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At least 19 recordsLinked to original sources
PubMed1979

Colitis in the elderly: ischemic colitis mimicking ulcerative and granulomatous colitis.

Eight patients over age 60 years had sudden onset of acute abdominal pain and rectal bleeding in the absence of prior inflammatory bowel disease. Several improved on medical therapy alone; those who required surgery suffered no recurrence up to 6 years. Although the pathologic specimens on these patients were first considered to represent ulcerative colitis or Crohn's disease, their histories and clinical courses are much more consistent with ischemic colitis. Since there are only a limited number of reactions that the bowel can muster against a host of damaging processes, histologic criteria alone are usually not sufficient to separate ischemic disease of the colon from ulcerative colitis and Crohn's disease. This is also true of radiographic features. Thus the diagnosis of ischemic colitis rests on clinical onset and course after treatment.

Aged↗
PubMed1977

Immunological studies in ulcerative colitis. VIII. Antibodies to colon antigen in patients with ulcerative colitis, Crohn's disease, and other diseases.

Sera from patients with ulcerative colitis or Crohn's disease had elevated titers to colon antigen from germ-free rats significantly more often than sera from patients with gastroenteritis, irritable colon, non-gastrointestinal diseases, and healthy controls. Elevated anticolon titers in significant frequency were also found in patients with liver cirrhosis, urinary tract infections, and in polyposis coli and their relatives. Females with ulcerative colitis had, on an average, higher titers than men especially in the age group 30 years and over. In Crohn's disease the antibody titers often increased with time--as opposed to those in ulcerative colitis and non-gastrointestinal diseases. In conjunction with results published earlier, the present work supports the assumption that the antibodies in ulcerative colitis patients react with antigenic determinants distinct from those recognized by the colon antibodies present in other groups, including patients with Crohn's disease and polyposis.

Adolescent↗
PubMed1975

Intercurrent cytomegalovirus colitis in a patient with ulcerative colitis.

Acute intercurrent CMV colitis developed in a patient with UC who was receiving prednisone. CMV infection was suggested by light and electron microscopic study of a rectal biopsy taken during the acute episode and was confirmed by serology done nine months later. The microscopic studies of plastic-embedded tissues demonstrated that infected cells were concentrated in a subendothelial location and were presumably macrophages. Epithelial and endothelial cells were not involved. Steroid therapy and the inflammation and repair process (granulartion tissue) of active UC may have predisposed the present patient to CMV colitis. CMV infection has been reported to be more common in patients with UC than in the general population. Detection of CMV colitis in patients with UC could be of special importance since alteration of immunosuppressive therapy may be indicated.

Acute Disease↗
PubMed2019

Dietary iron variably modulates assembly of the intestinal microbiota in colitis-resistant and colitis-susceptible mice.

Iron deficiency, a common comorbidity of gastrointestinal inflammatory disorders such as inflammatory bowel diseases (IBD), is often treated with oral iron supplementation. However, the safety of oral iron supplementation remains controversial because of its association with exacerbated disease activity in a subset of IBD patients. Because iron modulates bacterial growth and function, one possible mechanism by which iron may exacerbate inflammation in susceptible hosts is by modulating the intestinal microbiota. We, therefore, investigated the impact of dietary iron on the intestinal microbiota, utilizing the conventionalization of germ-free mice as a model of a microbial community in compositional flux to recapitulate the instability of the IBD-associated intestinal microbiota. Our findings demonstrate that altering intestinal iron availability during community assembly modulated the microbiota in non-inflamed wild type (WT) and colitis-susceptible interleukin-10-deficient (Il10-/-) mice. Depletion of luminal iron availability promoted luminal compositional changes associated with dysbiotic states irrespective of host genotype, including an expansion of Enterobacteriaceae such as Escherichia coli. Mechanistic in vitro growth competitions confirmed that high-affinity iron acquisition systems in E. coli enhance its abundance over other bacteria in iron-restricted conditions, thereby enabling pathobiont iron scavenging during dietary iron restriction. In contrast, distinct luminal community assembly was observed with dietary iron supplementation in WT versus Il10-/- mice, suggesting that the effects of increased iron on the microbiota differ with host inflammation status. Taken together, shifts in dietary iron intake during community assembly modulate the ecological structure of the intestinal microbiota and is dependent on host genotype and inflammation status.

Animals↗
PubMed1977

HLA antigens and ulcerative colitis in Japan.

