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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; Kehlet, Henrik

    2004-01-01

    healthy volunteers (median age, 63 years) underwent bowel preparation with bisacodyl and sodium phosphate. Fluid and food intake were standardized according to weight, providing adequate calorie and oral fluid intake. Before and after bowel preparation, weight, exercise capacity, orthostatic tolerance...... 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. Physiologic effects of bowel preparation

    DEFF Research Database (Denmark)

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

    2004-01-01

    , plasma and extracellular volume, balance function, and biochemical parameters were measured. RESULTS: Bowel preparation led to a significant decrease in exercise capacity (median, 9 percent) and weight (median, 1.2 kg). Plasma osmolality was significantly increased from 287 to 290 mmol kg(-1), as well as...... healthy volunteers (median age, 63 years) underwent bowel preparation with bisacodyl and sodium phosphate. Fluid and food intake were standardized according to weight, providing adequate calorie and oral fluid intake. Before and after bowel preparation, weight, exercise capacity, orthostatic tolerance...... increased phosphate and urea concentrations, whereas calcium and potassium concentrations decreased significantly after bowel preparation. No differences in plasma or extracellular volumes were seen. Orthostatic tolerance and balance function did not change after bowel preparation. CONCLUSIONS: Bowel...

  3. Understanding Bowel Preparation

    Science.gov (United States)

    ... will receive specific instructions. In general, here is what you can expect: Your doctor will prescribe the type of bowel prep that is best for you. ... out if you have any out-ofpocket costs. What determines the type of prep I get? Your medical condition is the most important factor in ...

  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. 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.

  7. 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...

  8. Mechanical bowel preparation for elective colorectal surgery

    DEFF Research Database (Denmark)

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

    2009-01-01

    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......: Four new trials were included at this update (total 13 RCTs with 4777 participants; 2390 allocated to MBP (Group A), and 2387 to no preparation (Group B), before elective colorectal surgery) .Anastomotic leakage occurred:(i) in 10.0% (14/139) of Group A, compared with 6.6% (9/136) of Group B for low...

  9. Improving the quality of colonoscopy bowel preparation using an educational video

    OpenAIRE

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

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. 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.

  13. 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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Prospective evaluation of small bowel preparation with bisacodyl and sodium phosphate for capsule endoscopy

    Science.gov (United States)

    Franke, Andreas; Hummel, Frank; Knebel, Phillip; Antoni, Christoph; Böcker, Ulrich; Singer, Manfred V; Löhr, Matthias

    2008-01-01

    AIM: To determine the effect of Prepacol®, a combination of sodium phosphate and bisacodyl, on transit and quality of capsule endoscopy (CE). METHODS: Fivety two consecutive patients were included in this prospective study. CE was performed following a 12 h fasting period. Twenty six patients were randomized for additional preparation with Prepacol®. The quality of CE was assessed separately for the proximal and the distal small bowel by 3 experienced endoscopists on the basis of a graduation which was initially developed with 20 previous CE. RESULTS: Preparation with Prepacol® accelerated small bowel transit time (262 ± 55 min vs 287 ± 97 min), but had no effect on the quality of CE. Visibility was significantly reduced in the distal compared to the proximal small bowel. CONCLUSION: The significantly reduced visibility of CE in the distal small bowel allocates the need for a good preparation. Since Prepacol® has no beneficial effect on CE the modality of preparation and the ideal time of application remains unclear. Further standardized examinations are necessary to identify sufficient preparation procedures and to determine the impact of the volume of the preparation solution. PMID:18395907

  17. MRI enterography with divided dose oral preparation: Effect on bowel distension and diagnostic quality

    Directory of Open Access Journals (Sweden)

    Rakesh Sinha

    2013-01-01

    Full Text Available Aim: To assess the impact of an extended oral preparation magnetic resonance (MR enterography protocol on bowel distension, timing of imaging, and the quality of diagnostic images. Materials and Methods: An analysis of 52 patients who underwent divided oral preparation and 39 patients who underwent standard preparation for MR enterography examination was done. Distension was assessed by measuring the transverse diameters of the jejunum, ileum, and the ileocecal region. Diagnostic quality of the examination was assessed subjectively by two radiologists and graded as poor, diagnostic, and excellent (Grades 1-3. Correlation between bowel diameter and diagnostic quality was assessed using regression analysis. Results: The mean diameters of the jejunum, ileum, and colon in patients who underwent divided preparation were 1.90 ± 0.47, 2.14 ± 0.41, and 4.27 ± 0.96 cm, respectively, and the mean diameters in patients who underwent standard preparation were 1.46 ± 0.47, 2.02 ± 0.47, and 4.45 ± 0.90 cm, respectively. A total of 96.6% of patients on divided dose had diagnostic distension of the bowel (Grades 2 and 3. A total of 87.9% of the patients on standard dose had diagnostic distension of the bowel (Grades 2 and 3. A greater number of patients who underwent divided preparation had diagnostic quality examinations compared to those given standard preparation (96.6% vs. 87.9%. A greater number of patients who underwent divided preparation had Grade 3 quality examinations compared to those on standard preparation (75.5% vs. 68.5%. There was significant difference between diagnostic (Grades 2 and 3 and optimal grades (Grade 3 of the jejunal diameters in patients having divided or standard preparation (89.7% vs. 66.6%, P < 0.05; 40.8% vs. 25%, P < 0.05, respectively. Linear regression showed a positive correlation between increasing bowel diameter and diagnostic grade of the examination (ρ = 0.76. Conclusion: Using an extended oral preparation with

  18. MRI enterography with divided dose oral preparation: Effect on bowel distension and diagnostic quality

    OpenAIRE

    Rakesh Sinha; Sudarshan Rawat

    2013-01-01

    Aim: To assess the impact of an extended oral preparation magnetic resonance (MR) enterography protocol on bowel distension, timing of imaging, and the quality of diagnostic images. Materials and Methods: An analysis of 52 patients who underwent divided oral preparation and 39 patients who underwent standard preparation for MR enterography examination was done. Distension was assessed by measuring the transverse diameters of the jejunum, ileum, and the ileocecal region. Diagnostic quality of ...

  19. 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

  20. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.)

  3. 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.)

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

    Science.gov (United States)

    Brimhall, Bryan B.; Hankins, Sam C.; Kankanala, Vineel; Austin, Gregory L.

    2016-01-01

    Background/Aims 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). Methods 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 colonoscopy due to suboptimal bowel preparation, ADR, and AADR. Models were adjusted for appropriate covariates. Results Medicare patients colonoscopy compared to commercial insurance patients. Medicare patients colonoscopy outcomes and reducing healthcare costs in these populations. PMID:27187809

  5. Influence of perception of colorectal cancer risk and patient bowel preparation behaviors: a study in minority populations

    Directory of Open Access Journals (Sweden)

    Gaduputi V

    2015-01-01

    Full Text Available Vinaya Gaduputi, Chaitanya Chandrala, Hassan Tariq, Sailaja Sakam, Anil Dev, Sridhar Chilimuri Bronx Lebanon Hospital Center, Department of Medicine, Bronx, New York, NY, USA Background: Large disparities exist in the utilization rates of screening modalities for colorectal cancer (CRC in different socioeconomic areas. In this study, we evaluated whether the quality of bowel preparation differed significantly among populations with a high risk of CRC compared with that among the general population after matching for potential confounding factors.Methods: Hispanic and African American patients who underwent routine screening or surveillance colonoscopies in an outpatient setting between 2003 and 2013 were included in this retrospective study. Patients who underwent colonoscopies for emergent indications and repeat routine screening colonoscopies because of prior history of inadequate bowel preparation were excluded from this study. The patients were divided into three groups: patients having an average risk of being diagnosed with CRC (group 1; patients having a high risk of being diagnosed with CRC because of a personal history of adenomatous polyps (group 2; and patients having a high risk of being diagnosed with CRC because of a family history of CRC in first-degree relatives (group 3. All the patients were given preprocedural counseling and written instructions for bowel preparation. Data on demographic information, method of bowel preparation, quality of bowel preparation, comorbidities, and prescription medications were collected.Results: In all, 834 patients had a "high-risk for CRC" surveillance colonoscopy in view of their personal history of adenomatous polyps and were included in group 2. In total, 250 patients had a "high-risk for CRC" screening colonoscopy in view of their family history of CRC in first-degree relatives and were included in group 3. Further, 1,000 patients were selected to serve as controls (after matching for age

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. Evaluating patients' preferences for type of bowel preparation prior to screening CT colonography: Convenience and comfort versus sensitivity and specificity

    International Nuclear Information System (INIS)

    Aims: To explore the relative value patients place on comfort and convenience versus test sensitivity and specificity in the context of computed tomographic colonography (CTC) screening. Materials and methods: Twenty semi-structured interviews were carried out with patients attending hospital for radiological tests unrelated to CTC. Preferences for CTC with different types of bowel preparation for CTC screening were examined and interviews were analysed thematically. The discussion guide included separate sections on CTC, bowel preparation methods (non-, reduced- and full-laxative), and sensitivity and specificity. Patients were given information on each topic in turn and asked about their views and preferences during each section. Results: Following information about the test, patients' attitudes towards CTC were positive. Following information on bowel preparation, full-laxative purgation was anticipated to cause more adverse physical and lifestyle effects than using reduced- or non-laxative preparation. However, stated preferences were approximately equally divided, largely due to patients anticipating that non-laxative preparations would reduce test accuracy (because the bowel was not thoroughly cleansed). Following information on sensitivity and specificity (which supported patients' expectations), the predominant stated preference was for full-laxative preparation. Conclusions: Patients are likely to value test sensitivity and specificity over a more comfortable and convenient preparation. Future research should test this hypothesis on a larger sample

  13. 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 ...

  14. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  16. 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.

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

    International Nuclear Information System (INIS)

    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

  18. 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.

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

    OpenAIRE

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

    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 satisf...

  20. 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.

  1. Use of a preparation of galactomannane for translucent small bowel presentation

    International Nuclear Information System (INIS)

    An improvement of radiological small bowel examination is achieved by a specially composed contrast medium, the use of a galactomannane based non methylcellulose containing distention medium and a specially adapted instillation technique. The distention of the terminal ileum can be supported pharmacologically by ceruletid. (orig.)

  2. 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.

  3. Does Polyethylene Glycol (PEG) Plus Ascorbic Acid Induce More Mucosal Injuries than Split-Dose 4-L PEG during Bowel Preparation?

    Science.gov (United States)

    Kim, Min Sung; Park, Jongha; Park, Jae hyun; Kim, Hyung Jun; Jang, Hyun Jeong; Joo, Hee Rin; Kim, Ji Yeon; Choi, Joon Hyuk; Heo, Nae Yun; Park, Seung Ha; Kim, Tae Oh; Yang, Sung Yeon

    2016-01-01

    Background/Aims The aims of this study were to compare the bowel-cleansing efficacy, patient affinity for the preparation solution, and mucosal injury between a split dose of poly-ethylene glycol (SD-PEG) and low-volume PEG plus ascorbic acid (LV-PEG+Asc) in outpatient scheduled colonoscopies. Methods Of the 319 patients, 160 were enrolled for SD-PEG, and 159 for LV-PEG+Asc. The bowel-cleansing efficacy was rated according to the Ottawa bowel preparation scale. Patient affinity for the preparation solution was assessed using a questionnaire. All mucosal injuries observed during colonoscopy were biopsied and histopathologically reviewed. Results There was no significant difference in bowel cleansing between the groups. The LV-PEG+Asc group reported better patient acceptance and preference. There were no significant differences in the incidence or characteristics of the mucosal injuries between the two groups. Conclusions Compared with SD-PEG, LV-PEG+Asc exhibited equivalent bowel-cleansing efficacy and resulted in improved patient acceptance and preference. There was no significant difference in mucosal injury between SD-PEG and LV-PEG+Asc. Thus, the LV-PEG+Asc preparation could be used more effectively and easily for routine colonoscopies without risking significant mucosal injury. PMID:26260754

  4. 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.

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

    International Nuclear Information System (INIS)

    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

  6. Comparison of Two Laxative Agents for Precolonoscopy Bowel Preparation: Sennoside Versus Standard Polyethylene Glycol Solution

    OpenAIRE

    NAD?R, I??lay; KAÇAR, Sabite; ÇAKAL, Ba?ak; AKDO?AN, Meral; ÖZ?N, Yasemin Özderin

    2009-01-01

    This study was undertaken to compare the efficacy of standard 4-liters polyethylene glycol solution (PEG) and sennoside for bowel cleansing. Eighty patients having colonoscopy indication for any reason were voluntarily admitted in to the study. Patients were randomized to two groups to receive either PEG (30 patients) or sennoside (50 patients) for colon cleansing. Colonic cleansing of the patients was evaluated by Aranchick scoring scale according to educational levels. The perfect c...

  7. 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

  8. 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.

  9. 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.)

  10. 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

  11. 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

  12. 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...

  13. 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

  14. 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

  15. 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

  16. 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.

  17. Bowel incontinence

    Science.gov (United States)

    ... move well enough to safely get to the bathroom on their own. These people need special care. They may become used to not getting to the toilet when it's time to have a bowel movement. To ... the bathroom is safe and comfortable. Using special pads or ...

  18. 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 ...

  19. 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 ...

  20. Large bowel resection

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002941.htm Large bowel resection To use the sharing features on this page, please enable JavaScript. Large bowel resection is surgery to remove all or ...

  1. 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 ...

  2. The Bowel Microbiota and Inflammatory Bowel Diseases

    Directory of Open Access Journals (Sweden)

    Gerald W. Tannock

    2010-01-01

    Full Text Available The human bowel contains a large and biodiverse bacterial community known as the microbiota or microbiome. It seems likely that the microbiota, fractions of the microbiota, or specific species comprising the microbiota provide the antigenic fuel that drives the chronic immune inflammation of the bowel mucosa that is characteristic of Crohn's disease and ulcerative colitis. At least twenty years of microbiological research have been expended on analysis of the composition of the bowel microbiota of inflammatory bowel disease patients in comparison to that of control subjects. Despite extensive speculations about the aetiological role of dysbiosis in inflammatory bowel diseases, knowledge that can be easily translated into effective remedies for patients has not eventuated. The causes of this failure may be due to poorly defined and executed bacteriological studies, as well as the overwhelming complexity of a biome that contains hundreds of bacterial species and trillions of bacterial cells.

  3. 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.)

  4. 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

  5. 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 ...

  6. 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 © ...

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. 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...

  12. 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

  13. 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.

  14. 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 ...

  15. 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...

  16. 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.

  17. 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 t...... epidemiology of IBD....

  18. 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,...

  19. 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)

  20. 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.

  1. 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.

  2. 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 ...

  3. 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

  4. 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

  5. Primary restorative colectomy in malignant left-sided large bowel obstruction.

    OpenAIRE

    Dorudi, S.; Wilson, N. M.; Heddle, R. M.

    1990-01-01

    A series of 18 consecutive patients who underwent primary resection and immediate anastomosis as the treatment for malignant left-sided large bowel obstruction are presented. Intraoperative mechanical preparation of the colon was omitted. There was no clinical evidence of anastomotic dehiscence or wound infection. The mean duration of hospital stay was 11 days. It is suggested that colonic continuity can be restored immediately and safely without mechanical bowel preparation, providing attent...

  6. Accuracy of abdominal auscultation for bowel obstruction

    DEFF Research Database (Denmark)

    Breum, Birger Michael; Rud, Bo; Kirkegaard, Thomas; Nordentoft, Tyge

    2015-01-01

    AIM: To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction. METHODS: Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann(®) Electronic Stethoscope. The recordings were processed...

  7. Adenocarcinoma of the small bowel

    International Nuclear Information System (INIS)

    Adenocarcinoma of small bowel is generally a rather rare primary tumour of small bowel with a prevalence rate of 0.5 - 3.0 / 100.000 population, but the most frequent tumour of small intestine. It more often involves the duodenum and jejunum than the ileum. The aim of this paper is also to point out the value of small bowel follow through (SBFT) in the diagnosis of stenosing lesions. An 83 - year old male patient suffered from abdominal pain, malaise, vomiting, cachexia and diarrhoea for 3 months. The result of occult blood testing was negative. Haemoglobin level was normal. Proctoscopy, colonoscopy, upper gastrointestinal (GI) endoscopy, and ultrasonography (US) did not explain the patient's problems. Ileus of the small bowel was established with abdominal plain film. Small bowel follow through (SBFT) and computer tomography (CT) showed a stenosing tumour in the jejunum. Adenocarcinoma of the small bowel was established with histological examination after resection of the tumor. SBFT, with manual compression of all segments of the small bowel, can be a very accurate diagnostic investigation for evaluation of stenosing lesions in this part of the intestine. (author)

  8. 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...... fructose caused marked abdominal distress in patients with demonstrable malabsorption. Ingestion of sucrose in these patients gave less pronounced symptoms of abdominal distress. Malabsorption of a 5-g dose of sorbitol could be detected in 8 of 13 patients. Mixtures of 25 g of fructose and 5 g of sorbitol...... caused significantly increased abdominal distress, and more than additive malabsorption was found in several cases. The present study shows that pronounced gastrointestinal distress may be provoked by malabsorption of small amounts of fructose, sorbitol, and fructose-sorbitol mixtures in patients with...

  9. International bowel function basic 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 Basic Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on bowel function in daily practice or in research....... 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 ISCo......S Scientific Committee, Council and ASIA Board received the data set for final review and approval. RESULTS: The International Bowel Function Basic SCI Data Set includes the following 12 items: date of data collection, gastrointestinal or anal sphincter dysfunction unrelated to SCI, surgical procedures on the...

  10. 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...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. Short bowel syndrome in adults

    DEFF Research Database (Denmark)

    Matarese, Laura E; Jeppesen, Palle B; O'Keefe, Stephen J D

    2014-01-01

    Short bowel syndrome (SBS) is a heterogeneous disorder with broad variation in disease severity arising from different types of intestinal resection. The spectrum of malabsorption ranges from intestinal insufficiency to intestinal failure. Individualized patient strategies involving modifications...

  15. Sleep and Irritable Bowel Syndrome

    Science.gov (United States)

    ... of IBS Who We Are Contact Us Donate Sleep and Irritable Bowel Syndrome Sleep difficulties are common ... More: Treating Pain in IBS How to improve sleep While there are a variety of medications that ...

  16. Neurostimulation for Neurogenic Bowel Dysfunction

    OpenAIRE

    J. Worsøe; Rasmussen, M.; Christensen, P.; Krogh, K.

    2013-01-01

    Background. Loss of normal bowel function caused by nerve injury, neurological disease or congenital defects of the nervous system is termed neurogenic bowel dysfunction (NBD). It usually includes combinations of fecal incontinence, constipation, abdominal pain and bloating. When standard treatment of NBD fails surgical procedures are often needed. Neurostimulation has also been investigated, but no consensus exists about efficacy or clinical use. Methods. A systematic literature search of NB...

  17. 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...

  18. 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...

  19. 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.

  20. 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.

  1. 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.

  2. 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...

  3. 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...

  4. Small bowel neoplasia in coeliac disease

    OpenAIRE

    Rampertab, S D; Forde, K A; Green, P. H. R.

    2003-01-01

    There is an increased risk of small bowel adenocarcinoma in patients with coeliac disease compared with the normal population. It has been suggested that adenocarcinoma of the small intestine in coeliac disease arises through an adenoma-carcinoma sequence but there has been only one reported case of a small bowel adenoma in a patient with coeliac disease. We report three additional cases of a small bowel adenoma in the setting of coeliac disease. In addition, four cases of small bowel adenoca...

  5. 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

  6. 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

  7. CT enteroclysis in small bowel Crohn's disease

    International Nuclear Information System (INIS)

    The diagnostic evaluation of small bowel Crohn's disease has changed dramatically over the last decade. The introduction of wireless capsule endoscopy, double balloon endoscopy and the introduction of newer therapeutic agents have changed the role of imaging in the small bowel. Additionally, advances in multidetector CT technology have further changed how radiologic investigations are utilized in the diagnosis and management of small bowel Crohn's disease. This article describes how we perform CT enteroclysis in the investigation of small bowel Crohn's disease and discusses the role of CT enteroclysis in the current management of small bowel Crohn's disease.

  8. 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

  9. Dysbiosis in inflammatory bowel disease

    OpenAIRE

    Tamboli, C P; Neut, C; Desreumaux, P; Colombel, J.F.

    2004-01-01

    Abundant data have incriminated intestinal bacteria in the initiation and amplification stages of inflammatory bowel diseases. However, the precise role of intestinal bacteria remains elusive. One theory has suggested a breakdown in the balance between putative species of “protective” versus “harmful” intestinal bacteria—this concept has been termed “dysbiosis”. Arguments in support of this concept are discussed.

