain. A Tc-99m stannous colloid WBC scan was performed, and tracer accumulation was seen in the small bowel in the region of the distal ileum on the initial 1-hour image. Delayed imaging at 3 hours also revealed tracer accumulation in the cecum and ascending colon, which was not seen on the early image. A biopsy of the colon during endoscopy showed no evidence of active inflammation in the colon. The small bowel was not seen. Computed tomography revealed changes suggestive of inflammatory bowel disease in the distal ileum. The appearance on the WBC study was most likely a result of inflammatory bowel disease involving the distal ileum, with transit of luminal activity into the large bowel.

  11. An unusual white blood cell scan in a child with inflammatory bowel disease: a case report.

    Science.gov (United States)

    Porn, U; Howman-Giles, R; O'Loughlin, E; Uren, R; Chaitow, J

    2000-10-01

    Technetium-99m-labeled leukocyte (WBC) imaging is a valuable screening method for inflammatory bowel disease, especially in children, because of its high rate of sensitivity, low cost, and ease of preparation. A 14-year-old girl is described who had juvenile arthritis and iritis complicated by inflammatory bowel disease. She was examined for recurrent abdominal pain. A Tc-99m stannous colloid WBC scan was performed, and tracer accumulation was seen in the small bowel in the region of the distal ileum on the initial 1-hour image. Delayed imaging at 3 hours also revealed tracer accumulation in the cecum and ascending colon, which was not seen on the early image. A biopsy of the colon during endoscopy showed no evidence of active inflammation in the colon. The small bowel was not seen. Computed tomography revealed changes suggestive of inflammatory bowel disease in the distal ileum. The appearance on the WBC study was most likely a result of inflammatory bowel disease involving the distal ileum, with transit of luminal activity into the large bowel. PMID:11043720

  12. Effect observation of taking polyethylene glycol-electrolyte solution at different time on bowel preparation in elderly for colonscopy%老年患者不同时间服用复方聚乙二醇电解质散肠道准备的效果

    Institute of Scientific and Technical Information of China (English)

    董云; 郭光艳; 林海

    2015-01-01

    Objective To compare the efficacy and side effects of split-dose Polyethylene glycol-electrolyte solution ( PEG ) with full-dose preparation in the elderly for colonoscopy, and to summary the experience of nursing care. Methods A total of 220 elderly undergoing colonoscopy were randomly divided into experimental group ( group A) and control group ( group B) , 110 cases in each group. Group A took half the dose of PEG (1. 5 L) at 5 PM on the day before colonoscopy and the remaining half (1. 5 L) were instructed to drink at 6 AM on the day of colonoscopy. Group B took all the PEG (3 L) at 6 AM on the day of colonoscopy. The quality of bowel cleansing was assessed according to the Boston bowel preparation scale ( BBPS) , and side effects ( nausea, vomiting, abdominal pain, fatigue and hunger ) and complication were also observed. In addition, the polyps and tumors of colon detection were compared within the two groups. Results The level of bowel preparation in group A was superior to group B [(6. 65 ± 1. 67) vs (6. 14 ± 1. 91, t =2. 097, P <0. 05)], however, the incidence of side effects such as nausea and vomiting, abdominal pain and bloating in group A were 14 cases, 34 cases and 22 cases less than those of group B (χ2 =4. 400,4. 111,4. 002,respectively;P<0. 05). The detection rate of colonic polyps and tumors in group A (37. 3%) were also higher than that of group B (24. 5%) (χ2 =4. 172, P<0. 05). Conclusions The use of a split-dose PEG for bowel preparation before colonoscopy significantly improved bowel preparation. Split-dose preparation is associated with a lower incidence of side effects, and higher detection rate of colonic polyps and tumors in the elderly.%目的:比较老年患者分次剂量与单次全剂量服用复方聚乙二醇电解质溶液进行肠道准备的效果及不良反应,总结肠道准备的护理经验。方法将220例行结肠镜检查的老年患者根据计算机生成的随机数字表分为试验组和对照组,每组110例

  13. Effect of bowel preparation with probiotics on intestinal barrier after surgery for colorectal cancer%联合益生菌的快速肠道准备对结直肠癌术后肠道黏膜屏障功能的影响

    Institute of Scientific and Technical Information of China (English)

    夏阳; 杨喆; 陈红旗; 秦环龙

    2010-01-01

    目的 观察联合益生菌的快速肠道准备方法的有效性及对结直肠癌术后肠道黏膜屏障功能的影响.方法 将60例行择期结直肠癌根治性手术的患者按硬币法随机化原则分为试验组(30例)和对照组(30例).对照组采用传统的3 d肠道准备方法,试验组在使用恒康正清快速1 d肠道准备的基础上添加益生菌口服,2g/d,至少5 d.术后接受等氮量等热卡营养支持.术中观察肠道清洁度;光镜下观察肠黏膜形态学变化;免疫组织化学染色检测肠黏膜occludin蛋白和IgA的表达;检测术后第1天和第7天全血细菌DNA片段及术后第7天血清C反应蛋白浓度;观察体温、心率、外周血白细胞计数以及全身炎性反应综合征(SIRS)和吻合口瘘的发生情况.结果 试验组和对照组清肠效果的优、良率分别为90.0%和93.3%(P=0.314);两组手术标本黏膜形态、绒毛高度、隐窝深度的差异无统计学意义.术后第7天PCR检测全血细菌DNA阳性者试验组2例(3.3%),对照组有8例(26.67%),差异有统计学意义(P=0.003).试验组和对照组手术标本中结肠上皮occludin表达分别为(19.32±2.40)%和(16.21±2.54)%(P=0.025);IgA表达分别为(7.60±1.48)%和(5.29±-1.57)%(P=0.031);差异均有统计学意义.两组术后分别有24例(80.0%)和26例(86.7%)出现SIRS,分别各有2例(6.67%)出现吻合口瘘,差异均无统计学意义(P>0.05).结论 联合益生菌的快速肠道准备方法有效可行,且有利于结直肠癌术后肠道黏膜屏障功能的保护,减少术后早期炎性反应.%Objective To study the effect of bowel preparation with probiotics on intestinal barrier function after surgery for colorectal cancer. Methods A total of 60 patients undergone colonic surgery were randomly divided into two groups:the trial group and the control group. One-day bowel preparation with probiotics was administered in trial group, while 3-day conventional bowel preparation in control group. Quality

  14. Cutaneous Manifestations in Inflammatory Bowel Diseases

    Directory of Open Access Journals (Sweden)

    Simona Roxana Georgescu

    2015-10-01

    Full Text Available Inflammatory bowel diseases have a high frequency in Europe. They are chronic disorders that evolve with relapses and remissions. Clinical features include the signs of underlying inflammatory bowel disease and also signs of extraintestinal manifestations. Cutaneous disorders are the most common extraintestinal manifestations associated with inflammatory bowel diseases, which can be dependent on or independent of gastrointestinal disease activity. The main cutaneous disorders are erythema nodosum and pyodermagangrenosum. The pathogenic mechanisms are not fully understood but it seems that related mechanisms are involved in the development of inflammatory bowel diseases and extraintestinal manifestations. Treatment should be aimed at both the cutaneous manifestations and the bowel inflammation

  15. Cancer in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Jianlin Xie; Steven H Itzkowitz

    2008-01-01

    Patients with long-standing inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer (CRC). Many of the molecular alterations responsible for sporadic colorectal cancer, namely chromosomal instability, microsatellite instability, and hypermethylation, also play a role in colitis-associated colon carcinogenesis. Colon cancer risk in inflammatory bowel disease increases with longer duration of colitis, greater anatomic extent of colitis, the presence of primary sclerosing cholangitis, family history of CRC and degree of inflammation of the bowel. Chemoprevention includes aminosalicylates, ursodeoxycholic acid, and possibly folic acid and statins. To reduce CRC mortality in IBD, colonoscopic surveillance with random biopsies remains the major way to detect early mucosal dysplasia. When dysplasia is confirmed, proctocolectomy is considered for these patients. Patients with small intestinal Crohn's disease are at increased risk of small bowel adenocarcinoma. Ulcerative colitis patients with total proctocolectomy and ileal pouch anal- anastomosis have a rather low risk of dysplasia in the ileal pouch, but the anal transition zone should be monitored periodically. Other extra intestinal cancers, such as hepatobiliary and hematopoietic cancer, have shown variable incidence rates. New endoscopic and molecular screening approaches may further refine our current surveillance guidelines and our understanding of the natural history of dysplasia.

  16. Surgery for inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    John M Hwang; Madhulika G Varma

    2008-01-01

    Despite the new and ever expanding array of medications for the treatment of inflammatory bowel disease (IBD),there are still clear indications for operative management of IBD and its complications.We present an overview of indications,procedures,considerations,and controversies in the surgical therapy of IBD.

  17. Fetal bowel anomalies - US and MR assessment

    Energy Technology Data Exchange (ETDEWEB)

    Rubesova, Erika [Stanford University, Department of Radiology, Lucile Packard Children' s Hospital, Stanford, CA (United States)

    2012-01-15

    The technical quality of prenatal US and fetal MRI has significantly improved during the last decade and allows an accurate diagnosis of bowel pathology prenatally. Accurate diagnosis of bowel pathology in utero is important for parental counseling and postnatal management. It is essential to recognize the US presentation of bowel pathology in the fetus in order to refer the patient for further evaluation or follow-up. Fetal MRI has been shown to offer some advantages over US for specific bowel abnormalities. In this paper, we review the normal appearance of the fetal bowel on US and MRI as well as the typical presentations of bowel pathologies. We discuss more specifically the importance of recognizing on fetal MRI the abnormalities of size and T1-weighted signal of the meconium-filled distal bowel. (orig.)

  18. Review article: the incidence and prevalence of colorectal cancer in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Munkholm, P

    2003-01-01

    Although colorectal cancer (CRC), complicating ulcerative colitis and Crohn's disease, only accounts for 1-2% of all cases of CRC in the general population, it is considered a serious complication of the disease and accounts for approximately 15% of all deaths in inflammatory bowel disease (IBD......) patients. The magnitude of the risk was found to differ, even in population-based studies. Recent figures suggest that the risk of colon cancer for people with IBD increases by 0.5-1.0% yearly, 8-10 years after diagnosis. The magnitude of CRC risk increases with early age at IBD diagnosis, longer duration...... explanations have to be investigated. One possible cancer-protective factor could be treatment with 5-aminosalicylic acid preparations (5-ASAs). Adenocarcinoma of the small bowel is extremely rare, compared with adenocarcinoma of the large bowel. Although only few small bowel cancers have been reported...

  19. The short-bowel syndrome.

    Science.gov (United States)

    Nightingale, J M

    1995-06-01

    Patients with a short bowel have usually had a bowel resection for Crohn's disease. Two types of short-bowel patient can be distinguished: those with a jejunostomy and those with their jejunum anastomosed to a functioning colon. Both types of patient have problems with macronutrient absorption, although those with a colon experience fewer problems because some energy from unabsorbed carbohydrate is salvaged in the colon. Patients with a jejunostomy have problems with large stomal losses of water, sodium and magnesium, whereas those with a jejuno-colic anastomosis rarely have problems with water and electrolyte absorption. Patients with a jejunostomy 100-200 cm from the duodeno-jejunal flexure ('absorbers') usually absorb more from the diet than they pass through the stoma and therefore require oral electrolyte or nutrient supplements. Those with a residual jejunal length of less than 100 cm usually secrete more from the stoma than they take in orally ('secretors') and therefore require long-term parenteral fluid or nutrient supplements. A high output resulting from a jejunostomy is treated by reducing the oral intake of hypotonic fluid, administering a sipped glucose-saline solution and, often, by giving drugs that reduce intestinal motility (most effective in absorbers) or gastrointestinal secretions (most effective in secretors). Gallstones are common both in short-bowel patients with and in those without a colon (45%), and calcium oxalate renal stones occur in the former (25%). However, it is now possible to provide adequate nutrition and fluid supplements for most patients with a short bowel, and the prospects for the rehabilitation of such patients are good. PMID:7552632

  20. Iron deficiency anemia in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Sindhu; Kaitha; Muhammad; Bashir; Tauseef; Ali

    2015-01-01

    Anemia is a common extraintestinal manifestation of inflammatory bowel disease(IBD) and is frequently overlooked as a complication. Patients with IBD are commonly found to have iron deficiency anemia(IDA) secondary to chronic blood loss, and impaired iron absorption due to tissue inflammation. Patients with iron deficiency may not always manifest with signs and symptoms; so, hemoglobin levels in patients with IBD must be regularly monitored for earlier detection of anemia. IDA in IBD is associated with poor quality of life, necessitating prompt diagnosis and appropriate treatment. IDA is often associated with inflammation in patients with IBD. Thus, commonly used labora-tory parameters are inadequate to diagnose IDA, and newer iron indices, such as reticulocyte hemoglobin content or percentage of hypochromic red cells or zinc protoporphyrin, are required to differentiate IDA from anemia of chronic disease. Oral iron preparations are available and are used in patients with mild disease activity. These preparations are inexpensive and con-venient, but can produce gastrointestinal side effects, such as abdominal pain and diarrhea, that limit their use and patient compliance. These preparations are partly absorbed due to inflammation. Non-absorbed iron can be toxic and worsen IBD disease activity. Although cost-effective intravenous iron formulations are widely available and have improved safety profiles, physicians are reluctant to use them. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD.

  1. Bowel cleansing before colonoscopy: Balancing efficacy,safety, cost and patient tolerance

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Effective colorectal cancer screening relies on reliablecolonoscopy findings which are themselves dependenton adequate bowel cleansing. Research has consistentlydemonstrated that inadequate bowel preparationadversely affects the adenoma detection rate and leadsgastroenterologists to recommend earlier follow up thanis consistent with published guidelines. Poor preparationaffects as many as 30% of colonoscopies and contributesto an increased cost of colonoscopies. Patient tolerability isstrongly affected by the preparation chosen and mannerin which it is administered. Poor tolerability is, in turn,associated with lower quality bowel preparations. Recently,several new developments in both agents being usedfor bowel preparation and in the timing of administrationhave brought endoscopists closer to achieving the goal ofeffective, reliable, safe, and tolerable regimens. Historically,large volume preparations given in a single dose wereadministered to patients in order to achieve adequatebowel cleansing. These were poorly tolerated, and theunpleasant taste of and significant side effects producedby these large volume regimens contributed significantlyto patients' inability to reliably complete the preparationand to a reluctance to repeat the procedure. Smallervolumes, including preparations that are administered astablets to be consumed with water, given as split doseshave significantly improved both the patient experienceand efficacy, and an appreciation of the importance ofthe preparation to colonoscopy interval have producedadditional cleansing.

  2. 两种肠道准备方法预防前列腺穿刺活检术后并发症效果比较%Comparation the effects of two bowel preparation methods in preventing the complications of prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    迟易欣; 唐喆; 关升

    2011-01-01

    [ Objective] To investigate the effects of two different bowel preparation methods in the prevention of the complications following prostate biopsy. [ Methods] All of 98 patients with suspected prostate cancer were divided into A and B groups. All patients received routine bowel preparation for 2 ~ 3 days, took oral antibiotics, began fasting after 8 the night before. The patients in group A received oral cathartic agent but not enema, while those in group B received oral cathartic agent and routine cleansing enema in the morning before biopsy. [ Results] In group A,63.6% patients (35 of 55 ) had complications,including 2 patients with fever(T >38 ℃ ) and chill (3.6%) ;in group B,67.4% patients (29 of 43) had complications, including 2 patients with fever (4.7 % ), one of them expressing chill (2.3%). [ Conclusion ] The prebiopsy enemas might not decrease overall rates of complication in patients with prostate biopsy.%[目的]探讨两种肠道准备方法对前列腺穿刺活检术后并发症发生率的影响.[方法]将2008年12月~2010年10月疑前列腺癌并行穿刺活检患者98例分为A、B两组.A组(n=55)术前不行灌肠,术前夜口服导泻剂;B组(n=43)术前夜口服导泻剂,术晨灌肠.两组患者术前2~3 d均行常规肠道准备、口服抗感染药物,术前晚禁食.[结果]A组患者中35例出现并发症(63.6%),发热(T>38℃)伴寒战2例(3.6%);B组43例患者中29例出现并发症(67.4%),发热2例(4.7%),出现寒战者1例(2.3%).[结论]术前灌肠可能不会减少前列腺活检患者术后并发症发生率.

  3. Irritable Bowel Syndrome.

    Science.gov (United States)

    Wald

    1999-02-01

    I believe there are four essential elements in the management of patients with irritable bowel syndrome (IBS): to establish a good physician-patient relationship; to educate patients about their condition; to emphasize the excellent prognosis and benign nature of the illness; and to employ therapeutic interventions centering on dietary modifications, pharmacotherapy, and behavioral strategies tailored to the individual. Initially, I establish the diagnosis, exclude organic causes, educate patients about the disease, establish realistic expectations and consistent limits, and involve patients in disease management. I find it critical to determine why the patient is seeking assistance (eg, cancer phobia, disability, interpersonal distress, or exacerbation of symptoms). Most patients can be treated by their primary care physician. However, specialty consultations may be needed to reinforce management strategies, perform additional diagnostic tests, or institute specialized treatment. Psychological co-morbidities do not cause symptoms but do affect how patients respond to them and influence health care-seeking behavior. I find that these issues are best explored over a series of visits when the physician-patient relationship has been established. It can be helpful to have patients fill out a self-administered test to identify psychological co-morbidities. I often use these tests as a basis for extended inquiries into this area, resulting in the initiation of appropriate therapies. I encourage patients to keep a 2-week diary of food intake and gastrointestinal symptoms. In this way, patients become actively involved in management of their disease, and I may be able to obtain information from the diary that will be valuable in making treatment decisions. I do not believe that diagnostic studies for food intolerances are cost-effective or particularly helpful; however, exclusion diets may be beneficial. I introduce fiber supplements gradually and monitor them for

  4. Heritability in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Gordon, Hannah; Trier Moller, Frederik; Andersen, Vibeke;

    2015-01-01

    Since Tysk et al's pioneering analysis of the Swedish twin registry, twin and family studies continue to support a strong genetic basis of the inflammatory bowel diseases. The coefficient of heritability for siblings of inflammatory bowel disease probands is 25 to 42 for Crohn's disease and 4 to 15...... for ulcerative colitis. Heritability estimates for Crohn's disease and ulcerative colitis from pooled twin studies are 0.75 and 0.67, respectively. However, this is at odds with the much lower heritability estimates from Genome-Wide Association Studies (GWAS). This "missing heritability" is likely due...... underestimate heritability due to incomplete linkage disequilibrium, and because some single nucleotide polypeptides (SNPs) do not reach a level of significance to allow detection. SNPs missed by GWAS include common SNPs with low penetrance and rare SNPs with high penetrance. All methods of heritability...

  5. [Blastocystis hominis and bowel diseases].

    Science.gov (United States)

    Ustün, Sebnem; Turgay, Nevin

    2006-01-01

    Blastocystis hominis (B. hominis) is a parasite of uncertain role in human disease. It may be identified during a workup for gastrointestinal symptoms, usually in stools. The clinical consequences of B. hominis infection are mainly diarrhea and abdominal pain as well as nonspecific gastrointestinal symptoms such as nausea, anorexia, vomiting, weight loss, lassitude, dizziness, and flatulence. Case reports and series have suggested a pathogenic role of B. hominis in causing intestinal inflammation. Also some studies have suggested that inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are associated with B. hominis infection. The investigators indicate that the stools of all patients presenting with IBD or IBS should be examined, and culture methods for B. hominis carried out. Invasion and mucosal inflammation of the intestine with B. hominis have been observed in studies of gnotobiotic guinea pigs. The transmission, pathogenicity, culture characteristics, taxonomy, life cycle, biochemistry and molecular biology of B. hominis remain unclear. More studies are necessary for this parasite. PMID:17106862

  6. Comorbidity in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Antonio López San Román; Fernando Mu(n)oz

    2011-01-01

    Patients with inflammatory bowel disease (IBD) can be affected by other unrelated diseases. These are called comorbid conditions, and can include any secondary health problem that affects a person suffering from a primary or main disease, and which is neither linked physiopathologically to the primary condition, nor is it due to the treatments used for the primary condition or to its long-term anatomical or physiological consequences.Different comorbid conditions, as well as their influence on IBD, are discussed.

  7. Diet and Inflammatory Bowel Disease

    OpenAIRE

    Knight-Sepulveda, Karina; Kais, Susan; Santaolalla, Rebeca; Abreu, Maria T.

    2015-01-01

    Patients with inflammatory bowel disease (IBD) are increasingly becoming interested in nonpharmacologic approaches to managing their disease. One of the most frequently asked questions of IBD patients is what they should eat. The role of diet has become very important in the prevention and treatment of IBD. Although there is a general lack of rigorous scientific evidence that demonstrates which diet is best for certain patients, several diets—such as the low-fermentable oligosaccharide, disac...

  8. Somatostatin in inflammatory bowel disease

    OpenAIRE

    van Bergeijk, J D; Wilson, J H P

    1997-01-01

    Intestinal inflammation is controlled by various immunomodulating cells, interacting by molecular mediators. Neuropeptides, released by enteric nerve cells and neuroendocrine mucosa cells, are able to affect several aspects of the general and intestinal immune system, with both pro- as well as anti-inflammatory activities. In inflammatory bowel disease (IBD) there is both morphological as well as experimental evidence for involvement of neuropeptides in the pathogenesis. Somatostatin is the m...

  9. Anorexia nervosa complicating inflammatory bowel disease.

    OpenAIRE

    Mallett, P; MURCH, S.

    1990-01-01

    Two cases of inflammatory bowel disease, occurring in adolescence and complicated by anorexia nervosa, are presented. The management of the bowel disease with corticosteroids appeared to precipitate the eating disorder in one case whereas covert withdrawal of steroid treatment led to life threatening complications of inflammatory bowel disease in the other. The difficulties of managing two serious conditions, each ideally treated in a specialist centre, are discussed and the dangers of treati...

  10. Cutaneous Manifestations in Inflammatory Bowel Diseases

    OpenAIRE

    Simona Roxana Georgescu; Cristina Iulia Mitran; Madalina Irina Mitran; Monica Costescu; Vasile Benea; Maria Isabela Sarbu; Mircea Tampa

    2015-01-01

    Inflammatory bowel diseases have a high frequency in Europe. They are chronic disorders that evolve with relapses and remissions. Clinical features include the signs of underlying inflammatory bowel disease and also signs of extraintestinal manifestations. Cutaneous disorders are the most common extraintestinal manifestations associated with inflammatory bowel diseases, which can be dependent on or independent of gastrointestinal disease activity. The main cutaneous disorders are erythema nod...

  11. Small-bowel permeability in collagenous colitis

    DEFF Research Database (Denmark)

    Wildt, Signe; Madsen, Jan L; Rumessen, Jüri J

    2006-01-01

    OBJECTIVE: Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small-intestin......OBJECTIVE: Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small...

  12. Whole-bowel transit in patients with the irritable bowel syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Hardy, J.G.; Clark, A.G.; Wood, E.; Reynolds, J.R.

    1986-02-01

    The transit of radiolabelled preparations through the stomach, small intestine and colon was monitored in ten patients with the irritable bowel syndrome. Five patients complained of diarrhoea, and five complained of constipation. The preparations comprised a non-disintegrating capsule and a multiparticulate system. Both preparations emptied from the stomach together and at the same rates in both groups of patients. In the patients complaining of constipation, the transit times through the small intestine were the same for both preparations. In the patients complaining of diarrhoea, the capsule passed through the small intestine slightly faster than the particles, but there were no significant differences in the small-intestinal transit rates of the two patient groups. Within the colon, the transit of the capsule was faster than that of the small particles. Although movement through the colon was, on average, faster in the group of patients complaining of diarrhoea, there was considerable intersubject variability, and the differences in transit rates between the two patient groups were not statistically significant. (orig.).

  13. 聚乙二醇电解质溶液分次与单次口服肠道准备方案的清洁效果和耐受性比较%Cleanliness and Tolerance of Fractionated Dose and Single Dose Polyethylene Glycol Electrolyte Solution Bowel Preparation Regimens for Colonoscopy:A Comparative Study

    Institute of Scientific and Technical Information of China (English)

    蒋淼; 田培营; 李欢庆; 卜淑蕊; 樊晓明

    2014-01-01

    Colonoscopy has been accepted as the standard method for evaluation of colon and rectum,its success rate depends on the quality of bowel preparation. Aims:To evaluate the cleanliness and tolerance of fractionated dose versus single dose polyethylene glycol electrolyte solution( PEG-ES) bowel preparation regimens for colonoscopy. Methods:A total of 427 consecutive asymptomatic individuals undergoing colorectal cancer screening were enrolled and randomly assigned into 2 groups. Subjects in group A drank 1. 5 L PEG-ES on the eve and 4 hours before colonoscopy, respectively;subjects in group B received a single dose of 3 L PEG-ES 5 hours before colonoscopy. Score and degree of Boston bowel preparation scale(BBPS)and PEG-ES related adverse effects of the two groups were assessed and compared. Results:There were no significant differences in gender,age and cecal insertion rate between group A and group B(P ﹥ 0. 05). Score of BBPS was significantly higher in group A than in group B(P ﹤0. 01). Both regimens met the requirement of conventional colonoscopy,however,the cleanliness of colon was graded as excellent in more subjects of group A( P ﹤ 0. 01),and less subjects of group A complained PEG-ES related nausea(P ﹤0. 05). Logistic regression analysis revealed that the PEG-ES drinking pattern was associated with cleanliness of colon and occurrence of nausea( P ﹤ 0. 05). Conclusions:Fractionated dose PEG-ES regimen provides a better colonic cleansing quality and tolerance for bowel preparation of colonoscopy,which is superior to that of single dose regimen.%背景:结肠镜检查是公认的结直肠检查的金标准,而良好的肠道准备是检查成功的前提条件。目的:评价聚乙二醇电解质溶液( PEG-ES)分次与单次口服作为结肠镜检查肠道准备方案的清洁效果和耐受性。方法:连续纳入427例进行结直肠癌筛查的无症状个体,随机分为A组和B组。A组于检查前夜和检查前4 h分别口服1

  14. Segmental reversal of the small bowel as treatment of short bowel syndrome in adults

    DEFF Research Database (Denmark)

    Burgdorf, Stefan K; Qvist, Niels; Gögenur, Ismail

    2014-01-01

    Short bowel syndrome is the result of extensive surgical resection, inherited defects or loss of functional absorbing intestine. Parenteral nutrition is associated with high economical expenses, increased morbidity and decreased quality of life. Intestinal transplantation is associated with high...... morbidity and mortality rates. Segmental reversal of the small bowel can prolong the transit time in the small bowel and in many cases permanently end parenteral nutrition dependency. Segmental reversal of the small bowel should be integrated in the surgical treatment of adults with short bowel syndrome....

  15. Surgical techniques in short bowel syndrome.

    Science.gov (United States)

    Waag, K L; Heller, K

    1990-01-01

    An operation according to Bianchi in a 2-year-old girl is described and indications as well as technical procedure are discussed. The girl was born with a gastroschisis. There was a jejunal perforation 10 cm below the ligament of Treitz caused by a volvulus. Only 20 cm of the jejunum remained. Moreover, only the left part of the colon was present. Total parenteral nutrition for 2 years was necessary. The principle of the operation is based on a longitudinal division of the remaining bowel and a creation of two separate bowel tubes out of the divided bowel halves, thus effecting an isoperistaltic serial connection by means of two anastomoses. This is technically possible since each half of the bowel wall has its own blood supply. The vessels originating from the mesenterium branch off before they reach the bowel wall so that the mesenteric dissection line can be anastomosed longitudinally with the antimesenteric border. This results in doubling of the bowel length, narrowing of the preoperatively dilated bowel diameter, closer contact of bowel contents with the mucosa, prolonged transit time and a Bacteroides colonization which is reduced by more effective peristalsis. Indications, time of operation and our own experiences are discussed and three cases are described. All children are alive and show marked improvement in nutrition. PMID:2105523

  16. Primary small bowel anastomosis in generalised peritonitis

    NARCIS (Netherlands)

    deGraaf, JS; van Goor, Harry; Bleichrodt, RP

    1996-01-01

    Objective: To find out if primary small bowel anastomosis of the bowel is safe in patients with generalised peritonitis who are treated by planned relaparotomies. Design: Retrospective study. Setting: University hospital, The Netherlands. Subjects. 10 Patients with generalised purulent peritonitis c

  17. Bowel perforation detection using metabolic fluorescent chlorophylls

    Science.gov (United States)

    Han, Jung Hyun; Jo, Young Goun; Kim, Jung Chul; Choi, Sujeong; Kang, Hoonsoo; Kim, Yong-Chul; Hwang, In-Wook

    2016-03-01

    Thus far, there have been tries of detection of disease using fluorescent materials. We introduce the chlorophyll derivatives from food plants, which have longer-wavelength emissions (at >650 nm) than those of fluorescence of tissues and organs, for detection of bowel perforation. To figure out the possibility of fluorescence spectroscopy as a monitoring sensor of bowel perforation, fluorescence from organs of rodent models, intestinal and peritoneal fluids of rodent models and human were analyzed. In IVIS fluorescence image of rodent abdominal organ, visualization of perforated area only was possible when threshold of image is extremely finely controlled. Generally, both perforated area of bowel and normal bowel which filled with large amount of chlorophyll derivatives were visualized with fluorescence. The fluorescence from chlorophyll derivatives penetrated through the normal bowel wall makes difficult to distinguish perforation area from normal bowel with direct visualization of fluorescence. However, intestinal fluids containing chlorophyll derivatives from food contents can leak from perforation sites in situation of bowel perforation. It may show brighter and longer-wavelength regime emissions of chlorophyll derivatives than those of pure peritoneal fluid or bioorgans. Peritoneal fluid mixed with intestinal fluids show much brighter emissions in longer wavelength (at>650 nm) than those of pure peritoneal fluid. In addition, irrigation fluid, which is used for the cleansing of organ and peritoneal cavity, made of mixed intestinal and peritoneal fluid diluted with physiologic saline also can be monitored bowel perforation during surgery.

  18. Hypertrophic osteoarthropathy of chronic inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Oppenheimer, D.A.; Jones, H.H.

    1982-12-01

    The case of a 14-year old girl with painful periostitis and ulcerative colitis is reported. The association of chronic inflammatory bowel disease with osteoarthropathy is rare and has previously been reported in eight patients. The periosteal reaction found in association with inflammatory bowel disease is apparently related to a chronic disease course and may cause extreme localized pain.

  19. Familial occurrence of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Orholm, M; Munkholm, P; Langholz, E;

    1991-01-01

    BACKGROUND AND METHODS: We assessed the familial occurrence of inflammatory bowel disease in Copenhagen County, where there has been a long-term interest in the epidemiology of such disorders. In 1987 we interviewed 662 patients in whom inflammatory bowel disease had been diagnosed before 1979...

  20. Small bowel transplantation : immunological and functional studies

    NARCIS (Netherlands)

    R.W.F. de Bruin (Ron)

    1993-01-01

    textabstractSmall bowel transplantation (SBT) would be the treatment of choice for patients suffering from the short bowel syndrome. Although in some centers SBT in patients is done with a considerable degree of success (Grant et al 1990, Todo et al. 1992), it is by no means an established and widel

  1. Small-bowel permeability in collagenous colitis

    DEFF Research Database (Denmark)

    Wildt, Signe; Madsen, Jan L; Rumessen, Jüri J

    2006-01-01

    Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small-intestinal biopsies...

  2. Pregnancy outcome in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Bortoli, A; Pedersen, N; Duricova, D;

    2011-01-01

    Inflammatory bowel disease (IBD) frequently affects women during their reproductive years. Pregnancy outcome in women with IBD is well described, particularly in retrospective studies.......Inflammatory bowel disease (IBD) frequently affects women during their reproductive years. Pregnancy outcome in women with IBD is well described, particularly in retrospective studies....

  3. Radiological Evaluation of Bowel Ischemia.

    Science.gov (United States)

    Dhatt, Harpreet S; Behr, Spencer C; Miracle, Aaron; Wang, Zhen Jane; Yeh, Benjamin M

    2015-11-01

    Intestinal ischemia, which refers to insufficient blood flow to the bowel, is a potentially catastrophic entity that may require emergent intervention or surgery in the acute setting. Although the clinical signs and symptoms of intestinal ischemia are nonspecific, computed tomography (CT) findings can be highly suggestive in the correct clinical setting. In our article, we review the CT diagnosis of arterial, venous, and nonocclusive intestinal ischemia. We discuss the vascular anatomy, pathophysiology of intestinal ischemia, CT techniques for optimal imaging, key and ancillary radiological findings, and differential diagnosis. PMID:26526436

  4. PPARγ in Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Vito Annese

    2012-01-01

    Full Text Available Peroxisome proliferator-activated receptor gamma (PPARγ is member of a family of nuclear receptors that interacts with nuclear proteins acting as coactivators and corepressors. The colon is a major tissue which expresses PPARγ in epithelial cells and, to a lesser degree, in macrophages and lymphocytes and plays a role in the regulation of intestinal inflammation. Indeed, both natural and synthetic PPARγ ligands have beneficial effects in different models of experimental colitis, with possible implication in the therapy of inflammatory bowel disease (IBD. This paper will specifically focus on potential role of PPARγ in the predisposition and physiopathology of IBD and will analyze its possible role in medical therapy.

  5. Small Bowel Review: Part II

    Directory of Open Access Journals (Sweden)

    ABR Thomson

    1996-01-01

    Full Text Available Major scientific advances have been made over the past few years in the areas of small bowel physiology, pathology, microbiology and clinical sciences. Over 1000 papers have been reviewed and a selective number are considered here. Wherever possible, the clinical relevance of these advances have been identified. Topics discussed are enterocyte proliferation and growth factors; amino acids, peptides and allergies; motility; salt and water absorption and secretion – diarrhea; vitamins and minerals; early development and ageing of the intestine; and ethanol effects.

  6. Immunopathogenesis of inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    David Q Shih; Stephan R Targan

    2008-01-01

    Crohn's disease and ulcerative colitis are chronic relapsing immune mediated disorders that results from an aberrant response to gut luminal antigen in genetically susceptible host. The adaptive immune response that is then triggered was widely considered to be a T-helper-1 mediated condition in Crohn's disease and T-helper-2 mediated condition in ulcerative colitis. Recent studies in animal models, genome wide association, and basic science has provided important insights in in the immunopathogenesis of inflammatory bowel disease, one of which was the characterization of the interleukin-23/Th-17 axis.

  7. Adhesive bowel obstruction? Not always

    Directory of Open Access Journals (Sweden)

    Mittapalli D

    2011-01-01

    Full Text Available A 58-year-old man presented acutely with features of post-surgical adhesive small bowel obstruction. Following an unsuccessful trial of conservative management, computed tomography (CT of the abdomen was performed. This revealed a mass in the ileocaecal region, for which he underwent a subsequent right hemicolectomy. Histology revealed diffuse B-cell Non-Hodgkin′s lymphoma of the terminal ileum. Confounding obstructive lesion of the intestine in patients with a history of previous laparotomy is extremely uncommon. Early high resolution imaging may predict diagnosis and consolidate clinical management plans.

  8. Inflammatory Bowel Disease and Thrombosis

    Directory of Open Access Journals (Sweden)

    Ahmet Tezel

    2012-06-01

    Full Text Available Inflammatory Bowel Disease (IBD is a group of chronic and relapsing inflammatory disorders of the gastrointestinal system. In these cases, findings are detected in extraintestinal systems also. There is a tendency for thrombotic events in IBD, as in the other inflammatory processes. The pathogenesis of this thrombotic tendency is multidimensional, including lack of natural anticoagulants, prothrombotic media induced via the inflammatory process, long-term sedentary life style, steroid use, surgery, and catheter placement. The aim of this review was to highlight the positive relationship between IBD and thrombotic events, and the proper treatment of at-risk patients.

  9. Irritable bowel syndrome: contemporary nutrition management strategies.

    Science.gov (United States)

    Mullin, Gerard E; Shepherd, Sue J; Chander Roland, Bani; Ireton-Jones, Carol; Matarese, Laura E

    2014-09-01

    Irritable bowel syndrome is a complex disorder whose pathophysiology involves alterations in the enteric microbiota, visceral hypersensitivity, gut immune/barrier function, hypothalamic-pituitary-adrenal axis regulation, neurotransmitters, stress response, psychological factors, and more. The importance of diet in the management of irritable bowel syndrome has taken center stage in recent times as the literature validates the relationship of certain foods with the provocation of symptoms. Likewise, a number of elimination dietary programs have been successful in alleviating irritable bowel syndrome symptoms. Knowledge of the dietary management strategies for irritable bowel syndrome will help guide nutritionists and healthcare practitioners to deliver optimal outcomes. This tutorial reviews the nutrition management strategies for irritable bowel syndrome.

  10. A prospective study assessing the efficacy of abdominal computed tomography scan without bowel preparation in diagnosing intestinal wall and luminal lesions in patients presenting to the emergency room with abdominal complaints

    Institute of Scientific and Technical Information of China (English)

    Michal Mizrahi; Yoav Mintz; Avraham Rivkind; David Kisselgoff; Eugene Libson; Mayer Brezis; Eran Goldin; Oren Shibolet

    2005-01-01

    AIM: To evaluate the positive predictive value of abdominal non-prepared computed tomography (CT) for diagnosing intestinal lumen or wall lesions in patients presenting to the emergency room (ER) with abdominal complaints.METHODS: For 1-year we prospectively evaluated all ER patients hospitalized after abdominal CT scan detected either intraluminal or intestinal wall lesions. These patients underwent colonoscopy serving as gold standard. Patients with prior abdominal pathology or CT findings of appendicitis or diverticulitis were excluded.RESULTS: Five hundred and sixty-eight abdominopelvic CT scans were performed in the ER, 96 had positive colonic findings. Sixty-two patients were excluded, 46 because of diverticulitis or appendicitis, 16 because of prior abdominal pathology. Of the remaining 34 patients, 14 did not undergo colonoscopy during hospitalization.Twenty eligible patients were included in the study. The positive predictive value of the CT scans performed in the ER was calculated to be 45% (95% CI 25-67).CONCLUSION: CT findings correlated with colonoscopic findings only in approximately half of the cases. Relying on non-prepared CT scan findings in planning patient management and colonoscopy may lead to unnecessary diagnostic work-ups.

  11. Implications of probiotics in the treatment on functional bowel diseases in infants

    Directory of Open Access Journals (Sweden)

    Marushko RV

    2014-03-01

    Full Text Available Nowadayes in the treatment of most diseases of the gastrointestinal tract correction of microbiota is one of the important part of pathogenetic therapy. Studies of relationship between intestinal microbiota disorders and functional bowel diseases in infants are actually insufficient. Promising is the use of spores generating probiotics in functional bowel disease in infants Aim of this study was to evaluate the efficacy and safety of the preparation called «BiosporinBiopharma» in the treatment of functional bowel disorders in infants. Materials and methods. The study involved 86 children aged from 3 to 18 months of which 45 were children with functional constipation and 41 children with functional diarrhea. Underwent clinical and laboratory investigations, including bacteriological, biochemical (structural components of mucosal bar rier mucins. We studied the clinical efficacy of the drug «BiosporinBiopharma» — shores generating probiotic, which is composed of bacteria of the Bacillus genus (B. Subtilis, B. Licheniformis in young children. Results. Revealed characteristic clinical manifestations of functional constipation and functional diarrhea accompanied by severe disorders of intestinal microbial flora, reduction of the level main representatives of the indigenous microflora (Bifidobacterium, Lactobacillus and E. Coli and increasing the concentration of saprophytic microflora, opportunistic bacteria and fungal flora as well as changes in the status of mucin glycoproteins in intestinal mucosa. Using the preparation «BiosporinBiopharma» in a complex treatment of functional bowel disease had pronounced positive effect on the clinical course of functional bowel disorders, with improvement and normalization of the sntestinal microbial flora and the status protective mucosal barrier of the intestine. Conclusions. The results of studies on the effectiveness of the preparation «BiosporinBiopharma» allow us to recommend it for widespread

  12. [Inflammatory Bowel Disease Competence Network].

    Science.gov (United States)

    Schreiber, Stefan; Hartmann, Heinz; Kruis, Wolfgang; Kucharzik, Torsten; Mudter, Jonas; Siegmund, Britta; Stallmach, Andreas; Witte, Christine; Fitzke, Klaus; Bokemeyer, Bernd

    2016-04-01

    The Inflammatory Bowel Disease Competence Network is a network of more than 500 physicians and scientists from university clinics, hospitals and gastroenterology practices. The focus extends from the two major forms of inflammatory bowel diseases, Crohn's disease and ulcerative colitis, into other chronic inflammatory conditions affecting the intestine, including coeliac disease and microscopic colitis. The network translates basic science discoveries (in particular in the molecular epidemiology research) into innovative diagnostics and therapy. Through its strong networking structures it supports a continuous process to improve quality and standardisation in patient care that is implemented in close interaction with European networks addressing this disease group.Optimisation of patient care based on scientifically proven evidence is a main focus of the network. Therefore, it supports and coordinates translational research and infrastructure projects that investigate aetiology, improvement of diagnostic methods, and development of new or improved use of established therapies. Members participate in various training projects, thus ensuring the rapid transfer of research results into clinical practice.The competence network cooperates with the main patient organisations to engage patients in all levels of activities. The network and the patient organisations have interest in promoting public awareness about the disease entities, because their importance and burden is underestimated in non-specialised medical fields and among the general public.

  13. [Inflammatory Bowel Disease Competence Network].

    Science.gov (United States)

    Schreiber, Stefan; Hartmann, Heinz; Kruis, Wolfgang; Kucharzik, Torsten; Mudter, Jonas; Siegmund, Britta; Stallmach, Andreas; Witte, Christine; Fitzke, Klaus; Bokemeyer, Bernd

    2016-04-01

    The Inflammatory Bowel Disease Competence Network is a network of more than 500 physicians and scientists from university clinics, hospitals and gastroenterology practices. The focus extends from the two major forms of inflammatory bowel diseases, Crohn's disease and ulcerative colitis, into other chronic inflammatory conditions affecting the intestine, including coeliac disease and microscopic colitis. The network translates basic science discoveries (in particular in the molecular epidemiology research) into innovative diagnostics and therapy. Through its strong networking structures it supports a continuous process to improve quality and standardisation in patient care that is implemented in close interaction with European networks addressing this disease group.Optimisation of patient care based on scientifically proven evidence is a main focus of the network. Therefore, it supports and coordinates translational research and infrastructure projects that investigate aetiology, improvement of diagnostic methods, and development of new or improved use of established therapies. Members participate in various training projects, thus ensuring the rapid transfer of research results into clinical practice.The competence network cooperates with the main patient organisations to engage patients in all levels of activities. The network and the patient organisations have interest in promoting public awareness about the disease entities, because their importance and burden is underestimated in non-specialised medical fields and among the general public. PMID:26968556

  14. Towards an integrated psychoneurophysiological approach of irritable bowel syndrome

    NARCIS (Netherlands)

    Veek, Patrick Petrus Johannes van der

    2009-01-01

    Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by recurrent abdominal pain or discomfort accompanied by disturbed bowel habits. It is among the most frequently occurring functional bowel syndromes, but the pathophysiology is poorly understood. A variety of mechanisms hav

  15. Current Role of Ultrasound in Small Bowel Imaging.

    Science.gov (United States)

    Wale, Anita; Pilcher, James

    2016-08-01

    Bowel ultrasound is cheap, relatively quick, allows dynamic evaluation of the bowel, has no radiation burden, is well tolerated by patients, and allows repeat imaging. Bowel ultrasound requires a systematic assessment of the entire bowel using high-frequency probes. In addition, hydrosonography and contrast-enhanced ultrasound may be performed. We present the normal sonographic appearances of large and small bowel and the sonographic appearances of acute appendicitis, Crohn's disease, celiac disease, intussusception, infectious enteritis, intestinal tuberculosis, small bowel ileus and obstruction, small bowel ischemia, and malignant tumors. PMID:27342894

  16. Short bowel syndrom as a complication of Crohn's disease

    OpenAIRE

    Skok, Pavel; Ocepek, Andreja

    2015-01-01

    During the course of Crohn's disease, some patients require surgical bowel resection due to intestinal stenosis. Attention is drawn to a possible complication of such surgical procedures: in a patients with Crohn's disease, short bowel syndrome developed following several small and large intestine resections that were necessary in the treatment of recidiving acute bowel obstructions. When the remnant small bowel is shorter than 200 cm, characteristic symptoms of short bowel syndrome develop i...

  17. Novel susceptibility genes in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Colin Noble; Elaine Nimmo; Daniel Gaya; Richard K Russell; Jack Satsangi

    2006-01-01

    The inflammatory bowel disease, Crohn's disease and ulcerative colitis, are polygenic disorders with important environmental interactions. To date, the most widely adopted approach to identifying susceptibility genes in complex diseases has involved genome wide linkage studies followed by studies of positional candidate genes in loci of interest. This review encompasses data from studies into novel candidate genes implicated in the pathogenesis of inflammatory bowel disease. Novel techniques to identify candidate genes-genome wide association studies, yeast-two hybrid screening, microarray gene expression studies and proteomic profiling,are also reviewed and their potential role in unravelling the pathogenesis of inflammatory bowel disease are discussed.

