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Query: UMLS:C0021390 (inflammatory bowel disease)
 23,302 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A personal series (E.S.R.H.) of 37 patients with inflammatory bowel disease, treated by colectomy and ileorectal anastomosis 15 years or more ago, is reviewed. Twenty-one patients (57 per cent) continue to be in satisfactory condition. Patients subjected to the two-stage operation have a notably lower rate of conversion to ileostomy than those treated by one-stage colectomy. One patient developed a carcinoma of the rectal stump. This 15-year review leads support to the opinion that ileorectal anastomosis has an important place in the treatment of inflammatory bowel disease.
Dis Colon Rectum 1979 Sep
PMID:Ileorectal anastomosis for inflammatory bowel disease: 15-year follow-up. 49 96

One hundred fifty-one cases of patients who underwent proctectomy for inflammatory bowel disease at the Lahey Clinic were analyzed with respect to the factors that predispose to delay in perineal wound healing. Significantly poorer healing took place in patients with Crohn's colitis, in men with ulcerative colitis, and in patients with ulcerative colitis who underwent one-stage operations. Factors that were not statistically significant but that appeared to contribute to delay in healing were younger age of patients and presence of anal fistula. A comparison is made with the results of other series, and recommendations for treatment and prevention are presented.
Dis Colon Rectum 1978 Apr
PMID:Perineal wound healing after proctectomy for inflammatory bowel disease. 64 97

During 1964 through 1973, 76 men underwent abdominoperineal resection as part of or subsequent to resection for inflammatory bowel disease. No instance of permanent impotence was found. Proctectomy should not be deferred because of the risk of impotence.
Dis Colon Rectum 1978 Sep
PMID:Impotence after proctectomy for inflammatory disease of the bowel. 69 39

We have reported long-term results in the cases of 42 patients following total colectomy and ileorectal anastomosis for inflammatory bowel disease. In this group, 35 patients had Crohn's disease and seven had ulcerative colitis. Five of those seven patients with ulcerative colitis had carcinoma of the colon at the time of colectomy. A diverting loop ileostomy was constructed in 14 of the 35 patients who had Crohn's colitis at the time of operation, and none of these patients had any anastomotic leakage either before or after the ileostomy was closed. However, there patients with Crohn's colitis in whom anastomotic leaks developed postoperatively; all three patients died. In the group with ulcerative colitis, one patient had an anastomotic leak but there was no operative nortality. Of the 29 patients with Crohn's disease followed for one to 18 years, 12 (41 per cent) developed recurrences in the ileum and/or rectum, and seven of these patients had to have their anastomoses taken down.
Dis Colon Rectum 1977 Mar
PMID:Ileorectal anastomosis for inflammatory disease of the colon. 84 95

From 1964 to 1973, 50 patients who initially underwent ileostomy for inflammatory bowel disease at the Lahey Clinic required 84 revisions. The commonest reason for revision was stenosis. Fistula, prolapse, and retraction followed in order of frequency. Patients with Crohn's disease seemed to have a higher incidence of revision, but this was not statistically significant. Other reasons for revision were analyzed, and recommendations for treatment were discussed. Retrospective study revealed that 50% of ileostomy revisions were performed for probably preventable complications.
Dis Colon Rectum 1977 Apr
PMID:Ileostomy complications requiring revision: Lahey clinic experience, 1964-1973. 84 90

A survey of 47 Israeli ileostomates known to the Israel Ostomy Association was performed. The outstanding features are 1) a low (5 per cent) referral rate of patients with inflammatory bowel disease for procto colectomy and ileostomy; 2) a high (64-85 per cent) incidence of cutaneous problems; 3) a low rate of rehabilitation, as measured by return to previous occupation, sexual life and social adjustment. However, our 47 ostomates were operated on 14 institutions in five countries and live in a subtropical climate-factors that may negatively affect the outcome. Since the study, the situation has improved.
Dis Colon Rectum 1977 Sep
PMID:Ileostomates in Israel. 90 44

