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PubMed1991

15-HETE is the main eicosanoid present in mucus of ulcerative proctocolitis.

Prostaglandins, leukotrienes and mono-hydroxy acid products of arachidonic acid were measured in mucus of freshly recovered morning stools of a patient with an exacerbation of ulcerative proctocolitis. Eicosanoids in ether extracts were separated by high performance liquid chromatography and amounts determined by radioimmunoassay. Four hydroxy-eicosatetraenoic acids were detected, of which the most important one was identified as 15-hydroxy eicosatetraenoic acid (530 ng/g mucus). Leukotriene B4 was also present (21 ng/g mucus) and small amounts of immunoreactive leukotriene C4 (less than 0.8 ng/g mucus). The prostaglandins 6-keto-PGF1 alpha and PGE2 and thromboxane B2 were found in amounts of 3.7, 2.0 and 9.2 ng/g mucus, respectively.

Adult↗
PubMed1976

Proctocolitis and Crohn's disease of the colon: a comparison of the clinical course.

This study suggests that proctocolitis is an illness with an acute and potentially dangerous onset but which appears to become less severe after survival for one year, whereas Crohn's colitis tends to be a more chronic and progressive illness over several years with a greater need for surgical treatment and a greater tendency to anal complications.

Adolescent↗
PubMed1985

Crypt cell production rate in ulcerative proctocolitis: differential increments in remission and relapse.

Crypt cell production rate (CCPR) has been measured by a stathmokinetic technique in the relapse and remission phases of ulcerative proctocolitis. Rectal biopsies were obtained from eight patients with colitis in relapse, 14 patients with colitis in remission, and 14 patients with histologically normal mucosa. Biopsies were maintained in organ culture for 16 hours and were then exposed to vincristine for one to three hours. Crypt cell production rate was determined from the rate of accumulation of arrested metaphases. Mean CCPR in the relapse group (14.2 cells/crypt/hour) was 45% faster than in the remission group (9.8 cells/crypt/hour; p less than 0.001), which was in turn 14% faster than in normal mucosa (8.6 cells/crypt/hour; p less than 0.04). More rapid turnover of the rectal epithelium in quiescent as well as active colitis may help to explain the enhanced risk of carcinogenesis in this disease.

Adolescent↗
PubMed1981

Relapse of ulcerative proctocolitis during treatment with non-steroidal anti-inflammatory drugs.

In four patients with inactive ulcerative proctocolitis, oral administration of non-steroidal anti-inflammatory drugs appeared to precipitate relapse. These observations suggest that inhibitors of prostaglandin synthesis should be used with care in patients with this disease, and are consistent with the hypothesis that prostaglandins may have a protective role in the lower as well as the upper gastrointestinal tract.

Adult↗
PubMed1988

Evaluation of ileorectal anastomosis for the treatment of ulcerative proctocolitis.

Of 327 patients treated for ulcerative proctocolitis, 165 underwent surgery and an ileorectal anastomosis was performed in 59: 19 of these patients were operated upon in one stage and 40 in two stages. In 13 cases the anastomoses had to be converted, 5 during the initial hospitalization and 8 during a later admission. Three patients developed carcinoma of the rectal stump. The median follow-up period was 15 years. It is concluded that ileorectal anastomosis has a place in the treatment of inflammatory bowel disease, but requires careful follow up of the patients.

Anastomosis, Surgical↗
PubMed1992

Ulcerative proctocolitis in Orebro, Sweden. A retrospective epidemiologic study, 1963-1987.

In a retrospective epidemiologic study of the period 1963 to 1987 the annual incidence of definite ulcerative proctocolitis increased from 3.3 to 14.9/10(5), and during the last 10 years the mean incidence was 13.1/10(5) population. The incidence of extensive and total colitis was fairly stable, whereas an increase of ulcerative proctitis and distal colitis was seen. The increase in incidence is probably an artefact caused by better retrieval of cases in the latter part of the study. The prevalence on 31 December 1987 was 234/10(5) inhabitants. The male to female ratio was 1.59:1, compared with 0.96:1 in the general population. The median age at diagnosis was 33 years and increased almost 7 years by the end of the study, probably caused by an increased proportion of ex-smokers, who at diagnosis were, on average, 9 years older than lifetime non-smokers. The highest age- and sex-specific incidence was found in middle-aged men, who were ex-smokers to a significantly higher extent than women. No specific birth cohort was at an increased risk, and no second incidence peak in older age groups was seen.

Adolescent↗
PubMedDate not supplied

[Eosinophilic proctocolitis induced by foods. Report of a case].

The food-induced eosinophilic proctocolitis is a major cause of blood-tinged stools and appears in the first two months of life. The infant is generally described as well, but the clinical features and laboratory results are often nonspecific. We present an early infant with fresh blood stools at 50 days. The colonoscopy and biopsy of the rectum and lower sigmoid revealed lymphoid nodular hyperplasia of the submucose and eosinophil infiltration (40 to 50 per high power field) of the lamina propria and intraepithelial. Elimination of the offending protein from the diet, through the use of an extensively hydrolyzed casein-based formula and soy, lead to clinical resolution of bleeding at 48 hours. We made a review of the case.