  18. No difference in small bowel microbiota between patients with irritable bowel syndrome and healthy controls

    OpenAIRE

    Aldona Dlugosz; Björn Winckler; Elin Lundin; Katherina Zakikhany; Gunnar Sandström; Weimin Ye; Lars Engstrand; Greger Lindberg

    2015-01-01

    Several studies have indicated that colonic microbiota may exhibit important differences between patients with irritable bowel syndrome (IBS) and healthy controls. Less is known about the microbiota of the small bowel. We used massive parallel sequencing to explore the composition of small bowel mucosa-associated microbiota in patients with IBS and healthy controls. We analysed capsule biopsies from the jejunum of 35 patients (26 females) with IBS aged 18-(36)-57 years and 16 healthy voluntee...

  19. Changes of smooth muscle contractile filaments in small bowel atresia

    Institute of Scientific and Technical Information of China (English)

    Stefan Gfroerer; Henning Fiegel; Priya Ramachandran; Udo Rolle; Roman Metzger

    2012-01-01

    AIM:To investigate morphological changes of intestinal smooth muscle contractile fibres in small bowel atresia patients.METHODS:Resected small bowel specimens from small bowel atresia patients (n =12) were divided into three sections (proximal,atretic and distal).Standard histology hematoxylin-eosin staining and enzyme immunohistochemistry was performed to visualize smooth muscle contractile markers α-smooth muscle actin (SMA) and desmin using conventional paraffin sections of the proximal and distal bowel.Small bowel from agematched patients (n =2) undergoing Meckel's diverticulum resection served as controls.RESULTS:The smooth muscle coat in the proximal bowel of small bowel atresia patients was thickened compared with control tissue,but the distal bowel was unchanged.Expression of smooth muscle contractile fibres SMA and desmin within the proximal bowel was slightly reduced compared with the distal bowel and control tissue.There were no major differences in the architecture of the smooth muscle within the proximal bowel and the distal bowel.The proximal and distal bowel in small bowel atresia patients revealed only minimal differences regarding smooth muscle morphology and the presence of smooth muscle contractile filament markers.CONCLUSION:Changes in smooth muscle contractile filaments do not appear to play a major role in postoperative motility disorders in small bowel atresia.

  20. Semitransparent peroral small bowel imaging

    Energy Technology Data Exchange (ETDEWEB)

    Emons, D.

    1981-10-01

    171 follow-through examinations of the small bowel performed in children and adolescents with a large contrast medium meal and the high voltage-low density barium technique (10 to 25 g BaSO/sub 4//100 ml, depending on age), are described. A ready made suspension, diluted with water, proved unsatisfactory. Coating properties and stability of the diluted, weak suspension were then greatly improved by hydroxyethylcellulose as a thickening agent and in addition by premedication of the patient with cimetidine. Pure cellulose solution instead of the last portion of barium prevented thickening in the ileum. The procedure has the well known advantages of a large contrast medium meal without the problem of overly dense superpositions.

  1. Disturbances in small bowel motility.

    LENUS (Irish Health Repository)

    Quigley, E M

    2012-02-03

    Recently, the small intestine has become the focus of investigation as a potential site of dysmotility in the irritable bowel syndrome (IBS). A number of motor abnormalities have been defined in some studies, and include \\'clustered\\' contractions, exaggerated post-prandial motor response and disturbances in intestinal transit. The significance of these findings remains unclear. The interpretation of available studies is complicated by differences in subject selection, the direct influence of certain symptoms, such as diarrhoea and constipation, and the interference of compounding factors, such as stress and psychopathology. Dysmotility could also reflect autonomic dysfunction, disturbed CNS control and the response to heightened visceral sensation or central perception. While motor abnormalities may not explain all symptoms in IBS, sensorimotor interactions may be important in symptom pathogenesis and deserve further study.

  2. Diet and Inflammatory Bowel Disease.

    Science.gov (United States)

    Knight-Sepulveda, Karina; Kais, Susan; Santaolalla, Rebeca; Abreu, Maria T

    2015-08-01

    Patients with inflammatory bowel disease (IBD) are increasingly becoming interested in nonpharmacologic approaches to managing their disease. One of the most frequently asked questions of IBD patients is what they should eat. The role of diet has become very important in the prevention and treatment of IBD. Although there is a general lack of rigorous scientific evidence that demonstrates which diet is best for certain patients, several diets-such as the low-fermentable oligosaccharide, disaccharide, monosaccharide, and polyol diet; the specific carbohydrate diet; the anti-inflammatory diet; and the Paleolithic diet-have become popular. This article discusses the diets commonly recommended to IBD patients and reviews the supporting data. PMID:27118948

  3. Genetics of irritable bowel syndrome.

    Science.gov (United States)

    Henström, Maria; D'Amato, Mauro

    2016-12-01

    Irritable bowel syndrome (IBS) is a common condition with a complex and largely unknown etiology. There is no cure, and treatment options are mainly directed to the amelioration of symptoms. IBS causes reduced quality of life and poses considerable repercussions on health and socioeconomic systems. There is a heritable component in IBS, and genetic research is a valuable tool for the identification of causative pathways, which will provide important insight into the pathophysiology. However, although some gene-hunting efforts have been conducted and a few risk genes proposed, IBS genetic research is lagging behind compared to other complex diseases. In this mini-review, we briefly summarize existing genetic studies, discuss the main challenges in IBS genetic research, and propose strategies to overcome these challenges for IBS gene discovery. PMID:26873717

  4. Biomarkers in inflammatory bowel diseases

    DEFF Research Database (Denmark)

    Bennike, Tue; Birkelund, Svend; Stensballe, Allan;

    2014-01-01

    Unambiguous diagnosis of the two main forms of inflammatory bowel diseases (IBD): Ulcerative colitis (UC) and Crohn's disease (CD), represents a challenge in the early stages of the diseases. The diagnosis may be established several years after the debut of symptoms. Hence, protein biomarkers...... for early and accurate diagnostic could help clinicians improve treatment of the individual patients. Moreover, the biomarkers could aid physicians to predict disease courses and in this way, identify patients in need of intensive treatment. Patients with low risk of disease flares may avoid treatment...... with medications with the concomitant risk of adverse events. In addition, identification of disease and course specific biomarker profiles can be used to identify biological pathways involved in the disease development and treatment. Knowledge of disease mechanisms in general can lead to improved future...

  5. Multidetector row computed tomography in bowel obstruction. Part 2. Large bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Sinha, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)]. E-mail: rakesh.sinha@uhl-tr.nhs.uk; Verma, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)

    2005-10-01

    Large bowel obstruction may present as an emergency as high-grade colonic obstruction and can result in perforation. Perforated large bowel obstruction causes faecal peritonitis, which can result in high morbidity and mortality. Multidetector row computed tomography (MDCT) has the potential of providing an accurate diagnosis of large bowel obstruction. The rapid acquisition of images within one breath-hold reduces misregistration artefacts than can occur in critically ill or uncooperative patients. The following is a review of the various causes of large bowel obstruction with emphasis on important pathogenic factors, CT appearances and the use of multiplanar reformatted images in the diagnostic workup.

  6. Diet in irritable bowel syndrome.

    Science.gov (United States)

    El-Salhy, Magdy; Gundersen, Doris

    2015-01-01

    Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that is characterized by intermittent abdominal pain/discomfort, altered bowel habits and abdominal bloating/distension. This review aimed at presenting the recent developments concerning the role of diet in the pathophysiology and management of IBS. There is no convincing evidence that IBS patients suffer from food allergy/intolerance, and there is no evidence that gluten causes the debated new diagnosis of non-coeliac gluten sensitivity (NCGS). The component in wheat that triggers symptoms in NCGS appears to be the carbohydrates. Patients with NCGS appear to be IBS patients who are self-diagnosed and self-treated with a gluten-free diet. IBS symptoms are triggered by the consumption of the poorly absorbed fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) and insoluble fibre. On reaching the distal small intestine and colon, FODMAPS and insoluble fibre increase the osmotic pressure in the large-intestine lumen and provide a substrate for bacterial fermentation, with consequent gas production, abdominal distension and abdominal pain or discomfort. Poor FODMAPS and insoluble fibres diet reduces the symptom and improve the quality of life in IBS patients. Moreover, it changes favourably the intestinal microbiota and restores the abnormalities in the gastrointestinal endocrine cells. Five gastrointestinal endocrine cell types that produce hormones regulating appetite and food intake are abnormal in IBS patients. Based on these hormonal abnormalities, one would expect that IBS patients to have increased food intake and body weight gain. However, the link between obesity and IBS is not fully studied. Individual dietary guidance for intake of poor FODMAPs and insoluble fibres diet in combination with probiotics intake and regular exercise is to be recommended for IBS patients. PMID:25880820

  7. Fecal calprotectin in inflammatory bowel disease.

    Science.gov (United States)

    Walsham, Natalie E; Sherwood, Roy A

    2016-01-01

    Inflammatory bowel disease (IBD) and irritable bowel syndrome share many symptoms. While irritable bowel syndrome is a functional bowel disorder for which no specific treatment is available, the range of effective therapies for IBD is evolving rapidly. Accurate diagnosis of IBD is therefore essential. Clinical assessment, together with various imaging modalities and endoscopy, has been the mainstay of diagnosis for many years. Fecal biomarkers of gastrointestinal inflammation have appeared in the past decade, of which calprotectin, a neutrophil cytosolic protein, has been studied the most. Crohn's disease and ulcerative colitis are chronic remitting and relapsing diseases, and objective assessment of disease activity and response to treatment are important. This review focuses on the use of fecal calprotectin measurements in the diagnosis and monitoring of patients with IBD. PMID:26869808

  8. Spectrum of short bowel syndrome in adults

    DEFF Research Database (Denmark)

    Jeppesen, Palle B

    2014-01-01

    Short bowel syndrome (SBS) refers to the malabsorptive state caused by physical or functional loss of portions of the small intestine, most commonly following extensive intestinal resection. Such resections hinder absorption of adequate amounts of macronutrients, micronutrients, electrolytes, and...

  9. Serotonin, visceral sensation in irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    QIAN Jia-ming

    2007-01-01

    @@ Irritable bowel syndrome(IBS) is highly prevalent and can affect up to 20% of the population.1 It is a common gastrointestinal(GI) disorder associated with alterations in motility,secretion and visceral sensation.

  10. Diet and risk of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Andersen, Vibeke; Olsen, Anja; Carbonnel, Franck;

    2012-01-01

    Background: A better understanding of the environmental factors leading to inflammatory bowel disease should help to prevent occurrence of the disease and its relapses. Aim: To review current knowledge on dietary risk factors for inflammatory bowel disease. Methods: The PubMed, Medline and Cochrane...... Library were searched for studies on diet and risk of inflammatory bowel disease. Results: Established non-diet risk factors include family predisposition, smoking, appendectomy, and antibiotics. Retrospective case–control studies are encumbered with methodological problems. Prospective studies...... on European cohorts, mainly including middle-aged adults, suggest that a diet high in protein from meat and fish is associated with a higher risk of inflammatory bowel disease. Intake of the n-6 polyunsaturated fatty acid linoleic acid may confer risk of ulcerative colitis, whereas n-3 polyunsaturated fatty...

  11. Use of thiopurines in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Frei, Pascal; Biedermann, Luc; Nielsen, Ole Haagen;

    2013-01-01

    The use of thiopurines as immunosuppression for the treatment of refractory or chronic active inflammatory bowel disease is established for both Crohn's disease and ulcerative colitis. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine, 6-mercaptopurine...

  12. Feasibility of laparoscopy for small bowel obstruction

    OpenAIRE

    De Sol Angelo A; Migliaccio Carla; Delmonaco Pamela; Cattorini Lorenzo; Morelli Umberto; La Mura Francesco; Cirocchi Roberto; Farinella Eriberto; Cozzaglio Luca; Sciannameo Francesco

    2009-01-01

    Abstract Background Adherential pathology is the most common cause of small bowel obstruction. Laparoscopy in small bowel obstruction does not have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere with abdominal wall integrity. Methods We performed a review without any language restrictions considering international literature indexed from 1980 to 2007 in Medline, Embase and Cochrane Library. We analyzed th...

  13. Short Bowel Syndrome: A Case Report

    OpenAIRE

    Celayir, Sinan; Sarımurat, Nüvit; Ilıkkan, Barbaros; ERAY, Nur; Yeşildağ, Ebru; Yeker, Daver

    1996-01-01

    Necrotizing enterocolitis atresia volvulus gastroschisis are the most common causes of short bowel syndrome in the pediatric population Although the prognosis for patients with short bowel syndrome improved since the advent of parenteral nutrition the cost of long term total parenteral nutrition and attendant morbidity and mortality cannot be ignored in these patients Long term follow up of a case with short small intestine of 25 cm length following surgery is presented and the problems assoc...

  14. Genetic epidemiology of irritable bowel syndrome

    OpenAIRE

    Makker, Jasbir; Chilimuri, Sridhar; Bella, Jonathan N

    2015-01-01

    Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder characterized by presence of abdominal pain or discomfort associated with altered bowel habits. It has three main subtypes - constipation predominant IBS (C-IBS), diarrhea predominant IBS (D-IBS) and IBS with mixed features of both diarrhea as well as constipation (M-IBS). Its pathophysiology and underlying mechanisms remain elusive. It is traditionally believed that IBS is a result of multiple factors incl...

  15. Modern treatment of short bowel syndrome

    DEFF Research Database (Denmark)

    Jeppesen, Palle B

    2013-01-01

    Recently, the US Food and Drug Administration and the European Medicines Agency approved the glucagon-like peptide 2 analogue, teduglutide, for the treatment of short bowel syndrome (SBS), and this review describes the physiological basis for its clinical use.......Recently, the US Food and Drug Administration and the European Medicines Agency approved the glucagon-like peptide 2 analogue, teduglutide, for the treatment of short bowel syndrome (SBS), and this review describes the physiological basis for its clinical use....

  16. Small bowel emergency surgery: literature's review

    Directory of Open Access Journals (Sweden)

    Di Saverio Salomone

    2011-01-01

    Full Text Available Abstract Emergency surgery of the small bowel represents a challenge for the surgeon, in the third millennium as well. There is a wide number of pathologies which involve the small bowel. The present review, by analyzing the recent and past literature, resumes the more commons. The aim of the present review is to provide the main indications to face the principal pathologies an emergency surgeon has to face with during his daily activity.

  17. [Contemporary dietotherapy of the irritable bowel syndrome].

    Science.gov (United States)

    Pilipenko, V I; Burliaeva, E A; Isakov, V A

    2013-01-01

    Irritable bowel syndrome (IBS) is the most prevalent functional disease of the gastrointestinal tract. This highly prevalent condition is best diagnosed by assessing the constellation of symptoms with which patients present to their physicians. Because some critics have previously questioned whether irritable bowel syndrome and other functional gastrointestinal disorders truly exist because they do not have defining structural features, the Rome Foundation fostered the use of symptom-based criteria for universal use. In most cases treatment is reduced to symptomatic therapy because a lot of unknown in pathogenesis by irritable bowel syndrome. Irritable bowel syndrome leads to decrease of quality of life of the patients and could be one of the reasons of patients' disability. Food is believed by patients promotes symptoms and the diet or avoiding specific food can reduce symptoms. Possible role of different food and microbiota in the pathophysiology of irritable bowel syndrome, as well as the data from randomized, controlled clinical trials dedicated to the effects of diet in irritable bowel syndrome are summarized and discussed in this review. The efficacy of the diet, enriched by fiber, prebiotics, probiotics, peppermint oil, curcumin and vitamin B6 in irritable bowel syndrome patients was shown in numerous studies. In some studies restriction in consumption of fermented carbohydrates, coffee and alcohol, as well as diet with elimination IgG-sensed food was also shown to be effective in irritable bowel syndrome. Food intolerances, defined as non-toxic non-immune adverse reactions to food, include reactions to bioactive chemicals in foods and metabolic reactions to poorly absorbed dietary carbohydrates. New dietary approaches like polyunsaturated fatty acids intake correction and the low tryptophan intake are discussed. PMID:23808281

  18. Delayed bowel perforation following suprapubic catheter insertion

    OpenAIRE

    Mehta Ajay; Ahmed Shwan J; Rimington Peter

    2004-01-01

    Abstract Background Complications of suprapubic catheter insertion are rare but can be significant. We describe an unusual complication of a delayed bowel perforation following suprapubic catheter insertion. Case presentation A gentleman presented with features of peritonitis and feculent discharge along a suprapubic catheter two months after insertion of the catheter. Conclusion Bowel perforation is the most feared complication of suprapubic catheter insertion especially in patients with low...

  19. NATURAL AGENTS FOR INFLAMMATORY BOWEL DISEASE

    OpenAIRE

    Darji Vinay Chhanalal; Bariya Aditi Hemrajbhai; Deshpande Shrikalp Shrikant

    2011-01-01

    Inflammatory bowel disease (IBD) is a chronic inflammatory disease of gastrointestinal tract. It comprises the two conditions, Crohn’s disease and ulcerative colitis, characterized by chronic recurrent ulceration of the bowel. Conventional drugs for colitis treatment include aminosalicylate, corticosteroids,antibiotics & immunomodulators. 5- Amino salicylic acid having side effects in 30% of the patients. Systemic corticosteroids producing incidence of complication is 4.3%. Antibiotic therapy...

  20. The Immune System in Irritable Bowel Syndrome

    OpenAIRE

    Barbara, Giovanni; Cremon, Cesare; Carini, Giovanni; Bellacosa, Lara; Zecchi, Lisa; De Giorgio, Roberto; Corinaldesi, Roberto; Stanghellini, Vincenzo

    2011-01-01

    The potential relevance of systemic and gastrointestinal immune activation in the pathophysiology and symptom generation in the irritable bowel syndrome (IBS) is supported by a number of observations. Infectious gastroenteritis is the strongest risk factor for the development of IBS and increased rates of IBS-like symptoms have been detected in patients with inflammatory bowel disease in remission or in celiac disease patients on a gluten free diet. The number of T cells and mast cells in the...

  1. Cutaneous manifestations of inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Al Roujayee Abdulaziz

    2007-01-01

    Full Text Available Inflammatory bowel disease (IBD has many extraintestinal manifestations, and skin lesions are one of the most frequently described extraintestinal findings. Reports indicate an incidence of cutaneous manifestations ranging from 2 to 34%, Cutaneous manifestations are usually related to the activity of the bowel disease but may have an independent course. In this review we aim to address the various cutaneous manifestations associated with IBD, their impact on the disease course, and the treatment options available.

  2. Evaluation of the effects of oral water and low-density barium sulphate suspension on bowel appearance on FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Blake, Michael A.; Setty, Bindu N.; Kalra, Mannudeep; Holalkere, Nagaraj Setty; Mueller, Peter R.; Sahani, Dushyant V. [Massachusetts General Hospital, Department of Radiology, Division of Abdominal Imaging and Interventional Radiology, Boston, MA (United States); Cronin, Carmel G. [Massachusetts General Hospital, Department of Radiology, Division of Abdominal Imaging and Interventional Radiology, Boston, MA (United States); Massachusetts General Hospital, Department of Radiology, Division of Nuclear Medicine, Boston, MA (United States); Fischman, Alan J. [Massachusetts General Hospital, Department of Radiology, Division of Nuclear Medicine, Boston, MA (United States)

    2010-01-15

    The purpose of this study is to assess which of five bowel preparation regimes offers superior bowel distension and to assess if these regimes adversely affect FDG activity on PET/CT imaging. The study conformed to HIPAA regulations. Ninety patients were divided into five groups of 18 who received no oral contrast agent (group A); 900 ml of water orally (group B); or 900, 1,350, or 1,800 ml of LDB (groups C, D, E, respectively). PET/CT examinations were assessed quantitatively (bowel diameter, SUV) and qualitatively (visual assessment grading scale) for bowel distension and FDG activity by two blinded readers. ANOVA was utilized to determine if a statistically significant difference (SSD) existed between the groups in terms of distension and FDG uptake. Qualitatively superior bowel distension was observed in group C (LDB) compared to B (water) and greater distension was noted with increased volumes of LDB in C, D, and E. Quantitatively there was an SSD in mean distension between groups C and B (P < 0.001 except duodenum). Qualitatively and quantitatively there was no significant difference in bowel FDG uptake among the groups (P > 0.05). LDB as an oral contrast agent provides superior bowel distension over water and does not induce increased FDG bowel activity. (orig.)

  3. Incidence and initial disease course of inflammatory bowel diseases in 2011 in Europe and Australia

    DEFF Research Database (Denmark)

    Vegh, Z; Burisch, J.; Pedersen, N.;

    2014-01-01

    BACKGROUND AND AIMS: The aim of the present study was to validate the IBD (inflammatory bowel diseases) incidence reported in the 2010 ECCO-EpiCom (European Crohn's and Colitis Organization-Epidemiological Committee) inception cohort by including a second independent inception cohort from...... (25%) from Eastern, 461 (65%) from Western Europe and 72 (10%) from Australia; 259 (37%) patients were diagnosed with Crohn's disease, 380 (53%) with ulcerative colitis and 72 (10%) with IBD unclassified. The mean annual incidence rate for IBD was 11.3/100,000 in Eastern Europe, 14...... participating centers in 2011 and an Australian center to investigate whether there is a difference in the incidence of IBD between Eastern and Western European countries and Australia. METHODS: Fourteen centers from 5 Eastern and 9 Western European countries and one center from Australia participated...

  4. SEVERE SHORT-BOWEL SYNDROME AFTER TOTAL SMALL BOWEL RESECTION

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Extensive intestine resection may result in short bowel syndrome (SBS) which is difficult to manage. This study reports a rare SBS case in a 6-year-old boy following resection of total jujunoileum and right colon. Our experience in 4-years follow-up and literature reports on SBS is discussed. The purpose of this study was also to evaluate the nutritional absorptive capacity and intestinal adaptation. In the 15th postoperative month, barium x-ray study showed a significantly extended and enlarged duodenum and colon. The intestinal transit time was prolonged to 22 hours. The absorption rate of palmic acid, glycine and D-xylose had increased from 57%, 50% and 4% respectively in the 15th postoperative month, to 75%, 65% and 6% in the 2nd postoperative year. His absorptive capacity allowed him normal oral feeding and normal school life. Our data confirmed the reports of the colon as an energy-salvage organ, and suggested that it may have some capacity to absorb long-chain fatty acids and amino acids.

  5. A case of enterolith small bowel obstruction and jejunal diverticulosis

    Institute of Scientific and Technical Information of China (English)

    Buhussan Hayee; Hamed Noor Khan; Talib Al-Mishlab; John F Mcpartlin

    2003-01-01

    We reported a case of 79-year old woman with known large bowel diverticulosis presenting with small bowel obstruction due to stone impaction - found on plain abdominal X-ray.Contrast studies demonstrated small bowel diverticulosis.At laparotomy, the gall bladder was normal with no stones and no abnormal communication with small bowel - excluding the possibility of a gallstone ileus. Analysis of the stone revealed a composition of bile pigments and calcium oxalate.This was a rare case of small bowel obstruction due to enterolith formation - made distinctive by calcification (previously unreported in the proximal small bowel).

  6. Contrast enema depiction of small-bowel volvulus in complicated neonatal bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, Oscar M.; Daneman, Alan; Miller, Stephen F. [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2004-12-01

    About one-half of patients with meconium ileus (MI) present with a complication such as volvulus, atresia, meconium peritonitis or giant cystic meconium peritonitis. The treatment of these complications requires surgery. However, the preoperative diagnosis of complicated MI is difficult. We describe two neonates with complicated small-bowel obstruction, one with MI related to cystic fibrosis and the other not related to cystic fibrosis. In both, contrast enema depicted a spiral appearance of the distal small bowel, which at surgery proved to be the result of volvulus associated with antenatal bowel perforation. This appearance of the small bowel on contrast enema in this clinical setting has not been previously described. The recognition of this spiral appearance of the distal small bowel suggests the need for surgery. (orig.)

  7. Feasibility of laparoscopy for small bowel obstruction

    Directory of Open Access Journals (Sweden)

    De Sol Angelo A

    2009-01-01

    Full Text Available Abstract Background Adherential pathology is the most common cause of small bowel obstruction. Laparoscopy in small bowel obstruction does not have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere with abdominal wall integrity. Methods We performed a review without any language restrictions considering international literature indexed from 1980 to 2007 in Medline, Embase and Cochrane Library. We analyzed the reference lists of the key manuscripts. We also added a review based on international non-indexed sources. Results The feasibility of diagnostic laparoscopy is high (60–100%, while that of therapeutic laparoscopy is low (40–88%. The frequency of laparotomic conversions is variable ranging from 0 to 52%, depending on patient selection and surgical skill. The first cause of laparotomic conversion is a difficult exposition and treatment of band adhesions. The incidence of laparotomic conversions is major in patients with anterior peritoneal band adhesions. Other main causes for laparotomic conversion are the presence of bowel necrosis and accidental enterotomies. The predictive factors for successful laparoscopic adhesiolysis are: number of previous laparotomies ≤ 2, non-median previous laparotomy, appendectomy as previous surgical treatment causing adherences, unique band adhesion as phatogenetic mechanism of small bowel obstruction, early laparoscopic management within 24 hours from the onset of symptoms, no signs of peritonitis on physical examination, experience of the surgeon. Conclusion Laparoscopic adhesiolysis in small bowel obstruction is feasible but can be convenient only if performed by skilled surgeons in selected patients. The laparoscopic adhesiolysis for small bowel obstruction is satisfactorily carried out when early indicated in patients with a low number of laparotomies resulting in a short hospital stay and a lower postoperative

  8. Heterotaxy syndromes and abnormal bowel rotation

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Koppolu, Raji; Sylvester, Karl [Lucile Packard Children' s Hospital at Stanford, Department of Surgery, Stanford, CA (United States); Murphy, Daniel [Lucile Packard Children' s Hospital at Stanford, Department of Cardiology, Stanford, CA (United States)

    2014-05-15

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  9. Selenium and inflammatory bowel disease.

    Science.gov (United States)

    Kudva, Avinash K; Shay, Ashley E; Prabhu, K Sandeep

    2015-07-15

    Dietary intake of the micronutrient selenium is essential for normal immune functions. Selenium is cotranslationally incorporated as the 21st amino acid, selenocysteine, into selenoproteins that function to modulate pathways involved in inflammation. Epidemiological studies have suggested an inverse association between selenium levels and inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis that can potentially progress to colon cancer. However, the underlying mechanisms are not well understood. Here we summarize the current literature on the pathophysiology of IBD, which is multifactorial in origin with unknown etiology. We have focused on a few selenoproteins that mediate gastrointestinal inflammation and activate the host immune response, wherein macrophages play a pivotal role. Changes in cellular oxidative state coupled with altered expression of selenoproteins in macrophages drive the switch from a proinflammatory phenotype to an anti-inflammatory phenotype to efficiently resolve inflammation in the gut and restore epithelial barrier integrity. Such a phenotypic plasticity is accompanied by changes in cytokines, chemokines, and bioactive metabolites, including eicosanoids that not only mitigate inflammation but also partake in restoring gut homeostasis through diverse pathways involving differential regulation of transcription factors such as nuclear factor-κB and peroxisome proliferator-activated receptor-γ. The role of the intestinal microbiome in modulating inflammation and aiding in selenium-dependent resolution of gut injury is highlighted to provide novel insights into the beneficial effects of selenium in IBD.

  10. Inflammatory bowel disease in pregnancy

    Institute of Scientific and Technical Information of China (English)

    Dawn B Beaulieu; Sunanda Kane

    2011-01-01

    Crohn's disease and ulcerative colitis affect women in their child-bearing years. Family planning has come to be a common discussion between the gastroenterologist and the inflammatory bowel disease (IBD) patient.Disease control prior to desired conception and throughout pregnancy is the most important thing to keep in mind when caring for the IBD patient. Continued medical management during pregnancy is crucial in optimizing outcomes. Studies indicate that quiescent disease prior to conception infer the best pregnancy outcomes, similar to those in the general population.Active disease prior to and during pregnancy, can lead to complications such as pre-term labor, low birth weight, and small for gestational age infants. Although there are no definitive long term effects of pregnancy on IBD, there are some limited studies that suggest that it may alter the disease course. Understanding the literature and its limitations is important in the modern era of IBD care. Educating the patient and taking a team approach with the obstetrician will help achieve successful outcomes for mother and baby.

  11. [Parasitosis and irritable bowel syndrome].

    Science.gov (United States)

    Ibarra, Catalina; Herrera, Valentina; Pérez de Arce, Edith; Gil, Luis Carlos; Madrid, Ana María; Valenzuela, Lucía; Beltrán, Caroll J

    2016-06-01

    Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterised by multi-factorial aetiology. In IBS physiopathology are involved diverse factors between them biological, psychosocial, and environmental components which affect the immune activation status of gut mucosa. Among these factors is recognized the intestinal parasitosis. Post-infection IBS (PI-IBS) is recognised as a subgroup of functional disorders whose symptoms onset appear after a symptomatic intestinal infection caused by microbial agents. There are few studies regarding of relationship between IBS and intestinal parasitosis in Chile. However, is has been well described a positive association between IBS and Blastocystis hominis infections, one of prevalent parasites in Chile. In other countries, is also described a relationship between IBS and amebiasis and giardiasis. Both, characterized by a common mode of transmission through water as well as contaminated food. Because the high prevalence of parasitosis in our country it is necessary to expand the association studies to clarify the strength of the parasites ethiology in IBS. PMID:27598274

  12. Pharmacogenetics in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Marie Pierik; Paul Rutgeerts; Robert Vlietinck; Severine Vermeire

    2006-01-01

    Pharmacogenetics is the study of the association between variability in drug response and (or) drug toxicity and polymorphisms in genes. The goal of this field of science is to adapt drugs to a patient's specific genetic background and therefore make them more efficacious and safe. In this article we describe the variants in genes that influence either the efficacy or toxicity of common drugs used in the treatment of inflammatory bowel diseases (IBD), ulcerative colitis (UC),and Crohn's disease (CD) including sulfasalazine and mesalazine, azathioprine (AZA) and 6-mercaptopurine (6-MP), methotrexate (MTX), glucocorticosteroids (CSs) and infliximab. Furthermore, difficulties with pharmacogenetic studies in general and more specifically in IBD are described. Although pharmacogenetics is a promising field that already contributed to a better understanding of some of the underlying mechanisms of action of drugs used in IBD, the only discovery translated until now into daily practice is the relation between thiopurine S-methyltransferase (TPMT) gene polymorphisms and hematological toxicity of thiopurine treatment. In the future it is necessary to organize studies in well characterized patient cohorts who have been uniformly treated and systematically evaluated in order to quantitate drug response more objectively. An effort should be made to collect genomic DNA from all patients enrolled in clinical drug trials after appropriate informed consent for pharmacogenetic studies.

  13. Etiopathogenesis of inflammatory bowel diseases

    Institute of Scientific and Technical Information of China (English)

    Silvio Danese; Claudio Fiocchi

    2006-01-01

    Theories explaining the etiopathogenesis of inflammatory bowel disease (IBD) have been proposed ever since Crohn's disease (CD) and ulcerative colitis (UC) were recognized as the two major forms of the disease. Although the exact cause(s) and mechanisms of tissue damage in CD and UC have yet to be completely understood, enough progress has occurred to accept the following hypothesis as valid: IBD is an inappropriate immune response that occurs in genetically susceptible individuals as the result of a complex interaction among environmental factors, microbial factors, and the intestinal immune system. Among an almost endless list of environmental factors, smoking has been identified as a risk factor for CD and a protective factor for UC. Among microbial factors, no convincing evidence indicates that classical infectious agents cause IBD, while mounting evidence points to an abnormal immune response against the normal enteric flora as being of central importance. Gut inflammation is mediated by cells of the innate as well as adaptive immune systems, with the additional contribution of non-immune cells, such as epithelial, mesenchymal and endothelial cells, and platelets.

  14. [Parasitosis and irritable bowel syndrome].

    Science.gov (United States)

    Ibarra, Catalina; Herrera, Valentina; Pérez de Arce, Edith; Gil, Luis Carlos; Madrid, Ana María; Valenzuela, Lucía; Beltrán, Caroll J

    2016-06-01

    Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterised by multi-factorial aetiology. In IBS physiopathology are involved diverse factors between them biological, psychosocial, and environmental components which affect the immune activation status of gut mucosa. Among these factors is recognized the intestinal parasitosis. Post-infection IBS (PI-IBS) is recognised as a subgroup of functional disorders whose symptoms onset appear after a symptomatic intestinal infection caused by microbial agents. There are few studies regarding of relationship between IBS and intestinal parasitosis in Chile. However, is has been well described a positive association between IBS and Blastocystis hominis infections, one of prevalent parasites in Chile. In other countries, is also described a relationship between IBS and amebiasis and giardiasis. Both, characterized by a common mode of transmission through water as well as contaminated food. Because the high prevalence of parasitosis in our country it is necessary to expand the association studies to clarify the strength of the parasites ethiology in IBS.

  15. Fecal calprotectin in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Walsham NE

    2016-01-01

    Full Text Available Natalie E Walsham,1 Roy A Sherwood2 1Department of Clinical Biochemistry, University Hospital Lewisham, Lewisham, 2Department of Clinical Biochemistry, Viapath at King’s College Hospital NHS Foundation Trust, London, UK Abstract: Inflammatory bowel disease (IBD and irritable bowel syndrome share many symptoms. While irritable bowel syndrome is a functional bowel disorder for which no specific treatment is available, the range of effective therapies for IBD is evolving rapidly. Accurate diagnosis of IBD is therefore essential. Clinical assessment, together with various imaging modalities and endoscopy, has been the mainstay of diagnosis for many years. Fecal biomarkers of gastrointestinal inflammation have appeared in the past decade, of which calprotectin, a neutrophil cytosolic protein, has been studied the most. Crohn’s disease and ulcerative colitis are chronic remitting and relapsing diseases, and objective assessment of disease activity and response to treatment are important. This review focuses on the use of fecal calprotectin measurements in the diagnosis and monitoring of patients with IBD. Keywords: calprotectin, Crohn’s disease, ulcerative colitis, inflammatory bowel disease, inflammation 

  16. Visceral hypersensitivity in Irritable Bowel Syndrome:pathophysiological mechanisms

    NARCIS (Netherlands)

    Kerckhoffs, A.P.M.

    2009-01-01

    Irritable Bowel Syndrome (IBS) is a functional bowel disease characterized by abdominal pain or discomfort associated with a disordered defecation. No unique pathophysiological mechanism has been identified. It is most likely a multifactorial disease involving alterations in intestinal microbiota co

  17. Jejunitis and brown bowel syndrome with multifocal carcinogenesis of the small bowel.

    Science.gov (United States)

    Raithel, Martin; Rau, Tilman T; Hagel, Alexander F; Albrecht, Heinz; de Rossi, Thomas; Kirchner, Thomas; Hahn, Eckhart G

    2015-09-28

    This is the first report describing a case where prolonged, severe malabsorption from brown bowel syndrome progressed to multifocally spread small bowel adenocarcinoma. This case involves a female patient who was initially diagnosed with chronic jejunitis associated with primary diffuse lymphangiectasia at the age of 26 years. The course of the disease was clinically, endoscopically, and histologically followed for 21 years until her death at the age 47 due to multifocal, metastasizing adenocarcinoma of the small bowel. Multiple lipofuscin deposits (so-called brown bowel syndrome) and severe jejunitis were observed microscopically, and sections of the small bowel showed dense lymphoplasmacytic infiltration of the lamina propria as well as blocked lymphatic vessels. After several decades, multifocal nests of adenocarcinoma cells and extensive, flat, neoplastic mucosal proliferations were found only in the small bowel, along with a loss of the mismatch repair protein MLH1 as a long-term consequence of chronic jejunitis with malabsorption. No evidence was found for hereditary nonpolyposis colon carcinoma syndrome. This article demonstrates for the first time multifocal carcinogenesis in the small bowel in a malabsorption syndrome in an enteritis-dysplasia-carcinoma sequence. PMID:26420973

  18. Transient small bowel angioedema due to intravenous iodinated contrast media

    OpenAIRE

    Hu, Xiu-Hua; Gong, Xiang-Yang; Hu, Peng

    2012-01-01

    Three cases of transient proximal small bowel angioedema induced by intravenous administration of nonionic iodinated contrast media (CM) are presented. Computed tomography (CT) images in the venous phase displayed the proximal small bowel with circumferential thickening of the wall including the duodenum and proximal segment of the jejunum. The bowel wall was normal in non-enhanced images, and normal or inconspicuous in arterial phase enhanced images. In one of the three cases, the bowel wall...

  19. The role of fecal calprotectin in investigating inflammatory bowel diseases

    OpenAIRE

    Mustafa Erbayrak; Cansel Turkay; Elife Eraslan; Hulya Cetinkaya; Benan Kasapoglu; Mehmet Bektas

    2009-01-01

    INTRODUCTION: Invasive and non-invasive tests can be used to evaluate the activity of inflammatory bowel diseases. OBJECTIVE: The aim of the present study was to investigate the role of fecal calprotectin in evaluating inflammatory bowel disease activity and the correlation of fecal calprotectin with the erythrocyte sedimentation rate and C reactive protein values in inflammatory bowel disease. METHOD: Sixty-five patients affected with inflammatory bowel disease were enrolled. Twenty outpatie...

  20. Cannabis for inflammatory bowel disease.

    Science.gov (United States)

    Naftali, Timna; Mechulam, Raphael; Lev, Lihi Bar; Konikoff, Fred M

    2014-01-01

    The marijuana plant Cannabis sativa has been used for centuries as a treatment for a variety of ailments. It contains over 60 different cannabinoid compounds. Studies have revealed that the endocannabinoid system is involved in almost all major immune events. Cannabinoids may, therefore, be beneficial in inflammatory disorders. In murine colitis, cannabinoids decrease histologic and microscopic inflammation. In humans, cannabis has been used to treat a plethora of gastrointestinal problems, including anorexia, emesis, abdominal pain, diarrhea, and diabetic gastroparesis. Despite anecdotal reports on medical cannabis in inflammatory bowel disease (IBD), there are few controlled studies. In an observational study in 30 patients with Crohn's disease (CD), we found that medical cannabis was associated with improvement in disease activity and reduction in the use of other medications. In a more recent placebo-controlled study in 21 chronic CD patients, we showed a decrease in the CD activity index >100 in 10 of 11 subjects on cannabis compared to 4 of 10 on placebo. Complete remission was achieved in 5 of 11 subjects in the cannabis group and 1 of 10 in the placebo group. Yet, in an additional study, low-dose cannabidiol did not have an effect on CD activity. In summary, evidence is gathering that manipulating the endocannabinoid system can have beneficial effects in IBD, but further research is required to declare cannabinoids a medicine. We need to establish the specific cannabinoids, as well as appropriate medical conditions, optimal dose, and mode of administration, to maximize the beneficial effects while avoiding any potential harmful effects of cannabinoid use. PMID:24969296

  1. Small Bowel Obstruction due to Intestinal Xanthomatosis

    Directory of Open Access Journals (Sweden)

    L. E. Barrera-Herrera

    2015-01-01

    Full Text Available Vast majority of bowel obstruction is due to postoperative adhesions, malignancy, intestinal inflammatory disease, and hernias; however, knowledge of other uncommon causes is critical to establish a prompt treatment and decrease mortality. Xanthomatosis is produced by accumulation of cholesterol-rich foamy macrophages. Intestinal xanthomatosis is an uncommon nonneoplastic lesion that may cause small bowel obstruction and several cases have been reported in the English literature as obstruction in the jejunum. We report a case of small intestinal xanthomatosis occurring in a 51-year-old female who presented with one day of copious vomiting and intermittent abdominal pain. Radiologic images revealed jejunal loop thickening and inflammatory changes suggestive of foreign body obstruction, diagnostic laparoscopy found two strictures at the jejunum, and a pathologic examination confirmed a segmental small bowel xanthomatosis. This case illustrates that obstruction even without predisposing factors such as hyperlipidemia or lymphoproliferative disorders.

  2. Arteriovenous Malformation Detected by Small Bowel Endoscopy

    Directory of Open Access Journals (Sweden)

    Takaaki Fujii

    2014-10-01

    Full Text Available Gastrointestinal bleeding that originates in the small intestine is often difficult to diagnose. When successful diagnosis reveals a lesion that can be localized preoperatively, the laparoscopic approach is an appropriate and beneficial treatment modality for small bowel resection. A 69-year-old man presented with a 6-month history of gastrointestinal bleeding and symptomatic transfusion-dependent anemia. Upper and lower endoscopy were normal. Double-balloon endoscopy established the source of the bleeding as a 0.5-cm polypoid mass appearing as a submucosal tumor with redness and pulsation in the lower ileum, suggesting a vascular lesion. Laparoscopic small bowel resection was successful in removing the mass in the ileum. Histological evaluation of the mass revealed an arteriovenous malformation. Preoperative small bowel endoscopy can be useful for diagnosing the cause and localization of arteriovenous malformation in the small intestine.

  3. Confocal Laser Endomicroscopy in Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Rasmussen, Ditlev Nytoft; Karstensen, John Gásdal; Riis, Lene Buhl;

    2015-01-01

    of confocal laser endomicroscopy for inflammatory bowel disease. METHODS: Available literature was searched systematically for studies applying confocal laser endomicroscopy in Crohn's disease or ulcerative colitis. Relevant literature was reviewed and only studies reporting original clinical data were...... included. Next, eligible studies were analysed with respect to several parameters, such as technique and clinical aim and definitions of outcomes. RESULTS: Confocal laser endomicroscopy has been used for a wide range of purposes in inflammatory bowel disease, covering assessment of inflammatory severity...... of histological features such as colonic crypts, epithelial gaps and epithelial leakiness to fluorescein. CONCLUSIONS: Confocal laser endomicroscopy remains an experimental but emerging tool for assessment of inflammatory bowel disease. It is the only method that enables in vivo functional assessment...

  4. Colonic stenting as a bridge to surgery in malignant large-bowel obstruction: a report from two large multinational registries

    DEFF Research Database (Denmark)

    Jiménez-Pérez, J; Casellas, J; García-Cano, J;

    2011-01-01

    To date, this is the largest prospective series in patients with malignant colorectal obstruction to evaluate the effectiveness and safety of colonic self-expanding metal stents (SEMSs) as an alternative to emergency surgery. SEMSs allow restoration of bowel transit and careful tumor staging...... in preparation for elective surgery, hence avoiding the high morbidity and mortality associated with emergency surgery and stoma creation....

  5. Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE)

    DEFF Research Database (Denmark)

    Peyrin-Biroulet, L; Sandborn, W; Sands, B E;

    2015-01-01

    OBJECTIVES: The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) program was initiated by the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD). It examined potential treatment targets for inflammatory bowel disease (IBD) to be used for a "treat-t...

  6. Small Bowel Obstruction Due to Suprapubic Catheter Placement

    OpenAIRE

    Bonasso, Patrick C.; Brandon Lucke-Wold; Uzer Khan

    2016-01-01

    Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection.

  7. Small Bowel Obstruction Due to Suprapubic Catheter Placement

    Directory of Open Access Journals (Sweden)

    Patrick C. Bonasso

    2016-07-01

    Full Text Available Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection.

  8. Small Bowel Obstruction Due to Suprapubic Catheter Placement.

    Science.gov (United States)

    Bonasso, Patrick C; Lucke-Wold, Brandon; Khan, Uzer

    2016-07-01

    Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection. PMID:27335801

  9. Delayed bowel perforation following suprapubic catheter insertion

    Directory of Open Access Journals (Sweden)

    Mehta Ajay

    2004-12-01

    Full Text Available Abstract Background Complications of suprapubic catheter insertion are rare but can be significant. We describe an unusual complication of a delayed bowel perforation following suprapubic catheter insertion. Case presentation A gentleman presented with features of peritonitis and feculent discharge along a suprapubic catheter two months after insertion of the catheter. Conclusion Bowel perforation is the most feared complication of suprapubic catheter insertion especially in patients with lower abdominal scar. The risk may be reduced with the use of ultrasound scan guidance.

  10. Case report: Congenital short bowel syndrome

    Directory of Open Access Journals (Sweden)

    Palle Lalitha

    2010-01-01

    Full Text Available Congenital short bowel syndrome (SBS is a relatively rare condition as compared to acquired SBS. It is associated with significant mortality and morbidity. Infants usually present with failure to thrive, recurrent vomiting, and diarrhea. It is important to suspect and diagnose this condition promptly, as early initiation of parenteral nutrition or surgery, if necessary, may result in a favorable outcome. We discuss a case of an infant aged 26 days, who presented with failure to thrive, recurrent vomiting, and weight loss. A contrast study of the gastrointestinal tract revealed a short small bowel, with malrotation. The infant was started on parenteral nutrition, but succumbed shortly thereafter to severe disseminated sepsis.

