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At least 757 records · Page 42Linked to original sources
PubMed1981

Hemoccult screening in selected patients.

One hundred patients, asymptomatic relative to gastrointestinal disease, who applied for elective hernia repair were tested as outpatients for occult blood in the stool. Twenty-six had one or more positive specimens. Among this group colonic disease was found in seven, including adenocarcinoma (Dukes' stage A) in one, adenomatous polyps in three, and colonic diverticula in the remainder. The unexpectedly high false-positive rate (33%) was reduced markedly by giving a meat-free diet before stool collection. Patient compliance was excellent and the cost-benefit ratio appeared to be acceptable.

Adenocarcinoma↗
PubMed1979

Mucosal hyperplasia in clonic diverticula.

Benign, nonpolypoid mucosal hyperplasia has been consistently observed adjacent to colonic carcinomas. In order to determine the specificity of this association we looked for this type of mucosa in diverticulosis with or without diverticulitis, a disease thought not to be causally related to carcinoma. Nonpolypoid mucosal hyperplasis was frequently found within diverticula suggesting that this mucosal abnormality is, in some instances, unrelated specifically to malignancy.

Aged↗
PubMed1975

The results of diagnostic colonoscopy in the management of unexplained bleeding from the rectum.

A consecutive series of 71 colonoscopies performed for unexplained bleeding per rectum is reported. All patients had had previous barium enema examinations reported as normal. In 26 colonoscopies lesions were detected; there were 12 cancers and 11 polyps. Twenty-five of these lesions were in the left colon. These findings illustrate the value of colonoscopy in supplementing the available radiological findings. The sighting of blood at sigmoidoscopy was associated with a lesion found on colonoscopy in most instances, whereas the presence of occult blood was associated with a lesion in very few. Colonoscopy should be considered prior to laparotomy in every case of unexplained blood in the stools.

Adenocarcinoma↗
PubMed1998

A randomized trial comparing three methods of bowel preparation for flexible sigmoidoscopy.

OBJECTIVE: The aim of this study was to assess the optimum method of bowel preparation for flexible sigmoidoscopy. METHODS: A total of 164 adults undergoing flexible sigmoidoscopy at an ambulatory clinic were randomized to receive one of three preparations: a single hyperphosphate enema 1 h before the procedure; a hyperphosphate enema given 1 and 2 h before the procedure; or a hyperphosphate enema administered 1 and 2 h before the procedure, preceded by a 296 ml bottle of magnesium citrate taken p.o. the night before. Patients completed surveys on preparation and procedure comfort and satisfaction. The performing endoscopist assessed preparation quality, procedure duration, and depth of sigmoidoscope insertion. RESULTS: All three preparations were equally well tolerated with slightly more diarrhea reported among patients receiving magnesium citrate (p = 0.007). The addition of magnesium citrate resulted in more procedures rated by the endoscopist as excellent or good (RR 1.5, 95% CI: 1.3-1.9), deeper sigmoidoscope insertion (56 vs 51 cm, p = 0.0036), fewer procedures requiring repeat preparation (RR: 0.21, 95% CI: 0.04-0.98) and more procedures rated by patients as discomfort free (RR: 2.2, 95% CI: 1.39-3.60). Excellent and good preparations were associated with shorter procedure duration (19 vs 14 min, p = 0.008) and greater depth of insertion (56 vs 50 cm, p = 0.003). Fewer diverticuli were noted with a single enema than the two enema preparation (p = 0.006) with the remaining outcomes equal between these two groups. CONCLUSION: The addition of bottle of magnesium citrate to a 2-hyperphosphate enema preparation is well tolerated and improves bowel preparation for flexible sigmoidoscopy.

Abdominal Pain↗
PubMed1978

Colonoscopy for unexplained rectal bleeding.

Two hundred and thirty-nine patients underwent colonoscopy for unexplained rectal bleeding. Local anorectal conditions were excluded by digital and proctosigmoidoscopic examinations and results of barium studies were negative for all patients. A cause for bleeding was found in 95 patients. Thirty-nine had adenomatous polyps, 24 had unrecognised inflammatory bowel disease, and most importantly 23 (10% of series) had carcinomas. Forty patients had diverticular disease, but nine of them were found to have an adenomatous polyp and four a carcinoma. Colonoscopy can contribute positively to the investigation and treatment of unexplained rectal bleeding and may prevent unnecessary laparotomy.

Colitis↗
PubMed1981

An evaluation of flexible fibreoptic sigmoidoscopy.

Results of 350 flexible fibreoptic sigmoidoscopy examinations showed a diagnostic yield of 30% compared with 6.5% by rigid sigmoidoscopy of the same patients. The mean time for the examinations was eight minutes, a distance of over 50 cm being visualised in 65% of the patients. Preparation of the bowel with a single phosphate enema was adequate in 95% of the patients. As an outpatient investigation for clinicians fibreoptic sigmoidoscopy is a safe, quick, and useful addition to rigid sigmoidoscopy and should result in a decrease in the number of barium enema examinations required.

Adenoma↗
PubMed1972

Uptake of gallium-67 in colonic and rectal tumours.

The uptake of (67)Ga in biopsy specimens of normal and abnormal tissue was measured in 20 cases of colonic and rectal disease and the ratio between the (67)Ga uptake in these diseases and in the normal colon or rectum was determined. Uptake of the isotope was high in most of the 14 primary malignant tumours, being highest in poorly differentiated tumours. This uptake was found to be concentrated at the active tumour edge. Uptake of the isotope was generally low in non-malignant lesions.