  10. 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.

  11. 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.)

  12. Bowel resection in Nigerian children

    Directory of Open Access Journals (Sweden)

    Abdur-Rahman L

    2009-01-01

    Full Text Available Background : Although bowel resections are commonly done for congenital malformations in children in developed countries, they usually follow neglected and preventable acquired diseases of the intestine in developing countries. Objectives : To determine the indications and outcome of bowel resections in children of a developing country in a university teaching hospital. Materials and Methods: Data of the patients operated (from birth to 15 years was retrospectively collected over eight years (January 1999 to December 2006. The biodata of children included the following: Indications for operation, type of operations, duration of admission, and outcome of treatment including complications. Patients with Hirschsprung′s disease were excluded from the study because bowel resection forms part of their definitive surgical management. Results : There were 70 patients (38 boys and 32 girls. The age ranged between four hours to 15 years (median, five months. There were 16 (22.9% neonates, 26 (37.1% infants, and 28 (40% grown children. The indications were congenital anomalies in the 16 neonates. Also, 23 (88.5% infants had intussusception, 2 (7.7% had midgut vovulusm and 1 (3.8% had congenital small intestine band. Among the grown children, typhoid ileal perforation (TIP was seen in 14 (50.0%, intussusception in 5 (17.9%, and other causes in nine patients. Overall, intussusception was the most common indication for bowel resection, followed by TIP. A total of 24 patients developed 33 complications. Complications included wound infection in 47.8% and anastomotic leak in 42.8%. The duration of admission ranged between 4-35 days (median, 15 days. The overall mortality was 17.1% -; which was highest among neonates (56.3%, followed by the infants (26.9% -. Conclusion : Bowel resections are mainly done for intussusception and complications of TIP at our centre. Late presentation, preexisting malnutrition, and nonavailability of parenteral nutrition

  13. 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

  14. Iron deficiency anemia in inflammatory bowel disease.

    Science.gov (United States)

    Kaitha, Sindhu; Bashir, Muhammad; Ali, Tauseef

    2015-08-15

    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 laboratory 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 convenient, 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. PMID:26301120

  15. 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.

  16. Small bowel intubation using guide wire: use in decompression of small bowel obstruction

    International Nuclear Information System (INIS)

    Small bowel intubation is a useful method in the non-operative decompression of small bowel obstruction and enteral hyperalimentation in malnourished patients. We have tried small bowel intubation with Ventrol tube guided by small bowel enteroclysis guide wire (Bilbao-Dotter wire) in 12 patients. Ten cases were successfully intubated. In 11 cases of bowel obstruction, 9 cases were intubated and 8 cases were effectively drained. One malnourished patient was improved in nutritional state after enteral hyperalimentation through the intubated tube. We believe this method is an easy and time-saving method in the small bowel decompression

  17. 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.

  18. Iohexol for contrast enhancement of bowel in pediatric abdominal CT

    International Nuclear Information System (INIS)

    Abdominal CT scans from 160 examinations performed on pediatric patients using iohexol 2 percent as contrast medium for bowel enhancement were evaluated retrospectively. When diluted with a beverage of the child's choice, iohexol has a neutral taste and cannot be detected, and 139 out of 142 patients drank the full amount of dilute contrast offered to them. The enhancement of bowel in the area of interest was graded as good (58%), reasonable (23%), or poor (19%). The contrast medium was prepared from leftovers from our angiocardiography studies. We conclude that the use of water-soluble contrast medium in a low concentration is a safe and cost-effective way of facilitating ingesion of sufficient amounts of the medium in oncologic pediatric patients undergoing cytotoxic and/or radiation treatment. (orig.)

  19. 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...... estimation regard genetic and environmental variance as separate entities, although it is now understood that there is a complex multidirectional interplay between genetic are environmental factors mediated by the microbiota, the epigenome, and the innate and acquired immune systems. Due to the limitations...

  20. 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...

  1. 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.

  2. Inflammatory Bowel Disease and Thrombosis

    OpenAIRE

    Ahmet Tezel; Muzaffer Demir

    2012-01-01

    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, s...

  3. 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...

  4. Neurostimulation for Neurogenic Bowel Dysfunction

    Directory of Open Access Journals (Sweden)

    J. Worsøe

    2013-01-01

    Full Text Available Background. Loss of normal bowel function caused by nerve injury, neurological disease or congenital defects of the nervous system is termed neurogenic bowel dysfunction (NBD. It usually includes combinations of fecal incontinence, constipation, abdominal pain and bloating. When standard treatment of NBD fails surgical procedures are often needed. Neurostimulation has also been investigated, but no consensus exists about efficacy or clinical use. Methods. A systematic literature search of NBD treated by sacral anterior root stimulation (SARS, sacral nerve stimulation (SNS, peripheral nerve stimulation, magnetic stimulation, and nerve re-routing was made in Pubmed, Embase, Scopus, and the Cochrane Library. Results. SARS improves bowel function in some patients with complete spinal cord injury (SCI. Nerve re-routing is claimed to facilitate defecation through mechanical stimulation of dermatomes in patients with complete or incomplete SCI or myelomeningocele. SNS can reduce NBD in selected patients with a variety of incomplete neurological lesions. Peripheral stimulation using electrical stimulation or magnetic stimulation may represent non-invasive alternatives. Conclusion. Numerous methods of neurostimulation to treat NBD have been investigated in pilot studies or retrospective studies. Therefore, larger controlled trials with well-defined inclusion criteria and endpoints are recommended before widespread clinical use of neurostimulation against NBD.

  5. Management of irritable bowel syndrome.

    Science.gov (United States)

    Torii, Akira; Toda, Gotaro

    2004-05-01

    Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders. The prevalence rate is 10-20% and women have a higher prevalence. IBS adversely affects quality of life and is associated with health care use and costs. IBS comprises a group of functional bowel disorders in which abdominal discomfort or pain is associated with defecation or a change in bowel habit, and with features of disordered defecation. The consensus definition and criteria for IBS have been formalized in the "Rome II criteria". Food, psychiatric disorders, and gastroenteritis are risk factors for developing IBS. The mechanism in IBS involves biopsychosocial disorders; psychosocial factors, altered motility, and heightened sensory function. Brain-gut interaction is the most important in understanding the pathophysiology of IBS. Effective management requires an effective physician-patient relationship. Dietary treatment, lifestyle therapy, behavioral therapy, and pharmacologic therapy play a major role in treating IBS. Calcium polycarbophil can benefit IBS patients with constipation or alternating diarrhea and constipation. PMID:15206545

  6. Primary Amyloidosis Presenting as Small Bowel Encapsulation

    OpenAIRE

    Jones, Jennifer; van Rosendaal, Guido; Cleary, Cynthia; Urbanski, Stefan; Woodman, Richard C.

    2004-01-01

    Amyloidosis is a pathological process which encompasses a spectrum of diseases that result from extracellular deposition of pathological fibrillar proteins. Clinical presentations vary depending on the organs involved. There is no documented case of amyloidosis presenting as small bowel encapsulation. A previously healthy 62-year-old man developed a small bowel obstruction in 1997. At surgery, a peculiar membrane encasing his entire small bowel was discovered. This appeared to have no vascula...

  7. 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...

  8. 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...

  9. 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.).

  10. 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

  11. 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....

  12. 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.

  13. Pregnancy outcome in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Bortoli, A; Pedersen, N; Duricova, D; D'Inca, R; Gionchetti, P; Panelli, M R; Ardizzone, S; Sanroman, A L; Gisbert, J P; Arena, I; Riegler, G; Marrollo, M; Valpiani, D; Corbellini, A; Segato, S; Castiglione, F; Munkholm, P

    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....

  14. 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.

  15. Hypertrophic osteoarthropathy of chronic inflammatory bowel disease

    International Nuclear Information System (INIS)

    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. (orig.)

  16. 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

  17. 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

  18. [Inflammatory bowel disease and pregnancy].

    Science.gov (United States)

    Parfenov, A I

    2012-01-01

    Inflammatory bowel disease (IBD) in pregnant women in their characteristics do not differ from general population, unless they had operations on the pelvic organs. Women with a first pregnancy, regardless of the activity of IBD have an increased risk of adverse pregnancy and high risk births. Most treatment methods are compatible with pregnancy and breastfeeding. Women affected by IBD should discuss their plans for pregnancy with the doctor first in order to know the possible dangers. Every patient in the IBD during pregnancy must be observed by a gastroenterologist, accoucheur and pediatrician to ensure peace of mother and child. PMID:22830229

  19. 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.

  20. 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.

  1. 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.

  2. [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

  3. 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

  4. Transabdominal Ultrasonography of the Small Bowel

    Directory of Open Access Journals (Sweden)

    Rudolf Kralik

    2013-01-01

    Full Text Available In the era of double balloon enteroscopy, capsule endoscopy, CT, and MRI enterography is transabdominal ultrasonography (TUS underestimated method for evaluation of small bowel pathology. As often initial imagine method in abdominal complaints, nowadays has TUS much better diagnostic potential than two decades ago. High-resolution ultrasound probes with harmonic imaging significantly improve resolution of bowel wall in real time, with possibility to asses bowel peristalsis. Color flow doppler enables evaluation of intramural bowel vascularisation, pulse wave doppler helps to quantificate flow in coeliac and superior mesenteric arteries. Small intestine contrast ultrasonography with oral contrast fluid, as well as contrast enhanced ultrasonography with intravenous microbubble contrast also improves small bowel imaging. We present a review of small intestine pathology that should be detected during ultrasound examinations, discuss technical requirements, advantages and limitations of TUS, typical ultrasound signs of Crohn's disease, ileus, celiac disease, intussusception, infectious enteritis, tumours, ischemic and haemorrhagic conditions of small bowel. In the hands of experienced investigator, despite some significant limitations(obesity, meteorism, is transabdominal ultrasonography reliable, noninvasive and inexpensive alternative method to computerised tomography (CT and magnetic resonance imaging (MRI in small bowel examination.

  5. 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

  6. 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...

  7. 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...

  8. 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

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. Magnetic resonance imaging of the small bowel

    Energy Technology Data Exchange (ETDEWEB)

    Deeab, Dhafer A., E-mail: dhafer_ahmed@yahoo.co [Department of Radiology, St Mary' s Campus, Imperial College NHS Trust, London (United Kingdom); Dick, Elizabeth; Sergot, Antoni A.; Sundblon, Lauren; Gedroyc, Wady [Department of Radiology, St Mary' s Campus, Imperial College NHS Trust, London (United Kingdom)

    2011-02-15

    Magnetic Resonance Imaging of the Small Bowel (MR Enterography, or MRE) is becoming increasingly popular as the first imaging modality for the diagnosis and follow-up of small bowel diseases. The inherent advantages of MRI, including excellent soft tissue contrast, multiplanar capability and lack of ionising radiation are well known. In addition, the use of luminal contrast agents in MRE has the added advantage of demonstrating the lumen and the wall directly, something not possible to achieve with conventional small bowel barium follow-through imaging. This review will highlight recent technical advances to this low cost, simple technique which is easily achievable in all hospitals. It will also review normal and abnormal radiological findings and highlight the value of this technique to both the clinician and patient alike in the investigation of small bowel disease.

  14. Magnetic resonance imaging of the small bowel

    International Nuclear Information System (INIS)

    Magnetic Resonance Imaging of the Small Bowel (MR Enterography, or MRE) is becoming increasingly popular as the first imaging modality for the diagnosis and follow-up of small bowel diseases. The inherent advantages of MRI, including excellent soft tissue contrast, multiplanar capability and lack of ionising radiation are well known. In addition, the use of luminal contrast agents in MRE has the added advantage of demonstrating the lumen and the wall directly, something not possible to achieve with conventional small bowel barium follow-through imaging. This review will highlight recent technical advances to this low cost, simple technique which is easily achievable in all hospitals. It will also review normal and abnormal radiological findings and highlight the value of this technique to both the clinician and patient alike in the investigation of small bowel disease.

  15. 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 ...

  16. 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

  17. 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...

  18. 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....

  19. Rifaximin Therapy of Irritable Bowel Syndrome

    OpenAIRE

    Koo, Hoonmo L.; Saman Sabounchi; Huang, David B.; Herbert L. DuPont

    2012-01-01

    Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by abdominal pain and altered bowel habits in the absence of specific organic pathology. Although the underlying pathogenesis of IBS is not well-understood, small intestinal bacterial overgrowth (SIBO) or other abnormalities in the gut flora is believed to contribute to the development of a subset of IBS cases. Rifaximin is a poorly absorbed antimicrobial with activity against enteric pathogens. A number of stu...

  20. 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.

  1. 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...

  2. 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...

  3. 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.

  4. 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...

  5. Use of Prebiotics for Inflammatory Bowel Disease

    OpenAIRE

    Szilagyi, Andrew

    2005-01-01

    The relevance of diet in both the pathogenesis and the therapy of inflammatory bowel disease is an evolving science. Disturbance of intestinal microflora (dysbiosis) is putatively a key element in the environmental component causing inflammatory bowel disease. Prebiotics are among the dietary components used in an attempt to counteract dysbiosis. Such predominantly carbohydrate dietary components exert effects on the luminal environment by physicochemical changes through pH alteration, by pro...

  6. Rheumatic manifestations of inflammatory bowel disease

    OpenAIRE

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

    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...

  7. PYODERMA GANGRENOSUM WITH INFLAMATORY BOWEL DISEASE

    OpenAIRE

    Guru Prasad; Jhansi Lakshmi; Krishna Rao; Parvathi; Durga Bhavani

    2015-01-01

    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 w...

  8. 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...

  9. 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...

  10. [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

  11. 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.)

  12. 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.)

  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. 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.

  15. 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.

  16. Smoking and inflammatory bowel disease.

    Science.gov (United States)

    Rubin, D T; Hanauer, S B

    2000-08-01

    It is well established that smoking cigarettes is associated with Crohn's disease (CD) and that non-smoking is associated with ulcerative colitis (UC). Furthermore, there is convincing evidence that smoking cigarettes has a negative effect on the course of CD, and that smoking cigarettes may improve the disease severity or have a 'protective' effect in some patients with UC. Despite these well-described associations, the mechanism by which cigarette smoking affects CD and UC is not known. Researchers have studied the systemic effects, cellular and humoral immune effects, mucosal changes, and the intestinal permeability changes with inflammatory bowel disease (IBD) and smoking. To date, none of these studies adequately explains the observed clinical patterns. It has been assumed that nicotine is the active agent in these associations, but clinical trials of nicotine chewing gum and transdermal nicotine in UC have shown limited benefit, and have been complicated by significant side-effects. Topical delivery systems for nicotine therapy are currently under development and await future clinical trials. PMID:10958212

  17. [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

  18. 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.)

  19. 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

  20. 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 

  1. Biofeedback & Bowel Disorders: Teaching Yourself to Live without the Problem

    Science.gov (United States)

    ... Constipation Personal Stories Contact Us Biofeedback & Bowel Disorders: Teaching Yourself to Live Without the Problem Home Biofeedback ... donation. Adapted from IFFGD Publication: Biofeedback & Bowel Disorders: Teaching Yourself to Live without the Problem by Mary ...

  2. 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

  3. 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

  4. 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

  5. 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...

  6. 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...

  7. 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.

  8. Small-bowel permeability in collagenous colitis

    DEFF Research Database (Denmark)

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

    2006-01-01

    -intestinal biopsies, indicating that CC is a pan-intestinal disease. In small-intestinal disease, the intestinal barrier function may be impaired, and the permeability of the small intestine altered. The purpose of this research was to study small-bowel function in patients with CC as expressed by intestinal...... permeability. MATERIAL AND METHODS: Ten patients with CC and chronic diarrhoea participated in the study. Coeliac disease was excluded by small-bowel biopsy and/or serology. Intestinal permeability was assessed as urinary excretion (ratios) 2, 4 and 6 h after ingestion of 14C-labelled mannitol (14C......: No alterations in intestinal permeability in patients with CC could be demonstrated. Impairment of the integrity of the mucosa of the small bowel and the presence of a general dysfunction of the small intestine in patients with CC seem unlikely....

  9. Laparoscopic Management of Adhesive Small Bowel Obstruction

    Science.gov (United States)

    Konjic, Ferid; Idrizovic, Enes; Hasukic, Ismar; Jahic, Alen

    2016-01-01

    Introduction: Adhesions are the reason for bowel obstruction in 80% of the cases. In well selected patients the adhesive ileus laparoscopic treatment has multiple advantages which include the shorter hospitalization period, earlier food taking, and less postoperative morbidity rate. Case report: Here we have a patient in the age of 35 hospitalized at the clinic due to occlusive symptoms. Two years before an opened appendectomy had been performed on him. He underwent the treatment of exploration laparoscopy and laparoscopic adhesiolysis. Dilated small bowel loops connected with the anterior abdominal wall in the ileocecal region by adhesions were found intraoperatively and then resected harmonically with scalpel. One strangulation around which a small bowel loop was wrapped around was found and dissected. Postoperative course was normal. PMID:27041815

  10. 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.

  11. 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.

  12. 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

  13. Multidetector CT findings of bowel Transection in blunt abdominal trauma

    International Nuclear Information System (INIS)

    Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published. In the present study we describe the incidence and new CT signs of bowel transection in blunt abdominal trauma. We investigated the incidence of bowel transection in 513 patients admitted for blunt abdominal trauma who underwent multidetector CT (MDCT). The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign (transection of bowel loop), Janus sign (abnormal dual bowel wall enhancement, both increased and decreased), and fecal spillage. The incidence of bowel transection in blunt abdominal trauma was 1.56%. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: complete cutoff in 8 (100%), Janus sign in 6 (100%, excluding duodenal injury), and fecal spillage in 2 (25%). The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection. Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables an accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity.

  14. Multidetector CT findings of bowel Transection in blunt abdominal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hyun Suk; Woo, Ji Young; Hong, Hye Suk; Park, Mee Hyun; Yang, Ik; Lee, Yul; Jung, Ah Young; Hwang, Ji Young [Dept. of Radiology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Ha, Hong Il [Dept. of Radiology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2013-08-15

    Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published. In the present study we describe the incidence and new CT signs of bowel transection in blunt abdominal trauma. We investigated the incidence of bowel transection in 513 patients admitted for blunt abdominal trauma who underwent multidetector CT (MDCT). The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign (transection of bowel loop), Janus sign (abnormal dual bowel wall enhancement, both increased and decreased), and fecal spillage. The incidence of bowel transection in blunt abdominal trauma was 1.56%. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: complete cutoff in 8 (100%), Janus sign in 6 (100%, excluding duodenal injury), and fecal spillage in 2 (25%). The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection. Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables an accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity.

  15. 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.

  16. 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.

  17. 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 p...... preparation for elective surgery, hence avoiding the high morbidity and mortality associated with emergency surgery and stoma creation....

  18. Hemoccult II Screening for Bowel Cancer: Will Family Practice Patients Accept It?

    OpenAIRE

    Sangster, J. F.; Gerace, T. M.; Bass, M. J.

    1986-01-01

    Acceptability to patients of Hemoccult II® screening for bowel cancer will be a major determinant of whether such screening programs can be successfully implemented. In order to evaluate the screening test's acceptability to patients, compliance rates were assessed in 17 family practices in London, Ontario. Patients' reactions to the test were assessed by both a retrospective questionnaire and a similar prospective questionnaire. Respondents indicated the test's unpleasantness, dietary prepar...

  19. 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.)

  20. Fecal lactoferrin in discriminating inflammatory bowel disease from Irritable bowel syndrome: a diagnostic meta-analysis

    OpenAIRE

    Zhou, Xing-lu; Xu, Wen; Tang, Xiao-xiao; Luo, Lai-sheng; Tu, Jiang-feng; Zhang, Chen-jing; Xu, Xiang; Wu, Qin-dong; Pan, Wen-Sheng

    2014-01-01

    Background To perform a meta-analysis evaluating the diagnostic ability of fecal lactoferrin (FL) to distinguish inflammatory bowel disease (IBD) from irritable bowel syndrome (IBS). Methods The Medline, EMBASE, Web of Science, Cochrane library and CNKI databases were systematically searched for studies that used FL concentrations to distinguish between IBD and IBS. The sensitivity, specificity, and other diagnostic indexes of FL were pooled using a random-effects model. Results Seven studies...

  1. 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...

  2. 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.

