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)

A 32 year-old male presented to his general practitioner for a routine health check. Microscopic haematuria was noted in an otherwise asymptomatic and fit patient. Subsequent investigation was normal apart from abnormal liver function tests for which no cause was found. A cholecystectomy was performed for gallstones which were detected by ultrasound after the patient complained of upper right quadrant pain. Wedge biopsy of the liver at operation was suggestive of cholangitis. A barium enema was performed which revealed ulceration of the transverse colon suggestive of Crohn's disease. The association of cholangitis and inflammatory bowel disease is discussed.
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PMID:An unusual presentation of inflammatory bowel disease. 325 41

Gastrointestinal inflammation after allogeneic bone marrow transplantation may be due to acute graft-versus-host disease (GVHD) and/or superinfection with opportunistic organisms. Twenty-eight patients with barium studies suggesting gastrointestinal inflammation after bone marrow transplantation and either acute GVHD, viral infection, or both were studied to characterize the radiographic appearances of each disease and to determine whether acute GVHD could be distinguished from viral superinfection on the basis of radiographic findings. Thirteen patients had minimal or no acute GVHD, with viral infection proved in eight and strongly suspected in four others; the remaining patient was thought to have nonspecific inflammatory bowel disease. Five patients had pure acute GVHD, and 10 patients had viral enteritis superimposed on acute GVHD. Radiographic abnormalities were found in the gastrointestinal tract in both acute GVHD and viral infection and were more extensive than previously reported. Findings were similar in both entities, although gastric abnormalities were not seen in pure acute GVHD but only in viral infection, either alone or together with acute GVHD. Prolonged small bowel barium coating occurred in both viral infection and acute GVHD. Fold thickening evolved into fold effacement with a shaggy contour in two patients with viral infection. Colonic findings in all groups mimicked ulcerative colitis. Our data indicate that differentiation between acute GVHD and viral enteritis is not possible on the basis of radiographic findings alone. Both entities should be considered when gastrointestinal inflammation occurs after bone marrow transplantation.
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PMID:Gastrointestinal inflammation after bone marrow transplantation: graft-versus-host disease or opportunistic infection? 327 85

The cross-sectional imaging modalities provide an important diagnostic perspective in patients with inflammatory bowel disease that often has a profound influence on the therapeutic decision-making process. They can directly and noninvasively image infectious and inflammatory complications involving the bowel wall, serosa, and mesentery that can only be assessed indirectly by colonoscopy and barium studies. At the present time, CT is superior to ultrasound and MR in diagnosing these extramucosal complications.
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PMID:Cross-sectional imaging of inflammatory bowel disease. 354 65

With the availability of indium-labeled white blood cells, radionuclide imaging studies have a definite role in the diagnosis and staging of patients with inflammatory bowel disease. The In-111 white blood cell study is particularly helpful in evaluating recurrent disease in patients with severe intercurrent diseases and in screening patients without the need for barium examinations.
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PMID:Nuclear medicine imaging of inflammatory bowel disease. 354 66

The value of plain abdominal radiography in children with inflammatory bowel disease (IBD) has not been ascertained. We reviewed the scout radiographs prior to first barium examination in 100 children with IBD [53 Crohn, 47 ulcerative colitis (UC) and scout films prior to excretory urography in 50 patients who had no clinical evidence of intestinal disease (controls)]. The films were reviewed without clinical information, and the abnormalities on each film scored according to severity and location. Criteria included: mural thickening, dilatation and mucosal abnormalities of the small bowel and colon, as well as abnormal quantity and/or distribution of feces in the colon. Eighty percent (40/50) of the films in the control group were interpreted as normal. Abnormalities suggestive of IBD were present in 73% of the IBD group (76% Crohn and 72% UC). Thirty-one percent of the films in the IBD group had a moderately abnormal score (greater than or equal to 3) or markedly abnormal score (greater than or equal to 5) at presentation. The most reliable radiographic findings were: mucosal abnormality in the colon and small bowel and an abnormal stool pattern (feces completely absent or only present in one colonic segment). The clinical presentation of IBD in childhood is often vague and nonspecific. Abnormalities in plain films of the abdomen are common in these patients and may be helpful in suggesting the presence and, to a great degree, the severity of disease in these children.
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PMID:Plain abdominal radiographs in children with inflammatory bowel disease. 370 95

Four cases of giant inflammatory polyps were found in a series of 86 consecutive colectomies for inflammatory bowel disease. Two presented a distinctive clinical syndrome of abdominal pain and chronic iron-deficiency anemia due to blood loss. Secondary ulceration of the heads of the polyps accounted for the bleeding and anemia, and the size of the polyps accounted for the abdominal pain. In both cases unusually long portions of colon were involved by the giant polyps. The third and fourth cases had rare complications--reactivation of an enterocutaneous fistula and perforation of an acquired diverticulum. These cases demonstrate that giant inflammatory polyps may produce symptoms independently of the underlying inflammatory bowel disease. In reported cases of giant inflammatory polyps, approximately two-thirds had Crohn's disease and one-third had ulcerative colitis. The transverse colon was the commonest location, pain was the commonest symptom, and the polyps were localized to a short segment of colon in the majority of cases. More than 50% of cases mimicked neoplasm on barium enema. Giant inflammatory polyps may produce a variety of distinctive signs and symptoms and deserve independent recognition.
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PMID:Giant and symptomatic inflammatory polyps of the colon in idiopathic inflammatory bowel disease. 371 97