  11. Evaluation of the effects of oral water and low-density barium sulphate suspension on bowel appearance on FDG-PET/CT

    International Nuclear Information System (INIS)

    The purpose of this study is to assess which of five bowel preparation regimes offers superior bowel distension and to assess if these regimes adversely affect FDG activity on PET/CT imaging. The study conformed to HIPAA regulations. Ninety patients were divided into five groups of 18 who received no oral contrast agent (group A); 900 ml of water orally (group B); or 900, 1,350, or 1,800 ml of LDB (groups C, D, E, respectively). PET/CT examinations were assessed quantitatively (bowel diameter, SUV) and qualitatively (visual assessment grading scale) for bowel distension and FDG activity by two blinded readers. ANOVA was utilized to determine if a statistically significant difference (SSD) existed between the groups in terms of distension and FDG uptake. Qualitatively superior bowel distension was observed in group C (LDB) compared to B (water) and greater distension was noted with increased volumes of LDB in C, D, and E. Quantitatively there was an SSD in mean distension between groups C and B (P 0.05). LDB as an oral contrast agent provides superior bowel distension over water and does not induce increased FDG bowel activity. (orig.)

  12. Endoscopic Evaluation of Surgically Altered Bowel in Patients with Inflammatory Bowel Diseases

    OpenAIRE

    Sinh, Preetika; Shen, Bo

    2015-01-01

    Abstract: Patients with inflammatory bowel diseases often undergo surgical procedures for medically refractory disease or colitis associated dysplasia. Endoscopic evaluation of the surgically altered bowel is often needed to assess for disease recurrence, its severity, and for therapy. It is important to obtain and review the operative report and abdominal imaging before performing the endoscopy. Diagnostic and therapeutic endoscopy can be safely performed in most patients with inflammatory b...

  13. ARMA-based spectral bandwidth for evaluation of bowel motility by the analysis of bowel sounds

    International Nuclear Information System (INIS)

    Approximately 10%–20% of adults and adolescents suffer from irritable bowel syndrome (IBS) worldwide. IBS is characterized by chronic gastrointestinal dysfunction which may reflect in altered motility. Currently, the diagnosis of IBS is made through expensive invasive radiographic and endoscopic examinations. However these are inconvenient and unsuited for community screening. Bowel sounds (BSs) can be easily recorded with non-invasive and low-cost equipment. Recently, several researchers have pointed out changes in features obtained from BS according to the pathological condition of bowel motility. However a widely accepted, simple automatic BS detection algorithm still has to be found, and the appropriate recording period needs to be investigated for further evaluation of bowel motility. In this study we propose a novel simple automatic method to detect the BSs based on the 3 dB bandwidth of the frequency peaks in the autoregressive moving average spectrum. We use the measure, sound-to-sound interval (SSI) obtained by the proposed method, to capture bowel motility. In this paper, we show that the proposed method for automatic detection could achieve a sensitivity of 87.8±5.88%, specificity of 91.7±4.33% and area under the curve of 0.923 when working on 16 healthy volunteers during mosapride administrations. Furthermore, we show that the measured SSI averaged over a period of 30 min can clearly capture bowel motility. Our findings should have the potential to contribute toward developing automated BS-based diagnosis of IBS. (paper)

  14. Analysis of bowel perforation in necrotizing enterocolitis

    Energy Technology Data Exchange (ETDEWEB)

    Frey, E.E.; Smith, W.; Franken, E.A. Jr.; Wintermeyer, K.A.

    1987-07-01

    The most severe complication of necrotizing enterocolitis (NEC) is bowel perforation. Identification of neonates at high risk for perforation and optimization of radiologic imaging to identify bowel perforation are necessary to reduce the high mortality rate associated with this catastrophic event. One hundred 55 cases of NEC were seen at our institution during a 5.5 year period. Nineteen (12%) progressed to perforation. A review of surgical findings, autopsy results and radiographs from these patients shows only 63% had radiographic evidence of free air in the peritoneal cavity at the time of perforation. Twenty-one percent had radiographic evidence of ascites but no pneumoperitoneum, and 16 percent had neither free air nor ascites. Thus purely radiographic criteria for bowel perforation in NEC are imprecise, and paracentesis is mandatory in NEC patients with ascites or clinical findings indicative of peritonitis. Timing of radiographic studies and site of bowel involvement are also important. Seventy-nine percent of perforations occurred by 30 h from confirmation of diagnosis (by clinical or radiographic criteria). Surgery or autopsy revealed involvement of the ileo-cecal region in 89% of cases with the actual site of perforation occurring in this area in 58% of patients.

  15. New pharmaceuticals in inflammatory bowel disease

    OpenAIRE

    Łodyga, Michał; Eder, Piotr; Bartnik, Witold; Gonciarz, Maciej; Kłopocka, Maria; Linke, Krzysztof; Małecka-Panas, Ewa; Radwan, Piotr; Rydzewska, Grażyna

    2015-01-01

    This paper complements the previously published Guidelines of the Working Group of the Polish Society of Gastroenterology and former National Consultant in Gastroenterology regarding the management of patients with Crohn's disease and ulcerative colitis. Attention was focused on the new pharmaceutical recently registered for inflammatory bowel disease treatment.

  16. Inflammatory Bowel Disease. Medical and psychological aspects

    NARCIS (Netherlands)

    Albersnagel, Frans; Dijkstra, Gerard

    2007-01-01

    A review is presented in which the state of the art of behavioural-scientific research on inflammatory bowel disease (BID) is sorted out. After a short introduction on medical aspects of the two diseases that constitute IBD, i.e. Crohn's disease and ulcerative colitis, the factors that may have an i

  17. Management of inflammatory bowel disease in pregnancy

    NARCIS (Netherlands)

    S. Vermeire (Silvio); F. Carbonnel (Franck); P.G. Coulie (Pierre); V. Geenen (Vincent); J.M.W. Hazes (Mieke); P.L. Masson (Pierre); F. de Keyser (Filip); E. Louis (Edouard)

    2012-01-01

    textabstractBackground and Aims: Inflammatory bowel disease (IBD) is a chronic disease affecting mainly young people in their reproductive years. IBD therefore has a major impact on patients' family planning decisions. Management of IBD in pregnancy requires a challenging balance between optimal dis

  18. Neuropeptide receptor expression in inflammatory bowel disease

    NARCIS (Netherlands)

    Beek, Willy Pascale ter

    2008-01-01

    Inflammatory bowel disease (IBD), i.e. Crohn’s disease and ulcerative colitis are characterized by a chronic inflammation of the gastrointestinal tract. Neuropeptides are involved in the regulation of intestinal motility, chloride secretion and inflammatory response, three processes that are disturb

  19. Recovery After Stroke: Bladder and Bowel Function

    Science.gov (United States)

    ... effects from prescription drugs.  Being unaware that you need to use the bathroom.  Weakness in the muscle that holds a bowel ... toilet  Occupational therapists can help if your home needs to be ... issues. They can with grants to adapt the bathroom or to build a new one, and can ...

  20. Inflammatory Bowel Disease and Cervical Neoplasia

    DEFF Research Database (Denmark)

    Rungoe, Christine; Simonsen, Jacob; Riis, Lene;

    2015-01-01

    BACKGROUND & AIMS: We examined the risk of cervical neoplasia (dysplasia or cancer) in women with ulcerative colitis (UC) or Crohn's disease (CD). We also calculated the reverse, the risk for diagnosis with cervical neoplasia before development of inflammatory bowel disease (IBD). METHODS: We...

  1. Clostridium difficile and pediatric inflammatory bowel disease

    DEFF Research Database (Denmark)

    Martinelli, Massimo; Strisciuglio, Caterina; Veres, Gabor;

    2014-01-01

    BACKGROUND: Clostridium difficile infection is associated with pediatric inflammatory bowel disease (IBD) in several ways. We sought to investigate C. difficile infection in pediatric patients with IBD in comparison with a group of children with celiac disease and to evaluate IBD disease course...

  2. Familial risk of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Trier Møller, Frederik; Andersen, Vibeke; Jess, Tine;

    2014-01-01

    Background The inflammatory bowel diseases (IBD) – ulcerative colitis (UC) and Crohn’s disease (CD) - are caused by complex gene-environment interactions. This study provides updated familial aggregation patterns in a large population-based Danish IBD cohort. Methods: Our cohort study was based...

  3. Nuclear medicine imaging of inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Froelich, J.W.

    1987-01-01

    With the availability of indium-labeled white blood cells, radionuclide imaging studies have a definite role in the diagnosis and staging of patients with inflammatory bowel disease. The In-/sup 111/ white blood cell study is particularly helpful in evaluating recurrent disease in patients with severe intercurrent diseases and in screening patients without the need for barium examinations.

  4. Current treatment for inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Chang-tai Xu; Xiue-gan Guo; Bo-rong Pan

    2003-01-01

    @@Introduction Idiopathic inflammatory bowel disease consists of Crohn's disease (CD) and ulcerative colitis (UC). CD can affect any part of the gastrointestinal tract, from the mouth to the anus, and is also known as regional enteritis, terminal ileitis, or granulomatous……

  5. Inflammatory Bowel Disease: School Nurse Management

    Science.gov (United States)

    Kitto, Lisa

    2010-01-01

    Initial symptoms and diagnosis of inflammatory bowel disease (IBD) usually occur between 10 and 20 years of age, although younger cases are reported. The complicated nature of IBD diagnosis and treatment can interfere with physical and emotional development that normally occurs in school-age children and adolescents. The school nurse should be…

  6. A rare cause of small bowel infarction

    OpenAIRE

    Lim, L.; Collier, K; Harland, R; Temperley, D

    2011-01-01

    We report a rare case of small bowel infarction due to superior mesenteric artery occlusion secondary to cardiac tumour embolism. To our knowledge, this has not been previously reported in the literature. This case highlights a rare case and reviews current knowledge on the subject.

  7. Stem cell therapy for inflammatory bowel disease

    NARCIS (Netherlands)

    Duijvestein, Marjolijn

    2012-01-01

    Hematopoietic stem cell transplantation (HSCT) and mesenchymal stromal (MSC) cell therapy are currently under investigation as novel therapies for inflammatory bowel diseases (IBD). Hematopoietic stem cells are thought to repopulate the immune system and reset the immunological response to luminal a

  8. Environmental factors in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Hansen, Tanja Stenbaek; Jess, Tine; Vind, Ida;

    2011-01-01

    The role of environmental factors in development of inflammatory bowel disease (IBD) remains uncertain. The aim of the present study was to assess a number of formerly suggested environmental factors in a case-control study of an unselected and recently diagnosed group of patients with IBD...

  9. Microbiota biodiversity in inflammatory bowel disease

    OpenAIRE

    Comito, Donatella; Cascio, Antonio; Romano, Claudio

    2014-01-01

    Gut microbiota plays a significant role in human health and energy balance, and provides protection against disease states. An altered balance between microbiota and its host (dysbiosis) would appear to contribute to the development of Inflammatory Bowel Disease (IBD), Crohn’s Disease (CD) and Ulcerative Colitis (UC). CD and UC are chronic inflammatory diseases of the gastrointestinal tes.

  10. Intestinal preparation prior to capsule endoscopy administration

    Institute of Scientific and Technical Information of China (English)

    Vicente Pons Beltrán; Cristina Carretero; Bego(n)a Gonzalez-Suárez; I(n)aqui Fernández-Urien; Miguel Mu(n)oz Navas

    2008-01-01

    In order to have an adequate view of the whole small intestine during capsule endoscopy,the preparation recommended consists of a clear liquid diet and an overnight fast.However,visualization of the small bowel during video capsule endoscopy can be impaired by intestinal contents.To improve mucosal visualization,some authors have evaluated different regimens of preparation.There is no consensus about the necessity of intestinal preparation for capsule endoscopy and it should be interesting to develop adequate guidelines to improve its efficacy and tolerability.Moreover,the effect of preparation type (purgative) on intestinal transit time is not clear.Since a bowel preparation cannot definitively improve its visibility (and theoretically the yield of the test),it is not routinely recommended.

  11. [Irritable Bowel Syndrome treatment: a multidisciplinary approach].

    Science.gov (United States)

    Shani-Zur, Dana; Wolkomir, Keren

    2015-01-01

    Irritable Bowel Syndrome affects 9-23% of the general population. This diagnosis contributes to more frequent doctor visits and multiple consultations by patients. The current approach to treating IBS is symptomatic and consists of a regimen of first line pharmacological treatment options; the use of anti-depressant drugs is also common. The efficiency of complementary medicine in the treatment of IBS has been studied in the last few years. Qualitative multidisciplinary approach studies, using personalized medicines with complementary therapies are needed. We present the case of a 39-year-old woman with a diagnosis of IBS since 2009, who complained about gastrointestinal symptoms since the age of 13 and severe episodes of spasmodic stomach aches in the last year self-ranked as 10, on a 0-10 scale; 3-4 episodes a month, which last for 5 days, accompanied by severe flatulence and bloating. In addition, she has constipation (one bowel movement every 10 days), alternating with multiple diarrheic bowel movements (6 times a day). Using a multidisciplinary approach, including medicinal care, Chinese medicine, reflexology and naturopathy resulted in significant improvement in symptoms and quality of life, as well as gradual reduction of drugs, approved by her physician. Stomach ache self-ranked now as 1, on a 0-10 scale; and flatulence and bloating self-ranked as mild. Bowel movement frequency increased and is now every other day. She no longer has diarrheic and/or multiple bowel movements. This case report emphasizes the importance of integrative treatment in IBS and its benefit in improving patients' quality of life.

  12. 复方聚乙二醇电解质散在小儿结肠造口关闭手术前肠道准备中的应用%Application of polyethylene glycol electrolyte powder compound for pediatric bowel preparation before colostomy closure

    Institute of Scientific and Technical Information of China (English)

    邝云莎; 刘艳青; 刘秋菊

    2015-01-01

    Objective:To observe the effect of peros polyethylene glycol electrolyte powder compound for pediatric bowel preparation before colostomy clo-sure. Methods:60 cases before colostomy closure were randomly divided into control group and experimental group. The experimental group drunk the solu-tion 6 hours before the operation,while the control group got two times of intestinal lavage (12 hours and 1 hour before the operation) from the near - end of the colostomy mouth. Compared the cleanliness of the near - end of the colostomy mouth, obedience and untoward effect. Results:The experimental group got much better cleanliness (P < 0. 05) and further obedience (P < 0. 05) than control group. The experimental group came out 4 cases of oral difficulty, control group. With 11 cases of acute crying and action,among 11 cases,there were 3 cases of mucosal injury,1 case of operation delaying,1 case of emesis. Conclusion:The effect and obedience of drinking the solution before colostomy closure is satisfactory. However,minority got untoward effect such as oral diffi-culty,emesis. It is still need futher study.%目的::探讨复方聚乙二醇电解质散在小儿结肠造口关闭手术前肠道准备中的应用效果。方法:将60例结肠造口术后拟行造口关闭手术的患儿随机等分为试验组和对照组,试验组采用术晨(术前6 h)口服复方聚乙二醇电解质散溶液的方法进行肠道准备,对照组采用术前晚(术前12 h)、术晨(术前1~2 h)自结肠造口近端各回流洗肠1次的方法进行肠道准备,比较两组患儿造口近端肠道清洁度、依从性及不良反应发生情况。结果:试验组造口近端肠道清洁度明显优于对照组(P <0.05),依从性高于对照组(P <0.05)。试验组出现口服困难4例,其中2例出现恶心、呕吐;对照组出现剧烈哭闹、活动11例,其中因剧烈哭闹导致造口近端黏膜损伤出血3例,延期手术1例(大量

  13. Use of biosimilars in inflammatory bowel disease: Statements of the Italian Group for Inflammatory Bowel Disease.

    Science.gov (United States)

    Annese, Vito; Vecchi, Maurizio

    2014-11-01

    The introduction of biological therapies, particularly anti-TNFα agents, has revolutionized the management of inflammatory bowel disease in those cases which are refractory to conventional treatment; however these drugs are not risk-free and their use has substantially increased the cost of treatment. As marketing protection expires for original, first-generation biopharmaceuticals, lower-cost "copies" of these drugs produced by competitor companies-referred to as biosimilars-are already entering the market. In September 2013, the European Medicines Agency approved two infliximab biosimilars for treatment of adult and paediatric inflammatory bowel disease patients, a decision based largely on efficacy and safety data generated in studies of patients with ankylosing spondylitis and rheumatoid arthritis. For many clinicians, extrapolation practices and the general question of interchangeability between biosimilars and reference biologics are cause for concern. In the present paper, the Italian Group for inflammatory bowel disease presents its statements on these issues, with emphasis on the peculiar clinical characteristics of inflammatory bowel disease and the importance of providing physicians and patients with adequate information and guarantees on the safety and efficacy of these new drugs in the specific setting of inflammatory bowel disease.

  14. Use of biosimilars in inflammatory bowel disease: Statements of the Italian Group for Inflammatory Bowel Disease.

    Science.gov (United States)

    Annese, Vito; Vecchi, Maurizio

    2014-11-01

    The introduction of biological therapies, particularly anti-TNFα agents, has revolutionized the management of inflammatory bowel disease in those cases which are refractory to conventional treatment; however these drugs are not risk-free and their use has substantially increased the cost of treatment. As marketing protection expires for original, first-generation biopharmaceuticals, lower-cost "copies" of these drugs produced by competitor companies-referred to as biosimilars-are already entering the market. In September 2013, the European Medicines Agency approved two infliximab biosimilars for treatment of adult and paediatric inflammatory bowel disease patients, a decision based largely on efficacy and safety data generated in studies of patients with ankylosing spondylitis and rheumatoid arthritis. For many clinicians, extrapolation practices and the general question of interchangeability between biosimilars and reference biologics are cause for concern. In the present paper, the Italian Group for inflammatory bowel disease presents its statements on these issues, with emphasis on the peculiar clinical characteristics of inflammatory bowel disease and the importance of providing physicians and patients with adequate information and guarantees on the safety and efficacy of these new drugs in the specific setting of inflammatory bowel disease. PMID:25139379

  15. Enhanced Diagnostic Yield with Prolonged Small Bowel Transit Time during Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Jonathan M. Buscaglia, Sumit Kapoor, John O. Clarke, Juan Carlos Bucobo, Samuel A. Giday, Priscilla Magno, Elaine Yong, Gerard E. Mullin

    2008-01-01

    Full Text Available Background: The effect of small bowel transit time (SBTT on diagnostic yield during capsule endoscopy (CE has not been previously evaluated. Our study aim was to assess the effect of SBTT on the likelihood of detecting intestinal pathology during CE. Methods: We reviewed collected data on CE studies performed at Johns Hopkins Hospital from January 2006 to June 2007. In patients investigated for anemia or obscure bleeding, the following lesions were considered relevant: ulcers, erosions, AVMs, red spots, varices, vascular ectasias, and presence of blood. In patients with diarrhea or abdominal pain, ulcers, erosions, and blood were considered relevant. Age, gender, study indication, hospital status, and quality of bowel preparation were identified as candidate risk factors affecting SBTT. Univariate logistic and linear regression analyses were performed to study the effect of SBTT on diagnostic yield. Results: Total of 212 CE studies were analyzed; most were in outpatients (n=175, 82.9% and with excellent bowel preparation (n=177, 83.5%. Mean SBTT was 237.0min (3.9hrs. Age, gender, bowel prep, hospital status, and study indication did not significantly affect SBTT. However, increased SBTT was independently associated with increased diagnostic yield; OR=1.7 in SBTT=2-4hr (p=0.41, OR=1.8 in SBTT=4-6hrs (p=0.30, OR=9.6 in SBTT=6-8hrs (p=0.05. Conclusion: Prolonged SBTT during CE (>6 hr is associated with an increased diagnostic yield. This may be due to a positive effect on image quality during a “slower” study. The use of promotility agents may adversely affect the ability of CE to detect significant intestinal pathology.

  16. Leukocyte migration in experimental inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    E. P. Van Rees

    1997-01-01

    Full Text Available Emigration of leukocytes from the circulation into tissue by transendothelial migration, is mediated subsequently by adhesion molecules such as selectins, chemokines and integrins. This multistep paradigm, with multiple molecular choices at each step, provides a diversity in signals. The influx of neutrophils, monocytes and lymphocytes into inflamed tissue is important in the pathogenesis of chronic inflammatory bowel disease. The importance of each of these groups of adhesion molecules in chronic inflammatory bowel disease, either in human disease or in animal models, will be discussed below. Furthermore, the possibilities of blocking these different steps in the process of leukocyte extravasation in an attempt to prevent further tissue damage, will be taken into account.

  17. [SHORT BOWEL SYNDROME AND NUTRITIONAL ENTERAL].

    Science.gov (United States)

    Ariadel Cobo, Diana; Pereira Cunill, José Luis; Socas Macías, María; Serrano Aguayo, Pilar; Gómez Liébana, Eulalia; Morales Conde, Salvador; García Luna, Pedro Pablo

    2015-12-01

    The particularity of this case is the nutritional management that has managed to avoid the use of prolonged parenteral nutrition and possible complications by placing jejunal tube at the distal end in patients with short bowel. It is a 34-year-old colecistectomizado complicated with postoperative peritonitis and dehiscence; two years he studied with small bowel obstruction, he was made de-volvulus and was complicated with two leak at different times after the second escape took place jejunostomy side double barreled shotgun level dehiscence, presented high debits by afferent loop of the terminal jejunostomy; during admission, polyurethane probe enteral feeding was inserted by the efferent loop jejunostomy. He received jejunal tube feeding laundry in the efferent loop terminal with decreased weight gain and subsequent reconstruction of intestinal transit debit proximal jejunostomy.

  18. Liver Disorders in Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Victor Uko

    2012-01-01

    Full Text Available Disorders of the hepatobiliary system are relatively common extraintestinal manifestations of inflammatory bowel disease (IBD. These disorders are sometimes due to a shared pathogenesis with IBD as seen in primary sclerosing cholangitis (PSC and small-duct primary sclerosing cholangitis (small-duct PSC. There are also hepatobiliary manifestations such as cholelithiasis and portal vein thrombosis that occur due to the effects of chronic inflammation and the severity of bowel disease. Lastly, medications used in IBD such as sulfasalazine, thiopurines, and methotrexate can adversely affect the liver. It is important to be cognizant of these disorders as some do have serious long-term consequences. The management of these disorders often requires the expertise of multidisciplinary teams to achieve the best outcomes.

  19. NATURAL AGENTS FOR INFLAMMATORY BOWEL DISEASE

    Directory of Open Access Journals (Sweden)

    Darji Vinay Chhanalal

    2011-02-01

    Full Text Available Inflammatory bowel disease (IBD is a chronic inflammatory disease of gastrointestinal tract. It comprises the two conditions, Crohn’s disease and ulcerative colitis, characterized by chronic recurrent ulceration of the bowel. Conventional drugs for colitis treatment include aminosalicylate, corticosteroids,antibiotics & immunomodulators. 5- Amino salicylic acid having side effects in 30% of the patients. Systemic corticosteroids producing incidence of complication is 4.3%. Antibiotic therapy is beneficial in 70% of the patients & Immunomodulators having 50 to 70% beneficial effects. This report shows that there is no any appropriate treatment available to treat IBD without side effects. A natural agent with reduced or no toxicity is therefore essential. In nature there are so many types of natural agents which are used as protective agents in IBD. This article emphasizes many natural products obtained from plant & other sources, which possess potent activity against experimentally induced IBD.

  20. Diagnosis and treatment of irritable bowel syndrome.

    Science.gov (United States)

    Dalton, C B; Drossman, D A

    1998-07-01

    Irritable bowel syndrome (IBS) is a common medical disorder characterized by symptoms of abdominal pain and bowel dysfunction. It is associated with significant disability and health care costs. A practical approach to diagnosis is the symptom-based Rome criteria. Management of patients has been helped by recent findings relating to the epidemiology, pathophysiology and psychosocial contributions of the disorder. Dysregulation of intestinal motor, sensory and central nervous system function is currently believed to be the basis for IBS symptoms. Symptoms are due to both abnormal intestinal motility and enhanced visceral sensitivity. Psychosocial factors are not a cause but can affect the illness experience and clinical outcome. Finally, treatment involves an effective physician-patient relationship and an integrated pharmacologic and behavioral approach that is determined by the needs of the patient, the type and severity of the symptoms and the degree of disability. PMID:14988758

  1. Imaging of inflammatory bowel disease. How?

    Energy Technology Data Exchange (ETDEWEB)

    Hiorns, Melanie P. [Great Ormond Street Hospital for Children, Radiology Department, London (United Kingdom)

    2008-06-15

    Traditionally the small bowel (barium) follow through (SBFT) has been the investigation of choice for that otherwise inaccessible length of gut between the duodenum and the ileocaecal valve. Whilst it is still a widely practised examination by radiologists it is being largely overtaken by other imaging modalities with CT, MRI and capsule endoscopy (CE) all competing for the territory. At the end of the last century, proponents of enteroclysis were predicting the eventual decline of the SBFT (in adults) although at that stage, in a 'state of the art' article, they were still brave enough to say that 'only in the small bowel does barium radiography remain unchallenged'. The same authors now write of how radiological investigations complement other techniques but are no longer the mainstay. (orig.)

  2. Current medical therapy of inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Kiron M. Das; Sherif A. Farag

    2000-01-01

    The current established drugs used to treat inflammatory bowel disease include glucocorticoids includingnewer agent budesonide, sulfasalazine and 5-ASA compounds such as Asacol, Pentasa, Dipentum andBalsalazide and immunomodulatory agents such as azathioprine, and 6-mercaptopurine. Additional drugswhich have been found to be useful, particularly in refractory cases of Crohn's disease including fistulizingtype of Crohn's disease, include cyclosporine A, methotrexate, humanized antibody against TNFa(cA2),FK506, IL-10, IL-11 and Probiotics. Various agents, whether used alone or in combination, have to betailored for each patient and none is ideal. Exciting new developments directed against proinflammatorypathways, cytokines, free oxygen radicals and cell surface related immune targets are areas of intense recentinvestigations and many novel therapeutic agents are expected to be available in the near future for medicaltreatment of inflammatory bowel disease.

  3. Persistent omphalomesenteric duct causing small bowel obstruction in an adult

    Institute of Scientific and Technical Information of China (English)

    Haridimos Markogiannakis; Dimitrios Theodorou; Konstantinos G Toutouzas; Panagiotis Drimousis; Sotirios Georgios Panoussopoulos; Stilianos Katsaragakis

    2007-01-01

    An extremely rare case of persistent omphalomesenteric duct causing small bowel obstruction is presented. A 20-year-old female patient without medical history presented with colicky abdominal pain, vomiting, absence of passage of gas and feces, and abdominal distension of 24 h duration. Physical examination and blood tests were normal. Abdominal X-ray showed small bowel obstruction.Computed tomography of the abdomen demonstrated dilated small bowel and a band originating from the umbilicus and continuing between the small bowel loops;an omphalomesenteric duct remnant was suspected. In exploratory laparotomy, persistent omphalomesenteric duct causing small bowel obstruction was identified and resected. The patient had an uneventful recovery and was discharged on the 5th postoperative day. Although persistent omphalomesenteric duct is an extremely infrequent cause of small bowel obstruction in adult patients, it should be taken into consideration in patients without any previous surgical history.

  4. The prevention of radiation-induced small bowel complications

    Energy Technology Data Exchange (ETDEWEB)

    Letschert, J.G.J. [Amsterdam Univ. (Netherlands). Academisch Ziekenhuis

    1995-07-01

    Moderate dose pelvic radiotherapy is associated with a 5% severe complication risk related to the small bowel. Strictures and/or fistulation can occur many years after treatment. These complications are difficult to treat, and surgical treatment (excision, bypass) bears a significant morbidity risk. The risk of chronic diarrhoea or malabsorption may increase to 40%, depending on the irradiated small bowel volume. Late small bowel complications are generally irreversible due to vascular aetiology. Prevention of these complications can be achieved by limiting the volume of small bowel treated. Consequence for radiotherapeutic techniques in treatment for rectal cancer are multiple beam set-up, customised blocking based on visualisation of the small bowel in the treatment position, and the use of a special open table-top device that results in a small bowel shift from the treatment field. (author).

  5. Case report: Congenital short bowel syndrome

    OpenAIRE

    Palle Lalitha; Reddy Balaji

    2010-01-01

    Congenital short bowel syndrome (SBS) is a relatively rare condition as compared to acquired SBS. It is associated with significant mortality and morbidity. Infants usually present with failure to thrive, recurrent vomiting, and diarrhea. It is important to suspect and diagnose this condition promptly, as early initiation of parenteral nutrition or surgery, if necessary, may result in a favorable outcome. We discuss a case of an infant aged 26 days, who presented with failure to thrive, recur...

  6. Gas Embolic Stroke Secondary to Bowel Infarction.

    Science.gov (United States)

    Parikh, Dhruv; Leyon, Joe Joseph; Chavda, Swarupsinh

    2016-01-01

    A 69-year-old gentleman with metastatic esophageal adenocarcinoma presented with acute abdominal pain to the emergency medicine department and subsequently developed an acute left hemiplegia while in the resuscitation unit. An unenhanced computed tomography (CT) scan of the head showed right frontal cerebral gas emboli while an unenhanced CT scan of the abdomen and pelvis showed extensive portal venous gas and pneumatosis intestinalis, presumed secondary to bowel infarction.

  7. Environmental Risk Factors for Inflammatory Bowel Disease

    OpenAIRE

    Natalie A Molodecky; Gilaad G. Kaplan

    2010-01-01

    Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract and is associated with significant morbidity. The etiology of IBD has been extensively studied during the last several decades; however, causative factors in disease pathology are not yet fully understood. IBD is thought to result from the interaction between genetic and environmental factors that influence the normal intestinal commensal flora to trigger an inappropriate mucosal immune res...

  8. Recent advances in small bowel diseases: PartⅡ

    Institute of Scientific and Technical Information of China (English)

    Alan BR Thomson; Angeli Chopra; Michael Tom Clandinin; Hugh Freeman

    2012-01-01

    As is the case in all areas of gastroenterology and hepatology,in 2009 and 2010 there were many advances in our knowledge and understanding of small intestinal diseases.Over 1000 publications were reviewed,and the important advances in basic science as well as clinical applications were considered.In Part Ⅱ we review six topics:absorption,short bowel syndrome,smooth muscle function and intestinal motility,tumors,diagnostic imaging,and cystic fibrosis.

  9. Arthritic manifestations of inflammatory bowel disease.

    OpenAIRE

    Suh, C. H.; Lee, C H; Lee, J.; Song, C. H.; Lee, C.W.; Kim, W. H.; S.K. Lee

    1998-01-01

    Inflammatory bowel disease (IBD) is commonly associated with arthritic manifestations. They are divided into three clinical categories; peripheral arthritis, spondylitis, and sacroiliitis. To evaluate the incidence of arthritis associated with IBD in Korea, we retrospectively reviewed one hundred and twenty-nine patients with IBD, 77 with ulcerative colitis (UC) and 52 with Crohn's disease (CD). Arthritis occurred in twenty-two patients (17.1%); 15 with UC(19.6%), 7 with CD (13.5%). Patients ...

  10. [Chronic inflammatory bowel diseases in cats].

    Science.gov (United States)

    Ghermai, A K

    1989-01-01

    The aetiology of chronic idiopathic intestinal inflammation is unknown. It is characterized by a diffuse infiltration with inflammatory cells into the intestinal mucosa and sometimes submucosa. Cats with chronic intermittent vomiting and diarrhoea, later on accompanied by anorexia and weight loss, are presented. Definitive diagnosis can be obtained by intestinal biopsy only. An immune pathogenesis is suspected, which is supported by the fact, that chronic inflammatory bowel disease responds to steroid therapy.

  11. Minimally Invasive Surgery for Inflammatory Bowel Disease

    OpenAIRE

    Holder-Murray, Jennifer; Marsicovetere, Priscilla; Holubar, Stefan D

    2015-01-01

    Abstract: Surgical management of inflammatory bowel disease is a challenging endeavor given infectious and inflammatory complications, such as fistula, and abscess, complex often postoperative anatomy, including adhesive disease from previous open operations. Patients with Crohn's disease and ulcerative colitis also bring to the table the burden of their chronic illness with anemia, malnutrition, and immunosuppression, all common and contributing independently as risk factors for increased su...

  12. Review of Inflammatory Bowel Disease in China

    Directory of Open Access Journals (Sweden)

    Lingna Ye

    2013-01-01

    Full Text Available Inflammatory bowel disease mainly consisting of ulcerative colitis and Crohn’s disease has been rising gradually during the last two decades in China. In this review article, we provide the latest epidemiological trends in incidence, prevalence, and mortality of IBD patients in China and summarize the risk factors and genetic susceptibility of Chinese IBD patients. We also compare these characteristics to those of IBD patients in Western countries.

  13. Use of thiopurines in inflammatory bowel disease

    OpenAIRE

    Frei, Pascal; Biedermann, Luc; Nielsen, Ole Haagen; Rogler, Gerhard

    2013-01-01

    The use of thiopurines as immunosuppression for the treatment of refractory or chronic active inflammatory bowel disease is established for both Crohn's disease and ulcerative colitis. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine, 6-mercaptopurine and thioguanine. We will briefly summarize dose recommendations, indications for thiopurine therapy and side effects which are relevant in clinical practice. We discuss some currently debated topics, ...

  14. Environment and the Inflammatory Bowel Diseases

    OpenAIRE

    Frolkis, Alexandra; Dieleman, Levinus A.; Barkema, Herman W.; Panaccione, Remo; Ghosh, Subrata; Richard N Fedorak; Madsen, Karen; Kaplan, Gilaad G; on behalf of the Alberta IBD Consortium

    2013-01-01

    Inflammatory bowel diseases (IBD), which consists of Crohn disease and ulcerative colitis, are chronic inflammatory conditions of the gas-trointestinal tract. In genetically susceptible individuals, the interaction between environmental factors and normal intestinal commensal flora is believed to lead to an inappropriate immune response that results in chronic inflammation. The incidence of IBD have increased in the past century in developed and developing countries. The purpose of the presen...

  15. Environmental Triggers for Inflammatory Bowel Disease

    OpenAIRE

    Ananthakrishnan, Ashwin N

    2013-01-01

    Inflammatory bowel diseases [IBD; Crohn’s disease (CD), ulcerative colitis (UC)] are chronic immunologically mediated diseases that are due to a dysregulated immune response to intestinal flora in a genetically susceptible host. Despite advances in genetics, the likelihood of occurrence of disease remains incompletely explained and there appears to be a strong role for the environment in mediating risk of disease. Smoking remains the most widely studied and replicated risk factor, contributin...

  16. Environment and the inflammatory bowel diseases

    OpenAIRE

    Frolkis, Alexandra; Dieleman, Levinus A.; Barkema, Herman W.; Panaccione, Remo; Ghosh, Subrata; Richard N Fedorak; Madsen, Karen; Kaplan, Gilaad G

    2013-01-01

    Inflammatory bowel diseases (IBD), which consists of Crohn disease and ulcerative colitis, are chronic inflammatory conditions of the gas-trointestinal tract. In genetically susceptible individuals, the interaction between environmental factors and normal intestinal commensal flora is believed to lead to an inappropriate immune response that results in chronic inflammation. The incidence of IBD have increased in the past century in developed and developing countries. The purpose of the presen...

  17. Functional findings in irritable bowel syndrome

    OpenAIRE

    Posserud, Iris; Ersryd, Amanda; Simrén, Magnus

    2006-01-01

    The pathophysiology of IBS is complex and still incompletely known. Both central and peripheral factors, including psychosocial factors, abnormal GI motility and secretion, and visceral hypersensitivity, are thought to contribute to the symptoms of IBS. Several studies have demonstrated altered GI motor function in IBS patients and the pattern differs between IBS subgroups based on the predominant bowel pattern. Few studies have so far addressed GI secretion in IBS, but there are some evidenc...

  18. Asian Motility Studies in Irritable Bowel Syndrome

    OpenAIRE

    Lee, Oh Young

    2010-01-01

    Altered motility remains one of the important pathophysiologic factors in patients with irritable bowel syndrome (IBS) who commonly complain of abdominal pain and stool changes such as diarrhea and constipation. The prevalence of IBS has increased among Asian populations these days. Gastrointestinal (GI) physiology may vary between Asian and Western populations because of differences in diets, socio-cultural backgrounds, and genetic factors. The characteristics and differences of GI dysmotili...

  19. Using abdominal massage in bowel management.

    Science.gov (United States)

    Connor, Michelle; Hunt, Catherine; Lindley, Alison; Adams, John

    2014-07-15

    This article describes the introduction of abdominal massage techniques by a community team as part of a total bowel management programme for people with learning disabilities. A trust-wide audit of prescribed laxative use by this client group raised concerns, and led to a more systematic approach to managing constipation in people with learning disabilities. An education programme for carers proved to be successful. Some reported that adopting abdominal massage provided further opportunity to develop the therapeutic relationship. PMID:25005415

  20. Intestinal epithelium in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Coskun, Mehmet

    2014-01-01

    The intestinal epithelium has a strategic position as a protective physical barrier to luminal microbiota and actively contributes to the mucosal immune system. This barrier is mainly formed by a monolayer of specialized intestinal epithelial cells (IECs) that are crucial in maintaining intestina...... of inflammatory bowel disease (IBD). Understanding the role of the intestinal epithelium in IBD pathogenesis might contribute to an improved knowledge of the inflammatory processes and the identification of potential therapeutic targets....

  1. Inflammatory bowel disease-associated spondyloarthropathies

    Institute of Scientific and Technical Information of China (English)

    Walter Fries

    2009-01-01

    This issue presents a symposium held in Messina talking about inflammatory bowel disease (IBD) and associated spondyloarthropathies. The topic covers epidemiology and clinical manifestations of IBD-related arthropathies,common genetic and immunologic features, combined therapies for gut and joint inflammation, and future biologic therapies etc. I believe this series of articles will deeply facilitate understanding of and the approach to IBD and associated arthropathies.

  2. Intestinal epithelial cells in inflammatory bowel diseases

    Institute of Scientific and Technical Information of China (English)

    Giulia; Roda; Alessandro; Sartini; Elisabetta; Zambon; Andrea; Calafiore; Margherita; Marocchi; Alessandra; Caponi; Andrea; Belluzzi; Enrico; Roda

    2010-01-01

    The pathogenesis of inflammatory bowel diseases (IBDs) seems to involve a primary defect in one or more of the elements responsible for the maintenance of intestinal homeostasis and oral tolerance. The most important element is represented by the intestinal barrier, a complex system formed mostly by intestinal epithelial cells (IECs). IECs have an active role in producing mucus and regulating its composition; they provide a physical barrier capable of controlling antigen traff ic through the intestinal muco...

  3. Inflammatory bowel disease: Genetic and epidemiologic considerations

    Institute of Scientific and Technical Information of China (English)

    Judy H Cho

    2008-01-01

    Genome-wide association studies have firmly established that many genomic loci contribute to inflammatory bowel disease, especially in Crohn's disease. These studies have newly-established the importance of the interleukin 23 and autophagy pathways in disease pathogenesis. Future challenges include: (1) the establishment of precisely causal alleles, (2) definition of altered functional outcomes of associated and causal alleles and (3) integration of genetic findings with environmental factors.

  4. Nutritional concerns in pediatric inflammatory bowel disease

    Science.gov (United States)

    2016-01-01

    The pathophysiology and fundamental etiologic mechanism of inflammatory bowel disease (IBD) is not well understood even though therapeutic regimens and drugs are rapidly evolutionary. IBD has complicated connections with genetic, immunologic, gut microbial, environmental, and nutritional factors. It is not clearly well known to the physicians how to feed, what nutrients are more helpful, and what food to be avoided. This review discusses the issues of growth and important nutritional concerns in the management of IBD in childhood. PMID:27462352

  5. Video capsule endoscopy in inflammatory bowel disease

    Science.gov (United States)

    Collins, Paul D

    2016-01-01

    Video capsule endoscopy (VCE) has evolved to become an important tool for the non-invasive examination of the small bowel, which hitherto had been relatively inaccessible to direct visualisation. VCE has been shown to play a role in monitoring the activity of small bowel Crohn’s disease and can be used to assess the response to anti-inflammatory treatment in Crohn’s disease. For those patients with Crohn’s disease who have undergone an intestinal resection, VCE has been assessed as a tool to detect post-operative recurrence. VCE may also aid in the reclassification of patients with a diagnosis of Inflammatory Bowel Disease Unclassified to Crohn’s disease. The evolution of colon capsule endoscopy (CCE) has expanded the application of this technology further. The use of CCE to assess the activity of ulcerative colitis has been described. This advance in capsule technology has also fuelled interest in its potential role as a minimally invasive tool to assess the whole of GI tract opening the possibility of its use for the panenteric assessment of Crohn’s disease. VCE is a safe procedure. However, the risk of a retained capsule is higher in patients with suspected or confirmed Crohn’s disease compared with patients having VCE examination for other indications. A retained video capsule is rare after successful passage of a patency capsule which may be utilised to pre-screen patients undergoing VCE. This paper describes the use of VCE in the assessment of inflammatory bowel disease. PMID:27499830

  6. Immunogenetic Susceptibilities in Inflammatory Bowel Disease

    OpenAIRE

    Rotter, Jerome I

    1990-01-01

    It is now clear that the major identified risk factor for the inflammatory bowel diseases (IBDs) is a positive family history. Furthermore, the available data in spouses and twins indicate that the genetic susceptibility is due in large measure to shared familial predisposition. This emphasizes the importance of identifying the actual familial susceptibilities. Given the data for immunopathogenetic etiologies in the genesis of IBD, the logical candidate genes are those that involve the immune...

  7. The evolving epidemiology of inflammatory bowel disease.

    LENUS (Irish Health Repository)

    Shanahan, Fergus

    2009-07-01

    Epidemiologic studies in inflammatory bowel disease (IBD) include assessments of disease burden and evolving patterns of disease presentation. Although it is hoped that sound epidemiologic studies provide aetiological clues, traditional risk factor-based epidemiology has provided limited insights into either Crohn\\'s disease or ulcerative colitis etiopathogenesis. In this update, we will summarize how the changing epidemiology of IBD associated with modernization can be reconciled with current concepts of disease mechanisms and will discuss studies of clinically significant comorbidity in IBD.

  8. MAP kinases in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Coskun, Mehmet; Olsen, Jørgen; Seidelin, Jakob Benedict;

    2011-01-01

    of cellular activities and have been implicated in the pathogenesis of several diseases, including inflammatory bowel disease (IBD). This review summarizes recent findings on the regulatory mechanism of MAPK signaling pathways, focusing on nuclear targets and their role in IBD. Finally, it summarizes how...... these signaling pathways have been exploited for the development of therapeutics and discuss the current knowledge of potential MAPK inhibitors and their anti-inflammatory effects in clinical trials related to IBD....

  9. Inflammatory bowel disease: potential therapeutic strategies

    DEFF Research Database (Denmark)

    Nielsen, O H; Vainer, B; Bregenholt, S;

    1997-01-01

    This review deals with potential and possibly primary therapeutics that, through insight into the inflammatory cascade, result in more rational treatment principles replacing the classical therapy of inflammatory bowel disease (IBD), i.e. Crohn's disease (CD) and ulcerative colitis (UC). These new...... therapies might be useful for IBD patients, especially since the 'classical therapy' with agents like glucocorticoids, sulfasalazine, mesalazine, azathioprine, 6-mercaptopurine, cyclosporin and methotrexate is often only moderately effective and may have important side-effects. Controlled trials...

  10. Biologic Concentration Testing in Inflammatory Bowel Disease

    OpenAIRE

    Vaughn, Byron P; Sandborn, William J; Cheifetz, Adam S.

    2015-01-01

    Abstract: Anti-TNF medications have revolutionized the care of patients with inflammatory bowel disease. However, despite an initial robust effect, loss of response is common and long-term results are disappointing. Much of this lack of durability may be due to inadequate dose optimization, and recent studies suggest a correlation between serum drug concentrations and clinical outcomes. Currently, in clinical practice, measurement of drug concentrations and antibodies to drug are typically pe...

  11. Irritable bowel syndrome and its psychological management

    Directory of Open Access Journals (Sweden)

    Ravikesh Tripathi

    2015-01-01

    Full Text Available Irritable Bowel Syndrome (IBS is a chronic and disabling gastrointestinal problem that affects psychosocial functioning as well as the quality of life. This case study reports the utility of cognitive behavior therapy as a psychological intervention procedure in a chronic case of IBS. The use of psychological intervention was found to result in a reduction of anxiety; amelioration of the symptoms associated with IBS and improved functioning.

