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Biomedical subjects

B T Cooper

Publications and source records attributed to B T Cooper.

At least 55 records · Page 3Linked to original sources
PubMed1987

Erosive gastritis and gastrointestinal bleeding in a female runner. Prevention of the bleeding and healing of the gastritis with H2-receptor antagonists.

A 33-yr-old female runner presented with upper gastrointestinal symptoms and iron deficiency anemia. She was found to have erosive gastritis that was present when she exercised and which was associated with symptoms. Gastrointestinal blood loss during exercise periods was confirmed by measuring fecal blood loss using 51Cr-labeled red cells. Symptoms, gastritis, and blood loss disappeared with cessation of running or with H2-receptor antagonist therapy.

Adult↗
PubMed1987

Treatment of Barrett's esophagus with H2 blockers.

The effect of the H2 receptor antagonists, cimetidine and ranitidine, on Barrett's esophagus was assessed in a retrospective study. There was no evidence of regression of Barrett's epithelium in the 22 patients treated for a mean of 13 months with 800-1,600 mg/day cimetidine, or in the 13 patients treated for a mean of 5.7 months with 300 mg/day ranitidine. Eight of 12 esophageal (Barrett's) ulcers healed on cimetidine therapy over a mean period of 8.7 months, and eight of nine esophageal ulcers healed on ranitidine therapy over a mean period of 3.5 months. We conclude that short-term treatment with H2 blockade does not cause regression of Barrett's esophagus, although such treatment can heal esophageal ulcers.

Adult↗
PubMed1987

Barrett's oesophagus: a clinical study of 52 patients.

This paper reports a series of 52 patients with Barrett's (or columnar-lined) oesophagus from one medical unit diagnosed over a six-year period. The commonest associated symptoms were heartburn, regurgitation and dysphagia but 10 patients had no oesophageal symptoms and two had no symptoms at all. Gastrointestinal bleeding (overt or occult) was observed in almost one-third of patients. At diagnosis, 26 patients had oesophagitis, 23 had oesophageal ulceration and 10 had benign oesophageal strictures. An association between oesophageal ulceration and non-steroidal anti-inflammatory drug ingestion was suggested by the data and patients with oesophageal ulceration were significantly older than patients with uncomplicated Barrett's oesophagus. No patient had adenocarcinoma of the oesophagus at diagnosis and neither carcinoma nor dysplasia were seen during a mean period of 16.4 months. However, 17 per cent of patients in the series had malignancies in other sites. Most patients did well on medical treatment and only two were referred for anti-reflux surgery (both for non-healing oesophageal ulcers). Barrett's oesophagus was seen in 10 per cent of patients with gastro-oesophageal reflux at endoscopy. Oesophageal ulceration in patients with Barrett's oesophagus made up 21 per cent of oesophageal ulcers seen and benign oesophageal stricture in patients with Barrett's oesophagus constituted 13 per cent of all benign strictures seen. Barrett's oesophagus is common in our population and despite complications, it can be managed successfully, at least in the short term, by conservative means.

Adolescent↗
PubMed1986

Clostridium difficile toxin in chronic idiopathic colitis.

Clostridium difficile toxin was isolated from the stools of three patients with chronic idiopathic colitis. Two patients were known to have chronic idiopathic colitis before Cl difficile toxin was isolated. The third patient was subsequently found to have ulcerative colitis after presentation with Cl difficile toxin in the stool. Two patients were on sulphasalazine at the time of diagnosis of Cl difficile infection and one had taken sulphasalazine two months previously. Only one patients had antibiotic exposure and that was at least three months before presentation. In each patient, treatment with vancomycin was accompanied by symptomatic improvement and disappearance of the toxin. The underlying colitis remained unaffected. In patients with inflammatory bowel disease in relapse, the presence of Cl difficile toxin should be sought as this may be a factor in the relapse. In any patient presenting with diarrhoea, the presence of Cl difficile toxin may obscure the presence of underlying inflammatory bowel disease.

Adult↗
PubMed1986

The delayed diagnosis of coeliac disease.

The prevalence of coeliac disease in New Zealand appears to be much lower than in the British Isles suggesting the possibility that coeliac disease is not being diagnosed in this country. This view point is supported by the two patients reported in this paper who had coeliac disease diagnosed after ten years and at least 36 years of symptoms respectively. The importance of diagnosing coeliac disease is stressed, particularly because of the greatly increased risk of developing lymphoma (from which one of the two patients died). The need to investigate all patients with chronic diarrhoea and other gastrointestinal symptoms is stressed.

Aged↗
PubMed1986

Small intestinal permeability in normal Sudanese subjects: evidence of tropical enteropathy.

