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Results for “INTESTINAL DISEASES”

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[Study of intestinal malabsorption diseases as cause of monosymptomatic short stature]

OBJECTIVE: This study was carried out in order to evaluate the etiology of monosymptomatic childhood short stature (below the third percentile or with growth rate of less than 5 cm/year) with emphasis on causes due to intestinal malabsorption. METHODS: Each patient was submitted to endocrinological, biochemical and hematological investigation. Determination of serum anti-gliadin antibodies, fecal fat, chloride levels in sweat, jejunal biopsy and bone age was also obtained.RESULTS: A total of 51 children was studied, most of them belonging to the group of normal variants. Four children had abnormally high sweat chloride, compatible with the diagnosis of cystic fibrosis. These children were asymptomatic regarding respiratory and gastrointestinal tract. CONCLUSIONS: We conclude that cystic fibrosis, besides celiac disease, must be included in the differential diagnosis of short stature in childhood.

Journal Article↗

[Immunoproliferative disease of the small intestine. A rare differential diagnosis of Crohn's disease].

For 2 years a 39-year-old Turkish man had had abdominal pain as well as weight loss of more than 10 kg over 4 months, associated with a raised ESR (33 mm/h) and recurrent gastrointestinal bleedings which endoscopy revealed to have been caused by a marked erosive duodenitis. Biopsies from the duodenum and terminal ileum demonstrated lymphoplasmocytic infiltration of the entire small intestine in the sense of immunoproliferative small intestinal disease (IPSID). By immunohistochemistry the lymphoplasmacellular infiltrate showed polyclonal expression of IgA without IgA increase in serum, urine and duodenal juice. The patient was treated with tetracycline (500 mg twice daily) for one year. The symptoms and histological lesions were much improved after 4 months. One year after diagnosis he was symptom-free.

Adult↗

Idiopathic subclinical enteropathy in southern Iran.

A study of 100 normal subjects from villages in southern Iran revealed that almost one third of this population had one (or more) absorptive or morphological abnormality of the small-bowel mucosa. The finding of morphologically normal bowel mucosa in stillborn fetuses and in newborns who died within two weeks of birth was consistent with the possibility that the abnormalities noted in the village population were postnatally acquired. Finally, speculations are offered regarding the relationship of idiopathic enteropathy and "immunoproliferative small intestinal disease," which is often seen in the region.

Adolescent↗

The role of neuroenteric hormones in intestinal infectious diseases.

It is now well established that communication among the enteric nerves, hormones, and neuropeptides plays a role in the pathogenesis of infectious gastrointestinal conditions. The results of several studies suggest that enteric nerves and hormones modulate important gastrointestinal functions such as intestinal motility and transport, intestinal permeability, fluid secretion, and inflammation in response to infectious agents. During the past year several gut-brain peptides, including substance P, neurotensin, and galanin, emerged as important mediators in the development and progress of intestinal infectious conditions. The intestinal mechanism of neuropeptide and hormone action involves direct effects via binding to receptors on the intestinal epithelium as well as on immune cells localized underneath the epithelial layer. Based on the available evidence from whole animal models it is possible that these new paradigms may offer novel therapeutic strategies in the treatment of gastrointestinal infections. This review summarizes recent progress on the identification of peptide hormones participating in the pathophysiology of infectious intestinal conditions and discusses the possible mechanism(s) of action involved in these processes.

Journal Article↗

Intestinal barrier: an interface between health and disease.

The intestine constitutes the largest interface between a person and his or her environment, and an intact intestinal barrier is thus essential in maintaining health and preventing tissue injury and several diseases. The intestinal barrier has various immunological and non-immunological components. The epithelial barrier is one of the most important non-immunological components. Hyperpermeability of this barrier is believed to contribute to the pathogenesis of several gastrointestinal disorders including inflammatory bowel disease, celiac disease and food allergy. Hence, assessing barrier integrity is of the utmost importance. One of the more quantitative gauges for this assessment is transepithelial permeability of various molecular probes, among which sugars are commonly used. Measures of intestinal permeability might also be useful as markers for assessment of prognosis and follow up in various gastrointestinal disorders. The present article is a review of the normal and abnormal functioning of the intestinal barrier, the diseases that can result from loss of barrier integrity, and some promising agents and strategies for restoring barrier normality and integrity.

Biological Transport↗

Gastrointestinal issues in children with rheumatologic disease.

Distinctive arthritic patterns, some of which may parallel or even precede intestinal disease activity, are seen in inflammatory bowel disease. Some spondyloarthropathies are associated with transient ileocolic inflammation. Vasculitis frequently affects the gastrointestinal tract, predominantly manifesting with abdominal pain. In severe cases, intestinal ischemia and perforation may occur. Various arthritides are thought to be associated with other gastrointestinal diseases, such as celiac disease and hepatitis. The association between intestinal disease and arthritis is still being investigated. Interactions between the inflammatory intestinal cells and inflamed synovial cells have been demonstrated. Certain intestinal bacteria such as Klebsiella pneumoniae are suspected to play a role as triggers for the development of arthropathies. Genetic factors, especially human leukocyte antigen associations, are also being increasingly investigated for better characterization of the types of arthritis and possible prognostic implications. Various therapies, including nonsteroidal anti-inflammatory drugs, used to treat rheumatologic diseases have the potential to cause gastrointestinal complications.

