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Query: UMLS:C0009319 (colitis)
 19,384 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To study the pathogenesis of shigella diarrhea, we evaluated 11 patients for colonic fluid and electrolyte flux. Methods used were subtraction of the fecal flow rate from the ileocecal flow rate and colonoscopic perfusion of the colon. The mean ileocecal flow rate was 0.57 ml/min compared with a mean fecal flow rate of 0.48 ml/min, and the mean of the differences showed a slight net colonic water absorption of +0.09 ml/min. With use of perfusion, these patients showed an overall mean of slight net fluid secretion by the colon of -0.04 ml/min. Seven patients restudied during convalescence showed a mean net rate of colonic water absorption of +0.65 ml/min, which was significantly greater than in the acute phase (P less than .05), and a mean ileocecal flow rate of 0.56 ml/min. Ion transport by the colon during acute shigellosis showed net secretion of K+, which changed to net absorption in convalescence (P less than .05), and a decreased absorption of Cl-, which improved in convalescence (P less than .05). Patients with extensive colitis showed more impairment of net water absorption by the colon than did patients with colitis limited to the rectosigmoid colon. These findings demonstrate that shigella diarrhea results from colonic dysfunction, without evidence of increased small intestinal flow rate, and this colonic dysfunction consists of diminished net absorption of water and Cl- and increased secretion of K+.
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PMID:Colonic dysfunction during shigellosis. 377 63

Water-soluble and sodium dodecyl sulfate (SDS)-extractable fractions were prepared from feces of four patients with inflammatory and six with non-inflammatory bowel disease. Both types of fractions were run on polyacrylamide gel electrophoresis, followed by electroblotting on nitrocellulose sheets of the separated components. The antibody reactivities in serum and in the intestinal wall against the extracted and separated fecal components were investigated. A striking lack of reactivity was observed when serum was used as antibody source against the fecal extracts both in patients with inflamed and in those with non-inflamed intestinal mucosa. The locally produced gut-associated IgG reacted more intensely with SDS-extractable fecal components than with water-soluble components. A strong reaction between intestinal-wall IgG extracts and a water-soluble antigen of 46-48 kD in the feces of two colitis patients was, however, observed. No clear correlation between the single bands and the occurrence of inflammatory bowel disease could be established because of the small number of patients.
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PMID:Application of electroblotting technique to studies of the intestinal antibody response to extractable fecal antigens. 388 56

Escherichia coli serotype O157:H7 is a rarely identified organism that has recently been associated with hemorrhagic colitis in all age groups and with the hemolytic uremic syndrome (HUS) in children. We now report the development of HUS in two young women following enteric infection with E coli O157:H7. Both patients were hospitalized because of the severity of their colitis. They later developed major hemolysis requiring transfusion and significant renal failure requiring, in one case, hemodialysis. One patient underwent laparotomy, where sterile ascites, marked right colonic edema, and intraserosal hemorrhage were noted. Both women survived and are currently improving. Fecal E coli serotype O157:H7 was sought only after routine cultures were negative and features of HUS were recognized. The search for the E coli was facilitated by the continued availability of stool cultures obtained early in the course of the illness. The source of infection was not ascertained, but ingestion of untreated water was a feature of both cases. The HUS is a potential complication of the hemorrhagic colitis associated with E coli serotype O157:H7 and may develop in adults as well as children following enteric infection with this organism.
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PMID:Hemorrhagic colitis with Escherichia coli O157:H7 preceding adult hemolytic uremic syndrome. 390 63

