Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The rectal pouches of 45 patients who underwent Hartmann's procedure and were not scheduled to have a colostomy closure were examined with an endoscope at least 1 year after operation. Twenty-five patients had no symptoms related to the rectal pouch. The rest had pain, mucous discharge, moderate-to-severe bleeding, or discharge of small bowel contents. Endoscopic findings included moderate-to-severe proctitis in 20 patients, 10 of whom had no symptoms. Polyps were found in four patients (two asymptomatic) and carcinoma in seven (one asymptomatic). Of 24 patients operated upon for diverticulitis, 12 had proctitis and 2 had polyps. Of 14 patients with carcinoma, 4 had proctitis, 1 polyps, and 5 carcinoma. Of two patients with benign polyps, one had polyps and one, carcinoma and of five patients with inflammatory bowel disease, four had proctitis and one, carcinoma. The treatment of polyps and carcinoma is the same as for other patients with these conditions. Proctitis should be treated with reanastomosis. The frequent presence of abnormality in the rectal pouch indicates the need for regular follow-up examinations of these patients.
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PMID:The fate of the forgotten rectal pouch after Hartmann's procedure without reconstruction. 229 86

26 patients with unresectable locally recurrent adenocarcinoma of the rectum were treated with a mixed beam schedule. 40 Gy photons were delivered to the whole pelvis followed by a neutron boost of 6.6 or 10 Gy. Neutron therapy was carried out with a 14 MeV d-t generator (KARIN) using an isocentric are technique. Fluctuation in neutron dose rate during irradiation was monitored by a computer which controlled the gantry speed. All patients were followed clinically by CEA monitoring and CT-scans. In 18 patients positron-emission-tomography (PET) was used to verify the therapeutic efficacy. All patients were symptomatic with severe pain prior to therapy. After a mean follow-up interval of 12.8 months (range six to 26 months), the palliative effect in terms of pain relief was excellent in 22 patients in spite of the poor general condition of most patients and the large tumor extension. In four patients, further pain symptoms developed again after six to nine months due to renewed tumor progression. We observed proctitis at late side effects in one, enteritis in two and a fistula in one patient six to ten months after therapy. Changes in tumor glucose metabolism were monitored by serial PET examinations in all patients. The typical pattern observed by PET was a decrease in the F-18-Deoxyglucose (FDG) accumulation, approximately six weeks after onset of therapy.
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PMID:Photon-neutron therapy for recurrent colorectal cancer--follow up and preliminary results. 230 Aug 91

Large single-fraction irradiation is effective palliation for advanced ovarian cancer. It has an acceptable complication rate and requires only a limited number of visits (i.e., one treatment per 4-week course) to administer. Forty-two patients received single or multiple fractions of (three maximum) 10 Gray (Gy) to the pelvis. Most patients had advanced disease, 71.4% had Stage III or IV and 90.5% Grade 2 or 3 at the time of diagnosis. Forty patients had received preirradiation chemotherapy. Tumor size before and after radiotherapy was evaluable in 34 patients and decreased in 25. Bleeding decreased or stopped in 15 of 21 patients, and pain lessened or ceased in 11 of 20 patients. Thirteen patients had surgical procedures performed after irradiation therapy. Ten had gastrointestinal procedures, and in six radiation injury was believed to be the main contributor to complication. Hemorrhagic cystitis or proctitis occurred 6 to 18 months after irradiation in four patients. Three of these four patients received three 10 Gy fractions. The safest and most efficient dose may be one or two fractions, since three 10 Gy fractions may not increase palliation.
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PMID:Palliative radiotherapy for ovarian cancer. 243 58

We present 3 homosexual male patients, with lesions confined to the rectum, produced by chlamydia trachomatis. In the 3 patients the lesions were confined to the first 10 cm from of the anal margin, they were nodular, ulcerated and with stenotic tendency, difficult to differentiate macroscopically from a neoplasm. Multiple biopsy specimens from all patients reported chronic unspecific proctitis. In the 3 patients the presence of chlamydia trachomatis was confirmed by staining with lugol and giemsa from samples obtained by rectal smear, two of them presented simultaneous infection by neisseria gonorrhoeae, all were positive for HBsAg and one for HIV. Symptoms were tenesmus rectal urge, pain, thin feces and mucosanguinolent discharge. Treatment with 100 mg. Doxycycline BID for 21 days resulted in total remission in two patients; one patient with significant clinical improvement needed rectal bougienage.
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PMID:[Chlamydial proctitis in homosexual men]. 253 52

Radiation proctitis is a well-known complication of abdominal and pelvic radiation. Conventional medical and surgical treatment often is disappointing. 5-Aminosalicylic acid (5-ASA) is the active component in sulfasalazine and is effective in the treatment of distal ulcerative colitis. Four patients with radiation proctitis were treated with 4 g 5-ASA by enema nightly for two to six months. Patients were seen monthly, interviewed, and a sigmoidoscopic exam performed. No change was seen in the degree of mucosal inflammation on follow-up sigmoidoscopic exams. Three patients noted no change in their symptoms of bleeding, pain, or tenesmus. One patient noted initial improvement, but this was not sustained. 5-ASA enemas do not appear to be effective in the treatment of radiation proctitis.
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PMID:Failure of 5-aminosalicylic acid enemas to improve chronic radiation proctitis. 271 49

