The administration of pteroylmonoglutamic acid and either sodium bicarbonate or phenytoin sodium in normal subjects and epileptics results in lower serum levels of folic acid than when administered alone. Bicarbonate administration was shown to produce a more alkaline pH in the jejunum, while an alkaline pH was found in some epileptics on phenytoin therapy. The physicochemical mechanisms whereby folic acid absorption is reduced in an alkaline medium are considered, and the implications on folate absorption in other disease states are discussed. The mechanism by which phenytoin sodium alters the intrajejunal milieu is obscure.

Bicarbonates↗

PubMed1971

The effects of diversion of intestinal contents on the progress of Crohn's disease of the large bowel.

This study shows that faecal diversion by ileostomy or colostomy results in an improvement in the patient's general health which is substantiated by the haematological and biochemical findings. However, in the bowel distal to the diversion there is always histological evidence of mucosal and transmural disease and complications such as fistulae may still occur. In only two patients (7%) was restoration of bowel continuity successful.

Anus Diseases↗

PubMed1971

Impaired lymphocyte reactivity against tumour cells in patients with coeliac disease.

The lymphocytes of patients with coeliac disease are shown to have a significant diminution of proliferative and cytotoxic capacity as compared to normal lymphocytes when challenged in vitro with tumour cells from a lymphoma cell line. This impaired responsiveness is partly related to an intrinsic cellular defect but an inhibiting factor in the serum of coeliac patients has also been demonstrated. The impaired coeliac lymphocyte response in this in-vitro test system may serve as an indicator of a comparable defect in immune surveillance in vivo. This would account for the increased incidence of lymphosarcoma known to arise in patients with longstanding coeliac disease and might also explain the raised incidence of other gut-related tumours in these patients.

Adolescent↗

PubMed1971

The fate of ileorectal anastomosis in Crohn's disease.

An assessment has been made of 25 patients who have undergone ileorectal anastomosis for Crohn's disease. The rate of anastomotic leakage was high (32%) but was fatal in only one patient. The likelihood of leakage was not affected by a safety valve ileostomy, failure to excise all diseased bowel, or steroid therapy. The overall recurrence rate was 60 per cent. This was not affected by the age of the patient, duration of the disease, steroid therapy, or anastomotic leak but was affected adversely by the presence of concurrent small bowel disease and by residual rectal disease at the site of the anastomosis.

Abscess↗

PubMed1971

Finger clubbing and regional enteritis.

Finger clubbing was present in 105 of 181 (58%) patients. It was related to the activity but not to the site of the disease and disappeared two to three months after the disease became quiescent.

Crohn Disease↗

PubMed1971