Escherichia coli serotype O157:H7 has been isolated from outbreaks and sporadic cases of hemorrhagic colitis. There is convincing evidence that it can cause this diarrheal disease. Because of the interest in hemorrhagic colitis, it has become desirable to detect this particular strain in human feces, which usually contains many other strains of E. coli. Two characteristics of the incriminated E. coli O157:H7 strain have made its isolation and identification easier. It does not ferment D-sorbitol rapidly, in contrast to about 95% of other E. coli strains. In addition, the strain has H antigen 7, but only about 10% of other E. coli strains have this particular antigen. To screen for E. coli O157:H7 we devised H7 antiserum-sorbitol fermentation medium (18 g of enteric fermentation base, 10 g of D-sorbitol, 4 g of agar, 10 ml of Andrade indicator, 989 ml of water; all ingredients were mixed, autoclaved, and cooled; 1 ml of E. coli H7 antiserum was then added). Colonies to be screened were inoculated into this medium. Strains of E. coli O157:H7 gave a characteristic pattern; they did not ferment sorbitol and were immobilized in the semisolid medium because of the reaction of their flagella with the flagella antiserum. Almost all other strains of E. coli gave a different pattern; they fermented sorbitol or were not immobilized by the H7 serum or both. Strains which were presumptive positives (sorbitol negative, H7 positive) were then tested in E. coli O157 serum by slide or tube agglutination. The number of strains which were presumptive positive by H7-sorbitol medium but then were not found to be O157 was less than 1%. A second approach has been helpful in deciding which colonies to screen in H7-sorbitol medium. MacConkey-sorbitol agar (22.2 g MacConkey agar base [which contains no sugar], 10 g of D-sorbitol, 1,000 ml of water) was designed as a plating medium. Stools were plated on MacConkey agar to estimate the number of E. coli colonies and also plated on MacConkey-sorbitol agar to estimate the number of sorbitol-negative colonies of E. coli. These two approaches have proved useful for isolating and identifying E. coli O157:H7 form human feces and from feces of animals infected in the laboratory with this strain. The results suggest that media may be formulated in a similar fashion for detecting other specific strains of E. coli.
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PMID:H7 antiserum-sorbitol fermentation medium: a single tube screening medium for detecting Escherichia coli O157:H7 associated with hemorrhagic colitis. 390 74

Some patients with chronic idiopathic diarrhea have an apparent nonspecific inflammation of colonic mucosa, even though their colons appear normal by barium enema and colonoscopy. This has been referred to as microscopic colitis. However, the significance of this finding is unclear, because the ability of pathologists to accurately distinguish mild degrees of abnormality has not been established. Furthermore, even if the mucosa of these patients is nonspecifically inflamed, it is not known whether this is associated with deranged colonic function that could contribute to the development of chronic diarrhea. To assess these questions, we first examined colonic biopsy specimens in a blinded fashion, comparing biopsy results from patients with microscopic colitis with biopsy specimens from subjects in two control groups. This analysis revealed that colonic mucosa from six patients with microscopic colitis was in fact abnormal. For example, their mucosa contained an excess of both neutrophiles and round cells in the lamina propria, cryptitis, and reactive changes. These and other differences were statistically significant. Second, colonic absorption, measured by the steady state nonabsorbable marker perfusion method, was severely depressed in the patients. For example, mean water absorption rate was 159 ml/h in normal subjects and was reduced to only 26 ml/h in six patients with microscopic colitis. Results of net and unidirectional electrolyte fluxes and of electrical potential difference suggested that colonic fluid absorption was abnormal because of reduced active and passive sodium and chloride absorption and because of reduced Cl/HCO3 exchange. Small intestinal fluid and electrolyte absorption was abnormally reduced in two of the six patients, suggesting the possibility of coexistent small intestinal involvement in some of these patients. We conclude that nonspecific inflammation of colonic mucosa is associated with a severe reduction of colonic fluid absorption, and that the latter probably contributes to the development of chronic diarrhea.
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PMID:An evaluation of the significance of microscopic colitis in patients with chronic diarrhea. 399 49

