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PubMed2005

[The effects of kuijiekang capsule on ulcerative colitis induced by TNBS in rats].

OBJECTIVE: To evaluate the effects of Kuijiekang Capsule (KJK) on rats colitis induced by TNBS. METHODS: Rats with TNBS/ethanol-induced colitis were used and treated with KJK. The experimental animals were divided into 6 groups: control group, model group, SASP group (0.50 g/kg), KJK group (0.64, 0.32, 0.16 g/kg). The animals were administrated 0. 5% carboxymethyl cellulose, SASP and KJK respectively (from the 6th d after the establishment of ulcerative colitis model to the end of the experiment, 18 d totally). At the end of the experiment, the colon mucosal damage index (CMDI), the activity of myelperoxidase (MPO) and the occult blood test (OB) in feces were observed, the mucosa pathohistology was measured and thymus and spleen of rats were weighed respectively. Meanwhile, the content of malondiadehyde (MDA) , superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) of colonic tissue were detected. RESULTS: The remarkable effects of KJK at dosage of 0.64, 0.32 g/kg on TNBS-induced colitis were observed, the extent of CMDI and OB were decreased, MPO activeity of colonic tissue was reduced. The extent of atrophy of thymus gland and intumesce of spleen of rat were ameliorated. Meanwhile, the content of MDA was reduced, and the activities of SOD and GSH-Px were increased. Pathological histology results showed that KJK could alleviate the pathohistological lesion of the colon of rat. CONCLUSION: Treatment with KJK shows beneficial effects on the mucosal damage of rats colitis induced by TNBS/ethanol. The mechanism of the actions of KJK may relate to anti-inflammatory effect, immunoloregulation and anti-oxidation.

Animals↗
PubMed2005

[Study on differentially expressed genes of ulcerative colitis in the rat treated by herbs-partitioned moxibustion].

OBJECTIVE: To probe the mechanism of herbs-partitioned moxibustion for treatment of ulcerative colitis. METHODS: The rats with ulcerative colitis were randomly divided into 3 groups, normal control group, model group, and herbs-partitioned moxibustion group. The rats in the herbs-partitioned moxibustion group were treated by herbs-partitioned moxibustion at bilateral Tianshu (ST 25). BiostarR-40s gene chip was applied to detect the differentially expressed gene of their colonic tissues and fluorescence quantitative polymerase chain reaction was employed to confirm the results of the microarray analysis with interleukin-1 beta messenger RNA (IL-1beta mRNA) expression. RESULTS: Of 174 differential expression genes identified, 28 genes (including 7 known genes) elevated in rats of ulcerative colitis were down-regulated and 146 genes (including 42 known genes) reduced in the rat of ulcerative colitis were up-regulated after herbs-partitioned moxibustion treatment. CONCLUSION: Many abnormally expressed genes are involved in occurrence of ulcerative colitis and herbs-partitioned moxibustion can regulate expression of IL-1beta and other genes to exert therapeutic effect.

Animals↗
PubMed2006

Protective effect of geranylgeranylacetone on trinitrobenzene sulfonic acid-induced colitis in mice.

Geranylgeranylacetone (GGA) has recently been reported to have a protective effect against ischemic, injurious and apoptotic stress in several tissues. The aim of this study was to determine the effect of GGA on colitis induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS) in mice. Colitis was induced by intrarectal instillation of TNBS in 50% ethanol in BALB/c mice. Survival, change in body weight and change in wet colon weight were assessed. Histological score in the colon was evaluated 5 days after TNBS treatment. The level of myeloperoxidase (MPO) activity in the colon was also determined. Immunohistochemistry for CD4 in the colon was performed. In addition, the level of heat shock protein (HSP) 70 in the colon was determined by Western blot analysis. Mice were orally treated with GGA (300 mg/kg) 2 h before and every other day after starting TNBS administration. Treatment with GGA markedly improved the survival rate, and reduced the loss of body weight and loss of wet colon weight in mice with TNBS-induced colitis. GGA also suppressed the increase in MPO activity and the number of CD4-positive cells infiltrating the colons of mice with TNBS-induced colitis. Furthermore, treatment with GGA remarkably up-regulated the expression of HSP70 in the colons of mice with TNBS-induced colitis. Our results provide further evidence that GGA has therapeutic potential for intestinal inflammation.

Animals↗
PubMed2006

[A case of idiopathic colitis developed after barium enema].