  12. Neurological Manifestations In Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    youssef HNACH

    2015-06-01

    Full Text Available IntroductionThe purpose of this retrospective study was to report neurological manifestations noted in patients who were monitored for inflammatory bowel disease, in order to document the pathophysiological, clinical, progressive, and therapeutic characteristics of this entity.Material and methodsWe conducted a retrospective study on patients monitored -in the gastroenterology service in Ibn Sina Hospital in Rabat, Morocco- for inflammatory bowel disease from 1992 till 2013 and who developed neurological manifestations during its course. Patients with iatrogenic complications were excluded, as well as patients with cerebrovascular risk factors.ResultsThere were 6 patients, 4 of whom have developed peripheral manifestations. Electromyography enabled the diagnosis to be made and the outcome was favorable with disappearance of clinical manifestations and normalization of the electromyography.The other 2 patients, monitored for Crohn’s disease, developed ischemic stroke. Cerebral computed tomography angiography provided positive and topographic diagnosis. Two patients were admitted to specialized facilities.ConclusionNeurological manifestations in inflammatory bowel disease are rarely reported.  Peripheral neuropathies and stroke remain the most common manifestations. The mechanisms of these manifestations are not clearly defined yet. Currently, we hypothesize the interaction of immune mediators.

  13. Occult spondyloarthritis in inflammatory bowel disease.

    Science.gov (United States)

    Bandinelli, Francesca; Manetti, Mirko; Ibba-Manneschi, Lidia

    2016-02-01

    Spondyloarthritis (SpA) is a frequent extra-intestinal manifestation in patients with inflammatory bowel disease (IBD), although its real diffusion is commonly considered underestimated. Abnormalities in the microbioma and genetic predisposition have been implicated in the link between bowel and joint inflammation. Otherwise, up to date, pathogenetic mechanisms are still largely unknown and the exact influence of the bowel activity on rheumatic manifestations is not clearly explained. Due to evidence-based results of clinical studies, the interest on clinically asymptomatic SpA in IBD patients increased in the last few years. Actually, occult enthesitis and sacroiliitis are discovered in high percentages of IBD patients by different imaging techniques, mainly enthesis ultrasound (US) and sacroiliac joint X-ray examinations. Several diagnostic approaches and biomarkers have been proposed in an attempt to correctly classify and diagnose clinically occult joint manifestations and to define clusters of risk for patient screening, although definitive results are still lacking. The correct recognition of occult SpA in IBD requires an integrated multidisciplinary approach in order to identify common diagnostic and therapeutic strategies. The use of inexpensive and rapid imaging techniques, such as US and X-ray, should be routinely included in daily clinical practice and trials to correctly evaluate occult SpA, thus preventing future disability and worsening of quality of life in IBD patients.

  14. [Irritable bowel syndrome: a functional disorder?].

    Science.gov (United States)

    Man, Fernando; Bustos Fernández, Luis María

    2013-12-01

    Irritable bowel syndrome is a highly prevalent condition responsible for almost one third of visits to the gastroenterologist and huge expenses for diagnosis, treatment and loss of working days. A unique pathophysiologic mechanism has not been elucidated yet and several possibilities have been proposed such as senso-perception and motor disturbances, the effect of stress and anxiety, serotonin receptor failures, activation of abnormal brain areas and pain modulation differences, among others. The absence of a biological marker has led the investigators to consider this syndrome as an exclusion diagnostic condition, once the organic diseases have been discarded The changes in gut microbiota have recently raised great interest among gastroenterologists. The study of the small intestinal bowel overgrowth syndrome, the effect of antibiotics upon the flora, the recognition of post-infectious irritable bowel syndrome and the action of probiotics, together with the effect of malabsortion of diet carbohydrates have brought some new light in our knowledge. The present update will focus on the published evidence about the subject, bearing in mind that the mechanisms elicited here are only suitable for a subgroup of patients. PMID:24516961

  15. Effect of cholecystectomy on bowel function: a prospective, controlled study

    OpenAIRE

    Hearing, S; Thomas, L.; HEATON, K; Hunt, L.

    1999-01-01

    BACKGROUND—Published estimates of the prevalence of postcholecystectomy diarrhoea derive from retrospective or uncontrolled data. They ignore functional bowel syndromes and possible changes in diet and drug use.
AIMS—To determine prospectively whether and how often cholecystectomy leads to changes in bowel function and bowel symptoms, especially to liquid stools, over and above any non-specific effect of laparoscopic surgery.
SUBJECTS—Patients: 106 adults undergoing laparoscopic cholecystecto...

  16. 5-Millimeter Trocar-Site Bowel Herniation Following Laparoscopic Surgery

    OpenAIRE

    Khurshid, Nauman; Chung, Maurice; Horrigan, Terrence; Manahan, Kelly; Geisler, John P.

    2012-01-01

    Background and Objectives: This is a case report of a 5-mm trocar-site large bowel herniation following laparoscopic tubal sterilization. During laparoscopic sterilization, the 5-mm port site was closed initially. Large bowel herniation was recognized at the end of the case and managed immediately by laparoscopically reducing the hernia and closing the port site without any short- or long-term complications. Trocar-site bowel hernia is a rare complication after laparoscopic surgery. It is usu...

  17. Small bowel obstruction secondary to a liberated Meckel's enterolith

    OpenAIRE

    Demetriou, Vias; McKean, David; Briggs, James; Moore, Niall

    2013-01-01

    A 30-year-old woman presented with a short history of abdominal pain which rapidly progressed to absolute constipation. An abdominal radiograph demonstrated a paucity of bowel gas and a 4 cm lesion with concentric laminar calcification projected over the pelvis. A CT scan revealed a 4 cm giant Meckel's diverticulum, downstream of which a laminated mass was impacted in the lumen of the distal ileum causing small bowel obstruction. Subsequent surgery confirmed small bowel obstruction secondary ...

  18. Intussusception of the bowel in adults: A review

    OpenAIRE

    Marinis, Athanasios; Yiallourou, Anneza; Samanides, Lazaros; Dafnios, Nikolaos; Anastasopoulos, Georgios; Vassiliou, Ioannis; Theodosopoulos, Theodosios

    2009-01-01

    Intussusception of the bowel is defined as the telescoping of a proximal segment of the gastrointestinal tract within the lumen of the adjacent segment. This condition is frequent in children and presents with the classic triad of cramping abdominal pain, bloody diarrhea and a palpable tender mass. However, bowel intussusception in adults is considered a rare condition, accounting for 5% of all cases of intussusceptions and almost 1%-5% of bowel obstruction. Eight to twenty percent of cases a...

  19. Pathophysiology of acute small bowel disease with CT correlation

    International Nuclear Information System (INIS)

    The objective of this article is to review the pathophysiology of acute small bowel diseases, and to correlate the mechanisms of disease with computed tomography (CT) findings. Disease entities will be classified into the following: immune mediated and infectious causes, vascular causes, mechanical causes, trauma, and others. Having an understanding of acute small bowel pathophysiology is a useful teaching tool, and can lead to imaging clues to the most likely diagnosis of acute small bowel disorders.

  20. 18B. Integrative Solutions for the Irritable Bowel Syndrome

    OpenAIRE

    Mullin, Gerard; Lee, Linda

    2013-01-01

    Focus Areas: Integrative Approaches to Care, Pediatrics The irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain and altered bowel movements. The diagnosis of IBS is established by the Rome III criteria. IBS afflicts 10% to 15% of the US population (30 million Americans) and is the most common digestive disorder seen in the primary care setting. Patients with IBS have an impaired quality of life and high rate of absenteeism from work with diminished pr...

  1. Intestinal microbiota in pathophysiology and management of irritable bowel syndrome

    OpenAIRE

    Lee, Kang Nyeong; Lee, Oh Young

    2014-01-01

    Irritable bowel syndrome (IBS) is a functional bowel disorder without any structural or metabolic abnormalities that sufficiently explain the symptoms, which include abdominal pain and discomfort, and bowel habit changes such as diarrhea and constipation. Its pathogenesis is multifactorial: visceral hypersensitivity, dysmotility, psychosocial factors, genetic or environmental factors, dysregulation of the brain-gut axis, and altered intestinal microbiota have all been proposed as possible cau...

  2. Dysmotility of the small intestine in irritable bowel syndrome.

    OpenAIRE

    Kellow, J E; Phillips, S F; Miller, L J; Zinsmeister, A R

    1988-01-01

    Though the pathophysiology of the irritable bowel syndrome (IBS) is commonly attributed to dysfunction of the large intestine, evidence exists to incriminate the small bowel. In order to further explore the role of the small bowel in IBS several stimuli were applied, in an attempt to unmask the dysmotility of the jejunum and ileum. These included infusions of cholecystokinin-octapeptide (CCK-OP), a high fat meal, neostigmine and balloon distension of the ileum. Three groups (n = 8) each of ag...

  3. CT of complicated inflammatory bowel disease in children

    Energy Technology Data Exchange (ETDEWEB)

    Riddlesberger, M.M. Jr.

    1985-09-01

    Most children with inflammatory bowel disease do not need a CT scan. However, when the course becomes complicated if often is necessary to evaluate what is happening outside the bowel lumen. CT is the examination of choice for that evaluation. With CT, the presence and extent of an abscess can be diagnosed and followed; fistulae can be detected; bowel wall and mesenteric thickening can generally be differentiated from an abscess.

  4. Venous Small Bowel Infarction: Intraoperative Laser Doppler Flowmetry Discriminates Critical Blood Supply and Spares Bowel Length

    Directory of Open Access Journals (Sweden)

    S. A. Käser

    2012-01-01

    Full Text Available Introduction. In mesenteric infarction due to arterial occlusion, laser Doppler flowmetry and spectrometry are known reliable noninvasive methods for measuring microvascular blood flow and oxygen utilisation. Case Presentation. As an innovation we used these methods in a patient with acute extensive mesenteric infarction due to venous occlusion, occurring after radical right hemicolectomy. Aiming to avoid short bowel syndrome, we spared additional 110 cm of small bowel, instead of leaving only 80 centimetres of clinically viable small bowel in situ. The pathological examination showed only 5 mm of vital mucosa to be left distal to the dissection margin. No further interventions were necessary. Conclusion. Laser doppler flowmetry and spectrometry are potentially powerful methods to assist the surgeon’s decision-making in critical venous mesenteric perfusion, thus having an important impact on clinical outcome.

  5. Pathophysiology of the nodular and micronodular small bowel fold

    International Nuclear Information System (INIS)

    The normal small bowel fold is easily seen on conventional studies of the small intestine, but visualization of the small bowel villus is just at the resolution of current roentgenographic technique. When the villi are enlarged, they can be seen radiographically as an irregularity or micronodularity of the small bowel fold. The anatomy of the fold and the pathophysiology of diseases producing fold nodularity (tumor, inflammatory disease, NLH, mastocytosis) and micronodularity (lymphangiectasia, Waldenstrom macroglobulinemia, Whipple disease) are presented, with an emphasis on radiologic-pathologic correlation. The radiologist should suggest certain diseases or conditions based on the roentgenographic characteristics of the closely analyzed small bowel fold

  6. Laparoscopic Techniques: What is the Role in Inflammatory Bowel Disease?

    Directory of Open Access Journals (Sweden)

    Tracy L Hull

    1995-01-01

    Full Text Available Laparoscopic cholecystectomy has quickly become the preferred technique for removing the gallbladder. Real advantages in the area of laparoscopic gallbladder removal have spurred interest towards other areas of laparoscopic surgery. There has been interest in laparoscopic bowel surgery but this approach has not gained popularity as quickly as gallbladder surgery. Reasons surround the fact that the bowel is a continuous organ (versus an end organ like the gallbladder laden with bacteria and it has a rich blood supply. These differences make laparoscopic bowel surgery more difficult and challenging. If inflammatory bowel disease (IBD is considered, the indications to approach surgery laparoscopically fall into two categories: current and future indications. The current indications are diagnostic laparoscopy, fecal diversion, limited bowel resections with extracorporeal anastomosis and stoma closures. Future indications include laparoscopic subtotal colectomy and laparoscopic assisted pelvic pouch procedures. As experience is gained and laparoscopic instruments are modified and refined for bowel surgery, intracorporeal anastomosis and more extensive bowel resections will be feasible. Currently laparoscopic bowel surgery can be done in select circumstances for problems associated with IBD. It has yet to be proven if doing the surgery laparoscopically provides advantages for bowel surgery as has been demonstrated with gallbladder surgery. Prospective studies are underway to answer these questions.

  7. An immunoglobulin G-4 related sclerosing disease of the small bowel: CT and small bowel series findings

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Young Hwan; Hwang, Dae Hyun; Min, Seon Jeong [Dept. of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong (Korea, Republic of); Woo, Ji Young; Kim, Jeong Won; Hong, Hye Sook; Yang, Ik; Lee, Yul [Hallym University Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of)

    2013-10-15

    Immunoglobulin G4 (IgG4)-related sclerosing disease is rare and is known to involve various organs. We present a case of histologically proven IgG4-related sclerosing disease of the small bowel with imaging findings on computed tomography (CT) and small bowel series. CT showed irregular wall thickening, loss of mural stratification and aneurysmal dilatation of the distal ileum. Small bowel series showed aneurysmal dilatations, interloop adhesion with traction and abrupt angulation.

  8. No difference in small bowel microbiota between patients with irritable bowel syndrome and healthy controls.

    Science.gov (United States)

    Dlugosz, Aldona; Winckler, Björn; Lundin, Elin; Zakikhany, Katherina; Sandström, Gunnar; Ye, Weimin; Engstrand, Lars; Lindberg, Greger

    2015-01-01

    Several studies have indicated that colonic microbiota may exhibit important differences between patients with irritable bowel syndrome (IBS) and healthy controls. Less is known about the microbiota of the small bowel. We used massive parallel sequencing to explore the composition of small bowel mucosa-associated microbiota in patients with IBS and healthy controls. We analysed capsule biopsies from the jejunum of 35 patients (26 females) with IBS aged 18-(36)-57 years and 16 healthy volunteers (11 females) aged 20-(32)-48 years. Sequences were analysed based on taxonomic classification. The phyla with the highest total abundance across all samples were: Firmicutes (43%), Proteobacteria (23%), Bacteroidetes (15%), Actinobacteria (9.3%) and Fusobacteria (7.0%). The most abundant genera were: Streptococcus (19%), Veillonella (13%), Prevotella (12%), Rothia (6.4%), Haemophilus (5.7%), Actinobacillus (5.5%), Escherichia (4.6%) and Fusobacterium (4.3%). We found no difference among major phyla or genera between patients with IBS and controls. We identified a cluster of samples in the small bowel microbiota dominated by Prevotella, which may represent a common enterotype of the upper small intestine. The remaining samples formed a gradient, dominated by Streptococcus at one end and Escherichia at the other. PMID:25687743

  9. Small bowel angiodysplasia and novel disease associations: a cohort study.

    LENUS (Irish Health Repository)

    Holleran, Grainne

    2013-04-01

    Gastrointestinal angiodysplasias recurrently bleed, accounting for 3-5% of obscure gastrointestinal bleeding. The advent of small bowel capsule endoscopy (SBCE) has led to an increased recognition of small bowel angiodysplasias (SBAs) but little is known about their etiology. Previous small cohorts and case reports suggest an equal gender incidence and associations with cardiovascular disease, renal impairment, and coagulopathies.

  10. Small Bowel Imaging in Managing Crohn’s Disease Patients

    Directory of Open Access Journals (Sweden)

    Jörg G. Albert

    2012-01-01

    bowel CD, and treatment control with imaging is increasingly used to optimize the patients outcome. Thereby, capsule endoscopy, Balloon-assisted enteroscopy, and Magnetic resonance imaging have become key players to manage CD patients. In this review, role of small bowel imaging is detailed discussed for use in diagnosing and managing Crohn's disease patients.

  11. What I Need to Know about Bowel Control

    Science.gov (United States)

    ... Organizations​​ (PDF, 341 KB)​​​​​ Alternate Language URL Español What I Need to Know about Bowel Control Page ... about anal discomfort? Points to Remember Clinical Trials What is a bowel control problem? You have a ...

  12. Childhood Sexual Abuse and Psychosomatic Symptoms in Irritable Bowel Syndrome

    Science.gov (United States)

    Ross, Colin A.

    2005-01-01

    Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the…

  13. Visceral hypersensitivity in Irritable Bowel Syndrome:pathophysiological mechanisms

    OpenAIRE

    Kerckhoffs, A.P.M.

    2009-01-01

    Irritable Bowel Syndrome (IBS) is a functional bowel disease characterized by abdominal pain or discomfort associated with a disordered defecation. No unique pathophysiological mechanism has been identified. It is most likely a multifactorial disease involving alterations in intestinal microbiota composition, intestinal mucosal barrier, serine protease and serotonergic signalling components which may play a role in the visceral hypersensitivity. We showed alterations in microbiota composition...

  14. Small-bowel neoplasms in patients undergoing video capsule endoscopy

    DEFF Research Database (Denmark)

    Rondonotti, E; Pennazio, M; Toth, E;

    2008-01-01

    (6), diarrhea with malabsorption (1). The main primary small-bowel tumor type was gastrointestinal stromal tumor (GIST) (32%) followed by adenocarcinoma (20%) and carcinoid (15%); 66% of secondary small-bowel tumors were melanomas. Of the tumors, 80.6% were identified solely on the basis of VCE...

  15. Infantile Short Bowel Syndrome: short and long term evaluation

    NARCIS (Netherlands)

    J.F. Olieman

    2009-01-01

    textabstractInfantile short bowel syndrome is a condition which is characterized by malabsorption of nutrients, as a result of congenital intestinal shortening or massive small bowel resection. Survival rates have improved over the years, but morbidity remains high and clinical management of these p

  16. Early cervical cancer coexistent with idiopathic inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, M.; Kalter, C.; Roberts, W.S.; Cavanagh, D.

    1989-07-01

    Early invasive carcinoma of the cervix may be treated by surgery or radiation therapy. Two patients with early cervical cancer are presented whose concomitant inflammatory bowel disease figured significantly in the selection of surgery as treatment. The use of radiotherapy in the face of inflammatory bowel disease, however, is not clearly addressed in the literature.

  17. The research progress of acute small bowel perforation

    Institute of Scientific and Technical Information of China (English)

    Rudolf Schiessel

    2015-01-01

    This article reviews the various aetiologies of small bowel perforations and their management. In addition to the well-known aetiologies such as trauma, inflammation and circulatory disorders, several new causes of small bowel perforation have been described in recent years. The spectrum reaches from iatrogenic perforations during laparoscopic surgery or enteroscopies to drug-induced perforations with new anticancer agents. The management of small bowel perforations requires a concept consisting of the safe revision of the leaking bowel and the treatment of the peritonitis. Depending on the local situation and the condition of the patient, several treatment options are available. The surgical management of the bowel leak can range from a simple primary closure to a delayed restoration of bowel continuity. When the condition of the bowel or patient is frail, the risk of a failure of a closure or anastomosis is too high, and the exteriorization of the bowel defect as a primary measure is a safe option. The treatment of the peritonitis is also dependent on the condition of the patient and the local situation. Early stages of peritonitis can be treated by a simple peritoneal lavage, either performed by laparoscopy or laparotomy. Severe forms of peritonitis with multiorgan failure and an abdominal compartment syndrome need repeated peritoneal revisions. In such cases, the abdomen can only be closed temporarily. Different technical options are available in order to overcome the difficult care of these patients.

  18. Effects of bowel rehabilitation and combined trophic therapy on intestinal adaptation in short bowel patients

    Institute of Scientific and Technical Information of China (English)

    Guo-Hao Wu; Zhao-Han Wu; Zhao-Guang Wu

    2003-01-01

    AIM: To evaluate the effects of bowel rehabilitation and combined trophic therapy on intestinal adaptation in short bowel patients.METHODS: Thirty-eight patients with severe short-bowel syndrome (SBS) were employed in the present study, whose average length of jejunum-ileum was 35.8±21.2 cm. The TPN treatment was initiated early to attain positive nitrogen balance and prevent severe weight loss. The TPN composition was designated to be individualized and altered when necessary. Enteral feeding was given as soon as possible after resection and increased gradually. Meals were distributed throughout the day. Eight patients received treatment of growth hormone (0.14 mg/kg.day) and glutamine (0.3 g/kg.day) for 3 weeks. D-xylose test, 15N-Gly trace test and 13C-palmitic acid breath test were done to determine the patients' absorption capability.RESULTS: Thirty-three patients maintained well body weight and serum albumin concentration. The average time of follow-up for 33 survival patients was 5.9±4.3 years.Twenty-two patients weaned from TPN with an average TPN time of 9.5±6.6 months. Two patients, whose whole small bowel, ascending and transverse colon were resected received home TPN. An other 9 patients received parenteral or enteral nutritional support partly as well as oral diet. Three week rhGH+GLN therapy increased nutrients absorption but the effects were transient.CONCLUSION: By rehabilitation therapy, most short bowel patients could wean from parenteral nutrition. Dietary manipulation is an integral part of the treatment of SBS.Treatment with growth hormone and glutamine may increase nutrients absorption but the effects are not sustained beyond the treatment period.

  19. Observational multicentric study to evaluate efficacy, adverse effects and acceptance of bowel cleansing prior to colonoscopy with sodium picosulfate / magnesium citrate formulation CitraFleet®.

    Science.gov (United States)

    Janisch, H D; Koppold, B; Deissler, H; Riemann, J F

    2016-01-01

    The various efficient methods available for bowel preparation prior to colonoscopy differ in patient acceptance. Combining the laxative sodium picosulfate with hyperosmotic magnesium citrate, used in this study in the formulation CitraFleet(®), allows the uptake of the purgative substances as a solution of low volume. This observational study with 737 patients evaluated efficacy of bowel preparation, potential side or adverse effects and patient acceptance of this medicinal product when used by resident physicians in Germany.Colon cleansing with CitraFleet(®) was considered very good to sufficient in 95.2 % of the patients and inadequate in only 4.8 %. In 75 % of the colonoscopies, bowel preparation was rated very good or good. Compared to the standard regimen of two portions taken the day before endoscopy, cleaning efficacy was better when patients received one of the doses on the morning of the day of colonoscopy. The quality of bowel preparation was rated lower by gastroenterologists without any prior experience with sodium picosulfate/magnesium citrate. The overall assessment of the colon cleansing procedure by the 76 participating physicians was very positive and patient acceptance was also very high which can be considered a clear advantage over alternative methods. Efficacy of colon cleansing with CitraFleet(®) was not substantially affected by typical deviations from the recommended standard procedure, emphasizing the robustness of the method. Only one of the patients reported a mild adverse effect potentially caused by the cleansing agents.

  20. Inflammatory Bowel Disease: Changing Associations to Mechanisms.

    Science.gov (United States)

    Click, Benjamin; Whitcomb, David C

    2016-01-01

    Managing the health of individual patients suffering from complex disorders is a challenge and is costly. Inflammatory bowel disease (IBD) is a prototypic complex disorder of the small and large intestines. Susceptibility is complex, severity is variable, and response to treatment is unpredictable. Di Narzo et al. (Clin Transl Gastroenterol 7: e177; doi:10.1038/ctg.2016.34) bring diverse teams of physicians and scientists together to break down the mechanisms of IBD by linking pathogenic genetic variants with altered gene expression in specific cell types causing IBD. Framing new findings in the context of other complex diseases provides a roadmap for predictive medicine. PMID:27607898

  1. Bowel Function in Acute Stroke Patients

    OpenAIRE

    Yi, Jin Hwa; Chun, Min Ho; Kim, Bo Ryun; Han, Eun Young; Park, Ji Young

    2011-01-01

    Objective To investigate factors related to bowel function and colon motility in acute stroke patients. Method Fifty-one stroke patients (29 males, mean age 63.4±13.6 years, onset 13.4±4.8 days) were recruited and divided into two groups: constipation (n=25) and non-constipation (n=26) groups. We evaluated the amount of intake, voiding function, concomitant swallowing problem and colon transit time (CTT) using radio-opaque markers for ascending, descending and rectosigmoid colons. The Adapted...

  2. Immunogenetic phenotypes in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Marla C Dubinsky; Kent Taylor; Stephan R Targan; Jerome I Rotter

    2006-01-01

    The currently accepted etiopathogenic hypothesis suggests that the chronic intestinal inflammation and related systemic manifestations characteristic of inflammatory bowel disease (IBD) are due to an overly aggressive or pathologic immune response to resident luminal bacterial constituents. Predisposing factors are genetic dysregulation of mucosal immune responses and/or barrier function, with onset triggered by environmental stimuli. These factors and their interactions may also be important determinants of disease phenotype and disease progression. The emergence of immunogenetic phenotypes lends support to the proposed hypothesis that susceptibility genes regulate distinct immune processes, driven by luminal antigens, expressed as specific immune phenotypes which in turn influence clinical phenotypes in IBD patient

  3. Pancreatic disorders in inflammatory bowel disease

    Science.gov (United States)

    Antonini, Filippo; Pezzilli, Raffaele; Angelelli, Lucia; Macarri, Giampiero

    2016-01-01

    An increased incidence of pancreatic disorders either acute pancreatitis or chronic pancreatitis has been recorded in patients with inflammatory bowel disease (IBD) compared to the general population. Although most of the pancreatitis in patients with IBD seem to be related to biliary lithiasis or drug induced, in some cases pancreatitis were defined as idiopathic, suggesting a direct pancreatic damage in IBD. Pancreatitis and IBD may have similar presentation therefore a pancreatic disease could not be recognized in patients with Crohn’s disease and ulcerative colitis. This review will discuss the most common pancreatic diseases seen in patients with IBD. PMID:27574565

  4. Inflammatory bowel disease and airway diseases

    Science.gov (United States)

    Vutcovici, Maria; Brassard, Paul; Bitton, Alain

    2016-01-01

    Airway diseases are the most commonly described lung manifestations of inflammatory bowel disease (IBD). However, the similarities in disease pathogenesis and the sharing of important environmental risk factors and genetic susceptibility suggest that there is a complex interplay between IBD and airway diseases. Recent evidence of IBD occurrence among patients with airway diseases and the higher than estimated prevalence of subclinical airway injuries among IBD patients support the hypothesis of a two-way association. Future research efforts should be directed toward further exploration of this association, as airway diseases are highly prevalent conditions with a substantial public health impact. PMID:27678355

  5. Current medical therapy of inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Kiron M. Das; Sherif A. Farag

    2000-01-01

    The 1990's have brought a significant promise and the hope for a better and brighter future in the new millennium for patients with inflammatory bowel disease (I3D). A better understanding of the pathophysiology of IBD symptoms has led to newer treatnent modalities and streamlining of therapy for specific subsets of patients. ULCERATIVE COUTISThe treatnent for ulcerative colitis (UC) is aimed at modulating the inflammatory response. The drugs which are found to be effective are sulfasalazine (Azulfidine, Salazopyrin) and its 5ASA derivatives, glucocorticosteroids, immunomodulators/immunosuppressants, and other new potential drugs (Table 1).

  6. Meta-omics in Inflammatory Bowel Disease Research: Applications, Challenges, and Guidelines.

    Science.gov (United States)

    Valles-Colomer, Mireia; Darzi, Youssef; Vieira-Silva, Sara; Falony, Gwen; Raes, Jeroen; Joossens, Marie

    2016-06-01

    Meta-omics [metagenomics, metatranscriptomics, and metaproteomics] are rapidly expanding our knowledge of the gut microbiota in health and disease. These technologies are increasingly used in inflammatory bowel disease [IBD] research. Yet, meta-omics data analysis, interpretation, and among-study comparison remain challenging. In this review we discuss the role these techniques are playing in IBD research, highlighting their strengths and limitations. We give guidelines on proper sample collection and preparation methods, and on performing the analyses and interpreting the results, reporting available user-friendly tools and pipelines. PMID:26802086

  7. Imaging differentiation of phytobezoar and small-bowel faeces: CT characteristics with quantitative analysis in patients with small- bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Ya-Cheng; Liu, Chang-Hsien; Hsu, Hsian-He; Yu, Chih-Yung [Tri-Service General Hospital, National Defense Medical Center, Department of Radiology, Taipei (China); Wang, Hong-Hau [Tri-Service General Hospital, National Defense Medical Center, Department of Radiology, Taipei (China); Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Department of Radiology, Taipei (China); Fan, Hsiu-Lung [Tri-Service General Hospital, National Defense Medical Center, Division of General Surgery, Department of Surgery, Taipei (China); Chen, Ran-Chou [Taipei City Hospital, Department of Radiology, Taipei (China); National Yang-Ming Univeristy, Department of Biochemical Imaging and Radiological Sciences, Taipei (China); Chang, Wei-Chou [Tri-Service General Hospital, National Defense Medical Center, Department of Radiology, Taipei (China); National Yang-Ming Univeristy, Department of Biochemical Imaging and Radiological Sciences, Taipei (China)

    2015-04-01

    The objective is to use multidetector computed tomography (MDCT) to differentiate phytobezoar impaction and small-bowel faeces in patients with small-bowel obstruction (SBO). We retrospectively reviewed 91 consecutive SBO patients with surgically proven phytobezoars (n = 31) or adhesion with small-bowel faeces (n = 60). Two readers blinded to the diagnosis recorded the following MDCT features: degree of obstruction, transition point, mesenteric fatty stranding, intraperitoneal fluid, air-fluid level, pneumatosis intestinalis, and portal venous gas. MDCT measurements of the food debris length, attenuation, luminal diameter, and wall thickness of the obstructed bowel were also compared. A higher grade of obstruction with an absence of mesenteric fatty stranding and intraperitoneal fluid was more commonly seen in the phytobezoar group than in the small-bowel faeces group (p < 0.01). The food debris length (phytobezoar, 5.7 ± 2.8 cm; small-bowel feces, 20.3 ± 7.9 cm, p < 0.01) and mean attenuation (phytobezoar, -59.6 ± 43.3 Hounsfield units (HU); small-bowel faeces, 8.5 ± 7.7 HU, p <0.01) were significantly different between the two groups. The ROC curve showed that food debris length <9.5 cm and mean attenuation value < -11.75 HU predicted phytobezoar impaction. MDCT features with measurements of the food debris length and mean attenuation assist the differentiation of phytobezoar impaction and small-bowel faeces. (orig.)

  8. Plain magnetic resonance imaging as an alternative in evaluating inflammation and bowel damage in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Jesuratnam-Nielsen, Kayalvily; Løgager, Vibeke B; Rezanavaz-Gheshlagh, Bijan;

    2015-01-01

    -52%, 83-94% and 76-92% for DWI, respectively. The κ values for bowel wall thickening, DWI, and mural hyperenhancement were detected with fair agreement (κ = 0.26-0.39) at both MRI examinations, whereas only bowel wall thickening in MRFT were detected with moderate agreement (κ = 0.47) Conclusion. Plain...

  9. Efficacy and safety of gum chewing in adjunct to high-dose senna for bowel cleansing before colonoscopy: A single-blind randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bilal Ergül

    2014-01-01

    Full Text Available Background/Aims: Inadequate bowel cleaning leads to a suboptimal colonoscopic examination. Gum chewing has been reported to have a favorable effect on postoperative bowel functions. We conducted this study to establish if gum chewing added to high-dose senna before colonoscopy promotes bowel cleaning. Patients and Methods: In this randomized controlled study, consecutive outpatients scheduled for elective colonoscopy were randomized into two groups. Group 1 patients (n = 65 used senna solution 150 mL (300 mg senna the night before colonoscopy. The patients also used sennoside tablet 80 mg daily for 3 days before the colonoscopy. Patients in group 2 (n = 64 were additionally advised to chew sugarless gum half an hour three-times daily after meals for these 3 days. The overall quality of colonoscopy cleaning was evaluated using the Aronchick scale by a single endoscopist who was blinded to the intervention. Difficulty of procedure, patients′ tolerance, and adverse events were also evaluated. Results: A total 129 patients were enrolled in the study. Superior cleaning was found in gum chewing group when compared with other group particularly in the cecum and ascending colon. Cecal intubation time was significantly shorter in the gum-chewing group (8.6 ± 5.1 and 7.1 ± 2.8 min, P = 0.03. Adverse events were more common in group 1 compared to the gum-chewing group. Conclusions: Gum chewing enhances colonoscopy bowel preparation quality. Moreover, it is a physiologically sound, safe, and an inexpensive part of the colonoscopy bowel preparation. Gum chewing could be advised in addition to high-dose senna containing bowel preparation.

  10. INVASIVE AMOEBIASIS COMPLICATING IFLAMMATORY BOWEL DISEASE

    Directory of Open Access Journals (Sweden)

    Ziglam H

    2007-01-01

    Full Text Available INTRODUCTIONAmoebiasis, which is caused by the intestinal protozoan Entamoeba histolytica, is a ubiquitous parasitic infection affecting approximately 10% of the world’s population and causing more deaths every year (100,000 deaths than any other parasitic infection, with the exception of malaria and schistosomiasis [1–3]. Most individuals with an E. histolytica infection are asymptomatic, but some develop severe invasive disease, such as amoebic colitis. Other manifestations, such as pulmonary, cardiac or brain involvement, are rare. Intestinal amoebiasis can probably also present as a chronic, non-dysenteric syndrome of diarrhoea, weight loss, and abdominal pain that can last for years and mimic inflammatory bowel disease. Fulminant colitis with bowel necrosis leading to perforation and peritonitis occurs in only about 0.5% of cases, but it is associated with a mortality rate of more than 40%. Patients with invasive amoebiasis living in the United Kingdom and other developed countries generally acquire the infection in another country in which the pathogenic species is endemic. Areas that have high rates of amoebic infection include India, Africa, Mexico and parts of Central and South America. Infection with pathogenic E. histolytica is not a common cause of travelers’ diarrhoea, and gastrointestinal infection is uncommon in travelers who have spent less than one month in endemic areas.

  11. Bacteria, genetics and irritable bowel syndrome.

    LENUS (Irish Health Repository)

    Craig, Orla F

    2010-06-01

    EVALUATION OF: Villani AC, Lemire M, Thabane M et al. Genetic risk factors for post-infectious irritable bowel syndrome following a waterborne outbreak of gastroenteritis. Gastroenterology 138, 1502-1513 (2010). While the pathogenesis of irritable bowel syndrome (IBS) remains to be fully defined, two clinical observations - the occurrence, de novo, of IBS following bacterial gastroenteritis and the history, commonly obtained from IBS patients, of other instances of the syndrome within their families - have instigated investigations, in IBS, of the potential roles, on the one hand, of the gut microbiota and the host response and, on the other hand, of genetic factors. The study reviewed here relates to both of these factors by studying genetic predisposition to postinfective IBS in a large population of individuals who were exposed to a multimicrobial enteric infection, which resulted in a severe outbreak of gastroenteritis and was followed by the development of IBS in over a third. In this detailed study, the investigators identified a number of genes that were linked significantly to the development of postinfectious-IBS in the Toll-like receptor 9, IL-6 and cadherin 1 regions. These genes play important roles in bacterial recognition, the inflammatory response and epithelial integrity, respectively, and provide considerable support for the hypothesis that links IBS onset to disturbances in the microbiota and the host response.

  12. Management of patients with a short bowel

    Institute of Scientific and Technical Information of China (English)

    Jeremy M D Nightingale

    2001-01-01

    There are two common types of adult patient with a short bowel, those with jejunum in continuity with a functioning colon and those with a jejunostomy. Both groups have potential problems of undemutrition, but this is a greater problem in those without a colon, as they do not derive energy from anaerobic bacterial fermentation of carbohydrate to short chain fatty acids in the colon. Patients with a jejunostomy have major problems of dehydration,sodium and magnesium depletion all due to a large volume of stomal output. Both types of patient have lost at least 60cm of terminal ileum and so will become deficient of vitamin B12. Both groups have a high prevalence of gallstones (45%) resulting from periods of biliary stasis. Patients with a retained colon have a 25% chance of developing calcium oxalats renal atones and they may have problems with D (-)lactic acidosis. The survival of patients with a short bowel,even if they need long-term parenteral nutrition, is good.

  13. Biologic concentration testing in inflammatory bowel disease.

    Science.gov (United States)

    Vaughn, Byron P; Sandborn, William J; Cheifetz, Adam S

    2015-06-01

    Anti-TNF medications have revolutionized the care of patients with inflammatory bowel disease. However, despite an initial robust effect, loss of response is common and long-term results are disappointing. Much of this lack of durability may be due to inadequate dose optimization, and recent studies suggest a correlation between serum drug concentrations and clinical outcomes. Currently, in clinical practice, measurement of drug concentrations and antibodies to drug are typically performed only when a patient presents with active inflammatory bowel disease symptoms or during a potential immune-mediated reaction to anti-TNF ("reactive" setting). However, proactive monitoring of anti-TNF concentrations with titration to a therapeutic window (i.e., therapeutic concentration monitoring) represents a new strategy with many potential clinical benefits including prevention of immunogenicity, less need for IFX rescue therapy, and greater durability of IFX treatment. This review will cover the salient features of anti-TNF pharmacokinetics and pharmacodynamics and provide a rational approach for the use of anti-TNF concentration testing in both the reactive and proactive settings. PMID:25590953

  14. Nutritional therapy of irritable bowel syndrome.

    Science.gov (United States)

    Friedman, G

    1989-09-01

    Nutritional factors relative to IBS include diagnostic and therapeutic considerations. Etiologically, foods do not cause IBS. A small percentage of patients with childhood allergic diatheses, usually in association with atopic dermatitis and asthma, may be intolerant to one or more of wheat, corn, dairy products, coffee, tea, or citrus fruits. Diagnostically, many patients labeled as IBS subjects are in fact intolerant to the ingestion of lactose-containing foods, sorbitol, fructose, or combinations of fructose and sorbitol. A precise dietary history will characterize this group. Taken in its broadest context, IBS involves the entire hollow tract inclusive of esophagus, stomach, small bowel, and colon. The symptomatic presentation relative to the hollow organ involved allows the selection of dietary manipulations that may help to reduce symptoms. Gastroesophageal reflux, a consequence of low LES pressure in some IBS patients, may be treated with the elimination of fatty foods, alcohol, chocolate, and peppermint. Delayed gastric emptying may be helped by the elimination of fatty foods and reduction of soluble fiber. Aberrant small bowel motor function may be ameliorated by reduction of lactose, sorbitol, and fructose and the addition of soluble fiber. Gas syndromes may be improved by reduced intake of beans, cabbage, lentils, legumes, apples, grapes, and raisins. Colonic motor dysfunction may be overcome by the gradual addition of combinations of soluble and insoluble fiber-containing foods and supplements. The selective use of activated charcoal and simethicone may be helpful. PMID:2553606

  15. Structural brain lesions in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Can; Dolapcioglu; Hatice; Dolapcioglu

    2015-01-01

    Central nervous system(CNS) complications or manifes-tations of inflammatory bowel disease deserve particular attention because symptomatic conditions can require early diagnosis and treatment, whereas unexplained manifestations might be linked with pathogenic me-chanisms. This review focuses on both symptomatic and asymptomatic brain lesions detectable on imaging studies, as well as their frequency and potential mecha-nisms. A direct causal relationship between inflammatory bowel disease(IBD) and asymptomatic structural brain changes has not been demonstrated, but several possible explanations, including vasculitis, thromboembolism and malnutrition, have been proposed. IBD is associated with a tendency for thromboembolisms; therefore, cerebro-vascular thromboembolism represents the most frequent and grave CNS complication. Vasculitis, demyelinating conditions and CNS infections are among the other CNS manifestations of the disease. Biological agents also represent a risk factor, particularly for demyelination. Identification of the nature and potential mechanisms of brain lesions detectable on imaging studies would shed further light on the disease process and could improve patient care through early diagnosis and treatment.

  16. Zinc absorption in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Valberg, L.S.; Flanagan, P.R.; Kertesz, A.; Bondy, D.C.

    1986-07-01

    Zinc absorption was measured in 29 patients with inflammatory bowel disease and a wide spectrum of disease activity to determine its relationship to disease activity, general nutritional state, and zinc status. Patients with severe disease requiring either supplementary oral or parenteral nutrition were excluded. The mean 65ZnCl2 absorption, in the patients, determined using a 65Zn and 51Cr stool-counting test, 45 +/- 17% (SD), was significantly lower than the values, 54 +/- 16%, in 30 healthy controls, P less than 0.05. Low 65ZnCl2 absorption was related to undernutrition, but not to disease activity in the absence of undernutrition or to zinc status estimated by leukocyte zinc measurements. Mean plasma zinc or leukocyte zinc concentrations in patients did not differ significantly from controls, and only two patients with moderate disease had leukocyte zinc values below the 5th percentile of normal. In another group of nine patients with inflammatory bowel disease of mild-to-moderate severity and minimal nutritional impairment, 65Zn absorption from an extrinsically labeled turkey test meal was 31 +/- 10% compared to 33 +/- 7% in 17 healthy controls, P greater than 0.1. Thus, impairment in 65ZnCl2 absorption in the patients selected for this study was only evident in undernourished persons with moderate or severe disease activity, but biochemical evidence of zinc deficiency was uncommon, and clinical features of zinc depletion were not encountered.

  17. Preventive health measures in inflammatory bowel disease

    Science.gov (United States)

    Abegunde, Ayokunle T; Muhammad, Bashir H; Ali, Tauseef

    2016-01-01

    We aim to review the literature and provide guidance on preventive health measures in inflammatory bowel disease (IBD). Structured searches were performed in PubMed, MEDLINE, EMBASE, Web of Science and Cochrane Library from January 1976 to June 2016 using the following keywords: (inflammatory bowel disease OR Crohn’s disease OR ulcerative colitis) AND (health maintenance OR preventive health OR health promotion). Abstracts of the articles selected from each of these multiple searches were reviewed, and those meeting the inclusion criteria (that is, providing data regarding preventive health or health maintenance in IBD patients) were recorded. Reference lists from the selected articles were manually reviewed to identify further relevant studies. Patients with IBD are at increased risk of developing adverse events related to the disease course, therapeutic interventions, or non-adherence to medication. Recent studies have suggested that IBD patients do not receive preventive services with the same thoroughness as patients with other chronic diseases. Preventive health measures can avert morbidity and improve the quality of life of patients with IBD. Gastroenterologists and primary care physicians (PCPs) should have an up to date working knowledge of preventive health measures for IBD patients. A holistic approach and better communication between gastroenterologists and PCPs with explicit clarification of roles will prevent duplication of services and streamline care. PMID:27678347

  18. The epidemiology of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Burisch, Johan; Munkholm, Pia

    2015-01-01

    BACKGROUND AND AIMS: The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC), are chronic relapsing disorders of unknown aetiology. The aim of this review is to present the latest epidemiology data on occurrence, disease course, risk for surgery, as well as mortality...... overall in Europe from 6.0 per 100,000 person-years in UC and 1.0 per 100,000 person-years in CD in 1962 to 9.8 per 100,000 person-years and 6.3 per 100,000 person-years in 2010, respectively. The highest incidence of IBD is found on the Faroe Islands. Overall, surgery rates have been declining over...... and cancer risks. MATERIAL AND METHODS: Gold standard epidemiology data on the disease course and prognosis of patients with inflammatory bowel disease (IBD) are based on unselected population-based cohort studies. RESULTS: The incidence of ulcerative colitis (UC) and Crohn's disease (CD) has increased...

  19. Psychosocial determinants of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Teodora Surdea-Blaga; Adriana Bǎban; Dan L Dumitrascu

    2012-01-01

    From a pure motor disorder of the bowel,in the past few years,irritable bowel syndrome (IBS) has become a multifactorial disease that implies visceral hypersensitivity,alterations at the level of nervous and humoral communications between the enteric nervous system and the central nervous system,alteration of the gut microflora,an increased intestinal permeability and minimum intestinal inflammation.Psychological and social factors can interfere with the communication between the central and enteric nervous systems,and there is proof that they are involved in the onset of IBS and influence the response to treatment and outcome.There is evidence that abuse history and stressful life events are involved in the onset of functional gastrointestinal disorders.In order to explain clustering of IBS in families,genetic factors and social learning mechanisms have been proposed.The psychological features,such as anxiety,depression as well as the comorbid psychiatric disorders,health beliefs and coping of patients with IBS are discussed in relation to the symptoms and outcome.

  20. PYODERMA GANGRENOSUM WITH INFLAMATORY BOWEL DISEASE

    Directory of Open Access Journals (Sweden)

    Guru Prasad

    2015-01-01

    Full Text Available Pyoderma gangrenosum (PG is a chronic , painful ulcerated skin disease of unknown etiology. Its association with inflammatory bowel disease like ulcerative colitis is common . The lesions generally appear dur ing the course of active bowel disease , frequently concur with exacerbations of colitis , sometimes with inactive ulcerative colitis. 15 to 20 % of patients with Pyoderma gangrenosum have ulcerative colitis and 0.5 to 5 % of patients with ulcerative colitis have Pyoderma gangrenosum . occasionally skin lesions may preceed active inflammation of colon . Here we report a case of 50 year old female presenting with large ulcerated lesion over the anterior aspect of the middle 1/3 rd of left leg associated with sev ere pain and bloody discharge. skin biopsy shows epidermis with necrosis and diffuse dense neutrophilic infiltrate in superficial epidermis extending into the deep dermis. Colonoscopy shows features of ulcerative colitis . Patient showed rapid response with systemic steroids and specific treatment with 5 - amino salicylic acid (mesalamine. ulcer healed within 6 weeks and followed for 3months with no recurrence.