The present study determined whether in vitro nuclear magnetic resonance could be used to assess experimentally induced colitis in rats. Acute colitis was induced in 6 Sprague-Dawley rats by acetic acid enema, while 6 control animals received saline enemas. All animals were sacrificed 24 hours post-enema, and NMR relaxation times, T1 and T2, of colonic samples were determined on a 10 MHz spin analyzer (RADX, Houston, TX). Colonic water content was determined on the same samples by desiccation. Colitis animals showed significantly higher T1 and T2 relaxation times and tissue water content than controls. T1 and T2 times correlated significantly with tissue water content. Twelve additional animals were studied histologically, six of which received acetic acid enemas and showed extensive transmural colitis. Our results suggest that in vivo proton NMR might be a useful means of non-invasively assessing the degree of colonic inflammation.
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PMID:Identification of experimentally induced colitis by in vitro nuclear magnetic resonance. 408 Aug 25

A patient is described with chronic colitis, watery diarrhea, and colonic mucosal subepithelial collagen deposition that resolved while being treated with sulfasalazine. The clinicopathologic features were consistent with collagenous colitis. Theoretically, the thickened collagen layer impairs water and electrolyte absorption, producing watery diarrhea. Such increased collagen is rarely observed in other inflammatory colon diseases and may represent a distinct morphologic reaction to various, yet undefined, injuries. Although the clinical course is benign, appropriate therapy for the debilitating symptoms is poorly understood. This report suggests that sulfasalazine may be helpful in some cases.
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PMID:Sulfasalazine in treatment of collagenous colitis. Case report and review of the literature. 614 59

Urinary stones are much more common in subjects with intestinal diseases than in the general population. The chemical composition of the stones depends on the type of intestinal disease. In diarrhoeas with loss of water and electrolytes (inflammatory colitis and, chiefly, ileostomy), the urine is acid and concentrated and the stones are composed of uric acid. Extensive lesions of the ileum or wide resections of the small bowel increase the intestinal absorption of oxalates and expose the patients to oxalate stones. Treatment, which must be preventive, is based upon a knowledge of the pathophysiology of urolithiasis.
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PMID:[Urinary lithiasis secondary to intestinal diseases]. 622 18

No available test objectively measures impairment of function of the inflamed colonic mucosa in ulcerative colitis. To study function we assessed rectal bicarbonate output by rectal dialysis in the presence of water and bacterial fatty acid (n-butyrate) in 21 controls, 18 patients with acute ulcerative colitis, 12 patients with ulcerative colitis in remission, and 12 patients with other forms of colitis. In acute ulcerative colitis, compared with controls, bicarbonate output and pH was reduced (p less than 0.001); stimulated bicarbonate output with bacterial fatty acid (incremental bicarbonate output) was reduced by 80% in acute ulcerative colitis (p less than 0.01). Results indicate that bicarbonate output is a useful and selective test of mucosal function in acute ulcerative colitis. A diminished incremental bicarbonate output with n-butyrate supports the view of inadequate oxidation of bacterial fatty acids in vivo by the mucosa in ulcerative colitis. Whether the test will prove to be an index of prognosis or will aid choice between medical or surgical therapy requires further study.
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PMID:Colonic bicarbonate output as a test of disease activity in ulcerative colitis. 632 78

A recent mortality study of patients with ulcerative colitis showed significant deficits in deaths from cardiovascular disease and from respiratory disease in males. The reasons for the observed deficits have been examined by studying the risk factors in a consecutive series of 103 patients with ulcerative colitis using matched controls. The patients and controls were assessed for age, sex, social class, alcohol and tobacco consumption. Height, weight and blood pressure were recorded and fasting blood samples were taken for serum lipid estimation. Patients with ulcerative colitis had significantly lower systolic and diastolic blood pressures and the changes were particularly marked in patients with extensive colitis and after panproctocolectomy. After matching for age, sex and social class the patients with ulcerative colitis smoked significantly less than controls. Serum lipid measurements were similar in both groups. The lower blood pressure may be related to sodium and water depletion particularly in ileostomy patients and those with extensive colitis.
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PMID:Ulcerative colitis: why is the mortality from cardiovascular disease reduced? 648 17


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