It has been reported that colitis may be associated with intrarectally administered drugs or chemicals. Colonotoxicity may results from conventional medical therapy, herbal or other illicit drugs, contrast materials, and detergents. Clues that a colitis may be due to an intrarectally administered agent include perianal excoriation, segmental distal colitis due to a concentration gradient from enema administration, and recent diagnostic or therapeutic administration of high risk solutions such as hypertonic contrast agents or detergent enemas. Barium is a highly viscous contrast agent that is insoluble in water. Barium enemas are usually very safe. Also, no case report of barium-induced chemical colitis has been reported yet. We report a case of chemical colitis with colonic stricture occurring after the barium enema for diagnostic purpose.

Barium Sulfate↗
PubMed2007

Depletion of endothelial progenitor cells in the peripheral blood of patients with ulcerative colitis.

There is strong evidence to suggest that endothelial progenitor cells (EPCs) play a significant role in re-endothelialization and subsequent tissue repair. This study examined the role of EPCs in inflammatory bowel disease, a disease in which impairment of mucosal healing has been implicated. Peripheral blood mononuclear cells obtained from 50 patients with ulcerative colitis (UC), 29 patients with Crohn's disease (CD), 14 patients with infectious colitis, and 35 normal control subjects were cultured in EPC medium, harvested after 7 days, and characterized by immunocytochemistry and flow cytometry. Colony assay for hematopoietic progenitor cells was also performed. Patients with active UC had a significantly decreased number of circulating EPCs as compared with healthy controls (p=0.0013), patients with inactive UC (p=0.0099), patients with active CD (p=0.0235) and patients with infectious colitis (p=0.0002). On the other hand, patients with infectious colitis had a significantly increased number of circulating EPCs as compared with healthy controls (p=0.0406), patients with active UC (p=0.0002), and patients with active CD (p=0.0316). In patients with UC, the number of circulating EPCs was correlated with the serum hemoglobin levels (r=0.485, p=0.007) and inversely with the platelet count (r=-0.372, p=0.0382). The number of hematopoietic progenitor cell colonies was comparable among patients with UC, patients with CD, patients with infectious colitis, and healthy controls. Our observations indicate that the number of circulating EPCs in patients with UC is significantly reduced. Further studies are needed to define the mechanisms that underlie the reduction in the number of circulating EPCs and to better understand the pathophysiological consequences of this event in patients with UC.

Adult↗
PubMed1991

Cytomegalovirus colitis in AIDS: presentation in 44 patients and a review of the literature.

As part of a double-blind, placebo-controlled study of ganciclovir in cytomegalovirus (CMV) colitis, the clinical characteristics of 44 patients enrolled at one center were analyzed in detail. All were homosexual men who had CMV on colonic biopsy. CMV colitis was the index diagnosis for acquired immune deficiency syndrome (AIDS) in 11 (25%) of the 44 patients. All had diarrhea, but it was intermittent in 13 patients (30%). Bleeding was uncommon, but 35 patients (80%) were febrile (median temperature of 38.9 degrees C). Weight loss was reported by 39 patients (89%), among whom the median loss was 6.8 kg. Endoscopy revealed normal colonic mucosa but CMV on biopsy in 11 patients (25%). Colonoscopic biopsies positive for CMV were found only in the cecum in 7 (39%) of 18 patients. Most patients (54%) had received zidovudine before the diagnosis of CMV colitis. The median time to the development of CMV colitis after the diagnosis of AIDS was 16 months in those patients who had received zidovudine and 3 months in those who had not (p less than 0.02). We conclude that CMV colitis can present early in AIDS and often with such nonspecific signs as fever, intermittent diarrhea, weight loss, and hematochezia. Importantly, it can appear normal on colonoscopy and occurs frequently only in the right colon, necessitating full colonoscopy and multiple biopsies for accurate diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Dysplasia in ulcerative colitis detected by surveillance colonoscopy].

A total of 222 surveillance colonoscopies were performed in 84 patients with ulcerative colitis between 1979-1989. In 60 patients with total colitis, 3 carcinomas, 2 high-grade, 4 low-grade and 8 indefinite for dysplasia were found. In 24 with left-sided colitis, 1 low-grade and 1 indefinite for dysplasia were found. The overall incidence of dysplasia in patients with total colitis was 28%, similar to the reported incidence from the Western countries. A sequence of dysplasia development was recorded in 14 cases. Progression of dysplasia was found in some of the low-grade or indefinite cases, however regression was also recorded in another cases. These results suggest the usefulness of surveillance colonoscopy for early detection of carcinoma in long-standing ulcerative colitis.

