Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Colonic Diseases”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

The course of colonic disease in ulcerative colitis patients with primary sclerosing cholangitis.

BACKGROUND/AIMS: Although there are many studies reporting that colonic dysplasia and cancer develop more frequently in ulcerative colitis patients with ulcerative colitis with primary sclerosing cholangitis, there are insufficient data on the course of the colonic disease. In this study, the course of the colonic disease in ulcerative colitis patients with primary sclerosing cholangitis was investigated. METHODS: Data obtained from ten patients with total colitis and accompanying primary sclerosing cholangitis (three females, seven males, mean age: 44.5+/-10.0 years) were compared with data obtained from 64 patients with pancolitis but without primary sclerosing cholangitis (27 females, 37 males; mean age: 42.3+/-17.1 years). RESULTS: The follow-up period was 6.4+/-6.2 years in patients without primary sclerosing cholangitis, 12.7+/-6.2 years in total and 5.1+/-4.0 years (after development of the condition) in patients with primary sclerosing cholangitis (p<0.01). The number of disease attacks (3.7 attacks/yr vs. 0.5 attacks/yr), duration of the active disease (12.9+/-8.0 months vs. 0,3+/-1.0 months), the number of patients in whom corticosteroids were used (47 patients vs. one patient), the number of patients hospitalized (50 patients vs. one patient) and duration of hospitalization (1.2+/-0.8 months vs. 0,1+/-03 months) were higher in patients with than without primary sclerosing cholangitis (after development of the condition) (p<0.001). There was no significant difference in data obtained from patients with and without primary sclerosing cholangitis before development of the disease. CONCLUSIONS: Colonic disease subsides when primary sclerosing cholangitis develops. The higher frequency of colonic dysplasia and cancer seen in patients with primary sclerosing cholangitis can be explained by the fact that most of them have a longer duration of total colitis and fewer need total colectomy. Even though it does not seem to cause clinical problems, the colonic disease should not be ignored in these patients.

Journal Article↗

Mucosal microhernias in the nonhuman primate colon: their role in the pathogenesis of colonic disease.

Microhernias of colonic mucosal glands through the muscularis mucosae are common in human and nonhuman primate colons, and are related to submucosal lymphoid nodules. In nonhuman primates they have been shown to play an important role in the spread of inflammatory diseases from the lamina propria to the submucosa by allowing the infective agents to pass through the muscularis mucosae. The lymphoid tissue of the alimentary tract is composed predominantly of B lymphocytes and produces humoral antibodies. This property of the lymphoid component of these microhernias may thus play a significant role in determining which infective colonic diseases penetrate into the submucosa and which remain largely confined to the lamina propria.

Animals↗

Mucosal microhernias in the nonhuman primate colon: their role in the pathogenesis of colonic disease.

Microhernias of colonic mucosal glands through the muscularis mucosae are common in human and nonhuman primate colons, and are related to submucosal lymphoid nodules. In nonhuman primates they have been shown to play an important role in the spread of inflammatory diseases from the lamina propria to the submucosa by allowing the infective agents to pass through the muscularis mucosae. The lymphoid tissue of the alimentary tract is composed predominantly of B lymphocytes and produces humoral antibodies. This property of the lymphoid component of these microhernias may thus play a significant role in determining which infective colonic diseases penetrate into the submucosa and which remain largely confined to the lamina propria.

Animals↗

Expression of binding of plasminogen, thrombospondin, vitronectin, and fibrinogen, and adhesive properties by Escherichia coli strains isolated from patients with colonic diseases.

