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PubMed1989

[Collagenous colitis. Studies on the differentiation and incidence of the syndrome].

All colon biopsy specimens of 28 months collected in an institute of pathology, providing a region of 660,000 inhabitants were reviewed for thickening of the subepithelial layer above the normal range of 7 mu. 16 cases were found, eleven of them with mild, uncharacteristic symptoms, eight even without diarrhea. Of the five cases with collagen layers above 10 mu, three suffered from intestinal diseases (unspecific protocolitis, active ulcerative colitis and malabsorption after ileum resection); two showed chronic diarrhea as symptoms of collagenous colitis. We conclude, that a subepithelial collagen layer is without any significance. Above 10 mu, two forms can be postulated: a reactive one, following chronic intestinal diseases and the idiopathic collagenous colitis syndrome of unknown etiology and pathogenesis. The presence of 185 cases is assumed in Western Germany, five of them already published.

Adult↗
PubMed2001

Mast-cells distribution and colonic mucin composition in Hirschsprung's disease and intestinal neuronal dysplasia.

Intestinal neuronal dysplasia (IND) is a malformation of the enteric plexus that clinically resembles Hirschsprung's disease (HD). In HD, the aganglionic bowel is characterized by the presence of hypertrophic nerve trunks and increased numbers of adrenergic and cholinergic nerve fibers, whereas IND type B (IND-B) is characterized by dysplasia of parasympathetic nerves, hyperganglionosis, and giant ganglia. The aims of this study were to investigate the relationship between the distribution of mast cells (MC) and abnormal neuronal innervation and the impact of abnormal neuronal innervation on colonic epithelial differentiation in relation to the typical innervation abnormalities seen in HD and IND. Full-thickness rectal-biopsy or resected surgical specimens from 15 patients (7 HD, 4 IND, 4 control) were examined by conventional hematoxylin-eosin, periodic acid-Schiff Alcian blue (PAS-AB), toluidine blue staining. The aganglionic and IND-B segments had larger numbers of MC in all layers than the ganglionic and control segments. There was a close relationship between the hypertrophic nerve fibers and the distribution of the MC. In contrast to the aganglionic segments, the mucin composition of the IND-B segments was normal. This finding suggests that innervation anomalies do not reflect epithelial differentiation to the same extent.

Biopsy↗
PubMedDate not supplied

[Hypoplasia of enamel. A useful marker in the diagnosis of celiac disease in its subclinical form].

Oral cavity alterations are often indicative sign of chronic gastrointestinal disorders, such as malabsorption and malnutrition syndromes. The relationship between oral pathology and intestinal diseases is rarely a chance association. This prompted odontostomatological research to focus on the study of alterations of the oral cavity, hypotetical markers of intestinal disorders if they can be measured in terms of frequency and incidence, as a tool for the early diagnosis of the intestinal disease itself. This paper should be seen against this background since it examines the possible connection between celiac disease and the presence of oral alterations as an index of disease.

Adolescent↗
PubMed1995

[Risk factors for recurrence of Crohn disease after intestinal resection].

From 1965 to 1990, postoperative risk factors (age, sex, preoperative history of CD, initial location of CD, length of affected intestinum, extent of bowel resection) for recurrence of Crohn's Disease (CD) were retrospectively analysed from data of 172 patients (104 men, 68 women; age 14 to 65 yrs.) with primary bowel resection and compared with the international literature. The mean follow-up interval was 10 (1-21) years. Additionally full thickness biopsies from resection margins of 66 consecutive ileocecal specimen (45 men, 21 women; age 21-70 years) with ileitis were studied, histopathologically classified into 3 groups and correlated with the rate, manifestation and onset of early recurrence. The cumulative CD recurrence rate was 69% after 10 years and 86.4% after 15 years. There was no statistically significant correlation between recurrence rate and age, sex, initial location or extent of bowel resection, only an higher rate with an preoperative duration of CD longer than 5 years (p < 0.05). The histopathology of the ileocecal resection specimen showed no statistically significant differences of the recurrence rate within the 3 groups. Surgery cannot minimize the recurrence rate of CD after resection but do clearly improve the quality of life.

Adolescent↗
PubMed2000

The role of probiotic cultures in the control of gastrointestinal health.