Neuropeptides form a part of the brain-gut axis which may regulate gastrointestinal functions, including immune regulation. Various changes in the neuropeptides--most important, vasoactive intestinal peptide and substances P (VIP and SP)--have been described in inflammatory bowel disease. We employed a sensitive immunoperoxidase (avidin-biotin-peroxidase complex) technique, using anti-VIP and anti-SP antibodies to localize and compare the distribution of VIP and SP in the colon. Colon specimens from 19 normal subjects, eight patients with ulcerative colitis (UC), and eight with Crohn's disease (CD) were used. In the normal colon, VIP and SP immunoreactivity (IR) were localized in the muscularis mucosa, circular muscles, walls of blood vessels, nerve fibers, and some distinct cells, probably enterochromaffin cells. SP-IR was also present in the epithelial cells, mainly along the basolateral domain. VIP-IR was considerably diminished at all locations in patients with UC and CD. However, the SP-IR was increased in UC in the colonic epithelial cells along the basolateral areas. The SP-IR was intense in patients with CD, in the epithelium, the granulomas, cells lining the mucosal fissure, and in the muscle layers. In contrast to normals, SP-IR in patients with CD was observed both in the longitudinal and circular muscles. We conclude that VIP-IR and SP-IR are distributed widely in the mucosa, submucosa, and in the circular muscle in normal colon. VIP-IR is decreased in UC and CD, whereas SP-IR is increased in both, but more so in CD.
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PMID:Immunocytochemical localization of vasoactive intestinal peptide and substance P in the colon from normal subjects and patients with inflammatory bowel disease. 137 Aug 72

Temporary diverting loop ileostomy is a generally accepted component of the ileal pouch-anal anastomosis (IPAA) procedure. Ileostomy closure is usually performed within two to three months but may be delayed because of disruption of the ileonanal anastomosis, suspected leak from the ileal reservoir, concomitant medical problems, or patient convenience. Of 362 patients undergoing IPAA at The Cleveland Clinic Foundation for inflammatory bowel disease, 10 have had their ileostomy closures delayed for more than six months. Clinical and manometric parameters are examined in these patients and compared with those who had earlier closure. There appears to be no significant difference in the functional outcome of IPAA in these patients in terms of number of bowel movements and degree of continence. Reservoir compliance and maximum tolerated volumes are similar. We conclude that delaying ileostomy closure for more than six months after IPAA has no deleterious effect on pouch function.
Dis Colon Rectum 1992 Sep
PMID:Consequences of delayed ileostomy closure after ileal pouch-anal anastomosis. 151 48

The diagnosis of inflammatory bowel disease (IBD) in a proband increases the probability of a parallel IBD diagnosis in a family member. In this study, we were able to confirm the IBD diagnosis in 35 (9.9 percent) of the relatives of 352 registry probands. To confirm a proband's report of a positive family history of IBD, efforts were made to directly contact all first-degree relatives regardless of their IBD status (parents, siblings, and children). Consent to contact family members was obtained from the proband, who furnished the registry personnel with names, addresses, and phone numbers. We then attempted to contact each identified relative by phone. After verbal consent was obtained, family members were asked if they had been diagnosed with IBD. This diagnosis was confirmed by contacting the relative's physician. A McNemar (chi 2 Mc) matched-pair analysis was used to analyze concordance between the proband and the affected family member. Within the CD/CD (Crohn's disease) concordant pairs, sex was a significant risk factor. Sex was not a significant risk factor within the UC/UC (ulcerative colitis) concordant pairs. In the concordant surgery pairs, no surgical procedure was a significant risk factor for the prediction of a similar surgical procedure for the affected relative. In concordant extraintestinal complications, only the appearance of a skin rash was significantly related to the appearance of a skin rash in the affected relative.
Dis Colon Rectum 1992 May
PMID:Concordance of familial characteristics in Crohn's disease and ulcerative colitis. 156 91

Over the past decade, awareness of the association between portal hypertension and changes in the intestinal circulation has increased. Most of the observations have been made by endoscopic examination and biopsy of the mucosa. The fundamental pathologic change is a vasculopathy. Portal hypertensive intestinal vasculopathy (PHIV) most often involves the stomach (gastropathy) and can be a common source of bleeding. The significance of small bowel involvement (enteropathy) is unknown. Colon involvement (colopathy) has been associated with bleeding, and mimics inflammatory bowel disease. The reliability of endoscopic appearances and histologic examination in establishing the diagnosis is questionable. Recent observations of other diagnostic modalities and associated physiologic alterations and treatment options are discussed. Further prospective evaluations that use uniform terminology for endoscopic and histologic descriptions are needed to establish criteria for accurate diagnosis and assessment of response to treatment.
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PMID:Portal hypertensive intestinal vasculopathy: a review of the clinical, endoscopic, and histopathologic features. 843 62


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