Colitis↗
PubMed1989

Ulcerative proctocolitis in black Zimbabweans.

Over the last eight years seven patients with ulcerative proctocolots were seen and diagnosed at Mpilo Central Hospital (Bulawayo). A diagnosis of ulcerative proctocolitis was taken as definite if there was a history of diarrhoea with blood where an infective cause could reasonably be excluded, and only if there was sigmoidoscopic, histological and radiological confirmation of the diagnosis.

Adult↗
PubMedDate not supplied

Surgery of aggressive idiopathic proctocolitis and principles of rectal preservation.

During 1969-1985 seventy-one patients with aggressive idiopathic disease of the large intestine (i.e. ulcerative and Crohn's proctocolitis) were treated by colectomy and ileorectal anastomosis (IRA). In sixty-two of them proctitis was associated with colitis and required topical preparation of the rectum. The use of an antiphlogistic drug (6-methylprednisolone or betamethasone) in saline solution by daily enemas was followed by proctitis regression and permitted a safe IRA. After the surgical procedure the rectal treatment with the same drugs in smaller doses continued, so as to prevent long-term side effects. In some patients the steroid was replaced periodically by sulphasalazine per os or by 5-ASA per rectum in a daily maintenance dosage. This rectal care for unlimitated time has proved able to prevent recurrences of proctitis, while the epithelial recovery with regression of dysplasia gives protection against the risk of cancer.

Adrenal Cortex Hormones↗
PubMed1986

Anti-brush border antibodies (ABBA) in sera from patients with ulcerative proctocolitis and in sera with antibodies against Yersinia enterocolitica 0:3.

20 serum samples from patients with ulcerative proctocolitis (UC), and 20 serum samples with previously demonstrated IgG antibodies against Yersinia enterocolitica serotype 0:3 were analyzed with respect to the occurrence of anti-brush border antibodies (ABBA). 50% of the UC-sera and 20% of the anti-0:3 sera were ABBA-positive. Occurrence of ABBA did not apparently correlate to disease activity, or disease extension, or medication.

Adult↗
PubMed1996

Change in the extent of idiopathic ulcerative proctocolitis.

Two complete colonoscopic examinations, up to the ileocecal valve, were performed in 51 patients with idiopathic ulcerative proctocolitis. The extent of the disease was assessed as prevalent in the endoscopic and histological observations on biopsy tissue. The mean interval between the two endoscopies was 36 months (minimum interval 3 months). In 58.8% of cases, a variation of extent was observed: in 33.3% with an upward diffusion, in 25.5% with a reduction. In a larger group (51 vs 31) of patients observed for a longer period of time (36 vs 17 months), the findings of Niv et al. were confirmed. No correlation between epidemiological and clinical data and changes in the anatomical extent of colitis was shown. Disease extent does not, therefore, appear to contribute to the prognosis, in particular to the more severe attacks and cancer.

Adolescent↗
PubMed1998

[A bizarre inflammatory polyposis of the colon in chronic ulcerative proctocolitis].

A case report of a young patient (born in 1980) with a 2-year history of chronic ulcerative proctocolitis was described. Checking colonoscopy 6 months from the beginning of disease showed multiple and even confluent polypoid lesions in transverse gut starting from hepatic flexure in addition to diffuse inflammatory rectosigmoideal changes. Biopsy found only colic mucosa without any tumorous structures. Five months later the patient's state got worse accompanied instantly by vomiting, weight loss and malabsorption symptoms. A duodenocolic fistula was supposed according to gastroduodenoscopy and biopsy. Because of progressive suffering of the patient colectomy with ileoduodenoanastomosis and ileosigmoidoanastomosis was performed. Polypous lesions were observed from the blind gut up to descendent colon and a transversoduodenal fistula was proved. The removed part of gut was completely changed into a dense network of elongated polypous lesions. In microscopy, bigger polyps showed an inner stromal part often with bands of smooth muscle cells covered by nearly normal gut mucosa. Smaller polyps were formed by hypertrophic gut mucosa only. At the base of polyps, a stagnation of gut contents was found as well as ulcerous defects of various depth. Macroscopy and microscopy of polypoid lesions formed by non-neoplastic gut mucosa were those of so called bizzare ("giant") inflammatory polyposis of the gut. Up to now the patient's clinical picture and local finding in the stump of resected gut have been typical for chronic ulcerous colitis and polypous lesions were not revealed by checking investigations.

Adult↗
PubMed2001

How does pouch construction for a final diagnosis of Crohn's disease compare with ileoproctostomy for established Crohn's proctocolitis?

