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Query: UMLS:C0009402 (colorectal cancer)
 53,228 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Changes in diet from ancient times until the present are described. Previously relatively low in energy and animal products yet high in fibre-containing foods, diets are now high in energy and animal products (particularly fat), yet contain less fibre. The changing incidences of bowel disorders and diseases are described, with assessments of the role of diet. Clearly, diet is implicated as regards predisposition to constipation, appendicitis, colorectal cancer and diverticular disease; however, a meaningful dietary role in irritable bowel syndrome, ulcerative colitis and Crohn's disease is doubtful. In South Africa the rarity of bowel diseases in rural blacks compared with whites affords valuable aetiological information about some bowel diseases. The low occurrence thereof (except inflammatory bowel disease) in Indian and coloured populations is not readily explicable. While dietary changes in whites are being widely urged in order to combat degenerative diseases, the magnitude of changes made is unlikely to reduce the occurrence of bowel diseases. The progressive westernization of the diets and lifestyles of less-privileged populations is likely to be associated with increases in the incidences of these diseases.
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PMID:Diet and bowel diseases--past history and future prospects. 299 4

The short and long-term effects of postoperative total parenteral nutrition (TPN) on body composition were studied in a randomised series of patients undergoing major colorectal surgery. Ninety-two patients (colorectal cancer: 50, ulcerative colitis or Crohn's disease: 42) were grouped according to diagnosis and clinical inflammatory activity. TPN was given for 9.7 +/- 1.1 days. The complication rate was not changed by the TPN. Nitrogen balance was studied during the first week. Body weight, total body potassium, triceps skinfold, serum albumin and body water were measured before and at intervals up to 24 weeks after the operation. Cumulative nitrogen balance in control patients at 7 days after surgery was -47.3 g. Patients given TPN balanced nitrogen intake and output (cancer patients and patients with quiescent inflammatory bowel disease, IBD) or were in positive balance (patients with active IBD). Weight loss at 1 week after surgery was less in TPN patients compared to controls and this difference remained statistically significant up to 6 months after termination of the nutritional treatment. A similar, although not statistically significant, difference was noted in total body potassium and triceps skinfold. Patients with active IBD regained pre-operative body composition earlier than cancer patients and patients with quiescent IBD. It is concluded that TPN after major colorectal surgery reduces postoperative weight loss and that this effect lasts after termination of the nutritional treatment. In the absence of increased body potassium and increased body water, we conclude that the long-term effect of TPN on body weight is most likely due to preservation of fat.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The immediate and long-term effects of postoperative total parenteral nutrition on body composition. 311 32

A total of 541 open access referrals for fibresigmoidoscopy over five years were compared with 495 hospital initiated procedures during the same period. The number of open access fibresigmoidoscopies doubled during the five years but diagnostic yield remained unchanged at about 40% and was similar to that of the hospital initiated procedures. Colorectal carcinoma was seen in 64 open access patients compared with 47 hospital referred patients, the proportion of Dukes's type A lesions being similar (34%) in both groups. Polyps, colitis, and diverticular disease were equally common in open access and hospital referred patients. Fibresigmoidoscopy failed to detect disease in only 12 patients (1.2%) and the procedure was unsatisfactory in only 54. Referral was considered justified in 475 (88%) open access patients, and only 54 (17%) patients with normal appearances at endoscopy required further investigations. Diagnostic yields were low (19%; 30/156 cases) in open access patients under 40 and in patients with abdominal pain, constipation, or abdominal pain with constipation (0-17%). Most of these young patients presumably suffer from the irritable bowel syndrome and do not justify fibresigmoidoscopy. In contrast, there was a high diagnostic yield (90-100%) in patients of all ages referred for diarrhoea and rectal bleeding, altered blood from the rectum, and rectal bleeding associated with abdominal pain. Open access fibresigmoidoscopy is an effective service that should be freely available to general practitioners.
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PMID:Open access fibresigmoidoscopy: a comparative audit of efficacy. 313 21

Mucus secreted by colorectal cancer differs in three respects from that produced normally: an overall reduction, a loss of O-acetyl substituents in sialic acid, and an increase in neutral mucin. Similar changes have been reported in apparently normal mucosa bordering colorectal cancer. "Normal" left sided colorectal mucosa from 32 patients with rectal cancer was studied. Each case was matched by age and sex to a patient with diverticular disease and a patient with irritable bowel syndrome. Twenty five patients with right sided cancer were matched to patients with Crohn's disease. Sections were stained with mild periodic acid Schiff (mPAS) (selectively stains N-acetyl sialic acid lacking in O-acetyl group) and other closely related techniques. Reactions were graded negative, weak, and intense. An intense reaction was found in 9% of cases; there was no difference between the various matched groups. Phenylhydrazine interposition failed to block the mPAS effect, indicating that a positive result was due to a deficiency of sialic acid with O-acetyl substituents rather than neutral mucin. Different staining patterns in left and right colon were probably due to differing ratios of total sialic acid:fucose. These findings indicate a hitherto unsuspected colorectal goblet cell sialomucin heterogeneity within the general population, but no association with neoplastic disease is apparent.
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PMID:Colorectal goblet cell sialomucin heterogeneity: its relation to malignant disease. 378 84