Escherichia coli strains isolated from patients with colonic disorders (n = 27) and strains isolated from the rectal mucosa of healthy subjects (n = 24) were compared with respect to expression of cell surface hydrophobicity, carriage of intestinal virulence factors, adhesion to tissue culture cells, and expression of binding of extracellular matrix proteins and plasma proteins. Strains isolated from patients with colonic disease did not express a more hydrophobic cell surface than strains from healthy subjects. Few strains from both groups carried genes encoding for recognised virulence factors of E coli. Only one strain, carrying the eae gene induced actin polymerisation in tissue culture cells. Strains from patients with colonic diseases adhered to HT29 cells, which are of intestinal origin, to a higher extent than E coli from healthy subjects. Significantly more strains from patients with colonic disorders than E coli from healthy subjects expressed binding of fibronectin, collagens, laminin, vitronectin, plasminogen, throbospondin, and fibrinogen. Expression of binding of these proteins may influence the pathogenesis of colonic disease by mediating binding to ulcerated tissue, preventing complement induced lysis of bacteria and by exerting proteolytic activity. There was no correlation between serotype, expression of cell surface hydrophobicity, and binding of extracellular matrix and plasma proteins.

Bacterial Adhesion↗

Should colonoscopy be the first investigation for colonic disease?

Many patients with suspected colonic disease undergo rigid sigmoidoscopy, barium enema examination, and ultimately total colonoscopy, but the need for preliminary radiology has not been formally assessed. A total of 168 patients requiring large bowel investigation were therefore randomised to undergo either rigid sigmoidoscopy plus double contrast barium enema examination or total colonoscopy. Disease was found in 56 patients, including 14 with a carcinoma, 11 with polyps, and 16 with inflammatory bowel disease, the remainder having diverticular disease alone. Of the 89 patients allocated to double contrast barium enema examination, nine required a subsequent colonoscopy for suspected tumour or polyps, three because of incomplete radiological examination, and 12 for rectal bleeding for which no cause was found at the radiological examination. In 16 patients this yielded further information or altered treatment. Of the 79 patients undergoing total colonoscopy, only six required subsequent radiology. As both procedures were well tolerated with no major complications total colonoscopy may be the preferred initial investigation where facilities allow.

Adult↗

Colon diseases: MR evaluation using combined T2-weighted single-shot echo train spin-echo and gadolinium-enhanced spoiled gradient-echo sequences.

This study demonstrates the appearance of large bowel diseases on magnetic resonance (MR) images using breath-hold T2-weighted half-Fourier acquisition snapshot turbo spin-echo (HASTE), breath-hold T1-weighted spoiled gradient-echo (SGE), and breath-hold gadolinium-enhanced T1-weighted SGE with and without fat-suppression sequences. The study represents a collective experience using a generalized combined abdominal-pelvic imaging protocol. Of 29 patients, 27 had surgical, endoscopic, microbiological, and/or histopathological correlation, and 2 had a diagnosis based on characteristic imaging findings. Fifteen patients had neoplastic disease including colon adenocarcinoma (n = 11), rectosigmoid carcinoid (n = 1), familial adenomatous polyposis (n = 2), and cecal lipoma (n = 1). Fourteen patients had non-neoplastic disease including diverticulosis (n = 6), ischemic colitis (n = 2), pseudomembranous colitis (n = 2), acute appendicitis with periappendiceal abscess (n = 2), Mycobacterium avium intracellulare (MAI) colitis (n = 1), and Crohn's proctocolitis (n = 1). In all 15 patients with neoplastic diseases, MR imaging depicted the primary lesions and demonstrated local extent. Mass lesions were best shown on T2-weighted HASTE and gadolinium-enhanced fat-suppressed SGE images. Of 14 patients with non-neoplastic diseases, inflammatory changes were best shown on gadolinium-enhanced fat-suppressed T1-weighted SGE images in all cases. MR imaging with fast scanning breath-hold techniques and intravenous gadolinium enhancement provided good depiction and characterization of large bowel diseases.

Adolescent↗

A morphometric study of the canine colon: comparison of control dogs and cases of colonic disease.

