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PubMed1980

HLA antigens in inflammatory bowel disease.

HLA antigens were studied in 60 patients with ulcerative colitis, 10 with Crohn's disease and 120 healthy Japanese controls. HLA typing was performed by the microdroplet lymphocyte cytotoxicity test.B5 was recognized in 62% of the patients with ulcerative colitis, whereas in 40% of controls (p smaller than 0.01). Furthermore, in these patients B7 was decreased in incidence (p smaller than 0.05) and there was the highest relative risk value for A3 (R.R = 6.3). When the patients were classified into 2 groups according to the extent of the lesions, left-sided or total colitis group and proctitis group, B5 was recognized in 65% of the patients with left-sided colitis or total colitis; and this increase was statistically significant. However, no significant difference in the incidence of B5 was recognized between the patients with proctitis and controls, probably because the number of patients studied was too small for evaluation. In the patients with Crohn's disease, B27 was recognized in one patient, showing an increase in incidence (p smaller than 0.001), although the number of patients studied was very small.

Adult↗
PubMed1989

Malignancy in ulcerative colitis.

All patients with ulcerative colitis referred to Rigshospitalet, Copenhagen, from 1 April 1964 to 1 January 1983 (18 years and 9 months) were studied from time of referral until death, proctocolectomy, or end of the study (1983). There were 759 patients, 423 females (56%) and 336 males (44%). None was lost to follow-up study. Median time from onset of disease until death, proctocolectomy, or end of the study was 11 years (range, 0-54 years). Median age at onset was 28 years (range, 0-83) among the males and 28 years (range, 4-83) among the females. Pancolitis was present in 312 patients (41%), left-sided colitis in 212 (28%), and haemorrhagic proctitis in 235 (31%). Surgical treatment was performed in 299 patients (39%): proctocolectomy in 197 (26%), colectomy with occluded rectal stump in 72 (9%), and colectomy with ileorectal anastomosis in 30 (4%). Altogether, 49 patients developed cancer, 20 being intestinal and 29 extraintestinal cancer. Compared with the general population matched for age, sex, and calendar time, there was an excessive number with intestinal cancer in both sexes (p less than 0.05). In females the number with extraintestinal cancer was higher than in the general population (p less than 0.01), a finding that has not been reported elsewhere. We found a similar, significantly increased incidence of extraintestinal cancer in females with Crohn's disease in a previous report. We found no increased risk of colorectal cancer in patients with early onset of ulcerative colitis. For all age classes we found that the age of appearance of colorectal cancer followed the equation: age at colorectal cancer = 14 + age at onset of ulcerative colitis. We found no higher potential for development of colorectal cancer in patients with pancolitis. In our series the incidence of colorectal cancer in pancolitis and left-sided colitis was equal. The incidence in patients with haemorrhagic proctitis was zero.

Adolescent↗
PubMed1990

Role of rectal formulations: suppositories.

Mesalazine (5-aminosalicylic acid) suppositories are safe, effective, well tolerated, and well retained in patients with active distal proctitis. The best results are seen in patients with idiopathic ulcerative proctitis. Approximately 85% of these patients are healed within 4 weeks and virtually 100% by 10 weeks, with mucosal healing and complete loss of symptoms. Suppositories cover the last 20 cm of the rectum, as shown by technetium labelling. Maintenance therapy using suppositories alone--in doses varying from 500 mg every second bedtime to 1000 mg per day in divided doses--is at least as effective as oral sulphasalazine. Mesalazine suppositories are also useful in treating patients with Crohn's disease affecting the rectum, although the response rate is slower and healing is incomplete in half the patients treated. In the rare solitary rectal ulcer syndrome, mesalazine suppositories may be as efficacious as mesalazine enemas. Patient compliance and dramatic response even when conventional therapy has failed make an excellent case for mesalazine suppositories being the treatment of choice for distal ulcerative proctocolitis.

Administration, Rectal↗
PubMed1993

Treatment of ulcerative colitis with high doses of oral prednisolone. The rate of remission, the need for surgery, and the effect of prolonging the treatment.

