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At least 775 records · Page 43Linked to original sources
PubMed1988

Short chain fatty acid distributions of enema samples from a sigmoidoscopy population: an association of high acetate and low butyrate ratios with adenomatous polyps and colon cancer.

We investigated the distribution of short chain fatty acids (SCFA) in enema samples taken from subjects before sigmoidoscopy as an indicator of possible microbial community differences between subjects subsequently diagnosed as normal or having colonic disorders. The major SCFA in all groups were acetic, propionic, and butyric acids. A significantly higher ratio of acetate to total SCFA and lower ratio of butyrate to total SCFA was found for polyp-colon cancer subjects than for normal subjects. There were no significant differences in the ratios of acetate, propionate, or butyrate between the diverticulosis or inflammatory bowel groups and the normal group. There were no significant sex differences nor were there correlations with the ratios of acetate, propionate or butyrate and age, subject weight, or dry weights of samples. Significant differences in concentrations of individual acids were found between normal and certain diagnostic groups. The difference in proportions of individual SCFA between groups suggest differences in fermentation patterns of the colonic microflora.

Acetates↗
PubMed1993

Increased risk of left sided colon cancer in patients with diverticular disease.

Certain similar epidemiological characteristics suggest a common aetiology for colon cancer and diverticulosis of the colon. The hypothesis that patients with diverticulosis are at increased risk of developing colon cancer was tested in a retrospective, population based, cohort study in Sweden. A total of 7159 patients (2478 men and 4681 women) who had been given a hospital discharge diagnosis of diverticulosis or diverticulitis of the colon between 1965 and 1983 were followed up during 1985 by means of record linkage procedures. After excluding the first 2 years of follow up, there was not a significant increase in risk (SIR) overall for colon cancer (SIR = 1.2; 95% confidence intervals (CI) 0.9, 1.6) or for rectal cancer (SIR = 1.1; 95% CI 0.7, 1.7). The observed number of right sided colon cancers was as expected (SIR = 0.9; 95% CI 0.5, 1.5). In contrast, an increased risk of left sided colon cancer was found both overall (SIR = 1.8; 95% CI 1.1, 2.7) and consistently in men and women as well as in different age groups. This risk increased the longer the follow up (p value for trend < 0.001). These results do not support the hypothesis of a common aetiology in diverticular disease and colonic cancer but suggest a causal relationship between diverticular disease and cancer of the left colon.

Adult↗
PubMed1991

Colonic involvement in Fabry's disease.

The case of a 54 year old man with Fabry's disease and extensive jejunal and colonic diverticulosis causing colonic stricture is presented. Histological examination of the resected colon revealed evidence of ceramide trihexose deposition in the myenteric nerve plexus. Colonic involvement in Fabry's disease has not been reported before.

Colon, Sigmoid↗
PubMed1988

Diverticular disease: imaging with post-double-contrast sigmoid flush.

In a prospective study, the effect of infusion of a low-density contrast material was evaluated as an adjunct to high-density, double-contrast imaging of the sigmoid colon. After double-contrast barium enema (DCBE) study, 52 consecutive patients with sigmoid diverticulosis received an additional 500-750-mL enema either with water or a 1.5% barium suspension for computed tomography. Rectosigmoid radiographs were evaluated for luminal distention, visualization of the interhaustral space, definition of diverticula, and interpretation of polypoid defects. While double-contrast views were excellent in 21% of patients, improvement in multiple factors by water or 1.5% barium flush resulted in improved sigmoid images in 65% and 75% of patients, respectively. Polyps were confirmed and artifactual defects confidently excluded. Sigmoid flush, particularly with low-density barium, is a simple adjunct to DCBE study that improves visualization of the diverticular sigmoid and increases interpretive confidence.

Barium Sulfate↗
PubMed1996

Segmental colitis complicating diverticular disease.