The microstructure of the canine colon was described morphometrically. The artifacts induced by administration of enemas and biopsy technique were studied by comparing biopsy specimens to tissues obtained at necropsy from 15 normal dogs. Biopsies from control dogs and clinical cases of colonic disease were then evaluated quantitatively, and histological abnormalities which might clarify mechanisms underlying large bowel dysfunction in the dog were sought. In control dogs, gland length and diameter, epithelial, goblet cell and mucosal mast cell numbers, and intraepithelial lymphocyte and mitotic indices were remarkably uniform throughout the colon. Minor variations were found in the proximal and distal regions of the colon. An apparent shortening of glands, and a reduction in mucous goblets and intraepithelial lymphocytes in biopsies were attributed to suboptimal orientation and irritation caused by enemas. The only significant difference from controls identified by morphometric analysis of biopsies from clinical cases was fewer epithelial cells lining longitudinal sections of glands. It was concluded that failure to identify morphometric variations in the colonic mucosa of clinical cases might reflect either a biased, homogeneously mild clinical syndrome in this group, or the possibility that in many of the clinical cases, a functional rather than physical abnormality was involved. The proprial inflammatory cell population was not examined quantitatively; further investigation of this component is merited.

Animals↗

Apoptotic colonic disease: a new entity in a primate.

A Macaca fascicularis died following chronic, intractable diarrheas. At autopsy, the entire colon was macroscopically red and swollen. At histology, the most conspicuous histologic finding was a marked accumulation of intraepithelial apoptotic granules in the lower one third of the epithelium of the colonic crypts. The cells in those crypts showed various degrees of swelling or necrobiosis. Since no other explanation was found at autopsy, it was concluded that the marked apoptosis with marked epithelial cell destruction was the cause of the colonic disease which apparently resulted in untreatable protracted diarrheas in this animal. The term apoptotic colonic disease is proposed for this previously unreported condition.

Animals↗

Dietary fiber. Can it prevent certain colonic diseases?

Most of the serious organic diseases of the colon are etiologically linked to the high-saturated-fat and low-fiber Western diet. Benign but common conditions, such as appendicitis and diverticular disease of the colon, appear to be due to deficiency of fiber and attendant low-bulk stools. Colon cancer appears to be due to carcinogens created in the colon itself. Contributing to carcinogen production are cocarcinogens in bile and an increase in anaerobic bacteria, both directly related to high levels of saturated fat in the diet. If these common disorders of the colon are to be controlled, our diet will require major modification. Changes will have to include reduction of saturated fats of animal origin and increase in cereal grains.

Appendicitis↗

[CT-colonography with the 16-slice CT for the diagnostic evaluation of colorectal neoplasms and inflammatory colon diseases].

PURPOSE: Comparison of the performance of virtual and conventional colonoscopy for the detection of colorectal polyps and inflammatory colon diseases using a 16-slice spiral CT scanner. Furthermore, presentation of the first experiences with a new three-dimensional reconstruction mode ("colon-dissection") that dissects the colonic wall like a pathologic-anatomic preparation to increase the sensitivity. MATERIALS AND METHODS: Forty patients were studied using a 16-slice spiral CT (Lightspeed 16, General Electric Medical Systems, Milwaukee, Wisconsin 53201, USA). The examination was performed after standard oral preparation for colonoscopy. The colonic distension was achieved with room air and intravenous butylscopolamine. Images were obtained in supine and prone position using a detector configuration of 16 x 0.625 mm, pitch 1.7, rotation time 0.5 s, 160 mAs and 120 kV. Axial reconstruction with a slice thickness of 0.625 mm. The CT data were assessed by two radiologists on an Advantage Workstation (Volume Analysis 2, USA) using a software with the capabilities of axial, multiplanar and volume rendering, virtual endoscopy, and colon dissection. Conventional colonoscopy was used to determine the sensitivity. RESULTS: A total of 30 polyps were found in 8 patients and a carcinoma was detected in two patients. Colonography identified 4 polyps with a diameter of 10 mm or more, 6 polyps with a diameter of 5 mm to 9.9 mm, 11 polyps with a diameter of 3 to 4.9 mm and 9 polyps with a diameter of 3.0 mm or less. There were two false negative findings (one polyp of 3 mm and one of 4 mm had been overseen) and two false positive findings for polyps (polyps of 4 mm and 6 mm). The sensitivity and specificity for the detection of colonic polyps were 93% and 94% with the "colonic-dissection" mode, 87 % and 94 % with the "virtual-endoscopy" mode and 63 % and 97 % with multi-planar reconstruction, respectively. Depending on the diameter of the colonic polyps, the "colon-dissection" mode ("virtual-coloscopy") had a sensitivity and specificity of 100 % and 100 % for polyps with a diameter over 5.0 mm, 91 % and 82 % for polyps with a diameter from 3.0 to 4.9 mm and 89 % and 78 % for polyps with a diameter under 3.0 mm, respectively. Inflammatory colon diseases presented as thickening of the colon wall over 5 mm. CONCLUSIONS: Virtual colonoscopy with 16-slice spiral CT allows accurate detection of colonic polyps, including small polyps below a diameter of 3 mm. In comparison with the 2D- and 3D-"virtual-endoscopic" reconstruction, the 3D-reconstruction software "colon-dissection" achieves the highest sensitivity for the detection of colonic masses. Therefore, the combination of a 16-slice spiral CT and the "colon-dissection" reconstruction software provides a high resolution in the z-axis for detecting colonic masses and polyps down to a diameter of less than 2 mm, with a sensitivity of about 90 %. This sensitivity is much higher than the sensitivity achievable with 4-slice spiral CT and without "colon-dissection" mode. A thickened colon wall over 5 mm indicates inflammatory colon disease.

