Four months of diet supplementation with fish oil in patients with inflammatory bowel disease resulted in reductions in rectal dialysate leukotriene B4 levels, improvements in histologic findings, and weight gain.

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MO 63110.Stress ulcer syndrome refers to gastroduodenal erosions or ulcers that develop acutely in relation to major physiological stress, usually manifested clinically as upper gastrointestinal (UGI) bleeding. These lesions occur most often in the gastric fundus. Endoscopy has shown gastroduodenal mucosal lesions in 75 to 100% of intensive care unit (ICU) patients within 72 hours of admission. Patients at high risk for stress ulcer include those with large body surface area burns, intracranial lesions associated with coma, fulminant hepatic failure, sepsis, and trauma and abdominal, cardiovascular, and thoracic surgery patients. Also considered high risk are ICU patients with superimposed complications such as shock, mechanical ventilation for more than 3 days, coagulopathy, jaundice, and sepsis. Approximately 15% of ICU patients will experience UGI bleeding from stress ulcer. Patients bleeding from stress ulcer have an overall mortality rate approaching 65% compared with 9 to 22% mortality in patients without stress ulcer. When stratified according to occult blood loss versus clinically significant bleeding, mortality can be as high as 90% in patients overtly bleeding; 30% of deaths are directly related to bleeding. Both antacids and H 2 receptor antagonists are effective in prophylaxis for stress ulcer bleeding.Gastrointestinal bleeding is a major problem in intensive care medicine, and upper gastrointestinal (UGI) hemorrhage may occur in 10% or more of intensive care unit (ICU) patients [1]. Bleeding representing the usual spectrum of UGI mucosal lesions can be responsible for admission to the ICU, but bleeding can also be a secondary complication that occurs during the ICU stay. The latter has been referred to as the clinical syndrome of &dquo;stress ulcer.&dquo; Stress ulcers are acutely formed defects in the gastroduodenal mucosa that develop in a critically ill patient with a severe physiological derangement.

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