Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021390 (inflammatory bowel disease)
 23,302 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Crohn's disease is often described as a contraindication to the construction of a Kock pouch (KP), but a consensus opinion is less definite. One hundred consecutive patients with a KP were reviewed after a minimum follow-up time of 2 1/2 years. The 95 patients with inflammatory bowel disease were analyzed for serious complications. All eight patients in whom the diagnosis of Crohn's disease or inflammatory disease of indeterminate type was made suffered serious complications requiring resections of the pouch or continuing treatment. By contrast, of the 87 cases with ulcerative colitis, only 17 (20 percent) had complications, six of which were readily and simply corrected. Our findings suggest that Crohn's disease should continue to be regarded as a firm contraindication to the KP procedure. It should be actively sought out preoperatively, and it should be treated aggressively if it is discovered after surgery. If such a patient requires further surgery, the KP should be removed.
Dis Colon Rectum 1993 Sep
PMID:Crohn's disease as a contraindication to Kock pouch (continent ileostomy). 837 25

Solitary rectal ulcer syndrome (SRUS) often goes unrecognized or is misdiagnosed. Of 98 patients with a final clinicopathologic diagnosis of SRUS, an initially incorrect diagnosis had been made in 25 patients (26 percent). In these 25 patients with a misdiagnosis, the median age was 43 years and the female-to-male ratio was 3.2:1. The median duration of incorrect diagnosis was five years (range, three months to 30 years), and seven patients received prednisone (> 30 mg/day) for a mistaken diagnosis of inflammatory bowel disease. The main clinical symptoms were rectal bleeding (84 percent) and a disturbance of bowel function (56 percent). Rectal prolapse was present in 13 patients. Original rectal biopsy specimens from 23 patients were reviewed; inadequate specimens and failure to recognize diagnostic features of SRUS contributed to delayed diagnosis in 13 and 10 patients, respectively. The most common clinicopathologic misdiagnoses in SRUS patients with rectal ulcers or mucosal hyperemia were Crohn's disease and mucosal ulcerative colitis. In patients with "polypoid" SRUS, diagnostic confusion was usually with a neoplastic polyp. Persistent bowel symptoms and rectal lesions led to review of the presentations and repeat biopsy directed toward the edge of the rectal ulcers or from within the polypoid or hyperemic rectal lesions, finally establishing the diagnosis of SRUS. Intractable symptoms led to surgery in 15 patients (60 percent), with symptomatic improvement in over two-thirds.
Dis Colon Rectum 1993 Feb
PMID:Clinical and pathologic factors associated with delayed diagnosis in solitary rectal ulcer syndrome. 842 18

A prospective study was performed to determine the incidence of colorectal neoplasia and inflammatory bowel disease in patients with benign anorectal disease. Over a three-year period, 102 consecutive patients who presented with hemorrhoids, fissure, fistula-in-ano, anorectal abscess, and anal condylomata and who did not have gastrointestinal symptoms underwent colonoscopy. The mean age of all patients was 53.5 years; males out-numbered females 1.6:1. No patient was found to have inflammatory bowel disease. Ten of 102 (9.8 percent) were found to have a neoplastic lesion (nine adenomas and one adenocarcinoma). Patients found to have a neoplastic lesion tended to be older (61 years vs. 52.7 years; P = 0.06). Neoplasia was found in 4 of 21 (19 percent) with a family history of colorectal cancer and in 6 of 81 (7.4 percent) without a family history (P = 0.24). Patients presenting with outlet-type bleeding were not found to have a higher detection of neoplasia. The specific type of anorectal disease present was not associated with an increased risk for colorectal neoplasia. Our study suggests that benign anorectal disease and colorectal neoplasia may coexist. Anorectal disease is not predictive of neoplasia. The decision to perform colonoscopy should be based on age, gastrointestinal symptoms, and other risk factors.
Dis Colon Rectum 1993 Apr
PMID:Colonoscopy in patients with benign anorectal disease. 845 64