Previous studies have suggested that patients with Barrett's oesophagus may be at increased risk of colorectal neoplasia, though the association is disputed. In a multicentre prospective study we compared the prevalence of colorectal adenomas in patients with Barrett's oesophagus and controls. Barrett's oesophagus patients (n = 104) had histological confirmation of columnar epithelium extending more than 3 cm above the gastro-oesophageal junction. The 537 controls were patients with symptoms suggesting irritable bowel syndrome. No participant had a personal history of colonic neoplasm. Each patient underwent colonoscopy. Histologically proven adenomas were found in 26 Barrett's patients (25%) and 75 controls (14%). Three colorectal cancers were discovered in each group. The prevalence of adenomas was greater in the Barrett's oesophagus group than in the control group (p < 0.01) but the relation became non-significant after adjustment for age and sex and control for other known risk factors by a logistic regression model (odds ratio 1.4 [0.7-2.7]). The relative risk of adenoma was significantly higher in patients older than 59 than in younger patients (2.2 [1.3-3.5]) and in men than in women (3.4 [2.0-5.7]). Other factors contributing significantly to the risk of adenoma were a family history of colorectal cancer (2.3 [1.1-4.8]), rectal bleeding (2.1 [1.1-3.9]), previous colonic investigation (0.3 [0.1-0.7]), and complete as opposed to partial colonoscopy (6.4 [0.8-48.3]). We conclude that Barrett's oesophagus is not an independent risk factor for colorectal neoplasia and, therefore, is not, in itself an indication for colorectal screening.
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PMID:Multicentre prospective controlled study of Barrett's oesophagus and colorectal adenomas. Groupe d'Etude de l'Oesophage de Barrett. 853 84

The diagnostic accuracy for colorectal cancer (CRC) of rigid sigmoidoscopy and faecal occult blood test (Hemoccult-II) (H-II) was investigated in patients with irritable bowel syndrome in general practice in a three year period and the results were compared with those of the previous three years, where rigid sigmoidoscopy and double contrast barium enema (DCBE) were the initial preferred examinations. Colonoscopy was recommended in patients with positive H-II, but also in patients with repeated negative H-II within three months, provided that the symptoms persisted. CRC was detected in 141 of 630 patients with positive H-II and in 52 of 8697 with negative H-II. The number of CRC's in the two study periods was similar, in spite of a pronounced reduction in DCBE's from 12,196 to 5656 and a small increase in colonoscopies from 3053 to 4127. It was concluded that the new strategy was no worse than the previous one and the major savings in DCBE's could be used to exchange the rigid sigmoidoscopy with a 60 cm flexible sigmoidoscopy, increasing diagnostic accuracy, shortening delay of diagnosis and removing more adenomas, which eventually may reduce the future incidence of CRC and thereby the mortality from CRC.
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PMID:[Rectoscopy and Hemoccult-II as initial diagnosis. A procedure in patients with symptoms of irritable colon]. 799 11

In recent years, many health claims have been made about dietary and supplemental fiber. However, some reports (eg, those regarding oat bran) have been controversial. A review of scientifically rigorous studies shows that fiber has some preventive or therapeutic benefits in irritable bowel syndrome, diverticulosis, colorectal cancer, diabetes, and hypercholesterolemia. However, it appears to have no direct benefit in patients with inflammatory bowel disease, gallstones, or obesity. The United States has one of the lowest per capita intakes of fiber in the world. Therefore, increasing daily fiber intake either through diet or with supplements is recommended for most Americans. Consumer interest groups should lobby for more fiber-enriched foods. The challenge for education and healthcare professionals alike is to remold the nation's interest in and understanding of dietary fiber.
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PMID:Benefits of dietary fiber. Myth or medicine? 863 64

