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PubMed1975

Lowered serum cholesterol following the ingestion of a hydrophilic colloid.

An attempt was made to test the possible clinical application of the cholesterol-lowering effect of hydrophilic colloids. 10 patients with high mean serum cholesterol levels during a 3-week control period and 9 with normal mean levels were each fed 11.5 g daily of undiluted hydrophilic colloid for 5 weeks. Serum cholesterol decreased significantly in 8 of the 10 (80%) patients with control-period hypercholesteremia and 6 of the 9 (66 2/3%) with control-period normal levels. These findings tend to confirm the observation that a simple and commonly used type of medication for chronic constipation, particularly in the elderly, may be a useful adjunct in the management of hypercholesterolemia.

Administration, Oral↗
PubMed2000

Micronized purified flavonidic fraction compared favorably with rubber band ligation and fiber alone in the management of bleeding hemorrhoids: randomized controlled trial.

PURPOSE: The aim of this study was to assess the role of micronized purified flavonidic fraction in the management of bleeding nonprolapsed hemorrhoids. METHODS: Patients were randomly assigned to receive ispaghula husk alone, rubber band ligation plus ispaghula husk, or micronized purified flavonidic fraction plus ispaghula husk. Other colorectal diseases were excluded by colonoscopy. Blinded observers noted the time for bleeding to stop completely, recurrences, and treatment complications. RESULTS: A total of 162 patients were randomly assigned with no significant differences in the age and gender distributions among the groups. Hemorrhoidal bleeding was relieved most expediently in the micronized purified flavonidic fraction plus ispaghula husk group (ispaghula husk alone n = 66, mean (standard error of the mean) 10.6 (2.3) days; rubber band ligation plus ispaghula husk n = 57, 5.6 (1.1) days; micronized purified flavonidic fraction plus ispaghula husk n = 39, 3.9 (1.2) days; P = 0.03). However, there were no significant differences in the recurrences at six months of follow-up (ispaghula husk alone n = 8 (12 percent); rubber band ligation plus ispaghula husk n = 12 (21 percent); micronized purified flavonidic fraction plus ispaghula husk n = 2 (5.1 percent); P = 0.075). No complications or side-effects were noted. CONCLUSIONS: micronized purified flavonidic fraction used with fiber supplements rapidly and safely relieved bleeding from nonprolapsed hemorrhoids.

Adult↗
PubMedDate not supplied

Conservative treatment of anal fissure: an unselected, retrospective and continuous study.

Three hundred and ninety-three patients who had anal fissures were followed continuously for approximately five years. More than 44 per cent of them were cured nonsurgically within a four-to-eight-week period. There was an 8 per cent complication rate, consisting of abscesses and fistulas, necessitating surgical treatment. The recurrence rate following healing was 27 per cent, but a third of these patients had recurrent fistulas that healed in response to further conservative treatment. The authors feel that conservative treatment of anal fissure is justified unless there is advanced anal stenosis.

Adolescent↗
PubMedDate not supplied

Helical CT of the small bowel with an alternative oral contrast material in patients with Crohn disease.

BACKGROUND: We assessed the usefulness of helical computed tomography (CT) with a negative oral contrast material for detecting Crohn disease. METHODS: Thirty-eight patients with proven Crohn disease were examined. We administered a large volume of a new negative oral contrast material (Mucofalk suspended in water) and then proceeded with helical CT scanning. This technique is an alternative to CT and conventional enteroclyses that use a nasojejunal tube. Two radiologists interpreted the scans, and patients were interviewed about their tolerance of the procedure. We created multiplanar reformatted images in all cases. Potential of small bowel distention by Mucofalk was evaluated by two observers on a three-point scale, and interobserver agreement was calculated with kappa statistics. RESULTS: All patients who underwent enteroclysis stated that CT was the more comfortable method, the taste of the peroral contrast medium was considered good by 52.6% and acceptable by 47.4%. Small bowel distention was excellent in 55% of cases, moderate in 26%, and poor in 19%, with an interoberserver agreement of 78%. CT findings correlated with enteroclysis in 27 patients who underwent both methods. Analysis of CT versus enteroclysis showed a sensitivity of 89% for CT versus 78% for small bowel enteroclysis. CONCLUSION: Mucofalk CT is a simple, rapid, noninvasive, and accurate method of evaluating extramucosal manifestations of Crohn disease. The tubeless procedure improved patients' comfort and decreased time, cost, and radiation exposure.

Administration, Oral↗
PubMed1994

Soluble fiber and serum lipids: a literature review.

