Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011991 (diarrhea)
 57,543 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Activated T cells can be visualized in the intestinal lamina propria in a number of gastrointestinal diseases including food-sensitive enteropathy (coeliac disease), inflammatory bowel disease and intractable diarrhoea of infancy. Experimental studies have shown that T-cell activation in human intestinal lamina propria in vitro produces an increase in crypt cell proliferation, villous atrophy, increased HLA-DR expression on enterocytes, increased intra-epithelial lymphocyte numbers, and phenotypically, macrophage activation. All of these features are seen in human gastrointestinal disorders and it is proposed that T-cell activation to wheat (in coeliac disease), milk (cows' milk-sensitive enteropathy), and unidentified luminal antigens (Crohn's disease) plays a primary role in the pathogenesis of these disorders.
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PMID:The role of activated T lymphocytes in gastrointestinal disease. 219 36

Diarrhea is one manifestation of GI disturbance. Symptoms may be acute if caused by such things as infections, drug reactions, alterations in diet, heavy metal poisoning, or fecal impaction. Chronic diarrhea is a symptom of GI diseases such as irritable bowel syndrome, lactase deficiency, cancer of the colon, inflammatory bowel disease, and malabsorption diseases. Chronic diarrhea may also be associated with GI surgery, radiation therapy, laxative abuse, alcohol abuse, and chemotherapeutic agents. When interventions are required to deal with diarrhea, they may include such things as alteration in tube feeding products and methods of administration, fluid replacement by oral rehydration procedures, a rapid return to feeding, and education aimed at the health information clients need to prevent or control the symptom of diarrhea.
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PMID:Diarrhea. 223 42

THe recent trend toward decreased dosages of estrogen and progestogen in oral contraceptives (OCs) makes it especially important that attention be directed toward additional factors-- dietary factors, gastrointestinal disturbances or diseases, or drugs that interact with OCs--that may further reduce the bioavailability of steroids and thus compromise contraceptive protection. At present, there is no evidence that antibiotics interfere with OC steroids at the level of enterohepatic circulation; also unlikely is a clinically significant interaction between OCs and antacids. Unlike estrogens, progestogens do not undergo enterohepatic recirculation as unchanged drugs; presumably due to the lack of direct conjugation at the 17 position. Thus, no impact on contraceptive efficacy is produced by disruptions in progestogen metabolism. On the other hand, there is an ample body of research suggesting a link between OCs and chronic inflammatory bowel disease, especially Crohn's disease. The finding of reduced bioavailability of estrogen and progestogen in women who have undergone jejunoileostomy demonstrates that OCs are mainly absorbed in the small bowel and that contraceptive efficacy is related to its absorptive capacity. Overall, it is recommended that careful attention be given to OC acceptors with chronic inflammatory disease, non-colonic diarrhea, ileostomy, and jejunoileal bypass.
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PMID:Gastrointestinal disease and oral contraception. 225 27

Serum samples from 20 Indian children with diarrhoea were compared with those from 20 children resident in the United Kingdom who had been diagnosed as having ulcerative colitis, or Crohn's disease, or indeterminate colitis using enzyme linked immunosorbent assays specific for Entamoeba histolytica and Giardia lamblia. More than 50% of the United Kingdom patients had high IgG responses in ELISAs for E histolytica and G lamblia. A confirmatory ELISA showed that the British sera reacted specifically to bovine serum proteins rather than to protozoal antigens. Prior incubation of sera with 5% bovine serum prohibited this reaction. Bovine serum is an integral part of the crude soluble antigen used in most ELISAs for E histolytica and G lamblia and needs to be replaced with purified antigen preparations. The British sera also reacted to other commonly used blocking agents such as bovine serum albumin, casein, and normal sheep serum. These reactions were attributed to uptake of dietary antigens or an enhanced immunological response to these antigens in patients with inflammatory bowel disease.
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PMID:Non-specific reactions in enzyme linked immunosorbent assays for serum antibody to entamoeba histolytica and Giardia lamblia in non-endemic areas. 226 68