Individuals with chronic ulcerative colitis are at increased risk of developing colorectal carcinoma, particularly if there is long-standing disease or extensive colitis. It is generally accepted that the risk of colorectal cancer does not begin until 8 to 10 years after the time of diagnosis of ulcerative colitis. Thereafter it increases by approximately 0.5% to 1.0% per year. In patients with Crohn's disease, the risk of malignancy is smaller and less well defined. The most significant predictor of the risk of malignancy in patients with inflammatory bowel disease is the presence of dysplasia in colonic biopsies. There is considerable controversy in the literature regarding the efficacy of colonoscopic surveillance programs and the role of prophylactic surgery to prevent colorectal cancer. Surveillance certainly fails to detect carcinoma in some patients who are having regular colonoscopy. Concerns have also been raised as to the cost-benefit of colonoscopic surveillance in patients with colitis. Randomized controlled trials of surveillance programs are highly unlikely in view of the low prevalence of IBD in the population, the long period of observation required, and the probability of contamination of surveillance programs by colonoscopy for assessment of disease activity. Despite the lack of clear guidelines, surveillance colonoscopy and biopsy continues to be widely practiced. Research is proceeding to identify genetic and biochemical markers that may prove clinically useful for predicting cancer risk. At present, however, surveillance programs are likely to continue according to institutional practice. It is important for those participating in such programs to be aware of the limitations of colonoscopy and biopsy as a means of reducing the risk of cancer in inflammatory bowel disease.
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PMID:Cancer and inflammatory bowel disease: bias, epidemiology, surveillance, and treatment. 952 16

Endogenously formed nitrogen and oxygen free radicals are believed to be involved in human cancer etiology. Plasma nitrate/nitrite originates from endogenous nitric oxide production in fasting humans, decrease in superoxide scavenger activity (SSA), and free sulfhydryl groups (SH) reflects the amount of superoxide anion generated, and nitrotyrosine is believed to be formed by the interaction of tyrosine and peroxynitrite in vivo. The aim of the current study was to measure plasma nitrate/ nitrite, SSA, and SH in 69 patients (mean age +/- standard deviation, 66 +/- 11 years) with colorectal carcinoma. Nitrotyrosine was measured from both the plasma and tumor tissues in 32 patients. All patients had adenocarcinoma of the colon or rectum. Twenty-five patients were classified as stage B according to Dukes classification as modified by Astler-Coller, 13 were classified as stage C, and 31 patients were classified as stage D. To determine whether the changes are specific for colorectal cancer, 20 patients with active inflammatory bowel disease (IBD; mean age, 52 +/- 18 years) and 30 healthy volunteers, who served as control subjects (mean age, 48 +/- 11 years), were studied. Plasma nitrate/nitrite was measured by the modified Griess method, SSA was measured by an electron/spin resonance spin trapping method, free SH was measured by Ellman's method, and the presence of nitrotyrosine in the plasma and tumor tissue was detected by high performance liquid chromatography (HPLC) using C- 18-derivatized silica (5 microm) column (C18S, Crestpaque, New York, NY, USA) and at a wavelength of 274 nm. Patients with colorectal carcinoma and with active IBD had a significantly higher plasma nitrate/ nitrite level (51.2 +/- 26.2 microm and 56.0 +/- 14.6 microm versus. 29.6 +/- 6.3 microm; p < 0.01), and a lower SSA level (39 +/- 11.5 U/g protein and 52.0 +/- 18.9 U/g protein versus. 88 +/- 25.1 U/g protein; p < 0.05) and SH level (7.7 +/- 3.89 microm protein and 6.4
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PMID:Evidence of in vivo peroxynitrite formation in patients with colorectal carcinoma, higher plasma nitrate/nitrite levels, and lower protection against oxygen free radicals. 1063 9

Low-digestible carbohydrates represent a class of enzyme-resistant saccharides that have specific effects on the human gastrointestinal tract. in the small bowel, they affect nutrient digestion and absorption, glucose and lipid metabolism and protect against known risk factors of cardiovascular disease. In the colon they are mainly degraded by anaerobic bacteria in a process called fermentation. As a consequence, faecal nitrogen excretion is enhanced, which is used clinically to prevent or treat hepatic encephalopathy. Low-digestible carbohydrates are trophic to the epithelia of the ileum and colon, which helps to avoid bacterial translocation. Short-chain fatty acids are important fermentation products and are evaluated as new therapeutics in acute colitis. They are considered in the primary prevention of colorectal cancer. The bifidogenic effect of fructo-oligosaccharides merits further attention, Unfermented carbohydrates increase faecal bulk and play a role in the treatment of chronic functional constipation, symptomatic diverticulosis and, possibly, the irritable bowel syndrome. In conclusion, low-digestible carbohydrates may play a role in the maintenance of human digestive health. However, the strength of evidence differs between disease entities.
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PMID:Beneficial health effects of low-digestible carbohydrate consumption. 1132 Oct 25


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