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Query: UMLS:C1510475 (diverticular disease)
 2,138 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of pressure recording in patients with irritable bowel syndrome, diverticulosis and diverticulosis with pain were compared with the results in control subjects. The motility showed variable higher values in patients with irritable bowel syndrome. The motility was clearly higher in patients with diverticulosis and in patients with diverticulosis with pain. The patients with irritable bowel syndrome were younger than the patients in the two groups with diverticulosis. These findings are consistent with the hypothesis that the irritable bowel syndrome is an aetiologic factor in diverticulosis.
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PMID:[Motility of the sigmoid in irritable bowel syndrome and colonic diverticulosis]. 237 31

This review examines the evidence linking dietary fibre to gastrointestinal disease. Fibre increases stool weight, decreases whole gut transit time and lowers colonic intraluminal pressure. While it may be of benefit in the treatment of constipation, the irritable bowel syndrome and diverticular disease, its role in the prevention or treatment of other gastrointestinal disease has yet to be established.
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PMID:Dietary fibre and gastrointestinal disease. 284 Jan 68

Changes in diet from ancient times until the present are described. Previously relatively low in energy and animal products yet high in fibre-containing foods, diets are now high in energy and animal products (particularly fat), yet contain less fibre. The changing incidences of bowel disorders and diseases are described, with assessments of the role of diet. Clearly, diet is implicated as regards predisposition to constipation, appendicitis, colorectal cancer and diverticular disease; however, a meaningful dietary role in irritable bowel syndrome, ulcerative colitis and Crohn's disease is doubtful. In South Africa the rarity of bowel diseases in rural blacks compared with whites affords valuable aetiological information about some bowel diseases. The low occurrence thereof (except inflammatory bowel disease) in Indian and coloured populations is not readily explicable. While dietary changes in whites are being widely urged in order to combat degenerative diseases, the magnitude of changes made is unlikely to reduce the occurrence of bowel diseases. The progressive westernization of the diets and lifestyles of less-privileged populations is likely to be associated with increases in the incidences of these diseases.
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PMID:Diet and bowel diseases--past history and future prospects. 299 4

A total of 541 open access referrals for fibresigmoidoscopy over five years were compared with 495 hospital initiated procedures during the same period. The number of open access fibresigmoidoscopies doubled during the five years but diagnostic yield remained unchanged at about 40% and was similar to that of the hospital initiated procedures. Colorectal carcinoma was seen in 64 open access patients compared with 47 hospital referred patients, the proportion of Dukes's type A lesions being similar (34%) in both groups. Polyps, colitis, and diverticular disease were equally common in open access and hospital referred patients. Fibresigmoidoscopy failed to detect disease in only 12 patients (1.2%) and the procedure was unsatisfactory in only 54. Referral was considered justified in 475 (88%) open access patients, and only 54 (17%) patients with normal appearances at endoscopy required further investigations. Diagnostic yields were low (19%; 30/156 cases) in open access patients under 40 and in patients with abdominal pain, constipation, or abdominal pain with constipation (0-17%). Most of these young patients presumably suffer from the irritable bowel syndrome and do not justify fibresigmoidoscopy. In contrast, there was a high diagnostic yield (90-100%) in patients of all ages referred for diarrhoea and rectal bleeding, altered blood from the rectum, and rectal bleeding associated with abdominal pain. Open access fibresigmoidoscopy is an effective service that should be freely available to general practitioners.
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PMID:Open access fibresigmoidoscopy: a comparative audit of efficacy. 313 21

Intraluminal pressures were measured with four open ended, water perfused tubes in the fasting state and after a standard liquid meal (400 KCal, 375 ml, protein 15 g, carbohydrate 55 g, lipid 13.4 g) in six patients with sigmoid diverticular disease, 20 with the irritable bowel syndrome and in 13 controls. The pressure sensors were positioned in the true sigmoid colon at colonoscopy at 25, 35, 45, and 55 cm from the anus. Colonic pressures were significantly higher in diverticular disease than in controls before (p less than 0.02) and after the meal (p less than 0.002), some pressure amplitudes exceeding 300 cm H2O. Patients with the irritable bowel syndrome had lower (p less than 0.05) pressures than controls before the meal. Postprandial sigmoid pressures were within the mean +/- 2 SD of controls in 10, above in two and below in eight patients with the irritable bowel. Hypercontractility of the sigmoid colon in the irritable bowel syndrome was not confirmed under the conditions of this study. The association between sigmoid diverticulosis and high intraluminal pressures is confirmed.
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PMID:Sigmoid motility in diverticular disease and the irritable bowel syndrome. 334 33