Adult↗
PubMed1991

Neutrophil cytoplasmic antibodies: a link between primary sclerosing cholangitis and ulcerative colitis.

Whether serum autoantibodies to neutrophil cytoplasmic components, previously found in ulcerative colitis, are also associated with primary sclerosing cholangitis was determined. In an enzyme-linked immunosorbent assay for immunoglobulin G neutrophil antibodies, neutrophil binding by primary sclerosing cholangitis sera was significantly greater than that for primary biliary cirrhosis, chronic hepatitis B, and chronic non-A, non-B hepatitis. Similar differences were seen when sera from patients with primary sclerosing cholangitis without evidence for ulcerative colitis were compared with sera from liver disease controls. Perinuclear immunofluorescence staining of neutrophils was exhibited by the majority of ulcerative colitis, primary sclerosing cholangitis, and primary sclerosing cholangitis without ulcerative colitis sera. The combination of elevated immunoglobulin G neutrophil antibodies and a perinuclear pattern was 65% sensitive and 100% specific for primary sclerosing cholangitis compared with the liver disease control sera. It is concluded that neutrophil cytoplasmic antibodies in ulcerative colitis and primary sclerosing cholangitis may be markers of shared underlying immunopathogenic mechanisms. Identification of the target antigen(s) may facilitate understanding of the underlying immune response and development of an improved disease marker assay.

Autoantibodies↗
PubMed1990

Crohn's disease and ulcerative colitis: morbidity and mortality.

This study analyzes hospital discharges and deaths from 1971 to 1986 for patients with inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis. The data are based on hospital morbidity and mortality statistics provided to Statistics Canada by the provinces. For Crohn's disease, age-standardized rates per 100,000 population for hospital discharges increased by 148% for males and by 192% for females over the study period. In 1986, the rate for females was 48% higher than the rate for males. For both males and females, age-specific discharge rates were highest in the 20-24 age group. For ulcerative colitis, male age-standardized discharge rates decreased by 17% from 1971 to 1977, and then increased by 41% from 1977 to 1986. For females, the rates decreased by 18% from 1971 to 1976, then remained fairly stable from 1976 to 1986. Male and female discharge rates were similar over the study period. For females, rates were highest in the 20-34 age groups; for males, they were highest in the 65 and older age groups. In 1971, rates for both types of IBD were almost the same, but by the end of the study period the rate per 100,000 population for Crohn's disease was 34 for females and 23 for males, while for ulcerative colitis the rates were 13 for females and 14 for males. During the 16-year study period, cause of death data showed 556 deaths directly attributed to Crohn's disease and 761 deaths attributed to ulcerative colitis. The under 45 age group accounted for 25% of deaths due to Crohn's disease and for 17% of deaths due to ulcerative colitis. The time trends for IBD hospital discharge rates in Canada closely parallel the findings of hospital discharge rates in the United States and England-Wales. A comparison with epidemiological population surveys strongly suggests that increased discharge rates are due mostly to increases in incidence and prevalence of IBD in the general population.

Adolescent↗
PubMed1975

Growth retardation in children with ulcerative colitis: the effect of medical and surgical therapy.

The growth of 37 children with ulcerative colitis have been analyzed. While conventional growth charts showed only percentile changes in height, height data plotted on Tanner et al.'s growth charts showed increases and decreases in growth velocity. Growth retardation is a prominent complication of ulcerative colitis with onset on bowel symptoms. Both ulcerative colitis and "high-dose" steroid therapy (greater than 12 mg/sq m/day of cortisol) can hinder growth but in some instances there is a growth spurt after high-dose steroid therapy. "Low-dose" steroid therapy does not retard growth. Colectomy is more effective than high-dose steroid therapy in reversing the growth retardation caused by ulcerative colitis and is of greatest value if not delayed too long. Growth following subtotal colectomy with ileorectal anastomosis (Aylett procedure) is not likely to be as much as that after subtotal colectomy with ileostomy. Growth retardation is infrequently the only indication for surgical intervention but ileostomy and colectomy are appropriate for this complication of ulcertive colitis in itself when not improved by adequate medical treatment.

Adolescent↗
PubMed1990

Obstructive colitis. Ulceroinflammatory lesions occurring proximal to colonic obstruction.