Treatment of acute attacks of ulcerative colitis in 89 patients with doses of prednisolone above or equal to 40 mg resulted in an overall remission in 67%. Remission rate and colectomy rate were 47% and 42%, respectively, when the disease was severe, 80% and 13% when moderate, and 84% and 3% when mild. The need for surgery was 28% in pancolitis, 11% in left-sided colitis, and 5% in proctitis. After subsequent treatment episodes colectomy was performed in 35% of patients with pancolitis, in 37% with left-sided colitis, and in 5% with proctitis. The median total duration of therapy in patients who went into clinical remission was 4 months, and the median dose just above 3 g prednisolone. Patients who stayed in remission during the follow-up received a significantly higher start dose and total dose of prednisolone in the treatment episode than patients who had a relapse. In 25 patients treatment with doses equal to or above 75 mg of prednisolone was continued beyond 10 days, and 11 patients experienced remission whereas 14 patients had surgery performed. Orally administered corticosteroids produce results comparable to those obtained after the previously suggested intravenous regimen.

Administration, Oral↗
PubMed1995

Mesalazine suppositories versus hydrocortisone foam in patients with distal ulcerative colitis. A comparison of the efficacy and practicality of two topical treatment regimens.

BACKGROUND: Topical treatment is effective in patients with distal ulcerative colitis. This trial compares the efficacy, safety, and practicality of 4 weeks' treatment with 500 mg mesalazine suppositories with those of 178 mg hydrocortisone foam, both given twice daily. METHODS: Seventy-nine patients with distal ulcerative colitis were stratified on the basis of the extent of the disease (proctitis and proctosigmoiditis) and randomized to one of the treatment groups. A disease activity index (DAI) based on symptoms and endoscopic findings was calculated. The patients evaluated the practicality of the treatment regimens, patients compliance was measured, and histologic findings recorded. RESULTS: Of all the patients 22% and 38% were complete responders after 2 and 4 weeks, respectively. Median DAIs in the mesalazine and hydrocortisone groups before and after 2 and 4 weeks' treatment were 14, 6, and 4, and 13, 8, and 6, respectively. The difference between the treatment groups was statistically significant (p = 0.02) due to a better effect of mesalazine in patients with proctitis. Patients' evaluation of practicality and patient compliance were statistically significantly better in the mesalazine group. CONCLUSIONS: Both treatment regimens are effective; mesalazine suppositories seem to be the preferred alternative.

Administration, Rectal↗
PubMedDate not supplied

Expression of the Kp43 (CD 94) receptor by natural killer (NK) cells in ulcerative colitis.

BACKGROUND/AIMS: The presence of natural killer cells in the colon mucosa of patients with ulcerative colitis has not been studied, therefore, the study was designed to investigate the densities of cells expressing CD3+, CD4+, CD8+, CD56+ and the new CD94+ in colon mucosa of active and inactive ulcerative colitis patients. METHODOLOGY: Twenty ulcerative colitis patients, 10 with active disease and 10 with inactive disease, and 10 subjects with a histologically normal rectal mucosa were used as patients and controls. Additionally, a subgroup of 6 patients with active proctitis has been studied. Two biopsy specimens from rectal mucosa were taken for all patients and controls. Two biopsy specimens of proximal colon mucosa of the subgroup of 6 patients were also taken. One biopsy was processed for immunohistochemical studies and another for histologic study. RESULTS: The densities of CD3+, CD16+, CD56+ and CD 94+ were significantly increased in active ulcerative colitis patients compared to inactive subjects (P < 0.001). The increase in the CD4+ and CD8+ was not statistically significant. Patients with inactive ulcerative colitis also presented increased numbers of CD3+, CD56+ and CD94+ cells compared to controls (P < 0.001). In the subgroup of proctitis, the densities of cells expressing all the antigens were significantly lower in the normal mucosa compared to the affected colon (P < 0.001). No differences in the number of lamina propria DC1a+ cells between patients and controls were found. CONCLUSIONS: These findings suggest that natural killer cells are increased in active ulcerative colitis subjects and that the affected mucosa of ulcerative colitis patients with inactive disease is in state of "latent" inflammation. On the other hand, the normal looking mucosa from active ulcerative colitis patients does not differ from the mucosa of control subjects. Therefore, it seems that in ulcerative colitis the immunological alterations are limited to the affected mucosa.

Adult↗
PubMed2002

[Low-dose rate intracavitary afterloading radiotherapy for cancer of uterine cervix].