  1. Stimulating erythropoiesis in inflammatory bowel disease associated anemia

    Institute of Scientific and Technical Information of China (English)

    Georgia Tsiolakidou; Ioannis E Koutroubakis

    2007-01-01

    Anemia is a frequent complication in patients with inflammatory bowel disease (IBD), and is associated with decreased quality of life and increased rate of hospitalization. The primary therapeutic targets of IBDassociated anemia are iron deficiency and anemia of chronic disease. An important prognostic parameter of the success or failure of therapy is the outcome of the underlying disease. Iron deficiency should be appropriately managed with iron supplementation.However, the use of oral iron therapy is limited by several problems, the most important being gastrointestinal side effects leading occasionally to disease relapse and poor iron absorption. Intravenous iron preparations are more reliable, with iron sucrose demonstrating the best efficacy and tolerability. Treatment with erythropoietin or darbepoetin has been proven to be effective in patients with anemia, who fail to respond to intravenous iron. Patients with ongoing inflammation have anemia of chronic disease and may require combination therapy comprising of intravenous iron sucrose and erythropoietin. After initiating treatment, careful monitoring of hemoglobin levels and iron parameters is needed in order to avoid recurrence of anemia. In conclusion, anemia in the setting of IBD should be aggressively diagnosed, investigated, and treated. Future studies should define the optimal dose and schedule of intravenous iron supplementation and appropriate erythropoietin therapy in these patients.

  2. HISTOLOGICAL STUDY OF NEONATAL BOWEL IN ANORECTAL MALFORMATIONS

    Directory of Open Access Journals (Sweden)

    Amrish Tiwari

    2014-06-01

    Full Text Available Anorectal malformations are the congenital condition, seen in approximately 1 in 5000 live births. It affects male and female in the ratio of 1.3:1. Anorectal malformations include a wide range of malformations, that not only involves the anus and rectum, but it also involves urinary and genital tract. Aims and objectives of the study, was to understand the structures involved in anorectal malformations by histological study of surgically excised segments of involved part of neonatal intestine and to understand the degree and cause of possible structural impairment in different segments of involved parts of neonatal bowel that may help in the surgical management of anorectal malformations. Present study was conducted on surgically excised segments of fifteen cases of anorectal malformations, that have been collected from Department of Paediatrics Surgery, IMS, BHU. After that processing of the samples have been done and blocks have been prepared. Then after sectioning and staining with Hematoxyline and Eosin, findings have been noted under the microscope. Histopathological examination revealed the abnormalities of varying degrees. To conclude this study supports that the malformed segments should be excised, regarding controversial issue of preserving or excising the distal segment of anorectum for better functional outcome.

  3. OMOM capsule endoscopy in diagnosis of small bowel disease

    Institute of Scientific and Technical Information of China (English)

    Chen-yi LI; Bing-ling ZHANG; Chun-xiao CHEN; You-ming LI

    2008-01-01

    Objective: To assess the diagnostic efficiency of OMOM capsule endoscopy (CE) in a group of patients with different indications. Methods: Data from 89 consecutive patients (49 males, 40 females) with suspected small bowel disease who under-went OMOM CE (Jinshan Science and Technology Company, Chongqing, China) examination were obtained by retrospective review. The patients' indications of the disease consisted of the following: obscure gastrointestinal bleeding (OGIB), abdominal pain or diarrhea, partial intestinal obstruction, suspected inflammatory bowel disease, tumor of unknown origin, hypoproteinemia, constipation, weight loss, and elevated tumor markers. Results: CE failed in one patient. Visualization of the entire small bowel was achieved in 75.0%. Capsules were naturally excreted by all patients. The detection rate of abnormalities was 70.5% for pa-tients with suspected small bowel disease, and the diagnostic yield for patients with OGIB was higher than that for patients with abdominal pain or diarrhea (85.7% vs 53.3%, P<0.005). Angiodysplasia was the most common small bowel finding. Active bleeding sites were noted in the small intestine in 11 cases. Conclusion: OMOM CE is a useful diagnostic tool for the diagnosis of variably suspected small bowel disease, whose diagnostic efficiency is similar to that of the Pillcam SB (small bowel) CE (Given Imaging, Yoqneam, Israel).

  4. Intussusception of the bowel in adults: A review

    Institute of Scientific and Technical Information of China (English)

    Athanasios Marinis; Anneza Yiallourou; Lazaros Samanides; Nikolaos Dafnios; Georgios Anastasopoulos; Ioannis Vassiliou; Theodosios Theodosopoulos

    2009-01-01

    Intussusception of the bowel is defined as the telescoping of a proximal segment of the gastrointestinal tract within the lumen of the adjacent segment. This condition is frequent in children and presents with the classic triad of cramping abdominal pain, bloody diarrhea and a palpable tender mass. However, bowel intussusception in adults is considered a rare condition, accounting for 5% of all cases of intussusceptions and almost 1%-5% of bowel obstruction. Eight to twenty percent of cases are idiopathic, without a lead point lesion. Secondary intussusceptionis caused by organic lesions, such as inflammatory bowel disease,postoperative adhesions,Meckel's diverticulum, benign and malignant lesions, metastatic neoplasms or even iatrogenically, due to the presence of intestinal tubes, jejunostomy feeding tubes or after gastricsurgery. Computed tomography is the most sensitive diagnostic modality and can distinguish between intussusceptions with and without a lead point. Surgery is the definitive treatment of adult intussusceptions. Formal bowel resection with oncological principles is followed for every case where a malignancy is suspected. Reduction of the intussuscepted bowel is considered safe for benign lesions in order to limit the extent of resection or to avoid the short bowel syndrome in certain circumstances.

  5. Transient small-bowel intussusception in children on CT

    Energy Technology Data Exchange (ETDEWEB)

    Strouse, Peter J. [Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, MI (United States); C.S. Mott Children' s Hospital, 1500 E. Medical Center Drive, F3503, Ann Arbor, MI 48109-0252 (United States); DiPietro, Michael A.; Saez, Fermin [Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, MI (United States)

    2003-05-01

    To determine the frequency and significance of small-bowel intussusception identified in children on CT. All abdomen CT reports between July 1995 and April 2002 were reviewed to identify patients with small-bowel intussusception. Intussusceptions were identified as an intraluminal mass with a characteristic layered appearance and/or continuity with adjacent mesenteric fat. Ileocolic intussusceptions and intussusceptions related to feeding tubes were excluded. Imaging studies and medical records were reviewed. Twenty-five pediatric patients (16 boys, 9 girls; mean age 11.2 years) were identified with small-bowel intussusception on CT. No patient had a persistent intussusception requiring surgery. Fourteen had limited immediate repeat CT images as part of the same examination, ten of which demonstrated resolution of the CT abnormality. Follow-up CT [n=13 (6 within 24 h)], ultrasound (n=3), small-bowel follow-through (n=4) and surgery (n=3) showed no intussusception. In four patients with persistent symptoms, underlying pathology was identified requiring treatment (giardiasis, 2; small-bowel inflammation/strictures, 1; abscess and partial small-bowel obstruction after perforated appendicitis, 1). In 21 other patients, direct correlation of symptoms to CT abnormality was absent or questionable, no treatment was required, and there was no clinical or imaging evidence of persistence or recurrence. Most small-bowel intussusceptions identified in children by CT are transient and of no clinical significance. (orig.)

  6. Transient small-bowel intussusception in children on CT

    International Nuclear Information System (INIS)

    To determine the frequency and significance of small-bowel intussusception identified in children on CT. All abdomen CT reports between July 1995 and April 2002 were reviewed to identify patients with small-bowel intussusception. Intussusceptions were identified as an intraluminal mass with a characteristic layered appearance and/or continuity with adjacent mesenteric fat. Ileocolic intussusceptions and intussusceptions related to feeding tubes were excluded. Imaging studies and medical records were reviewed. Twenty-five pediatric patients (16 boys, 9 girls; mean age 11.2 years) were identified with small-bowel intussusception on CT. No patient had a persistent intussusception requiring surgery. Fourteen had limited immediate repeat CT images as part of the same examination, ten of which demonstrated resolution of the CT abnormality. Follow-up CT [n=13 (6 within 24 h)], ultrasound (n=3), small-bowel follow-through (n=4) and surgery (n=3) showed no intussusception. In four patients with persistent symptoms, underlying pathology was identified requiring treatment (giardiasis, 2; small-bowel inflammation/strictures, 1; abscess and partial small-bowel obstruction after perforated appendicitis, 1). In 21 other patients, direct correlation of symptoms to CT abnormality was absent or questionable, no treatment was required, and there was no clinical or imaging evidence of persistence or recurrence. Most small-bowel intussusceptions identified in children by CT are transient and of no clinical significance. (orig.)

  7. Experiences of healing therapy in patients with irritable bowel syndrome and inflammatory bowel disease

    OpenAIRE

    Soundy, Andrew; Lee, Rhonda T.; Kingstone, Tom; Singh, Sukhdev; Pankaj R Shah; Roberts, Lesley

    2015-01-01

    Background The use and value of different complementary therapies requires investigation. In particular, qualitative research is required to understand the perceptions and experiences of patients who undergo healing therapy as one type of complementary therapy. The aim of this research is to consider patients perceptions and experiences following a course of healing therapy. Methods Twenty two patients took part in this study. This included 13 patients with irritable bowel disease (3 male, 10...

  8. Normal small bowel wall characteristics on MR enterography

    Energy Technology Data Exchange (ETDEWEB)

    Cronin, Carmel G., E-mail: carmelcronin2000@hotmail.co [Department of Radiology, University College Hospital, Galway (Ireland); Delappe, Eithne; Lohan, Derek G.; Roche, Clare; Murphy, Joseph M. [Department of Radiology, University College Hospital, Galway (Ireland)

    2010-08-15

    Purpose: To assess the normal small bowel parameters, namely bowel diameter, bowel wall thickness, number of folds (valvulae connivientes) per 2.5 cm (in.), fold thickness and interfold distance per small bowel segment (duodenum, jejunum, proximal ileum, distal ileum and terminal ileum) on MR enterography. Materials and methods: Between September 2003 and January 2008, 280 MR enterography examinations were performed for investigation of known or suspected small bowel pathology. 120 of these examinations were normal. Sixty-five (m = 29, f = 36, mean age = 34 years, range = 17-73 years) of 120 examinations without a prior small bowel diagnosis, with no prior or subsequent abnormal radiology or endoscopy examinations, no prior small bowel surgery and with a minimum 3 years follow-up demonstrating normality were retrospectively evaluated for the described small bowel parameters. Results: We found the mean diameter of the duodenum to be 24.8 mm (S.D. = 4.5 mm), jejunum to be 24.5 mm (S.D. = 4.2 mm), proximal ileum to be 19.5 mm (S.D. = 3.6 mm), distal ileum to be 18.9 mm (S.D. = 4.2 mm) and terminal ileum to be 18.7 mm (S.D. = 3.6 mm). The number of folds per 2.5 cm varied from 4.6 in the jejunum to 1.5 in the terminal ileum. The fold thickness varied from 2.1 mm in the duodenum to 1.8 mm in the terminal ileum. The small bowel parameters gradually decreased in size from the duodenum to the smallest measurements which were in the terminal ileum. The bowel wall is similar in size throughout the small bowel measuring 1.5 {+-} 0.5 mm. Conclusion: These results provide the mean, range of normality and standard deviation of the small bowel parameters per segment on the current population on MR enterography. From our experience, knowledge of these parameters is extremely helpful and essential in the everyday assessment of MR enterography studies.

  9. Extraintestinal manifestations and complications in inflammatory bowel diseases

    Institute of Scientific and Technical Information of China (English)

    Katja S Rothfuss; Eduard F Stange; Klaus R Herrlinger

    2006-01-01

    Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that often involve organs other than those of the gastrointestinal tract. These nonintestinal affections are termed extraintestinal symptoms. Differentiating the true extraintestinal manifestations of inflammatory bowel diseases from secondary extraintestinal complications, caused by malnutrition, chronic inflammation or side effects of therapy, may be difficult. This review concentrates on frequency, clinical presentation and therapeutic implications of extraintestinal symptoms in inflammatory bowel diseases. If possible, extraintestinal manifestations are differentiated from extraintestinal complications. Special attention is given to the more recently described sites of involvement; I.e. Thromboembolic events, osteoporosis, pulmonary involvement and affection of the central nervous system.

  10. Diagnostic yield of small bowel capsule endoscopy depends on the small bowel transit time

    Institute of Scientific and Technical Information of China (English)

    Jessie Westerhof; Jan J Koornstra; Reinier A Hoedemaker; Wim J Sluiter; Jan H Kleibeuker; Rinse K Weersma

    2012-01-01

    AIM:TO investigate whether the small bowel transit time (SBTT) influences the diagnostic yield of capsule endoscopy (CE).METHODS:Six hundred and ninety-one consecutive CE procedures collected in a database were analyzed.SBTT and CE findings were recorded.A running mean for the SBTT was calculated and correlated to the diagnostic yield with a Spearman's correlation test.Subgroup analyses were performed for the various indications for the procedure.RESULTS:There was a positive correlation between the diagnostic yield and SBTT (Spearman's rho 0.58,P < 0.01).Positive correlations between diagnostic yield and SBlT were found for the indication obscure gastrointestinal bleeding (r =0.54,P < 0.01),for polyposis and carcinoid combined (r =0.56,P < 0.01) and for the other indications (r =0.90,P <0.01),but not for suspected Crohn's disease (r =-0.40).CONCLUSION:The diagnostic yield in small bowel capsule endoscopy is positively correlated with the small bowel transit time.This is true for all indications except for suspected Crohn's disease.

  11. Oral contrast agents for small bowel distension in MRI: influence of the osmolarity for small bowel distention

    International Nuclear Information System (INIS)

    To assess the effect of the osmolarity for small bowel distension in MRI, ten volunteers ingested at two separate occasions negative oral contrast agents with different quantity and osmolarity: (1) a water solution combined with 2.0% sorbitol and 0.2% locus bean gum (LBG) with a quantity of 1500 ml and an osmolarity of 148 mOsmol/l, (2) a water solution combined with 2.0% sorbitol and 2.0% barium sulphate with a quantity of 1000 ml and an osmolarity of 194 mOsmol/l. Small bowel distension was quantified on coronal 2D-TrueFISP images by measuring the small bowel diameters. There were no statistically significant differences in mean small bowel diameter between both contrast agents. The mean small bowel distension was 19.2 mm after ingestion of 1500 ml of sorbitol-LBG solution and 19.0 mm after ingestion of 1000-ml sorbitol-barium sulphate solution. Furthermore, all volunteers found the ingestion of 1000-ml solution more pleasant than the 1500-ml solution. The ingestion of 1000 ml of sorbitol-barium sulphate solution led to a sufficient small bowel distension compared to 1500 ml of sorbitol-LBG solution. The side effect rate of both solutions was low. Based on these data, we recommend a quantity of 1000 ml of sorbitol-barium sulphate solution as an alternative for 1500-ml sorbitol-LBG solution for optimal bowel distension. (orig.)

  12. Neurobiology of Depression and Irritable Bowel Syndrome Comorbidity

    Directory of Open Access Journals (Sweden)

    Ozlem Donat Eker

    2009-08-01

    Full Text Available Irritable bowel syndrome is a disabling functional disorder with a frequent comorbidity of depression though underlying mechanisms remain yet little understood. Various signs and symptoms have been determined as diagnostic criteria in recent years and standardized as Rome-III criteria. Irritable bowel syndrome can have constipation-dominant, diarrhea-dominant or mixed clinical presentations. Main features can be summarized as continuous and recurrent abdominal pain or discomfort associated with a change of stool frequency or consistency and usually relief of symptoms with defe-cation in the absence of physical or laboratory abnormalities indicative of an organic etiology. The frequency of major depressive disorder diagnosis reaches up to two thirds of irritable bowel syndrome patients. Moreover, the comorbidity of irritable bowel syndrome among patients with major depression is highly frequent (30%. The mechanism underlying irritable bowel syndrome which have been considered as a kind of a somatization disorder for a long time and now as a functional bowel disease is in the brain-gut axis. Low grade mucosal inflammation and cytokines originating from mucosal inflammation have important functions in the pathophysiology of irritable bowel syndrome and its comorbidity with major depression. Besides the inflammatory factors lumbosacral visceral hyperexcitability which is an individual variation is proposed as the main underlying cause of irritable bowel syndrome. Visceral hyper-excitability is mediated by cytokines and neuro-mediators and stress is known to increase the effect of this mechanism. Furthermore, molecules participating in this mechanism (e.g. cytokines, corticotrophin releasing factor, neurokinins and monoamines play important roles in the pathophysiology of depression. Increased activation in the pain matrix (thalamus – insula – prefrontal cortex and insufficiency of endogenous pain inhibitory system are regarded as possible

  13. Changing face of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Eamonn MM Quigley

    2006-01-01

    Recent years have witnessed tremendous progress in our understanding of irritable bowel syndrome (IBS). It is evident that this is a truly global disease associated with significant symptoms and impairments in personal and social functioning for afflicted individuals. Advances in our understanding of gut flora-mucosal interactions, the enteric nervous system and the brain-gut axis have led to substantial progress in the pathogenesis of symptoms in IBS and have provided some hints towards the basic etiology of this disorder, in some subpopulations, at the very least. We look forward to a time when therapy will be addressed to pathophysiology and perhaps, even to primary etiology. In the meantime, a model based on a primary role for intestinal inflammation serves to integrate the various strands, which contribute to the presentation of IBS

  14. Irritable Bowel Syndrome: Yoga as Remedial Therapy

    Directory of Open Access Journals (Sweden)

    Vijaya Kavuri

    2015-01-01

    Full Text Available Irritable bowel syndrome (IBS is a group of symptoms manifesting as a functional gastrointestinal (GI disorder in which patients experience abdominal pain, discomfort, and bloating that is often relieved with defecation. IBS is often associated with a host of secondary comorbidities such as anxiety, depression, headaches, and fatigue. In this review, we examined the basic principles of Pancha Kosha (five sheaths of human existence concept from an Indian scripture Taittiriya Upanishad and the pathophysiology of a disease from the Yoga approach, Yoga Vasistha’s Adhi (originated from mind and Vyadhi (ailment/disease concept. An analogy between the age old, the most profound concept of Adhi-Vyadhi, and modern scientific stress-induced dysregulation of brain-gut axis, as it relates to IBS that could pave way for impacting IBS, is emphasized. Based on these perspectives, a plausible Yoga module as a remedial therapy is provided to better manage the primary and secondary symptoms of IBS.

  15. Extraluminal factors contributing to inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Arvind Batra; Thorsten Stroh; Britta Siegmund

    2011-01-01

    Many identified and yet unknown factors contribute to the pathogenesis of inflammatory bowel disease (IBD).The genome-wide association studies clearly support the earlier developed concept that IBD occurs in genetically predisposed individuals who are exposed to distinct environmental factors, which together result in dysregulation of the mucosal immune system. Thus, the majority of previous studies have focused on the immune response within the intestinal wall. The present review aims to emphasize the contribution of three extraluminal structures to this inflammatory process, namely the mesenteric fat tissue, the lymphatics and the microvasculature.Broadening our view across the intestinal wall will not only facilitate our understanding of the disease,but will also us to identify future therapeutic targets.

  16. Case Report: Inflammatory Bowel Disease and Thrombosis.

    Science.gov (United States)

    Maneval, Rhonda E; Clemence, Bonnie J

    2016-01-01

    Patients with inflammatory bowel disease (IBD) have a greater risk for developing venous thromboembolism (VTE). Patients admitted to the hospital with IBD flares often require insertion of long-term venous access devices, such as peripherally inserted central catheters (PICCs), to provide access for medications, blood draws, fluid management, and nutrition. PICCs have been associated with an increased risk for upper extremity deep vein thrombosis. In this case study analysis, 2 patients with IBD and PICCs who developed VTE are examined. The case report includes a thorough discussion of medical history, symptomology, PICC insertion, and events leading to VTE development. A review of acquired risk factors for IBD patients and a comparison of risk factors that predisposed each to VTE are explored. These cases highlight the need for nurses and physicians to heighten surveillance and engage in proactive strategies to prevent VTE in this population of patients. PMID:27074991

  17. [Fecal Calprotectin in Inflammatory Bowel Disease].

    Science.gov (United States)

    Lee, Jun

    2016-05-25

    Inflammatory bowel disease (IBD), Crohn's disease and ulcerative colitis comprise conditions characterized by chronic, relapsing immune activation and inflammation within the gastrointestinal tract. Objective estimation of intestinal inflammation is the mainstay in the diagnosis and observation of IBD, but is primarily dependent on expensive and invasive procedures such as endoscopy. Therefore, a simple, noninvasive, inexpensive, and accurate test would be extremely important in clinical practice. Fecal calprotectin is a calcium-containing protein released into the lumen that is excreted in feces during acute and chronic inflammation. It is well-researched, noninvasive, and has high sensitivity and specificity for identification of inflammation in IBD. This review will focus on the use of fecal calprotectin to help diagnose, monitor, and determine treatment in IBD. PMID:27206433

  18. Post-infectious irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Marroon Thabane; John K Marshall

    2009-01-01

    Post-infectious irritable bowel syndrome (PI-IBS) is a common disorder wherein symptoms of IBS begin after an episode of acute gastroenteritis. Published studies have reported incidence of PI-IBS to range between 5% and 32%. The mechanisms underlying the development of PI-IBS are not fully understood, but are believed to include persistent sub-clinical inflammation, changes in intestinal permeability and alteration of gut flora. Individual studies have suggested that risk factors for PI-IBS include patients' demographics, psychological disorders and the severity of enteric illness. However, PI-IBS remains a diagnosis of exclusion with no specific disease markers and, to date, no definitive therapy exists. The prognosis of PIIBS appears favorable with spontaneous and gradual resolution of symptoms in most patients.

  19. Count Bowell at record heliocentric distance

    Science.gov (United States)

    Meech, Karen J.; Jewitt, David

    1987-01-01

    New observations of Comet Bowell at the record distance of 13.6 AU are presented. An extended coma is present, the size of which is consistent with the same slow expansion rate of roughly 1 m/s detected around perihelion. The cross-section of the solid grains within the central 10 arcsec of the coma has decreased by over an order of magnitude since 1980-84, which indicates that the coma production is declining. The decline began near R of roughly 10 AU, the same distance at which production began on the preperihelion leg. The coma at R of 10 AU or less may be formed by sublimation of CO2 or an ice of similar volatility from the nucleus.

  20. Microbiome, Metabolome and Inflammatory Bowel Disease.

    Science.gov (United States)

    Ahmed, Ishfaq; Roy, Badal C; Khan, Salman A; Septer, Seth; Umar, Shahid

    2016-01-01

    Inflammatory Bowel Disease (IBD) is a multifactorial disorder that conceptually occurs as a result of altered immune responses to commensal and/or pathogenic gut microbes in individuals most susceptible to the disease. During Crohn's Disease (CD) or Ulcerative Colitis (UC), two components of the human IBD, distinct stages define the disease onset, severity, progression and remission. Epigenetic, environmental (microbiome, metabolome) and nutritional factors are important in IBD pathogenesis. While the dysbiotic microbiota has been proposed to play a role in disease pathogenesis, the data on IBD and diet are still less convincing. Nonetheless, studies are ongoing to examine the effect of pre/probiotics and/or FODMAP reduced diets on both the gut microbiome and its metabolome in an effort to define the healthy diet in patients with IBD. Knowledge of a unique metabolomic fingerprint in IBD could be useful for diagnosis, treatment and detection of disease pathogenesis. PMID:27681914

  1. Fertility and pregnancy in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Elspeth Alstead

    2001-01-01

    @@ INTRODUCTION Inflammatory bowel disease(IBD)is a chronic disorder affecting young adults in the reproductive years.It is comon for both female and male patients with IBD to ask questions about IBD's effect on their relationships,sexual and reproductive function,in particular fertility,the outcome of pregnancy and its possible effets on the disease.An open discussion of the social situation and education targeted at these issues therefore forms an essential part of the management of any young person with IBD.the questions that are most commonly asked are summarised in Table 1.In order to answer these questions we need evidence.There are few large prospective case controlled studies to provide the information which is required but the available data,some of it from small observational studies,will be summarised in this chapter.

  2. Therapeutic innovations in inflammatory bowel diseases.

    Science.gov (United States)

    Vanhove, W; Nys, K; Vermeire, S

    2016-01-01

    Inflammatory bowel disease (IBD) is a spectrum of complex multifactorial immune disorders characterized by chronic inflammation of the gut. Significant advances have been made in unraveling the pathogenesis of this disease spectrum, which have spurred the discovery of new therapeutic targets and strategies. In this review, we highlight the emerging new classes of IBD therapeutics under clinical evaluation and their method of action, including JAK inhibitors, anti-SMAD7 oligonucleotides, and cell-based therapies. Moreover, we discuss how an approach based on unique molecular insights in a given patient will, in the future, lead to a truly individualized/tailored disease management, starting at diagnosis, aiding in prognosis, and resulting in a personalized therapeutic approach. PMID:26509246

  3. Special issues in pediatric inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Maria Dubinsky

    2008-01-01

    The incidence of pediatric inflammatory bowel disease (IBD) is rising and recent advances in diagnostics and therapeutics have improved the care provided to these children. There are distinguishing features worth noting between early onset and adult onset IBD. Physical and psychosocial development remains a critical target for the comprehensive management of pediatric IBD. Children are not just little adults and consideration must be given to the stages of development and how these stages impact disease presentation and management. The final stage will be the transition from pediatric care to that of adult oriented care and special consideration must be given to make this a successful process. This review highlights special considerations in the management of the child with IBD.

  4. Flavonoids in Inflammatory Bowel Disease: A Review

    Directory of Open Access Journals (Sweden)

    Teresa Vezza

    2016-04-01

    Full Text Available Inflammatory bowel disease (IBD is characterized by chronic inflammation of the intestine that compromises the patients’ life quality and requires sustained pharmacological and surgical treatments. Since their etiology is not completely understood, non-fully-efficient drugs have been developed and those that have shown effectiveness are not devoid of quite important adverse effects that impair their long-term use. In this regard, a growing body of evidence confirms the health benefits of flavonoids. Flavonoids are compounds with low molecular weight that are widely distributed throughout the vegetable kingdom, including in edible plants. They may be of great utility in conditions of acute or chronic intestinal inflammation through different mechanisms including protection against oxidative stress, and preservation of epithelial barrier function and immunomodulatory properties in the gut. In this review we have revised the main flavonoid classes that have been assessed in different experimental models of colitis as well as the proposed mechanisms that support their beneficial effects.

  5. Familial risk of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Moller, Frederik Trier; Andersen, Vibeke; Wohlfahrt, Jan;

    2015-01-01

    OBJECTIVES: Estimates of familial risk of inflammatory bowel diseases (IBDs), Crohn's disease (CD), and ulcerative colitis (UC) are needed for counseling of patients and could be used to target future prevention. We aimed to provide comprehensive population-based estimates of familial risk of IBD....... METHODS: The study encompassed the entire Danish population during 1977-2011 (N=8,295,773; 200 million person-years). From national registries, we obtained information on diagnosis date of IBD (N=45,780) and family ties. Using Poisson regression, we estimated incidence rate ratios (IRRs) of IBD...... in relatives of IBD cases compared with individuals with relatives of the same type without IBD. RESULTS: The risk of CD was significantly increased in first-degree (IRR, 7.77; 95% confidence interval (CI), 7.05-8.56), second-degree (IRR, 2.44; 95% CI, 2.01-2.96), and third-degree relatives (IRR, 1.88; 95% CI...

  6. Use of thiopurines in inflammatory bowel disease.

    Science.gov (United States)

    Frei, Pascal; Biedermann, Luc; Nielsen, Ole Haagen; Rogler, Gerhard

    2013-02-21

    The use of thiopurines as immunosuppression for the treatment of refractory or chronic active inflammatory bowel disease is established for both Crohn's disease and ulcerative colitis. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine, 6-mercaptopurine and thioguanine. We will briefly summarize dose recommendations, indications for thiopurine therapy and side effects which are relevant in clinical practice. We discuss some currently debated topics, including the combination of azathioprine and allopurinol, switching of thiopurine therapy in case of side effects, the use of azathioprine in pregnancy, the infection risk using thiopurines and the evidence when to stop thiopurines. Excellent reviews have been published on the thiopurine metabolic pathway which will not be discussed here in detail. PMID:23467510

  7. Environmental risk factors for inflammatory bowel disease.

    Science.gov (United States)

    Molodecky, Natalie A; Kaplan, Gilaad G

    2010-05-01

    Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract and is associated with significant morbidity. The etiology of IBD has been extensively studied during the last several decades; however, causative factors in disease pathology are not yet fully understood. IBD is thought to result from the interaction between genetic and environmental factors that influence the normal intestinal commensal flora to trigger an inappropriate mucosal immune response. Although many IBD susceptibility genes have been discovered, similar advances in defining environmental risk factors have lagged. A number of environmental risk factors have been explored, including smoking, appendectomy, oral contraceptives, diet, breastfeeding, infections/ vaccinations, antibiotics, and childhood hygiene. However, most of these factors have demonstrated inconsistent findings, thus making additional studies necessary to better understand the etiology of IBD. PMID:20567592

  8. Environment and the inflammatory bowel diseases.

    Science.gov (United States)

    Frolkis, Alexandra; Dieleman, Levinus A; Barkema, Herman W; Panaccione, Remo; Ghosh, Subrata; Fedorak, Richard N; Madsen, Karen; Kaplan, Gilaad G

    2013-03-01

    Inflammatory bowel diseases (IBD), which consists of Crohn disease and ulcerative colitis, are chronic inflammatory conditions of the gastrointestinal tract. In genetically susceptible individuals, the interaction between environmental factors and normal intestinal commensal flora is believed to lead to an inappropriate immune response that results in chronic inflammation. The incidence of IBD have increased in the past century in developed and developing countries. The purpose of the present review is to summarize the current knowledge of the association between environmental risk factors and IBD. A number of environmental risk factors were investigated including smoking, hygiene, microorganisms, oral contraceptives, antibiotics, diet, breastfeeding, geographical factors, pollution and stress. Inconsistent findings among the studies highlight the complex pathogenesis of IBD. Additional studies are necessary to identify and elucidate the role of environmental factors in IBD etiology. PMID:23516681

  9. Flavonoids in Inflammatory Bowel Disease: A Review

    Science.gov (United States)

    Vezza, Teresa; Rodríguez-Nogales, Alba; Algieri, Francesca; Utrilla, Maria Pilar; Rodriguez-Cabezas, Maria Elena; Galvez, Julio

    2016-01-01

    Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the intestine that compromises the patients’ life quality and requires sustained pharmacological and surgical treatments. Since their etiology is not completely understood, non-fully-efficient drugs have been developed and those that have shown effectiveness are not devoid of quite important adverse effects that impair their long-term use. In this regard, a growing body of evidence confirms the health benefits of flavonoids. Flavonoids are compounds with low molecular weight that are widely distributed throughout the vegetable kingdom, including in edible plants. They may be of great utility in conditions of acute or chronic intestinal inflammation through different mechanisms including protection against oxidative stress, and preservation of epithelial barrier function and immunomodulatory properties in the gut. In this review we have revised the main flavonoid classes that have been assessed in different experimental models of colitis as well as the proposed mechanisms that support their beneficial effects. PMID:27070642

  10. Role of scintigraphy in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Maria I Stathaki; Sophia I Koukouraki; Nikolaos S Karkavitsas; Ioannis E Koutroubakis

    2009-01-01

    The diagnosis of inflammatory bowel disease (IBD) depends on direct endoscopic visualization of the colonic and ileal mucosa and the histological study of the obtained samples.Radiological and scintigraphic methods are mainly used as an adjunct to endoscopy.In this review,we focus on the diagnostic potential of nuclear medicine procedures.The value of all radiotracers is described with special reference to those with greater experience and more satisfactory results.Tc-99m hexamethylpropylene amine oxime white blood cells remain a widely acceptable scintigraphic method for the diagnosis of IBD,as well as for the evaluation of disease extension and severity.Recently,pentavalent Tc-99m dimercaptosuccinic acid has been recommended as an accurate variant and a complementary technique to endoscopy for the follow-up and assessment of disease activity.Positron emission tomography alone or with computed tomography using fluorine-18 fluorodeoxyglucose appears to be a promising method of measuring inflammation in IBD patients.

  11. Innate immunity in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The human intestinal tract is home to an enormous bacterial flora. The host defense against microorganisms can be divided into innate and adaptive immunity. The former is the most immediate line of response to immunologic challenges presented by bacteria, viruses, and fungi. The mucosal immune system has evolved to balance the need to respond to pathogens while co-existing with commensal bacteria and food antigens. In inflammatory bowel disease (IBD), this hyporesponsiveness or tolerance breaks-down and inflammation supervenes driven by the intestinal microbial flora. Bacteria contain compounds and are recognized by a variety of receptors, including Toll-like receptors (TLRs) and NODs (a family of intracellular bacterial sensors) and are potent stimuli of innate immune responses. Several mutations in these receptors have been associated with development of IBD.

  12. Microbiome, Metabolome and Inflammatory Bowel Disease

    Science.gov (United States)

    Ahmed, Ishfaq; Roy, Badal C.; Khan, Salman A.; Septer, Seth; Umar, Shahid

    2016-01-01

    Inflammatory Bowel Disease (IBD) is a multifactorial disorder that conceptually occurs as a result of altered immune responses to commensal and/or pathogenic gut microbes in individuals most susceptible to the disease. During Crohn’s Disease (CD) or Ulcerative Colitis (UC), two components of the human IBD, distinct stages define the disease onset, severity, progression and remission. Epigenetic, environmental (microbiome, metabolome) and nutritional factors are important in IBD pathogenesis. While the dysbiotic microbiota has been proposed to play a role in disease pathogenesis, the data on IBD and diet are still less convincing. Nonetheless, studies are ongoing to examine the effect of pre/probiotics and/or FODMAP reduced diets on both the gut microbiome and its metabolome in an effort to define the healthy diet in patients with IBD. Knowledge of a unique metabolomic fingerprint in IBD could be useful for diagnosis, treatment and detection of disease pathogenesis. PMID:27681914

  13. Innovative therapeutics for inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Jesus K Yamamoto-Furusho

    2007-01-01

    Inflammatory bowel diseases (IBD) are chronic inflammatory conditions of the gastrointestinal tract,which clinically present as one of two disorders, Crohn's disease or ulcerative colitis. Mainstays of drug treatments for IBD include aminosalicylates, corticosteroids and immunosuppressants such as azathioprine, methotrexate and cyclosporin. Advances in basic research of the pathophysiological process in IBD have been applied to generate a variety of new therapeutics targeting at different levels of the inflammatory processes. New therapies are classified as: (1) Anti-TNFα antibodies; (2) Recombinant cytokines; (3) Selective adhesion blockade;(4) Growth factors; (5) Innate immunostimulation; (6) Nucleic acid based therapies; (7) Gene therapy; (8) Autologous bone-marrow transplantation; (9) Helminths and (10) Extracorporeal immunomodulation. All treatments have the potential to provide more effective and safe treatment for IBD.

  14. Intestinal epithelium in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Mehmet eCoskun

    2014-08-01

    Full Text Available The intestinal epithelium has a strategic position as a protective physical barrier to luminal microbiota and actively contributes to the mucosal immune system. This barrier is mainly formed by a monolayer of specialized intestinal epithelial cells (IECs that are crucial in maintaining intestinal homeostasis. Therefore, dysregulation within the epithelial layer can increase intestinal permeability, lead to abnormalities in interactions between IECs and immune cells in underlying lamina propria, and disturb the intestinal immune homeostasis, all of which are linked to the clinical disease course of inflammatory bowel disease (IBD. Understanding the role of the intestinal epithelium in IBD pathogenesis might contribute to an improved knowledge of the inflammatory processes and the identification of potential therapeutic targets.

  15. Food components and irritable bowel syndrome.

    Science.gov (United States)

    Gibson, Peter R; Varney, Jane; Malakar, Sreepurna; Muir, Jane G

    2015-05-01

    Ingestion of food has long been linked with gut symptoms, and there is increasing interest in using diet in the management of patients with irritable bowel syndrome (IBS). The West has developed an intense interest in specialized, restrictive diets, such as those that target multiple food groups, avoid gluten, or reduce fermentable oligo-, di-, and mono-saccharides and polyols. However, most gastroenterologists are not well educated about diets or their effects on the gut. It is important to understand the various dietary approaches, their putative mechanisms, the evidence that supports their use, and the benefits or harm they might produce. The concepts behind, and delivery of, specialized diets differ from those of pharmacologic agents. High-quality research is needed to determine the efficacy of different dietary approaches and the place of specific strategies. PMID:25680668

  16. Microbiome, Metabolome and Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Ishfaq Ahmed

    2016-06-01

    Full Text Available Inflammatory Bowel Disease (IBD is a multifactorial disorder that conceptually occurs as a result of altered immune responses to commensal and/or pathogenic gut microbes in individuals most susceptible to the disease. During Crohn’s Disease (CD or Ulcerative Colitis (UC, two components of the human IBD, distinct stages define the disease onset, severity, progression and remission. Epigenetic, environmental (microbiome, metabolome and nutritional factors are important in IBD pathogenesis. While the dysbiotic microbiota has been proposed to play a role in disease pathogenesis, the data on IBD and diet are still less convincing. Nonetheless, studies are ongoing to examine the effect of pre/probiotics and/or FODMAP reduced diets on both the gut microbiome and its metabolome in an effort to define the healthy diet in patients with IBD. Knowledge of a unique metabolomic fingerprint in IBD could be useful for diagnosis, treatment and detection of disease pathogenesis.

  17. Importance of nutrition in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Alfredo José Lucendo; Livia Cristina De Rezende

    2009-01-01

    Inflammatory bowel disease (IBD) results from the interaction between an individual's immune response and precipitant environmental factors, which generate an anomalous chronic inflammatory response in those who are genetically predisposed. Various feeding practices have been implicated in the origin of IBD based on epidemiological observations in developed countries, but we do not have solid evidence for the etiological role played by specific food types. IBD is associated with frequent nutritional deficiencies, the pattern and severity of which depends on the extent, duration and activity of the inflammation. Nutritional support allows these deficiencies in calories, macro and micronutrients to be rectified. Enteral nutrition is also a primary therapy for IBD, especially for Crohn's disease, as it allows the inflammatory activity to be controlled, kept in remission, and prevents or delays the need for surgery. Nutritional support is especially important in childhood IBD as an alternative to pharmacological t reatment . This repor t discusses the complex relationship between diet and IBD.

  18. Extraintestinal manifestations in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Silvio Danese; Stefano Semeraro; Alfredo Papa; Italia Roberto; Franco Scaldaferri; Giuseppe Fedeli; Giovanni Gasbarrini; Antonio Gasbarrini

    2005-01-01

    Inflammatory bowel diseases (IBD) can be really considered to be systemic diseases since they are often associated with extraintestinal manifestations,complications, and other autoimmune disorders. Indeed,physicians who care for patients with ulcerative colitis and Crohn's disease, the two major forms of IBD, face a new clinical challenge every day, worsened by the very frequent rate of extraintestinal complications. The goal of this review is to provide an overview and an update on the extraintestinal complications occurring in IBD.Indeed, this paper highlights how virtually almost every organ system can be involved, principally eyes, skin,joints, kidneys, liver and biliary tracts, and vasculature (or vascular system) are the most common sites of systemic IBD and their involvement is dependent on different mechanisms.

  19. Targeting intestinal microflora in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Mario Guslandi

    2006-01-01

    @@ TO THE EDITOR In their recent review article[1], Andoh and Fujiyama examined the various therapeutic approaches targeting intestinal microflora in patients with inflammatory bowel disease (IBD). I would like to provide some additional data to complete and update their comments. First of all, when considering the role of probiotics in 1BD treatment it must be emphasized that, in addition to Bifidobacteria, the Nissle 1917 E. coli strain and cocktails of microorganisms such as VSL # 3 mentioned in the article, other probiotic agents have been tested in the short- and long-term treatment of either ulcerative colitis and Crohn's disease, the results of those studies being reported in major international scientific journals.

  20. Irritable bowel syndrome: Diagnosis and pathogenesis

    Institute of Scientific and Technical Information of China (English)

    Magdy El-Salhy

    2012-01-01

    Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder that considerably reduces the quality of life.It further represents an economic burden on society due to the high consumption of healthcare resources and the non-productivity of IBS patients.The diagnosis of IBS is based on symptom assessment and the Rome Ⅲ criteria.A combination of the Rome Ⅲ criteria,a physical examination,blood tests,gastroscopy and colonoscopy with biopsies is believed to be necessary for diagnosis.Duodenal chromogranin A cell density is a promising biomarker for the diagnosis of IBS.The pathogenesis of IBS seems to be multifactorial,with the following factors playing a central role in the pathogenesis of IBS:heritability and genetics,dietary/intestinal microbiota,low-grade inflammation,and disturbances in the neuroendocrine system (NES) of the gut.One hypothesis proposes that the cause of IBS is an altered NES,which would cause abnormal GI motility,secretions and sensation.All of these abnormalities are characteristic of IBS.Alterations in the NES could be the result of one or more of the following:genetic factors,dietary intake,intestinal flora,or low-grade inflammation.Post-infectious IBS (PI-IBS) and inflammatory bowel disease-associated IBS (IBD-IBS) represent a considerable subset of IBS cases.Patients with PI-and IBD-IBS exhibit low-grade mucosal inflammation,as well as abnormalities in the NES of the gut.

  1. Updates on treatment of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Christopher W Hammerle; Christina M Surawicz

    2008-01-01

    Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder characterized by abdominal pain and discomfort in association with altered bowel habits.It is estimated to affect 10%-15% of the Western population,and has a large impact on quality of life and (in)direct healthcare costs.IBS is a multifactorial disorder involving dysregulation within the brain-gut axis,and it is frequently associated with gastrointestinal motor and sensory dysfunction,enteric and central nervous system irregularities,neuroimmune dysregulation,and postinfectious inflammation.As with other functional medical disorders,the treatment for IBS can be challenging.Conventional therapy for those with moderate to severe symptoms is largely unsatisfactory,and the development of new and effective drugs is made difficult by the complex pathogenesis,variety of symptoms,and lack of objective clinical findings that are the hallmark of this disorder.Fortunately,research advances over the past several decades have provided insight into potential mechanisms responsible for the pathogenesis of IBS,and have led to the development of several promising pharmaceutical agents.In recent years there has been much publicity over several of these new IBS medications (alosetron and tegaserod) because of their reported association with ischemic colitis and cardiovascular disease.While these agents remain available for use under restricted prescribing programs,this highlights the need for continued development of safe and effective medication for IBS.This article provides a physiologicallybased overview of recently developed and frequently employed pharmaceutical agents used to treat IBS,and discusses some non-pharmaceutical options that may be beneficial in this disorder.

