Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010346 (Crohn's disease)
 21,615 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

By measuring total faecal radioactivity, correlated to 24-hour enterohepatic circulation, following i.v. administration of 14C-cholic acid, bile salt malabsorption was evaluated before and/or after surgery in 80 patients with Crohn's disease localized to the ileum and/or the colon and the results related to the length of ileum diseased or resected. Before operation bile salt malabsorption was observed only in patients with inflammation of the terminal ileum, but no significant correlation was found between bile salt excretion and the extent of ileal disease. In patients subjected to ileal resection with sacrifice of the ileocaecal valve, bile salt malabsorption correlated strongly to the length of ileum resected. This correlation was about the same in ileostomy patients and in patients subjected to restorative operation. We concluded that determination of 14C in faeces is a more sensitive test than the Schilling test and the faecal fat excretion test in reflecting ileal dysfunction, at least in patients with ileal resections.
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PMID:Determination of the faecal excretion of labelled bile salts after i.v. administration of 14C-cholic acid. An evaluation of the bile salt malabsorption before and after surgery in patients with Crohn's disease. 63 64

Urinary oxalate excretion was studied in healthy subjects and before and after surgery in patients with Crohn's disease. Urinary oxalate excretion in relation to the length of diseased or resected ileal segment in patients subjected to restorative and colectomy procedures, as well as in relation to faecal excretion of fat and bile salts and to urinary excretion of vitamin B12 and calcium, was also studied. The studies were performed in patients on a free diet or standard hospital diet and on a high-oxalate and/or high-fat diet. When patients subjected to ileal resection in conjunction with minor colonic resection were studied on a high-oxalate diet, urinary oxalate excretion increased with length of ileum resected and correlated with faecal fat excretion and urinary excretion of vitamin B12 but not with faecal excretion of bile salts. Increasing the dietary fat intake in these patients further increased urinary oxalate excretion. Although urinary oxalate excretion increased somewhat in colectomized patients on a high-oxalate diet, indicating an increased absorption of dietary oxalate, this increase showed no correlation either to faecal fat or bile salt excretion, or to urinary excretion of vitamin B12. The result are consistent with the "solubility theory". A diet low in fat and oxalate and high in calcium is recommended in patients with hyperoxaluria.
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PMID:Urinary oxalate excretion related to ileocolic surgery in patients with Crohn's disease. 67 58

14C-glycocholate breath-tests were performed in 22 clinical patients without gastointestinal disorders, in 11 cases with M. Crohn of the ileum and in 8 patients, in whom an intestinal overgrowth with bacteria was suspected. Additional to the usual discontinuous measurement of the specific activity of 14CO2 the exhaled amount of CO2 and 14CO2 and 14C-serum activity were determined. No advantage was found in the determination of the latter; for 1. discontinuous measurement of the specific activity of 14CO2 was sufficient for detecting disturbed enterohepatic bile-salt circulation; and 2. measurement of 14C-serum-activity or 14C-activity in cholic acids or protein were of no help in differentiating between bacterial overgrowth and diseases of the ileum. There remained doubts regarding the clinical usefulness of the test. Low specificity and many positive tests in patients without corresponding symptoms require that therapeutical procedures in such patients are initiated with some reserve.
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PMID:[Performance and clinical usefulness of the 14CO2-glycocholate-breath-test]. 87 46

Electrolyte and water movement was studied by steady state perfusion technique in the ileum of 11 patients with regional ileitis (Crohn's disease). Six patients who at the time of investigation had diarrhoea showed a constant secretion of salts and fluid during perfusion with control perfusate. Per 24 hours, the ileal effluents to colon would exceed the normal amount by 1-2 litres. In the 5 patients without diarrhoea the absorption patterns were normal. Electrolytes and water moved in parallel. Dihydroxy bile acids enhanced secretion or decreased absorption respectively, in the two groups of patients. It is concluded that functional disturbances of salt and water absorption in the inflamed ileum may be of significant physiological importance in the pathogenesis of diarrhoea observed in patients with regional ileitis.
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PMID:Regional ileitis (Crohn's disease). II. Electrolyte and water movement in the ileum during perfusion with bile acids. 95 62

1. The incidence of gallstones in patients with Crohn's disease is increased compared with that in healthy control subjects. This is in part due to reduced terminal ileal bile salt absorption and consequent increased cholesterol saturation in bile. The aim of this study was to evaluate gallbladder contractility, a second important factor in the pathogenesis of gallstones, in Crohn's disease. 2. Thirty patients with Crohn's disease and no known biliary tract disease and nine healthy control subjects were studied. After an overnight fast, gallbladder volume was determined by real-time ultrasonography before and 10, 20, 30, 40, and 50 min after ingestion of a standard liquid fatty meal. 3. Compared with healthy control subjects, patients with Crohn's disease had similar fasting gallbladder volumes (control, 18.7 +/- 2.3 ml; Crohn's disease, 18.2 +/- 2.3 ml). Percentage emptying was significantly impaired at 30, 40 and 50 min in patients with Crohn's disease compared with control subjects. Patients with Crohn's disease limited to the small bowel had gallbladder contractility that was comparable with that of control subjects, whereas in those with large-bowel disease, minimum residual gallbladder volume was significantly smaller than in control subjects. Patients with both large- and small-bowel Crohn's disease demonstrated the most marked abnormalities, with gallbladder volumes significantly larger than those of control subjects at 30, 40 and 50 min. Likewise, patients with Crohn's disease who had undergone previous bowel resection had impaired emptying at 30, 40 and 50 min.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impaired fatty-meal-stimulated gallbladder contractility in patients with Crohn's disease. 133 39