OBJECTIVE: To evaluate the results of Gynatron low dose rate (LDR) brachytherapy for cancer of uterine cervix. METHODS: From April 1980 to June 1986, 136 patients with uterine cervical carcinoma were given radical radiotherapy through LDR afterloading irradiation and (60)Co external irradiation, compared with those through radium and high dose rate (HDR) intracavitary therapy. RESULTS: All patients except 5 were followed up for 15 years with a follow-up rate of 96.3% (131/136). The overall 10-year survival rate was 63.5%. The 10-year survival rates of stage II and III patients were 83.9% and 43.2%. The frequency of proctitis and cystitis were 12.5% (17/136) and 9.6% (13/136). CONCLUSION: Gynatron LDR system has achieved good results with tolerable complications including proctitis and cystitis which are more often than those of radium and less so than those of HDR.

Adult↗
PubMed1990

Entamoeba histolytica--the virulence of imported strains.

We tested the virulence of 15 strains of Entamoeba histolytica, imported to Czechoslovakia, by intracaecal inoculation of laboratory rats. According to the scoring system of Neal, none of the 15 strains possessed the virulence index greater than 2. This indicates that all the organisms tested should be classified as avirulent. However, it should be noted that all the strains produced infection of the caecum and thus should be considered infective for rat. For 7 strains, isoenzyme patterns were determined for PGM, HK and ME. One imported strain, obtained from student from Congo, demonstrated isoenzyme pattern for PGM and HK indicated that the strain was virulent. This organisms had the index of virulence 1.8 (avirulent) in animal experiment; it was isolated from cysts of clinically asymptomatic patient. Examination of the rectal mucosa of the donor of the strain indicated typical chronic catarrhal proctitis of mild degree. Examination of the patient's serum demonstrated the presence of anti E. histolytica antibodies by CIEP, while the ELISA test was negative. Twenty-one cyst carriers were examined by rectoscopy. Pathologic changes were observed in 20 of these, as follows: altered vascular structure (13X), roughened mucosa (12X), mucosal reddening (10X), decreased glistening (7X), mucus in mucosa (5X), inflammatory pseudopolypes (2X), ulcers (2X), enanthema (1X). Histological biopsies were obtained in 15 cases. One was considered normal. Remaining 14 biopsies exhibited following morphological changes: increased mucus secretion (8X), edema (7X), lymphocytic and plasmocytic infiltration (6X), lymphocytic and plasmocytic infiltration in addition to the presence of eosinophilic granulocytes (6X), presence of mucophages (5X), haemorrhages (4X), increased vascularity (3X), lymphocytic and plasmocytic infiltration with presence of extremely abundant eosinophilic granulocytes (1X), erosive-ulcerative changes of mucosa (1X). The changes observed indicated chronic catarrhal proctitis with expression to greater or less degree of signs of chronic catarrhal inflammation.

Amebiasis↗
PubMed1990

[Treatment of isolated rectal ulcer syndrome].

Our study involved a group of 46 cases of isolated rectal ulcer syndrome. We believed that our management procedure would have to take several factors into consideration. Firstly, the clinical context is of primary importance: the age, psychological context, functional signs and, above all, the state of the lesions. We attached particular importance to distinguishing between the forms of proctitis (whether ulcerated or not) and the pseudotumoral polypoid forms. In addition, complementary explorations (dynamic rectography and anorectal manometry) can provide valuable information (the degree of prolapse, impairment of the exoneration mechanism and the status of sphincter function). In both ulcerated and non-ulcerated forms of proctitis, the treatment is essentially medical and intended to treat the constipation and rehabilitate the exoneration. This treatment suffices in most cases. In poorly tolerated cases, involving persistent bleeding or in forms corresponding to major prolapse, surgery is required which usually includes proctopexy. The first problem posed by pseudotumoral polypoid forms is that of a differential diagnosis to formally exclude cancer or an inflammatory disease process. Transanal biopsy exeresis may be crucial in the diagnosis. In addition, this transanal resection may well initiate therapy, in combination with medication. In some forms, involving major prolapse, it is logical to combine rectopexy. In some cases, rectopexy may be necessary if simple transanal resection is unsuccessful (persistence or recurrence of lesions). Rectopexy is also frequently the only treatment possible of pseudotumoral forms affecting extensive areas or higher regions of the bowel.

Colorectal Surgery↗
PubMed1989

Medium-term follow-up of ulcerative colitis in Cape Town.