  2. Irritable Bowel Syndrome: A Clinical Review.

    Science.gov (United States)

    Cashman, Michael D; Martin, Daniel K; Dhillon, Sonu; Puli, Srinivas R

    2016-01-01

    Symptoms of irritable bowel syndrome (IBS) are common in population studies including chronic abdominal pain associated with altered bowel habits. Patients often have associated gastrointestinal and somatic symptoms suggesting a possible common contributing mechanism, but the heterogeneous symptom patterns of individual patients make generalizations difficult. The pathophysiology of IBS is incompletely understood but includes disturbances of the brain-gut axis. Central mechanisms are: the psychosocial history and environment, dysfunctional brain processing of peripheral signals attributed to the intestine including the enteric nervous system, the microbiome and the innate and adaptive immune system. As a result there is visceral hypersensitivity and disturbed intestinal secretory and motor activity. Some mechanisms of visceral pain hypersensitivity may overlap with other pain syndromes including fibromyalgia (FMS). Central Sensitization (CS) would offer a way to conceptualize an integration of life experience and psychologic response into a biopsychosocial framework of pathophysiology, diagnosis and treatment of IBS. Corticotropin-releasing factor, a principle regulator in the stress and pain response may contribute to a neuroendocrine mechanism for the brain-gut interaction. The positive diagnostic approach to IBS symptoms to avoid excess testing and enhance the patient-provider therapeutic relationship requires the recognition of the "cluster" of IBS symptoms while identifying "alarm" symptoms requiring specific attention. The severity of the symptoms and other individual psychosocial factors characterize patients who seek medical care. The presence of significant psychosocial comorbidities adds to the complexity of management which often requires a multidisciplinary approach. Several treatment options exist but no single method is effective for all the symptoms of IBS. The therapeutic benefit of the well-executed physician-patient relationship is considered

  3. Oral pathology in inflammatory bowel disease

    Science.gov (United States)

    Muhvić-Urek, Miranda; Tomac-Stojmenović, Marija; Mijandrušić-Sinčić, Brankica

    2016-01-01

    The incidence of inflammatory bowel diseases (IBD) - Crohn’s disease (CD) and ulcerative colitis (UC) - has been increasing on a global scale, and progressively, more gastroenterologists will be included in the diagnosis and treatment of IBD. Although IBD primarily affects the intestinal tract, extraintestinal manifestations of the disease are often apparent, including in the oral cavity, especially in CD. Specific oral manifestations in patients with CD are as follows: indurate mucosal tags, cobblestoning and mucogingivitis, deep linear ulcerations and lip swelling with vertical fissures. The most common non-specific manifestations, such as aphthous stomatitis and angular cheilitis, occur in both diseases, while pyostomatitis vegetans is more pronounced in patients with UC. Non-specific lesions in the oral cavity can also be the result of malnutrition and drugs. Malnutrition, followed by anemia and mineral and vitamin deficiency, affects the oral cavity and teeth. Furthermore, all of the drug classes that are applied to the treatment of inflammatory bowel diseases can lead to alterations in the oral cavity due to the direct toxic effects of the drugs on oral tissues, as well as indirect immunosuppressive effects with a risk of developing opportunistic infections or bone marrow suppression. There is a higher occurrence of malignant diseases in patients with IBD, which is related to the disease itself and to the IBD-related therapy with a possible oral pathology. Treatment of oral lesions includes treatment of the alterations in the oral cavity according to the etiology together with treatment of the primary intestinal disease, which requires adequate knowledge and a strong cooperation between gastroenterologists and specialists in oral medicine. PMID:27433081

  4. Oral pathology in inflammatory bowel disease.

    Science.gov (United States)

    Muhvić-Urek, Miranda; Tomac-Stojmenović, Marija; Mijandrušić-Sinčić, Brankica

    2016-07-01

    The incidence of inflammatory bowel diseases (IBD) - Crohn's disease (CD) and ulcerative colitis (UC) - has been increasing on a global scale, and progressively, more gastroenterologists will be included in the diagnosis and treatment of IBD. Although IBD primarily affects the intestinal tract, extraintestinal manifestations of the disease are often apparent, including in the oral cavity, especially in CD. Specific oral manifestations in patients with CD are as follows: indurate mucosal tags, cobblestoning and mucogingivitis, deep linear ulcerations and lip swelling with vertical fissures. The most common non-specific manifestations, such as aphthous stomatitis and angular cheilitis, occur in both diseases, while pyostomatitis vegetans is more pronounced in patients with UC. Non-specific lesions in the oral cavity can also be the result of malnutrition and drugs. Malnutrition, followed by anemia and mineral and vitamin deficiency, affects the oral cavity and teeth. Furthermore, all of the drug classes that are applied to the treatment of inflammatory bowel diseases can lead to alterations in the oral cavity due to the direct toxic effects of the drugs on oral tissues, as well as indirect immunosuppressive effects with a risk of developing opportunistic infections or bone marrow suppression. There is a higher occurrence of malignant diseases in patients with IBD, which is related to the disease itself and to the IBD-related therapy with a possible oral pathology. Treatment of oral lesions includes treatment of the alterations in the oral cavity according to the etiology together with treatment of the primary intestinal disease, which requires adequate knowledge and a strong cooperation between gastroenterologists and specialists in oral medicine. PMID:27433081

  5. Multiphasic MDCT in small bowel volvulus

    Energy Technology Data Exchange (ETDEWEB)

    Feng Shiting, E-mail: fst1977@163.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Chan Tao, E-mail: taochan@hku.hk [Department of Diagnostic Radiology, University of Hong Kong, Room 406, Block K, Queen Mary Hospital (Hong Kong); Sun Canhui, E-mail: canhuisun@sina.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Li Ziping, E-mail: liziping163@tom.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Guo Huanyi, E-mail: guohuanyi@163.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Yang Guangqi, E-mail: shwy03@126.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Peng Zhenpeng, E-mail: ppzhen@21cn.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China); Meng Quanfei, E-mail: mzycoco@gmail.com [Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th The Second Zhongshan Road, Guangzhou 510080 (China)

    2010-11-15

    Objective: Evaluate the use of MDCT with 3D CT angiography (CTA) and CT portal venography (CTPV) reconstruction for the diagnosis of small bowel volvulus (SBV). Methods: Multiphasic MDCT findings in nine patients (seven males and two females, age range 2-70) with surgically proven SBV were retrospectively reviewed. Non-contrast and double phase contrast enhanced MDCT including 3D CTA and CTPV reconstruction were performed in all the patients. Two experienced abdominal radiologists evaluated the images and defined the location, direction and degree of SBV. Results: On axial MDCT images, all cases show segmental or global dilatation of small intestine. Other findings include circumferential bowel wall thickening in eight cases, halo appearance and hyperemia in seven cases, whirl sign in six cases, beak-like appearance in six cases, closed loops in six cases and ascites in one case. CTA/CTPV showed abnormal courses involving main trunks of superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in seven cases, with or without distortion of their tributaries. Normal course of SMA but abnormal course of SMV was seen in the other two cases. Of all the nine cases, whirl sign was seen in six cases and barber's pole sign in five cases. Dilated SMV was observed in eight cases and abrupt termination of SMA was found in one case. Compared with surgical findings, the location, direction and degree of SBV were correctly estimated in all cases based on CTA/CTPV. Conclusion: Multiphasic MDCT with CTA/CTPV reconstruction can play an important role in the diagnosis of SBV. The location, direction and degree of SBV can all be defined preoperatively using this method.

  6. Rheumatic manifestations of inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Tatiana Sofía Rodríguez-Reyna; Cynthia Martínez-Reyes; Jesús Kazúo Yamamoto-Furusho

    2009-01-01

    This article reviews the literature concerning rheumatic manifestations of inflammatory bowel disease(IBD), including common immune-mediated pathways,frequency, clinical course and therapy. Musculoskeletal complications are frequent and well-recognized manifestations in IBD, and affect up to 33% of patients with IBD. The strong link between the bowel and the osteo-articular system is suggested by many clinical and experimental observations, notably in HLA-B27 transgenic rats. The autoimmune pathogenic mechanisms shared by IBD and spondyloarthropathies include genetic susceptibility to abnormal antigen presentation,aberrant recognition of self, the presence of autoantibodies against specific antigens shared by the colon and other extra-colonic tissues, and increased intestinal permeability. The response against microorganisms may have an important role through molecular mimicry and other mechanisms. Rheumatic manifestations of IBD have been divided into peripheral arthritis, and axial involvement, including sacroiliitis,with or without spondylitis, similar to idiopathic ankylosing spondylitis. Other periarticular features can occur,including enthesopathy, tendonitis, clubbing, periostitis,and granulomatous lesions of joints and bones.Osteoporosis and osteomalacia secondary to IBD and iatrogenic complications can also occur. The management of the rheumatic manifestations of IBD consists of physical therapy in combination with local injection of corticosteroids and nonsteroidal anti-inflammatory drugs; caution is in order however, because of their possible harmful effects on intestinal integrity, permeability,and even on gut inflammation. Sulfasalazine,methotrexate, azathioprine, cyclosporine and leflunomide should be used for selected indications. In some cases, tumor necrosis factor-α blocking agents should be considered as first-line therapy.

  7. How many meals should you skip before undergoing a colonoscopy? A randomized controlled trial: association between duration of abstinence from solid food to cleanliness of the bowel in patients undergoing elective colonoscopy

    Directory of Open Access Journals (Sweden)

    Aziz DA

    2015-01-01

    Full Text Available Dayang A Abdul Aziz,1 Loh H Peow,2 Jasiah Zakaria,2 Mahmud M Nor,3 Zarina A Latiff41Pediatric Surgery Unit, Department of Surgery, UKM Medical Center, Kuala Lumpur, Malaysia; 2Department of Surgery, Hospital Tuanku Jaafar, Seremban, Malaysia; 3Department of Surgery, Universiti Sains Islam, 4Department of Pediatrics, UKM Medical Center, Kuala Lumpur, Malaysia Purpose: An ideal cleansing regime to prepare a clean colon is important for yielding best results during colonoscopy. Many centers practice strict dietary modifications – ie, skipping more than one solid meal 1 or 2 days before the procedure with the consumption of a bowel cleansing agent. No formal studies have been performed to determine how long a patient should withhold solid meals during bowel preparation prior to an outpatient colonoscopy. Materials and methods: A randomized prospective controlled trial was carried out with patients who underwent elective colonoscopy at a tertiary general hospital in Malaysia for 7 months’ duration. Patients were randomized into one of two groups. Group A patients abstained from a solid diet for 24 hours (the last solid meal was breakfast the day before the colonoscopy. Group B patients abstained from a solid diet 14 hours prior to the colonoscopy (the last solid meal was dinner the day before the colonoscopy. We standardized the time for the oral intake of sodium phosphosoda in both groups. The Boston Bowel Preparation Scale was used to grade the cleanliness between the two groups and a score ≥2 was taken as clean bowel preparation. Results: A total of 178 patients (each arm had 89 patients were recruited for this study. Group A showed a mean bowel cleanliness score of 3. Group B showed a mean bowel cleanliness score of 2.5. However, there was a significant difference in bowel cleanliness between the groups (P≤0.05. Conclusion: Abstinence of solid food for either 24 hours or 14 hours prior to the colonoscopy both produced clean bowel

  8. Psychosocial factors in peptic ulcer and inflammatory bowel disease.

    Science.gov (United States)

    Levenstein, Susan

    2002-06-01

    Over the past decade, while gastroenterologists' interest in mind-body interactions in organic disorders dwindled, stronger evidence has linked psychosocial factors with the incidence and recurrence of peptic ulcer and with the course of inflammatory bowel disease. Psychological-behavioral approaches to treatment continue to be disappointing. Psychosocial factors may affect ulcer by increasing duodenal acid load, altering local circulation or motility, intensifying Helicobacter pylori infection, stimulating corticosteroid secretion, and affecting health risk behaviors; possible mechanisms for inflammatory bowel disease include immune deregulation, gut permeability changes, and poor medication adherence. Both belong to the growing category of diseases thought to have an infectious component: for peptic ulcer the bacterium Helicobacter pylori, for inflammatory bowel disease an exaggerated immune response to gut bacteria. Peptic ulcer and inflammatory bowel disease, which present unique interactions among psychological, immunologic, endocrine, infectious, and behavioral factors, are splendid paradigms of the biopsychosocial model.

  9. Small bowel enteroclysis using a hemodialysis blood pump

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Soon Jin; Lim, Hyo Keun; Lee, Won Jae; Kim, Kyeong Ah; Lee, Yeon Ok; Hwang, Jung Hwa; Choi, Sang Hee; Lim, Jae Hoon [Samsung Medical Center, Seoul (Korea, Republic of)

    1998-04-01

    The purpose of this study is to describe the usefulness of small bowel enteroclysis using a hemodialysis blood pump. Over 1 16 month period, 135 double contrast small bowel enteroclysis examinations were performed in 132 patients using a hemodialysis blood pump. Following incubation of the proximal jejunum, barium at a dilution of 50 % and 0.5 %-methylcellulose were infused at a constant rate using a hemodialysis blood pump and multiple spot films of the small intestine were obtained. Success rate, quality of radiographs, positive findings, fluoroscopic time and complications were evaluated. It spite of the long fluoroscopic time and invasiveness, double contrast small bowel enteroclysis is useful for the evaluation of small bowel disease. The infusion of barium and methylcellulose using a hemodialysis blood pump give radiographs of good quality. (author). 18 refs., 2 tabs., 10 figs.

  10. What I Need to Know about Bowel Control

    Science.gov (United States)

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... Español What I Need to Know about Bowel Control Page Content On this page: What is a ...

  11. Steroid allergy in patients with inflammatory bowel disease.

    LENUS (Irish Health Repository)

    Malik, M

    2007-11-01

    Background: Contact allergy to a steroid enema leading to worsening of inflammatory bowel disease (IBD) has recently been reported. This study was designed to look for evidence of steroid allergy in patients with IBD.

  12. Preoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma

    Directory of Open Access Journals (Sweden)

    Hiroaki Shiba

    2009-11-01

    Full Text Available Adult intussusception is rare, accounting for only 5% of all intussusceptions, for which preoperative diagnosis is difficult. We herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma. A 33-year-old man was admitted to our hospital with three weeks history of colicky epigastric pain. Computed tomography revealed thickening of the ileal wall suggestive of intussusception. Colonoscopy revealed an ileocolic intussusception. Barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve. The intussusception was reduced, and the patient underwent partial resection of the ileum encompassing the small bowel tumor. Histological findings confirmed the diagnosis of lipoma of the small bowel. The patient made a satisfactory recovery and remains well.

  13. Metastatic choriocarcinoma in the small bowel: a case report

    Directory of Open Access Journals (Sweden)

    Zohreh Yousefi

    2014-08-01

    Conclusion: In abnormal postpartum hemorrhage, we should consider the possibility of choriocarcinoma. Although, it is important to note rare manifestations of metastatic choriocarcinoma of small bowel in massive gastrointestinal hemorrhage.

  14. Quality of Life in Irritable Bowel Syndrome: A Narrative Overview

    OpenAIRE

    Liang,; Tien

    2016-01-01

    Context Health-related quality of life (HRQoL) is increasingly important in the assessment of chronic conditions, especially for irritable bowel syndrome (IBS), which has no associated mortality, but is prevalent and significantly impacts patient’s lives. Disease-specific instruments such as the irritable bowel syndrome quality of life instrument (IBS-QOL), in addition to generic instruments such as the short form (SF)-36, are useful in measuring health-related quality of life, a...

  15. Practical Evaluation and Handling of Patients with Irritable Bowel Syndrome

    OpenAIRE

    Bodil Ohlsson

    2012-01-01

    Irritable bowel syndrome (IBS) is a functional bowel disorder by unknown aetiology. Several reviews are written about pharmacological and psychological treatment of the disease. Nevertheless, healthcare professionals consider these patients difficult to handle in daily practice. There is an uncertainty about how to measure symptoms and to evaluate the effect of any given treatment. In the absence of objective markers, professionals feel unsure of how to manage the condition and the patients d...

  16. Integrated real time bowel sound detector for artificial pancreas systems

    OpenAIRE

    Khandaker A. Al Mamun; Nicole McFarlane

    2016-01-01

    This paper reports an ultra-low power real time bowel sound detector with integrated feature extractor for physiologic measure of meal instances in artificial pancreas devices. The system can aid in improving long term diabetic patient care and consists of a front end detector and signal processing unit. The front end detector transduces the initial bowel sound recorded from a piezoelectric sensor into a voltage signal. The signal processor uses a feature extractor to determine whether a bowe...

  17. Recent results of laparoscopic surgery in inflammatory bowel disease

    OpenAIRE

    Kessler, Hermann; Mudter, Jonas; Hohenberger, Werner

    2011-01-01

    Inflammatory bowel diseases are an ideal indication for the laparoscopic surgical approach as they are basically benign diseases not requiring lymphadenectomy and extended mesenteric excision; well-established surgical procedures are available for the conventional approach. Inflammatory alterations and fragility of the bowel and mesentery, however, may demand a high level of laparoscopic experience. A broad spectrum of operations from the rather easy enterostomy formation for anal Crohn’s dis...

  18. Immunomodulation of enteric neural function in irritable bowel syndrome

    OpenAIRE

    O’Malley, Dervla

    2015-01-01

    Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder which is characterised by symptoms such as bloating, altered bowel habit and visceral pain. It’s generally accepted that miscommunication between the brain and gut underlies the changes in motility, absorpto-secretory function and pain sensitivity associated with IBS. However, partly due to the lack of disease-defining biomarkers, understanding the aetiology of this complex and multifactorial disease remains elusi...

  19. Complementary Practitioners’ View of Treatment for Inflammatory Bowel Disease

    OpenAIRE

    Verhoef, Marja J; Rapchuk, Ivan; Liew, Trina; Weir, Vanessa; Hilsden, Robert J

    2002-01-01

    A substantial number of patients with inflammatory bowel disease use complementary therapies to manage their disease, including chiropractic and herbal therapies. The objective of this study was to explore whether providers of these therapies see patients with inflammatory bowel disease and recommend therapies, and to determine their opinions about the treatments that they recommend. The study sample comprised 66 chiropractors, 19 pharmacists, 16 herbalists and 15 health food store employees ...

  20. Maternal inflammatory bowel disease and offspring body size

    DEFF Research Database (Denmark)

    Ajslev, Teresa Adeltoft; Sorensen, Thorkild I A; Jess, Tine

    2012-01-01

    Maternal inflammatory bowel disease (IBD) may influence intrauterine growth and hence size at birth, but the consequences for offspring in later life remain uncertain. This study investigated the growth of children of mothers with Crohn's disease (CD) or ulcerative colitis (UC).......Maternal inflammatory bowel disease (IBD) may influence intrauterine growth and hence size at birth, but the consequences for offspring in later life remain uncertain. This study investigated the growth of children of mothers with Crohn's disease (CD) or ulcerative colitis (UC)....

  1. Effects of Hypericum perforatum extract on rat irritable bowel syndrome

    OpenAIRE

    Shilan Mozaffari; Hadi Esmaily; Roja Rahimi; Maryam Baeeri; Yara Sanei; Azar Asadi-Shahmirzadi; Mohammad-Hossein Salehi-Surmaghi; Mohammad Abdollahi

    2011-01-01

    Context: In irritable bowel syndrome (IBS), disturbance of bowel motility is associated with infiltration of inflammatory mediators and cytokines into the intestine, such as neutrophils, myeloperoxidase (MPO), tumor necrosis factor alfa (TNF-α), and lipid peroxide. Aims: Regarding promising anti-inflammatory and anti-oxidative effects of Hypericum perforatum (HP) extract, besides its anti-depressant effect, this study was designed to evaluate the effects of HP in an experimental model of IBS....

  2. Low-FODMAP Diet for Treatment of Irritable Bowel Syndrome

    OpenAIRE

    Magge, Suma; Lembo, Anthony

    2012-01-01

    Functional bowel disorders, including irritable bowel syndrome (IBS), are common disorders that have a significant impact on patients’ quality of life. These disorders present major challenges to healthcare providers, as few effective medical therapies are currently available. Recently, there has been increasing interest in dietary therapies for IBS, particularly a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). Since ingestion of FODMAPs incre...

  3. Role of antispasmodics in the treatment of irritable bowel syndrome

    OpenAIRE

    Annaházi, Anita; Róka, Richárd; Rosztóczy, András; Wittmann, Tibor

    2014-01-01

    Irritable bowel syndrome (IBS) is a long-lasting, relapsing disorder characterized by abdominal pain/discomfort and altered bowel habits. Intestinal motility impairment and visceral hypersensitivity are the key factors among its multifactorial pathogenesis, both of which require effective treatment. Voltage-gated calcium channels mediate smooth muscle contraction and endocrine secretion and play important roles in neuronal transmission. Antispasmodics are a group of drugs that have been used ...

  4. Limitations in assessment of mucosal healing in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Hugh; James; Freeman

    2010-01-01

    An emerging parameter to define the effectiveness of new therapeutic agents in clinical trials,and by extension,for use in day-to-day clinical practice has been labeled mucosal healing.It has been hypothesized that complete healing of the intestinal mucosa in inflammatory bowel diseases should result in reduced disease complications,reduced hospitalization and reduced surgical treatment.By implication,the natural history of inflammatory bowel disease might then be altered. Measurement of mucosal healing,how...

  5. What's new in inflammatory bowel disease in 2008?

    Institute of Scientific and Technical Information of China (English)

    Daniel C Baumgart

    2008-01-01

    Ulcerative colitis and Crohn's disease represent the two major forms of inflammatory bowel disease. In this highlight topic series of articles we cover the latest developments in genetics and epiderniology, intestinal physiology, mucosal immunology, mechanisms of epithelial cell injury and restitution, current medical therapy, modern surgical management, important extraintestinal complications such as primary sclerosing cholangitis, cholangiocellular carcinoma and autoimmune hepatitis as well as endoscopic and molecular screening, detection and prevention of small bowel and colorectal cancer.

  6. Skeletal demineralization and growth retardation in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Genant, H.K.; Mall, J.C.; Wagonfeld, J.B.; Vander Horst, J.; Lanzl, L.H.

    1976-01-01

    Skeletal growth and mineralization in 54 adolescent and adult patients with inflammatory bowel disease have been analyzed comprehensively. Quantitative and qualitative radiologic techniques consisted of conventional roentgenography, photon absorptiometry, and radiographic morphometry. The data are correlated with the type, duration, and severity of disease, and with several modes of therapy. The results indicate that osteopenia and retardation of growth are common in patients with inflammatory bowel disease, particularly in adolescents, in whom the effects of corticosteroids on the skeleton are most deleterious.

  7. IRRITABLE BOWEL SYNDROME: Relationships with Abuse in Childhood

    OpenAIRE

    Sansone, Randy A.; Sansone, Lori A.

    2015-01-01

    Irritable bowel syndrome is allegedly the most common gastrointestinal diagnosis in the United States. The etiology of this syndrome appears to entail the interaction of both genes and the environment. One potential environmental contributory factor to irritable bowel syndrome is abuse in childhood. Of the various forms of abuses previously examined, sexual abuse in childhood appears to be the most patent contributor. However, both emotional and physical abuses may also contribute to irritabl...

  8. Computer-assisted ex vivo, normothermic small bowel perfusion

    OpenAIRE

    Stangl, M.J.; Krapp, J.; Theodorou, D; Eder, M.; Hammer, C; Land, W.; Schildberg, Friedrich Wilhelm

    2000-01-01

    Background: In the present study, a technique for computer-assisted, normothermic, oxygenated, ex vivo, recirculating small bowel perfusion was established as a tool to investigate organ pretreatment protocols and ischemia/reperfusion phenomena. A prerequisite for the desired setup was an organ chamber for ex vivo perfusion and the use of syngeneic whole blood as perfusate. Methods: The entire small bowel was harvested from Lewis rats and perfused in an organ chamber ex vivo for at least 2 h....

  9. Integrated real time bowel sound detector for artificial pancreas systems

    Directory of Open Access Journals (Sweden)

    Khandaker A. Al Mamun

    2016-03-01

    Full Text Available This paper reports an ultra-low power real time bowel sound detector with integrated feature extractor for physiologic measure of meal instances in artificial pancreas devices. The system can aid in improving long term diabetic patient care and consists of a front end detector and signal processing unit. The front end detector transduces the initial bowel sound recorded from a piezoelectric sensor into a voltage signal. The signal processor uses a feature extractor to determine whether a bowel sound is detected. The feature extractor consists of a low noise, low power signal front-end, peak and trough locator, signal slope and width detector, digitizer, and bowel pulse locator. The system was fabricated in a standard 0.18 μm CMOS process, and the bowel sound detection system was characterized and verified with experimentally recorded bowel sounds. The integrated instrument consumes 53 μW of power from a 1 V supply in a 0.96 mm2 area, and is suitable for integration with portable devices.

  10. The Role of Fecal Calprotectin in Investigating Inflammatory Bowel Diseases

    Science.gov (United States)

    Erbayrak, Mustafa; Turkay, Cansel; Eraslan, Elife; Cetinkaya, Hulya; Kasapoglu, Benan; Bektas, Mehmet

    2009-01-01

    INTRODUCTION: Invasive and non-invasive tests can be used to evaluate the activity of inflammatory bowel diseases. OBJECTIVE: The aim of the present study was to investigate the role of fecal calprotectin in evaluating inflammatory bowel disease activity and the correlation of fecal calprotectin with the erythrocyte sedimentation rate and C reactive protein values in inflammatory bowel disease. METHOD: Sixty-five patients affected with inflammatory bowel disease were enrolled. Twenty outpatients diagnosed with inflammatory bowel disease comprised the control group. RESULTS: In the present study, all patients in the control group had an fecal calprotectin value lower than the cut-off point (50 mg/kg). CONCLUSION: In conclusion, fecal calprotectin was found to be strongly associated with colorectal inflammation indicating organic disease. Fecal calprotectin is a simple and non-invasive method for assessing excretion of macrophages into the gut lumen. Fecal calprotectin values can be used to evaluate the response to treatment, to screen asymptomatic patients, and to predict inflammatory bowel disease relapses. PMID:19488608

  11. The role of fecal calprotectin in investigating inflammatory bowel diseases

    Directory of Open Access Journals (Sweden)

    Mustafa Erbayrak

    2009-05-01

    Full Text Available INTRODUCTION: Invasive and non-invasive tests can be used to evaluate the activity of inflammatory bowel diseases. OBJECTIVE: The aim of the present study was to investigate the role of fecal calprotectin in evaluating inflammatory bowel disease activity and the correlation of fecal calprotectin with the erythrocyte sedimentation rate and C reactive protein values in inflammatory bowel disease. METHOD: Sixty-five patients affected with inflammatory bowel disease were enrolled. Twenty outpatients diagnosed with inflammatory bowel disease comprised the control group. RESULTS: In the present study, all patients in the control group had an fecal calprotectin value lower than the cut-off point (50 mg/kg. CONCLUSION: In conclusion, fecal calprotectin was found to be strongly associated with colorectal inflammation indicating organic disease. Fecal calprotectin is a simple and non-invasive method for assessing excretion of macrophages into the gut lumen. Fecal calprotectin values can be used to evaluate the response to treatment, to screen asymptomatic patients, and to predict inflammatory bowel disease relapses.

  12. Nutritional impact of inflammatory bowel diseases on children and adolescents

    Directory of Open Access Journals (Sweden)

    Gilton Marques dos Santos

    2014-12-01

    Full Text Available OBJECTIVE: To perform a sistematiy review of the literature about the nutritional impact of inflammatory bowel diseases in children and adolescents.DATA SOURCES: A systematic review was performed using PubMed/MEDLINE, LILACS and SciELO databases, with inclusion of articles in Portuguese and in English with original data, that analyzed nutritional aspects of inflammatory bowel diseases in children and adolescents. The initial search used the terms "inflammatory bowel diseases" and "children" or "adolescents" and "nutritional evaluation" or "nutrition deficiency". The selection of studies was initially performed by reading the titles and abstracts. Review studies and those withouth data for pediatric patients were excluded. Subsequently, the full reading of the articles considered relevant was performed.RESULTS: 237 studies were identified, and 12 of them were selected according to the inclusion criteria. None of them was performed in South America. During the analysis of the studies, it was observed that nutritional characteristics of patients with inflammatory bowel disease may be altered; the main reports were related to malnutrition, growth stunting, delayed puberty and vitamin D deficiency.CONCLUSION: There are nutritional consequences of inflammatory bowel diseases in children and adolescents, mainly growth stunting, slower pubertal development, underweight and vitamin deficiencies. Nutritional impairments were more significant in patients with Crohn's disease; overweight and obesity were more common in patients with ulcerative rectocolitis. A detailed nutritional assessment should be performed periodically in children and adolescents with inflammatory bowel disease.

  13. Pharmacological treatment of bowel obstruction in cancer patients.

    LENUS (Irish Health Repository)

    O'Connor, Brenda

    2012-02-01

    INTRODUCTION: Malignant bowel obstruction (MBO) is a common complication of advanced cancer, occurring most frequently in gynaecological and colorectal cancer. Its management remains complex and variable. This is in part due to the lack of evidence-based guidelines for the clinicians involved. Although surgery should be considered the primary treatment, this may not be feasible in patients with a poor performance status or advanced disease. Advances have been made in the medical management of MBO which can lead to a considerable improvement in symptom management and overall quality of life. AREAS COVERED: This review emphasizes the importance of a prompt diagnosis of MBO with early introduction of pharmacological agents to optimize symptom control. The authors summarize the treatment options available for bowel obstruction in those patients for whom surgical intervention is not a feasible option. The authors also explore the complexities involved in the introduction of parenteral hydration and total parenteral nutrition in this group of patients. EXPERT OPINION: It is not always easy to distinguish reversible from irreversible bowel obstruction. Early and aggressive management with the introduction of pharmacological agents including corticosteroids, octreotide and anti-cholinergic agents have the potential to maintain bowel patency, and allow for more rapid recovery of bowel transit. A combination of analgesics, anti-emetics and anti-cholinergics with or without anti-secretory agents can successfully improve symptom control in patients with irreversible bowel obstruction.

  14. Altered gastric emptying in patients with irritable bowel syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Caballero-Plasencia, A.M.; Valenzuela-Barranco, M. [Department of Medicine, School of Medicine, University of Granada (Spain); Herrerias-Gutierrez, J.M. [Division of Gastroenterology, University Hospital ``Virgen de la Macarena``, Sevilla (Spain); Esteban-Carretero, J.M. [Central Service of Investigation in Health Sciences, University of Cadiz, Cadiz (Spain)

    1999-04-29

    Irritable bowel syndrome is the most frequent functional disorder of the digestive system. Patients with irritable bowel syndrome have motor disorders not only in the colon, but also in other parts of the digestive tract such as the oesophagus and small intestine; however, it is not known whether the stomach is also involved. We used a radiolabelled mixed solid-liquid meal (technetium-99m for the solid component, indium-111 for the liquid component) to study gastric emptying of solids (GES), liquids (GEL) and indigestible solids (GER) in 50 patients diagnosed as having irritable bowel syndrome (30 with predominant constipation and 20 with predominant diarrhoea). GER was measured by counting the number of indigestible solids remaining in the stomach 4 h after they were swallowed. In patients with irritable bowel syndrome, GES and GEL were slower than in control subjects (P<0.05). GER was normal in all patients except for two women. Thirty-two patients (64%) showed delayed GES, 29 (58%) delayed GEL, and 2 (4%) delayed GER. Among patients with irritable bowel syndrome, GES was slower in those with predominant constipation than in those with predominant diarrhoea (P<0.05); GEL and GER were similar in both groups. Gastroparesis was found in a large proportion of patients with irritable bowel syndrome, suggesting the presence of a more generalised motor disorder of the gut. (orig.) With 1 fig., 3 tabs., 48 refs.

  15. IRRITABLE BOWEL SYNDROME: Relationships with Abuse in Childhood.

    Science.gov (United States)

    Sansone, Randy A; Sansone, Lori A

    2015-01-01

    Irritable bowel syndrome is allegedly the most common gastrointestinal diagnosis in the United States. The etiology of this syndrome appears to entail the interaction of both genes and the environment. One potential environmental contributory factor to irritable bowel syndrome is abuse in childhood. Of the various forms of abuses previously examined, sexual abuse in childhood appears to be the most patent contributor. However, both emotional and physical abuses may also contribute to irritable bowel syndrome, although less distinctly. Studies examining a combined childhood-abuse variable (i.e., sexual, emotional, and/or physical abuses) in relationship to irritable bowel syndrome also indicate inconsistent results. Given the presence of childhood abuse as a potential factor in the development of irritable bowel syndrome, a number of pathophysiological events are postulated to explain this relationship, including alterations in norepinephrine and serotonin levels as well as dysregulation of the hypothalamic-pituitary-adrenal axis. Only future research will clarify the specific abuse elements (i.e., further clarification of the individual types of abuse, duration of abuse, roles of the perpetrator/victim) and the pathophysiological changes that culminate in irritable bowel syndrome. PMID:26155376

  16. CT Findings of Small Bowel Anisakiasis: Analysis of Four Cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Wee Kyoung; Song, Soon Young; Cho, On Koo; Koh, Byung Hee [Hanyang University College of Medicine, Seoul (Korea, Republic of); Kim, Yong Soo; Jung, Woo Kyoung; Kim, Min Yeong [Hanyang University Guri Hospital, College of Medicine, Guri (Korea, Republic of)

    2011-02-15

    We wanted to describe the CT findings of small bowel anisakiasis with the pathologic correlation. Four patients with surgically and pathologically proven small bowel anisakiasis were included in this retrospective study. They were three men and one woman and their ages ranged from 28 to 43 years (mean age: 38 years). We evaluated their clinical, CT and histological findings. All the patients had a history of ingesting raw fish within 24 hours from the time of symptom onset. They complained of abdominal pain (n=4), nausea (n=4), vomiting (n=2) and diarrhea (n=1). Physical examination revealed tenderness (n=4), rebound tenderness (n=4) and increased bowel sounds (n=3). Leukocytosis was noted in all the patients on the laboratory examination. None of the patients showed eosinophilia. The CT findings were segmental small bowel wall thickening with preserved layering (n=4), focal segmental luminal narrowing with proximal dilatation (n=4), peritoneal thickening (n=3), mesenteric or omental infiltration (n=4) and varying degrees of ascites (n=4). On the histopathologic examination, they revealed an infiltration of eosinophils (n=4) in all layers of the bowel wall with severe edema. The larvae were found on surgico-pathologic examination in all the cases. The CT findings may be helpful to make the specific diagnosis of small bowel anisakiasis in a patient with the clinical findings of an acute abdomen and a history of eating raw fish

  17. Mesenteric Air Embolism Following Enteroscopic Small Bowel Tattooing Procedure

    Directory of Open Access Journals (Sweden)

    Natalie Chen

    2012-01-01

    Full Text Available Double balloon enteroscopy (DBE is a revolutionary procedure in which the entire small bowel can be visualized endoscopically. DBE has the advantage of both diagnostic and therapeutic capabilities in the setting of small bowel neoplasms and vascular malformations. We present a unique case of a 76-year-old female who underwent small bowel DBE tattoo marking of a distal small bowel tumor complicated by development of severe abdominal pain postprocedure secondary to bowel air embolism into the mesenteric veins. Mesenteric air can be seen after other endoscopic procedures such as biopsy, mucosal clip placement and polypectomy, or following a colonoscopy. Mesenteric air embolism following small bowel tattooing procedure has not been previously reported in the literature. Mesenteric air when present may be attributed to mesenteric ischemia and can subject the patient to unnecessary surgical intervention if misdiagnosed. Thus, this report holds significance for the radiologist as computed tomography (CT findings of mesenteric air embolism must be evaluated in the context of appropriate clinical history before treatment decisions are made.

  18. Mesenteric air embolism following enteroscopic small bowel tattooing procedure.

    Science.gov (United States)

    Chen, Natalie; Lamba, Ramit; Lee, John; Lall, Chandana

    2012-01-01

    Double balloon enteroscopy (DBE) is a revolutionary procedure in which the entire small bowel can be visualized endoscopically. DBE has the advantage of both diagnostic and therapeutic capabilities in the setting of small bowel neoplasms and vascular malformations. We present a unique case of a 76-year-old female who underwent small bowel DBE tattoo marking of a distal small bowel tumor complicated by development of severe abdominal pain postprocedure secondary to bowel air embolism into the mesenteric veins. Mesenteric air can be seen after other endoscopic procedures such as biopsy, mucosal clip placement and polypectomy, or following a colonoscopy. Mesenteric air embolism following small bowel tattooing procedure has not been previously reported in the literature. Mesenteric air when present may be attributed to mesenteric ischemia and can subject the patient to unnecessary surgical intervention if misdiagnosed. Thus, this report holds significance for the radiologist as computed tomography (CT) findings of mesenteric air embolism must be evaluated in the context of appropriate clinical history before treatment decisions are made. PMID:23393642

  19. Structure refinement and one-center luminescence of Eu{sup 3+} activated ZnBi{sub 2}B{sub 2}O{sub 7} under UV excitation

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Liwei; Zhang, Fangxin [The MOE Key Laboratory of Weak-Light Nonlinear Photonics, School of Physics, Nankai University, Tianjin 300071 (China); Wu, Li, E-mail: lwu@nankai.edu.cn [The MOE Key Laboratory of Weak-Light Nonlinear Photonics, School of Physics, Nankai University, Tianjin 300071 (China); Yi, Huan [The MOE Key Laboratory of Weak-Light Nonlinear Photonics, School of Physics, Nankai University, Tianjin 300071 (China); Wang, Hongrun [Institute of Photo-electronic Thin Film Devices and Technology, Tianjin Key Laboratory of Photo-electronic Thin Film Devices and Technology, and Key Laboratory of Optoelectronic Information Science and Technology, Ministry of Education, Nankai University, Tianjin 300071 (China); Zhang, Yi, E-mail: yizhang@nankai.edu.cn [Institute of Photo-electronic Thin Film Devices and Technology, Tianjin Key Laboratory of Photo-electronic Thin Film Devices and Technology, and Key Laboratory of Optoelectronic Information Science and Technology, Ministry of Education, Nankai University, Tianjin 300071 (China); Kong, Yongfa; Xu, Jingjun [The MOE Key Laboratory of Weak-Light Nonlinear Photonics, School of Physics, Nankai University, Tianjin 300071 (China)

    2015-11-05

    A series of Eu{sup 3+}-activated red phosphors ZnBi{sub 2}B{sub 2}O{sub 7}:xEu{sup 3+} were synthesized by high temperature solid-state reaction method. Rietveld refinement on the powder X-ray diffraction (XRD) data was performed to study the local crystal environment of Eu{sup 3+} in ZnBi{sub 2}B{sub 2}O{sub 7} host. The refinement results disclose that the doped Eu{sup 3+} do not change the host structure. Although two different cation sites are available, the doped Eu{sup 3+} is inclined to occupy Zn site instead of Bi site. This indicates that there is only one luminescent center when Eu{sup 3+} is doped into ZnBi{sub 2}B{sub 2}O{sub 7} phosphor, which is further confirmed by the luminescence properties of ZnBi{sub 2}B{sub 2}O{sub 7}:xEu{sup 3+}. The influences of the doping concentration and the excitation wavelength on the one-center luminescence of Eu{sup 3+} in ZnBi{sub 2}B{sub 2}O{sub 7} are discussed along with the decay characteristics. Based on the temperature-dependent PL spectra, the fast decrease of emission intensity with the increase of temperature is due to the non-radiative relaxation. - Highlights: • New red-emitting ZnBi{sub 2}B{sub 2}O{sub 7}:xEu{sup 3+} phosphors excited by near ultraviolet light were synthesized. • The doped Eu{sup 3+} prefers to occupy Zn{sup 2+} site and there is only one-center luminescence of Eu{sup 3+} in ZnBi{sub 2}B{sub 2}O{sub 7} host. • CIE coordinates are very much closer to that of standard red light (0.67, 0.33)

  20. Overview of 5-ASA in Therapy of Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    CN Williams

    1994-01-01

    Full Text Available There are two forms of 5-aminosalicylic acid (5-ASA drug delivery. First, a pro-drug form in which 5-ASA, the active principal, is attached to a c.arrier molecule and released in the intestine by bacterial cleavage. An example of this is sulfasalazine, originally developed in the 1940s and found to be effective, cheap, but limited by side effects due to the sulfapyridine component. The second drug delivery system depends on an enteric coating for delayed pH-dependent release or for a timed-released mechanism. 5-ASA inhibits 5-lipoxygenase, modulates leukocyte function and inhibits soluble mediator release, and is an effective scavenger action of free oxygen radicals, the relative importance of which is unknown. The multiplicity of action is probably its strength because drugs that have only one of these actions are relatively ineffective in inflammatory bowel disease. 5-ASA compounds are effective in treating mild to moderate acute ulcerative colitis and in maintaining remission, and are equivalent to sulfasalazine in this regard. 5-ASA used topically in enema or suppository form is highly efficient in both acute disease and in maintaining remission. 5-ASA is also effective in active Crohn’s disease, but not as effective as in maintenance therapy compared with ulcerative colitis. The pro-drugs tend to have more side effects. Slow release compounds are well tolerated with few side effects, allowing increases to effective dosage. In patients intolerant of sulfasalazine, switching to a 5-ASA preparation usually results in tolerance and therapeutic benefit, with an occasional allergic reaction to the 5-ASA molecule limiting its use.

  1. Investigation of the blastocystis hominis frequency in patients with irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Bayram Pektaş

    2014-06-01

    Full Text Available AimIn this study, it was aimed to investigate the relationship between Blastocystis hominis infection and inflammatory bowel syndrome (IBS. Methods: In this study, the frequency of B. hominis in the stool samples of 52 patients applied to Microbiology laboratory and pre-diagnosed with irritable bowel syndrome in January 2013-June 2013 was investigated, retrospectively. Microscopic investigations were evaluated after macroscopic examination. For this purpose, the stool samples of the diarrheal cases were investigated by trichrome staining after they were prepared by native-lugol and formol ethyl acetate concentration method. The results were compared with the examination of 2160 stool samples sent to our laboratory during the same period. Results: Stool samples of 52 patients pre-diagnosed with IBS were accepted to our laboratory in January 2013-June 2013. 13 of the patients were found as B. hominis positive. Weight loss and anorexia was identified only in one patient while abdominal pain, diarrhea and gas complaints were identified in all of the IBH and B. hominis positive patients. During the same period, parasites were detected in 96 (4.4% of 2160 stool samples sent to our laboratory and the most common was B. hominis 48 (2.2%. 452 of these patients applied with diarrhea symptoms and B. hominis was detected in 36 samples (7.96%. Conclusion: The limited studies investigating the presence of B. hominis in patients with irritable bowel syndrome are far from illuminating the role of this agent in disease pathogenesis. We believe that further investigations should be performed. In this study, 25% of the patients were found as positive. J Clin Exp Invest 2014; 5 (2: 242-245

  2. US features of transient small bowel intussusception in pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hye [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2004-09-15

    To describe the sonographic (US) and clinical features of spontaneously reduced small bowel intussusception, and to discuss the management options for small bowel intussusception based on US findings with clinical correlation. During a five years of period, 34 small bowel intussusceptions were diagnosed on US in 32 infants and children. The clinical presentations and imaging findings of the patients were reviewed. The clinical presentations included abdominal pain or irritability (n = 25), vomiting (n 5), diarrhea (n = 3), bloody stool (n = 1), and abdominal distension (n = 1), in combination or alone. US showed multi-layered round masses of small (mean, 1.5 {+-} 0.3 cm) diameters and with thin (mean, 3.5 {+-} 1 mm) outer rims along the course of the small bowel. The mean length was 1.8 {+-} 0.5 cm and peristalsis was seen on the video records. There were no visible lead points. The vascular flow signal appeared on color Doppler images in all 21 patients examined. Spontaneous reduction was confirmed by combinations of US (n = 28), small bowel series (n = 6), CT scan (n = 3), and surgical exploration (n 2). All patients discharged with improved condition. Typical US findings of the transient small bowel intussusception included 1) small size without wall swelling, 2) short segment, 3) preserved wall motion, and 4) absence of the lead point. Conservative management with US monitoring rather than an immediate operation is recommended for those patient with typical transient small bowel intussusceptions. Atypical US findings or clinical deterioration of the patient with persistent intussusception warrant surgical exploration.

  3. Predictive factors of small bowel patency in Crohn's disease patients

    Directory of Open Access Journals (Sweden)

    Andreia Albuquerque

    2016-02-01

    Full Text Available Background: Patency capsule was developed to avoid small bowel video capsule endoscopy retention, namely in patients with Crohn's disease. Aims: To evaluate the predictive factors of small bowel patency in Crohn's disease patients. Patients and methods: Retrospective analysis including 151 Crohn's disease patients submitted to patency capsule (Agile® Patency Capsule from 2011 to 2012. Patients that excreted the intact patency capsule were classified as having a patent small bowel (without patency capsule retention, other patients were considered to have negative patency of the small bowel (patency capsule retention. Results: Patients had a mean age of 41±14 years, 54% were female and 25% had been previously submitted to surgery. Stricturing disease was seen in 20% of cases and penetrating disease in 16% of cases. Left-sided colonic lesions and ileal strictures were observed at colonoscopy in 13% and 9% of patients, respectively. In our sample, 28% of patients had negative patency of the small bowel (patency capsule retention. In multivariate analysis, independent factors that were associated with negative patency of the small bowel in Crohn's disease patients were stricturing (OR 10.16, p < 0.001 and penetrating phenotypes (OR 11.73, p = 0.001, left-sided colonic lesions (OR 3.77, p = 0.038, ileal stricture (OR 9.76, p = 0.003; previous intestinal surgery was found to be protective (OR 0.16, p = 0.006. Conclusions: Stricturing or penetrating disease, ileal strictures, no previous surgery and left-sided colonic lesions were the factors associated with negative small bowel patency in Crohn's disease patients.

  4. Small bowel capsule endoscopy in 2007: Indications, risks and limitations

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Capsule endoscopy has revoluzionized the study of the small bowel by providing a reliable method to evaluate,endoscopically, the entire small bowel. In the last six years several papers have been published exploring the possible role of this examination in different clinical conditions. At the present time capsule endoscopy is generally recommended as a third examination, after negative bidirectional endoscopy, in patients with obscure gastrointestinal bleeding. A growing body of evidence suggests also an important role for this examination in other clinical conditions such as Crohn's disease, celiac disease, small bowel polyposis syndromes or small bowel tumors. The main complication of this examination is the retention of the device at the site of a previously unknown small bowel stricture. However there are also some other open issues mainly due to technical limitations of this tool (which is not driven from remote control, is unable to take biopsies, to insufflate air, to suck fluids or debris and sometimes to correctly size and locate lesions).The recently developed double balloon enteroscope, owing to its capability to explore a large part of the small bowel and to take targeted biopsies, although being invasive and time consuming,can overcome some limitations of capsule endoscopy.At the present time, in the majority of clinical conditions (i.e. obscure GI bleeding), the winning strategy seems to be to couple these two techniques to explore the small bowel in a painless, safe and complete way (with capsule endoscopy) and to define and treat the lesions identified (with double balloon enteroscopy).