39 missionaries working at 38 separate mission hospitals or clinics in Bangladesh. India, Nepal and Pakistan completed questionnaires about their clinical practice during the previous year, 1980. Data were collected about gastrointestinal disorders, including coeliac disease, tropical sprue, bloody diarrhoea, amoebiasis, typhoid, cholera, inflammatory bowel disease and diverticular disease. More than 386,000 out-patients and over 56,000 in-patients were treated with an estimated 12,272 cases of bloody diarrhoea, 7,310 of amoebiasis, 2,113 of typhoid and 872 cases of intestinal tuberculosis, 74 cases of inflammatory bowel disease were diagnosed, of which 56 were ulcerative colitis and the remainder were said to have Crohn's disease. Surgery was performed in 28 hospitals, but only 10 (26%) had a histology service. Inflammatory bowel disease appears to be a relatively more common cause of diarrhoea in the Indian subcontinent than in sub-Saharan Africa (z = 5.47, p less than 0.001). The proportion of patients with bloody diarrhoea who have ulcerative colitis Crohn's disease was similar throughout the region. The rate of cases having ulcerative colitis rather than Crohn's disease was greater in India (z = 3.1, p less than 0.005), and in Bangladesh (z = 3.2, p less than 0.005), than in Pakistan (z = 1.28, NS) or Nepal and Bhutan (z = 0, NS). The relative risk of Indians developing ulcerative colitis rather than Crohn's disease is 2.6 (95% confidence limits 1.4-4.8, NS). This may reflect diagnostic difficulties in distinguishing Crohn's disease from intestinal tuberculosis, but it may also shed light on similar differences now being reported in migrant groups in Western Europe.
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PMID:Inflammatory bowel disease in the rural Indian subcontinent: a survey of patients attending mission hospitals. 229 48

Immunohistochemical techniques were used to investigate the epithelial expression of VLA-1 in inflammatory bowel disease in six patients with Crohn's disease, in four patients with ulcerative colitis, and in one patient with indeterminate colitis, and compared with that in the small intestine and colons of 10 normal controls. In normal small bowel VLA-1 was expressed on crypt epithelial cells and only weakly or not at all on surface epithelium. VLA-1 was again expressed weakly in normal colon, except in one case, a 1 year old child with diarrhoea but no histological abnormalities. In small and large intestine affected with Crohn's disease, ulcerative colitis, or indeterminate colitis, there was increased expression of VLA-1 on the basolateral aspects of crypt cells and de novo expression on surface epithelium. It is suggested that this is an adaptive response to prevent epithelial cell loss as a result of inflammation in the underlying lamina propria.
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PMID:Increased expression of laminin/collagen receptor (VLA-1) on epithelium of inflamed human intestine. 234 67

In temperate, developed countries, the principle indications for surgical intervention in inflammatory bowel disease are 1) for the removal of bowel severely damaged by acute or chronic colitis, either Crohn's disease or ulcerative colitis; and 2) for small-bowel Crohn's disease, to overcome the effects of fibrous stenosis and its sequelae, such as abscess or fistula. Unresponsive acute colitis that necessitates emergency surgical intervention involves a total colectomy, end ileostomy, and a mucous fistula of the rectosigmoid above the symphysis pubis. Once the diagnosis is confirmed, a pouch can be considered for patients with ulcerative colitis and an ileorectal anastomosis or proctectomy for those with Crohn's disease. For socially inconvenient colitis (when life with chronic colitis becomes intolerable because of urgency, frequency, or chronic ill health), the patient with ulcerative colitis can be offered proctocolectomy with pouch-to-anus anastomosis as a primary procedure, providing the anal sphincter and pelvic floor function normally. For patients with Crohn's disease, total colectomy and an ileorectal anastomosis can be considered if the rectum is not grossly diseased, and if the anal sphincter has a squeeze pressure of 100 cm and the rectum is capable of holding the balloon distended to 200 ml. It should be noted that better early medical therapy has already led to fewer operations for patients with acute colitis and that safer operations will tend to induce earlier referral for surgery; specifically, safer pouches will induce earlier referrals for patients who have chronic incapacitating diarrhoea. Despite improvement in medical control of the disease, small-bowel Crohn's disease will still tend to be associated with gradual stenosis of the bowel.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical aspects of inflammatory bowel disease. 235 69