Biopsy↗
PubMed1970

Faecal stasis and diverticular disease in ulcerative colitis.

The incidence of faecal stasis and of diverticular disease has been studied in a group of 399 patients with ulcerative colitis. Sixty-one patients had faecal stasis and 23 patients had diverticular disease. Pathological studies demonstrated an increase in the thickness of the inner spiral muscle in colitis patients with faecal stasis. The thickening was not as great as that seen in diverticular disease. Preliminary studies on the motility patterns in patients with faecal stasis show a higher mean activity in the pelvic colon than in normals but not as great as that seen in diverticular disease. Pressure studies in patients with faecal stasis have shown hypotonia in the proximal colon associated with dilatation.The possible significance of these results is discussed. It is suggested that ulcerative colitis may initiate a motility disturbance which leads to muscle thickening similar to that in diverticular disease. Diverticula associated with ulcerative colitis are usually not involved in the mucosal inflammatory process.

Barium Sulfate↗
PubMed2004

Colorectal visceral perception in diverticular disease.

BACKGROUND AND AIMS: The pathogenesis of asymptomatic diverticular disease (ADD) and symptomatic uncomplicated diverticular disease (SUDD) has not been elucidated. The aim of our study was to assess whether altered visceral perception or abnormal compliance of the colorectal wall play a role in these clinical entities. METHODS: Ten ADD patients, 11 SUDD patients, and nine healthy controls were studied. Using a dual barostat device, sensations were scored and compliance curves obtained using stepwise intermittent isobaric distensions of the rectum and sigmoid, before and after a liquid meal. In addition, the colonic response to eating was assessed by monitoring the volumes of both barostat bags at operating pressure before and after the meal. RESULTS: In the rectum, perception was increased in the SUDD group compared with controls (p = 0.010) and the ADD group (p = 0.030). Rectal compliance curves were not different between the groups. In the sigmoid colon, perception in the pre- and postprandial periods was increased in SUDD compared with controls (p = 0.018) but not when compared with ADD. Sigmoid volume-pressure curves had comparable slopes (compliance) in all groups but were shifted downwards in SUDD compared with ADD in the preprandial period (p = 0.026). The colonic response to eating (decrease in intrabag volume) was similar in all three groups, both in the rectum and sigmoid. CONCLUSION: Symptomatic but not asymptomatic uncomplicated diverticular disease is associated with heightened perception of distension, not only in the diverticula bearing sigmoid, but also in the unaffected rectum. This hyperperception is not due to altered wall compliance.

Adult↗
PubMed1983

Motility study in right sided diverticular disease of the colon.

Intraluminal pressure in the ascending colon of 13 patients with right sided diverticular disease and 10 of normal subjects was studied with catheter-tip transducer inserted through colonoscopes. In the resting state the colonic motility index of patients with diverticular disease was greater than that of the controls. After intravenous injection of neostigmine methylsulphate higher pressure waves were more frequently observed in patients with diverticular disease than the controls, and the colonic motility index of patients was much greater than that of the controls with statistical significance. From these observations it is suggested that high intraluminal pressure and the abnormal motility in the ascending colon plays an important role in the pathogenesis of right sided diverticular disease.

Adolescent↗
PubMed1985

Polyps and diverticula of the large intestine: a necropsy survey in Hong Kong.

The study is based on a prospective survey of 200 necropsies, to determine the prevalence of colonic polyps and diverticula in Hong Kong. Adenomatous polyps were found in 34% of men and 19% of women. The corresponding figures for hyperplastic polyps were 22% and 15%. When compared with European countries having similar rates for colorectal cancer, the polyp pattern by type, prevalence, and distribution is very similar. For diverticula the prevalence rate in this study was only 5%; most of these were situated in the caecum. This is at marked variance to the European pattern.

Aged↗
PubMed1986

Electrophysiology of the human colon: evidence of segmental heterogeneity.

The electrical properties of epithelial cell membranes in human descending and ascending colon were studied using microelectrodes and the Na channel blocker amiloride. Under control (pre-amiloride) conditions, the transepithelial electrical measurements in the two colonic segments were similar. The mucosal addition of 0.1 mM amiloride to descending colon totally abolished the transepithelial voltage (Vt) and short-circuit current (Isc), and significantly increased the total tissue resistance (Rt) by 19% (p less than 0.005). Intracellular recordings in descending colon obtained with microelectrodes revealed that the transepithelial effects of amiloride reflected hyperpolarization of the apical membrane and a significant increase in apical membrane resistance, changes which were consistent with amiloride-blockade of apical Na channels and complete inhibition of electrogenic Na transport. An appreciable amiloride-insensitive conductance was also present in the apical membrane of the descending colon. In contrast, the mucosal addition of 0.1 mM amiloride to ascending colon decreased Vt by only 30% (p less than 0.02) and Isc by 43% (p less than 0.05), but had no significant effect on Rt. These results indicate that electrogenic Na transport accounts totally for Isc in human descending colon in vitro, but only partly for Isc in human ascending colon, suggesting that Na transport in ascending colon is mediated primarily by electroneutral processes, and the apical membrane of human descending colon contains an amiloride-sensitive conductance for Na in parallel with an amiloride-insensitive conductance, which may transport K.

Adult↗