Arthritis↗

Minireview: the glucagon-like peptides.

The glucagon-like peptides GLP-1 and GLP-2 are produced in enteroendocrine L cells of the small and large intestine and secreted in a nutrient-dependent manner. GLP-1 regulates nutrient assimilation via inhibition of gastric emptying and food intake. GLP-1 controls blood glucose following nutrient absorption via stimulation of glucose-dependent insulin secretion, insulin biosynthesis, islet proliferation, and neogenesis and inhibition of glucagon secretion. Experiments using GLP-1 antagonists and GLP-1 receptor-/- mice indicate that the glucoregulatory actions of GLP-1 are essential for glucose homeostasis. In the central nervous system, GLP-1 regulates hypothalamic-pituitary function and GLP-1-activated circuits mediate the CNS response to aversive stimulation. GLP-2 maintains the integrity of the intestinal mucosal epithelium via effects on gastric motility and nutrient absorption, crypt cell proliferation and apoptosis, and intestinal permeability. Both GLP-1 and GLP-2 are rapidly inactivated in the circulation as a consequence of amino-terminal cleavage by the enzyme dipeptidyl peptidase IV (DP IV). The actions of these peptides on nutrient absorption and energy homeostasis and the efficacy of GLP-1 and GLP-2 in animal models of diabetes and intestinal diseases, respectively, suggest that analogs of these peptides may be clinically useful for the treatment of human disease.

Animals↗

Mechanisms of disease: adipocytokines and visceral adipose tissue--emerging role in intestinal and mesenteric diseases.

Adipose tissue has long been regarded as a passive type of connective tissue that stores energy as triglycerides and releases energy as free fatty acids, however, this point of view has now changed. The wide variety of products expressed and secreted by adipose tissue, such as adiponectin, leptin, and resistin, mean that the total adipose tissue mass can be defined as a real endocrine organ. The anatomic, metabolic and biochemical characteristics of visceral adipose tissue make it interesting in the context of intestinal and mesenteric diseases. These characteristics include increased lipolysis, venous drainage via the portal vein and local glucocorticoid excess owing to the specific expression of 11-beta-hydroxysteroid-dehydrogenase type 1. In this review, the role of the visceral adipose tissue and its secretory products in intestinal and mesenteric diseases is systematically reviewed, with special focus on 'creeping fat' in Crohn's disease and mesenteric panniculitis.

Adipocytes↗

[Perforations during contrast enema].

During contrast enema, perforation into the retroperitoneal space can be differentiated from perforation into the peritoneum and perforation into the intestinal wall associated with formation of barium granulomas or submucosal spreading of the contrast medium. Other special forms are perforation with contrast medium embolism of diverticula; of the processus vermiformis; penetration of contrast medium into fistulous systems and from the operated area. Risk factors are: balloon catheter, intestinal tubes with a hard tip, preternatural anus, excessive enema pressure, contrast medium additions, preceding manipulations, intestinal diseases, advanced age and delegation of manipulations to assistants and unskilled staff. Children are particularly at risk.

Barium Sulfate↗

Small intestinal permeability in pediatric clinical practice.

Passive permeability of small intestine to lactulose and mannitol was studied in children suspected of having intestinal disease, using a hypertonic differential sugar absorption test. Children with coeliac disease and cows' milk intolerance were shown to have an elevated urinary lactulose/mannitol recovery ratio when compared with controls, children with normal jejunal biopsy, or children in whom alternative explanations for failure to thrive had been demonstrated. The abnormality in permeability ratio principally reflects a reduced urinary recovery of mannitol following oral administration. This study demonstrates that a hypertonic sugar absorption test is well tolerated even by young children, is practicable in routine clinical pediatric practice, and is capable of demonstrating abnormal intestinal function in children with small intestinal disease.

Adolescent↗

Toll-like receptors and intestinal defence: molecular basis and therapeutic implications.

Toll-like receptors (TLRs) play a principle role in distinct pathogen recognition and in the initiation of innate immune responses of the intestinal mucosa. Activated innate immunity interconnects downstream with adaptive immunity in complex feedback regulatory loops. Intestinal disease might result from inappropriate activation of the mucosal immune system driven by TLRs in response to normal luminal flora.

Dimerization↗

[A study of the evacuatory function of the small and large intestines using the dynamic scintigraphic method in inflammatory diseases of the intestines].

Intestinal and colon evacuatory function was studied in 10 patients without pathology of the digestive organs and in 66 patients with chronic colitis. This method allows adequate assessment of the state of the hepatobiliary system, intestinal and colon evacuatory function without additional radiation exposure of the examinees and personnel.

Adult↗