The 114 patients with ulcerative colitis diagnosed in Greater Cape Town between 1970 and 1979 were followed up 11 years later. Ninety per cent of those contacted were in remission or had mild symptoms only. Eleven patients had died; 3 deaths (in total colitis patients) were disease-related but the overall mortality rate in ulcerative colitis was not increased. There was only 1 case of carcinoma of the colon. The 5-year surgical rate was 5% increasing to 23% 10 years after diagnosis. Six patients (35%) had had a Park's pouch, 3 (18%) ileorectal anastomosis, and 8 (47%) panproctocolectomy or colectomy with an ileostomy. The incidence of surgery was higher in those with total colitis. In those patients who did not have the rectum removed, there was a 100% recurrence of proctitis. Park's pouch patients remained well and incontinence was not a problem. Thirty-one per cent of patients with proctitis at diagnosis had evidence of extension of disease to the colon at follow-up. Ulcerative colitis may be a more benign disease than often believed, with mortality from the disease and need for surgery being associated almost exclusively with extensive disease.

Adolescent↗
PubMed1988

[Postoperative irradiation of carcinoma of the corpus uteri using the iridium afterloading technic].

From 1981 to 1986 a prospective study was conducted of University of Vienna, 1st gynecology department, for 708 patients with operated and postoperatively irradiated endometrial cancer. These patients were treated by total hysterectomy, bilateral salpingo-oophorectomy and postoperative vaginal irradiation with high-dose-afterloading (iridium 192). A percutaneous irradiation (cobalt 60) was done in stage I cases only when myometrial infiltration was deep. Highly differentiated tumors with infiltration of the first and second third of the myometrium were treated by vaginal irradiation alone. Poorly differentiated tumors (G2, G3) with infiltration of the second and third third of the myometrium were treated by vaginal and percutaneous irradiation. A group of 125 cases with good prognosis (infiltration 1/3, G1) and with postoperative vaginal irradiation alone had the same five-year-survival of 83% as a group of 152 cases with bad prognosis (infiltration 2/3 and 3/3, G2 or G3) treated by vaginal and percutaneous irradiation. This result shows clearly the importance of additional irradiation of the pelvis in cases with bad prognosis factors. The incidence of radiation side effect in all 708 cases was: cystitis 4.6%, proctitis 5.2%, vaginal or rectal ulcers 1.4% and fistulas 0.2%. Cases with vaginal irradiation alone and with the optimal intravaginal fraction dose of 700 cGy (twice) had the lowest level of side effects: cystitis 3.8%, proctitis 2.1%, vaginal necrosis 0.7%, no further severe complications. None of the patients with postoperative vaginal irradiation alone had a vaginal recurrence. The incidence of recurrences in 708 patients was 1.6%. All recurrence cases in stage I (0.7%) had bad prognosis factors and were treated with vaginal and percutaneous irradiation. It is concluded that primary surgery of endometrial cancer should be followed by postoperative vaginal radiation. It appears that the remote afterloading treatment for vaginal radiation produces minimally complications and gives complete protection from radiation exposure to the medical staff. With additional external radiation in high-risk cases the same good result can be achieved as in cases with low-risk and vaginal radiation alone.

Adult↗
PubMed1987

[Radiation proctocolitis following gynecologic radiotherapy: an endoscopic study].

The prevalence of radiation injuries was assessed in 155 of 206 surviving patients who had had radiation therapy for carcinoma of the uterus or vagina. The patients were examined according to a standardized protocol. 51 (32.9%) exhibited endoscopic proctitis, and in 10 of them sigmoid colon was also affected. The prevalence of colitis was 31 of 66 (47%) in patients treated for carcinoma of cervix and 19 of 86 (47%) in those treated for carcinoma of corpus. 41 (80.4%) had clinical symptoms (bleeding and diarrhea in 53% each). The mean time lag between radiation therapy and beginning of symptoms was 9 months. Histology was positive in only 24 (47.1%) of 51 endoscopically documented cases of proctocolitis. There was no increase in the prevalence of radiation injury after previous surgery of any kind. Nor was higher risk found in patients with hypertension, diabetes, or congestive heart failure. However, patients with low body mass were at increased risk (p less than 0.01). There was a dose-response relationship between total dose and endoscopic proctitis (p less than 0.001). The incidence was 0% below 40 Gy, 20% at 60 Gy and 50% at 90 Gy.

Adult↗
PubMed1985

Anorectal and enteric infections in homosexual men.