The term "obstructive colitis" refers to ulceroinflammatory lesions occurring in the colon proximal to an obstructing or potentially obstructing lesion. We studied nine cases identified over a 9-month period. The patients were predominantly female (only one was male), elderly (mean age, 73), and usually had hypertension, diabetes, or other prior chronic illness. The colonic obstruction was due to adenocarcinoma in seven cases and to diverticular disease in two cases. Areas of colitis occurred either as circumscribed ulcers 0.5-2 cm in diameter (three cases) or as confluent circumferential lesions 8-25 cm in length; they were always separated from the more distal obstructing lesions by a segment of normal colon measuring 2.5-35 cm (mean, 14.6 cm). The involved area of colon was usually only mildly dilated; it exhibited moderate thickening of the wall and had a granular luminal surface accentuated in areas by deeper longitudinal or transverse ulcers. Often there were scattered pseudopolyps, and the margin separating the lesion from normal mucosa was well demarcated and irregular. In one case, two distinct separate areas of colitis were present; in another, the appendix was acutely inflamed. Microscopically, the lesions were composed of granulation tissue with a mixed acute and chronic inflammatory infiltrate that replaced the mucosa and often the submucosa; sometimes it extended into the muscularis propria, with associated peritonitis and perforation. Many of the features of obstructive colitis suggest an ischemic origin, probably mainly due to hypoperfusion following raised intramural pressure, but altered fecal flora may have a synergistic effect. The features of the disease are usually sufficiently characteristic to distinguish it from Crohn's disease and other forms of colitis. Complications include peritonitis, perforation and breakdown of anastomoses made through involved segments of colon that may appear externally normal at surgery.

Aged↗
PubMedDate not supplied

Ulcerative colitis in Israel: epidemiology, morbidity, and genetics.

We have reviewed the epidemiology of ulcerative colitis in Israel. Ulcerative colitis is twice as common as Crohn's disease, and has increased in frequency in both sexes and in all ethnic sections of the Jewish population since 1960. The disease is more prevalent in European- and American-born Jews than in Asian- and African-born Jews and Israeli-born Jews, but this difference appears to be decreasing in magnitude. With the exception of European- and American-born Jews, ulcerative colitis is less prevalent in Israel than in Jews living elsewhere. Major regional differences in disease severity by sex, and in the extent of colonic involvement, were detected. Colorectal cancer occurs less frequently in colitis patients in Israel than elsewhere. The peak age at onset is 15-30 years, with Israeli-born colitis patients having a significantly earlier mean age at onset. Genetic and environmental causative factors are incompletely understood. The disease has become more prevalent in the Arab population.

Colitis, Ulcerative↗
PubMed1989

Medium-term follow-up of ulcerative colitis in Cape Town.

The 114 patients with ulcerative colitis diagnosed in Greater Cape Town between 1970 and 1979 were followed up 11 years later. Ninety per cent of those contacted were in remission or had mild symptoms only. Eleven patients had died; 3 deaths (in total colitis patients) were disease-related but the overall mortality rate in ulcerative colitis was not increased. There was only 1 case of carcinoma of the colon. The 5-year surgical rate was 5% increasing to 23% 10 years after diagnosis. Six patients (35%) had had a Park's pouch, 3 (18%) ileorectal anastomosis, and 8 (47%) panproctocolectomy or colectomy with an ileostomy. The incidence of surgery was higher in those with total colitis. In those patients who did not have the rectum removed, there was a 100% recurrence of proctitis. Park's pouch patients remained well and incontinence was not a problem. Thirty-one per cent of patients with proctitis at diagnosis had evidence of extension of disease to the colon at follow-up. Ulcerative colitis may be a more benign disease than often believed, with mortality from the disease and need for surgery being associated almost exclusively with extensive disease.

Adolescent↗
PubMed1989

Coffee and alcohol use and the risk of ulcerative colitis.

We performed a population-based, case-control study of the risk of ulcerative colitis associated with coffee and alcohol use among the 304,000 members of a prepaid health plan. We compared coffee and alcohol use histories before ulcerative colitis onset in 209 cases and an equal number of age- and sex-matched controls selected from the enrollment file of the prepaid health plan. Neither coffee use, amount of coffee consumed daily, or cumulative coffee consumption before disease onset altered the risk of developing ulcerative colitis. A decreased risk of ulcerative colitis was associated with alcohol consumption before disease onset among never-smokers only. This risk declined as daily alcohol consumption increased. These results suggest that alcohol consumption may lower ulcerative colitis incidence.

Coffee↗
PubMed1989

Ischemic colitis following abdominal aortic reconstruction for ruptured aneurysm. A 10-year experience.