The use of probiotics to enhance intestinal health has been proposed for many years. Probiotics are traditionally defined as viable microorganisms that have a beneficial effect in the prevention and treatment of specific pathologic conditions when they are ingested. There is a relatively large volume of literature that supports the use of probiotics to prevent or treat intestinal disorders. However, the scientific basis of probiotic use has been firmly established only recently, and sound clinical studies have begun to be published. Currently, the best-studied probiotics are the lactic acid bacteria, particularly Lactobacillus sp. and Bifidobacterium sp. However, other organisms used as probiotics in humans include Escherichia coli, Streptococcus sp., Enterococcus sp., Bacteroides sp., Bacillus sp., Propionibacterium sp. and various fungi. Some probiotic preparations contain mixtures of more than one bacterial strain. Probiotics have been examined for their effectiveness in the prevention and treatment of a diverse spectrum of gastrointestinal disorders such as antibiotic-associated diarrhea (including Clostridium difficile-associated intestinal disease), infectious bacterial and viral diarrhea (including diarrhea caused by rotavirus, Shigella, Salmonella, enterotoxigenic E. coli, Vibrio cholerae and human immunodeficiency virus/acquired immunodeficiency disorder, enteral feeding diarrhea, Helicobacter pylori gastroenteritis, sucrase maltase deficiency, inflammatory bowel disease, irritable bowel syndrome, small bowel bacterial overgrowth and lactose intolerance. Probiotics have been found to inhibit intestinal bacterial enzymes involved in the synthesis of colonic carcinogens. There are many mechanisms by which probiotics enhance intestinal health, including stimulation of immunity, competition for limited nutrients, inhibition of epithelial and mucosal adherence, inhibition of epithelial invasion and production of antimicrobial substances. Probiotics represent an exciting prophylactic and therapeutic advance, although additional investigations must be undertaken before their role in intestinal health can be delineated clearly.

Clinical Trials as Topic↗
PubMed1968

Plesiomonas shigelloides in South Australia.

Plesiomonas shigelloides, a motile, oxidase-positive, Gram-negative rod that may possess shigella antigens, was isolated from the faeces of 36 children and two adults. In 13 children the organism was thought to be possibly the cause of enteritis and in eight children there was no evidence of intestinal disease. In nine children with gastroenteritis other enteropathogenic bacteria were found in addition, and six children had intestinal disease due, or possibly due, to other factors. Only four of the 38 strains had shigella antigens.

Adult↗
PubMed1989

[Oxygen free radicals and inflammatory diseases of intestines].

Free oxygen radicals (F.O.R.) belong to a very aggressive chemical species derived from molecular oxygen. Their role in inflammation is well established and Polymorphonuclear neutrophils (PMNS) make use of them as antibacterial weapons. Their role has been experimentally demonstrated in numerous ischemia-reperfusion models. Free radical scavengers such as the superoxide dismutase, allopurinol or desferrioxamine can prevent the occurrence of lesions. The essential role of PMNS in these models is demonstrated by the fact that previous depletion of the animal in PMNS also prevents such lesions. Histologically, in these ischemia-reperfusion models, PMNS infiltration may be quantified by assay of myeloperoxidase. In experimental models of inflammatory colitis (acetic acid, bacterial polysaccharides) intestinal wall infiltration by PMNS is a fundamental phenomenon and is also a characteristic of Crohn's disease and exacerbations of Ulcerative Colitis. Thus, it is probable in both disorders that F.O.R. play an important role since steroids inhibit their secretion by PMNS and 5-aminosalicylic acid has been shown to be a F.O.R. scavenger.

Free Radicals↗
PubMed1985

Copper malabsorption in coeliac disease.

Copper uptake during three hours from an oral test dose of copper sulphate solution giving three mg Cu++, close to the recommended daily dietary intake, was significantly reduced in patients with proximal intestinal disease, compared with normal subjects. Three out of ten patients had abnormal and otherwise unexplained blood counts compatible with the known haematological effects of copper deficiency and were restored to normal levels on a gluten-free diet. Copper deficiency and proximal intestinal disease should be suspected in patients with otherwise unexplained anaemia, especially neutropenia.

Adult↗
PubMed2002

How useful is fecal pancreatic elastase 1 as a marker of exocrine pancreatic disease?

OBJECTIVES: To evaluate the role of fecal elastase 1 (E1) as a marker of exocrine pancreatic insufficiency (PI). STUDY DESIGN: Fecal E1 was measured in patient groups with (1) failure to thrive but no pancreatic or intestinal disease (disease control patients); (2) PI; (3) pancreatic sufficiency; and (4) steatorrhea caused by a variety of intestinal diseases. RESULTS: Fecal E1 in all disease control patients exceeded 200 microg/g stool. Only 1 (2%) of 50 patients with PI exceeded the minimum reference value of 100 microg/g stool. In contrast, 3 (11%) of 28 patients with pancreatic sufficiency (with Shwachman-Diamond syndrome) had fecal E1 concentrations <100 microg/g stool, as did 5 (20%) of 25 patients with steatorrhea from intestinal causes, all of whom had diluted feces caused by short gut. CONCLUSIONS: Fecal E1 is a useful noninvasive screening test of PI in childhood. A negative test (>100 microg/g stool) had 99% predictive value for ruling out PI. However, a positive test in those with short gut or Shwachman-Diamond syndrome must be interpreted with caution.

Adolescent↗
PubMed2005

Double balloon enteroscopy-the last blind-point of the gastrointestinal tract.