Small intestinal permeability to mannitol and lactulose was studied in healthy English and apparently healthy Sudanese subjects to determine whether any differences were apparent. Permeability was assessed by measuring urinary recovery of the test substances after oral ingestion. The mean excretion of lactulose was significantly higher and the mean excretion of mannitol was significantly lower in the Sudanese than in the English subjects. Lactulose to mannitol excretion ratios were significantly higher in the Sudanese. These data demonstrate abnormal intestinal permeability in the Sudanese subjects and indicate the presence of an asymptomatic enteropathy.

Adult↗
PubMed1986

Upper gastrointestinal endoscopy in patients aged 80 years or more.

A retrospective study of 208 upper gastrointestinal endoscopies (including 56 therapeutic procedures) performed over a 3-year period on 150 patients aged 80 years or more has shown that endoscopy is safe and well tolerated in this age group. Only 10% of first endoscopies were normal. If endoscopies performed for therapy or assessment of peptic ulcer healing are excluded, 79% of endoscopies were considered helpful in revealing the cause of the patients symptoms and/or aiding the patients' management. Endoscopy was particularly helpful in patients with gastrointestinal haemorrhage or dysphagia. Of 63 emergency endoscopies for acute upper gastrointestinal haemorrhage, a source of bleeding was found in 82%. Out-patient diagnostic endoscopy and even out-patient endoscopic oesophageal dilatation was safe in the more robust elderly patient. Patients aged 80 years or more made up 5% of all upper gastrointestinal endoscopies and 10% of all emergency endoscopies performed in our unit. The study emphasizes the important contribution of sophisticated investigative techniques to the care of the elderly.

Aged↗
PubMed1985

Small intestinal permeability as an indicator of jejunal mucosal recovery in patients with celiac sprue on a gluten-free diet.

Lactulose/mannitol excretion ratios were measured in 13 patients with celiac disease at diagnosis and after 5-8 months on a gluten-free diet. Jejunal biopsies were assessed histologically at diagnosis and during treatment. The excretion ratios in untreated patients were significantly higher than in 25 normal controls (P less than 0.01). On the diet, the excretion ratios fell in every patient, but in only eight did the ratio return to normal. There was a good correlation between the ratio and jejunal histological grading. During treatment, the ratios significantly inversely correlated with jejunal villous height/mucosal thickness ratios (P less than 0.001). Therefore, excretion ratios provide a well-tolerated noninvasive means of assessing the jejunal mucosa in patients with celiac disease on a gluten-free diet.

Absorption↗
PubMed1985

Gastrocnemius myositis in a patient with inflammatory bowel disease.

A young woman with long-standing inflammatory bowel disease presented with a tender left gastrocnemius myositis in association with an exacerbation of her disease. Muscle biopsy showed a chronic inflammatory cell infiltrate and atrophic muscle fibres, but no granulomata or vasculitis, and her symptoms responded to high-dose steroids. Twelve months later she underwent subtotal colectomy for troublesome symptoms and incidentally was discovered to have an adenocarcinoma of the sigmoid colon. Myositis without granulomata has not been reported previously in either Crohn's disease or ulcerative colitis.

Adenocarcinoma↗
PubMed1985

Diarrhoea as a symptom.

Diarrhoea is a common symptom in all communities and in both general and hospital practice. Diarrhoeal diseases, particularly of infectious aetiology, are a huge health problem world-wide, causing much morbidity and mortality, especially amongst children. Although the symptom is almost universally understood, the definition of diarrhoea is difficult because of the wide variation in the bowel habits of normal individuals. Diarrhoea is, perhaps, best described as a change in bowel habit from normal with an increase in stool volume and/or fluidity with or without an increase in stool frequency. The disorders causing diarrhoea are many and various, but most episodes of diarrhoea are mild and self-limiting. However, all cases of chronic diarrhoea and all severe cases of acute diarrhoea require investigation after the initial clinical assessment. Investigation must be logical and structured and can be divided into three stages: the initial work-up (sigmoidoscopy, stool examination, screening blood tests), anatomical and functional assessment of the gastrointestinal tract, and further investigation of the difficult case (osmotic or secretory diarrhoea?, hormone levels, tests for laxative abuse, perfusion studies, laparotomy, etc.) Most cases are diagnosed after clinical assessment or the initial work-up. In the remainder, there are usually clues to the diagnosis or to the area of the gastrointestinal tract which needs to be investigated. Only a small number of cases require extensive investigation including the third stage of work-up. Analysis of the symptom of diarrhoea requires all the attributes of the good physician: wide clinical experience, careful history and examination, diagnostic and therapeutic acumen, a sound understanding of normal and abnormal physiology, skill and experience in selecting the appropriate investigations and interpreting their results, meticulous attention to detail and finally, a caring and sympathetic attitude to the patient.

Chronic Disease↗