Current Management of Inflammatory Bowel Disease

Bayless, Theodore M.; Chinitz, Marvin A.

doi:10.1097/00004836-199010000-00026

Cited by 3 publications

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“…Furthermore, in Israel the incidence is lower among Sephardic or Oriental Jews of Asian or African origin than among Ashkenazi Jews of European or American origin [5]. In the United States, the incidence of both ulcerative colitis and Crohn's disease in the African-American population has Ulcerative colitis and Crohn's disease, chronic inflammatory diseases of the gastrointestinal tract, are identified and diagnosed by the appearance of a set of clinical endoscopic, and histological characteristics [1][2][3]. The inflammatory response in ulcerative colitis is largely confined to the mucosa and submucosa, but in Crohn's disease inflammation extends through the intestinal wall from mucosa to serosa.…”

Section: Epidemiologymentioning

confidence: 99%

Inflammatory Bowel Disease

Stenson

Hanauer

Cohen

2008

Textbook of Gastroenterology

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In the US, H. pylori vacA shows allelic variation in the signal sequence (which may be type sla, slb or s2) and the mid-region (type ml or m2). Previous PCR-based vacA mid-region typing classified most, but not all, Asian and South American strains tested as ml or m2. We now sought to investigate vacA mid-region diversity further.MotlmodL We studied 13 Japanese, 6 Chinese, 9 Thai, and 8 Peruvian H. pylori isolates. cagA was identified by colony hybridisation (CH), vacA signal sequence was typed by PCR, and vacA mid-region was typed proximally by CH and distally by PCR. Sections of the vacA mid-region from 8 strains were PCR-amplified, sequenced, and compared with known sequences from 8 other strains.Rcuts Of the 36 Asian and South American strains studied, 35 were cagA+ (the cagA-was Peruvian) and 35 were vacA sla (1 cagA + Peruvian was slb). vacA mid-regions from the 13 Japanese strains were not PCR-amplified by ml or m2-specific primers, but hybridised weakly with an ml probe. Sequence analysis of vacA from 1 Japanese strain revealed 91% nucleotide identity with the ml probe but only 71% identity with the m2 probe. The previously equivocal Thai and Peruvian strains also had ml-like mid-region sequences. A Chinese strain was ml in the proximal mid-region and m2 distally, showing a clear crossover site. Final mid-region types were: Japanese, all 13 ml; Chinese, 1 ml, 1 ml/m2, 4 m2; Thai, 3 ml, 6 m2; Peruvian 4 ml, 4 m2. Distal mid-region sequences of 16 strains, compared over 294 bp, clustered into 2 groups, ml and m2. Nucleotide identity between ml and m2 strains ranged from 73-78%. Within groups, m2 strains were less diverse than ml strains (m2 range 94-99.7%, ml 88-99.3%, p<0.001). Sequence analysis of 7 ml and 3 m2 strains over 1.1kb proximally showed maintenance of clustering outside the 294bp region C duions These Asian and South American strains are similar in terms of cagA status and vacA sla genotype, but fall into 2 vacA midregion groups. ml sequences are more diverse than m2, and thus may be phylogenetically older. The vacA sequence of 1 Chinese strain suggests recombination in vivo between ml and m2 alleles. Introduction: H.pylori antimicrobial susceptibility is an important determinant ofthe efficacy of eradication therapies'. The prevalence of antimicrobial resistance varies within the UK and may increase given the increased use of eradication therapy. This multicentre study assesses the prevalence and possible associations ofH.pylon antimicrobial resistance. Methods: H.pylon was isolated from antral biopsies of patients undergoing routine endoscopy and cultured according to standard microbiological methods. Antimicrobial resistance was determined using "E-tests" or disc tests (tinidazole only) with breakpoints defined by previous studies. Results: H.pyloni was isolated from 32% (1222/3823) of patients and antimicrobial susceptibility determined in 90% (1077/1222) Previous case-control studies of IBD have used hospital or community derived controls. There are obvious inherent biases in both metho...

