No abstract

Vrij AA, Jansen JM, Schoon EJ, de Bruṏne A, Hemker HC, Stockbrügger RW. Low molecular weight heparin treatment in steroid refractory ulcerative colitis: clinical outcome and influence on mucosal capillary thrombi. Scand J Gastroenterol 2001;36 Suppl 234:41-47. Background: In ulcerative colitis, a state of hypercoagulation has frequently been observed. Unfractionated heparin has shown bene cial effects as an adjuvant treatment of steroid refractory ulcerative colitis in open trials and in one placebo-controlled trial. Low molecular weight heparin (LMWH) offers advantages in the method of administration, but it has not been evaluated in severe ulcerative colitis. We therefore assessed the tolerability, safety and potential therapeutical effects of LMWH in hospitalized patients with steroid refractory ulcerative colitis. Methods: Twenty-ve patients with severely active ulcerative colitis were included in an open-labelled trial. All patients had a are-up of disease under glucocorticosteroid treatment. Nadroparine calcium 5.700 IE anti-Xa/0.6 mL s.c. was self-administered twice daily for 8 weeks. Patients were monitored for possible adverse events, and changes in clinical symptoms and in laboratory, endoscopical and histological results were analysed. Results: Tolerability and compliance were excellent and no serious adverse events occurred. In 20 of 25 patients, a good clinical and laboratory response was observed. Also, the endoscopic and histological signs of in ammation were found to be signi cantly improved. However, this was not accompanied by a signi cant reduction in the number of mucosal microvascular thrombi after 8 weeks of LMWH treatment. Conclusion: LMWH may be a safe adjuvant therapy for patients with active, glucocorticosteroid refractory ulcerative colitis.

Platelet factors were correlated with inflammatory bowel disease activity. Levels of platelet factor 4 and beta-thromboglobulin, however, were markedly raised for a long time in clinically inactive inflammatory bowel disease, which might point to a pre-thrombotic state of disease.

SUMMARY`4C-urea breath test was used to detect Campylobacter pylorn colonisation in 129 consecutive non-ulcer There is increasing interest in the presence of Campylobacter pylori in gastric biopsies and their possible role in the aetiology of gastritis and peptic ulcer.'`This spiral organism colonises the gastric antrum in 90-100% of patients with duodenal or gastric ulcer and in 50-70% of patients with non-ulcer dyspepsia.7-" C pylori is also present in 20% of asymptomatic individuals.7 C pylori colonisation can be established by culture or histological examination of antral mucosal biopsies. The use of endoscopy to obtain biopsies precludes large scale epidemiologic studies of this organism. We have previously reported that Cpylori has a very high urease activity.7 Intragastric hydrolysis of urea will result in the production of carbon dioxide and the generation of ammonia. We have utilised this urease activity to