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At least 757 records · Page 42Linked to original sources
PubMed1996

The development of a treatment protocol for patients with chronic radiation-induced rectal bleeding.

UNLABELLED: BACKGROUNDS AND METHODS: This study reviews the clinical features and reports the preliminary results of treatment of 34 consecutive patients with clinically significant bleeding from chronic, radiation-induced proctitis, using a combination of endoscopic YAG Laser and the application of topical formalin dressings to the rectal mucosa. RESULTS: Bleeding ceased in 25 patients (74%); bleeding continued but occurred only slightly and occasionally in five patients (15%); and three patients required operation to control the bleeding (9%). One patient relapsed after treatment and died while receiving a further transfusion. CONCLUSIONS: This experience has been used to develop a management protocol for patients with this serious complication.

Administration, Topical↗
PubMed1986

Isolation of "Campylobacter hyointestinalis" from a human.

We isolated "Campylobacter hyointestinalis" from the rectal culture of a homosexual man with proctitis. Phenotypic characterization of the isolate was confirmed by DNA hybridization by using the taxonomic spot blot. "C. hyointestinalis" was previously isolated only from animals but should be considered in the identification of Campylobacter species isolated from humans.

Adult↗
PubMed1998

Sigmoidoscopy in minor lower gastrointestinal bleeding.

The role of sigmoidoscopic examination in the diagnosis, evaluation, and treatment of minor lower gastrointestinal bleeding was investigated. A hundred patients with minor rectal bleeding were examined by rigid sigmoidoscopy under general anaesthesia between January 1989 and July 1996. Patients who had bleeding secondary to infections, anal fissure, or haemorrhoids were excluded from study. Patients were reviewed retrospectively according to their diagnosis and endoscopic and histopathological findings. Twenty nine of these patients were girls and 71 boys; their ages ranged between 8 month and 14 years (mean 7.2 years). Endoscopic pathological findings were established in 60 patients; 32 had rectal polyps, 16 non-specific proctitis, four solitary rectal ulcers, three internal haemorrhoids, two ulcerative colitis, two Hirschsprung's enterocolitis, and one haemangioma. It is concluded that sigmoidoscopic examination should be performed for the diagnosis, prognosis, and choice of treatment in patients with minor rectal bleeding and the diagnosis should be confirmed histopathologically.

Adolescent↗
PubMed1979

Finger clubbing in inflammatory bowel disease: its prevalence and pathogenesis.

Finger clubbing, measured objectively by using the hyponychial angle, was present in 75 out of 200 (38%) patients with Crohn's disease, 15 out of 103 (15%) with ulcerative colitis, and two out of 24 (8%) with proctitis. In Crohn's disease and ulcerative colitis the hyponychial angle was significantly correlated with both disease activity and the extent of fibrosis in the resected specimens from 47 surgically treated patients. The prevalence of finger clubbing in patients with macroscopic disease within the area of the gut innervated by the vagus nerve was significantly higher than that in patients in whom the disease was confined to the distal colon and rectum. Finger clubbing in patients with Crohn's disease tended to regress after resection of macroscopic disease. It is concluded that finger clubbing is significantly commoner in Crohn's disease than ulcerative colitis. The focal stimuli for finger clubbing include mucosal inflammatory change and fibrosis mediated by the vagus and possibly other autonomic pathways acting as the afferent arc of a finger-clubbing reflex.

Adolescent↗
PubMed1984

Vasoactive intestinal peptide concentrations and immunocytochemical studies in rectal biopsies from patients with inflammatory bowel disease.

Vasoactive intestinal polypeptide (VIP)-containing nerves and VIP content of endoscopic rectal biopsies from 47 patients with inflammatory bowel disease and 17 normal controls were examined by immunocytochemistry and radioimmunoassay. Immunocytochemistry revealed a consistent increase in, and abnormal appearance of, VIP nerves in patients with Crohn's disease not only those with rectal involvement but also patients with no histological evidence of rectal disease. Normal control biopsies contained 1.64 +/- 0.39 pmol VIP/mg protein as compared with 3.43 +/- 1.24 pmol VIP/mg protein in tissue from patients with rectal Crohn's disease and 5.37 +/- 1.23 pmol VIP/mg protein in those with Crohn's disease without rectal involvement. Ten of the 17 biopsies examined from ulcerative colitics showed a normal pattern of VIP innervation. Examination of the conventional histology of these biopsies showed that only areas with obvious active proctitis had increased VIP nerves and, unlike the appearance in Crohn's disease, these nerves had a normal morphology. The VIP content of these biopsies was similar to that of the controls; 1.34 +/- 0.37 pmol/mg protein.