  5. Management of Inflammatory Bowel Disease During Pregnancy.

    Science.gov (United States)

    Bar-Gil Shitrit, Ariella; Grisaru-Granovsky, Sorina; Ben Ya'acov, Ami; Goldin, Eran

    2016-08-01

    Inflammatory bowel disease (IBD) usually affects women during their reproductive years and many concerns arise among these young patients. Pre-pregnancy consultation with a multi-disciplinary team is very important. The team should make patients aware of the critical importance of ensuring that conception occurs during a period of disease remission. Conception during an IBD flare-up results in disease activity or even exacerbates disease in two-thirds of women. Exacerbation of the disease is associated with increased frequency of maternal and fetal complications. Drug therapy constitutes a considerable source of patient anxiety but most drugs used for treating IBD are considered safe. Therefore, continuing pharmacological therapy during pregnancy is necessary to maintain disease control. Optimization of pre-conception nutritional status and smoking cessation are also emphasized. The general guideline for most patients, except for active perianal disease patients, is to aim for vaginal delivery in the absence of obstetric contraindications. Consistent, ongoing follow-up, as detailed in this review, should allay the anxieties and fears surrounding continuing immunosuppressive drugs during pregnancy, allowing each patient to attain the optimal conditions for achieving her goal of holding a healthy baby. PMID:27068171

  6. Infertility in men with inflammatory bowel disease.

    Science.gov (United States)

    Shin, Takeshi; Okada, Hiroshi

    2016-08-01

    Inflammatory bowel disease (IBD) predominantly affects young adults. Fertility-related issues are therefore important in the management of patients with IBD. However, relatively modest attention has been paid to reproductive issues faced by men with IBD. To investigate the effects of IBD and its treatment on male fertility, we reviewed the current literature using a systematic search for published studies. A PubMed search were performed using the main search terms "IBD AND male infertility", "Crohn's disease AND male infertility", "ulcerative colitis AND male infertility". References in review articles were used if relevant. We noted that active inflammation, poor nutrition, alcohol use, smoking, medications, and surgery may cause infertility in men with IBD. In surgery such as proctocolectomy with ileal pouch-anal anastomosis, rectal incision seems to be associated with sexual dysfunction. Of the medications used for IBD, sulfasalazine reversibly reduces male fertility. No other medications appear to affect male fertility significantly, although small studies suggested some adverse effects. There are limited data on the effects of drugs for IBD on male fertility and pregnancy outcomes; however, patients should be informed of the possible effects of paternal drug exposure. This review provides information on fertility-related issues in men with IBD and discusses treatment options. PMID:27602237

  7. Inflammatory Bowel Disease: Progress Towards a Gene

    Directory of Open Access Journals (Sweden)

    David A van Heel

    2000-01-01

    Full Text Available The pathogenesis of ulcerative colitis (UC and Crohn’s disease (CD is still unknown, but the importance of genetic susceptibility has been clearly shown by epidemiological data from family and twin studies. Linkage studies have identified two susceptibility loci for inflammatory bowel disease (IBD on chromosomes 12 and 16. Importantly, these linkages have been replicated by independent investigators, and studies of positional candidates within these regions continue, together with fine mapping strategies. Regions of ’suggestive’ linkage on chromosomes 1, 3, 4, 6, 7, 10, 22 and X have also been reported in individual studies. Other important candidate genes investigated include the interleukin-1 receptor antagonist, MUC3 and genes of the human leukocyte antigen (HLA system. The apparently conflicting data in different studies from around the world may be explained by ethnic differences, case mix and genetic heterogeneity. Replicated class II HLA associations include HLA DRB1*0103 and DR2 (DRB1*1502, involved in UC susceptibility, and HLA DRB1*03 and DR4 as resistance alleles for CD and UC respectively. Animal studies have provided insights from targeted mutations and quantitative trait locus analysis. The goals of continuing research include narrowing the regions of linkages and analysis of candidate genes, and possibly the application of newly developed methods using single nucleotide polymorphisms. Advances in IBD genetics hold the potential to provide knowledge about the disease pathogenesis at the molecular level, with ensuing benefits for clinical practice.

  8. Mouth cancer in inflammatory bowel diseases.

    Science.gov (United States)

    Giagkou, E; Christodoulou, D K; Katsanos, K H

    2016-05-01

    Mouth cancer is a major health problem. Multiple risk factors for developing mouth cancer have been studied and include history of tobacco and alcohol abuse, age over 40, exposure to ultraviolet radiation, human papilloma virus infection (HPV), nutritional deficiencies, chronic irritation, and existence or oral potentially malignant lesions such as leukoplakia and lichen planus. An important risk factor for mouth cancer is chronic immunosuppression and has been extensively reported after solid organ transplantation as well as HIV-infected patients. Diagnosis of inflammatory bowel disease (IBD) is not yet considered as a risk factor for oral cancer development. However, a significant number of patients with IBD are receiving immunosuppressants and biological therapies which could represent potential oral oncogenic factors either by direct oncogenic effect or by continuous immunosuppression favoring carcinogenesis, especially in patients with HPV(+) IBD. Education on modifiable risk behaviors in patients with IBD is the cornerstone of prevention of mouth cancer. Oral screening should be performed for all patients with IBD, especially those who are about to start an immunosuppressant or a biologic. PMID:26671147

  9. Intestinal barrier homeostasis in inflammatory bowel disease.

    Science.gov (United States)

    Goll, Rasmus; van Beelen Granlund, Atle

    2015-01-01

    The single-cell thick intestinal epithelial cell (IEC) lining with its protective layer of mucus is the primary barrier protecting the organism from the harsh environment of the intestinal lumen. Today it is clear that the balancing act necessary to maintain intestinal homeostasis is dependent on the coordinated action of all cell types of the IEC, and that there are no passive bystanders to gut immunity solely acting as absorptive or regenerative cells: Mucin and antimicrobial peptides on the epithelial surface are continually being replenished by goblet and Paneth's cells. Luminal antigens are being sensed by pattern recognition receptors on the enterocytes. The enteroendocrine cells sense the environment and coordinate the intestinal function by releasing neuropeptides acting both on IEC and inflammatory cells. All this while cells are continuously and rapidly being regenerated from a limited number of stem cells close to the intestinal crypt base. This review seeks to describe the cell types and structures of the intestinal epithelial barrier supporting intestinal homeostasis, and how disturbance in these systems might relate to inflammatory bowel disease.

  10. Genetic determination of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Cristina Hotoleanu; Radu Popp; Adrian Pavel Trifa; Laurentiu Nedelcu; Dan L Dumitrascu

    2008-01-01

    Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder.According to the Rome Ⅲ criteria,IBS is defined as recurrent abdominal pain or discomfort for at least 3 d per month during the previous 3 mo associated with two or more of the following symptoms:improvement with defecation,onset associated with a change in the frequency of stool and/or onset associated with a change in form or appearance of stool.There is growing evidence regarding the genetic contribution in IBS,however the precise etiology of IBS is still unknown.The evaluation of the genetic influence is based on twin studies,familial aggregation and genetic epidemiological investigations.Most studies showed a concordance for IBS significantly greater in monozygotic than in dizygotic twins.The majority of the studies have shown that familial aggregation may represent exposures to a similar environment,as well as the influence of genetic factors.Whereas no specific gene has been identified in association with IBS,recent studies have noticed the importance of polymorphisms in the promoter region of the serotonin reuptake transporter gene,G-protein beta 3 subunit gene (C825T),cholecystokinin receptor (CCKAR gene 779T>C),and high-producer tumornecrosis factor genotype.Further studies are necessary to determine how genetic factors influence the clinical manifestations and therapeutical response in IBS patients.

  11. Novel genetic markers in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Genetic factors play a significant role in determining inflammatory bowel disease (IBD) susceptibility. Epidemiologic data support genetic contribution to the pathogenesis of IBD, which include familial aggregation, twin studies, racial and ethnic differences in disease prevalence. Linkage studies have identified several susceptibility genes contained in different genomic regions named IBD1 to IBD9. Nucleotide oligomerization domain (NOD2) and human leukocyte antigen (HLA) genes are the most extensively studied genetic regions (IBD1 and IBD3 respectively) in IBD. Mutations of the NOD2 gene are associated with Crohn's disease (CD) and several HLA genes are associated with ulcerative colitis (UC) and CD. Toll like receptors (TLRs) have an important role in the innate immune response against infections by mediating recognition of pathogen-associated microbial patterns. Studying single-nucleotide polymorphisms (SNPs) in molecules involved in bacterial recognition seems to be essential to define genetic backgrounds at risk of IBD. Recently, numerous new genes have been identified to be involved in the genetic susceptibility to IBD: NOD1/Caspase-activation recruitment domains 4 (CARD4), Chemokine ligand 20 (CCL20), IL-11, and IL-18 among others. The characterization of these novel genes potentially will lead to the identification of therapeutic agents and clinical assessment of phenotype and prognosis in patients with IBD.

  12. Faecal calprotectin: Management in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    José; Manuel; Benítez; Valle; García-Sánchez

    2015-01-01

    Inflammatory bowel disease(IBD) is a chronic and relapsing disorder which leads to an inflammation of the gastrointestinal tract. A tailored therapy to achieve mucosal healing with the less adverse events has become a key issue in the management of IBD. In the past, the clinical remission was the most important factor to consider for adapting diagnostic procedures and therapeutic strategies. However, there is no a good correlation between symptoms and intestinal lesions, so currently the goals of treatment are to achieve not only the control of symptoms, but deep remission, which is related with a favourable prognosis. Thus, the determination of biological markers or biomarkers of intestinal inflammation play a crucial role. Many biomarkers have been extensively evaluated in IBD showing significant correlation with endoscopic lesions, risk of recurrence and response to treatment. One of the most important markers is faecal calprotectin(FC). Despite calprotectin limitations, this biomarker represents a reliable and noninvasive alternative to reduce the need for endoscopic procedures. FC has demonstrated its performance for regular monitoring of IBD patients, not only to the diagnosis for discriminating IBD from non-IBD diagnosis, but for assessing disease activity, relapse prediction and response to therapy. Although, FC provides better results than other biomarkers such as C-reactive protein and erythrocyte sedimentation rate, these surrogate markers of intestinal inflammation should not be used isolation but in combination with other clinical, endoscopic, radiological or/and histological parameters enabling a comprehensive assessment of IBD patients.

  13. Diagnostics in inflammatory bowel disease: Ultrasound

    Institute of Scientific and Technical Information of China (English)

    DeikeStrobel; RuedigerSGoertz; ThomasBernatik

    2011-01-01

    Diagnosis of chronic inflammatory bowel diseases (IBD) is based on a combination of clinical symptoms, laboratory tests and imaging data. Imaging of the morphological characteristics of IBD includes the assessment of mucosal alterations, transmural involvement and extraintestinal manifestations. No single imaging technique serves as a diagnostic gold standard to encompass all disease manifestations. Ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) allow cross-sectional imaging of the transmural alterations and extraintestinal manifestations. While in the USA the technique of choice is CT, in Europe the focus is more on MRI and ultrasound (US). Most patients with chronic IBD are diagnosed at a young age. After baseline diagnosis many of these young patients have to undergo repetitive imaging procedures during the variable clinical course of the disease, characterized by alternate periods of remission and active disease, and in monitoring the response to treatment. US has the advantage of being noninvasive, less costly, and easily repeatable, and thus can be very useful in following up patients with IBD. In addition, rising concern about radiation exposure in young adults indicates the demand for radiation-sparing techniques like US and MRI. This article focuses on the current clinical practice of US in IBD, describing the current technologies used in transabdominal intestinal US and the characteristic sonographic findings in Crohn′s disease and ulcerative colitis.

  14. Environmental triggers for inflammatory bowel disease.

    Science.gov (United States)

    Ananthakrishnan, Ashwin N

    2013-01-01

    Inflammatory bowel diseases [IBD; Crohn's disease (CD), ulcerative colitis (UC)] are chronic immunologically mediated diseases that are due to a dysregulated immune response to intestinal flora in a genetically susceptible host. Despite advances in genetics, the likelihood of occurrence of disease remains incompletely explained and there appears to be a strong role for the environment in mediating risk of disease. Smoking remains the most widely studied and replicated risk factor, contributing to increased risk and severity of CD while conferring protection against UC. Recent data has suggested novel risk factors. Lower plasma vitamin D is associated with an increased risk of Crohn's disease, and vitamin D supplementation may prevent relapse of disease. Several medications including oral contraceptives, post-menopausal hormone replacement, aspirin, NSAIDs, and antibiotics may increase risk of CD or UC with the mechanisms of effect remaining inadequately defined. There is continuing evidence that depression and psychosocial stress may play a role in the pathogenesis of both CD and UC, while at the same time also increasing risk for disease flares. There is also a growing understanding of the role of diet on IBD, in particular through its effect on the microbiome. Animal protein intake and n-6 fatty acids may increase risk of UC while n-3 fatty acids and dietary fiber may confer protection. The effect of diet on established disease remains poorly studied. There is need for routine measurement of a spectrum of environmental exposures in prospective studies to further our understanding. PMID:23250702

  15. Functional findings in irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Iris Posserud; Amanda Ersryd; Magnus Simrén

    2006-01-01

    The pathophysiology of IBS is complex and still incompletely known. Both central and peripheral factors, including psychosocial factors, abnormal GI motility and secretion, and visceral hypersensitivity, are thought to contribute to the symptoms of IBS. Several studies have demonstrated altered GI motor function in IBS patients and the pattern differs between IBS subgroups based on the predominant bowel pattern. Few studies have so far addressed GI secretion in IBS, but there are some evidence supporting altered secretion in the small intestine of IBS patients. Visceral hypersensitivity is currently considered to be perhaps the most important pathophysiological factor in IBS. Importantly, several external and internal factors can modulate visceral sensitivity, as well as GI motility, and enhanced responsiveness within the GI tract to for instance stress and nutrients has been demonstrated in IBS patients. Today IBS is viewed upon as a disorder of dysregulation of the so-called brain-gut axis, involving abnormal function in the enteric, autonomic and/or central nervous systems, with peripheral alterations probably dominating in some patients and disturbed central processing of signals from the periphery in others.

  16. Irritable bowel syndrome and psychological stress

    Directory of Open Access Journals (Sweden)

    Anita D Stuart

    1999-01-01

    Full Text Available The purpose of this study was twofold. The first aim was to clarify the relationship between psychological stress and lrritable Bowel Syndrome (IBS by establishing whether individuals suffering from IBS experience minor stress differently from healthy individuals in terms of its frequency or intensity. The second aim was more general and concerns theory building in a field filled with ambiguity and confusion. Two groups, one comprising IBS sufferers and the other healthy controls, completed the Daily Stress lnventory and the Occupational Stress lnventory - questionnaires designed to measure minor daily and occupational stress respectively. The findings indicate that IBS sufferers do not experience more stress than healthy individuals, but they experience the stressors with greater intensity.

    Opsomming
    Die doel van die studie was tweeledig. Eerstens is daar gepoog om duidelikheid te kry oor die verband tussen sielkundige stres en Prikkelbare Dermsindroom (PDS, deur te bepaal of individue wat aan PDS ly geringe stres anders ervaar as gesonde individue in terme van gereeldheid of intensiteit. Die tweede doelwit was meer algemeen en spreek die kwessie van teorie ontwikkeling aan in 'n veld gevul met dubbelsinningheid en verwarring. Twee groepe, een bestaande uit PDS lyers en die ander 'n gesonde kontrolegroep, het die "Daily Stress Inventory'' en die "Occupational Stress Inventory" voltooi. Die vraelyste is ontwerp om onderskeidelik daaglikse stres en werkstres te meet. Die resultate dui daarop dat PDS lyers nie meer stres ervaar as die gesonde individue nie, maar dat hulle wel die stressors ervaar met groter intensiteit.

  17. The Intestinal Microbiota and Irritable Bowel Syndrome.

    Science.gov (United States)

    Ringel, Yehuda; Ringel-Kulka, Tamar

    2015-01-01

    Irritable bowel syndrome (IBS) is the most prevalent and the best studied functional gastrointestinal disorder. The etiology and the pathogenesis of IBS are still not clear; however, recent studies have implicated a role for alterations in the intestinal microbiota (dysbiosis) in the pathophysiology of the disorder. Epidemiological observations have demonstrated that the development of IBS symptoms is often preceded by a disruption of the individual's normal intestinal microbiota, and microbiological studies have demonstrated compositional differences in the intestinal microbiota between patients with IBS patients and healthy controls. In addition, animal studies and a few recent human clinical studies have demonstrated that compositional changes in the intestinal microbiota in IBS are associated with relevant abnormal gastrointestinal and brain-gut axis functions that are often observed in patients with IBS. This article discusses points of interest from the current research on the microbiota-gut-brain interactions in IBS and highlights the relevance of the emerging data to our understanding of the disorder and the clinical implications for patients' care. PMID:26447966

  18. Fecal Microbiota Transplantation for Inflammatory Bowel Disease

    Science.gov (United States)

    Lopez, Joanna

    2016-01-01

    The gut bacterial microbiome, particularly its role in disease and inflammation, has gained international attention with the successful use of fecal microbiota transplantation (FMT) in the treatment of Clostridium difficile infection. This success has led to studies exploring the role of FMT in other conditions, including inflammatory bowel disease (IBD). Both Crohn’s disease and ulcerative colitis are chronic inflammatory conditions of the gastrointestinal system that have multifactorial etiologies. A shift in gut microbial composition in genetically susceptible individuals, an altered immune system, and environmental factors are all hypothesized to have a role in the pathogenesis of IBD. While numerous case reports and cohort studies have described the use of FMT in patients with IBD over the last 2 decades, the development of new sequencing techniques and results from 2 recent randomized, controlled trials have allowed for a better understanding of the relationship between the microbiome and the human host. However, despite these efforts, knowledge remains limited and the role of FMT in the management of IBD remains uncertain. Further investigation is necessary before FMT joins the current armamentarium of treatment options in clinical practice. PMID:27493597

  19. Infertility in men with inflammatory bowel disease

    Science.gov (United States)

    Shin, Takeshi; Okada, Hiroshi

    2016-01-01

    Inflammatory bowel disease (IBD) predominantly affects young adults. Fertility-related issues are therefore important in the management of patients with IBD. However, relatively modest attention has been paid to reproductive issues faced by men with IBD. To investigate the effects of IBD and its treatment on male fertility, we reviewed the current literature using a systematic search for published studies. A PubMed search were performed using the main search terms “IBD AND male infertility”, “Crohn’s disease AND male infertility”, “ulcerative colitis AND male infertility”. References in review articles were used if relevant. We noted that active inflammation, poor nutrition, alcohol use, smoking, medications, and surgery may cause infertility in men with IBD. In surgery such as proctocolectomy with ileal pouch-anal anastomosis, rectal incision seems to be associated with sexual dysfunction. Of the medications used for IBD, sulfasalazine reversibly reduces male fertility. No other medications appear to affect male fertility significantly, although small studies suggested some adverse effects. There are limited data on the effects of drugs for IBD on male fertility and pregnancy outcomes; however, patients should be informed of the possible effects of paternal drug exposure. This review provides information on fertility-related issues in men with IBD and discusses treatment options. PMID:27602237

  20. Interaction of obesity and inflammatory bowel disease

    Science.gov (United States)

    Harper, Jason W; Zisman, Timothy L

    2016-01-01

    Inflammatory bowel disease (IBD) is a chronic inflammatory condition of unknown etiology that is thought to result from a combination of genetic, immunologic and environmental factors. The incidence of IBD has been increasing in recent decades, especially in developing and developed nations, and this is hypothesized to be in part related to the change in dietary and lifestyle factors associated with modernization. The prevalence of obesity has risen in parallel with the rise in IBD, suggesting a possible shared environmental link between these two conditions. Studies have shown that obesity impacts disease development and response to therapy in patients with IBD and other autoimmune conditions. The observation that adipose tissue produces pro-inflammatory adipokines provides a potential mechanism for the observed epidemiologic links between obesity and IBD, and this has developed into an active area of investigative inquiry. Additionally, emerging evidence highlights a role for the intestinal microbiota in the development of both obesity and IBD, representing another potential mechanistic connection between the two conditions. In this review we discuss the epidemiology of obesity and IBD, possible pathophysiologic links, and the clinical impact of obesity on IBD disease course and implications for management. PMID:27672284

  1. Neutrophilic dermatoses and inflammatory bowel diseases.

    Science.gov (United States)

    Marzano, A V; Menicanti, C; Crosti, C; Trevisan, V

    2013-04-01

    Pyoderma gangrenosum (PG) and Sweet's Syndrome (SS) are inflammatory skin diseases caused by the accumulation of neutrophils in the skin and, rarely, in internal organs, which led to coining the term of neutrophilic dermatoses (ND) to define these conditions. Recently, ND have been included among the autoinflammatory diseases, which are forms due to mutations of genes regulating the innate immune responses. Both PG and SS are frequently associated with inflammatory bowel diseases (IBD), a group of chronic intestinal disorders which comprises ulcerative colitis and Crohn's disease and whose pathogenesis involves both the innate and adaptive immunity in genetically prone individuals. Patients with IBD develop PG in 1-3% of cases, while SS is rarer. PG presents with deep erythematous-to-violaceous painful ulcers with undermined borders, but bullous, pustular, and vegetative variants can also occur. SS, also known as acute febrile neutrophilic dermatosis, is characterized by the abrupt onset of fever, peripheral neutrophilia, tender erythematous skin lesions and a diffuse neutrophilic dermal infiltrate. In this review that will be focused on PG and SS, we will describe also the aseptic abscesses syndrome, a new entity within the spectrum of ND which frequently occurs in association with IBD and is characterized by deep abscesses mainly involving the spleen and skin and by polymorphic cutaneous manifestations including PG- and SS-like lesions. PMID:23588144

  2. Diagnostics in inflammatory bowel disease: Ultrasound

    Institute of Scientific and Technical Information of China (English)

    Deike Strobel; Ruediger S Goertz; Thomas Bernatik

    2011-01-01

    Diagnosis of chronic inflammatory bowel diseases (IBD) is based on a combination of clinical symptoms, laboratory tests and imaging data. Imaging of the morphological characteristics of IBD includes the assessment of mucosal alterations, transmural involvement and extraintestinal manifestations. No single imaging technique serves as a diagnostic gold standard to encompass all disease manifestations. Ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) allow cross-sectional imaging of the transmural alterations and extraintestinal manifestations. While in the USA the technique of choice is CT, in Europe the focus is more on MRI and ultrasound (US). Most patients with chronic IBD are diagnosed at a young age. After baseline diagnosis many of these young patients have to undergo repetitive imaging procedures during the variable clinical course of the disease, characterized by alternate periods of remission and active disease, and in monitoring the response to treatment. US has the advantage of being noninvasive, less costly, and easily repeatable, and thus can be very useful in following up patients with IBD. In addition, rising concern about radiation exposure in young adults indicates the demand for radiation-sparing techniques like US and MRI. This article focuses on the current clinical practice of US in IBD, describing the current technologies used in transabdominal intestinal US and the characteristic sonographic findings in Crohn′s disease and ulcerative colitis.

  3. Role of cytokines in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), rep- resents a group of chronic disorders characterized by inflammation of the gastrointestinal tract, typically with a relapsing and remitting clinical course. Mucosal mac- rophages play an important role in the mucosal im- mune system, and an increase in the number of newly recruited monocytes and activated macrophages has been noted in the inflamed gut of patients with IBD. Activated macrophages are thought to be major con- tributors to the production of inflammatory cytokines in the gut, and imbalance of cytokines is contributing to the pathogenesis of IBD. The intestinal inflammation in IBD is controlled by a complex interplay of innate and adaptive immune mechanisms. Cytokines play a key role in IBD that determine T cell differentiation of Th1, Th2, T regulatory and newly described Th17 cells. Cytokines levels in time and space orchestrate the development, recurrence and exacerbation of theinflammatory process in IBD. Therefore, several cyto- kine therapies have been developed and tested for the treatment of IBD patients.

  4. Pulse cyclophosphamide therapy for inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Zsolt Barta; László Tóth; Margit Zeher

    2006-01-01

    AIM: To assess the efficacy of intravenous cyclophosphamide pulse therapy for refractory inflammatory bowel disease (IBD).METHODS: We included in our cohort eight patients with (moderate/severe) steroid refractory IBD (4 with ulcerative colitis and 4 with Crohn's disease). They all received 6 cycles of intravenous cyclophosphamide (800mg) per month.RESULTS: Patients entered into remission after the second/third cyclophosphamide pulse. Disease activity decreased. There were no side effects and toxicity. All the patients went into long lasting remission. All Crohn's disease patients and 3 of 4 ulcerative colitis patients achieved complete remission. One patient with ulcerative colitis showed an impressive clinical response but did not enter into remission. For the maintenance, patients with Crohn's disease were treated with methotrexate (15 mg/wk) and patients with ulcerative colitis were treated with azathioprine (2.5 mg/kg body weight/d).CONCLUSION: Remission was maintained in all patients for 6 mo on the average. The drug was well tolerated. These findings suggest that aggressive immunosuppressive therapy may be useful in some refractory patients and further controlled study should be considered in order to fully evaluate this type of treatment as a potential therapy for IBD.

  5. The Social Toll of Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Richard G Farmer

    1994-01-01

    Full Text Available Inflammatory bowel disease (IBD – ulcerative colitis and Crohn’s disease – has become one the most important chronic digestive disorders found in the younger population. As a result of the nature of the illness, with remission and exacerbation of the inflammatory process, there has been increasing concern regarding the costs, both financial and social, of IBD. There have been attempts to quantify disease activity and to assess the results of treatment and the ability of the patient to function in society. As a result, there has been an increased interest in the ‘social toll’ of IBD. Begi1ming in 1988, and using a direct interview technique, ambulatory patients with IBD were evaluated for quality of life at the Cleveland Clinic Foundation. Included were patients whose disease had been present for about 10 years, and both surgical and nonsurgical patients. The interview questionnaire consisted of 47 items in four categories: functional/economic, social/recreational, affect/life in general and medical/symptoms. Patients with ulcerative colitis had better quality of life than those with Crohn’s disease and patients without surgery had better quality of life than those who had undergone surgery. Over the ensuing five-year period, it was shown that quality of life measures are of value in assessing the results of medical and surgical therapy, and the measures frequently give information not usually obtained by physicians and have implications for quality assurance and outcome measurement.

  6. Inflammatory bowel disease: immunodiagnostics, immunotherapeutics, and ecotherapeutics.

    LENUS (Irish Health Repository)

    Shanahan, F

    2012-02-03

    Treatment options for inflammatory bowel disease (IBD) reflect a continuing shift from empiricism to strategies based on improved understanding of the pathophysiology of disease. In susceptible individuals, IBD appears to be the result of defective regulation of mucosal immune interactions with the enteric microflora. This has prompted research directed at the interface of the traditional disciplines of immunology, microbiology, and epithelial cell biology. Whereas immunodiagnostics have been of limited clinical value in IBD, assessments of mucosal rather than systemic immune function are promising. Therapeutically, there is an increasing trend toward more aggressive and earlier use of immunomodulatory agents, particularly for prevention of relapse, with cytokine manipulation as a bridge therapy to achieve remission in patients with acute severe disease. Although most drug treatments are directed toward altering the host response, the rationale for manipulating the enteric flora appears sound and will be the basis of additional future therapeutic strategies. Notwithstanding the widening range of options for drug therapy in IBD, other outcome modifiers and well-established principles of managing chronic disease are as important as ever.

  7. State-of-the-art of irritable bowel syndrome and inflammatory bowel disease research in 2008

    Institute of Scientific and Technical Information of China (English)

    Lynne V McFarland

    2008-01-01

    Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two of the leading causes of chronic intestinal conditions in the world.This issue of World Journal of Gastroenterology (WJG) presents a series of papers from world experts who discuss the current knowledge and opinions on these important conditions.Although great strides have been made in the diagnosis,treatment and pathology of IBS and IBD;much has yet to be explained.The etiologies and risk factors of these multifactorial conditions remain elusive.Specific diagnostic biomarkers need to be developed and safer treatments developed.The burden of IBS and IBD on the healthcare system is felt with repeated medical care visits and high costs.IBS and IBD patients can account for 30%-50% of office visits at gastroenterology services/clinics.Over one million people have IBD in the United States,with 30000 new cases being diagnosed every year.One-quarter million people in the UK are afflicted with IBD.The cost of medical care in the United States for IBD is estimated to be $1.8 billion/year.

  8. Risk of inflammatory bowel disease following a diagnosis of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Porter Chad K

    2012-05-01

    Full Text Available Abstract Background Irritable bowel syndrome (IBS and inflammatory bowel disease (IBD symptoms often overlap. In some IBS cases there are subtle inflammatory changes similar to the immune-mediated pathophysiology of IBD, and the risk of both increases after infectious gastroenteritis (IGE. Methods To evaluate the effect of IBS and IGE on IBD risk utilizing US Department of Defense medical encounter data, active duty personnel with IBS were matched to subjects without IBS. Medical encounter history was analyzed to assess for incident IBD. IGE was identified from documented medical encounters and by self-report. Relative risks were calculated using Poisson regression models. Results We identified 9,341 incident IBS cases and 18,678 matched non-IBS subjects and found an 8.6-fold higher incidence (p p  Conclusions These data reflect a complex interaction between illness presentation and diagnosis of IBS and IBD and suggest intercurrent IGE may increase IBD risk in IBS patients. Additional studies are needed to determine whether IBS lies on the causal pathway for IBD or whether the two are on a pathophysiological spectrum of the same clinical illness. These data suggest consideration of risk reduction interventions for IGE among IBS patients at high disease risk.

  9. Metabolic inflammation in inflammatory bowel disease: crosstalk between adipose tissue and bowel.

    Science.gov (United States)

    Gonçalves, Pedro; Magro, Fernando; Martel, Fátima

    2015-02-01

    Epidemiological studies show that both the incidence of inflammatory bowel disease (IBD) and the proportion of people with obesity and/or obesity-associated metabolic syndrome increased markedly in developed countries during the past half century. Obesity is also associated with the development of more active IBD and requirement for hospitalization and with a decrease in the time span between diagnosis and surgery. Patients with IBD, especially Crohn's disease, present fat-wrapping or "creeping fat," which corresponds to ectopic adipose tissue extending from the mesenteric attachment and covering the majority of the small and large intestinal surface. Mesenteric adipose tissue in patients with IBD presents several morphological and functional alterations, e.g., it is more infiltrated with immune cells such as macrophages and T cells. All these lines of evidence clearly show an association between obesity, adipose tissue, and functional bowel disorders. In this review, we will show that the mesenteric adipose tissue and creeping fat are not innocent by standers but actively contribute to the intestinal and systemic inflammatory responses in patients with IBD. More specifically, we will review evidence showing that adipose tissue in IBD is associated with major alterations in the secretion of cytokines and adipokines involved in inflammatory process, in adipose tissue mesenchymal stem cells and adipogenesis, and in the interaction between adipose tissue and other intestinal components (immune, lymphatic, neuroendocrine, and intestinal epithelial systems). Collectively, these studies underline the importance of adipose tissue for the identification of novel therapeutic approaches for IBD.

  10. Quantitative in vivo analysis of small bowel motility using MRI examinations in mice--proof of concept study.

    Science.gov (United States)

    Bickelhaupt, S; Wurnig, M C; Lesurtel, M; Patak, M A; Boss, A

    2015-01-01

    Small bowel motility analyses using magnetic resonance imaging (MRI) could reduce current invasive techniques in animal studies and comply with the 'three Rs' rule for human animal experimentation. Thus we investigated the feasibility of in vivo small bowel motility analyses in mice using dynamic MRI acquisitions. All experimental procedures were approved by the institutional animal care committee. Six C57BL/6 mice underwent MRI without additional preparation after isoflurane anaesthetization in the prone position on a 4.7 T small animal imager equipped with a linear polarized hydrogen birdcage whole-body mouse coil. Motility was assessed using a true fast imaging in a steady precession sequence in the coronal orientation (acquisition time per slice 512 ms, in-plane resolution 234 × 234 µm, matrix size 128 × 128, slice thickness 1 mm) over 30 s corresponding to 60 acquisitions. Motility was manually assessed measuring the small bowel diameter change over time. The resulting motility curves were analysed for the following parameters: contraction frequency per minute (cpm), maximal contraction amplitude (maximum to minimum [mm]), luminal diameter (mm) and luminal occlusion rate. Small bowel motility quantification was found to be possible in all animals with a mean small bowel contraction frequency of 10.67 cpm (SD ± 3.84), a mean amplitude of the contractions of 1.33 mm (SD ± 0.43) and a mean luminal diameter of 1.37 mm (SD ± 0.42). The mean luminal occlusion rate was 1.044 (SD ± 0.45%/100). The mean duration needed for a single motility assessment was 185 s (SD ± 54.02). Thus our study demonstrated the feasibility of an easy and time-sparing functional assessment for in vivo small bowel motility analyses in mice. This could improve the development of small animal models of intestinal diseases and provide a method similar to clinical MR examinations that is in concordance with the 'three Rs' for humane animal

  11. Review article: antibiotics and probiotics in inflammatory bowel disease.

    Science.gov (United States)

    Kruis, W

    2004-10-01

    Treatment with antibiotics in inflammatory bowel disease has a long tradition and is widely used. The indications for antibiotic therapy are wide ranging, from specific situations such as abscesses or fistulae, to patients with severe disease (as an unspecific 'protective' measure), and to address the hypothesis that the enteric flora as a whole, or specific microorganisms such as mycobacteria, are involved in the pathogenesis of inflammatory bowel disease. The best-studied single antibiotic compound is metronidazole. However, overall, the scientific basis for the use of antibiotics is limited, which may reflect a lack of interest from sponsors within the pharmaceutical industry. Despite this weak evidence base, antibiotics are a globally established therapeutic tool in inflammatory bowel disease. Growing evidence from human and animal studies points towards a pivotal pathogenetic role of intestinal bacteria in inflammatory bowel disease. In view of these experimental findings, clinical trials have been undertaken to elucidate the therapeutic effects of probiotics in inflammatory bowel disease. Probiotics are viable nonpathogenic microorganisms which confer health benefits to the host by improving the microbial balance of the indigenous microflora. So far, of the many candidates, one specific strain (Escherichia coli Nissle 1917) and a mixture of eight different bacteria have demonstrated convincing therapeutic efficacy in controlled studies. Maintenance therapy in ulcerative colitis and prevention therapy, as well as the treatment of pouchitis, have emerged as areas in which probiotic therapy offers a valid therapeutic alternative to current treatments. Further investigations may detect additional clinically effective probiotics and other clinical indications.

  12. Etiology and pathophysiology of inflammatory bowel disease--environmental factors.

    Science.gov (United States)

    Andus, T; Gross, V

    2000-01-01

    Environmental factors play an important role in the pathophysiology of inflammatory bowel disease. There is a strong and consistent association between smoking and Crohn's disease, and between nonsmoking and ulcerative colitis. Despite extensive research, the exact pathophysiological mechanisms for these associations remain unclear. In spite of this, some clinical trials with nicotine-patches showed beneficial effects for the treatment of ulcerative colitis. Associations of Crohn's disease and ulcerative colitis with other environmental factors are weaker like the association with use of oral contraceptives or those less well investigated such as the association with childhood hygiene. Most studies suggesting a potential pathogenetic role of Mycobacterium paratuberculosis or an effect of tuberculostatic therapy in Crohn's disease could not be reproduced by others. Perinatal or childhood infections by viruses like measles are heavily debated, but not proven to be causal for inflammatory bowel disease. Coagulation disorders have been described as protecting from inflammatory bowel disease, suggesting hypercoagulability to be a pathogenetic factor. Some studies described that appendectomy may prevent the onset of ulcerative colitis in man and mice. Other environmental factors such as hydrogen sulfide, tonsillectomy, diet, blood transfusions, and Listeria also require confirmation. There are, however, convincing data from genetic animal models and twin studies that environmental factors as the intestinal bacterial flora interact with susceptible hosts to cause inflammatory bowel disease. Inflammatory bowel diseases have multifactorial etiologies, which require a differentiated approach for treatment and prevention. PMID:10690583

  13. Irritable bowel syndrome: the burden and unmet needs in Europe.

    LENUS (Irish Health Repository)

    Quigley, E M M

    2012-02-03

    Irritable bowel syndrome affects approximately 10-15% of the European population, although prevalence rates vary depending on the classification used and the country surveyed. This may be due to differences in patterns of medical care and diagnosis of the condition. Up to 70% of individuals with irritable bowel syndrome may not have been formally diagnosed. The disorder affects 1.5-3 times as many women as men and poses a significant economic burden in Europe, estimated at euro 700-euro 1600 per person per year. It also reduces quality of life and is associated with psychological distress, disturbed work and sleep, and sexual dysfunction. It is a chronic disorder, which affects many individuals for more than 10 years. Most patients are managed in primary care, although some are referred to gastroenterologists and other specialists. Patients with irritable bowel syndrome undergo more abdomino-pelvic surgery than the general population. We propose that a positive diagnosis of the condition may avoid the delay in diagnosis many patients experience. We conclude that, in Europe, there are significant unmet needs including lack of familiarity with irritable bowel syndrome, difficulties in diagnosis and lack of effective treatments for the multiple symptoms of the disorder. The development of pan-European guidelines for irritable bowel syndrome will benefit patients with this condition in Europe.

  14. Short bowel syndrome: A review of management options

    Directory of Open Access Journals (Sweden)

    Prasad Seetharam

    2011-01-01

    Full Text Available Extensive resection of the intestinal tract frequently results in inadequate digestion and/or absorption of nutrients, a condition known as short bowel syndrome (SBS. This challenging condition demands a dedicated multidisciplinary team effort to overcome the morbidity and mortality in these patients. With advances in critical care management, more and more patients survive the immediate morbidity of massive intestinal resection to present with SBS. Several therapies, including parenteral nutrition (PN, bowel rehabilitation and surgical procedures to reconstruct bowel have been used in these patients. Novel dietary approaches, pharmacotherapy and timely surgical interventions have all added to the improved outcome in these patients. However, these treatments only partially correct the underlying problem of reduced bowel function and have limited success resulting in 30% to 50% mortality rates. However, increasing experience and encouraging results of intestinal transplantation has added a new dimension to the management of SBS. Literature available on SBS is exhaustive but inconclusive. We conducted a review of scientific literature and electronic media with search terms ′short bowel syndrome, advances in SBS and SBS′ and attempted to give a comprehensive account on this topic with emphasis on the recent advances in its management.

  15. Alternatively Spliced EDA Domain of Fibronectin Is a Target for Pharmacodelivery Applications in Inflammatory Bowel Disease.

    Science.gov (United States)

    Bootz, Franziska; Schmid, Anja Sophie; Neri, Dario

    2015-08-01

    The antibody-based pharmacodelivery of cytokines to sites of disease has been extensively studied for various indications but not for the treatment of inflammatory bowel diseases. Here, we report that the alternatively spliced EDA domain of fibronectin, a marker of angiogenesis and of tissue remodeling, is expressed in the dextran sodium sulfate mouse model of colitis and in patients with inflammatory bowel conditions, while being virtually undetectable in most normal adult tissues. Radiolabeled preparations of the F8 antibody, specific to the EDA domain of fibronectin, were shown to selectively localize to sites of inflammation in mice with colitis, as revealed by autoradiographic analysis. Fusion proteins of the F8 antibody with various murine payloads (interleukin-4, the p40 subunit of interleukin-12, interleukin-13) were administered to mice with colitis. IL12p40-F8 mediated an anti-inflammatory activity, which was comparable with the one of cyclosporine, whereas F8-IL4 did not inhibit colitis and F8-IL13 worsened the inflammatory conditions. PMID:25993691

  16. Bowel conservation in a case of giant jejuno-ileal duplication

    Directory of Open Access Journals (Sweden)

    Sham Minakshi

    2010-01-01

    Full Text Available The management of very long tubular bowel duplications poses a special challenge to even the most skilled surgeon. In these cases, mucosal stripping is usually employed. We report a novel case of a two-year-old boy, with 120 cm long jejuno-ileal duplication, wherein, bowel salvage was achieved, utilizing the Bianchi principle, originally described for bowel lengthening in cases of short bowel syndrome.

  17. Functional and immunological aspects of small bowel transplantation : an experimental study in dogs

    OpenAIRE

    Meijssen, Maarten

    1993-01-01

    textabstractSmall bowel transplantation is thought to be the ultimate therapeutic treatment for patients with an irreversible short bowel syndrome and those with intolerance to long-term total parenteral nutrition. Although the small bowel was one of the first organs to be transplanted experimentally, it is the last to be engrafted successfully in humans. The extreme immunogenicity of the small bowel graft and its compromised function after the transplantation procedure still hamper clinical ...

  18. Serological markers of inflammatory bowel disease.

    Science.gov (United States)

    Kuna, Andrea Tesija

    2013-01-01

    Inflammatory bowel disease (IBD) is a heterogeneous group of chronic inflammatory disorders of the gastrointestinal tract with two main distinguishable entities, Crohn's disease (CD) and ulcerative colitis (UC). IBD-unclassified (IBD-U) is a diagnosis that covers the "grey" zone of diagnostic uncertainty between UC and CD. Current diagnosis of IBD relies on the clinical, endoscopic, radiological, histological and biochemical features, but this approach has shortcomings especially in cases of overlapping symptoms of CD and UC. The need for a diagnostic tool that would improve the conventional methods in IBD diagnosis directed the search towards potential immunological markers, since an aberrant immune response against microbial or endogenous antigens in a genetically susceptible host seems to be implicated in IBD pathogenesis. The spectrum of antibodies to different microbial antigens and autoantibodies associated with IBD is rapidly expanding. Most of these antibodies are associated with CD like anti-glycan antibodies: anti-Saccharomices cerevisiae (ASCA) and the recently described anti-laminaribioside (ALCA), anti-chitobioside (ACCA), anti-mannobioside (AMCA), anti-laminarin (anti-L) and anti-chitin (anti-C) antibodies; in addition to other antibodies that target microbial antigens: anti-outer membrane porin C (anti-OmpC), anti-Cbir1 flagellin and anti-12 antibody. Also, autoantibodies targeting the exocrine pancreas (PAB) were shown to be highly specific for CD. In contrast, UC has been associated with anti-neutrophil cytoplasmic autoantibodies (pANCA) and antibodies against goblet cells (GAB). Current evidence suggests that serologic panels of multiple antibodies are useful in differential diagnosis of CD versus UC and can be a valuable aid in stratifying patients according to disease phenotype and risk of complications.

  19. Inflammatory bowel diseases and reproductive health.

    Science.gov (United States)

    Kokoszko-Bilska, Agnieszka; Sobkiewicz, Slawomir; Fichna, Jakub

    2016-08-01

    Inflammatory bowel diseases (IBD) constitute a group of chronic intestinal diseases, including Crohn's disease and ulcerative colitis, which typically involve patients of reproductive age and may influence several features of human reproduction. There are many concerns regarding the interactions between the course of IBD, applied treatment (pharmacological or surgical), and fertility, reproductive outcomes, and also neonatal outcomes. To review the literature describing fertility in IBD patients (separately for female and male), and possible infertility treatment in this group of patients, a PubMed search for English only publications (articles and/or abstracts) was conducted. Initially, the titles of publications and their abstracts were screened, and the most appropriate articles were selected and reviewed. Overall, in patients with quiescent IBD, fertility is almost identical to the general population, but particular subgroups of patients (with active disease, on pharmacological treatment, and after pelvic or abdominal surgery) may be affected by reduced fertility. Additionally, patients with IBD have fewer children than the general population, mainly as a result of voluntary childlessness. The main objectives for successful reproductive outcomes in IBD patients are proper guidance and also optimal treatment for achieving and maintaining disease remission. Recently, the European Evidence-Based Consensus on Reproduction and Pregnancy in IBD (the European Crohn's and Colitis Organization Guidelines) has been established to optimize preconceptional counseling and to promote an appropriate clinical management for patients planning to conceive. However, further studies are needed regarding the preservation of fertility in IBD patients and introduction of optimal infertility treatment in this group of patients. PMID:27117378

  20. Role of Diet in Inflammatory Bowel Disease.

    Science.gov (United States)

    Ruemmele, Frank M

    2016-01-01

    The incidence of inflammatory bowel disease (IBD) is steadily in the rise in Western as well as in developing countries paralleling the increase of westernized diets, characterized by high protein and fat as well as excessive sugar intake, with less vegetables and fiber. An interesting hypothesis is that environmental (food-) triggered changes of the intestinal microbiome might cause a proinflammatory state preceding the development of IBD. Indeed, an intact intestinal epithelial barrier assuring a normal bacterial clearance of the intestinal surface is crucial to guarantee intestinal homeostasis. Any factors affecting the epithelial barrier function directly or indirectly may impact on this homeostasis, as well as any changes of the intestinal microbial composition. It is intriguing to learn that some frequently used food components impact on the quality of the intestinal barrier, as well as on the composition of the intestinal microbiome. This highlights the close interaction between living conditions, hygiene, food habits and food quality with the bacterial composition of the intestinal microbiome and the activation status of the intestinal immune system. There is clear evidence that nutritional therapy is highly successful in the treatment of Crohn's disease (CD). Exclusive enteral nutrition is well established as induction therapy of CD. New diets, such as a CD exclusion diet or defined diets (specific carbohydrate diets, FODMAP diet, Paleolithic diet) are being discussed as treatment options for IBD. Well-designed clinical trials in IBD are urgently required to define the precise role of each of these diets in the prevention or management of IBD. Up to now, the role of diet in IBD is highly undermined by lay and anecdotal reports without sufficient scientific proof. PMID:27355913

  1. Practical Evaluation and Handling of Patients with Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Bodil Ohlsson

    2012-12-01

    Full Text Available Irritable bowel syndrome (IBS is a functional bowel disorder by unknown aetiology. Several reviews are written about pharmacological and psychological treatment of the disease. Nevertheless, healthcare professionals consider these patients difficult to handle in daily practice. There is an uncertainty about how to measure symptoms and to evaluate the effect of any given treatment. In the absence of objective markers, professionals feel unsure of how to manage the condition and the patients do not feel that they are taken seriously. The development of the short, self-reported questionnaire, Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS, offers a practical guide to objective measurement of symptoms and effect of given treatments into numerical values in the daily practice.