Treatment of lower gastrointestinal bleeding was attempted in 13 patients by selective embolization of branches of the mesenteric arteries with Gelfoam. Bleeding was adequately controlled in 11 patients with active bleeding during the examination. One patient improved after embolization but bleeding recurred within 24 hours and in another patient the catheterization was unsuccessful. Five patients with diverticular hemorrhage were embolized in the right colic artery four times, and once in the middle colic artery. Three patients had embolization of the ileocolic artery because of hemorrhage from cecal angiodysplasia, post appendectomy, and leukemia infiltration. Three patients had the superior hemorrhoidal artery embolized because of bleeding from unspecific proctitis, infiltration of the rectum from a carcinoma of the bladder, and transendoscopic polypectomy. One patient was septic and bled from jejunal ulcers. Ischemic changes with infarction of the large bowel developed in two patients and were treated by partial semi-elective colectomy, three and four days after embolization. Four other patients developed pain and fever after embolization. Transcatheter embolization of branches of mesenteric arteries is an effective way to control acute lower gastrointestinal bleeding, but still has a significant rate of complications that must be seriously weighed against the advantages of operation.
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PMID:Transcatheter embolization for treatment of acute lower gastrointestinal bleeding. 295 57

We have reviewed 53 cases of allergic disorders of the gastrointestinal tract in children, including 15 with principal effects in the rectum (allergic proctitis) and 38 with dominant involvement of the upper and mid portions of the gut (allergic gastroenteritis). Most cases of allergic proctitis had their onset at less than 6 months of age, and all were under 2 years old when they presented with rectal bleeding alone or in combination with diarrhea. Rectal mucosal biopsy revealed in most cases a diffuse increase of eosinophils in the lamina propria together with a focal infiltration of the epithelium by eosinophils. Cases of allergic gastroenteritis affected all age groups and had a lower frequency of overt rectal bleeding. More common were other symptoms (vomiting, pain, and weight loss), an allergic history, anemia, blood eosinophilia, and increased serum IgE. Mucosal biopsy abnormalities were present in the gastric antrum in all cases sampled, the small intestine in 79%, the esophagus in 60%, and the gastric corpus in 52%. The lesions were usually diffuse and marked in the antrum and esophagus; in contrast, they tended to be focal and mild in the small intestine and gastric corpus. All cases of proctitis responded to a dietary change by cessation of symptoms without recurrences, whereas most of those with gastroenteritis had multiple relapses and required corticosteroid therapy.
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PMID:Allergic proctitis and gastroenteritis in children. Clinical and mucosal biopsy features in 53 cases. 395 38

Obliterating arteriosclerotic lesions of pelvic vessels may induce inflammation and fibrosis of the rectum and subsequently ischemic proctitis. This may lead to damage of the sphincter muscle and to complete incontinence. Clinical symptoms are pain and bloody stools, as in ischemic colitis. The combination of periproctitis and perianal necrosis may be misinterpreted as anal fistulas. An anus praeter sigmoideus is to be recommended for palliation. A case report of this particular disease is given including clinical, angiographic and morphological data.
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PMID:[Clinical symptoms and morphology of ischemic proctitis (author's transl)]. 615 57

Acute herpes simplex virus (HSV) infection was detected in 23 of 102 consecutively examined, sexually active male homosexuals who presented with anorectal pain, discharge, tenesmus, or hematochezia, as compared with 3 of 75 homosexual men without gastrointestinal symptoms (P less than 0.01). Findings that were significantly more frequent in men with HSV proctitis than in men with proctitis due to other infectious causes included fever (48 per cent), difficulty in urinating (48 per cent), sacral paresthesias (26 per cent), inguinal lymphadenopathy (57 per cent), severe anorectal pain (100 per cent), tenesmus (100 per cent), constipation (78 per cent), perianal ulcerations (70 per cent), and the presence of diffuse ulcerative or discrete vesicular or pustular lesions in the distal 5 cm of the rectum (50 per cent). Serologic evidence indicated that 85 per cent of the men with symptomatic HSV proctitis were having their first episode of HSV-2 infection. The diagnosis of HSV proctitis is suggested by the presence of severe anorectal pain, difficulty in urinating, sacral paresthesias or pain, and diffuse ulceration of the distal rectal mucosa.
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PMID:Herpes simplex virus proctitis in homosexual men. Clinical, sigmoidoscopic, and histopathological features. 630 Jun 74

Proctitis cystica profunda is an uncommon benign rectal condition with a range of appearances that has led to confusion in nomenclature. In a personal series of 28 patients with histologically proven proctitis cystica profunda, over 50 per cent had associated rectal prolapse. Cure of the prolapse cured the proctitis cystica profunda in 80 per cent of the patients only. Direct surgical excision (local or segmental) has not been successful and two patients have required a stoma for relief of pain.
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PMID:Proctitis cystica profunda. Incidence, etiology, and treatment. 669 41


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