Homosexual men are at increased risk for traditional sexually transmitted anorectal infections (gonorrhea, syphilis, venereal warts, herpes and chlamydial infection) and enteric infections characterized by a low infecting inoculum (hepatitis A and B, amebiasis, giardiasis, shigellosis and campylobacteriosis). Infections account for most of the gastrointestinal symptoms in homosexual men seen at sexually transmitted disease clinics, but asymptomatic and polymicrobial infections are also common. Distinguishing three syndromes-proctitis, proctocolitis and enteritis-is clinically useful because these syndromes correlate with specific microorganisms and modes of transmission. A careful anoscopic examination, rectal Gram's stain, cultures for gonorrhea and chlamydia, VDRL and darkfield examination of suspicious lesions should be routinely done when sexually active homosexual men present with unexplained gastrointestinal symptoms. Based on the history, physical examination and initial laboratory studies, patients can usually be classified as having proctitis, proctocolitis or enteritis. This distinction facilitates selection of both confirmatory diagnostic tests and antimicrobial therapy. The effectiveness of empiric treatment regimens for asymptomatic sexual contacts or for symptomatic patients in whom microbiological tests are pending has not been studied.

Anus Diseases↗
PubMed1994

Morbidity of pelvic lymphadenectomy, radical retropubic prostatectomy and external radiotherapy in patients with localised prostatic cancer.

Staging pelvic lymphadenectomy (PLND) was performed in 210 prostatic cancer patients (mean age 67 years, clinical stage T0-T3 M0). A radical retropubic prostatectomy was subsequently performed in 54 men, ten of whom also received postoperative radiotherapy due to positive surgical margins. Ninety-eight patients were treated with external beam radiation alone (70 Gy in 35 fractions) and the remaining 58 received endocrine therapy. The complications of PLND alone (156 patients), consisted of wound infection in eight patients, hematoma or lymphocele in seven, venous thrombosis in three, and cardiac infarction in one patient. Early side-effects of radiotherapy included mild to moderate proctitis and/or cystitis in 57 patients. One year after completion of therapy, 48 of the irradiated men had proctitis, but only six had severe symptoms. Four patients developed radiation cystitis and two urethral stricture. Following prostatectomy (54 patients), two patients died in pulmonary embolism and another one developed a deep venous thrombosis. Hematoma occurred in five patients. Of the 42 surviving patients who did not receive postoperative radiotherapy, eight developed anastomotic strictures and four had severe stress incontinence. Only five were fully potent one year after surgery. Eight of the ten patients receiving radiotherapy after prostatectomy developed side-effects from the intestine and/or the urinary bladder. Two of them became totally incontinent. One developed a severe hemorrhagic cystitis necessitating urinary diversion. All ten were impotent after treatment.

Aged↗
PubMed1994

[Prospective study of the incidence and prevalence of ulcerative colitis in a large urban population in Germany (western Ruhr area)].

A prospective epidemiological study of the incidence and prevalence of ulcerative colitis was conducted from 1980 to the end of 1984. The population at risk comprised 1.6 million inhabitants in the four industrial cities Essen, Duisburg, Mülheim and Oberhausen of the western Ruhr-area. All 35 hospitals of the area with 79 departments of internal medicine, surgery and pediatrics with in- and outpatients took part in the study. 225 patients with substantial ulcerative colitis (excluded proctitis) were newly diagnosed during the study period (129 men, 96 women); patients suffering only from ulcerative proctitis were not included. The mean incidence was 2.9 new cases per 100,000 inhabitants and year ranging from 2.3 to 3.7 without significant difference between these 5 years. Incidence figures were somewhat higher for men (3.5) than for women (2.4) and this difference was significant (p < 0.05). The age- and sex-adjusted incidence was found to have a broad range for both sexes between 20 and 65 years of age without a high incidence-peak in young adults or a second peak later in life. Additionally all formerly diagnosed cases of ulcerative colitis were registered during this time period and the hospital archives were looked backward for prevalent cases til 1975 retrospectively. From all these cases the prevalence of ulcerative colitis at December 31, 1984 was calculated for 27.3 patients per 100,000 inhabitants (n = 417) similarly with a significant preponderance of men against women (31.1 vs. 22.1 per 100,000 inhabitants, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Transformations of ileo-rectal anastomosis into ileo-anal anastomosis in hemorrhagic rectocolitis. Indications and results].