Intubation of the ileocecal valve and terminal ileoscopy is useful clinically, especially in conjunction with diagnostic colonoscopy in patients with suspected or established inflammatory bowel disease or lower gastrointestinal tract bleeding. We describe a simple method of successful intubation of the ileocecal valve to facilitate ileoscopy. This method also confirms successful completion of colonoscopy, because the ileocecal valve is the most relevant endoscopic landmark of the cecum.
Dis Colon Rectum 1997 Apr
PMID:Intubation of the ileocecal valve made easy. 936 22

Intestinal pseudomembrane formation, sometimes a manifestation of antibiotic-associated diarrheal illnesses, is typically limited to the colon but rarely may affect the small bowel. A 56-year-old female taking antibiotics, who had undergone proctocolectomy for idiopathic inflammatory bowel disease, presented with septic shock and hypotension. A partial small-bowel resection revealed extensive mucosal pseudomembranes, which were cultured positive for Clostridium difficile. Intestinal drainage contents from an ileostomy were enzyme immunoassay positive for C. difficile toxin A. Gross and histopathologic features of the small-bowel resection specimen were similar to those characteristic of pseudomembranous colitis. The patient was treated successfully with metronidazole. These findings suggest a reservoir for C. difficile also exists in the small intestine and that conditions for enhanced mucosal susceptibility to C. difficile overgrowth may occur in the small-bowel environment of antibiotic-treated patients after colectomy. Pseudomembranous enteritis should be a consideration in those patients who present with purulent ostomy drainage, abdominal pain, fever, leukocytosis, or symptoms of septic shock.
Dis Colon Rectum 2000 Apr
PMID:Pseudomembranous enteritis after proctocolectomy: report of a case. 1078 57

New diagnostic criteria for Crohn's disease and a review of Japanese epidemiologic studies are presented. New diagnostic criteria for Crohn's disease were established by the Research Committee of Inflammatory Bowel Disease, set up by the Japanese Ministry of Health and Welfare. For a definite diagnosis one of the following three conditions is required: 1) longitudinal ulcer or luminal deformity induced by longitudinal ulcer or cobblestone pattern, 2) intestinal small aphthous ulcerations arranged in a longitudinal fashion for at least three months plus noncaseating granulomas, and 3) multiple small aphthous ulcerations in both the upper and lower digestive tract not necessarily with longitudinal arrangement, for at least three months, plus noncaseating granulomas. Moreover, ulcerative colitis, ischemic enterocolitis, and acute infectious enterocolitis should be excluded. Data from the Japanese Ministry of Health and Welfare, in addition to data collected from two study groups, these being the two largest studies in Japan, are reviewed with regard to epidemiology. The number of patients with Crohn's disease has increased remarkably. The prevalence and the annual incidence of patients with Crohn's disease in Japan were estimated to be approximately 2.9 and 0.6 per 10(5) population in 1986, respectively, and 13.5 and 1.2 per 10(5) population in 1998. Characteristic features of Crohn's disease in Japan are that the male-female ratio exceeds 2, and that there is no second peak of incidence in the age group of 55 to 65 years. Clinically, Crohn's disease with only multiple small aphthous ulcerations, which is the earliest stage of the disease that is diagnosable, was found in 5 percent of patients.
Dis Colon Rectum 2000 Oct
PMID:Crohn's disease in Japan: diagnostic criteria and epidemiology. 1105 83