Technical challenges have obstructed the diagnosis and treatment of small intestine disease. An innovative form of enteroscopy-the double balloon method-permits visualization of the complete small intestine, to-and-fro examination of an area of interest, and biopsy and endoscopic procedures which are safer, faster, and less painful than earlier methods. From October 2003 to May 2004, a total of 10 patients with obscure gastrointestinal bleeding received 12 enteroscopic examinations, 8 per oral and 4 per rectal examinations, while 2 patients received per oral enteroscopy first and further per rectal procedures 2 days later. Two cases with intestinal submucosal tumors were discovered by per oral enteroscopy, one with a 5-cm SMT with reddish mucosa at the jejunum and another with a 4-cm SMT and surface ulceration, in which the biopsy showed GIST. Both patients received an operation later. Four patients were found to have intestinal angiodysplasia in jejunum(per oral) and one in ileum (per rectal), and after local therapy bleeding stopped. Multiple angiodysplasias were observed in a patient who was operated on for active bleeding from the ileum after Indian ink tattooing. The two patients who received per oral and per rectal procedures did not display definite small intestinal lesions. All patients underwent the procedures satisfactorily without any complications, and the examination times varied from 90 to 360 min. Double balloon enteroscopy permits deep insertion of an endoscope into the small intestine without excessive stretching of the intestinal tract. This method can use either an oral or an anal approach. To-and-fro observation of almost the complete small intestine is possible, as are interventions.

Adult↗
PubMed1994

[Alveolitis and pulmonary fibrosis in chronic diverticulitis and ulcerative colitis].

Associated reactions of the connective tissue of the lungs are by no means rare in several extrapulmonary disorders, for example, with the "so-called" collagenoses. They are less frequent in chronic inflammatory intestinal diseases. The mechanism of this pulmonary reaction is largely unclarified. The situation is complicated further by the fact that a drug side reaction may compete with the underlying disease. The problem of a change in the connective lung tissue within the framework of a chronic inflammatory intestinal disease or as a result of drug therapy of that disease, is described and demonstrated via the cases of two patients.

Adult↗
PubMed1997

Primary gastrointestinal lymphomas in Jordan are similar to those in Western countries.

It has been a common practice to divide gastrointestinal (GI) lymphomas into Western and Middle Eastern types; the former predominantly involves the stomach, whereas the latter are mostly intestinal. Recent studies suggested that these lymphomas are biologically different from their nodal counterpart and hence should be classified separately. In this retrospective study, we examined all of the primary GI lymphomas seen at Jordan University Hospital, Amman, Jordan, between 1983 and 1992 in an attempt to reclassify and immunophenotype these cases. We studied 53 cases of primary GI lymphomas for which available material was found. Lymphomas were morphologically reclassified according to current classification schemes. Immunoperoxidase stains were performed using the streptavidin biotin method using antibodies against leukocyte common antigen, B, and T-cells. The stomach was the most common site of involvement, accounting for 62% of the cases. The male-to-female ratio was 2.8:1. The three most common histologic types were, in order, diffuse large cell lymphoma, Burkitt's lymphoma, and lymphoma of mucosa-associated lymphoid tissue. Immunoproliferative small intestinal disease was seen in only one patient. The B-cell phenotype predominated in our cases; it was seen in 85% of the gastric and 100% of the intestinal cases. Unlike other series from the region, the stomach was the most commonly involved site by GI lymphoma. Immunoproliferative small intestinal disease seems to be a rare entity in Jordan, and the majority of intestinal and gastric lymphomas were diffuse large cell lymphomas. Histopathologic evidence of mucosa-associated lymphoid tissue origin was seen in at least 18% of the gastric cases. B-cell lymphomas were by far the most common type seen, and T-cell lymphomas were rare.

Adolescent↗
PubMed2000

Altered expression of laminins in Crohn's disease small intestinal mucosa.

Laminins are a large family of heterotrimeric basement membrane molecules that mediate crucial cell functions such as adhesion, proliferation, migration, and differentiation. Up to now, three distinct laminins have been identified in the normal human small intestinal epithelium. Laminin-1 (alpha1beta1gamma1) and laminin-5 (alpha3beta3gamma2) are mainly expressed at the base of villus cells, whereas laminin-2 (alpha2beta1gamma1) is restricted to the bottom of the crypts. The expression of these molecules has not yet been studied in Crohn's disease (CD), but it could be altered, in light of the important changes occurring in the architecture of the crypt-villus axis under the active state of the disease. To test this hypothesis, the expression of laminin alpha1, alpha2, and alpha3 subunits was analyzed in control, inflamed, and corresponding uninflamed CD small intestinal specimens by indirect immunofluorescence and reverse transcriptase-polymerase chain reaction. Surprisingly, alpha1 and alpha3 remained strongly expressed by all villus cells, whereas alpha2, normally expressed in the bottom of the crypts in control and uninflamed CD specimens, was lacking in inflamed CD specimens. However, this loss of alpha2 expression was associated with a significant up-regulation of both alpha1 and alpha3 expression in the crypts of inflamed CD specimens. A significant up-regulation of the alpha1 subunit was also observed in the crypts of uninflamed CD specimens. At the transcript levels, alpha1 was found significantly higher in inflamed than uninflamed CD specimens. Taken together, these observations identify important alterations in laminin expression in the small intestine with CD and suggest that compositional changes in the epithelial basement membrane may play a role in this disease.

Adult↗