Adolescent↗
PubMed1987

Mucosal surface pH of the large intestine of the rat and of normal and inflamed large intestine in man.

The surface pH of rat distal colonic mucosa and human rectal mucosa was measured in vitro using first a small pH electrode with a flattened tip. In buffer with pH 7.56 the mean rat colonic surface pH was 6.72. Lowering the buffer pH in steps resulted in a small fall in surface pH, the values being buffer pH 7.06 surface pH 6.64, buffer pH 6.58 surface pH 6.61 and finally buffer pH 6.09 surface pH 6.39. Similar results were obtained with a buffer where butyrate, 30 mmol/l replaced chloride and when a CO2/bicarbonate buffer was used. During the time taken for the study transmural potential difference only changed by 1-2 mV. Serosal surface pH changed with buffer pH, suggesting that the maintained surface pH is a property of the mucosal surface only. The surface pH of human rectal mucosa was similar to that of rat distal colonic mucosa. As buffer pH fell from pH 7.51 to 5.96 mucosal surface pH only fell from pH 6.80 to 6.26. The values obtained in ulcerative proctitis did not differ from normal mucosa. Secondly pH microelectrodes were used to measure the juxta mucosal pH and the pH-microclimate thickness when luminal pH was controlled. The microclimate had a pH 6.63 adjacent to the mucosa with a thickness of 840 micron. The importance of mucus in maintaining the microclimate was shown by n-acetyl cysteine thinning and prostaglandin E2 thickening the layer. These results describe a surface microclimate in the large intestine of appreciable thickness and a constant juxta mucosal pH. Luminal pH changes produce only a small change in microclimate pH.

Adult↗
PubMed1992

Anti-neutrophil antibodies in inflammatory bowel disease: prevalence and diagnostic role.

Anti-neutrophil antibodies have been shown in sera from patients with a variety of inflammatory diseases. Those reacting with components of neutrophil cytoplasm are associated with systemic vasculitis. Both nuclear and perinuclear staining patterns on human neutrophils have been reported using sera from patients with inflammatory bowel disease. We have evaluated the reactivity against human neutrophils of sera from 100 patients with inflammatory bowel disease, 14 disease controls, and 20 normal volunteers. Altogether 27/50 (54%) sera from patients with ulcerative colitis contained antibodies that reacted with cytospun ethanol fixed neutrophils compared with 5/50 (10%) from Crohn's disease (p less than 0.001) and 0/34 control sera (p less than 0.001). All seven sera from patients with proctitis alone were negative (p less than 0.01). There was no correlation between presence or titre of anti-neutrophil antibodies and either disease activity or treatment. Positive sera gave three different staining patterns on human neutrophils. The predominant pattern was perinuclear (17/32); 12 sera gave a cytoplasmic and three a homogeneous nuclear staining pattern. None of the patients or the controls had antibodies to myeloperoxidase, elastase, or serine proteinase 3, all of which are recognised by anti-neutrophil cytoplasmic antibodies. Only 2/27 sera positive by indirect immunofluorescence reacted with an extract of neutrophil primary granules. In conclusion, anti-neutrophil antibodies occur more commonly in ulcerative colitis than in Crohn's disease or control subjects and the anti-neutrophil antibodies found in inflammatory bowel disease are different from those associated with vasculitis.

Adult↗
PubMed1988

What is colitis? Statistical approach to distinguishing clinically important inflammatory change in rectal biopsy specimens.