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Section: Epidemiologymentioning

confidence: 99%

Inflammatory Bowel Disease

Stenson

Hanauer

Cohen

2008

Textbook of Gastroenterology

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“…Not uncommonly, colorectal surgeons perform a pouchoscopy and/or order a roentgenographic pouch study prior to ileostomy takedown [5]. Currently, there are no published studies or guidelines examining the indications/frequency of routine pouchoscopy between pouch stages; only expert recommendation is available [6].…”

Section: Introductionmentioning

confidence: 99%

Routine Pouchoscopy Prior to Ileostomy Takedown May Not Be Necessary in Patients with Chronic Ulcerative Colitis

Cai¹,

Barrow²,

Parian³

et al. 2017

Dig Dis

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Background: Creation of a J pouch is the gold standard surgical intervention in the treatment of chronic ulcerative colitis (UC). Pouchoscopy prior to ileostomy takedown is commonly performed. We describe the frequency, indication, and findings on pouchoscopy, and determine if pouchoscopy affects rates of complications after takedown. Methods: All UC or indeterminate inflammatory bowel disease patients with a J pouch were retrospectively evaluated from January 1994 to December 2014. Cases were defined as having routine (asymptomatic) pouchoscopy after pouch creation but before ileostomy takedown. Controls were defined as having no pouchoscopy or pouchoscopy on the same day as that of takedown. Results: The study included 178 patients (81.5% cases, 18.5% controls). Fifty two percent of pouchoscopies were reported as normal. Common abnormal endoscopy findings included stricture (35%), pouchitis (7%), and cuffitis (0.7%). Length of stay during takedown hospitalization was shorter for cases than controls (3 vs. 5 days; p = 0.001), but neither short- nor long-term complications were statistically different between cases and controls. Abnormalities on pouchoscopy were not predictive for short-term complications (p = 0.73) or long-term complications (p = 0.55). Routine pouchoscopy did not delay takedown surgery in any of the included patients. Conclusions: Routine pouchoscopy may not be necessary prior to ileostomy takedown; its greatest utility is in patients with suspected pouch complications.

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The Effect of Hwangnyeonhaedok-tang Pharmacopuncture on ST25 (天樞) in Rats with Dextran Sulfate Sodium (DSS)-Induced Colitis

Lee¹,

Park²,

Cho³

et al. 2016

The Journal of Oriental Obstetrics and Gynecology

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Objectives: The purpose of this study is to find out the effect of various concentrations of Hwangnyeonhaedok-tang (HTT) pharmacopuncture on ST25 (天樞) in rats with dextran sulfate sodium (DSS)-induced colitis.Methods: Colitis was experimentally induced by feeding rats with water mixed with 5% (w/v) DSS for 20 days. The rats were divided into 5 groups: the normal group (Nor, n=5), the control group -colitis induced rats with no treatment (Con, n=5), the acupuncture group -colitis induced rats with acupuncture applied on ST25 (Acu, n=5), the pharmacopuncture group 1 -colitis induced rats with 0.729 mg/250 g/40 μl of pharmacopuncture applied on ST25 (PA-1, n=5), the pharmacopuncture group 2 -colitis induced rats with 3.645 mg/250 g/40 μl of pharmacopuncture applied on ST25 (PA-2, n=5). The changes in weight, excrement concentration and hemafecia were observed 5 times every 2 days. The colon lengths were measured from appendix to the end of colon after the experiment. Hematological and serological exams were conducted the day after the last treatment by cardiac puncturing anesthetized rats.Results: ST25 is the abdominal front point (募穴) of large intestine meridian and is known to have effect in colitis. Various concentrations of HTT pharmacopuncture (HTTP) applied on ST25, in rats with DSS-induced colitis inhibited decrease in colon lengths and body weight in both PA-1 and PA-2 groups. Hematological and serological exam results also showed that HTTP has significant effect on colitis in both PA-1 and PA-2 groups.Conclusions: Colon lengths were significantly increased in the acupuncture group, PA-1 group and PA-2 group, compared to the control group. The body weight was significantly increased (p<0.05) in PA-2 group after the first treatment, compared to the control group. TNF-, IL-6, AST were significantly decreased in PA-1 and PA-2 groups, compared to the control group.

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Current Management of Inflammatory Bowel Disease

Cited by 3 publications

References 0 publications

Inflammatory Bowel Disease

Inflammatory Bowel Disease

Routine Pouchoscopy Prior to Ileostomy Takedown May Not Be Necessary in Patients with Chronic Ulcerative Colitis

The Effect of Hwangnyeonhaedok-tang Pharmacopuncture on ST25 (天樞) in Rats with Dextran Sulfate Sodium (DSS)-Induced Colitis

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