Portal vein thrombosis is a rare complication in ulcerative colitis. We present a patient with portal vein thrombosis in ulcerative colitis who was successfully treated with colectomy. A 38-year-old Japanese female was admitted to our hospital because of an exacerbation of colitis. Abdominal ultrasonography performed because of liver dysfunction showed the thrombus in an umbilical portion of the portal vein. The patient underwent a subtotal colectomy and ileostomy because her colitis did not respond to intensive intravenous therapy. Although portal vein thrombus was treated with an intravenous infusion of urokinase before the operation, no change in the thrombus size was found. Approximately three months after the colectomy, the thrombus of the portal vein disappeared without anticoagulant therapy. Although a resection of an inflamed colon may be theoretically effective in the thrombosis in the inflammatory bowel disease, its benefit has not been confirmed. Our case suggests that the resection of the diseased bowel may have a favorable effect on the course of portal vein thrombosis in acute attacks of ulcerative colitis.
Dis Colon Rectum 2001 Apr
PMID:Portal vein thrombosis successfully treated with a colectomy in active ulcerative colitis: report of a case. 1133 May 88

Since the identification of the double-stranded DNA helix by Watson and Crick in 1953, the knowledge of nucleotide structure and function has been an important potential tool in the study and therapy of disease. There is recent clinical evidence that antisense oligonucleotides may be important therapeutic compounds in the clinical therapy of a range of diseases, including infection (viruses and bacteria), oncology, and inflammation. Our laboratory-based understanding of antisense oligonucleotide activity has provided a foundation for their use in several human diseases. Potentially relevant applications include inflammatory bowel disease therapy, psoriasis, transplantation, rheumatoid arthritis, cytomegalovirus retinitis, hepatitis C, and solid tumor therapy. Here we will outline these applications as well as our ongoing clinical trials for Crohn's disease.
Dis Colon Rectum 2001 Sep
PMID:The concept and application of antisense oligonucleotides. 1158 92

Inflammatory bowel disease is characterized by clinical remission and relapse caused by severe intestinal inflammation. Drug therapy for inflammatory bowel disease is associated with unpleasant side effects. Furthermore, efficacy of conventional drugs decreases with chronic use, which can be a major difficulty in the long-term management of this disease. In active inflammatory bowel disease, leukocytes are elevated with activation behavior and increased survival time, and mucosal neutrophil level parallels the severity of intestinal inflammation and predicts relapse. Leukocyte-derived inflammatory cytokines are suspected to be major factors in the initiation and perpetuation of inflammatory bowel disease. Accordingly, leukocytes should be appropriate targets for therapy. To reduce peripheral blood level of leukocytes, centrifugation has been used to deplete peripheral blood leukocytes; this provided the initial evidence that reducing the level of peripheral blood leukocytes can benefit patients with inflammatory disease. To overcome the limitations of centrifugation, membrane filters, such as the Cellsorba trade mark column and leukocyte-adsorbing beads containing column like Adacolumn, have been developed that are direct blood perfusion systems for removing any desired level of leukocytes. In initial independent clinical studies, these two new models have produced striking clinical efficacy, safety, and a marked reduction in the dose of corticosteroids used to induce remission of active inflammatory bowel disease. Leukocytapheresis has been associated with a significant decrease in the amount of several proinflammatory cytokines produced by peripheral blood leukocytes. Accordingly, the Japan Ministry of Health has now approved both methods for the treatment of active ulcerative colitis. Clinical data suggest that leukocytapheresis might be an effective adjunct to therapy for inflammatory bowel disease to promote remission, taper conventional drug dosage, and potentially reduce the number of patients who require colectomy. The results should further understanding of the pathophysiology of inflammatory bowel disease.
Dis Colon Rectum 2003 Oct
PMID:Leukocytapheresis as an adjunct to conventional medication for inflammatory bowel disease. 1453 Jun 61

Ameboma is an uncommon manifestation of amebiasis, occurring in 1.5 percent of cases. It can mimic both carcinoma and inflammatory bowel disease. The first known report of the CT appearance of ameboma is presented. This entity should be considered in any patient with a colon mass, history of travel to an endemic area, and symptoms of amebiasis.
Dis Colon Rectum 2004 Apr
PMID:Colonic ameboma: its appearance on CT: report of a case. 1497 22


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