Although fiber has been increasingly recognized as an important dietary constituent, controversy and confusion still exist about the physiologic effects of fiber. Specifically, the independent ability of dietary fiber to lower serum lipid levels is controversial. The purpose of this article is to review available evidence regarding the impact of soluble fibers on serum lipid levels. Soluble fibers appear to have a greater potential to alter serum lipid levels than do insoluble fibers. Significant reduction in the level of serum total cholesterol by soluble fiber was found in 68 of the 77 (88%) human studies reviewed. Of the studies measuring low-density lipoprotein cholesterol, 41 of 49 (84%) reported significant reductions. No significant changes were reported in 43 of the 57 (75%) studies that reported high-density lipoprotein cholesterol and/or in 50 of the 58 (86%) studies that measured triglyceride levels.

Cholesterol↗
PubMed1989

Serum lipids and cholesterol metabolism during guar gum, plantago ovata and high fibre treatments.

Short-term viscous dietary fibres, plantago ovata and guar gum preparations, decreased serum cholesterol, mainly LDL cholesterol, as compared to low fibre or nonviscous high fibre periods, through enhancing cholesterol elimination as fecal bile acids. These changes were associated with significant increases in serum levels of cholesterol precursors, both in methylsterols and demethylated precursor sterols, while that of cholestanol (saturated cholesterol derivative) was decreased. In addition, cholesterol precursor contents were positively related, cholestanol negatively, to fecal cholesterol elimination both on and off viscous fibres. These findings indicate increased cholesterol synthesis, also seen by sterol balance data. As compared to low fibre diet, nonviscous high fibre diet conserved bile acids and decreased cholesterol absorption. Thus, it had no effect on cholesterol synthesis as indicated by fecal total steroids or serum levels of cholesterol precursors.

Cholesterol↗
PubMed1989

Sudan stain of fecal fat: new insight into an old test.

The 72-h fecal fat determination is used as the gold standard to document the presence of steatorrhea. Although the Sudan stain for fecal fat is advocated as a sensitive screening test, a quantitative correlation between the 72-h fecal fat quantitation and the fecal Sudan stain is lacking. This study was designed to examine the staining properties of different classes of purified lipids in an experimentally defined artificial matrix, and to elucidate the reasons for the lack of quantitative correlation between these two tests. Our results indicate that the "neutral fat" stain without acidification or heating identifies triglyceride; and at an appropriate pH, the "neutral stain" also identifies fatty acid. The "split fat" stain with acidification and heating identifies both triglyceride and fatty acid. After acidification, fatty acid soaps are converted to the nonionized fatty acid. Thus, fatty acid soaps can be identified indirectly as fat droplets that are stained by the split fat stain. Although cholesterol is stained with Sudan stain after heating, upon cooling, cholesterol forms crystals of anhydrous cholesterol, making its staining pattern distinct. Neither the neutral fat nor the split fat stain can detect phospholipid or cholesteryl ester. The 72-h fecal fat determination is a measure of the total fatty acid content after a specimen is saponified. The resulting fatty acids are derived from a variety of endogenous and exogenous sources, including free fatty acids, soaps of fatty acids, triglycerides, cholesterol esters, and phospholipids. Therefore, the 72-h fecal fat quantitation does not differentiate between the primary sources of the measured fatty acid. It is concluded that the 72-h fecal fat determination is not specific for documenting triglyceride (fat) malabsorption. Until new methods are developed that specifically measure fecal triglyceride and fatty acid, the Sudan stain of fecal fat appears to be a more specific method for detecting the presence of triglyceride and fatty acid in a matrix.

Azo Compounds↗
PubMed1990

Manipulation of fecal pH by dietary means.

Epidemiological and animal studies suggest that colonic fermentation and fecal pH may be risk factors for colorectal cancer. To modify these factors, we sought to develop a simple instrument for use in intervention studies. Three 14-day studies with 32, 40, and 30 healthy volunteers maintained on their regular diet were carried out to evaluate the effect of various food supplements on fecal pH. The interventions tested included supplementary lactulose, Metamucil, oat bran, wheat bran, or no supplement. The results showed that it is possible to provide a simple intervention to reduce fecal pH by 0.4 unit with oat bran administered at 75-100 g/day over a 14-day period, using a wheat combination, equivalent in macronutrients and fiber, as a control.

Adult↗
PubMed1981

Cervical dilatation in late first trimester termination by prostaglandin, hylase and isogel.