Recent years have seen a number of studies measuring electrical activities of the human colon muscle layers. In vitro studies have enhanced our understanding of myogenic control of colon motility. In vivo studies have suggested a relationship between patterns of electrical activities and the transport of colon contents. This chapter describes the patterns of electrical and motor activity that the human colon can perform depending on the nature and intensity of the stimulus, using recent in vitro and in vivo data. In vitro studies with human tissue have shown differences between the electrical activity of the longitudinal and circular muscles. They have also revealed the unique nature of the electrical control activity of the circular muscle of human colon. The electrical oscillatory activity of this layer is variable in frequency from 1 to 60 cpm, variable in amplitude, and not omnipresent. Furthermore, the activity is sensitive to stretch and markedly altered by excitatory and inhibitory substances. In vivo data, especially spike action potential recordings for 24 h, have revealed patterns of electrical activity related to intake of meals, sleep, and also constipation. The limitations of some intraluminal techniques to record electrical activity are discussed. Further studies are needed to accurately relate in vivo activities to cellular events recorded in vitro, and to relate these to altered patterns of activity in disease. The suggestion is made that a relevant in vivo assessment of the colonic motility of a patient can only be achieved by long-lasting (24-h) studies, because of the large variability in the hour-to-hour colonic activity. Timing of experimental drug intervention is important since colonic motility undergoes diurnal changes. Recent studies into profiles of electrical and motor activity in irritable bowel syndrome (IBS) suggest that there is not a typical IBS myogenic activity. Rather, patterns of electrical activity can be related to the symptoms of IBS: diarrhea and constipation. Recent electrophysiologic data on Hirschsprung's disease reveal absence of intrinsic inhibitory innervation in the aganglionic segment. In vitro studies on tissue from diverticular disease patients show abnormal myogenic activity.
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PMID:Electrophysiology of human colon motility in health and disease. 353 12

The influence of colonic diverticula on symptomatology and prognosis was investigated in 69 patients with irritable bowel syndrome. Roentgenograms at the time of diagnosis were blindly correlated to patient complaints and to result of follow-up 5 to 7 yr after the irritable bowel syndrome had been diagnosed. Patient complaints were not related to the presence or extent of diverticulosis. Half the patients had unchanged or aggravated symptoms at follow-up irrespective of diverticulosis. Accordingly, the presence of colonic diverticula did not change the natural history of the irritable bowel syndrome.
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PMID:Irritable bowel syndrome and symptomatic diverticular disease--different diseases? 371 13

Endoscopic retrograde bowel insertion (ERBI), a new method, offers rapid access to the entire colon for pressure sensors. The authors measured the pressure of both the ascending colon and the sigmoid colon and related them to the bowel habits of the subjects. The following groups were studied: control subjects, patients with diarrhea-dominant irritable bowel syndrome, patients with constipation-dominant irritable bowel syndrome, and patients with right-sided diverticular disease of the colon. In patients with irritable bowel syndrome with diarrhea or constipation, colonic motility indices (CMIs) showed a so-called "paradoxical motility" pattern. In patients with right-sided diverticular disease, the CMI was higher in the ascending colon than in the sigmoid colon. The pattern of CMIs for diverticular disease and irritable bowel syndrome varied inversely in the ascending colon and in the sigmoid colon with diarrhea and constipation. These results suggest that the mechanisms of altered bowel habits in patients with these diseases are quite different.
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PMID:An endoscopic method to study the relationship between bowel habit and motility of the ascending and sigmoid colon. 372 Nov 37

Mucus secreted by colorectal cancer differs in three respects from that produced normally: an overall reduction, a loss of O-acetyl substituents in sialic acid, and an increase in neutral mucin. Similar changes have been reported in apparently normal mucosa bordering colorectal cancer. "Normal" left sided colorectal mucosa from 32 patients with rectal cancer was studied. Each case was matched by age and sex to a patient with diverticular disease and a patient with irritable bowel syndrome. Twenty five patients with right sided cancer were matched to patients with Crohn's disease. Sections were stained with mild periodic acid Schiff (mPAS) (selectively stains N-acetyl sialic acid lacking in O-acetyl group) and other closely related techniques. Reactions were graded negative, weak, and intense. An intense reaction was found in 9% of cases; there was no difference between the various matched groups. Phenylhydrazine interposition failed to block the mPAS effect, indicating that a positive result was due to a deficiency of sialic acid with O-acetyl substituents rather than neutral mucin. Different staining patterns in left and right colon were probably due to differing ratios of total sialic acid:fucose. These findings indicate a hitherto unsuspected colorectal goblet cell sialomucin heterogeneity within the general population, but no association with neoplastic disease is apparent.
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PMID:Colorectal goblet cell sialomucin heterogeneity: its relation to malignant disease. 378 84

About five per cent of the adult population each year will see their doctor with complaints that are finally characterised as irritable bowel syndrome (IBS). The complaints are constipation (perhaps alternating with diarrhoea), abdominal pain (dull or colicky), abdominal distension, abdominal rumbling and flatulence. The diagnosis of IBS implies that a relevant examination has precluded any organic disease. The etiology is unknown and the syndrome probably does not represent a disease entity. It is therefore difficult, if not impossible, to produce a definite rationale of treatment. However, several aspects of the pathogenesis of the individual symptoms of IBS are well known: 1) chronic constipation is most likely due to fibre-depleted diet, psychological factors, local organic disorders (e.g., anal fissures, hemorrhoids, diverticulosis) and disturbance of the body fluid balance (e.g., high consumption of diuretic compounds such as coffee and tea); 2) pain is related to spasms and motility disturbances causing increased intraluminal pressure; 3) meteorism is not due to an increased amount of intestinal gas, but "air traps" and segmental accumulation of gas seem to occur. Furthermore, psychopathological factors and perhaps also food intolerance may play an etiological role. At present the rationale of treatment in IBS is: 1) management of constipation, 2) ease of spasms, 3) reduction of surface tension of intestinal contents, 4) ease of mental stress.
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PMID:Irritable bowel syndrome: current concepts and future trends. 389 85


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