Measurements of mucosal dimension, architecture, and cell counts in both lamina propria and epithelium were made on rectal biopsy specimens from 20 patients with irritable bowel syndrome ("normal" controls); 54 patients with ulcerative colitis, Crohn's disease, and non-specific proctitis; eight patients with small bowel Crohn's disease; and 34 in whom the rectal biopsy specimen was not diagnostic. Discriminant analysis was applied to multiple variables based on the measurements, and three variables were identified as of high predictive value. The most powerful discriminant was increased lamina propria cellularity in all forms of chronic colitis. The ratios of surface length to mucosal length and of surface epithelial height to crypt epithelial height also emerged as discriminants. Chronic inflammatory bowel disease was distinguished from normal in 95% of cases with a definite pathological diagnosis, and 85% of borderline cases were correctly classified as either normal or inflammatory when judged by the final diagnosis after follow up. This study provides a basis for automated diagnosis of rectal biopsy specimens and provides objectively validated criteria which can also be applied in routine histological diagnosis.

Adult↗
PubMed2006

The potential role of serology in diagnosing chronic lymphogranuloma venereum (LGV): a case of LGV mimicking Crohn's disease.

We present the case of a 26 year old HIV positive homosexual man who was managed for suspected Crohn's disease for over 1 year before lymphogranuloma venereum (LGV) was clinically diagnosed. He had presented with constipation, secondary to acute haemorrhagic proctitis, and subsequently had two chlamydia negative rectal smears, using direct fluorescent antibody (DFA) Chlamydia trachomatis staining. Positive chlamydial serology guided retrospective testing of an early rectal biopsy, which was found to have C trachomatis by polymerase chain reaction (Roche Cobas) and identified as LGV serovar L2 by the Sexually Transmitted Bacteria Reference Laboratory (STBRL), Health Protection Agency (HPA), Colindale, London. Chlamydial serology may have a role in identifying late stage LGV infection. Although no standardised test currently exists, consideration should be given to evaluating the role of chlamydial serology in establishing a diagnosis of LGV.

Adult↗
PubMed1976

Some characteristics of homosexual men.

Although recognition of homosexuals is often important, many doctors lack the necessary skill or experience, so to assist them a group of 5,302 men was surveyed using a computer-based data system and 9-1 per cent. were recorded as homosexual. Analysis showed a relatively high proportion of homosexuals among men with syphilis and gonorrhoea, and a low proportion among men with nonspecific genital infection (non-specific urethritis and proctitis) and other infections. All men with secondary syphilis were homosexual. A relatively high proportion of men born in Eire, Spain, and North America were homosexual and a relatively high proportion of men living in the West End of London were homosexual. While these findings will be of most value to those working in STD clinics in London they may also be helpful to those working elsewhere and in other disciplines.

Adolescent↗
PubMed1978

Diagnostic, treatment, and reporting criteria for non-specific genital infection in sexually transmitted disease clinics in England and Wales. 1: Diagnosis.

The current methods of diagnosis for non-specific genital infection (NSGI) in clinics in England and Wales are described. In most clinics (92%) microscopical findings were used by consultants to establish the diagnosis of non-specific urethritis (NSU) in male patients. However, the microscopical criteria that they used in reaching a diagnosis varied between clinics. The most commonly applied criterion was that of less than five leucocytes per high power field. NSGI in female patients and non-specific proctitis in passive homosexuals were recognised as distincy in 60% of clinics and the latter in 57%. Among those who recognised these conditions the diagnostic criteria varied. The establishment of acceptable and uniform criteria for diagnosis are discussed.

Bacteriological Techniques↗
PubMed1985

Single dose ciprofloxacin for treating gonococcal infections in men.

A single oral dose of ciprofloxacin 500 mg was used to treat five men with gonococcal urethritis and five men with gonococcal proctitis, and all were cured. In a subsequent study the dose of ciprofloxacin was reduced to 250 mg, and 54 men with 57 gonococcal infections (47 urethral, seven rectal, and three pharyngeal) were treated; of the isolates of Neisseria gonorrhoeae, four were penicillinase producing strains. All the patients were cured of gonococcal infection. Urethral specimens from nine of the men with gonococcal urethritis yielded Chlamydia trachomatis before treatment. These organisms were isolated again from all these patients seven days after treatment, and from a further seven men who had been chlamydia negative before treatment. It is concluded that a single oral dose of ciprofloxacin is an effective treatment for uncomplicated gonorrhoea, but is ineffective against C trachomatis. Of the 54 men given 250 mg ciprofloxacin, six (11%) showed minor abnormalities of liver function tests after treatment.

Anti-Infective Agents↗
PubMed1981

Pathogenesis of urgency in defaecation in Crohn's disease.