Two cases of idiopathic colitis affecting the sigmoid colon in elderly patients with underlying diverticulosis are presented. Segmental resection has permitted close review of the histopathology in this syndrome which demonstrates considerable similarity to changes seen in idiopathic ulcerative colitis. The reported experience with this syndrome and its clinical features are reviewed.

Aged↗
PubMed2001

Current practices in left-sided colonic emergencies: a survey of US gastrointestinal surgeons.

BACKGROUND: The paradigms in the surgical management of obstruction and perforation of the left colon - once considered absolute contraindications to primary resection and anastomosis - are changing. The aim of this survey was to poll American Gastrointestinal surgeons on their current approach to left colonic emergencies. METHODS: A questionnaire was sent to 500 US-based surgeons, randomly selected members from the membership list of the Society for Surgery of the Alimentary Tract. It surveyed the surgeons on how they would approach 'good-risk' and 'poor-risk' patients with left colonic obstruction or perforation. RESULTS: 215 (43%) surgeons responded to the questionnaire; 180 fully completed questionnaires (36%) were analyzed. Sigmoid obstruction: 96 responders (53%) selected a one-stage procedure in 'good-risk' patients; 78 preferred sigmoid resection with (n = 46) or without (n = 32) 'on-table' colonic lavage and 18 opted for a subtotal colectomy and ileo-rectal anastomosis. Most (94%) responders preferred a staged procedure in 'high-risk' patients: a Hartmann resection (n = 120) or a transverse colostomy (n = 46). Sigmoid diverticular perforation: only one third of the responders recommended a one-stage procedure in 'good-risk' patients: 58 would perform a sigmoidectomy with (n = 19) or without (n = 39) 'on-table' colonic lavage; only two opted for subtotal colectomy with ileo-rectal anastomosis. In 'high-risk' patients most surgeons opted for a Hartmann's (88%) procedure or a diverting colostomy (7%). CONCLUSIONS: This survey suggests that a half and one-third of the responders would perform a one-stage resection and anastomosis in 'good-risk' patients with left colonic obstruction and perforation, respectively. In 'poor-risk' patients most responders would still opt for a staged procedure.

Anastomosis, Surgical↗
PubMed1982

The incidence of occult bleeding per rectum in a general practice in Scotland: a study using haemoccult.

Haemoccult (Eaton Laboratories) was offered to all 405 subjects aged 45 to 65 years in a Scottish, rural general practice as a screening test for occult bleeding per rectum. Subjects contacted verbally had a compliance rate of 85.2 per cent and those by post 59.5 per cent--2.6 per cent (7) returned positive tests. Of these seven, one refused follow-up. Two had diverticular disease, one had haemorrhoids, one had a possible polyp, one had ingested aspirin and also had a few diverticula. In one patient, no cause of bleeding was found. The last two and one with diverticular disease were negative on re-testing. In general, the test was aesthetically acceptable to undertake for both patient and doctor and provided a suitable screening technique for occult bleeding.

Aged↗
PubMed1984

Conservative surgery for vesicocolic fistula.

Vesicocolic fistula due to diverticular disease of the colon is conventionally treated by resection of the diseased bowel and closure of the vesical defect. Three cases are described in which separation of the viscera and simple suture of the vesical and colonic defects was carried out. A greater omental graft was interposed between the rectum and bladder. Two of the patients are well 12 and 26 months postoperatively. The third patient died a year postoperatively from a complication of her diverticular disease.

Aged↗
PubMed1979

The radiological diagnosis of polyps in the presence of diverticular disease.

The double contrast barium enemas in 20 patients with endoscopically proven polyps within a segment of diverticular disease have been reviewed. Ninety per cent of the polyps were detected. The increased density sign and negative shadow filling defect proved valuable in their detection. Antispasmodics are advised to distend the sigmoid and allow double contrast views to be obtained. With severe diverticular changes it may be impossible to exclude a polyp, and if the patient complains of rectal bleeding, endoscopy is indicated.

Adult↗