In order to precise the indications and results of this procedure, we assessed 11 cases of transformation of ileorectal anastomosis (IRA) to ileal pouch-anal anastomosis (IPAA) in ulcerative colitis (UC). These 5 men and 6 women had undergone IRA at a mean age of 31 years, 33 months after the diagnosis of UC (range 3-120). Four of these IRA, excluded by an ileostomy, had never been in function: the cause was severe persistent proctitis in 2 cases and anastomotic leakage and peritonitis in 2 cases. The other 7 IRA had been in function during a mean period of 25 months (range 6-45) and were reoperated because of anal sepsis (1 case), low rectal stenosis (1 case), disabling proctitis (4 cases) and rectal dysplasia (1 case). No patient had specific pathologic signs of Crohn's disease. The 11 IPAA were complicated by pelvic sepsis in 3 cases; surgical drainage succeeded in 1 case, but the 2 others needed pouch excision and terminal ileostomy. The diagnosis of Crohn's disease was eventually made in these 2 patients. The 9 patients with functioning IPAA, at a mean follow-up of 40 months (range 12-60), had 5.2 stools per 24 h (range 2-12), 5 patients had no nocturnal stooling, and 6 had a perfect continence. One patient had disabling chronic pouchitis. In conclusion, proctectomy with IPAA is always feasible when a previous IRA for UC had failed or offers poor results, but should be rejected in case of anal involvement, as that may suggest Crohn's disease. This procedure is followed by similar functional results than after primary IPAA.

Adolescent↗
PubMed1993

[Total colectomy and ileorectal anastomosis in Crohn's colitis. Functional results and recurrence factors (83 cases)].

Eighty-three consecutive patients (38 men, 45 women) underwent colectomy and ileorectal anastomosis (IRA) for Crohn's colitis between 1960 and 1988. The mean age at the time of IRA was 28.5 years after a mean interval of four years from diagnosis. At the time of IRA, 31 patients had proctitis, while 25 had perianal disease. Two patients died postoperatively. Postoperative complications appeared in 21 cases (25.3%) including 7 anastomotic leaks (13.2%). Leakage did not imply IRA compromise and the diverting ileostomy did not decrease the risk of preservation of the ileorectal anastomosis. With a mean follow-up of 8 years after IRA, among the 81 surviving patients, it was necessary to retain the stomy in five, 24 required exclusion or excision of their IRA (10 defunctioning ileostomies, 14 proctectomies) and 52 still had a functioning IRA at follow-up (64.2%). Among the 43 recurrences (53%), 21 underwent reoperation. The mean interval between IRA and recurrence was 2.2 years. The cumulative rate of recurrence reached 47% at 5 years and 57% at 10 years. Fifty percent of the patients still had a functioning IRA and were satisfied. Preoperative ileal lesions affected the functional results of the IRA and the recurrence rate. Development of ileal, rectal or anal disease after IRA significantly increased the risk of exclusion of the rectum but did not require suppression of anal function. Patients under 30 years of age or patients suffering for more than 5 years had poorer functional results and more frequent reoperations at 5 years. Rectal preservation after IRA may be proposed with success to patients with a healthy rectum or with minimal or moderate proctitis, even if there is perianal disease that could be safely treated before IRA. In this last setting, the patient has to be informed of the risk of rectal preservation and the possible risk of requiring ulterior proctectomy.

Adolescent↗
PubMed1996

Inflammatory large bowel disease in immunodeficient mice naturally infected with Helicobacter hepaticus.

Large bowel disease detected clinically by rectal prolapse was studied in 64 immunodeficient mice (37 athymic NCr-nu/nu, 12 BALB/c AnNCr-nu/nu, 9 C57BL/6NCr-nu/nu, and 6 C.B17/Icr-scid/NCr) naturally infected with Helicobacter hepaticus. Rectal prolapse was found in approximately 5% of immunodeficient mice maintained in a research facility over a period of 3.5 years. All mice had various degrees of chronic proliferative typhlitis, colitis, and proctitis, usually without concomitant hepatitis. Some mice had severe proliferative proctitis with cystic hyperplasia. Histologic study of the large bowel of 48 athymic NCr-nu/nu mice without H. hepaticus infection and housed in another clean facility revealed only 12% of the mice with minimal-to-mild large bowel inflammation. Helicobacter hepaticus infection is associated with large bowel disease in immunodeficient mice but is not seen in H. hepaticus-infected immunocompetent mice. This new pathogenic bacterial infection should be considered as another potential cause or co-factor for rectal prolapse and large bowel disease in mice.

Animals↗