The HLA antigens in 44 cases of ulcerative colitis and 271 control individuals in Japan were studied. The NIH tissue typing method was used according to the new leukocyte nomenclature adapted by the WHO Committee. In normal Japanese populations, the HLA antigens, which were of high frequency, were HLA A2(37.3%), A9(60.9%) and B5 (40.6%). On the contrary, the significantly high frequency of HLA B5 was demonstrated in ulcerative colitis, compared with that in control. Moreover, HLA B5 in cases with ulcerative colitis excluding those with proctitis only, was found with higher frequency than that in total cases. Although the most frequent haplotype was HLA A9-B5 in control, so frequent haplotype was not found in ulcerative colitis. A family study revealed no significant diathesis on the hapolytpe of HLA in ulcerative colitis. The relationship between MLC locus and ulcerative colitis was not yet clarified from the study of one family whose two members suffered from ulcerative colitis.

Adult↗
PubMed1976

Evidence of an agent transmissible from ulcerative colitis tissue.

Five New Zealand White rabbits were injected intracolonically with homogenates (100 mum) of ulcerative-colitis tissue. Histological changes closely similar to those seen in the human donors were present in the mucosa and submucosa of the large intestine of four of these rabbits 3-12 months later. Similar changes were seen in the large intestine of three of four rabbits 6-13 months after intravenous or intracolonic inoculation of homogenates of rabbit mesenteric lymph-nodes after passage of human ulcerative colitis tissue (100 mum or 0.2 mum). Three of thirty A2G strain mice injected with similar tissue homogenates (100 mum or 0.2 mum) from patients with ulcerative colitis into the footpad or intraperitoneally, had granulomatous changes in footpad, bowel, liver and/or spleen 3-22 months later. Such changes did not develop in rabbits or mice inoculated with tissue from normal controls. The results of these experiments suggest that a transmissible factor is involved in the aetiology of ulcerative colitis.

Animals↗
PubMed1975

Crohn's disease of the colon. III. Toxic dilatation of the colon in Crohn's colitis.

In a group of 160 patients with Crohn's disease involving the colon, there were seven patients with toxic dilatation, four with granulomatous colitis and three with ileocolitis, all successfully treated without mortality. This complications is more common than previously recognized in Crohn's colitis. In Crohn's disease, toxic dilatation is less likely to proceed to perforation of the bowel, because of the nature of the pathology and is more likely to respond to conservative measures: intubation, with decompression, corticotropin, steroids and high-dose antibiotic administration. Although patients do recover from this life-threatening complication with conservative management, the majority of patients, if not all, will ultimately come to surgical excision of the colon. If surgery is mandatory, it should be carried out early, rather than late, in the patient who is failing to respond to medical therapy, certainly before the development of perforation, massive hemorrhage, or gram negative sepsis with shock. The surgical therapy will depend upon the state of the bowel at laparotomy. Thus, an intact bowel in a young patient, would favor subtotal colectomy or proctocolectomy; a sealed perforation, a diverting ileostomy with skin level colostomy decompression as suggested by Turnbull and a free perforation, the minimum adequate procedure which will tide the patient over the early postoperative period. Diverting ileostomy alone has been effective in two of our patients but should be avoided in ulcerative colitis. The critically ill patient with the ominous finding of "disintegrating colitis" and multiple leaks, will require nothing less than total radical excision of the diseased bowel in the hope of immediate salvage.

Adrenocorticotropic Hormone↗
PubMed1978

Role of prostaglandins in ulcerative colitis. Enhanced production during active disease and inhibition by sulfasalazine.

Prostaglandin E2 (PGE2) level in rectal mucosa excised from 17 patients suffering from ulcerative colitis was 2-fold higher than that found in rectal mucosa of 17 normal subjects: 2.0 +/- 0.4 and 0.9 +/- 0.2 ng per mg of wet tissue, respectively. Accumulation of PGE 2 in 24-hr cultures of rectal mucosa specimens obtained from patients with ulcerative colitis was 112% higher than that observed in cultures from control subjects. Addition of sulfasalazine, sulfapyridine, and 5-aminosalicylic, acid to the culture medium of ulcerative colitis mucosa resulted in inhibition of PGE2 production by 34, 32, and 62%, respectively, compared to rectal specimens cultured in drug-free medium. These results suggest that PGE may mediate the inflammatory response in ulcerative colitis and that some of the therapeutic effect of sulfasalazine and its constituents are related to the inhibition of PGE synthesis.

Aminosalicylic Acids↗
PubMed2026

Defined human Clostridia consortia reverse colitis via dual effects of tryptophan metabolites on microbiota and immunity.

Microbial dysbiosis and disrupted mucosal immune homeostasis are integrally involved in the pathogenesis of inflammatory bowel diseases (IBDs). Live biotherapeutic products (LBPs) offer a potential therapeutic strategy to restore beneficial microbes and mitigate disease. We investigated the therapeutic efficacy of 2 LBPs, human Clostridia consortia 17-mix and 11-mix, by treating established colitis in murine models. Both LBPs exhibited therapeutic effects in T cell-mediated chronic colitis models induced by human microbiota and in pathobiont-driven gnotobiotic colitis models established with combinations of IBD-relevant human-derived strains. Metagenomic and metabolomic analyses elucidated mechanisms that go beyond established functions driven by short-chain fatty acids (SCFAs) and interleukin (IL)-10-producing regulatory T cells. Notably, LBPs exerted therapeutic effects by directly inhibiting resident pathobionts and through IL-10-independent activation of host anti-inflammatory aryl hydrocarbon receptor (AhR) pathways by bacterial tryptophan metabolites. These results elucidate SCFA- and IL-10-independent protective mechanisms exerted by defined resident bacterial strains that are depleted in IBD dysbiosis.