  3. Unusual causes of mechanical small bowel obstruction

    International Nuclear Information System (INIS)

    We herein report our experience regarding unusual causes of bowel obstruction to increase the awareness of surgeons regarding this disease. From 1991 to 2003, we had experience at the University affiliated hospitals, northern Jordan with 24 patients with small bowel obstruction resulting from unusual causes. We retrospectively reviewed the medical records of these patients with regards to the mode of presentation, cause of obstruction, radiological and operative findings, management and outcome. We recorded 15 patients who underwent previous abdominal surgery. Preoperative diagnosis was correct in only one patient with an internal hernia, but the abdominal CT scan suggested the diagnosis in 5 of the 9 patients who had the scan. The final diagnosis was internal hernias in 11 patients, foreign bodies in 5, ischemic strictures in 3, carcinoid tumors in 2, endometriosis in 2, and metastatic deposit from interstitial bladder carcinoma in one patient. Nine of the 12 patients with recurrent obstruction had either short course or recurrence obstruction during the same hospital admission. W carried out bowel resections in 15 patients (5 resections were due to bowel strangulation). Post operative death occurred in 4 patients. Awareness of these rare causes of intestinal obstruction even in patients with previous abdominal operation might improve the outcome. The tentative diagnosis of adhesion obstruction in patients with unusual obstructive etiology might lead to a higher rate of gangrenous complications. Rigorous preoperative evaluation including careful history and early abdominal CT may show the obstructive cause. (author)

  4. 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...

  5. Small-bowel permeability in collagenous colitis

    DEFF Research Database (Denmark)

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

    2006-01-01

    , indicating that CC is a pan-intestinal disease. In small-intestinal disease, the intestinal barrier function may be impaired, and the permeability of the small intestine altered. The purpose of this research was to study small-bowel function in patients with CC as expressed by intestinal permeability....

  6. 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 and a...

  7. 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.

  8. 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 ...

  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. 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.

  11. 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)

  12. CT findings of bowel injury following blunt abdominal trauma

    International Nuclear Information System (INIS)

    To determine the diagnostic value of CT, the author retrospectively reviewed preoperative CT findings of 57 cases with surgically proven bowel injury following blunt trauma. The small bowel injuries were divided into two groups, i.e., those without mesenteric injury, group A, and those with mesenteric injury, group B. The incidence of CT findings including extraluminal air, bowel wall thickening, peritoneal fluid, mesenteric thickening, and high density hematoma, were determined. CT findings were also assessed by time intervals between injury and examination. CT scans of small bowel injury were compared with those of surgically proven 25 cases of mesenteric injury without bowel injury, group C. CT showed findings suggestive of bowel injury in 96.4% of the cases. There were 5 false negative CT scans, which consisted of 4 small bowel and one large bowel injuries, all performed within 2 hours from injury. The patients in group A small bowel injury had a higher incidence of pneumoperitoneum on CT scans performed over 4 hours after injury than on those performed within 4 hours. Bowel wall thickening was more frequent in group A than in group B or C. Peritoneal fluid collection within 4 hours from injury was less frequent in group A than in group B or C. High density hematoma was more frequent in group B and C than in group A. The analysis suggested that early diagnosis of isolated small bowel injury was difficult because of lack of signs indicating mesenteric injury. In these cases bowel wall thickening appeared earlier, then peritoneal fluid developed, with and without mesenteric thickening or extraluminal air. Thus in those with suspicion of bowel injury, bowel wall thickening on initial CT should be carefully followed up in regard to additional or progressive findings. Operative indication can be determined with careful clinical correlation before detection of extraluminal air. (K.H.)

  13. 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

  14. 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.

  15. Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review

    Directory of Open Access Journals (Sweden)

    Chan Siew F

    2011-05-01

    Full Text Available Abstract Background Bowel symptoms are often considered an indication to perform colonoscopy to identify or rule out colorectal cancer or precancerous polyps. Investigation of bowel symptoms for this purpose is recommended by numerous clinical guidelines. However, the evidence for this practice is unclear. The objective of this study is to systematically review the evidence about the association between bowel symptoms and colorectal cancer or polyps. Methods We searched the literature extensively up to December 2008, using MEDLINE and EMBASE and following references. For inclusion in the review, papers from cross sectional, case control and cohort studies had to provide a 2×2 table of symptoms by diagnosis (colorectal cancer or polyps or sufficient data from which that table could be constructed. The search procedure, quality appraisal, and data extraction was done twice, with disagreements resolved with another reviewer. Summary ROC analysis was used to assess the diagnostic performance of symptoms to detect colorectal cancer and polyps. Results Colorectal cancer was associated with rectal bleeding (AUC 0.66; LR+ 1.9; LR- 0.7 and weight loss (AUC 0.67, LR+ 2.5, LR- 0.9. Neither of these symptoms was associated with the presence of polyps. There was no significant association of colorectal cancer or polyps with change in bowel habit, constipation, diarrhoea or abdominal pain. Neither the clinical setting (primary or specialist care nor study type was associated with accuracy. Most studies had methodological flaws. There was no consistency in the way symptoms were elicited or interpreted in the studies. Conclusions Current evidence suggests that the common practice of performing colonoscopies to identify cancers in people with bowel symptoms is warranted only for rectal bleeding and the general symptom of weight loss. Bodies preparing guidelines for clinicians and consumers to improve early detection of colorectal cancer need to take into

  16. 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

  17. 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.

  18. Confocal Laser Endomicroscopy in Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND AND AIMS: Confocal laser endomicroscopy is an endoscopic method that provides in vivo real-time imaging of the mucosa at a cellular level, elucidating mucosal changes that are undetectable by white light endoscopy. This paper systematically reviews current indications and perspectives...... 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...

  19. Diet and risk of inflammatory bowel disease

    DEFF Research Database (Denmark)

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

    2012-01-01

    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...... dioxide and aluminium silicate). Conclusions: A diet high in protein, particular animal protein, may be associated with increased risk of inflammatory bowel disease and relapses. N-6 polyunsaturated fatty acids may predispose to ulcerative colitis whilst n-3 polyunsaturated fatty acid may protect. These...... results should be confirmed in other countries and in younger subjects before dietary counselling is recommended in high risk subjects....

  20. Imaging of inflammatory bowel disease. How?

    International Nuclear Information System (INIS)

    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.)

  1. CT assessment of anastomotic bowel leak

    International Nuclear Information System (INIS)

    Aim: To evaluate the predictors of clinically important gastrointestinal anastomotic leaks using multidetector computed tomography (CT). Subjects and methods: Ninety-nine patients, 73 with clinical suspicion of anastomotic bowel leak and 26 non-bowel surgery controls underwent CT to investigate postoperative sepsis. Fifty patients had undergone large bowel and 23 small bowel anastomoses. The time interval from surgery was 3-30 days (mean 10 ± 5.9 SD) for the anastomotic group and 3-40 days (mean 14 ± 11 SD) for the control group (p = 0.3). Two radiologists blinded to the final results reviewed the CT examinations in consensus and recorded the presence of peri-anastomotic air, fluid or combination of the two; distant loculated fluid or combination of fluid and air; free air or fluid; and intestinal contrast leak. Final diagnosis of clinically important anastomotic leak (CIAL) was confirmed at surgery or by chart review of predetermined clinical and laboratory criteria. Results: The prevalence of CIAL in the group undergoing CT was 31.5% (23/73). The CT examinations with documented leak were performed 5-28 (mean; 11.4 ± 6 SD) days after surgery. Nine patients required repeat operation, 10 percutaneous abscess drainage, two percutaneous drainage followed by surgery, and two prolonged antibiotic treatment and total parenteral nutrition (TPN). Of the CT features examined, only peri-anastomotic loculated fluid containing air was more frequently seen in the CIAL group as opposed to the no leak group (p = 0.04). There was no intestinal contrast leakage in this cohort. Free air was present up to 9 days and loculated air up to 26 days without CIAL. Conclusion: Most postoperative CT features overlap between patients with and without CIAL. The only feature seen statistically more frequently with CIAL is peri-anastomotic loculated fluid containing air

  2. 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 ...

  3. Small bowel neoplasm - a diagnostic dilemma

    International Nuclear Information System (INIS)

    Although uncommon, small bowel tumors often present as a diagnostic dilemma for the clinicians. This important clinical entity requires various diagnostic steps and quite often these steps have to be repeated to reach a firm diagnosis. We present here our experience with three such cases and a brief review of the literature regarding the presentation and the diagnostic steps found helpful in arriving at a diagnosis. (author)

  4. 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

  5. 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.

  6. 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.

  7. 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, ...

  8. Environmental Risk Factors for Inflammatory Bowel Disease

    OpenAIRE

    Molodecky, Natalie A; Kaplan, Gilaad G

    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...

  9. 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...

  10. 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...

  11. 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...

  12. CT assessment of anastomotic bowel leak

    Energy Technology Data Exchange (ETDEWEB)

    Power, N. [Department of Radiology, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada); Atri, M. [Department of Radiology, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada)]. E-mail: mostafa.atri@sw.ca; Ryan, S. [Department of Radiology, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada); Haddad, R. [Department of Surgery, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada); Smith, A. [Department of Surgery, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada)

    2007-01-15

    Aim: To evaluate the predictors of clinically important gastrointestinal anastomotic leaks using multidetector computed tomography (CT). Subjects and methods: Ninety-nine patients, 73 with clinical suspicion of anastomotic bowel leak and 26 non-bowel surgery controls underwent CT to investigate postoperative sepsis. Fifty patients had undergone large bowel and 23 small bowel anastomoses. The time interval from surgery was 3-30 days (mean 10 {+-} 5.9 SD) for the anastomotic group and 3-40 days (mean 14 {+-} 11 SD) for the control group (p = 0.3). Two radiologists blinded to the final results reviewed the CT examinations in consensus and recorded the presence of peri-anastomotic air, fluid or combination of the two; distant loculated fluid or combination of fluid and air; free air or fluid; and intestinal contrast leak. Final diagnosis of clinically important anastomotic leak (CIAL) was confirmed at surgery or by chart review of predetermined clinical and laboratory criteria. Results: The prevalence of CIAL in the group undergoing CT was 31.5% (23/73). The CT examinations with documented leak were performed 5-28 (mean; 11.4 {+-} 6 SD) days after surgery. Nine patients required repeat operation, 10 percutaneous abscess drainage, two percutaneous drainage followed by surgery, and two prolonged antibiotic treatment and total parenteral nutrition (TPN). Of the CT features examined, only peri-anastomotic loculated fluid containing air was more frequently seen in the CIAL group as opposed to the no leak group (p = 0.04). There was no intestinal contrast leakage in this cohort. Free air was present up to 9 days and loculated air up to 26 days without CIAL. Conclusion: Most postoperative CT features overlap between patients with and without CIAL. The only feature seen statistically more frequently with CIAL is peri-anastomotic loculated fluid containing air.

  13. 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...

  14. 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...

  15. Breath tests and irritable bowel syndrome

    OpenAIRE

    Rana, Satya Vati; Malik, Aastha

    2014-01-01

    Breath tests are non-invasive tests and can detect H2 and CH4 gases which are produced by bacterial fermentation of unabsorbed intestinal carbohydrate and are excreted in the breath. These tests are used in the diagnosis of carbohydrate malabsorption, small intestinal bacterial overgrowth, and for measuring the orocecal transit time. Malabsorption of carbohydrates is a key trigger of irritable bowel syndrome (IBS)-type symptoms such as diarrhea and/or constipation, bloating, excess flatulence...

  16. Irritable bowel syndrome and food interaction

    OpenAIRE

    Cuomo, Rosario; Andreozzi, Paolo; Zito, Francesco Paolo; Passananti, Valentina; De Carlo, Giovanni; Sarnelli, Giovanni

    2014-01-01

    Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders in Western countries. Despite the high prevalence of this disorders, the therapeutic management of these patients is often unsatisfactory. A number of factors have been suggested to be involved in the pathogenesis of IBS, including impaired motility and sensitivity, increased permeability, changes in the gut microbiome and alterations in the brain-gut axis. Also food seems to play a critical role: the most of ...

  17. Modern MRI of the small bowell

    International Nuclear Information System (INIS)

    The radiological diagnostics of diseases of the small intestine have undergone a great change in the last two decades. Through rapid progress with new treatments and an increasing therapeutic focus on transmural healing, a complete evaluation of the gastrointestinal tract is now crucial. With the introduction of endoscopy, gastrointestinal imaging with a relatively high radiation exposure had only limited applications. The development of cross-sectional imaging allowed a much broader radiological evaluation of abdominal diseases. Due to rapid investigation techniques, excellent soft tissue contrast and the distinct advantage of eliminating exposure to radiation, magnetic resonance imaging (MRI) of the gastrointestinal tract has gained increasing importance. With sufficient filling of the intestinal lumen, simultaneous imaging of all the intestinal wall layers, the perienteric structures and associated abdominal pathologies is now possible. New MR sequences, such as diffusion-weighted sequences, dynamic contrast-enhanced sequences and MR fluoroscopy, enable the detection of morphological changes, with additional characterization of affected bowel loops as well as the assessment of functional pathologies with dynamic information about intestinal motility disturbances. Recent guidelines of European radiological and gastroenterological organizations have confirmed the importance of cross-sectional imaging and particularly of MRI for diagnostics and follow-up in patients with Crohn's disease. Due to the possibility of assessment of all the layers of the intestinal wall and the presence of extramural complications, MRI has a significant impact on further therapeutic treatment in patients with inflammatory bowel disease. Especially in patients with inflammatory bowel disease, MR enterography and MR enteroclysis should be the methods of choice for the evaluation of small bowel pathologies because of radiation issues and the great diagnostic value they provide. A

  18. 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...

  19. 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...

  20. An atypical case of large bowel obstruction

    OpenAIRE

    Hughes, Kaylie E.; Arthur, James

    2013-01-01

    In Europe up to nine per cent of people suffer from renal calculi during their lifetime. Staghorn calculi are common and account for ∼11% of cases. Classic presentations include persistent loin pain, recurrent pyelonephritis or cystitis-like symptoms, renal colic or occasional haematuria. We present what we believe to be the first documented case of large bowel obstruction caused by a benign colonic stricture formed secondary to extravasation of a staghorn calculus.

  1. 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...

  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. Sellar inflammatory mass with inflammatory bowel disease

    OpenAIRE

    Freeman, Hugh J; Maguire, John

    2010-01-01

    Inflammatory bowel disease may be associated with different intracranial disorders. An inflammatory sellar mass is very rare but includes a variety of noninfectious causes including lymphocytic hypophysitis, granulomatous inflammation and Wegener’s granulomatosis. A 32-year-old man was diagnosed with an inflammatory sellar mass associated with an extensive colonic inflammatory process clinically characteristic of Crohn’s disease. The concurrent onset of these inflammatory disorders in distinc...

  4. 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...

  5. 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.

  6. 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.

  7. The epidemiology of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Canavan C

    2014-02-01

    Full Text Available Caroline Canavan, Joe West, Timothy Card Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK Abstract: Irritable bowel syndrome (IBS is a functional condition of the bowel that is diagnosed using clinical criteria. This paper discusses the nature of the diagnostic process for IBS and how this impacts epidemiological measurements. Depending on the diagnostic criteria employed, IBS affects around 11% of the population globally. Around 30% of people who experience the symptoms of IBS will consult physicians for their IBS symptoms. These people do not have significantly different abdominal symptoms to those who do not consult, but they do have greater levels of anxiety and lower quality of life. Internationally, there is a female predominance in the prevalence of IBS. There is 25% less IBS diagnosed in those over 50 years and there is no association with socioeconomic status. IBS aggregates within families and the genetic and sociological factors potentially underlying this are reviewed. Patients diagnosed with IBS are highly likely to have other functional disease and have more surgery than the general population. There is no evidence that IBS is associated with an increased mortality risk. The epidemiological evidence surrounding these aspects of the natural history is discussed. Keywords: irritable bowel syndrome, epidemiology, prevalence, mortality, natural history

  8. Osteoporosis in patients with inflammatory bowel disease

    International Nuclear Information System (INIS)

    The prevalence of osteoporosis in inflammatory bowel disease (IBD) has not been accurately established. Using single photon absorptiometry (SPA) and vertebral quantitative computerized tomography (QCT) the authors measured bone mineral content (BMC) in 75 unselected patients with IBD. Osteoporosis was present in 23 (31%). Seven had cortical and trabecular osteoporosis, 11 cortical only and five trabecular only. Three amenorrhoeic premenopausal females had clinically severe osteoporosis and a further 4 had vertebral crush fractures. The median lifetime steroid dose in osteoporotic patients was significantly greater than in patients with normal BMC; most patients with osteoporosis had small bowel IBD with one or more resections. Repeat QCT measurements in 18 patients after one year were unchanged in 12, increased in one and decreased between 10 and 37 mg/ml K2HPO4 in 5 of whom four were receiving steroids. Radial BMC decreased in one patient, increased in one and was unchanged in the remainder. Thus, osteoporosis was present in 30% of these patients, with severe clinical disease in three young females. Rapid spinal trabecular bone loss was demonstrated over the course of one year in some patients. Steroid therapy, amenorrhoe and small bowel IBD with resection appear to be important risk factors

  9. [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

  10. 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. PMID:26354428

  11. Can Probiotics Cure Inflammatory Bowel Diseases?

    Science.gov (United States)

    Korada, Siva Kumar; Yarla, Nagendra Sastry; Bishayee, Anupam; Aliev, Gjumrakch; Aruna Lakshmi, K; Arunasree, M K; Dananajaya, B L; Mishra, Vijendra

    2016-01-01

    Gastrointestinal (GI) disorders, especially microbial dysbiosis play role in several GI ailments such as irritable bowel syndrome, colorectal cancer, inflammatory bowel diseases, and antibiotic-associated diarrhoea. Role of inflammatory bowel disease (IBD) is multifactorial as it involves loss of maintaining intestinal epithelial barrier integrity, increased release of pro-inflammatory molecules, and microbial dysbiosis in gut microflora. Some specific pathogens also play a key role in the IBD development. The origin and causation are still in unfathomable condition and the exact root cause is unknown. Recently probiotic studies have been gaining importance because of their positive responses in their IBD experimental results. According to joint Food and Agricultural Organisation/World Health Organisation working group, probiotics are defined as live microorganisms which when administered in adequate amount confer health benefit on the host. These live beneficial microorganisms are considered helpful in improving gut colonization and perseverance thereby improves prophylactic effect. In the direction of IBD research, a number of studies are needed to standardize its methodology and its applicability on human usage. The particular review presents an overview of gut microflora and its impact on host health, types of IBD and existing therapies to treat this disorder, mechanism of several probiotic actions, role of probiotics in IBD prevention with their supporting evidences. PMID:26648465

  12. Rifaximin in irritable bowel syndrome: rationale, evidence and clinical use

    OpenAIRE

    Saadi, Mohammed; McCallum, Richard W.

    2013-01-01

    Irritable bowel syndrome (IBS) is the most common functional bowel disease that affects up to 15% of the US population. The majority of patients with IBS have significant bloating and gas. Recent evidence is beginning to suggest that patients with IBS may have an alteration in the gastrointestinal flora. Specifically, findings suggest that patients with IBS have excessive bacteria in the small bowel, referred to as bacterial overgrowth. Therefore there may be benefits of antibiotic-based ther...

  13. 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.

  14. 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...

  15. 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...

  16. 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...

  17. Pathophysiology of acute small bowel disease with CT correlation

    Energy Technology Data Exchange (ETDEWEB)

    Sarwani, N., E-mail: nsarwani@hmc.psu.ed [Department of Radiology, Section of Abdominal Imaging, Penn State Milton Hershey Medical Center, Hershey, PA (United States); Tappouni, R.; Tice, J. [Department of Radiology, Section of Abdominal Imaging, Penn State Milton Hershey Medical Center, Hershey, PA (United States)

    2011-01-15

    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.

  18. The Usefulness of Capsule Endoscopy for Small Bowel Tumors

    OpenAIRE

    Cheung, Dae Young; Kim, Jin Su; Shim, Ki-Nam; Choi, Myung-Gyu; ,

    2016-01-01

    Video capsule endoscopy (VCE) has expanded the range of endoscopic examination of the small bowel. The clinical application of VCE is mainly for obscure gastrointestinal bleeding (OGIB) and small bowel tumor is one of the clinically significant diagnoses of VCE, often requiring subsequent invasive interventions. Small bowel tumors are detected with a frequency of around 4% with VCE in indications of OGIB, iron deficiency anemia, unexplained abdominal pain, and others. Protruding mass with ble...