Bloody diarrhea is a common problem in children. It is important to distinguish bloody diarrhea from other causes of rectal bleeding. Bacterial infections and parasitic infestations are responsible for most of the cases. Milk allergy is a frequent cause in young infants. Chronic inflammatory bowel disease occurs in older children. The cause is most often apparent after a thorough history and physical assessment is performed and the stool is examined for pathogens. Proctosigmoidoscopy with biopsy is the procedure of choice if the stool tests for pathogens are negative. A few children require further diagnostic evaluation by colonoscopy and/or radiographic procedures.
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PMID:Bloody diarrhea in children. 248 18

We have studied rectal potential difference (pd) in 200 subjects: 30 healthy volunteers or control patients, 46 patients with irritable bowel syndrome (IBS) and painless diarrhoea (group I), 60 IBS patients without diarrhoea (group II) and 64 patients with inflammatory bowel disease (IBD) with (group III, n = 41) or without (group IV, n = 23) rectal involvement. Pd measurement used a rectal perfused probe and a subcutaneous needle both connected, via agar-KCl bridges, to calomel electrodes and a millivoltmeter. Statistical analysis used Student's t-test for paired and unpaired data and Mann-Whitney U-test as appropriate. Mean rectal pd values were, respectively -43.5 +/- 8.7 mV in control group, -32.9 +/- 10.2 mV in IBS-group I patients (P less than 0.001), -41.3 +/- 12 mV in IBS-group II patients (NS), -21.4 +/- 14.1 mV in IBD patients with rectal involvement (P less than 0.001), and -45.1 +/- 14.3 mV in IBD-group IV patients (NS). A histological examination was performed in 36 IBS patients; mean rectal pd was significantly decreased in patients showing abnormal patterns (n = 27, pd = -31.8 +/- 9 mV) compared to patients with normal mucosa (n = 9, pd = -41.1 +/- 6.5 mV; P less than 0.01). These results show that: (1) potential difference is significantly decreased in patients with ulcerative and rectal involvement; (2) in patients with Crohn's disease, normal rectal pd values do not assess the appearance of colonic mucosa above; (3) patients with IBS and diarrhoea also present a significant diminution in mean rectal pd. Although the mechanisms involved remain unclear, rectal pd measurement appears to be an objective test for intestinal mucosae weakness in functional or inflammatory diseases of the large intestine and rectum.
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PMID:Rectal potential differences in irritable bowel syndrome and in inflammatory bowel diseases in man. 248 27

Mucosal Na,K-ATPase activity was studied in rectal biopsy specimens from 19 children with ulcerative colitis (UC) (mean age, 13 years) and 4 children with Crohn's colitis (mean age, 14 years) and compared with biopsy specimens from 12 control children (mean age, 12 years). The Na,K-ATPase activity was significantly decreased in UC with severe rectal inflammation compared with UC in remission or with children with unspecific symptoms and normal mucosa (p less than 0.001, respectively). A higher enzyme activity was shown with age in the group with normal rectal mucosa and no evidence of inflammatory bowel disease (n = 17). The decreased Na,K-ATPase in UC with severe rectal inflammation might contribute to the diarrhoea by impairment of sodium transport.
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PMID:Na,K-ATPase activity in rectal mucosa of children with ulcerative colitis and Crohn's disease. 255 82


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