Colonic Polyps↗

[Hydrocolonic sonography--potentials and limitations of ultrasonographic diagnosis of colon diseases].

Hydrocolonic sonography - potentials and limitations of ultrasonographic diagnosis of colon diseases. Ultrasonic examination has become increasingly important in the diagnosis of diseases of the gastrointestinal tract. In neoplastic diseases of the large intestine, however, the diagnostic value of conventional transabdominal sonography is limited. The sonographic evaluation of the colon could be improved by the retrograde instillation of water into the colon in a procedure called hydrocolonic sonography. This technique allows the visualization of the colon sonographically from the rectosigmoid transition to the cecum. Hydrocolonic sonography enables a detailed sonographic examination of the hypoechoic colonic lumen, the five individual layers of the colon wall and the surrounding connective tissue, thus providing additional information and allowing a more precise diagnosis of many diseases of the colon. Colonic polyps and carcinomas appear sonographically as echogenic structures projecting from the intestinal wall into the lumen. Colonic polyps larger than 7 mm in diameter and carcinomas of the colon can be detected with great sensitivity. In addition, detailed evaluation of the structure of the bowel wall permits more precise staging of tumors of the colon. Aside from such localized changes, hydrocolonic sonography can also demonstrate changes in the wall structure in chronic inflammatory large bowel diseases such as Crohn's disease and ulcerative colitis. In addition hydrocolonic sonography has been proven to be of great value for the ultrasonographically-guided hydrostatic reduction of intussusception in children. On the other hand virtual colonoscopy is another promising new imaging method for the diagnosis of colon diseases. The differences between hydrcolonic sonography and virtual colonoscopy and their potential for screening purposes of colon cancer will be discussed.

Colon↗

[Abdominal echography in colonic diseases].

In the past few years, several studies have assessed the visualization of digestive diseases by ultrasound, but its clinical accuracy has been rarely defined. Thus we evaluated the contribution of sonographic examination as an initial diagnostic mean in the detection of colonic lesion. During a period of thirty six months (June 85-June 88) when we performed a standard sonographic abdominal examination, we utilized ultrasound to look for thickening or other modifications of the large bowel wall, if the clinical findings suggested a colonic disease. In these conditions we performed 453 US examinations. In our study, 363 cases were considered to be negative and the controls demonstrated colonic wall lesions in 24 cases. Thus the sensitivity was one of 77%. The sonographic examination was positive in 90 cases with 6 false positives. Thus our specificity reached 98.2% and the accuracy achieved was 93.3%. Thus sonographic examination appears to be a rapid, non invasive, mobile, mean of examining the abdominal cavity and also the large bowel in all patients. If this examination is negative, a colonic disease is possible since sensitivity is 77%. On the other hand, if the examination is positive, a colonic disease is very probable, since specificity reached 98.2%. The accuracy of US Colonic examination is 93.3% and with using abdominal plain film, theses percentages may be improved.

Adult↗