Pre-operative dilatation of the cervix was attempted in 223 cases prior to vacuum aspiration in patients seeking late first trimester termination beyond ten weeks. 15 Me PGF2a was used in the form of vaginal suppositories, intramuscular and intracervical injections. Dilatation of cervix of 10 mm or more was achieved within 4 hours in 86% cases with intra-cervical injections. Gastro-intestinal disturbances caused by intra-muscular injections could be avoided by intra-cervical injections, as the amount of prostaglandin required was only 100 ugm, but the success rate was significantly lower. The success with multiple dose suppositories was 80%. There was no significant difference in the success with 1.5 mgm or 1.0 mgm dosage, but the side effects were significantly higher with 1.5 mgm suppositories. Intra-cervical Hylase did not dilate the cervix but successfully softened it within 5 minutes to make metallic dilatation simple. The hygroscopic Isogel tents achieved dilatation of 10 mm or more in 73% of the patients in 12 hours. The tents as well as intra-cervical prostaglandin injection had the disadvantage of requiring an additional theatre procedure prior to suction curettage.

Abortion, Induced↗
PubMed1984

Effect of Metamucil on tumour formation by 1,2-dimethylhydrazine dihydrochloride in mice.

The effect of the plant cellulose metamucil on the tumorigenicity of 1,2-dimethylhydrazine dihydrochloride (1,2-DMH) was studied in random-bred Swiss mice. Three groups of mice, which were 5, 6 and 6 weeks old at the beginning of the experiment, were given the following treatments: (1) metamucil (20%, w/w) in powdered diet for their lifespan; (2) 1,2-DMH, ten weekly subcutaneous injections at 20 mg/kg body weight; (3) combination of treatments given to groups 1 and 2. The administration of metamucil enhanced the appearance of colon tumours induced by 1,2-DMH in males only. Metamucil had no statistically significant effect on the development of tumours elicited by 1,2-DMH at seven additional sites. It was expected that a high amount of dietary fibre would inhibit carcinogenesis in the large intestine. Instead, metamucil increased the incidence of colon tumours induced by 1,2-DMH, although only in males.

1,2-Dimethylhydrazine↗
PubMed2000

Calcium and fibre supplementation in prevention of colorectal adenoma recurrence: a randomised intervention trial. European Cancer Prevention Organisation Study Group.

BACKGROUND: Some epidemiological studies have suggested that high dietary intake of calcium and fibre reduces colorectal carcinogenesis. Available data are not sufficient to serve as a basis for firm dietary advice. We undertook a multicentre randomised trial to test the effect of diet supplementation with calcium and fibre on adenoma recurrence. METHODS: We randomly assigned 665 patients with a history of colorectal adenomas to three treatment groups, in a parallel design: calcium gluconolactate and carbonate (2 g elemental calcium daily), fibre (3.5 g ispaghula husk), or placebo. Participants had colonoscopy after 3 years of follow-up. The primary endpoint was adenoma recurrence. Analyses were by intention to treat. FINDINGS: 23 patients died, 15 were lost to follow-up, 45 refused repeat colonoscopy, and five developed severe contraindications to colonoscopy. Among the 552 participants who completed the follow-up examination, 94 stopped treatment early. At least one adenoma developed in 28 (15.9%) of 176 patients in the calcium group, 58 (29.3%) of 198 in the fibre group, and 36 (20.2%) of 178 in the placebo group. The adjusted odds ratio for recurrence was 0.66 (95% CI 0.38-1.17; p=0.16) for calcium treatment and 1.67 (1.01-2.76, p=0.042) for the fibre treatment. The odds ratio associated with the fibre treatment was significantly higher in participants with baseline dietary calcium intake above the median than in those with intake below the median (interaction test, p=0.028) INTERPRETATION: Supplementation with fibre as ispaghula husk may have adverse effects on colorectal adenoma recurrence, especially in patients with high dietary calcium intake. Calcium supplementation was associated with a modest but not significant reduction in the risk of adenoma recurrence.

Adenoma↗
PubMed2001

Non-invasive distension of the small bowel for magnetic-resonance imaging.

Magnetic resonance enteroclysis is a promising technique that allows assessment of the small bowel but needs invasive nasoduodenal intubation. We propose a non-invasive distension method for magnetic-resonance imaging (MRI) in which ispaghula, dissolved in an aqueous solution with meglumine gadoterate taken orally over 4 h forms a viscous hydrogel within the intestinal lumen. MRI results from ten volunteers showed good luminal distension, constant signal homogeneity, optimum demarcation of the bowel content from surrounding tissues, and a low rate of artefacts. Our method permits non-invasive high quality MRI of the small bowel.

Adult↗