  19. The diagnostic role of MDCT enterography in small bowel lesions

    OpenAIRE

    Hasan I. Megally; Hosam eldin Mohamed Elmalah; Gehan S. Seifeldein; Nisreen Adel Abbas; Hussien Ahmed Elamin

    2015-01-01

    Purpose: To evaluate the role of MDCT enterography in the diagnosis of small bowel diseases. Patient and methods: Thirty nine patients suspected to have small bowel diseases were examined with 64 MDCT enterography. Result: MDCT enterography easily diagnosed small intestinal diseases which confirmed with histopathological results, operative data and follow up. Conclusions: MDCT can be used as a front-line imaging and one stop imaging modality for the detection of small bowel diseases....

  20. 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...

  1. 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...

  2. 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 ...

  3. 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...

  4. 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

  5. Multislice CT enteroclysis in the diagnosis of bowel endometriosis

    International Nuclear Information System (INIS)

    This prospective study aims to evaluate the efficacy of multislice computed tomography combined with colon distension by water enteroclysis (MSCTe) in determining the presence and depth of bowel endometriotic lesions. Ninety-eight women with symptoms suggestive of colorectal endometriosis underwent MSCTe; locations, number of nodule/s, size of the nodule/s and depth of bowel wall infiltration were determined. Independently from the findings of MSCTe, all women underwent laparoscopy. MSCTe findings were compared with surgical and histological results. Abnormal findings suggestive of bowel endometriotic nodules were detected by MSCTe in 75 of the 76 patients with bowel endometriosis. MSCTe identified 110 (94.8%) of the 116 bowel endometriotic nodules removed at surgery; 6 nodules missed at MSCTe were located on the rectum. MSCTe correctly determined the degree of infiltration of the bowel wall in all of the 34 serosal bowel nodules identified at MSCTe. In six nodules reaching the submucosa, the depth of infiltration was underestimated by MSCTe. MSCTe had a sensitivity of 98.7%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 95.7% in identifying women with bowel endometriosis. MSCTe is effective in determining the presence and depth of bowel endometriotic lesions. (orig.)

  6. Multislice CT enteroclysis in the diagnosis of bowel endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Biscaldi, Ennio; Rollandi, Gian A. [' ' Duchesse of Galliera' ' -Hospital, Genoa (Italy). Dept. of Radiology; Ferrero, Simone; Ragni, Nicola; Remorgida, Valentino [San Martino Hospital and Genoa Univ. (Italy). Dept. of Obstretics and Gynaecology; Fulcheri, Ezio [San Martino Hospital and Genoa Univ. (Italy). Unit of Anatomy and Histopathology

    2007-01-15

    This prospective study aims to evaluate the efficacy of multislice computed tomography combined with colon distension by water enteroclysis (MSCTe) in determining the presence and depth of bowel endometriotic lesions. Ninety-eight women with symptoms suggestive of colorectal endometriosis underwent MSCTe; locations, number of nodule/s, size of the nodule/s and depth of bowel wall infiltration were determined. Independently from the findings of MSCTe, all women underwent laparoscopy. MSCTe findings were compared with surgical and histological results. Abnormal findings suggestive of bowel endometriotic nodules were detected by MSCTe in 75 of the 76 patients with bowel endometriosis. MSCTe identified 110 (94.8%) of the 116 bowel endometriotic nodules removed at surgery; 6 nodules missed at MSCTe were located on the rectum. MSCTe correctly determined the degree of infiltration of the bowel wall in all of the 34 serosal bowel nodules identified at MSCTe. In six nodules reaching the submucosa, the depth of infiltration was underestimated by MSCTe. MSCTe had a sensitivity of 98.7%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 95.7% in identifying women with bowel endometriosis. MSCTe is effective in determining the presence and depth of bowel endometriotic lesions. (orig.)

  7. Multi-detector CT (MDCT in bowel and mesenteric injury

    Directory of Open Access Journals (Sweden)

    Vajjalla Ravikumar

    2013-04-01

    Full Text Available Objectives: To evaluate multi-detector CT (MDCT findings in bowel and mesenteric injury due to blunt abdominal trauma.Method: Retrospective evaluation of MDCT scan reports of patients admitted in Hamad Medical Corporation, Doha, Qatar with bowel and mesenteric injury during the period of January 2005 to April 2008.Results: MDCT, without using oral contrast, clearly demonstrated various specific and less specific findings of bowel and mesenteric injury.Conclusion: Multi-detector CT is an excellent diagnostic modality in bowel and mesenteric injury. Routine administration of oral contrast agent is not mandatory for initial evaluation of these patients.

  8. CT findings of small bowel rupture after abdominal trauma

    International Nuclear Information System (INIS)

    The accuracy of CT in the detection of injuries of the solid visceral organ is well established, but the value of CT in diagnosing small bowel rupture after abdominal trauma is controversal. This study was conducted to ascertain CT finding of small bowel rupture result from abdominal trauma. A retrospective analysis of preoperative abdominal CT findings in 40 patients was performed. Small bowel rupture was confirmed by surgery. Precontrast and postcontrast enhanced CT images were obtained in all patients. Diagnostic findings of small bowel rupture including pneumoperitoneum or retroperitoneal air, discontinuity of the bowel wall and extravasation of oral contrast materials were observed in 33 cases(83%). Intraperitoneal or retroperitoneal free air was seen in 31 cases(78%) and intraperitoneal or retroperitoneal free fluid collection was seen in 38 patients(95%). Small bowel wall was thickened in 31 cases(78%), bowel wall was enhanced in 12 cases(30%) and bowel wall discontinuity and extravasation of oral contrast material was seen in 5 cases, respectively. The CT scan is sensitive and effective modality for evaluation of small bowel rupture after abdominal trauma, because of high detectability of diagnostic and suggestive CT findings

  9. The 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 at the limit of resolution of current roentgenographic technique. When the villi are enlarged, they appear 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

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

    International Nuclear Information System (INIS)

    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.

  11. 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.

  12. Inflammatory bowel disease—the role of cross-sectional imaging techniques in the investigation of the small bowel

    OpenAIRE

    Athanasakos, Athanasios; Mazioti, Argyro; Economopoulos, Nikolaos; Kontopoulou, Christina; Stathis, Georgios; Filippiadis, Dimitrios; Spyridopoulos, Themistoklis; Alexopoulou, Efthymia

    2014-01-01

    Abstract Background: The diagnosis of inflammatory bowel disease (IBD) in children and adolescents is based on the integration of clinical, biological, endoscopic, histological and radiological data. Methods: The most important part of the diagnosis is the histology, which is acquired by endoscopy. Imaging of the small bowel has changed in recent years, but the imaging goals are primarily to determine the extent of small bowel involvement, assess complications and define candidates for surger...

  13. Ileo-ileal Intussusception and Bowel Obstruction Caused by Plasmablastic Lymphoma of Small Bowel- A Rare Entity in Rare Location

    Science.gov (United States)

    Thakur, Sanjiv S.

    2016-01-01

    Intussusception of small bowel is considered a rare cause of bowel obstruction in adults accounting for only about 1% of bowel obstruction in adults. Intussusception in adults is uncommon with 95% cases of intussusceptions occurring in children. Adult intussusception from small intestinal lymphoma is also rare with only 36 cases reported in the literature between 2000 and 2011. Plasmablastic lymphoma (PBL) is an aggressive lymphoid neoplasm usually seen in the oral cavity in the clinical setting of human immunodeficiency virus (HIV) infection. Plasmablastic lymphoma of the small intestine is extremely rare. Here, we report a case of plasmablastic lymphoma of small bowel with ileoileal intussusception in an HIV-negative immunocompetent male patient.

  14. 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

  15. The heart in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Tsianos E.V.

    2007-03-01

    Full Text Available SUMMARY Cardiovascular involvement in inflammatory bowel disease (IBD has been occasionally reported, mainly in the form of case reports. Endocardium derangement in IBD involves endocarditis and subendocardial abscess. Endocarditis may occur as a result of septicemia or due to the prolonged use of total parental nutrition (TPN catheters or/and immunosuppression. The cause of endocarditis may be bacterial or fungal and require surgery in several cases. Prophylaxis for endocarditis in selected IBD patients is discussed. Myocarditis or perimyocarditis in IBD is reported as an autoimmune phenomenon during bowel disease excacerbations or as a side-effect of 5-aminosalicylic acid (5-ASA formulations. Ulcerative colitis (UC patients seem to be at a higher risk for this complication compared to Crohn�s disease (CD patients. Myocardial infarctions, selenium deficiency during TPN, the role of prolonged steroid use and the association with giant cell myocarditis are topics which need further analysis. Pericardium involvement seems to be the most frequent type of cardiovascular complication in IBD caused by drugs (5-ASA, azathioprine, cyclosporine, pericardio-colonic fistulas or unknown causes (idiopathic and it may occasionally be the disease presenting symptom. Coronary artery status and other factors for cardiovascular risk, such as smoking, hyperlipidemia and exercise are also discussed. Electrocardiogram and ultrasonographic changes are not so uncommon and cardiogenic sudden death in IBD is reviewed. Intracavitary coagulation abnormalities, amyloidosis, heart failure and aortitis syndrome are topics included and discussed in this review. A list of tables contributes to a more systemic overview of this current knowledge. Key Words: heart, inflammatory bowel disease, ulcerative colitis, Crohn�s diseas

  16. 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 ...

  17. Blunt abdominal trauma with transanal small bowel evisceration

    Directory of Open Access Journals (Sweden)

    Noushif Medappil

    2013-01-01

    Full Text Available Small bowel evisceration through the anus can occur spontaneously or post traumatically. Traumatic transanal small bowel evisceration results from iatrogenic injuries, suction injuries, and blunt abdominal trauma (BAT. We report a 48-year-old female who presented with evisceration of small intestinal loops through the anus following BAT and discuss the etiologies and mechanisms of injury of this rare presentation.

  18. 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...

  19. 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.

  20. The Usefulness of Capsule Endoscopy for Small Bowel Tumors.

    Science.gov (United States)

    Cheung, Dae Young; Kim, Jin Su; Shim, Ki-Nam; Choi, Myung-Gyu

    2016-01-01

    Video capsule endoscopy (VCE) has expanded the range of endoscopic examination of the small bowel. The clinical application of VCE is mainly for obscure gastrointestinal bleeding (OGIB) and small bowel tumor is one of the clinically significant diagnoses of VCE, often requiring subsequent invasive interventions. Small bowel tumors are detected with a frequency of around 4% with VCE in indications of OGIB, iron deficiency anemia, unexplained abdominal pain, and others. Protruding mass with bleeding, mucosal disruption, irregular surface, discolored area, and white villi are suggested as the VCE findings of small bowel tumor. Device assisted enteroscopy (DAE), computed tomography enteroclysis/enterography and magnetic resonance enteroclysis/enterography also have clinical value in small bowel examination and tumor detection, and they can be used with VCE, sequentially or complementarily. Familial adenomatous polyposis, Peutz-Jeghers syndrome, melanoma, lymphoma, and neuroendocrine tumor with hepatic metastasis are the high risk groups for small bowel tumors, and surveillance programs for small bowel tumors are needed. VCE and radiological imaging have value in screening, and in selected cases, DAE can provide more accurate diagnosis and endoscopic treatment. This review describes the usefulness and clinical impact of VCE on small bowel tumors. PMID:26855919

  1. Potential viral pathogenic mechanism for new variant inflammatory bowel disease

    OpenAIRE

    Uhlmann, V; Martin, C. M.; Sheils, O; Pilkington, L; I. Silva; Killalea, A; Murch, S B; Walker-Smith, J; Thomson, M.; Wakefield, A J; O'Leary, J J

    2002-01-01

    Aims: A new form of inflammatory bowel disease (ileocolonic lymphonodular hyperplasia) has been described in a cohort of children with developmental disorder. This study investigates the presence of persistent measles virus in the intestinal tissue of these patients (new variant inflammatory bowel disease) and a series of controls by molecular analysis.

  2. 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

  3. 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.

  4. CT enteroclysis in the diagnostics of small bowel diseases

    International Nuclear Information System (INIS)

    Background: The role of CT enteroclysis is gaining on importance in the diagnostics of small bowel diseases. The aim of the study was to present own experiences in CT enteroclysis application, with the use of a 64-detector CT unit. Material/Methods: CT enteroclyses were performed in 60 patients: 53 with the suspicion of the Crohns disease, 2 suspected for carcinoid, 1 with suspicion of the fistula between the small bowel and the bladder, 2 suspected for the tumor of the ileo-caecal region, and in 1 case, the aim of examination was to carry out an evaluation of the postsurgical state of the bowel-bowel anastomosis. We used own endoscopic technique of catheter insertion into the bowel, which shortens the examination time and improves patients comfort. Results: The catheter was correctly introduced into the small bowel in 58 patients (endoscopy had to be repeated in 4 cases). Only 2 examinations failed, because patients refused repeated endoscopy. Radiological signs of the Crohns disease were found in 50 out of 53 patients. In the 3 remaining patients, the appearance of the small bowel was normal. In 5 non-Crohns disease patients, CT enteroclysis enabled a good visualization of the pathology (tumors, fistula). Conclusions: CT enteroclysis with the use of the 64-detector CT unit is a valuable method in the diagnostics of small bowel diseases. It could supplement or precede capsule endoscopy. (authors)

  5. 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…

  6. 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.

  7. 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

  8. 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

  9. 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...

  10. MR colonography in inflammatory bowel disease.

    Science.gov (United States)

    Rimola, Jordi; Ordás, Ingrid

    2014-02-01

    MR colonography has a high diagnostic accuracy for detecting Crohn disease (CD) activity and determining the extent and severity of lesions. In the setting of stricturing CD, MR colonography can provide a detailed map of the lesions, which is useful for clinical decision making. MR colonography can be used as an alternative to conventional colonoscopy in the setting of CD, or as a complementary tool in selected patients with ulcerative colitis. This article reviews the spectrum of MR colonography findings in colonic inflammatory bowel disease and discusses the potential applications and limitations of MR colonography. PMID:24238130

  11. Inflammatory Bowel Disease and Cervical Neoplasia

    DEFF Research Database (Denmark)

    Rungoe, Christine; Simonsen, Jacob; Riis, Lene; Frisch, Morten; Langholz, Ebbe; Jess, Tine

    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...... with IBD were assessed by Cox proportional hazards regression analysis. Odds ratios (ORs) of cervical neoplasia before diagnosis of IBD were calculated by using conditional logistic regression. RESULTS: Women with CD underwent cervical cancer screening as often as women in the general population (IRR...

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

    International Nuclear Information System (INIS)

    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.)

  13. 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.)

  14. 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

    carried out in addition to MRFT, to which the patients were referred. All patients underwent both examinations on the same day. For the evaluation, the bowel was divided into nine segments. Two radiologists, blinded to clinical findings, evaluated bowel wall thickness, diffusion weighted imaging (DWI...

  15. MRI of the small bowel: can sufficient bowel distension be achieved with small volumes of oral contrast?

    International Nuclear Information System (INIS)

    Sufficient luminal distension is mandatory for small bowel imaging. However, patients often are unable to ingest volumes of currently applied oral contrast compounds. The aim of this study was to evaluate if administration of low doses of an oral contrast agent with high-osmolarity leads to sufficient and diagnostic bowel distension. Six healthy volunteers ingested at different occasions 150, 300 and 450 ml of a commercially available oral contrast agent (Banana Smoothie Readi-Cat, E-Z-EM; 194 mOsmol/l). Two-dimensional TrueFISP data sets were acquired in 5-min intervals up to 45 min after contrast ingestion. Small bowel distension was quantified using a visual five-grade ranking (5 very good distension, 1 = collapsed bowel). Results were statistically compared using a Wilcoxon-Rank test. Ingestion of 450 ml and 300 ml resulted in a significantly better distension than 150 ml. The all-over average distension value for 450 ml amounted to 3.4 (300 ml: 3.0, 150 ml: 2.3) and diagnostic bowel distension could be found throughout the small intestine. Even 45 min after ingestion of 450 ml the jejunum and ileum could be reliably analyzed. Small bowel imaging with low doses of contrast leads to diagnostic distension values in healthy subjects when a high-osmolarity substance is applied. These findings may help to further refine small bowel MRI techniques, but need to be confirmed in patients with small bowel disorders. (orig.)

  16. Effect of fruit extract of Fragaria vesca L. on experimentally induced inflammatory bowel disease in albino rats

    OpenAIRE

    Lalit Kanodia; Mondita Borgohain; Swranamoni Das

    2011-01-01

    Aim : Ulcerative colitis and Crohn′s disease are chronic recurrent inflammatory bowel disease (IBD) of unknown origin. Oxidative stress is believed to be a key factor in the pathogenesis and perpetuation of the mucosal damage in IBD. Materials and Methods : Ethanolic extract of Fragaria vesca (EFFV) fruits was prepared by percolation method and subjected to oral toxicity testing using OECD guidelines. Albino rats were pretreated orally for 5 days with 3% gum acacia in control, EFFV 500 mg...

  17. 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

  18. 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.

  19. 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

  20. Inflammatory bowel disease: clinical aspects and treatments

    Directory of Open Access Journals (Sweden)

    Fakhoury M

    2014-06-01

    Full Text Available Marc Fakhoury,1 Rebecca Negrulj,2 Armin Mooranian,2 Hani Al-Salami2 1Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering and Artificial Cells and Organs Research Center, Faculty of Medicine, McGill University, Montreal, QC, Canada; 2Biotechnology and Drug Development Research Laboratory, Curtin Health Innovation Research Institute, Biosciences Research Precinct, School of Pharmacy, Curtin University, Perth, WA, Australia Abstract: Inflammatory bowel disease (IBD is defined as a chronic intestinal inflammation that results from host-microbial interactions in a genetically susceptible individual. IBDs are a group of autoimmune diseases that are characterized by inflammation of both the small and large intestine, in which elements of the digestive system are attacked by the body's own immune system. This inflammatory condition encompasses two major forms, known as Crohn's disease and ulcerative colitis. Patients affected by these diseases experience abdominal symptoms, including diarrhea, abdominal pain, bloody stools, and vomiting. Moreover, defects in intestinal epithelial barrier function have been observed in a number of patients affected by IBD. In this review, we first describe the types and symptoms of IBD and investigate the role that the epithelial barrier plays in the pathophysiology of IBD as well as the major cytokines involved. We then discuss steps used to diagnose this disease and the treatment options available, and finally provide an overview of the recent research that aims to develop new therapies for such chronic disorders. Keywords: inflammatory bowel disease, Crohn's disease, ulcerative colitis, cytokines

  1. 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

  2. Is irritable bowel syndrome an infectious disease?

    Science.gov (United States)

    Thompson, John Richard

    2016-01-28

    Irritable bowel syndrome (IBS) is the most common of all gastroenterological diseases. While many mechanisms have been postulated to explain its etiology, no single mechanism entirely explains the heterogeneity of symptoms seen with the various phenotypes of the disease. Recent data from both basic and clinical sciences suggest that underlying infectious disease may provide a unifying hypothesis that better explains the overall symptomatology. The presence of small intestinal bowel overgrowth (SIBO) has been documented in patients with IBS and reductions in SIBO as determined by breath testing correlate with IBS symptom improvement in clinical trials. The incidence of new onset IBS symptoms following acute infectious gastroenteritis also suggests an infectious cause. Alterations in microbiota-host interactions may compromise epithelial barrier integrity, immune function, and the development and function of both central and enteric nervous systems explaining alterations in the brain-gut axis. Clinical evidence from treatment trials with both probiotics and antibiotics also support this etiology. Probiotics appear to restore the imbalance in the microflora and improve IBS-specific quality of life. Antibiotic trials with both neomycin and rifaximin show improvement in global IBS symptoms that correlates with breath test normalization in diarrhea-predominant patients. The treatment response to two weeks of rifaximin is sustained for up to ten weeks and comparable results are seen in symptom reduction with retreatment in patients who develop recurrent symptoms. PMID:26819502

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Sleep disturbances and inflammatory bowel disease.