Double-contrast barium examination of the colon can demonstrate the changes associated with inflammatory bowel disease more completely and specifically than the single-contrast barium study. However, endoscopy is slightly more sensitive than double-contrast examination for detection of disease. In general, between 18% and 20% of patients with Crohn's disease or ulcerative colitis may be expected to have normal radiographic findings but endoscopically detectable disease. However, most false-negative double-contrast colon studies are associated with mild or minimal findings at proctosigmoidoscopy. Although double-contrast radiography may be less sensitive than endoscopy in detection of inflammatory bowel disease, it has similar accuracy for classification and differentiation. Most studies indicate an accuracy of 95% to 98% in differentiating Crohn's disease and ulcerative colitis, due to the fact that morphologic changes detected by the double-contrast mucosal study rarely overlap in the two diseases. Double-contrast barium examination and endoscopy are complementary studies, and the use of both may provide valuable information for evaluation of patients with suspected inflammatory bowel disease.
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PMID:Crohn's disease and ulcerative colitis. Evaluation with double-contrast barium examination and endoscopy. 374 18

Many of the features that identify idiopathic inflammatory bowel disease are also found with other colorectal conditions that are often encountered by the primary care physician. Although, initially, symptoms of these disorders may appear to be caused by ulcerative colitis or Crohn's disease, the cause could be bacterial, viral, parasitic, or fungal infection. Ischemic colitis and radiation colitis are other conditions that are similar in presentation to ulcerative colitis. In most cases, the physician should be able to make a differential diagnosis from a thorough history and physical examination, anoscopy or sigmoidoscopy, rectal biopsy, stool examination, and serology. An occasional patient, in whom diagnosis is not made by these methods, may require a barium enema study, colonoscopy, or referral to a gastroenterologist.
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PMID:Conditions that mimic inflammatory bowel disease. Diagnostic clues and potential pitfalls. 377 62

The results of indium-111 tropolonate leucocyte scintigraphy in 105 patients with known inflammatory bowel disease are reviewed. Scintigraphy is as sensitive as radiology in detecting and assessing the extent of active colonic disease, and probably more sensitive in assessing small bowel disease. In a further 40 patients scintigraphy was successfully used as a screening test to identify, or exclude, bowel inflammation in patients with gastrointestinal symptoms. Scintigraphy has advantages over barium studies, being safe, non-invasive, more sensitive than small bowel radiology and giving additional information such as the bowel identification of intra-abdominal abscesses. The time required to label the leucocytes (about 2 hours) and the higher unit cost, unless many scintigrams are performed, are disadvantages.
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PMID:Indium-111 leucocyte scintigraphy in the investigation and management of inflammatory bowel disease. 377 75

The physiology, solution composition, indications, efficacy, and safety of whole-bowel irrigation (WBI) for mechanical bowel cleansing are reviewed. WBI with isotonic electrolyte solutions produces diarrhea when the infusion rate exceeds the capacity of the intestine to distend and absorb the solution. A number of solutions are used for WBI, including 0.9% sodium chloride, balanced electrolyte solutions, lactated Ringer's, mannitol, and electrolyte solutions containing polyethylene glycol 3350 (PEG). WBI solution administration rates vary from 15-90 mL/min, by oral ingestion or nasogastric tube, with total volumes ranging from 1 to 20 L. The onset of diarrhea occurs as soon as 20 minutes with clearing of the effluent as early as 90 minutes. Faster administration rates appear to shorten overall cleansing time. Two PEG-electrolyte lavage solutions (ELSs) have recently gained FDA approval. The recommended dosage rate is 1.2-1.8 L/hr orally or by nasogastric tube until rectal effluent is clear. In most patients, this requires a maximum of 4-6 L. Initial data indicate that PEG-ELSs are safe for elderly patients and for patients who have an increased risk of fluid overload, but these solutions have not been evaluated in children, pregnant women, or patients with inflammatory bowel disease. WBI is an effective alternative to other regimens for removing fecal material and reducing bowel lumen bacterial counts before colonoscopy and colorectal surgery. Retention of bacterial counts before colonoscopy and colorectal surgery. Retention of excess WBI solution may interfere with the quality of barium enema radiographs; this can be minimized by completing the irrigation the evening before the examination. Gastrointestinal side effects occur in about one third of the patients following WBI, but do not generally require discontinuing the irrigation. Solutions containing PEG with sodium sulfate as the primary electrolyte result in the least net water and electrolyte movement and are preferred over other solutions.
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PMID:Whole-bowel irrigation for mechanical colon cleansing. 389 70


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