  2. [Vaginal eviscentration with secondary strangulation of small bowel].

    Science.gov (United States)

    Gembal, Piotr; Grzegorczyk, Wiesław; Grabowski, Bogumił; Milik, Krzysztof; Pajak, Marek; Bielecki, Krzysztof

    2007-01-01

    A case of 81 year old patient with eviscentration through vagina with a strangulation of small bowel was described. The woman was treated gynecologically and underwent surgery previously. The eviscentration occurred 21 months after last surgery and was connected with high abdominal pressure during defecation. Woman was qualified to an urgent laparotomy, and the hole about 15 mm length in vaginal posterior vault was found. Through the hole passed small bowel which was strangulated. The bowel was removed to the abdominal cavity and during its control no necrosis was found. The color and vascularity return to normal and right peristaltic was noticed. The hole in parietal peritoneum was closed by a continuous suture. The hole in vagina was also closed by the continuous suture from the perineal side. Woman in good general condition was discharged from hospital in the 13th day after surgery. PMID:18540188

  3. Merkel cell carcinoma metastatic to the small bowel mesentery

    Directory of Open Access Journals (Sweden)

    Guang-Yu Yang

    2011-03-01

    Full Text Available Merkel cell carcinoma (MCC is an uncommon cutaneous malignant tumor that presents as a rapidly growing skin nodule on sun-exposed areas of the body. MCC is aggressive with regional nodal and distant metastases to the skin, lung, and bones. There have been no reports of metastatic MCC to the mesentery and 6 reports describing metastasis to the small intestine. We present a case of metastatic MCC to the mesentery with infiltration to the small bowel, 8 years after original tumor resection. This is the 5th metastasis and it encased the small bowel resulting in a hair-pin loop contributing to the unusual clinical presentation. Although MCC metastatic to the bowel is uncommon, it is not rare. It is important to recognize the unusual manifestations of this disease as they are becoming more common in the future. Routine radiologic surveillance and thorough review of systems are important to patient follow-up.

  4. Small-bowel perforation caused by fish bone

    Institute of Scientific and Technical Information of China (English)

    Sheng-Der Hsu; De-Chuan Chan; Yao-Chi Liu

    2005-01-01

    A diagnosis of small-bowel perforation, caused by a sharp or pointed foreign body, is rarely made preoperatively because the clinical symptoms are usually nonspecific and can mimic other surgical conditions, such as appendicitis and diverticulitis. We report the case of a 62-year-old woman who experienced severe pain in the right iliac fossa and fever for about five days before arrival at our hospital. The presumptive diagnosis was acute purulent appendicitis and an emergency appendectomy was planned. Swelling and erythema were noted in a segment of the small bowel in the lower right abdomen. A tiny pointed object was found penetrating the inflamed portion of the bowel, which proved to be a sharp fish bone (gray snapper). The bone was removed, followed by segmental resection of the terminal ileum and ascending colon. The postoperative course was uneventful.

  5. Expanding role of capsule endoscopy in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Capsule endoscopy has been shown to detect small bowel inflammatory changes better than any other imaging modality. Selection criteria have been optimized to increase the yield of capsule endoscopy in patients suspected to have Crohn's disease. Capsule endoscopy allows for earlier diagnosis of Crohn's disease of the small bowel and improved diagnosis of colitis in patients where it is unclear if they suffer from Crohn's or ulcerative colitis. A test capsule is available to assess for small bowel strictures and thus avoid capsule retention. A common language has been developed and a new scoring index will be added to capsule software. It is envisioned that the manner in which we treat Crohn's disease in the future will change, based on earlier diagnosis and treatment aimed at mucosal healing rather than symptom improvement.

  6. Psychological characteristics of patients with functional and inflammatory bowel disorders

    Directory of Open Access Journals (Sweden)

    Kozlova I.V.

    2014-03-01

    Full Text Available Objective: to study the psychological characteristics of patients with irritable bowel syndrome (IBS, ulcerative colitis (UC, Crohn's disease (CD. Material and methods. The study group included 98 patients with IBD (inflammatory bowel disease and IBS, the control group included 30 healthy individuals. Set of psychological tests included questionnaire (multifactorial systemic examination of the person, the Luscher color test, Beck Depression Inventory, a test on health, activity, mood. Results. Premorbid personality traits, communication disorders with stress have been revieled. According to the nosology different types of emotional response to the disease, changes in health and activity have been marked. There is a high level of frustration needs, increased frequency of anxiety and depression in all patients. Conclusion. Psychological mechanisms of pathology are similar in functional and organic bowel diseases with the greatest influence on the course of functional disorders.

  7. Retrograde spreading of hydrocortisone enema in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Jay, M.; Digenis, G.A.; Foster, T.S.; Antonow, D.R.

    1986-02-01

    A hydrocortisone suspension enema was radiolabeled with (/sup 99m/Tc)technetium sulfur colloid and administered to four normal subjects and eight patients with varying degrees of inflammatory bowel disease. The extent of enema spreading was monitored using external scintigraphy for a period of up to 4 hr after administration. Pretreatment of normal subjects with an evacuation enema resulted in spreading of the radiolabeled enema throughout the entire colon. In seven of the eight patients studied, the enema migrated a distance equal to or greater than the extent of disease involvement. An in vivo stability study with an indium-111-labeled enema, using the perturbed angular correlation technique, revealed that the enema retains its stability for up to 90 min after administration. These results indicate that the use of hydrocortisone enemas may not be restricted to distal bowel disease, but may also be effective in inflammatory bowel diseases involving proximal regions of the colon.

  8. MR enterography in the evaluation of small bowel dilation

    Energy Technology Data Exchange (ETDEWEB)

    Cronin, C.G. [Department of Radiology, University College Hospital, Galway (Ireland)], E-mail: carmelcronin2000@hotmail.com; Lohan, D.G.; Browne, A.M.; Alhajeri, A.N.; Roche, C.; Murphy, J.M. [Department of Radiology, University College Hospital, Galway (Ireland)

    2009-10-15

    Magnetic reasonance (MR) enterography enables high contrast resolution depiction of the location and cause of bowel obstruction through a combination of predictable luminal distension and multiplanar imaging capabilities. Furthermore, because the patient is not exposed to ionizing radiation, sequential 'dynamic' MR imaging can be performed repeatedly over time further facilitating depiction of the site and/or the cause of obstruction. With increasing availability of MR imaging and standardization of the oral contrast medium regimens, it is likely that this technique will assume an ever-increasing role in the evaluation of small bowel dilation in the coming years. We illustrate the utility of MR enterography in the evaluation of small bowel dilation, whether it be mechanical, functional (e.g., ileus), or related to infiltrative mural disease.

  9. Surgical management of small-bowel radiation enteritis

    Energy Technology Data Exchange (ETDEWEB)

    Lillemoe, K.D.; Brigham, R.A.; Harmon, J.W.; Feaster, M.M.; Saunders, J.R.; d' Avis, J.A.

    1983-08-01

    We treated 17 patients with severe small-bowel radiation enteritis surgically. Fourteen patients were female. Gynecologic malignant lesions (cervical, ovarian, and endometrial) were the most frequent sites of the primary tumors for which radiation was given. Thirteen patients had bowel obstruction, and the remainder had enterovaginal fistulae. Intestinal bypass, rather than resection, was the preferred approach in the treatment of these patients, and was used in 11 cases. Successful palliation was provided in nine patients, with minimal morbidity and no operative deaths. Follow-up at eight to 60 months has shown no further sequelae of radiation injury or of blind loop syndrome. This supports the relative safety of intestinal bypass for the surgical management of small-bowel radiation enteritis.

  10. Functional and immunological aspects of small bowel transplantation : an experimental study in dogs

    NARCIS (Netherlands)

    M.A.C. Meijssen (Maarten)

    1993-01-01

    textabstractSmall bowel transplantation is thought to be the ultimate therapeutic treatment for patients with an irreversible short bowel syndrome and those with intolerance to long-term total parenteral nutrition. Although the small bowel was one of the first organs to be transplanted experimentall

  11. Successful laparoscopic treatment of ileo-cecal endometriosis producing bowel obstruction.

    Science.gov (United States)

    Fujimoto, A; Osuga, Y; Tsutsumi, O; Fujii, T; Okagaki, R; Taketani, Y

    2001-08-01

    Bowel endometriosis manifesting with ileus is difficult to diagnose, often requiring laparotomy for diagnosis and treatment. We report here a case of ileo-cecal endometriosis causing bowel obstruction. A diagnosis of intestinal endometriosis with menstruation-associated bowel symptoms was made, and the patient was successfully treated by laparoscopic ileo-cecal resection. PMID:11721734

  12. Effects of Hypericum perforatum extract on rat irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Shilan Mozaffari

    2011-01-01

    Full Text Available Context: In irritable bowel syndrome (IBS, disturbance of bowel motility is associated with infiltration of inflammatory mediators and cytokines into the intestine, such as neutrophils, myeloperoxidase (MPO, tumor necrosis factor alfa (TNF-α, and lipid peroxide. Aims: Regarding promising anti-inflammatory and anti-oxidative effects of Hypericum perforatum (HP extract, besides its anti-depressant effect, this study was designed to evaluate the effects of HP in an experimental model of IBS. Settings and Design: IBS was induced by a 5-day restraint stress in rats. The HP extract was administered by gavage in doses of 150, 300, and 450 mg/kg for 26 days. Fluoxetine and loperamide were used as positive controls. Gastric emptying and small bowel and colon transit, besides the levels of TNF-α, MPO, lipid peroxidation, and antioxidant power, were determined in colon homogenates. Statistical Analysis Used: Data were analyzed by one-way ANOVA followed by Tukey′s post hoc test for multiple comparisons. Results: A significant reduction in small bowel and colonic transit (450 mg/kg, TNF-α, MPO, and lipid peroxidation and an increase in antioxidant power in all HP-treated groups (150, 300, and 450 mg/kg were seen as compared with the control group. Gastric emptying did not alter significantly when compared with the control group. Treatment with loperamide (10 mg/kg significantly inhibited gastric emptying and small bowel and colonic transit, while flouxetine (10 mg/kg decreased gastric emptying, TNF-α, MPO, and lipid peroxidation and increased the antioxidant power of the samples in comparison with the control group. Conclusions: HP diminished the recruitment of inflammatory cells and TNF-α following restraint stress not in a dose-dependent manner, possibly via inhibition of MPO activity and increasing colon antioxidant power, without any difference with fluoxetine. The HP extract inhibits small bowel and colonic transit acceleration like loperamide

  13. Small bowel injury in low-dose aspirin users.

    Science.gov (United States)

    Endo, Hiroki; Sakai, Eiji; Kato, Takayuki; Umezawa, Shotaro; Higurashi, Takuma; Ohkubo, Hidenori; Nakajima, Atsushi

    2015-04-01

    The use of low-dose aspirin (LDA) is well known to be associated with an increased risk of serious upper gastrointestinal complications, such as peptic ulceration and bleeding. Until recently, attention was mainly focused on aspirin-induced damage of the stomach and duodenum. However, recently, there has been growing interest among gastroenterologists on the adverse effects of aspirin on the small bowel, especially as new endoscopic techniques, such as capsule endoscopy (CE) and balloon-assisted endoscopy, have become available for the evaluation of small bowel lesions. Preliminary CE studies conducted in healthy subjects have shown that short-term administration of LDA can induce mild mucosal inflammation of the small bowel. Furthermore, chronic use of LDA results in a variety of lesions in the small bowel, including multiple petechiae, loss of villi, erosions, and round, irregular, or punched-out ulcers. Some patients develop circumferential ulcers with stricture. In addition, to reduce the incidence of gastrointestinal lesions in LDA users, it is important for clinicians to confirm the differences in the gastrointestinal toxicity between different types of aspirin formulations in clinical use. Some studies suggest that enteric-coated aspirin may be more injurious to the small bowel mucosa than buffered aspirin. The ideal treatment for small bowel injury in patients taking LDA would be withdrawal of aspirin, however, LDA is used as an antiplatelet agent in the majority of patients, and its withdrawal could increase the risk of cardiovascular/cerebrovascular morbidity and mortality. Thus, novel means for the treatment of aspirin-induced enteropathy are urgently needed. PMID:25501289

  14. Current trends in inflammatory bowel disease: the natural history

    OpenAIRE

    Langholz, Ebbe

    2010-01-01

    The description of the prognosis of inflammatory bowel disease (IBD) is based on systematic follow-up of population-based cohorts. A steady increase in incidence of IBD has occurred. The distribution of ulcerative colitis (UC) is fairly uniform with a preponderance of left-sided disease. One-third of Crohn’s disease (CD) patients present with colonic disease, one-third with ileocolonic disease and one-third with small bowel disease. IBD is associated with extra-intestinal manifestations (EIMs...

  15. Colon cancer and large bowel function in Denmark and Finland

    DEFF Research Database (Denmark)

    Cummings, J H; Branch, W J; Bjerrum, L;

    1982-01-01

    for large bowel cancer. Mean transit time (37 +/- 1 hours, Copenhagen; 43 +/- 1 hours, Helsinki; 40 +/- 1 hours, Them; 37 +/- 1 hours, Parikkala) was not significantly different among populations, but average 24-hour stool weights (136 +/- 13 g, Copenhagen; 176 +/- 17 g, Helsinki; 169 +/- 16 g, Them; 196...... +/- 15 g, Parikkala) were different and had a significant inverse relationship to total large bowel cancer incidence, with larger stool weights being found in the low-risk population. A high proportion of study subjects, especially in Finland, were found to be taking medication or to have a history...

  16. Degloving Injury of Bowel: An Unheard Complication of Surgical Abortion

    Science.gov (United States)

    Jain, Sandhya; Suneja, Amita; Guleria, Kiran

    2016-01-01

    Unsafe abortion is one of the leading causes of maternal mortality. Various types of intestinal injury in form of haematoma, perforation, contusion and transection have been reported. Degloving injury of intestine is one of the rarest complications. We report a case of 32-year-old lady Gravida 4, para 3 admitted with history of induced surgical abortion by a quack with degloving injury to bowel. Though there was no fecal soiling of peritoneal cavity but large segment of bowel was lost. She was managed by end ileostomy and discharged in stable condition.

  17. Modern treatment of adult short bowel syndrome patients

    DEFF Research Database (Denmark)

    Efsen, E; Jeppesen, P B

    2011-01-01

    By definition, intestinal failure prevails when oral compensation is no longer feasible and parenteral support is necessary to maintain nutritional equilibrium. In the past, conventional treatment has mainly focused on "making the most of what the short bowel syndrome patient still had" by optimi......By definition, intestinal failure prevails when oral compensation is no longer feasible and parenteral support is necessary to maintain nutritional equilibrium. In the past, conventional treatment has mainly focused on "making the most of what the short bowel syndrome patient still had...

  18. Acute small bowel obstruction due to chicken bone bezoar

    Directory of Open Access Journals (Sweden)

    Vetpillai P

    2012-12-01

    Full Text Available Preadeepan Vetpillai,1 Ayo Oshowo21CT2 Surgery in General, Charing Cross Hospital, 2Colorectal and Laparoscopic Surgery, Whittington Hospital, London, UKAbstract: Acute intestinal obstruction due to foreign bodies, or bezoar, is a rare occurrence in an adult with a normal intestinal tract. We report an unusual case of a 43-year-old black man with no previous abdominal surgery and no significant medical history who presented with an acute episode of small bowel obstruction due to an impacted undigested chicken bone.Keywords: small bowel obstruction, chicken bone, bezoar

  19. Splenic angiosarcoma metastasis to small bowel presented with gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Jun-Te Hsu; Chin-Yew Lin; Ting-Jun Wu; Han-Ming Chen; Tsann-Long Hwang; Yi-Yin Jan

    2005-01-01

    Primary splenic angiosarcoma is a very rare,aggressive neoplasm with a high metastatic rate and dismal prognosis. This neoplasm usually presents with abdominal pain, splenomegaly, anemia, and thrombocytopenia. Splenic angiosarcoma with bleeding gastrointestinal metastases is extremely rare. The literature contains only two case reports. This study reported a 44-year-old male patient with splenic angiosarcoma with sustained repeated gastrointestinal bleeding due to small bowel metastases. Salvage surgery was performed by splenectomy and resection of the metastatic small bowel tumors. The post-operative course was uneventful; the patient survived with the disease and had no GI bleeding, 7 mo after surgery.

  20. Hepatic manifestations of non-steroidal inflammatory bowel disease therapy

    Institute of Scientific and Technical Information of China (English)

    Robert; Hirten; Keith; Sultan; Ashby; Thomas; David; E; Bernstein

    2015-01-01

    Inflammatory bowel disease(IBD) is composed of Crohn’s disease and ulcerative colitis and is manifested by both bowel-related and extraintestinal manifestations. Recently the number of therapeutic options available to treat IBD has dramatically increased, with each new medication having its own mechanism of action and side effect profile. A complete understanding of the hepatotoxicity of these medications is important in order to distinguish these complications from the hepatic manifestations of IBD. This review seeks to evaluate the hepatobiliary complications of non-steroid based IBD medications and aide providers in the recognition and management of these side-effects.

  1. Incarcerated small bowel within a spontaneous lumbar hernia.

    Science.gov (United States)

    Teo, K A T; Burns, E; Garcea, G; Abela, J E; McKay, C J

    2010-10-01

    Lumbar hernias are rare, resulting from protrusion through the posterior abdominal wall that may be congenital, acquired or spontaneous. They very rarely present with acute bowel obstruction. We present a case of incarcerated small bowel within a spontaneous inferior (Petit's) lumbar hernia, treated by early open repair with mesh insertion. This case highlights the importance of thorough clinical examination and a high index of suspicion, even in the absence of previous surgery around the anatomical site of the suspected hernia, in order to effect an early repair before the onset of ischaemia in incarcerated contents.

  2. MRI for chronic inflammatory bowel disease; MRT chronisch entzuendlicher Darmerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Hansmann, H.J.; Hess, T.; Hahmann, M.; Erb, G.; Richter, G.M.; Duex, M. [Heidelberg Univ. (Germany). Abt. Roentgendiagnostik; Elsing, C. [Heidelberg Univ. (Germany). Abt. IV - Gastroenterologie

    2001-01-01

    Chronic inflammatory bowel disease is diagnosed and monitored by the combination of colonoscopy and small bowel enteroklysis. Magnetic resonance imaging has become the gold standard for the imaging of perirectal and pelvic fistulas. With the advent of ultrafast MRI small and large bowel imaging has become highly attractive and is being advocated more and more in the diagnostic work up of inflammatory bowel disease. Imaging protocols include fast T{sub 1}-weighted gradient echo and T{sub 2}-weighted TSE sequences and oral or rectal bowel distension. Furthermore, dedicated imaging protocols are based on breath-hold imaging under pharmacological bowel paralysis and gastrointestinal MR contrast agents (Hydro-MRI). High diagnostic accuracy can be achieved in Crohn's disease with special reference to the pattern of disease, depth of inflammation, mesenteric reaction, sinus tract depiction and formation of abscess. In ulcerative colitis, the mucosa-related inflammation causes significantly less bowel wall thickening compared to Crohn's disease. Therefore with MRI, the extent of inflammatory changes is always underestimated compared to colonoscopy. According to our experience in more than 200 patients as well as the results in other centers, Hydro-MRI possesses the potential to replace enteroklysis in the diagnosis of chronic inflammatory bowel disease and most of the follow-up colonoscopies in Crohn's disease. Further technical improvements in 3D imaging will allow interactive postprocessing of the MR data. (orig.) [German] Zusammenfassung: Die Standardverfahren in der Diagnostik und der Verlaufskontrolle chronisch entzuendlicher Darmerkrankungen, speziell des Morbus Crohn und der Colitis ulcerosa, sind die Koloskopie und das Enteroklysma. Die MRT hat sich dazu ihren festen Platz in der Diagnostik perirektaler Fisteln erobert. Mit schnellen, T{sub 1}-gewichteten Gradienten-Echo-Sequenzen und T{sub 2}-gewichteten Turbo-Spin-Echo-Sequenzen koennen auch Duenn

  3. Motility Evaluation in the Patient with Inflammatory Bowel Disease.

    Science.gov (United States)

    Abdalla, Sherine M; Kalra, Gorav; Moshiree, Baha

    2016-10-01

    Patients with inflammatory bowel disease (IBD) suffer frequently from functional bowel diseases (FBD) and motility disorders. Management of FBD and motility disorders in IBD combined with continued treatment of a patient's IBD symptoms will likely lead to better clinical outcomes and improve the patient's quality of life. The goals of this review were to summarize the most recent literature on motility disturbances in patients with IBD and to give a brief overview of the ranges of motility disturbances, from reflux disease to anorectal disorders, and discuss their diagnosis and specific management.

  4. Bowel injury: a rare but dreaded complication of unsafe abortion

    Directory of Open Access Journals (Sweden)

    Monika Ramola

    2016-09-01

    Full Text Available Unsafe abortions represent a preventable yet major cause of maternal mortality and morbidity in India. Intestinal perforation is a rare dreaded complication of unsafe abortion. It is commonly seen in countries in which abortions are performed by people without proper training and proper instruments. Bowel perforation occurs when the posterior vaginal wall or the uterine wall is perforated. The ileum and the sigmoid colon are the most commonly injured portion of the bowel. Here, we report a case of ileal perforation following induced unsafe abortion which was managed successfully. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3223-3225

  5. Prenatal ultrasonic diagnosis of obstructive bowel disease: A retrospective analysis

    OpenAIRE

    Heydanus, Rogier; Spaargaren, M.C.; Wladimiroff, Juriy

    1994-01-01

    textabstractFetal obstructive bowel disease was diagnosed in 29 patients at 22–37 weeks (median 32 weeks) of gestation, seven (24 per cent) of whom also displayed other anomalies. Polyhydramnios was present in 20/29 cases (69 per cent). An abnormal karyotype existed in 7/29 cases (24 per cent), of which six were diagnosed prenatally (trisomy 21, n = 5; 69, XXX, n = 1) and one postnatally (trisomy 21). There was always an association with the ultrasonic ‘double bubble’ sign. Obstructive bowel ...

  6. Metastatic melanoma to the small bowel complicated by fistula formation

    Directory of Open Access Journals (Sweden)

    Nausheen Khan

    2011-12-01

    Full Text Available Malignant melanoma (MM is an unpredictable tumour that can metastasise to any organ, and is well known for its widespread dissemination. The incidence of metastases to the gastro-intestinal (GI tract is well documented; this, however, is a late manifestation of the disease with an overall poor prognosis. Most GI metastases are asymptomatic and are only discovered on postmortem, with the majority in the small bowel. The presenting symptoms are usually of obstruction or intussusception; GI bleeding is also common. Fistula formation with the small bowel is rare; ours is believed to be the second case documented.

  7. Meditation over medication for irritable bowel syndrome? On exercise and alternative treatments for irritable bowel syndrome.

    Science.gov (United States)

    Asare, Fredrick; Störsrud, Stine; Simrén, Magnus

    2012-08-01

    Complimentary alternative treatment regimens are widely used in irritable bowel syndrome (IBS), but the evidence supporting their use varies. For psychological treatment options, such as cognitive behavioral therapy, mindfulness, gut-directed hypnotherapy, and psychodynamic therapy, the evidence supporting their use in IBS patients is strong, but the availability limits their use in clinical practice. Dietary interventions are commonly included in the management of IBS patients, but these are primarily based on studies assessing physiological function in relation to dietary components, and to a lesser degree upon research examining the role of dietary components in the therapeutic management of IBS. Several probiotic products improve a range of symptoms in IBS patients. Physical activity is of benefit for health in general and recent data implicates its usefulness also for IBS patients. Acupuncture does not seem to have an effect beyond placebo in IBS. A beneficial effect of some herbal treatments has been reported. PMID:22661301

  8. One center in Brussels has consistently had the lowestHbA1c values in the 4 studies (1994-2009) by the HvidoereInternational Study Group on Childhood Diabetes: What arethe "recipes"?

    Institute of Scientific and Technical Information of China (English)

    Harry Dorchy

    2015-01-01

    The principal aims of therapeutic management of thechild, adolescent and adult with type 1 diabetes areto allow good quality of life and to avoid long-termcomplications (retinopathy, neuropathy, nephropathy,cardiovascular disease, etc. ) by maintaining bloodglucose concentrations close to normal level. Glycatedhemoglobin levels (HbA1c) provide a good criterionof overall glycemic control. The Hvidoere Study Group(HSG) on Childhood Diabetes, founded in 1994, is aninternational group representing about twenty highlyexperienced pediatric centers from Europe, NorthAmerica, Japan and Australia. Four internationalcomparisons of metabolic control (1995, 1998, 2005,2009) have been performed. The one center that hasconsistently had the lowest HbA1c values (approximate7.3% or 56.3 mmol/mol) is my center in Brussels. Thisis more often obtained with a twice-daily free-mixedregimen with additional supplemental fast insulins adhoc. The so-called "Dorchy's recipes" are summarized.The conclusion is that the number of daily insulininjections, 2 or ≥ 4, or the use of pumps, by itselfdoes not necessarily give better results. Intensifiedtherapy should not depend upon the number of insulindoses per day, by syringe, pen or pump but rathershould be redefined as to intent-to-treat ascertainment(i.e. , goals). When there are no mutually agreed upongoals for BG and/or HbA1c, when there is insufficienteducation and psychosocial support by the medicalteam or at home, there is likely to be poor outcomes,as shown by the HSG. One of our recipes is not tosystematically replace rapid-acting human insulins byfast-acting analogues. Because the multicenter studiesof the HSG, performed in developed countries withoutfinancial restriction, show that treatment of childhooddiabetes is inadequate in general and that levels ofHbA1c are very different, diabetes treatment teamsshould individually explore the reasons for failure,without any prejudice or bias. Any dogmatism must

  9. One center in Brussels has consistently had the lowest HbA1c values in the 4 studies (1994-2009) by the Hvidoere International Study Group on Childhood Diabetes: What are the "recipes"?

    Science.gov (United States)

    Dorchy, Harry

    2015-02-15

    The principal aims of therapeutic management of the child, adolescent and adult with type 1 diabetes are to allow good quality of life and to avoid long-term complications (retinopathy, neuropathy, nephropathy, cardiovascular disease, etc.) by maintaining blood glucose concentrations close to normal level. Glycated hemoglobin levels (HbA1c) provide a good criterion of overall glycemic control. The Hvidoere Study Group (HSG) on Childhood Diabetes, founded in 1994, is an international group representing about twenty highly experienced pediatric centers from Europe, North America, Japan and Australia. Four international comparisons of metabolic control (1995, 1998, 2005, 2009) have been performed. The one center that has consistently had the lowest HbA1c values (approximate 7.3% or 56.3 mmol/mol) is my center in Brussels. This is more often obtained with a twice-daily free-mixed regimen with additional supplemental fast insulins ad hoc. The so-called "Dorchy's recipes" are summarized. The conclusion is that the number of daily insulin injections, 2 or ≥ 4, or the use of pumps, by itself does not necessarily give better results. Intensified therapy should not depend upon the number of insulin doses per day, by syringe, pen or pump but rather should be redefined as to intent-to-treat ascertainment (i.e., goals). When there are no mutually agreed upon goals for BG and/or HbA1c, when there is insufficient education and psychosocial support by the medical team or at home, there is likely to be poor outcomes, as shown by the HSG. One of our recipes is not to systematically replace rapid-acting human insulins by fast-acting analogues. Because the multicenter studies of the HSG, performed in developed countries without financial restriction, show that treatment of childhood diabetes is inadequate in general and that levels of HbA1c are very different, diabetes treatment teams should individually explore the reasons for failure, without any prejudice or bias. Any dogmatism

  10. Prevalence of Irritable Bowel Syndrome–like Symptoms in Japanese Patients with Inactive Inflammatory Bowel Disease

    Science.gov (United States)

    Tomita, Toshihiko; Kato, Yu; Takimoto, Mayu; Yamasaki, Takahisa; Kondo, Takashi; Kono, Tomoaki; Tozawa, Katsuyuki; Yokoyama, Yoko; Ikehara, Hisatomo; Ohda, Yoshio; Oshima, Tadayuki; Fukui, Hirokazu; Tanaka, Shigemi; Shima, Masayuki; Watari, Jiro; Miwa, Hiroto

    2016-01-01

    Background/Aims Few studies are available that have investigated the risk factors for overlapping irritable bowel syndrome (IBS)-like symptoms in patients with inactive inflammatory bowel disease (IBD). The present study has 3 objectives: (1) to assess the prevalence of IBS-like symptoms in Japanese patients with inactive IBD using Rome III criteria, (2) to examine the relationship of IBS-like symptoms to health related quality of life (HR-QOL), and (3) to investigate associations for developing IBS-like symptoms in patients with inactive IBD. Methods IBS-like symptoms were evaluated using the Rome III questionnaire for functional gastrointestinal disorders. HR-QOL and hospital anxiety and depression scale were evaluated. Results IBS-like symptoms were found in 17.5% (7/40) of patients with inactive ulcerative colitis, 27.1% (29/107) of patients with inactive Crohn’s disease (CD), and 5.3% (23/438) of healthy control subjects. The QOL level was significantly lower and anxiety score was significantly higher in inactive CD patients with IBS-like symptoms than in those without such symptoms (P = 0.003, P = 0.009). Use of anti-anxiety drugs was associated with the presence of IBS symptoms (P = 0.045). HR-QOL score was lower and anxiety score was higher in patients with inactive ulcerative colitis, but the difference was not statistically significant. Conclusions The prevalence of IBS-like symptoms in inactive IBD patients was significantly higher than in healthy controls. Inactive CD patients with IBS-like symptoms has low QOL and anxiety; suggesting that anxiety may be associated with symptom development in such patients. PMID:27193973

  11. Prebiotics and probiotics in irritable bowel syndrome and inflammatory bowel disease in children.

    Science.gov (United States)

    Guandalini, S; Cernat, E; Moscoso, D

    2015-01-01

    Underlying pathophysiological mechanisms of irritable bowel syndrome (IBS), a common disorder characterized by abdominal pain associated to a change in stool consistency or frequency, include low-grade inflammation and intestinal microbiota changes. Few and disappointing data are available for prebiotics. A few controlled trials (RCTs) of probiotics are instead available with favourable effects, although most are limited by suboptimal design and small sample size. A recent report from the Rome foundation group included 32 RCTs of probiotics, most of which showed an overall modest improvement in symptoms, with the patients most benefitting from probiotics being those with predominant diarrhoea and those having a post-infectious IBS. A review focusing only on children with functional gastrointestinal disorders concluded that probiotics are more effective than placebo in the treatment of patients with abdominal pain-related functional gastrointestinal disorders, although no effect on constipation was evident. The role for probiotics in inflammatory bowel disease (IBD) appears logical: the endogenous intestinal microbiota plays a central role in their development, and various probiotics have been found effective in animal models of IBD. However, research in humans has been overall quite limited, and it would seem that after a phase of intense research in the first decade of this century, the pace has slowed down, with fewer clinical trials been published in the past 2-3 years. To summarize current evidence: no probiotic has proven successful in Crohn's disease. In ulcerative colitis, on the other hand, data are more promising, and a very recent meta-analysis, that included 23 randomized controlled trials, concluded that there is evidence of efficacy for the probiotic mixture VSL#3 in helping inducing and maintaining remission, as well as in maintaining remission in patients with pouchitis. It is fair to state that for both IBD and IBS, more well-designed, rigorous

  12. Eluxadoline for Irritable Bowel Syndrome with Diarrhea.

    Science.gov (United States)

    Lembo, Anthony J; Lacy, Brian E; Zuckerman, Marc J; Schey, Ron; Dove, Leonard S; Andrae, David A; Davenport, J Michael; McIntyre, Gail; Lopez, Rocio; Turner, Lisa; Covington, Paul S

    2016-01-21

    Background Effective and safe treatments are needed for patients who have irritable bowel syndrome (IBS) with diarrhea. We conducted two phase 3 trials to assess the efficacy and safety of eluxadoline, a new oral agent with mixed opioid effects (μ- and κ-opioid receptor agonist and δ-opioid receptor antagonist), in patients with IBS with diarrhea. Methods We randomly assigned 2427 adults who had IBS with diarrhea to eluxadoline (at a dose of 75 mg or 100 mg) or placebo twice daily for 26 weeks (IBS-3002 trial) or 52 weeks (IBS-3001 trial). The primary end point was the proportion of patients who had a composite response of decrease in abdominal pain and improvement in stool consistency on the same day for at least 50% of the days from weeks 1 through 12 and from weeks 1 through 26. Results For weeks 1 through 12, more patients in the eluxadoline groups (75 mg and 100 mg) than in the placebo group reached the primary end point (IBS-3001 trial, 23.9% with the 75-mg dose and 25.1% with the 100-mg dose vs. 17.1% with placebo; P=0.01 and P=0.004, respectively; IBS-3002 trial, 28.9% and 29.6%, respectively, vs. 16.2%; P<0.001 for both comparisons). For weeks 1 through 26, the corresponding rates in IBS-3001 were 23.4% and 29.3% versus 19.0% (P=0.11 and P<0.001, respectively), and the corresponding rates in IBS-3002 were 30.4% and 32.7% versus 20.2% (P=0.001 and P<0.001, respectively). The most common adverse events associated with 75 mg of eluxadoline and 100 mg of eluxadoline, as compared with placebo, were nausea (8.1% and 7.5% vs. 5.1%), constipation (7.4% and 8.6% vs. 2.5%), and abdominal pain (5.8% and 7.2% vs. 4.1%). Pancreatitis developed in 5 (2 in the 75-mg group and 3 in the 100-mg group) of the 1666 patients in the safety population (0.3%). Conclusions Eluxadoline is a new therapeutic agent that reduced symptoms of IBS with diarrhea in men and women, with sustained efficacy over 6 months in patients who received the 100-mg dose twice daily. (Funded by

  13. New serological biomarkers of inflammatory bowel disease.

    Science.gov (United States)

    Li, Xuhang; Conklin, Laurie; Alex, Philip

    2008-09-01

    Serological biomarkers in inflammatory bowel disease (IBD) are a rapidly expanding list of non-invasive tests for objective assessments of disease activity, early diagnosis, prognosis evaluation and surveillance. This review summarizes both old and new biomarkers in IBD, but focuses on the development and characterization of new serological biomarkers (identified since 2007). These include five new anti-glycan antibodies, anti-chitobioside IgA (ACCA), anti-laminaribioside IgG (ALCA), anti-manobioside IgG (AMCA), and antibodies against chemically synthesized (Sigma) two major oligomannose epitopes, Man alpha-1,3 Man alpha-1,2 Man (SigmaMan3) and Man alpha-1,3 Man alpha-1,2 Man alpha-1,2 Man (SigmaMan4). These new biomarkers serve as valuable complementary tools to existing biomarkers not only in differentiating Crohn's disease (CD), ulcerative colitis (UC), normal and other non-IBD gut diseases, but also in predicting disease involvement (ileum vs colon), IBD risk (as subclinical biomarkers), and disease course (risk of complication and surgery). Interestingly, the prevalence of the antiglycan antibodies, including anti-Saccharomyces cerevisiae antibodies (ASCA), ALCA and AMCA, was found to be associated with single nucleotide polymorphisms (SNPs) of IBD susceptible genes such as NOD2/CARD15, NOD1/CARD4, toll-like receptors (TLR) 2 and 4, and beta-defensin-1. Furthermore, a gene dosage effect was observed: anti-glycan positivity became more frequent as the number of NOD2/CARD15 SNPS increased. Other new serum/plasma IBD biomarkers reviewed include ubiquitination factor E4A (UBE4A), CXCL16 (a chemokine), resistin, and apolipoprotein A-IV. This review also discusses the most recent studies in IBD biomarker discovery by the application of new technologies such as proteomics, fourier transform near-infrared spectroscopy, and multiplex enzyme-linked immunosorbent assay (ELISA)'s (with an emphasis on cytokine/chemokine profiling). Finally, the prospects of developing more

  14. New serological biomarkers of inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Xuhang Li; Laurie Conldin; Philip Alex

    2008-01-01

    Serological biomarkers in inflammatory bowel disease(IBD)are a rapidty expanding list of non-invasive tests for objective assessments of disease activity,early diagnosis,prognosis evaluation and surveillance.This review summarizes both old and new biomarkers in IBD,but focuses on the development and characterization of new serological iomarkers(identified since 2007).These include five new anti-glycan antibodies,anti-chitobioside IgA(ACCA),anti-laminaribioside IgG(ALCA),anti-manobioside IgG(AMCA),and antibodies against chemically synthesized(∑)two major oligomannose epitopes,Man α-1,3 Man α-1,2 Man(∑Man3)and Man α-1,3 Man α-1,2 Man α-1,2 Man(∑Man4).These new biomarkers erve as valuable complementary tools to existing biomarkers not only in differentiating Crohn's disease(CD),ulcerative colitis(UC),normal and other non-IBD gut diseases,but also in predicting disease involvement(ileum vs colon),IBD risk(as subclinical biomarkers),and disease course(risk of complication and surgery).Interestingly,the prevalence of he antiglycan antibodies,including anti-Saccharomyces cerevisiae antibodies(ASCA),ALCA and AMCA,was found to be associated with single nucleotide polymorphisms(SNPs)of IBD susceptible genes such as NOD2/CARDl5,NOD1/CARD4,toll-like receptors(TLR)2 and 4,and β-defensin-1.Further more,a gene dosage effect was observed:anti-glycan positivity became more requent as the number of NOD2/CARDl5 SNPS increased.Other new serum/plasma IBD biomarkers reviewed include ubiquitination factor E4A(UBE4A),CXCL16(a chemokine),resistin,and apolipoprotein A-Ⅳ.This review also discusses the most recent studies in IBD biomarker discovery by the application of new technologies such as proteomics,fourier transform near-infrared spectroscopy,and multiplex enzyme-linked immunosorbent assay(ELISA)'s(with an emphasis on cytokine/chemokine profiling).Finally,the prospects of developing more clinically useful novel diagnostic algorithms by incorporating new technologies in

  15. Inflammatory bowel disease in Turkish children

    Institute of Scientific and Technical Information of China (English)

    Murat Cakir; Fatih Unal; Gonul Dinler; Masallah Baran; Hasan Ali Yuksekkaya; Gokhan Tumgor; Erhun Kasirga; Ayhan Gazi Kalayci; Sema Aydogdu

    2015-01-01

    Background: This study was undertaken to evaluate demographics, clinical manifestations, laboratoryfi ndings and outcomes of children with inflammatory bowel disease (IBD) in Turkey. Methods: We analyzed the medical records of 127 children diagnosed with IBD (under 18 years old) between January 2004 and January 2012 in 8 pediatric gastroenterology centers. Results: Of the 127 patients, 90 (70.9%) suffered from ulcerative colitis (UC), 29 (22.8%) from Crohn's disease (CD), and 8 (6.3%) from IBD unclassified. The mean age of the 127 patients was 11.6±4.1 years, and 11.8% of the patients were below 5 years old. Of the patients, 49.6% were male, and males were more predominant in patients with CD than in those with UC (72.4%vs. 42.2%,P=0.008; a male/female ratio of 2.62 in CD, P=0.0016). Approximately one fifth of the patients had extra-intestinal manifestations and 13.3% of the patients had associated diseases. Extraintestinal manifestations and associated diseases were more common in early onset disease [P=0.017, odds ratio (OR)=4.02;P=0.03, OR=4.1]. Of the patients, 15% had normal laboratory parameters including anemia, high platelet count, hypoalbuminemia, hypoferritinemia, and high sedimentation rate. Area under receiver operation characteristics was used to predict pancolitis in patients with UC. The values of C-reactive protein, sedimentation rate and pediatric ulcerative colitis activity were 0.61 (P=0.06), 0.66 (P=0.01) and 0.76 (P=0.0001), respectively. Four (4.4%) patients with UC underwent colectomy, andfi nally two (1.5%, 95% confidence interval: 0-3.7%) patients died from primary disease or complications. Conclusions: IBD is an increasing clinical entity in Turkey. Features of IBD are similar to those in other populations, but prospective multicenter studies are needed to analyze the true incidence of IBD in Turkish children.

  16. Biologic therapy for inflammatory bowel disease.

    Science.gov (United States)

    Ardizzone, Sandro; Bianchi Porro, Gabriele

    2005-01-01

    Despite all of the advances in our understanding of the pathophysiology of inflammatory bowel disease (IBD), we still do not know its cause. Some of the most recently available data are discussed in this review; however, this field is changing rapidly and it is increasingly becoming accepted that immunogenetics play an important role in the predisposition, modulation and perpetuation of IBD. The role of intestinal milieu, and enteric flora in particular, appears to be of greater significance than previously thought. This complex interplay of genetic, microbial and environmental factors culminates in a sustained activation of the mucosal immune and non-immune response, probably facilitated by defects in the intestinal epithelial barrier and mucosal immune system, resulting in active inflammation and tissue destruction. Under normal situations, the intestinal mucosa is in a state of 'controlled' inflammation regulated by a delicate balance of proinflammatory (tumour necrosis factor [TNF]-alpha, interferon [IFN]-gamma, interleukin [IL]-1, IL-6, IL-12) and anti-inflammatory cytokines (IL-4, IL-10, IL-11). The mucosal immune system is the central effector of intestinal inflammation and injury, with cytokines playing a central role in modulating inflammation. Cytokines may, therefore, be a logical target for IBD therapy using specific cytokine inhibitors. Biotechnology agents targeted against TNF, leukocyte adhesion, T-helper cell (T(h))-1 polarisation, T-cell activation or nuclear factor (NF)-kappaB, and other miscellaneous therapies are being evaluated as potential therapies for IBD. In this context, infliximab is currently the only biologic agent approved for the treatment of inflammatory and fistulising Crohn's disease. Other anti-TNF biologic agents have emerged, including CDP 571, certolizumab pegol (CDP 870), etanercept, onercept and adalimumab. However, ongoing research continues to generate new biologic agents targeted at specific pathogenic mechanisms involved

  17. What's new about inflammatory bowel diseases in 2011

    Institute of Scientific and Technical Information of China (English)

    JonasMudter

    2011-01-01

    Inflammatory bowel diseases (IBD) are chronic disorders of the intestine with increasing incidence in Europe, Northern America and asiatic countries such as china. Thus, we have putted together these topic highlight articles to give insights into the current understanding of IBD pathogenesis, diagnostics and treatment.

  18. Long term benefits of hypnotherapy for irritable bowel syndrome

    OpenAIRE

    Gonsalkorale, W M; Miller, V; Afzal, A.; Whorwell, P J

    2003-01-01

    Background and aims: There is now good evidence from several sources that hypnotherapy can relieve the symptoms of irritable bowel syndrome in the short term. However, there is no long term data on its benefits and this information is essential before the technique can be widely recommended. This study aimed to answer this question.

  19. Neuroimmune regulation of inflammatory responses in inflammatory bowel disease

    NARCIS (Netherlands)

    Rijnierse, Anneke

    2006-01-01

    The term inflammatory bowel disease (IBD) is used to describe chronic inflammatory conditions of the gastro-intestinal tract. Patients suffer from abdominal pain, diarrhea, rectal bleeding and a substantial personal burden. The etiology of IBD is gradually being unraveled but remains a complex inter

  20. Pediatric Inflammatory Bowel Disease: from a translational perspective

    NARCIS (Netherlands)

    G.M. Damen (Gerard)

    2010-01-01

    textabstractCrohn’s disease (CD) and ulcerative colitis (UC), the two main subtypes of inflammatory bowel disease (IBD), are chronic relapsing inflammatory disorders of the gastrointestinal tract that have a peak age of onset in the second decade of life in children. There is strong evidence to supp