    Science.gov (United States)

    Ali, Tauseef; Orr, William C

    2014-11-01

    With an estimated 70 million Americans suffering, sleep disorders have become a global issue, and discovering their causes and consequences are the focus of many clinical research studies. Sleep is now also considered to be an important environmental and behavioral factor associated with the process of inflammation and the immune system. Increased sleepiness is considered part of the acute phase of response to tissue injury, and sleep loss activates inflammatory cytokines such as interleukin (IL)-1 and tumor necrosis factor (TNF)-α. Clinical studies in many immune-mediated diseases, such as systemic lupus erythematosus, rheumatoid arthritis, and ankylosing spondylitis, have revealed an association of sleep disturbances with disease activity. Recent research suggests that individuals with sleep abnormalities are also at greater risk of serious adverse health, economic consequences, and most importantly increased all-cause mortality. The importance of sleep in inflammatory bowel disease has recently gained attention with some published studies demonstrating the association of sleep disturbances with disease activity, subclinical inflammation, and risk of disease relapse. A comprehensive review of sleep physiology and its association with the immune system is provided here. Experimental and clinical studies exploring this relationship in inflammatory bowel disease are reviewed, and the clinical implications of this relationship and future directions for research are also discussed. PMID:25025716

  8. Correlations between Psoriasis and Inflammatory Bowel Diseases

    Directory of Open Access Journals (Sweden)

    Nevena Skroza

    2013-01-01

    Full Text Available For a long time the relationship between inflammatory bowel diseases (IBDs and psoriasis has been investigated by epidemiological studies. It is only starting from the 1990s that genetic and immunological aspects have been focused on. Psoriasis and IBD are strictly related inflammatory diseases. Skin and bowel represent, at the same time, barrier and connection between the inner and the outer sides of the body. The most important genetic correlations involve the chromosomal loci 6p22, 16q, 1p31, and 5q33 which map several genes involved in innate and adaptive immunity. The genetic background represents the substrate to the common immune processes involved in psoriasis and IBD. In the past, psoriasis and IBD were considered Th1-related disorders. Nowadays the role of new T cells populations has been highlighted. A key role is played by Th17 and T-regs cells as by the balance between these two cells types. New cytokines and T cells populations, as IL-17A, IL-22, and Th22 cells, could play an important pathogenetic role in psoriasis and IBD. The therapeutic overlaps further support the hypothesis of a common pathogenesis.

  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. 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.

  11. 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.

  12. CT imaging signs of surgically proven bowel trauma.

    Science.gov (United States)

    LeBedis, Christina A; Anderson, Stephan W; Bates, David D B; Khalil, Ramy; Matherly, David; Wing, Heidi; Burke, Peter A; Soto, Jorge A

    2016-06-01

    The objective of this study was to determine the incidence and interobserver agreement of individual CT findings as well as the bowel injury prediction score (BIPS) in surgically proven bowel injury after blunt abdominal trauma. This HIPAA-compliant retrospective study was IRB approved and consent was waived. All patients 14 years or older who sustained surgically proven bowel injury after blunt abdominal trauma between 1/1/2004 and 6/30/2015 were included. Admission trauma MDCT scans were independently interpreted by two abdominal fellowship-trained radiologists who recorded the following CT findings: intraperitoneal fluid, mesenteric hematoma/fat stranding, bowel wall thickening/hematoma, active intravenous contrast extravasation, free intraperitoneal air, bowel wall discontinuity, and focal bowel hypoenhancement. Subsequently, the electronic medical records of the included patients, admission abdominal physical exam results, admission white blood cell count, and findings at exploratory laparotomy of the included patients were recorded. Thirty-three patients met the inclusion criteria. The incidence and interobserver agreement of the CT findings were as follows: intraperitoneal fluid 93.9 %, kappa = 0.784 (good); mesenteric hematoma/fat stranding 84.8 %, kappa = 0.718 (good); bowel wall thickening/hematoma 42.4 %, kappa = 0.491 (moderate); active IV contrast extravasation 36.3 %, kappa = 1.00 (perfect); free intraperitoneal air 21.2 %, kappa = 0.904 (very good), bowel wall discontinuity 6.1 %, kappa = 1.00 (perfect); and focal bowel hypoenhancement 6.1 %, kappa = 0.468 (moderate). An absence of the specified CT findings was encountered in 9.1 % with surgically proven bowel injuries (kappa = 1.00, perfect). In our study, 9/16 patients or 56.3 % had a bowel injury prediction score (BIPS) of 2 or more as defined by McNutt et al. (J Trauma Acute Care Surg 78(1):105-111, 2014). The presence of intraperitoneal fluid and

  13. 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.)

  14. 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.)

  15. 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.

  16. 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...

  17. Bringing the Inflamed and Fibrotic Bowel into Focus: Imaging in Inflammatory Bowel Disease

    OpenAIRE

    Adler, Jeremy; Stidham, Ryan. W.; Higgins, Peter D. R.

    2009-01-01

    Radiologic imaging has been a critical aid in the diagnosis, assessment, and management of inflammatory bowel disease since the first description of the disease by Crohn in 1932. Newer techniques, including computed tomography enterography, magnetic resonance enterography, and ultrasound, have entered clinical use for assessing disease activity and complications, and have largely replaced classic barium studies. We review the clinical utility of these imaging modalities and examine several im...

  18. 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.

  19. Normal small bowel wall characteristics on MR enterography

    International Nuclear Information System (INIS)

    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.

  20. 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.

  1. Small Intestinal Bacterial Overgrowth is Associated with Intestinal Inflammation in the Irritable Bowel Syndrome

    OpenAIRE

    Liliana David; Alexandru Babin; Alina Picos; Dan Lucian Dumitrascu

    2014-01-01

    Background and aim. Small intestinal bacterial overgrowth is encountered in bowel disorders, including irritable bowel symptoms. Low degrees of inflammation have been recently reported in the irritable bowel syndrome. We looked for the association between intestinal inflammation and small intestinal bacterial overgrowth in irritable bowel syndrome.Methods. Small intestinal bacterial overgrowth was assessed by the H2 glucose breath test in 90 consecutive patients with irritable bowel syndrome....

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

    Energy Technology Data Exchange (ETDEWEB)

    Ajaj, Waleed; Kuehle, Christiane; Nuefer, Michael; Goehde, Susanne C.; Lauenstein, Thomas C. [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Goyen, Mathias [Medical Center Hamburg-Eppendorf, Hamburg (Germany); Schneemann, Hubert [University Hospital Essen, Institute of Pharmacy and Pharmaceutical Sciences, Essen (Germany); Ruehm, Stefan G. [David Geffen School of Medicine at UCLA, Department of Radiology, Los Angeles, CA (United States)

    2005-07-01

    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.)

  3. 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.)

  4. 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

  5. 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.

  6. Familial risk of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Trier Møller, Frederik; Andersen, Vibeke; Wohlfarht, Jan;

    2015-01-01

    . 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......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...... pronounced in relatives of CD cases. IRRs increased with two or more IBD-affected relatives and were modified by age, with the highest family-related IRR observed in early life. CONCLUSIONS: The risk of IBD is significantly increased in first -, second-, and third-degree relatives of IBD-affected cases, with...

  7. 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 on...... the entire Danish population during 1977-2011 (n=8,295,773). Through a unique personal identification number assigned to each Danish citizen, sex, date and location of birth, identity of parents, and information on vital status and emigration were available. This information was used to establish...... kinship in the entire population. Individuals receiving at least 2 diagnoses of IBD during the time period (n=45,780) were identified using the Danish National Registry of Patients. Risk of IBD in family members to individuals with IBD was assessed by Poisson regression analysis. Results: The overall...

  8. 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

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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

  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. Pulmonary manifestations of inflammatory bowel disease.

    Science.gov (United States)

    Majewski, Sebastian; Piotrowski, Wojciech

    2015-12-10

    Bronchopulmonary signs and symptoms are examples of variable extraintestinal manifestations of the inflammatory bowel diseases (IBD). These complications of Crohn's disease (CD) and ulcerative colitis (UC) seem to be underrecognized by both pulmonary physicians and gastroenterologists. The objective of the present review was to gather and summarize information on this particular matter, on the basis of available up-to-date literature. Tracheobronchial involvement is the most prevalent respiratory presentation, whereas IBD-related interstitial lung disease is less frequent. Latent and asymptomatic pulmonary involvement is not unusual. Differential diagnosis should always consider infections (mainly tuberculosis) and drug-induced lung pathology. The common link between intestinal disease and lung pathology is unknown, but many hypotheses have been proposed. It is speculated that environmental pollution, common immunological mechanisms and predisposing genetic factors may play a role. PMID:26788078

  16. 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 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....

  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. Genetics and Pathogenesis of Inflammatory Bowel Disease.

    Science.gov (United States)

    Liu, Ta-Chiang; Stappenbeck, Thaddeus S

    2016-05-23

    We are currently in an exciting time when our understanding of genetic underpinnings of inflammatory bowel disease (IBD) has undergone a revolution, based in large part on novel genotyping and sequencing technologies. With >160 susceptible loci identified for IBD, the goal is now to understand at a fundamental level the function of these susceptibility alleles. Determining the clinical relevance of how these susceptible genes shape the development of IBD is also a high priority. The main challenge is to understand how the environment and microbiome play a role in triggering disease in genetically susceptible individuals, as the interactions may be complex. To advance the field, novel in vitro and mouse models that are designed to interrogate complex genetics and functionally test hypotheses are needed. Ultimately, the goal of genetics studies will be to translate genetics to patients with IBD and improve their care. PMID:26907531

  19. 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.

  20. 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.

  1. 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

  2. [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

  3. 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.

  4. 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.

  5. 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 of...... period, stool specimens for C. difficile toxins analysis were collected from 112 children with celiac disease as controls. RESULTS: Clostridium difficile occurrence was significantly higher in patients with IBD compared with patients with celiac disease (7.5% versus 0.8%; P = 0.008). Clostridium...... C. difficile infected patients. METHODS: In this prospective, comparative, multicenter study, 211 pediatric patients with IBD were enrolled from October 2010 to October 2011 and tested for the presence of C. difficile toxins A and B in their stools at 0, 6, and 12 months. During the same study...

  6. 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.

  7. 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

  8. 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.

  9. 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

  10. 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.

  11. Rheumatic manifestations of inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

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

    2009-11-01

    Full Text Available 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.

  12. 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 ...

  13. 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.

  14. Increased expression of interleukin 17 in inflammatory bowel disease

    OpenAIRE

    Fujino, S; Andoh, A; Bamba, S; Ogawa, A.; Hata, K.; Araki, Y; Bamba, T; Fujiyama, Y.

    2003-01-01

    Background and aim: Interleukin (IL) 17 is a cytokine which exerts strong proinflammatory activities. In this study we evaluated changes in IL-17 expression in the inflamed mucosa and in the serum of patients with inflammatory bowel disease (IBD).

  15. 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.

  16. Biofeedback & Bowel Disorders: Teaching Yourself to Live without the Problem

    Science.gov (United States)

    ... Personal Stories Who We Are Contact Us Donate Biofeedback & Bowel Disorders: Teaching Yourself to Live Without the Problem What is biofeedback? Biofeedback is a neuromuscular reeducation tool therapists can ...

  17. 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.

  18. Small bowel perforation due to fish bone: A case report.

    Science.gov (United States)

    Pulat, Huseyin; Karakose, Oktay; Benzin, Mehmet Fatih; Benzin, Seyma; Cetin, Recep

    2015-09-01

    Accidental ingestion of foreign bodies are a common condition in clinical practice. However, small bowel perforation which dues to ingestion foreign bodies has been rarely seen. In this article, we report a case of small bowel perforation which dues to ingestion foreign body. A 80-year-old female patient, presenting with complaints of acute abdomen, was admitted to the emergency department. She denied abdominal pain, nausea and vomiting. The patient had tenderness and defense on the right lower quadrant. Contrast enhanced abdominal computed tomography has been used on the patient's diagnosis. This revealed small bowel perforation due to the ingestion of foreign body. The patient was operated emergency. A microperforation due to fish bone was detected on the terminal ileum. The patient underwent debridement and primary repair. The patient was discharged postoperative 7th day without problem. Bowel perforation due to the ingestion of foreign bodies should be considered in the differential diagnosis of acute abdomen. PMID:27239615

  19. 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

  20. Comparison of methods to facilitate postoperative bowel function.

    Science.gov (United States)

    Crainic, Christina; Erickson, Kathie; Gardner, Janet; Haberman, Sheri; Patten, Pam; Thomas, Pat; Hays, Victoria

    2009-01-01

    Improving postoperative return of bowel function after abdominal surgery is an important nursing and medical goal. One promising intervention to achieve this goal is to have patients chew gum several times per day in the early postoperative period to stimulate the cephalic-vagal reflex and bowel peristalsis. A study to determine if return of gastrointestinal function after abdominal surgery could be hastened by the simple intervention of chewing gum or sucking on hard candy three times per day is described. PMID:20552850

  1. Cognitive behavior therapy in the treatment of irritable bowel syndrome

    OpenAIRE

    Ljótsson, Brjánn

    2011-01-01

    Background: Irritable bowel syndrome (IBS) is a disorder characterized by abdominal pain or discomfort combined with altered bowel habits and is associated with impaired quality of life. The prevalence of IBS in the general adult population is approximately 10%. Psychological factors have been implicated in IBS because of high rates of comorbidity with psychiatric diagnoses and the fact that stress can cause IBS symptoms. Several studies have been conducted on psychological treatment for IBS....

  2. Massive small bowel bleeding caused by scrub typhus in Korea

    OpenAIRE

    2010-01-01

    A 79-year-old man was diagnosed with scrub typhus based on fever, eschar, skin rash and a markedly elevated serum tsutsugamushi antibody and doxycycline was started. Five days later, hematochezia developed and multiple small bowel ulcerations with hemorrhage were seen on colonoscopy. Despite intensive therapy, the massive hematochezia worsened and the distal small bowel was resected. Multiple ulcerated lesions were identified pathologically as vasculitis caused by scrub typhus. This is the fi...

  3. 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...

  4. Evaluation Of Irritable Bowel Syndrome Symptoms Amongst Warsaw University Students

    Directory of Open Access Journals (Sweden)

    Niemyjska Sylwia

    2015-05-01

    Full Text Available Irritable bowel syndrome (IBS belongs to functional gastrointestinal disorders and is characterized by abdominal pain and change in stool consistency and/or bowel habits. Etiological factors include gastrointestinal peristalsis disturbances, visceral hypersensitivity, chronic inflammation of the mucous membrane, dysbacteremia, intestinal infections, psychosomatic and nutritional factors. Gastrointestinal motility disturbances in case of IBS are manifested by the inhibition of the intestinal passage, which favors the development of constipation or occurrence of diarrhea.

  5. 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...

  6. Bowel function measurements of individuals with different eating patterns.

    OpenAIRE

    Davies, G. J.; Crowder, M; Reid, B.; Dickerson, J W

    1986-01-01

    Bowel function was assessed in 51 subjects: 10 women and seven men who habitually consumed an omnivorous, vegetarian, or vegan diet. The subjects on these diets had a mean intake of fibre of 23 g, 37 g, and 47 g respectively. Mean transit times were variable and not significantly different between the groups. Vegans, however, had a greater frequency of defecation and passed softer stools. All measurements of bowel function were significantly correlated with total dietary fibre. As dietary fib...

  7. 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 ...

  8. Pylephlebitis secondary to strangulated umbilical hernia with small bowel ischemia

    Directory of Open Access Journals (Sweden)

    Ennio Bruschi

    2013-08-01

    Full Text Available Pylephlebitis is a septic thrombophlebitis of the portal venous system that infrequently complicates small bowel infarction. We present a case of pylephlebitis with portomesenteric vein gas bubbles secondary to small bowel ischemia caused by a strangulated umbilical hernia, diagnosed on computed tomography (CT and confirmed in the operating theater. This case is an example of the usefulness of CT in early recognition of suggestive radiologic findings of pylephlebitis associated with intestinal ischemia for prompt treatment of the patient.

  9. 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....

  10. 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...

  11. 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...

  12. Small bowel stromal tumour revealed by a lower gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Assamoi B. F. Kassi

    2016-04-01

    Full Text Available Small bowel stromal tumour must be systematically researched in the presence of obscure and persistent low gastrointestinal bleeding despite a normal endoscopic examination (OGDF and colonoscopy. Video capsule endoscopy is the best diagnosis examination; if it is not available a CT enterography could be useful. Surgical treatment is effective on localized and weak malignancy small bowel stromal tumours. [Int J Res Med Sci 2016; 4(4.000: 1248-1250

  13. Small bowel stromal tumour revealed by a lower gastrointestinal bleeding

    OpenAIRE

    Assamoi B. F. Kassi; Lebeau, R; Y. S. Kacou; K. J. N'dah; Traore, M.

    2016-01-01

    Small bowel stromal tumour must be systematically researched in the presence of obscure and persistent low gastrointestinal bleeding despite a normal endoscopic examination (OGDF and colonoscopy). Video capsule endoscopy is the best diagnosis examination; if it is not available a CT enterography could be useful. Surgical treatment is effective on localized and weak malignancy small bowel stromal tumours. [Int J Res Med Sci 2016; 4(4.000): 1248-1250

  14. Computed Tomography Enterography for Evaluation of Inflammatory Bowel Disease

    OpenAIRE

    Park, Min Jung; Lim, Joon Seok

    2013-01-01

    Computed tomography enterography (CTE) has become a main modality for the evaluation of inflammatory bowel disease (IBD). It simultaneously offers visualization of the small bowel and extraintestinal status, which is helpful for diagnosing IBD. Crohn disease has long segmental enhancing wall thickening related with the eccentric longitudinal distribution. In addition, mural stratification, fibrofatty proliferation, positive comb sign by increased mesenteric vascularity and internal/perianal f...

  15. A Look into the Small Bowel in Crohn's Disease

    OpenAIRE

    Park, Soo Jung; Kim, Won Ho

    2012-01-01

    Crohn's disease (CD) is an inflammatory bowel disease that can affect the entire gastrointestinal tract, with the small bowel (SB) being the most commonly affected site. In some patients, refractory inflammation or chronic strictures of the SB are responsible for a debilitating course of the disease that might lead to severely reduced quality of life. Therefore, SB imaging is a crucial element in diagnosing and/or managing SB CD, and continues to evolve because of technologic advances. SB end...

  16. 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....

  17. Monitoring and Safety of Azathioprine Therapy in Inflammatory Bowel Disease

    OpenAIRE

    Kim, Mi Jin; Choe, Yon Ho

    2013-01-01

    Azathioprine is the most common drug used to maintain clinical remission in inflammatory bowel disease. This drug is also important as a steroid-sparing agent in steroid-dependent and chronically active inflammatory bowel disease. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine. The dose of azathioprine has to be reduced or the therapy has to be discontinued frequently because of drug-induced toxicity. In this review, we discuss monitoring of thio...

  18. 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...

  19. Acute Lower Gastrointestinal Haemorrhage Secondary to Small Bowel Ascariasis

    OpenAIRE

    Daphne Dewi, Stephen; Sze Li, Siow

    2012-01-01

    Acute lower gastrointestinal haemorrhage secondary to small bowel ascariasis is extremely rare. A high level of suspicion should be maintained when dealing with acute gastrointestinal haemorrhage in migrants and travellers. Small bowel examination is warranted when carefully repeated upper and lower endoscopies have failed to elicit the source of bleeding. Appropriate test selection is determined by the availability of local expertise. We present a case of acute lower gastrointestinal haemorr...

  20. 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...

  1. Thromboembolism in inflammatory bowel disease: role of platelets.

    OpenAIRE

    Webberley, M. J.; M. 't Hart; Melikian, V.

    1993-01-01

    Patients with inflammatory bowel disease are susceptible to thromboembolism and recently small vessel thrombosis has been implicated as an aetiological factor in Crohn's disease. This study therefore investigated platelet function in 104 patients with inflammatory bowel disease of whom eight had previous thromboembolism. Thirty five patients had reproducible spontaneous platelet aggregation of more than 30% (0 in controls) (p < 0.0001). A further 20 patients showed hypersensitivity of platele...

  2. 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...

  3. 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...

  4. Short Bowel Syndrome and Intestinal Failure in Crohn's Disease.

    Science.gov (United States)

    Limketkai, Berkeley N; Parian, Alyssa M; Shah, Neha D; Colombel, Jean-Frédéric

    2016-05-01

    Crohn's disease is a chronic and progressive inflammatory disorder of the gastrointestinal tract. Despite the availability of powerful immunosuppressants, many patients with Crohn's disease still require one or more intestinal resections throughout the course of their disease. Multiple resections and a progressive reduction in bowel length can lead to the development of short bowel syndrome, a form of intestinal failure that compromises fluid, electrolyte, and nutrient absorption. The pathophysiology of short bowel syndrome involves a reduction in intestinal surface area, alteration in the enteric hormonal feedback, dysmotility, and related comorbidities. Most patients will initially require parenteral nutrition as a primary or supplemental source of nutrition, although several patients may eventually wean off nutrition support depending on the residual gut anatomy and adherence to medical and nutritional interventions. Available surgical treatments focus on reducing motility, lengthening the native small bowel, or small bowel transplantation. Care of these complex patients with short bowel syndrome requires a multidisciplinary approach of physicians, dietitians, and nurses to provide optimal intestinal rehabilitation, nutritional support, and improvement in quality of life. PMID:26818425

  5. 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.