In 39 patients with Crohn's disease with 20 suffering from urgency in defaecation, the degree of proctitis, anal basal and squeeze pressures and anal sphincter responses to passive rapid or slow rectal filling were not correlated to the presence or absence of urgency or its severity. However, there was a positive correlation between urgency and both defaecation frequency and looseness of stools as well as extent of disease, with invariable involvement of the small intestine in urgency patients. Disease confined to the colon was found only in non-urgency cases. It was proposed that extensive disease involving both the small and large intestine could elicit abnormal bowel motility, and lead to unusually rapid rectal filling, inevitably followed by rapid reflex relaxation of the anal sphincter, manifesting itself as urgency. This hypothesis would be consistent with the observation that operative removal of diseased bowel with ileorectal anastomosis may abolish urgency.

Adolescent↗
PubMed1977

The pathogenesis of porcine rectal stricture. I. The naturally occurring disease and its association with salmonellosis.

Rectal stricture occurred in each of 23 pigs submitted for necropsy from eight Indiana farms. Each stricture was an annular cicatrization of the rectal wall, 2.0-5.0 cm anterior to the anorectal junction. Emaciation, colonic dilatation and compression atrophy of abdominal and thoracic viscera were a result of chronic obstipation and inanition. Most pigs with strictures had severe enteric disease 4-8 weeks before the strictures occurred. Salmonella typhimurium was isolated from seven of the eight groups of pigs examined. Ulcerative proctitis, a possible precursor of rectal stricture, was frequently in pigs with enterocolitis caused by S. typhimurium.

Animals↗
PubMed1998

Inflammatory large bowel disease in immunodeficient rats naturally and experimentally infected with Helicobacter bilis.

Proliferative and ulcerative typhlitis, colitis, and proctitis were found incidentally in a breeding colony of male athymic nude (Cr:NIH-rnu) rats. Within the crypts of the large intestine, modified Steiner's silver stain revealed spiral organisms that were identified by culture, polymerase chain reaction, and sequencing to be Helicobacter bilis. The large bowel disease was reproduced in H. bilis-free male athymic nude rats that were injected intraperitoneally with a culture of H. bilis from the affected colony. The organism was isolated from the feces and cecum of the experimentally infected rats. H. bilis should be considered a potential pathogen in immunocompromised rats. The infection in immunocompromised rats may serve as an animal model for inflammatory large bowel disease.

Animals↗
PubMed2006

Clinical correlates of rectal gonococcal and chlamydial infections.

As few studies have compared the clinical features of rectal gonorrhoea in men who have sex with men with or without concurrent chlamydial infection, this longitudinal study was undertaken to address this issue. The cohort consisted of 129 men with rectal gonorrhoea, 34 of whom had concurrent chlamydiae. Symptoms of proctitis in men with rectal gonorrhoea with or without concurrent chlamydial infection were significantly higher than in men with isolated chlamydial infection (27% versus 10% [chi2=17.55; P<0.0001]). There was, however, no significant difference in the prevalence of symptoms between those with rectal gonorrhoea only (28%) and those with concurrent chlamydiae (23%); chi2=0.11; P>0.05). The median prepatent period or rectal gonorrhoea (21 men) was 5.0 days (interquartile range 11.0 days).

Chlamydia Infections↗
PubMed1993

Long source-skin distance rectal irradiation technique: a review of results.

Endocavitary rectal irradiation is a well established curative treatment for patients with selected early cases of adenocarcinoma of the rectum. At McGill we use a long source-skin distance (SSD) rectal irradiation technique as an alternative to the standard short SSD rectal irradiation technique originally described by Papillon. Eight patients, seven women and one man, were treated between April 1986 and November 1988. Median age was 72.5 years (range 46-86 years). Seven patients were treated with curative intent, and one for palliation. The mean follow-up period for all patients was 43 months, with a median of 54 months (range 3-65 months). Actuarial survival and disease-free survival were 86% and 72% at 65 months for the seven patients treated with curative intent. Treatments were well tolerated by all patients and only one patient developed localized proctitis that required steroid enemas, which resulted in complete resolution of symptoms. Our results are comparable with those in other reports in the literature. The complications were similar in type and frequency to other published series.

Adenocarcinoma↗