Gallstones are usually present in patients with Crohn's disease involving the distal ileum. This may be due to disturbances of the enterohepatic circulation, with bile salt malabsorption and secondary precipitation of cholesterol in the gallbladder. The article describes three patients who were cholecystectomized for cholelithiasis, and where Crohn's disease was found incidentally during laparotomy.
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PMID:[Crohn disease found incidentally during cholecystectomy. Report of 3 cases with pronounced biliary tract problems]. 186 26

Previous reports of a selective mucin subclass defect in ulcerative colitis have been reassessed using high performance chromatography (Superose 6 and Mono Q) for mucin purification and fractionation coupled with analysis of the fractions obtained using a combination of enzyme linked lectin and mucin antibody assays. Mucin samples purified from snap frozen rectal biopsy specimens obtained from patients with ulcerative colitis (n = 12), Crohn's disease (n = 5), and non-inflammatory bowel disease control subjects (n = 9) were subject to ion exchange chromatography using a continuous 0-0.35 mol/l NaCl salt gradient with a final 2.5 mol/l NaCl step. In all samples the major proportion (mean (SD) 86.7 (8.9)%) of the mucin detectable by wheat germ agglutinin binding eluted between 0.15 and 0.35 mol/l NaCl with no significant difference in elution profile between ulcerative colitis and control subjects. Significant elution of glycoprotein at less than 0.15 mol/l NaCl did occur, however, when a lower molecular weight mucin containing fraction which contained concanavalin A positive (glucose or mannose containing) material was analysed similarly. Similar ion exchange profiles were obtained when (3H)N-acetylglucosamine labelled mucins were studied after tissue culture of rectal biopsy specimens. No significant alteration in the ion exchange profile of purified mucins in ulcerative colitis has been shown in these studies. It is possible that the previously reported relative depletion of mucin subclass IV (eluting with 0.20 mol/l NaCl) may simply have reflected mucin depletion.
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PMID:Ion exchange chromatography of purified colonic mucus glycoproteins in inflammatory bowel disease: absence of a selective subclass defect. 195 68

Analysis of a modified 14C-glycocholate breath test on 165 consecutive in-patients being investigated for chronic diarrhea showed that the measurement of 14CO2 between 3 and 6 h after oral dosing of 5 microCi of 14C-glycocholic acid was of only limited use to distinguish between patients with Crohn's disease (CD), idiopathic bile salt wastage (IBW), or ileal resection (IR) from those with the irritable bowel syndrome (IBS). Continuing 14CO2 collections for up to 24 h was of little more help in establishing the presence of bacterial overgrowth syndrome (BOS) and in distinguishing between BOS and CD. Stool bile acid measurements were of use in differentiating between IBW and IBS, but did not distinguish between CD and BOS or between CD and IR. Since the range of normal values was defined by measurements in the IBS group, a positive test was specific for an organic cause of chronic diarrhea. Even so, the sensitivity of the test was relatively low: CD, 53%; IR, 23%; IBW, 14%; and BOS, 10%. We believe that the 24-h 14C-glycocholic breath test combined with the measurement of stool bile acids represents a screening test of only limited use for the identification of organic causes of chronic diarrhea.
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PMID:Limitations in the use of 14C-glycocholate breath and stool bile acid determinations in patients with chronic diarrhea. 309 Jan 33

In a consecutive series of 107 patients operated on for Crohn's disease involving the distal ileum, the overall incidence of gallstones was 17% and of renal stones 12%. Whereas the frequency of gallstone disease was 9% in patients with minor resections, patients with more than 100 cm diseased or resected small bowel had a frequency of 35%. The probability of gallstone development in both sexes was calculated to be approximately 50% after 20 years of distal ileopathy. The frequency of renal stone disease in patients with minor resection was comparable to that of a population in Sweden but was significantly commoner in patients with resection of more than 100 cm (28%), provided they were not colectomized. The high frequency of stone disease after resection of distal ileum is attributed to metabolic disturbances due to steatorrhea and bile salt malabsorption.
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PMID:Cholelithiasis and urolithiasis in Crohn's disease. 357 31

Several factors play a role in the cause of malabsorption in CF. Besides the enzyme deficiency in the secretion of the exocrine pancreas, decreased bile-salt concentration in the gut may also be an important factor in the fat malabsorption. The contribution to the fat absorption by other lipases, such as lingual lipase and gastric lipase, remains to be proved. The therapeutic measures are only partly effective because of the breakdown of swallowed enzymes by gastric acid. Some improvement is reached by using a new acid-resistant coating for the enzyme supplement. Newly developed and essential for its success is the application of small coated particles to prevent retention in the stomach, and the easy breakdown of the coating in an alkaline solution. The treatment of the bile salt deficiency has not been successful until now. A trial with additional Tween 80, with the option of supplementing the detergent activity which was found to be successful in Crohn disease, was without marked success.
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PMID:Problems in the treatment of malabsorption in CF. 386 58


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