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

    International Nuclear Information System (INIS)

    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

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. Small Bowel Bacterial Overgrowth in Patients with Irritable Bowel Syndrome: The First Study in Iran

    OpenAIRE

    Abbasi, Mehdi HayatBakhsh; Zahedi, MohammadJavad; Darvish Moghadam, Sodaif; Shafieipour, Sara; HayatBakhsh Abbasi, Mahroo

    2015-01-01

    BACKGROUND Small intestinal bacterial overgrowth (SIBO) may have a role in the pathophysiology of irritable bowel syndrome (IBS). So, the aim of this study was to assess the association between SIBO and IBS by using glucose breath test (GBT) in Kerman city as the first study in Iranian population. METHODS 107 patients with IBS and 107 healthy individuals were enrolled in our study. All the participants underwent GBT. A peak of H2 values >20 p.p.m above the basal value after glucose ingestion ...

  13. 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)

  14. 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

  15. 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

  16. 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

  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. Irritable bowel syndrome and food interaction.

    Science.gov (United States)

    Cuomo, Rosario; Andreozzi, Paolo; Zito, Francesco Paolo; Passananti, Valentina; De Carlo, Giovanni; Sarnelli, Giovanni

    2014-07-21

    Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders in Western countries. Despite the high prevalence of this disorders, the therapeutic management of these patients is often unsatisfactory. A number of factors have been suggested to be involved in the pathogenesis of IBS, including impaired motility and sensitivity, increased permeability, changes in the gut microbiome and alterations in the brain-gut axis. Also food seems to play a critical role: the most of IBS patients report the onset or the exacerbation of their symptoms after the meals. Recently, an increasing attention has been paid to the role of food in IBS. In this review we summarize the most recent evidences about the role of diet on IBS symptoms. A diet restricted in fermentable, poorly absorbed carbohydrates and sugar alcohols has beneficial effects on IBS symptoms. More studies are needed to improve our knowledge about the relationship between food and IBS. However, in the foreseeable future, dietary strategies will represent one of the key tools in the therapeutic management of patients with IBS. PMID:25083057

  19. 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.

  20. Extraintestinal Manifestations of Inflammatory Bowel Disease.

    Science.gov (United States)

    Vavricka, Stephan R; Schoepfer, Alain; Scharl, Michael; Lakatos, Peter L; Navarini, Alexander; Rogler, Gerhard

    2015-08-01

    Extraintestinal manifestations (EIM) in inflammatory bowel disease (IBD) are frequent and may occur before or after IBD diagnosis. EIM may impact the quality of life for patients with IBD significantly requiring specific treatment depending on the affected organ(s). They most frequently affect joints, skin, or eyes, but can also less frequently involve other organs such as liver, lungs, or pancreas. Certain EIM, such as peripheral arthritis, oral aphthous ulcers, episcleritis, or erythema nodosum, are frequently associated with active intestinal inflammation and usually improve by treatment of the intestinal activity. Other EIM, such as uveitis or ankylosing spondylitis, usually occur independent of intestinal inflammatory activity. For other not so rare EIM, such as pyoderma gangrenosum and primary sclerosing cholangitis, the association with the activity of the underlying IBD is unclear. Successful therapy of EIM is essential for improving quality of life of patients with IBD. Besides other options, tumor necrosis factor antibody therapy is an important therapy for EIM in patients with IBD. PMID:26154136

  1. 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.

  2. Role of cytokines in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Fausto Sanchez-Muñoz, Aaron Dominguez-Lopez, Jesus K Yamamoto-Furusho

    2008-07-01

    Full Text Available Inflammatory bowel disease (IBD, which includes Crohn’s disease (CD and ulcerative colitis (UC, represents a group of chronic disorders characterized by inflammation of the gastrointestinal tract, typically with a relapsing and remitting clinical course. Mucosal macrophages play an important role in the mucosal immune 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 contributors 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 the inflammatory process in IBD. Therefore, several cytokine therapies have been developed and tested for the treatment of IBD patients.

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. Treatment of iron deficiency anemia in pediatric inflammatory bowel disease.

    Science.gov (United States)

    Thayu, Meena; Mamula, Petar

    2005-10-01

    Anemia is a frequent extraintestinal manifestation of inflammatory bowel disease (IBD) that is commonly overlooked, despite its significant impact on quality of life. Characteristic symptoms include chronic fatigue, headache, and subtle impairment of cognitive function, although some less common symptoms include dyspnea, dizziness, pica, angular stomatitis, shortened attention span, and esophageal webs. Several types of anemia are associated with IBD, but iron deficiency anemia (IDA) accounts for the majority of cases and others include anemia of chronic disease, anemia associated with vitamin deficiency (vitamin B12 and folate), autoimmune anemia, and anemia caused by medication used to treat IBD. The diagnosis of IDA relies on laboratory blood tests. Therefore, these tests should be obtained on a regular basis because characteristic symptoms may be absent or not readily recognized by patients and their clinicians. Complete blood count may suffice; however, iron studies and serum vitamin levels may be necessary to differentiate between specific types of anemia. During the diagnostic process, it is important to consider coexistence of different types of anemia, especially if no response to therapy is noted. The therapy for anemia is directed towards treatment of the underlying inflammatory process and supplemental therapy, depending on the type of deficiency. Iron deficiency anemia is treated with iron preparations, first orally, and if unresponsive or if associated with untoward adverse events leading to decrease in adherence with the therapeutic regimen, with intravenous preparations. Intramuscular therapy has been abandoned due to high rate of complications. Intravenous therapy may be administered as a multiple-dose regimen (intravenous iron sucrose and gluconate) or as a single intravenous dose (iron dextran), which is associated with a higher risk of allergic infusion reactions and requires obligatory test dose administration. Treatment with erythropoietin is

  9. 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

  10. 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.

  11. 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

  12. Use of CT Enterography for Small Bowel Pathology:Experience and Findings in 90 Patients

    International Nuclear Information System (INIS)

    Proper evaluation of the small intestine is achieved with the combination of intravenous contrast medium and large volume of neutral contrast medium administered orally to stretch the intestinal lumen and produce images for the assessment of the lumen, thickness and pattern of enhancement of the small intestine walls. Materials and methods: Between May 2007 and February 2009 we retrospectively collected 90 cases of mainly outpatients who consulted our clinic. They were prepared taking a liquid diet for 24 hours that had no residue and complete fasting 4 hours prior to the examination. A total of 2000 cc of water was administrated orally (divided in 500 cc, 75, 65, 25 and 15 minutes prior to the examination). Then 100 cc of contrast medium (OptirayTM ) were administered intravenously, at a rate of 4 cc/sec. An early arterial phase was performed 20 seconds after injection, and a portal phase 60 seconds after IV contrast administration. The studies were performed in a 16 channels, General Electric multidetector scanner, with 3.0 mm slices, with multiplanar reconstructions and MIP. Results: The studies were interpreted by a group body imaging radiologists. The most frequent findings were: diverticular disease, cystic lesions, neoplasia, Crohn's disease,ileitis, mechanical obstruction, hiatal hernia, cholelithiasis, hepatic hemangiomas, duodenal diverticulum, polyposis, intestinal mal rotation, and active bleeding. Conclusions: CT enterography is a useful and noninvasive technique for diagnosing small bowel disorders, allowing, in most cases, a satisfactory distension of the small bowel without the use of an enteral tube.

  13. 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

  14. 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

  15. 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

  16. Breath tests and irritable bowel syndrome.

    Science.gov (United States)

    Rana, Satya Vati; Malik, Aastha

    2014-06-28

    Breath tests are non-invasive tests and can detect H₂ and CH₄ gases which are produced by bacterial fermentation of unabsorbed intestinal carbohydrate and are excreted in the breath. These tests are used in the diagnosis of carbohydrate malabsorption, small intestinal bacterial overgrowth, and for measuring the orocecal transit time. Malabsorption of carbohydrates is a key trigger of irritable bowel syndrome (IBS)-type symptoms such as diarrhea and/or constipation, bloating, excess flatulence, headaches and lack of energy. Abdominal bloating is a common nonspecific symptom which can negatively impact quality of life. It may reflect dietary imbalance, such as excess fiber intake, or may be a manifestation of IBS. However, bloating may also represent small intestinal bacterial overgrowth. Patients with persistent symptoms of abdominal bloating and distension despite dietary interventions should be referred for H₂ breath testing to determine the presence or absence of bacterial overgrowth. If bacterial overgrowth is identified, patients are typically treated with antibiotics. Evaluation of IBS generally includes testing of other disorders that cause similar symptoms. Carbohydrate malabsorption (lactose, fructose, sorbitol) can cause abdominal fullness, bloating, nausea, abdominal pain, flatulence, and diarrhea, which are similar to the symptoms of IBS. However, it is unclear if these digestive disorders contribute to or cause the symptoms of IBS. Research studies show that a proper diagnosis and effective dietary intervention significantly reduces the severity and frequency of gastrointestinal symptoms in IBS. Thus, diagnosis of malabsorption of these carbohydrates in IBS using a breath test is very important to guide the clinician in the proper treatment of IBS patients. PMID:24976698

  17. New and emerging therapies for the treatment of irritable bowel syndrome: an update for gastroenterologists.

    Science.gov (United States)

    Foxx-Orenstein, Amy E

    2016-05-01

    Irritable bowel syndrome is a functional bowel disorder with gastrointestinal symptoms (e.g. abdominal pain, straining, urgency, incomplete evacuation, nausea, and bloating) that occur alongside bowel function alterations (i.e. constipation, diarrhea, or both). Patients with irritable bowel syndrome may also experience comorbid anxiety and depression. Irritable bowel syndrome is common, with a prevalence estimated between 3% and 28%, affecting patient health and quality of life. Patients with moderate or severe irritable bowel syndrome generally seek medical care, whereas those with milder symptoms may choose self-management. Most patients with irritable bowel syndrome receive outpatient care, but irritable bowel syndrome-related hospitalizations do occur. The pathophysiology of irritable bowel syndrome is multifactorial (i.e. genetics, immune components, changes in the gut microbiota, disturbances in physiologic stress response systems, and psychosocial factors). Management of irritable bowel syndrome can include lifestyle changes, dietary interventions, counseling, psychologic medication, and agents that affect gastrointestinal motility. A number of therapies have emerged in recent years with clinical trial data demonstrating efficacy and safety for patients with irritable bowel syndrome, including agents that target gastrointestinal motility (i.e. linaclotide), gastrointestinal opioid receptors (i.e. asimadoline, eluxadoline), and gut microbiota (i.e. rifaximin). Linaclotide has been shown to significantly improve stool frequency and abdominal pain compared with placebo in constipation-predominant irritable bowel syndrome (number needed to treat, 5.1). Asimadoline shows efficacy in patients with moderate-to-severe irritable bowel syndrome-related pain. Rifaximin provided adequate relief of global irritable bowel syndrome symptoms versus placebo for a significantly greater percentage of patients with diarrhea-predominant irritable bowel syndrome (p < 0

  18. The effect of bismuth subcitrate in patients with diarrhea predominant irritable bowel syndrome

    OpenAIRE

    Kalani M; Foroutan H; Rahimi R.; Ghofrani H; Ahadpoor Behnami Sh

    2010-01-01

    "nBackground: The irritable bowel syndrome (IBS) is one of the most common chronic medical conditions. Various mechanisms, including altered gut flora and/or small bowel bacterial overgrowth, have been suggested to play a role in the development of gas-related symptoms aim of study. The clinical evidence of small intestinal bacterial overgrowth as an important etiology of irritable bowel syndrome continues to accumulate. Clinical symptoms of bacterial overgrowth and irritable bowel syndr...

  19. 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.

  20. 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 ...

  1. 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.

  2. 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.

  3. Palliative management of malignant bowel obstruction in terminally Ill patient

    Directory of Open Access Journals (Sweden)

    Darshit A Thaker

    2010-01-01

    Full Text Available Mr. P was a 57-year-old man who presented with symptoms of bowel obstruction in the setting of a known metastatic pancreatic cancer. Diagnosis of malignant bowel obstruction was made clinically and radiologically and he was treated conservatively (non-operativelywith octreotide, metoclopromide and dexamethasone, which provided good control over symptoms and allowed him to have quality time with family until he died few weeks later with liver failure. Bowel obstruction in patients with abdominal malignancy requires careful assessment. The patient and family should always be involved in decision making. The ultimate goals of palliative care (symptom management, quality of life and dignity of death should never be forgotten during decision making for any patient.

  4. [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

  5. 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.

  6. 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.

  7. MR enterography in the evaluation of small bowel dilation

    International Nuclear Information System (INIS)

    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.

  8. Skin gangrene as an extraintestinal manifestation of inflammatory bowel disease*

    Science.gov (United States)

    Komatsu, Yumi Cristina; Capareli, Gabriela Cunha; Boin, Maria Fernanda Feitosa de Camargo; Lellis, Rute; de Freitas, Thaís Helena Proença; Simone, Karine

    2014-01-01

    Inflammatory bowel diseases can commonly present many cutaneous lesions which can contribute to the diagnosis of the disease or its activity. The most frequent cutaneous or mucocutaneous manifestations suggesting ulcerative rectocolitis activity are erythema nodosum (3-10%), pyoderma gangrenosum (5-12%) and aphthous stomatitis (4%). Other reactive skin manifestations related to immunological mechanisms associated with the inflammatory bowel disease are: Sweet's syndrome, arthritis-dermatitis syndrome associated with inflammatory bowel disease and leukocytoclastic vasculitis. We describe the case of a young man with diagnosis of ulcerative rectocolitis, which presented an extensive cutaneous gangrene secondary to microvascular thrombosis. The case represents a dermatologic rarity and should be recognized as a cutaneous manifestation related to the hypercoagulability state observed in the disease's activity. PMID:25387503

  9. Skin gangrene as an extraintestinal manifestation of inflammatory bowel disease.

    Science.gov (United States)

    Komatsu, Yumi Cristina; Capareli, Gabriela Cunha; Boin, Maria Fernanda Feitosa de Camargo; Lellis, Rute; Freitas, Thaís Helena Proença de; Simone, Karine

    2014-01-01

    Inflammatory bowel diseases can commonly present many cutaneous lesions which can contribute to the diagnosis of the disease or its activity. The most frequent cutaneous or mucocutaneous manifestations suggesting ulcerative rectocolitis activity are erythema nodosum (3-10%), pyoderma gangrenosum (5-12%) and aphthous stomatitis (4%). Other reactive skin manifestations related to immunological mechanisms associated with the inflammatory bowel disease are: Sweet's syndrome, arthritis-dermatitis syndrome associated with inflammatory bowel disease and leukocytoclastic vasculitis. We describe the case of a young man with diagnosis of ulcerative rectocolitis, which presented an extensive cutaneous gangrene secondary to microvascular thrombosis. The case represents a dermatologic rarity and should be recognized as a cutaneous manifestation related to the hypercoagulability state observed in the disease's activity. PMID:25387503

  10. 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.

  11. Risk factors for small bowel cancer in Crohn's disease.

    Science.gov (United States)

    Lashner, B A

    1992-08-01

    Suspected risk factors for adenocarcinoma of the small bowel in Crohn's disease include surgically excluded small bowel loops, chronic fistulous disease, and male sex. Review of all seven University of Chicago cases failed to confirm any suspected risk factor. A case-control study was performed to identify possible alternatives. Each case was matched to four randomly selected controls from an inflammatory bowel disease registry matched for year of birth, sex, and confirmed small bowel Crohn's disease. Three factors were significantly associated with the development of cancer: (1) Four cancers developed in the jejunum, and jejunal Crohn's disease was associated with the development of cancer [odds ratio (OR) 8.0, 95% confidence interval (CI) 1.6-39.3]. (2) There was an association between the development of cancer and occupations known to be associated with an increased colorectal cancer risk (OR 20.3, CI 2.7-150.5). Three cases (a chemist with exposure to halogenated aromatic compounds and aliphatic amines, a pipefitter with exposure to asbestos, and a machinist with exposures to cutting oils, solvents, and abrasives) and one of 28 controls (a fireman with multiple hazardous exposures) had an occupational risk factor. (3) Among medications taken for at least six months, only 6-mercaptopurine use was associated with cancer (OR 10.8, CI 1.1-108.7). In conclusion, proximal small bowel disease, 6-mercaptopurine use, and hazardous occupations are associated with cancer of the small bowel in patients with Crohn's disease and can be added to the list of suspected risk factors. PMID:1499440

  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. 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

  15. Diagnostic accuracy of three different MRI protocols in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Jesuratnam-Nielsen, Kayalvily; Løgager, Vibeke Berg; Munkholm, Pia;

    2015-01-01

    MRE within seven days. For the evaluation, the bowel was divided into nine segments. One radiologist, blinded to clinical findings, evaluated bowel wall thickness, diffusion weighted imaging (DWI), mural hyperenhancement, and other inflammatory changes in each bowel segment. RESULTS: Twenty patients...

  16. The lack of impact of pelvic irradiation on small bowel mobility: implications for radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Purpose: Small bowel contrast is frequently used during simulation for patients undergoing pelvic radiotherapy to assist in the design of blocks that exclude small bowel from the radiation field. In many instances, a large field is treated to 45 gray (Gy), followed by a field reduction to exclude the small bowel. This prospective study was designed to assess whether the position and mobility of the small bowel changed after the initial 45 Gy, thereby determining whether a special small bowel series done at initial simulation is applicable at the time of field reduction. Methods and Materials: Twelve patients undergoing pelvic irradiation were given small bowel contrast for their initial simulation. Radiographs were taken with the bladder empty and the bladder full. The location of the small bowel and its displacement with bladder distention was measured. This entire procedure was repeated prior to field reduction (after 39.6-46.0 Gy). Results: There was no demonstrable alteration in small bowel mobility after 39.6-46.0 Gy. The approximate position of the small bowel relative to bony landmarks was unchanged. Conclusion: The position and mobility of the small bowel appears not to be affected by 39.6-46.0 Gy of pelvic radiotherapy. Therefore, it is reasonable to design reduced pelvic fields to exclude the small bowel based on special small bowel series done at initial treatment simulation

  17. 78 FR 52824 - Proposed Information Collection (Bowel and Bladder Care Billing Form) Activity: Comment Request

    Science.gov (United States)

    2013-08-26

    ... AFFAIRS Proposed Information Collection (Bowel and Bladder Care Billing Form) Activity: Comment Request... evaluate the Bowel and Bladder Care Billing Form used by caregivers of eligible Veterans to document time...@va.gov . Please refer to ``OMB Control No. 2900-NEW (Bowel and Bladder Care Billing Form)'' in...

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. The Economic Impact of Inflammatory Bowel Disease in Canada

    OpenAIRE

    2004-01-01

    Longobardi and colleagues examined the effect of inflammatory bowel disease (IBD) on employment, using data from 10,891 respondents aged 20 to 64 years from the 1998 cycle of the Canadian National Population Health Survey (NPHS) (1). This sample included 187 (1.7%) subjects who self-reported IBD or a similar bowel disorder. A significantly greater proportion of IBD than non-IBD respondents reported that they were not in the labour force (28.9% versus 18.5%). Even after adjusting for other fac...

  4. 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 ...

  5. 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...

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    BACKGROUND AND STUDY AIM: Small-bowel tumors account for 1% - 3% of all gastrointestinal neoplasms. Recent studies with video capsule endoscopy (VCE) suggest that the frequency of these tumors may be substantially higher than previously reported. The aim of the study was to evaluate the frequency...... neoplasm seen in 29 centers of 10 European Countries. RESULTS: Of 5129 patients undergoing VCE, 124 (2.4%) had small-bowel tumors (112 primary, 12 metastatic). Among these patients, indications for VCE were: obscure gastrointestinal bleeding (108 patients), abdominal pain (9), search for primary neoplasm...