Between January 1, 1978, and December 31, 1987, a total of 103 patients had operations for ruptured abdominal aortic aneurysms. The average age was 73 years (range, 53 to 91 years). Thirty-two patients died during surgery or in the immediate postoperative period. In 19 of the remaining 71 patients ischemic colitis developed, an incidence of 27 per cent. This report reviews the clinical findings and course of these patients. The average age of patients developing ischemic colitis was 72 years (range, 53 to 90 years), not significantly different from the group as a whole. There was no correlation between the type of vascular reconstruction and the development of ischemic colitis. Eleven patients died and eight survived, for a mortality rate of 58 per cent. The most common clinical finding was diarrhea early in the postoperative period, which was noted in 20 patients. Thirteen of these patients had ischemic colitis confirmed by flexible sigmoidoscopy. Eight (62%) of these 13 patients survived; three were managed nonoperatively and five had colectomy. Six patients presented between postoperative days 9 and 20 with signs of increasing sepsis but with no diarrhea or other significant clinical findings; ischemic colitis was confirmed by sigmoidoscopy in all six patients. All of these patients died of septic complications. Seven patients with early postoperative diarrhea had normal sigmoidoscopic findings. None developed septic complications and five survived; two died of cardiac events.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

[Anatomopathological criteria of progression in chronic idiopathic colitis].

Idiopathic inflammatory colitis are diseases of remissions and exacerbations of various severity. The criteria of activity are based on a conjunction of clinical, radiologic, endoscopic and anatomopathological data. From the macroscopical point of view, they are different in ulcerative colitis and Crohn's disease. Ulcerative colitis is characterized by a diffuse and uniform mucosal inflammation; any biopsy outside an ulcerative area can be used to evaluate the inflammatory components which are in the acute phase (chronic active phase): oedema, vascular congestion and an inflammatory infiltrate composed of a mixture of lymphocytes, plasma cells and polymorphs with partial destruction of the glands (crypt abscesses). In the revolving phase, the inflammation regresses; the crypts are distorted, the crypt abscesses gradually disappear. In ulcerative colitis in remission, the inflammation vanishes but there is loss of parallelism and branching of the crypts. In Crohn's disease, the inflammation is often discontinuous and focal; biopsies must be taken from multiple sites. It is not rare to see a coincidence of lesions at different stages of activity. The criteria of activity are less reliable than in ulcerative colitis. Acute lesions present with oedema and infiltration of the lamina propria by polymorphs, neutrophils as well as eosinophils. Granulomas probably represent a particular reactional status. There features and number do not very significatively in the course of the disease.

Colitis, Ulcerative↗
PubMed1989

Colonic metaplasia of ileostomies. Biological significance for ulcerative colitis patients following total colectomy.

Two patients who had undergone proctocolectomy for ulcerative colitis developed lesions in their ileal stoma that appeared to be inflammatory polyps morphologically similar to those encountered in the large intestine of ulcerative colitis patients. One of these patients eventually developed mucinous adenocarcinoma in the ileal stoma. The ileal mucosa adjacent to the neoplasm had morphologic features of large-bowel mucosa and was richly populated by sulfomucin-containing goblet cells, which are characteristic of large-bowel mucosa. Sulfomucin-containing goblet cells were also found in the inflammatory lesions biopsied from the ileal stomas of both patients, as well as from the adenocarcinoma found in one patient. These findings support the hypothesis that colonic metaplasia can occur in ileal stomas of ulcerative colitis patients. Furthermore, the metaplastic colonic tissue is the site of origin of lesions typically found in ulcerative colitis. Colonic metaplasia occurring in ileal stoma should be recognized by pathologists as a clinical entity. When colonic metaplasia is identified in the ileal stoma of an ulcerative colitis patient, biopsy surveillance of stomal mucosa is recommended.

Adenocarcinoma↗
PubMed1989

Rectosigmoid motility in patients with quiescent and active ulcerative colitis.

We studied the pathophysiology of diarrhea in ulcerative colitis by evaluating and comparing rectosigmoid motility before, during, and after a 900-cal meal in healthy subjects, patients with quiescent ulcerative colitis, and patients with active ulcerative colitis. Three intraluminal pressure transducers were used for recording of rectosigmoid motility. Motility during fasting, eating, and after eating a meal was similar in patients with quiescent disease and controls. Motility increased significantly during eating in controls, but not in patients with quiescent disease. In patients with active colitis, motility was significantly reduced during fasting, eating, and after eating, compared with controls. Motility increased significantly during eating in patients with active disease. Propagated activity was similar in the three study groups; therefore, the decreased motility was due to decrease in segmental contractions. These findings suggest that diarrhea in patients with active colitis may be related to the loss of normal segmental contractions which delay distal stool transport.

Adult↗