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PubMed1981

[Ultrasonic diagnosis of gastrointestinal diseases].

The authors describe their experiences with the ultrasound tomography (compound scan and real-time scan) on the basis of 2,360 own examinations. This examination method was particularly suitable in cholelithiases, in concrements of the choledochus, in diseases of the pancreas above all in different forms of pancreatitis and pancreatic tumours and in abdominal lymphomas. The authors emphasize the advantages of the non-invasive method, however, they recommend to valuate the ultrasonographic findings always taking into consideration all other results of clinical examinations.

Cholelithiasis↗
PubMed1987

Humanitarian use of misoprostol in severe refractory upper gastrointestinal disease.

Misoprostol was provided on a humanitarian basis to 157 patients with severe, often life-threatening, refractory upper gastrointestinal (UGI) disease not managed by available medical therapy (cimetidine, ranitidine, antacids, sucralfate, and/or prior surgery). A total of 162 separate clinical treatment courses were evaluated in the 157 patients for the period May 1, 1981 to May 6, 1986. Misoprostol was administered orally or via nasogastric tube, 800 micrograms to 1,200 micrograms daily in four to six divided doses, for periods of from one day to 17 months. Patients were considered to have a favorable clinical outcome if they achieved significant improvement in symptoms, hemorrhagic status, or appearance of their condition on endoscopy. Favorable clinical outcomes were observed in 52 of 83 treatment courses (63 percent) involving UGI hemorrhage and in 44 of 79 treatment courses (56 percent) for long-standing nonhemorrhagic UGI disease. A total of 116 treatment courses were for patients with a single UGI entry diagnosis; 28 treatment courses were for patients with two UGI entry diagnoses; four courses were for patients with three UGI entry diagnoses; and 14 treatment courses were for miscellaneous UGI entry diagnoses. Treatment outcomes were analyzed by the four most commonly treated UGI entry diagnoses; patients who had an initial diagnosis of refractory duodenal ulcer (n = 28), refractory gastric ulcer (n = 41), reflux esophagitis (n = 23), or hemorrhagic gastritis (n = 63) had favorable clinical outcomes of 71 percent, 58 percent, 61 percent, and 62 percent, respectively. Misoprostol was well tolerated, with the most common adverse experience being mild to moderate diarrhea. It is concluded that in humanitarian clinical trials, misoprostol was frequently associated with symptomatic relief, with improvement in UGI hemorrhage, or with endoscopic improvement in severe UGI disease that had proven refractory to available medical therapy.

Alprostadil↗
PubMed2000

Complications of photodynamic therapy in gastrointestinal disease.

The primary complications of photodynamic therapy of the esophagus include cutaneous photosensitivity and esophageal strictures. Atrial fibrillation and pleural effusion have been reported but appear to be rare or not clinically significant. Cutaneous photosensitivity can be minimized if the adequate precautions are taken to protect patients from sunlight exposure. Stricture formation may be decreased by proper dosimetry and avoiding multiple overlapping light applications.

Chest Pain↗
PubMed1992

Use of gut peptide receptor agonists and antagonists in gastrointestinal diseases.

Because of the numerous actions of gut peptides and the numerous approaches to modification of their activity, it is likely that many other agents will be introduced in the near future. Although a peptide analogue has so far found the largest clinical role, given the problems of peptide pharmacology, the development of nonpeptide gut peptide agonists and antagonists has more promise of clinical usefulness.

Anti-Bacterial Agents↗
PubMed1987

Campylobacter hyointestinalis associated with human gastrointestinal disease in the United States.

Campylobacter hyointestinalis was isolated from stool specimens of four persons, all of whom were experiencing nonbloody, watery diarrhea. The youngest (8 months of age) and the oldest (79 years of age) individuals were females, and the other two were homosexual men. C. hyointestinalis was the only clinically significant pathogen isolated from stool specimens for three of the individuals. In case 3 (involving a 37-year-old homosexual man), Entamoeba histolytica and Shigella sonnei were also present in the stool. The identification of all C. hyointestinalis strains was made biochemically and confirmed by DNA hybridization. This study documented the isolation of C. hyointestinalis from four patients with diarrhea, and our findings suggest that the clinical significance of Campylobacter species must be expanded to include C. hyointestinalis as a potential cause of human gastrointestinal disease.