  7. Small bowel bacterial overgrowth in patients with irritable bowel syndrome: the first study in iran.

    Science.gov (United States)

    Abbasi, Mehdi HayatBakhsh; Zahedi, MohammadJavad; Darvish Moghadam, Sodaif; Shafieipour, Sara; HayatBakhsh Abbasi, Mahroo

    2015-01-01

    BACKGROUND Small intestinal bacterial overgrowth (SIBO) may have a role in the pathophysiology of irritable bowel syndrome (IBS). So, the aim of this study was to assess the association between SIBO and IBS by using glucose breath test (GBT) in Kerman city as the first study in Iranian population. METHODS 107 patients with IBS and 107 healthy individuals were enrolled in our study. All the participants underwent GBT. A peak of H2 values >20 p.p.m above the basal value after glucose ingestion was considered suggestive of SIBO. SPSS software version 17 was used for data analysis. P value SIBO. We suggest a Placebo-controlled bacterial eradication study for identifying the role of SIBO in IBS. PMID:25628852

  8. 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

  9. 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

  10. Comparative tolerability of treatments for inflammatory bowel disease.

    Science.gov (United States)

    Stein, R B; Hanauer, S B

    2000-11-01

    Despite limited understanding of therapeutic aetiopathogenesis of ulcerative colitis and Crohn's disease, there is a strong evidence base for the efficacy of pharmacological and biological therapies. It is equally important to recognise toxicity of the medical armamentarium for inflammatory bowel disease (IBD). Sulfasalazine consists of sulfapyridine linked to 5-aminosalicylic acid (5-ASA) via an azo bond. Common adverse effects related to sulfapyridine 'intolerance' include headache, nausea, anorexia, and malaise. Other allergic or toxic adverse effects include fever, rash, haemolytic anaemia, hepatitis, pancreatitis, paradoxical worsening of colitis, and reversible sperm abnormalities. The newer 5-ASA agents were developed to deliver the active ingredient of sulfasalazine while minimising adverse effects. Adverse effects are infrequent but may include nausea, dyspepsia and headache. Olsalazine may cause a secretory diarrhoea. Uncommon hypersensitivity reactions, including worsening of colitis, pancreatitis, pericarditis and nephritis, have also been reported. Corticosteroids are commonly prescribed for treatment of moderate to severe IBD. Despite short term efficacy, corticosteroids have numerous adverse effects that preclude their long term use. Adverse effects include acne, fluid retention, fat redistribution, hypertension, hyperglycaemia, psycho-neurological disturbances, cataracts, adrenal suppression, growth failure in children, and osteonecrosis. Newer corticosteroid preparations offer potential for targeted therapy and less corticosteroid-related adverse effects. Azathioprine and mercaptopurine are associated with pancreatitis in 3 to 15% of patients that resolves upon drug cessation. Bone marrow suppression is dose related and may be delayed. The adverse effects of methotrexate include nausea, leucopenia and, rarely, hypersensitivity pneumonia or hepatic fibrosis. Common adverse effects of cyclosporin include nephrotoxicity, hypertension, headache

  11. 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

  12. 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

  13. Established and emerging biological activity markers of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Nielsen, O H; Vainer, B; Madsen, S M; Seidelin, J B; Heegaard, Niels Henrik Helweg

    2000-01-01

    Assessment of disease activity in inflammatory bowel disease (IBD), i.e., ulcerative colitis (UC) and Crohn's disease (CD), is done using clinical parameters and various biological disease markers. Ideally, a disease marker must: be able to identify individuals at risk of a given disorder, be dis...

  14. Small bowel ultrasound in patients with celiac disease

    Energy Technology Data Exchange (ETDEWEB)

    Bartusek, D. [Department of Radiology, Masaryk University hospital Brno (Czech Republic)], E-mail: dbartusek@fnbrno.cz; Valek, V. [Department of Radiology, Masaryk University hospital Brno (Czech Republic)], E-mail: v.valek@fnbrno.cz; Husty, J. [Department of Radiology, Masaryk University hospital Brno (Czech Republic)], E-mail: jhusty@fnbrno.cz; Uteseny, J. [Department of Pediatric Internal Medicine, Masaryk University hospital Brno (Czech Republic)], E-mail: juteseny@fnbrno.cz

    2007-08-15

    Objective: Celiac disease (CD) is a common, lifelong disease with small bowel malabsorption based on genetically conditioned gluten intolerance. The clinical manifestation could be very heterogeneous. The proof of celiac disease is now based mainly on clinical and laboratory (antibodies and enterobiopsy) signs, which are in some cases problematic and inconvenient. Materials and methods: In our study we have examined 250 patients with suspection or with proven celiac disease and we evaluated specific ultrasound small bowel changes in this group. In the next step, we chose 59 patients with laboratory proved celiac disease and we statistically compared ultrasound, other laboratory and clinical findings in different forms and stages of the disease. Results: Specific small bowel pathologies in patients with celiac disease (like changes of intestinal villi in different parts of small bowel, abnormal peristalsis and mesenterial lymphadenopathy) can be well visualized by ultrasound and in combination with clinical and laboratory signs ultrasound examination could have an important role in screening, determination of diagnosis and monitoring of patients with different forms of celiac disease.

  15. Recent advances using immunomodulators for inflammatory bowel disease

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Bjerrum, Jacob Tveiten; Herfarth, Hans;

    2013-01-01

    Use of the immunomodulators thiopurines and methotrexate (MTX) in the treatment of inflammatory bowel disease (IBD), i.e., Crohn's disease and ulcerative colitis (UC), is considered to be good clinical practice. However, despite being administered to a considerable number of IBD patients over...

  16. How Probiotic Reduce Symptoms of Irritable Bowel Syndrome?

    Directory of Open Access Journals (Sweden)

    M Khalesi

    2014-04-01

    Full Text Available Introduction: Irritable bowel syndrome (IBS is a common gastrointestinal disorder in children that may lead to anxiety, frequent physician visits and school absenteeism. The aim of this study is to reviewe effects of probiotic for irritable bowel syndrome.   Materials and Methods: This study review articles about probiotic for irritable bowel syndrome in pubmed and google scholar.   Results: Multiple etiologic factors were suggested for IBS, including psychosocial factors, altered gastrointestinal motility,   malfermentation of food residues and changes in the intestinal micro flora. It is reported that patients with IBS have a great homogeneity in the fecal flora with a decrease in lactobacilli, coliforms and bifidobacteria in comparison to healthy individuals. The beneficial effects of probiotics in IBS could be explained by increasing the mass of beneficial bacteria such as lactobacilli strains in the digestive tract, decreasing bacterial overgrowth in the small bowel. Recently it was also demonstrated that some lactobacilli strains may modulate intestinal pain attacks by inducing the expression of μ-opioid and cannabinoid receptors in the intestinal epithelial cells. Probiotics can also reinforce the intestinal mucosal barrier and normalize the motility of the digestive tract and its visceral sensitivity and reversing the imbalance between the pro- and anti-inflammatory cytokines so that suggested as a therapeutic option for IBS.   Conclusion: Probiotic has been suggested as a therapeutic option for IBS by modulation pathophysiologic events in these patients. Keyword: Probiotic, IBS, Children.

  17. Mitogen activated protein kinases: a role in inflammatory bowel disease?

    DEFF Research Database (Denmark)

    Broom, O J; Widjaya, B; Troelsen, J;

    2009-01-01

    Since their discovery more than 15 years ago, the mitogen activated protein kinases (MAPK) have been implicated in an ever-increasingly diverse array of pathways, including inflammatory signalling cascades. Inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn's disease, are...... their related signalling proteins in influencing the progression of IBD....

  18. Small Bowel Injury in Peritoneal Encapsulation following Penetrating Abdominal Trauma

    OpenAIRE

    Naidoo, K.; Mewa Kinoo, S.; Singh, B.

    2013-01-01

    Small bowel encapsulation is a rare entity which is usually found incidentally at autopsy. We report the first case of peritoneal encapsulation encountered serendipitously at laparotomy undertaken for penetrating abdominal trauma and review the literature on peritoneal encapsulation. We also compare this phenomenon to abdominal cocoon and sclerosing encapsulating peritonitis.

  19. Small Bowel Injury in Peritoneal Encapsulation following Penetrating Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    K. Naidoo

    2013-01-01

    Full Text Available Small bowel encapsulation is a rare entity which is usually found incidentally at autopsy. We report the first case of peritoneal encapsulation encountered serendipitously at laparotomy undertaken for penetrating abdominal trauma and review the literature on peritoneal encapsulation. We also compare this phenomenon to abdominal cocoon and sclerosing encapsulating peritonitis.

  20. Primary sclerosing cholangitis and disease distribution in inflammatory bowel disease.

    LENUS (Irish Health Repository)

    O'Toole, Aoibhlinn

    2012-04-01

    The relationship between site of intestinal inflammation and primary sclerosing cholangitis (PSC) development in inflammatory bowel disease (IBD) has not been studied extensively, but may be important in understanding the pathogenesis of PSC. We aimed to determine patterns of disease distribution in IBD patients with and without PSC.

  1. The fecal microbiome in pediatric patients with short bowel syndrome

    Science.gov (United States)

    Changes in the intestinal microbiome of patients with short bowel syndrome (SBS) are thought to significantly affect clinical outcome. These changes may not only delay enteral diet advancement but may also predispose patients to bacterial translocation, bacteremia, and liver disease. Patients with S...

  2. Linking estrogen receptor β expression with inflammatory bowel disease activity.

    Science.gov (United States)

    Pierdominici, Marina; Maselli, Angela; Varano, Barbara; Barbati, Cristiana; Cesaro, Paola; Spada, Cristiano; Zullo, Angelo; Lorenzetti, Roberto; Rosati, Marco; Rainaldi, Gabriella; Limiti, Maria Rosaria; Guidi, Luisa; Conti, Lucia; Gessani, Sandra

    2015-12-01

    Crohn disease (CD) and ulcerative colitis (UC) are chronic forms of inflammatory bowel disease (IBD) whose pathogenesis is only poorly understood. Estrogens have a complex role in inflammation and growing evidence suggests that these hormones may impact IBD pathogenesis. Here, we demonstrated a significant reduction (p exploitation of T cell-associated ERβ as a biomarker of endoscopic disease activity. PMID:26497217

  3. Ectopic decidual reaction mimicking irritable bowel syndrome: a case report.

    Directory of Open Access Journals (Sweden)

    Soraya Salehgargari

    2014-01-01

    Full Text Available Ectopic decidualization with gross involvement of the peritoneum is one of the rare findings in pregnant women particularly when ectopic decidualization disseminated as an asymptomatic intra-abdominal nodule. We present here a case of an ectopic decidualization in a 33-year-old pregnant woman with symptoms of irritable bowel syndrome during pregnancy.

  4. Brain gut microbiome interactions and functional bowel disorders

    Science.gov (United States)

    Alterations in the bidirectional interactions between the intestine and the nervous system have important roles in the pathogenesis of irritable bowel syndrome (IBS). A body of largely preclinical evidence suggests that the gut microbiota can modulate these interactions. A small and poorly defined r...

  5. 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

  6. Gastric Versus Small Bowel Feeding in Critically Ill Adults.

    Science.gov (United States)

    Schlein, Kirsten

    2016-08-01

    Critically ill patients often require enteral feedings as a primary supply of nutrition. Whether enteral nutrition (EN) should be delivered as a gastric versus small bowel feeding in the critically ill patient population remains a contentious topic. The Society of Critical Care Medicine (SCCM)/American Society for Parenteral and Enteral Nutrition (ASPEN), the European Society for Parenteral and Enteral Nutrition (ESPEN), and the Canadian Clinical Practice Guidelines (CCPG) are not in consensus on this topic. No research to date demonstrates a significant difference between the two feeding routes in terms of patient mortality, ventilator days, or length of stay in the intensive care unit (ICU); however, studies provide some evidence that there may be other benefits to using a small bowel feeding route in critically ill patients. The purpose of this paper is to examine both sides of this debate and review advantages and disadvantages of both small bowel and gastric routes of EN. Practical issues and challenges to small bowel feeding tube placement are also addressed. Finally, recommendations are provided to help guide the clinician when selecting a feeding route, and suggestions are made for future research. PMID:26920643

  7. Normal tissue tolerance to external beam radiation therapy: Small bowel

    International Nuclear Information System (INIS)

    The small bowel is a hollow organ involved in the transit and absorption of food. In relation to its anatomical location, a significant amount of this organ is exposed in whole or in part to ionizing radiation in external radiotherapy during abdominal or pelvic irradiation either for primary cancers or metastasis. The acute functional changes during external beam radiation are mainly leading to diarrhea, abdominal pain and bloating. The main late side effects of irradiation of the small intestine are chronic diarrhea, malabsorption with steatorrhoea, abdominal spasms, intestinal obstruction, bleeding and fistulas. The architecture of the small intestine may be considered as parallel with a significant correlation between the irradiated volume of small bowel and the likelihood of acute toxicity, whatever the dose. The literature analysis recommends to consider the volume of small bowel receiving 15 Gy (threshold of 100 to 200 cm3) but also 30 and 50 Gy (thresholds of 35 to 300 cm3, depending on the level of dose considered). Modern techniques of conformal radiotherapy with modulated intensity will probably have beneficial impact on small bowel toxicity. (authors)

  8. A new method for radiolucent presentation of small bowel

    International Nuclear Information System (INIS)

    A new method for radiolucent presentation of small bowell is described. A modified easy introducible small tube for contrast medium instillation is used. For stabilization of contrast medium a contrast enhancing substance is added. A 0.5% solution of this substance is also used as distention medium. Consequently contrast medium is equally distributed and coating of intestinal mucosa pattern is greatly enhanced. (orig.)

  9. Lumbar hernia: a rare cause of large bowel obstruction

    OpenAIRE

    Hide, I; Pike, E; Uberoi, R

    1999-01-01

    We describe a 70-year-old woman presenting with large bowel obstruction secondary to incarceration of the mid descending colon within a lumbar hernia. This was diagnosed on barium enema and successfully treated surgically.


Keywords: hernia; intestinal obstruction; colon

  10. Inflammatory Bowel Disease in a Child with Sickle Cell Anemia

    OpenAIRE

    Khaled Alqoaer; Ahmed, Mohammed M.; Efteraj S. Alhowaiti

    2014-01-01

    Sickle cell anemia (SCA) is a chronic haemoglobinopathy that can affect many organs in the body including gastrointestinal tract. However, colonic involvement is very rare and usually in the form of ischemic colitis. We are reporting an 11-year-old Saudi girl with SCA who presented with persistent diarrhea and was found to have inflammaftory bowel disease.

  11. Biomarkers for inflammation and surveillance strategies in inflammatory bowel disease

    NARCIS (Netherlands)

    Mooiweer, E.

    2014-01-01

    Chronic inflammation of the colonic mucosa, as observed in patients with inflammatory bowel disease (IBD), is associated with an increased risk of colorectal cancer (CRC). Endoscopic surveillance aimed at the detection of dysplasia and asymptomatic CRC is therefore recommended in order to mitigate t

  12. 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...

  13. Non-pharmacological treatments in the irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    A Leahy; O Epstein

    2001-01-01

    @@INTRODUCTION The irritable bowel syndrome (IBS) is a gastrointestinal disorder characteried by chronic lower abdominal pain and disordered defaecation associated with bloating ,tenesmus and extra-intestinal symptoms including and functional upper gastrointestinal symptoms .Currently there is nounifying hypothesis which adepuately explains the pathogenesis of the disorder although a number of physiological and psychological abmormalites have been described.

  14. Perceptions of medication safety among patients with inflammatory bowel disease.

    LENUS (Irish Health Repository)

    Cullen, Garret

    2010-09-01

    The aim of this study was to assess attitudes towards and knowledge of medication safety in inflammatory bowel disease (IBD). IBD patients frequently require long-term treatment with potentially toxic medications. Techniques are employed to improve patient awareness of medication safety, but there are sparse data on their effectiveness.

  15. Electrostimulation to move endoscopes in the small bowel

    Science.gov (United States)

    Mosse, Charles A.; Mills, Timothy N.; Appleyard, Mark; Swain, Paul

    2001-01-01

    Background: Methods are required for propulsion of endoscopes through the small bowel and for propelling capsule endoscopes without cables. Aim: To test the hypothesis that electrical stimulation could propel an endoscope by stimulating muscular contraction. Methods: Prototype acrylic devices of ovoid shape were constructed with two stainless steel electrodes mounted on the tapered section. Five devices of 13 to 23 mm diameter with a taper of 16 degree(s) to 20 degree(s) (half angle) were tested. When in contact with the bowel wall electrostimulation was applied causing circular muscle contraction which when applied to the taper of the ovoid resulted in forward propulsion of the device. The method does not induce peristalsis but works by stimulating local contraction. The device was tested in small bowel and oesophagus of anaesthetized pigs. Results: Electrostimulation caused the ovoid to advance rapidly (6 mm/sec) up and down the oesophagus by inducing circular esophageal muscle contraction. When stimulated at 15 Hz with 30 ms pulses the threshold for movement was 12 mA; at 20 mA the device moved reliably in both directions in the small bowel at speeds of up to 4.5 mm/s, negotiating tight curves.

  16. Technologies in the evaluation of irritable bowel syndrome

    NARCIS (Netherlands)

    Smout, AJPM; Azpiroz, F; Brummer, RJ; Coremans, G; Dapoigny, M; Muller-Lissner, SA; Pace, F; Stockbrugger, RM; Vatn, M; Whorwell, PJ

    2004-01-01

    During a meeting in The Hague, The Netherlands, the IBiS Club evaluated the most important techniques that can be used in the investigation of irritable bowel syndrome, either in the context of scientific research or as a clinical diagnostic tool. In each of these, the relevance of findings made in

  17. Maintenance Therapy and Prospects for Inflammatory Bowel Disease

    Institute of Scientific and Technical Information of China (English)

    XU Chang-tai; PAN Bo-rong; GUO Xiue-gan

    2003-01-01

    @@ Introduction Medical therapy of inflammatory bowel disease (IBD) can be considered in several subcategories, and this review is designed to provide selective updates for some of the most important therapeutic entities currently marketed or soon to be available for the medical management of IBD [1-6].

  18. A radiologist's guide to small bowel and multivisceral transplantation

    International Nuclear Information System (INIS)

    This review will describe the indications for the various small bowel containing transplants. The importance of early referral will be highlighted. Radiologists play a central role in assessing these complex patients prior to transplantation. Furthermore, in the postoperative period, radiologists play an important part in diagnosing and treating complications

  19. Gastric emptying and disease activity in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Keller, Jutta; Binnewies, Ulrich; Rösch, Marie;

    2015-01-01

    BACKGROUND: Gastric emptying (GE) is delayed in a subset of patients with inflammatory bowel disease (IBD). We have shown before that altered release of gastrointestinal hormones may contribute to GE disturbances, but overall effects of disease activity remain unclear. Thus, we aimed to evaluate GE...

  20. Small bowel obstruction due to ingested superabsorbent beads

    Directory of Open Access Journals (Sweden)

    Hao D. Pham

    2015-05-01

    Full Text Available Superabsorbent water beads have found many uses as household decorative items, crafts, and other industrial uses. We report a case of ingestion of several LiquiBlock Rainbow brand superabsorbent beads by a ten month old girl leading to small bowel obstruction requiring laparotomy and removal of the beads.

  1. 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.

  2. Treatment of adult short bowel syndrome patients with teduglutide

    DEFF Research Database (Denmark)

    Nørholk, Lærke Marijke; Holst, Jens Juul; Jeppesen, Palle Bekker

    2012-01-01

    INTRODUCTION: Parenteral support is lifesaving in short bowel syndrome patients with intestinal failure (SBS-IF), who are unable to compensate for their malabsorption by metabolic or pharmacologic adaptation. Mutually, the symptoms of SBS-IF and the inconveniences and complications in relation to...

  3. Bovine colostrum to children with short bowel syndrome

    DEFF Research Database (Denmark)

    Aunsholt, Lise; Jeppesen, Palle Bekker; Lund, Pernille;

    2014-01-01

    Background: Management of short bowel syndrome (SBS) aims to achieve intestinal autonomy to prevent fluid, electrolyte, and nutrient deficiencies and maintain adequate development. Remnant intestinal adaptation is required to obtain autonomy. In the newborn pig, colostrum has been shown to support...