PURPOSE: There is a difference of opinion concerning the role of ileal pouch-anal anastomosis in Crohn's disease, even in the absence of small-bowel or perianal disease. One view is that ileal pouch-anal anastomosis should never be entertained, the other is that ileal pouch-anal anastomosis, like ileoproctostomy, can be justified sometimes, because it allows young people a period of stoma-free life. The aim of this study was to examine the outcome of ileal pouch-anal anastomosis and to contrast it with ileoproctostomy in patients with Crohn's disease without small-bowel or perianal disease. METHODS: Ileal pouch-anal anastomosis was performed in 23 patients with Crohn's disease (12 of whom had evidence of Crohn's disease at the time of operation and 11 who were eventually found to have Crohn's disease as a result of complications) and ileoproctostomy in 35. Patients were matched for age, gender, follow-up, and medication, but all ileoproctostomy cases had relative rectal sparing. Thus, the groups were not comparable and the reasons for ileal pouch-anal anastomosis and ileoproctostomy were therefore quite different. RESULTS: The outcome in ileal pouch-anal anastomosis at a mean follow-up of 10.2 years was pouch excision, 11 (47.8 percent); proximal stoma, 1 (4.3 percent; patient preference); average small-bowel resection, 65 cm; persistent perineal sinus, 8 of 11 having pouch excision (73 percent); and mean time in hospital, 37 (range, 8-108) days. Of those in circuit having ileal pouch-anal anastomosis (n = 12), 24-hour bowel frequency was 6, with no incontinence or urgency, but 6 (50 percent) were on medication. When ileal pouch-anal anastomosis was done for Crohn's disease in the resection specimen, only 4 of 12 (33 percent) were excised compared with 7 of 11 (64 percent) in whom the diagnosis was made as a result of complications. The outcome in ileoproctostomy at a mean follow-up of 10.9 years was rectal excision in 3 (8 percent), proximal stoma in 1 (3 percent), average small-bowel resection was 15 cm, persistent perineal sinus in 1 (3 percent), and time in hospital was 21 (range, 8-36) days. Of those in circuit (n = 32), 24-hour bowel frequency was 5, 2 had incontinence, 3 had urgency, and 12 (36 percent) were taking medication. CONCLUSIONS: These results indicate that the overall outcome of ileal pouch-anal anastomosis is inferior to that of ileoproctostomy, especially if Crohn's disease was diagnosed as a result of complications. Nevertheless, the functional results of those with a successful outcome are comparable.

Adolescent↗
PubMed2005

Is an ileal pouch an alternative for patients requiring surgery for Crohn's proctocolitis?

BACKGROUND: Most surgeons consider Crohn's colitis to be an absolute contraindication for a continent ileostomy, due to high complication and failure rates. This opinion may, however, be erroneous. The results may appear poor when compared with those after pouch surgery in patients with ulcerative colitis (UC), but the matter may well appear in a different light if the pouch patients are compared with Crohn's colitis patients who have had a proctocolectomy and a conventional ileostomy. METHODS: We assessed the long-term outcomes in a series of patients with Crohn's colitis who had a proctocolectomy and a continent ileostomy (59 patients) or a conventional ileostomy (57 patients). The median follow-up time was 24 years for the first group and 27 years for the second group. RESULTS: The outcomes in the two groups of patients were largely similar regarding both mortality and morbidity; the rates of recurrent disease and reoperation with loss of small bowel were also similar between groups. CONCLUSIONS: The possibility of having a continent ileostomy, thereby avoiding a conventional ileostomy-even if only for a limited number of years--may be an attractive option for young, highly motivated patients.

Adult↗
PubMed1985

Follicular proctocolitis and neuromatous hyperplasia with lymphogranuloma venereum.

Lymphogranuloma venereum (LGV), a sexually transmitted disease, is caused by certain immunotypes of Chlamydia trachomatis. Proctitis due to LGV may be histologically indistinguishable from Crohn's disease of the rectum, thereby creating a diagnostic and therapeutic dilemma. The pathologic features found at autopsy at The Johns Hopkins Hospital in the 28 patients in whom LGV had been diagnosed clinically were reviewed, with the clinical features, to determine whether any of those features could be used to distinguish between LGV and Crohn's colitis. The results showed that although many of the pathologic findings in the intestines of subjects with LGV were similar to those observed in patients with Crohn's disease, the distribution of lesions in the colons of subjects with LGV was distinctly different from that observed in patients with Crohn's colitis. With LGV, the salient histopathologic lesions consisted of follicular lymphohistiocytic-plasma cell infiltrates in the submucosa, muscularis propria, and serosa; neuromatous hyperplasia in the submucosal and myenteric plexuses; and extensive thickening and fibrosis of the bowel wall. The rectum was uniformly involved by these processes and, in addition, had deep ulceration and fissuring, while more proximal segments of the colon were generally spared of severe chronic inflammation. Thus, the colonic lesions of LGV have a distal left-sided predominance, in contrast to the usual right-sided predominance with rectal sparing in Crohn's colitis.

Adolescent↗