Adult↗
PubMed2000

[Enteral nutrition for gastrointestinal disease in home care].

We report 5 patients given enteral feeding in order to continue its nutritional supportive care of our hospital. In patients 1, 2, and 3 who were malnourished, enteral nutrition was provided due to poor oral intakes after surgical treatment. In patients 4 and 5, enteral feedings were made via the proximal jejunum in order to bypass the duodenum, for nutrients in the duodenum enhanced their biliary infection or chronic pancreatitis, respectively. All patients' nutritional status was satisfactory, but two of five patients could not be discharged from the hospital. The reason was that the patients and their families wanted to continue the hospital care in spite of the improvement in the clinical problem. They had no help at home to care for the patient. We conclude that enteral nutrition is very useful for gastrointestinal disease, but that social problems affect home care with enteral nutrition.

Aged↗
PubMed1971

Small intestinal bacterial flora and folate status in gastrointestinal disease.

Serumfolate folate levels and the bacteriology of the small intestine were studied in 13 patients with jejunal diverticulosis, 29 patients with partial gastrectomy, and five patients with ileal disease. The mean serum folate level in the patients with partial gastrectomy (7.2 mmug/ml) was similar to that of control subjects but the mean level in the patients with jejunal diverticulosis (14.6 mmug/ml) was significantly higher than the mean level of the control group (8.0 mmug/ml). Five of the 13 patients with jejunal diverticulosis and two of the patients with partial gastrectomy had levels above the upper limit of the control group (> 16.6 mmug/ml), and five of six patients with jejunal diverticulosis studied excreted raised amounts of folate in the urine (> 13.2 mug in 24 hours). Serum folate in one of these patients with jejunal diverticulosis was identified chromatographically as 5-methyltetrahydrofolic acid. The mean serum folate level (9.0 mmug/ml) in the patients with partial gastrectomy who had Esch. coli in the jejunal aspirates was significantly higher than in those without Esch. coli present (mean 4.2 mmug/ml). It is suggested that in gastrointestinal disease jejunal bacteria may contribute to the serum folate level even though this remains in an accepted normal range. Some patients had low serum folate levels despite having a large number of Esch. coli in the jejunum. No evidence of malabsorption of folic acid was found in three such patients even though one had lactobacilli capable of consuming folate in the jejunum. No relationship was found between serum folate level and ileal bacteriology.

Adult↗
PubMed2003

Refractory coeliac sprue is a diffuse gastrointestinal disease.

BACKGROUND: Refractory coeliac sprue (RCS) with an immunophenotypically aberrant clonal intraepithelial lymphocyte (IEL) population is considered a cryptic form of intestinal T cell lymphoma. AIMS: To investigate the distribution of the abnormal and monoclonal IEL population in the digestive tract of RCS patients. PATIENTS AND METHODS: We compared the frequency of lymphocytic gastritis (LG) and lymphocytic colitis (LC), together with IEL phenotype and T cell clonality, in gastric and colonic samples from 15 adults with RCS (all with aberrant CD3 intracytoplasmic(+) surface(-) CD8(-) clonal IELs on duodenojejunal biopsies), 18 patients with active coeliac disease (ACD), and 10 patients with coeliac disease (CD) on a gluten free diet (GFD-CD) by means of immunohistochemistry and multiplex polymerase chain reaction amplification of the T cell receptor gamma gene (TCR-gamma) rearrangement. Blood samples of nine RCS patients were also tested for clonality. RESULTS: LG was found in 9/14 (64%), 11/18 (61%), and 3/10 (30%) patients with RCS, ACD, and GFD-CD, respectively, while LC was found in 6/11 (55%), 3/4 (75%), and 2/3 (66%) patients. Contrary to CD, all samples from patients with LG and LC showed an aberrant IEL phenotype. Monoclonal TCR-gamma rearrangements were detected in 8/13 (62%), 8/10 (80%), and 4/9 (44%) of gastric, colonic, and blood samples, respectively, from RCS patients, while in CD patients such rearrangements were only found in 2/25 (8%) gastric samples. CONCLUSION: The immunophenotypically aberrant monoclonal IEL population present in the small intestine of patients with RCS frequently disseminates to the blood and the entire gastrointestinal epithelium, suggesting that this is a diffuse gastrointestinal disease.

Adult↗