  4. Comparison of three strategies to delineate the bowel for whole pelvis IMRT of prostate cancer

    International Nuclear Information System (INIS)

    Purpose: To compare three different contouring approaches of the bowel before and during whole pelvis IMRT of localized prostate cancer. Materials: Nine patients were randomly selected among those treated for localized prostate cancer at UTMB from March 2004 to August 2006. On the planning CT, besides the usual organs at risk (OAR), for each patient we contoured the bowel according to three different definitions: each bowel segment ('BS'); 'BS+1', BS uniformly expanded by 1 cm; intestinal cavity ('IC') or the 'container' of the bowel loops up to the pelvic/abdominal walls. For each patient we generated three rival plans each considering a different bowel definition, otherwise identical. Provided that the same target coverage and other OAR spare had been achieved, plans were compared for their ability to minimize bowel dose at planning. Furthermore, after co-registering 6 weekly CT to the initial planning CT for each patient, we investigated which of the three definitions would allow the best bowel protection also during treatment. Results: All definitions provided a very similar average bowel DVH at planning. During treatment BS allowed an average ∼20 cc more of bowel to receive at least 45 Gy over BS+1 and IC (p = 0.008 and 0.029, respectively); on the contrary bowel V45 between IC and BS+1 were not significantly different (p = 0.65). Conclusion: A definition that takes into account internal organ motion is warranted to maximize bowel protection during treatment

  5. MR imaging of the small bowel in Crohn's disease

    International Nuclear Information System (INIS)

    MR and CT techniques optimized for small bowel imaging are playing an increasing role in the evaluation of small bowel disorders. Several studies have shown the advantage of these techniques over tradition barium fluoroscopic examinations secondary to improvements in spatial and temporal resolution combined with improved bowel distending agents. The preference of MR vs. CT has been geographical and based on expertise and public policy. With the increasing awareness of radiation exposure, there has been a more global interest in implementing techniques that either reduce or eliminate radiation exposure [Brenner DJ, Hall EJ. Computed tomography-an increasing source of radiation exposure. N Engl J Med 2007;357:2277-84]. This is especially important in patients with chronic diseases such as inflammatory bowel disease who may require multiple studies over a lifetime or in studies that require sequential imaging time points such as in assessment of gastrointestinal motility [Froehlich JM, Patak MA, von Weymarn C, Juli CF, Zollikofer CL, Wentz KU. Small bowel motility assessment with magnetic resonance imaging. J Magn Reson Imaging 2005;21:370-75]. A recent study showed that certain subgroups of patients with Crohn's disease may be exposed to higher doses of radiation; those diagnosed at an early age, those with upper tract inflammation, penetrating disease, requirement of intravenous steroids, infliximab or multiple surgeries [Desmond AN, O'Regan K, Curran C, et al. Crohn's disease: factors associated with exposure to high levels of diagnostic radiation. Gut 2008;57:1524-29]. Therefore it has been suggested that techniques that can reduce or eliminate radiation exposure should be considered for imaging [Brenner DJ, Hall EJ. Computed tomography-an increasing source of radiation exposure. N Engl J Med 2007;357:2277-84]. Owing to the excellent softtissue contrast, direct multiplanar imaging capabilities, new ultrafast breath-holding pulse sequences, lack of ionizing

  6. Large Intraluminal Ileal Hematoma Presenting as Small Bowel Obstruction in a Child

    International Nuclear Information System (INIS)

    Intraluminal small bowel hematoma has been rarely reported in children, as a rare cause of small bowel obstruction. We present a case of an intraluminal ileal hematoma presenting as small bowel obstruction in a child. Computed Tomography (CT) indicated a large intraluminal hyperdense lesion in the distal ileum as the cause of small bowel obstruction. Abdominal ultrasonography (US) showed an echogenic mass-like lesion with multiple septa in the distal ileum. Small bowel obstruction due to a complicated cystic mass was provisionally diagnosed. Histopathologic examination of the resected mass suggested a submucosal ileal hematoma. Although intraluminal small bowel hematoma is rare in children, it can present as an intraluminal cystic mass and should be considered as a rare cause of small bowel obstruction. The US and CT findings of submucosal ileal hematoma could be useful for the diagnosis of such cases in the future

  7. Serotonin receptor modulators in the treatment of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Mohammad Fayyaz

    2008-03-01

    Full Text Available Mohammad Fayyaz, Jeffrey M LacknerDivision of Gastroenterology, Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USAAbstract: The aim of this article is to review the pathophysiology and clinical role of serotonin receptor modulators used in the treatment of irritable bowel syndrome. Serotonin is an important monoamine neurotransmitter that plays a key role in the initiation of peristaltic and secretory reflexes, and in modulation of visceral sensations. Several serotonin receptor subtypes have been characterized, of which 5HT3, 5HT4, and 5HT1b are the most important for GI function. 5HT4 agonists (eg, tegaserod potentiate peristalsis initiated by 5HT1 receptor stimulation. 5HT4 agonists are therefore useful in constipation predominant form of IBS and in chronic constipation. 5HT3 antagonists (Alosetron and Cilansetron prevent the activation of 5HT3 receptors on extrinsic afferent neurons and can decrease the visceral pain associated with IBS. These agents also retard small intestinal and colonic transit, and are therefore useful in diarrhea-predominant IBS. Tegaserod has been demonstrated in several randomized, placebo controlled trials to relieve global IBS symptoms as well as individual symptoms of abdominal discomfort, number of bowel movements and stool consistency. Several randomized, controlled trials have shown that alosetron relieves pain, improves bowel function, and provides global symptom improvement in women with diarrhea-predominant irritable bowel syndrome. However, ischemic colitis and severe complications of constipation have been major concerns leading to voluntary withdrawal of Alosetron from the market followed by remarketing with a comprehensive risk management program.Keywords: serotonin, irritable bowel syndrome, tegaserod

  8. Oats and bowel disease: a systematic literature review.

    Science.gov (United States)

    Thies, Frank; Masson, Lindsey F; Boffetta, Paolo; Kris-Etherton, Penny

    2014-10-01

    Whole-grain foods such as oats may protect against colorectal cancer and have benefits on inflammatory bowel disease and coeliac disease. The present study aimed to systematically review the literature describing intervention studies that investigated the effects of oats or oat bran on risk factors for bowel disease. A literature search was conducted using Embase, Medline and the Cochrane library, which identified 654 potential articles. Thirty-eight articles describing twenty-nine studies met the inclusion criteria. Two studies carried out in participants with a history of colorectal adenomas found no effects of increased oat-bran intake on indirect risk makers for colorectal cancer. One of two interventions with oat bran in patients with ulcerative colitis showed small improvements in the patients' conditions. Most of the eleven studies carried out in adults with coeliac disease showed no negative effects of uncontaminated oat consumption. The fourteen studies carried out in volunteers with no history of bowel disease suggest that oats or oat bran can significantly increase stool weight and decrease constipation, but there is a lack of evidence to support a specific effect of oats on bowel function compared with other cereals. A long-term dietary intake of oats or oat bran could benefit inflammatory bowel disorders, but this remains to be proven. A protective effect on colorectal adenoma and cancer incidence has not yet been convincingly shown. The majority of patients with coeliac disease could consume up to 100 g/d of uncontaminated oats, which would increase the acceptability of, and adherence to, a gluten-free diet. PMID:25267242

  9. Magnetic resonance imaging of the small bowel in children with idiopathic inflammatory bowel disease: evaluation of disease activity

    Energy Technology Data Exchange (ETDEWEB)

    Alexopoulou, Efthymia; Loggitsi, Dimitra; Economopoulos, Nikos; Papakonstantinou, Olympia; Kelekis, Nikolaos L. [National and Kapodistrian University of Athens, General University Hospital, Second Department of Radiology, Athens (Greece); Roma, Eleftheria; Panagiotou, Ioanna; Pahoula, Ioanna [National and Kapodistrian University of Athens, Aghia Sofia Children' s Hospital, First Department of Paediatrics, Athens (Greece)

    2009-08-15

    Examinations using ionizing radiation are frequently used in the evaluation of disease activity in children affected by idiopathic inflammatory bowel disease (IBD). To develop an MR imaging protocol without the need for fluoroscopic insertion of an enteral tube and to assess the disease activity in children with IBD. Included in the study were 37 children (22 girls and 15 boys; age range 7-15 years, mean 11.67 years) with IBD who underwent MR imaging of the small bowel. Of these 37 children, 32 had Crohn disease and 5 had indeterminate colitis. A water solution containing herbal fibres was administered orally or through a nasogastric tube. Patients were imaged on a 1.5-T MR scanner with T1-weighted and {tau}2-weighted sequences followed by a dynamic study using 3-D T1-W images after intravenous administration of gadolinium. The percentage enhancement of the bowel wall was significantly increased in patients with abnormal C-reactive protein (CRP) values compared to patients with CRP values in the normal range (P<0.001). A relatively weak but significant correlation between percentage enhancement of the bowel wall and CRP values was noted during all phases of enhancement. This MR imaging protocol is a safe and well-tolerated method for evaluating disease activity and extraintestinal manifestations of IBD in children. (orig.)

  10. Faecal S100A12 as a non-invasive marker distinguishing inflammatory bowel disease from irritable bowel syndrome

    NARCIS (Netherlands)

    Kaiser, T; Langhorst, J; Wittkowski, H; Becker, K; Friedrich, A W; Rueffer, A; Dobos, G J; Roth, J; Foell, D

    2007-01-01

    OBJECTIVE: S100A12 is a pro-inflammatory protein that is secreted by granulocytes. S100A12 serum levels increase during inflammatory bowel disease (IBD). We performed the first study analysing faecal S100A12 in adults with signs of intestinal inflammation. METHODS: Faecal S100A12 was determined by E

  11. Diagnostic performance of CT colonography with limited cathartic preparation in colorectal cancer screening; comparison with conventional colonoscopy

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    Mohammed Farghally Amin

    2015-09-01

    Conclusion: This study proved that CTC with limited cathartic bowel preparation and iodinated agents for fecal tagging can obtain high sensitivity and PPV values results for <5 mm polyps comparable to those obtained with conventional preparation with laxatives. Furthermore, this method could really improve the acceptance of CTC for colorectal cancer screening.

  12. Differentiation between active and chronic Crohn's disease using MRI small-bowel motility examinations — Initial experience

    International Nuclear Information System (INIS)

    Aim: To evaluate the influence of locally active Crohn's disease on systemic small-bowel motility in patients with chronic Crohn's disease compared to healthy individuals. Material and methods: Fifteen healthy individuals (11 men, four women; mean age 37 years) and 20 patients with histopathologically proven active (n = 15; 10 women, 5 men; mean age 45 years) or chronic (n = 5; four women, one man; mean age 48 years) Crohn's disease were included in this institutional review board-approved, retrospective study. Magnetic resonance imaging (MRI; 1.5 T) was performed after standardized preparation. Two-dimensional (2D) cine sequences for motility acquisition were performed in apnoea (27 s). Motility assessment was performed using dedicated software in three randomly chosen areas of the small-bowel outside known Crohn's disease-affected hotspots. The main quantitative characteristics (frequency, amplitude, occlusion rate) were compared using Student's t-test and one-way analysis of variance (ANOVA). Results: Three randomly chosen segments were analysed in each participant. Patients with active Crohn's disease had significantly (p < 0.05) reduced contraction frequencies (active Crohn's disease: 2.86/min; chronic: 4.14/min; healthy: 4.53/min) and luminal occlusion rates (active: 0.43; chronic: 0.70; healthy: 0.73) compared to healthy individuals and patients with chronic Crohn's disease. Contraction amplitudes were significantly reduced during active Crohn's disease (6.71 mm) compared to healthy participants (10.14 mm), but this only reached borderline significance in comparison to chronic Crohn's disease (8.87 mm). Mean bowel lumen diameter was significantly (p = 0.04) higher in patients with active Crohn's disease (16.91 mm) compared to healthy participants (14.79 mm) but not in comparison to patients with chronic Crohn's disease (13.68). Conclusion: The findings of the present study suggest that local inflammatory activity of small-bowel segments in patients with

  13. [Current issues on irritable bowel syndrome: diet and irritable bowel syndrome].

    Science.gov (United States)

    Kim, Jeong Hwan; Sung, In-Kyung

    2014-09-25

    Irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorders. It is a multifactorial disorder with its pathogenesis attributed to abnormal gastrointestinal motility, low-grade inflammation, visceral hypersensitivity, communication in the gut-brain axis, and so on. Traditionally, IBS has been treated with diet and lifestyle modification, fiber supplementation, psychological therapy, and pharmacological treatment. Carbohydrates are intermingled with a wide range of regularly consumed food including grains such as rye and wheat, vegetables, fruits, and legumes. Short-chain carbohydrates that are poorly absorbed exert osmotic effects in the intestinal lumen increasing its water volume, and are rapidly fermented by bacteria with consequent gas production. These effects may be the basis for the induction of most of the gastrointestinal symptoms. This has led to the use of lactose-free diets in those with lactose intolerance and of fructose-reduced diets for fructose malabsorption. As all poorly absorbed short-chain carbohydrates have similar and additive effects in the intestine, a concept has been developed to regard them collectively as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) and to evaluate a dietary approach that restricts them all. Based on the observational and comparative studies, and randomized-controlled trials, FODMAPs have been shown to trigger gastrointestinal symptoms in patients with IBS. Food choice via the low FODMAPs and potentially other dietary strategies is now a realistic and efficacious therapeutic approach for managing symptoms of IBS. PMID:25252862

  14. Management of fecal incontinence - focus on a vaginal insert for bowel control

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    Sokol ER

    2016-05-01

    Full Text Available Eric R Sokol Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA Abstract: Fecal incontinence, also referred to as accidental bowel leakage, is a debilitating condition that impacts quality of life in a significant number of women. Current treatments for fecal incontinence include behavioral modification, biofeedback, drug therapy, and invasive surgical procedures. However, these treatments have suboptimal efficacy due to patient adherence, variability of presentation across patients, cost, and additional health risks. A vaginal bowel control system (EclipseTM System was developed to offer a low-risk, effective, and patient-managed approach to treating accidental bowel leakage. The vaginal bowel control system consists of a vaginal insert and user-controlled, pressure-regulated pump. Once inflated, the balloon of the vaginal insert is directed posteriorly to occlude the rectum, allowing the woman to immediately regain control of bowel function. This article will introduce the design evolution and feasibility studies of the Eclipse System. In addition, this review will discuss the results from a recent clinical trial that demonstrated the safety and efficacy of the vaginal bowel control system in managing fecal incontinence and other symptoms of bowel dysfunction. Keywords: accidental bowel leakage, fecal urgency, vaginal bowel control system, Eclipse System, bowel function

  15. Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease.

    Science.gov (United States)

    Jang, Ki Ung; Yu, Chang Sik; Lim, Seok-Byung; Park, In Ja; Yoon, Yong Sik; Kim, Chan Wook; Lee, Jong Lyul; Yang, Suk-Kyun; Ye, Byong Duk; Kim, Jin Cheon

    2016-07-01

    In Crohn disease, bowel-preserving surgery is necessary to prevent short bowel syndrome due to repeated operations. This study aimed to determine the remnant small bowel length cut-off and to evaluate the clinical factors related to nutritional status after small bowel resection in Crohn disease.We included 394 patients (69.3% male) who underwent small bowel resection for Crohn disease between 1991 and 2012. Patients who were classified as underweight (body mass index bowel length cut-offs were determined using receiver operating characteristic curves. Variables associated with poor nutritional status were assessed retrospectively using Student t tests, chi-squared tests, Fisher exact tests, and logistic regression analyses.The mean follow-up period was 52.9 months and the mean patient ages at the time of the last bowel surgery and last follow-up were 31.2 and 35.7 years, respectively. The mean remnant small bowel length was 331.8 cm. Forty-three patients (10.9%) underwent ileostomy, 309 (78.4%) underwent combined small bowel and colon resection, 111 (28.2%) had currently active disease, and 105 (26.6%) underwent at least 2 operations for recurrent disease. The mean body mass index and modified nutritional risk index were 20.6 and 100.8, respectively. The independent factors affecting underweight status were remnant small bowel length ≤240 cm (odds ratio: 4.84, P bowel length ≤230 cm (odds ratio: 2.84, P = 0.012), presence of ileostomy (odds ratio: 3.36, P = 0.025), and currently active disease (odds ratio: 4.90, P bowel length ≤230 cm are risk factors affecting the poor nutritional status of patients with Crohn disease after small bowel resection. PMID:27472702

  16. Implications of multiprobiotics and fructooligosaccharides on functional bowel pathology in infants

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    Marushko RV

    2014-04-01

    Full Text Available Aim of this study was to evaluate the efficacy of the preparation called «Lactiale Maljuk» in the treatment of functional bowel diseases in infants associated with intestine dysbiosis. Materials and Methods. We examined 104 children aged 6 to 18 months, of which 55 children with functional constipation (FC and 49 children with functional diarrhea (FD. Underwent clinical and laboratory investigations, including bacteriological and immunological (TNF-a in blood serum, SIgA in fesus samples. Studied the clinical efficacy of the preparation «Lactiale Maljuk» — a combination of the multiprobiotic and fructooligosaccharides in FC and FD in infants. Results. Revealed significant disorders in the status of intestinal microbial flora, the main representatives of indigenous microflora (Bifidobacterium, Lactobacillus, an increase in the expression of TNF-a in serum and decrease the concentration of SIgA in fesus samples in infants with FC and FD. Use the combination of multiprobiotics which contains symbiotic complex of probiotic bacteria (Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus ther mophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium longum, Lactobacillus bulgaricus and fructooligosaccharides (prebiotic in a preparation «Lactiale Maljuk» has a pronounced positive effect on the clinical course of functional constipation and functional diarrhea, contributes to the nor malization and restoration of intestinal microbial flora, immune system parameters in infants with this pathology. Conclusions. The results of the study of the efficiency in using the preparation «Laktiale Maljuk» allows us to recommend this preparation for use in infants with functional constipation and functional diarrhea in prevention, treatment and rehabilitation of this pathology.

  17. [Prenatal discovery of Joubert syndrome associated with small bowel volvulus].

    Science.gov (United States)

    Aurégan, C; Donciu, V; Millischer, A-E; Khen-Dunlop, N; Deloison, B; Sonigo, P; Magny, J-F

    2016-03-01

    Joubert syndrome and prenatal volvulus are difficult to diagnose during pregnancy. Joubert syndrome and related diseases should be considered in case of prenatal abnormal features of the fourth ventricle. Small bowel volvulus is also a surgical emergency because of the risk of intestinal necrosis before or after delivery. This type of condition justifies the transfer of pregnant women to a specialized hospital where the newborn may receive appropriate care. We report the case of a 31-week and 4-day gestational-age fetus in whom intrauterine growth retardation and small-bowel volvulus were diagnosed. Additional imaging revealed associated Joubert syndrome. This highlights the need for regular ultrasound monitoring during pregnancy and the comanagement of obstetricians and pediatricians to provide appropriate care before and after delivery. PMID:26850151

  18. Capsule Endoscopy in Inflammatory Bowel Disease: Current Applications.

    Science.gov (United States)

    Singeap, Ana-Maria; Stanciu, Carol; Cojocariu, Camelia; Sfarti, Catalin; Trifan, Anca

    2015-06-01

    Since its introduction to clinical practice in 2001, small-bowel capsule endoscopy (SBCE) has become an important investigation procedure in many small bowel pathologies, including both suspected and known Crohn's disease (CD). SBCE has higher diagnostic yield than other radiologic and endoscopic modalities used in evaluation of patients with suspected CD. In addition, SBCE has proved useful, in a non-invasive and safe manner, as a monitoring method for evaluating the severity and extent of lesions, postoperative recurrence, and mucosal healing in patients with known CD. Monitoring of colonic inflammation in patients with ulcerative colitis (UC) using second-generation of colon capsule endoscopy (CCE-2) has also been reported. Besides its advantages, CE also has several limitations such as the inability to obtain biopsies and lack of therapeutic capabilities, hopefully to be overcome in the near future by advances in modern technologies. PMID:26058935

  19. Psychopharmacological Treatment and Psychological Interventions in Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Emanuele Sinagra

    2012-01-01

    Full Text Available Irritable bowel syndrome (IBS accounts for 25% of gastroenterology output practice, making it one of the most common disorders in this practice. Psychological and social factors may affect the development of this chronic disorder. Furthermore, psychiatric symptoms and psychiatric diseases are highly prevalent in this condition, but the approach to treating these is not always straightforward. As emphasized in the biopsychosocial model of IBS, with regard to the modulatory role of stress-related brain-gut interactions and association of the disease with psychological factors and emotional state, it proves useful to encourage psychopharmacological treatments and psychosocial therapies, both aiming at reducing stress perception. The aim of this paper is to analyze the effectiveness of psychopharmacological treatment and psychological interventions on irritable bowel syndrome.

  20. Extraintestinal manifestations of inflammatory bowel disease: epidemiology, diagnosis, and management

    DEFF Research Database (Denmark)

    Larsen, Signe; Bendtzen, Klaus; Nielsen, Ole Haagen

    2010-01-01

    Abstract Extraintestinal manifestations occur rather frequently in inflammatory bowel disease (IBD), e.g. ulcerative colitis (UC) and Crohn's disease (CD). The present paper provides an overview of the epidemiology, clinical characteristics, diagnostic process, and management of rheumatic...... the European Agency for the Evaluation of Medicinal Products (EMEA) and the US Food and Drug Administration (FDA) (cut-off date October 2009). The search terms 'Crohn's disease', 'inflammatory bowel disease', or 'ulcerative colitis' were combined with the terms 'adalimumab', 'anemia', 'arthritis...... evidence of treatment was difficult to obtain, and epidemiologic data on the rarer forms of extraintestinal manifestations are scarce. However, updates on the pathophysiology and treatment regimens are given for each of these disorders. This paper offers a current review of original research papers and...