Animals↗
PubMed1978

Colitis.

The disability caused by proctitis or colitis has been assessed among patients attending a hospital outpatient clinic. Although bowel frequency was a common and troublesome symptom, urgency of defaecation with a tendency to precipitate incontinence was a major factor limiting working life and leisure and social activities. Abdominal or rectal pain and lassitude were the other main symptoms. In every aspect of life studied the disability was as great for patients with proctitis or distal colitis as for those with more extensive inflammation of the colon. As a result of symptoms about a fifth of the patients had a reduced earning capacity and quarter were restricted in their social or leisure activities even when symptoms were at their least bad. The social disability of proctitis or colitis may be underestimated because patients do not mention their fear of incontinence and because their complaint of lassitude does not always correlate with the apparent activity or extent of the disease.

Adult↗
PubMed1979

How district hospitals see acute colitis.

Acute colitis was an uncommon cause of admission to twenty-two district hospitals in 1975--77. The overall mortality in this series of 130 patients was 5.2%, 1.8% during medical treatment and 20% after urgent surgical treatment. A third of the patients were admitted without previous diagnosis. Four-fifths responded to medical treatment and the rest were treated by urgent colectomy. Four of the six related deaths and half the urgent operations occurred among 18 patients iwth colonic dilatation. This complication was often detected within two days of admission by abdominal X-ray; symptoms and signs were unhelpful in its recognition. Early admission to hospital of patients with severe unexplained diarrhoea or a sharp attack of colitis, rapid investigation to exclude infection, and energetic treatment of colitis, monitored by abdominal X-rays to detect colonic dilatation at its earliest stage, might reduce the frequency and danger of this complication.

Acute Disease↗
PubMed1979

A histochemical comparison of the O-acylated sialic acids of the epithelial mucins in ulcerative colitis, Crohn's disease, and normal controls.

Two histochemical techniques, the PAT/KOH/PAS and the PBT/KOH/PAS, were used to investigate the side chain O-acyl substitution patterns of the sialic acids of the colonic epithelial mucins in cases of ulcerative colitis and Crohn's disease. In both diseases there was, as compared to normal, a reduction in the proportion of sialic acids O-acylated at C7C8, the reduction being greater in ulcerative colitis. Further, there appeared to be an association between the severity of the disease and the reduction in the staining of O-acylated sialic acids. This relationship was more marked in ulcerative colitis. In some cases of both diseases there was evidence for epithelial mucins containing predominantly C7-substituted sialic acids. This study has confirmed our previous conclusion that, in Crohn's disease of the terminal ileum, the disease is associated with an increase in the proportion of sialic acids bearing side chain substituents.

Colitis, Ulcerative↗
PubMed1979

The therapeutic effect of methyl-salazosulphapyridine versus salazosulphapyridine in active ulcerative colitis. A double-blind controlled trial.

In an attempt to improve the ratio between therapeutic effect and side effects of salazosulphapyridine (SASP), methyl-salazosulphapyridine (methyl-SASP) was compared with SASP in a randomized controlled double-blind trial, without cross-over, in patients with active ulcerative colitis. The patient group comprised 53 patients. The daily doses were 1 g SASP x 3 and 125 mg methyl-SASP x 3. The methyl-SASP group comprised 26 patients, the SASP group 27 patients. The treatment period was 4 weeks. Applying clinical symptoms (bowel movements, registered by the patients on special charts), clinical condition (assessed by the patient), proctoscopic signs, and registration of side effects, it is concluded that methyl-SASP had an effect on ulcerative colitis indistinguishable from that of SASP. The rate of side effects was significantly less in the methyl-SASP group. The blood concentrations of SASP, methyl-SASP, sulphapyridine, and methyl-sulphapyridine were estimated at start during, and at the end of the trial. The methyl-SASP concentration was on an average twice as high as that of SASP, and the methyl-sulphapyridine on an average 1/13 of sulphapyridine, the differences being significant. It is concluded that methyl-SASP presents an improvement in the effect/side effect ratio when dealing with symptomatic ulcerative colitis. The discrepancy between the outcome of the present trial and the lack of effect in a controlled trial on the relapse-preventing effect of methyl-SASP is at present unexplained. A type II error in the present trial (or a type I error in the prophylactic one) is a possibility, or the patient-group selected for the present trial had a spontaneously benign course, cases demanding prednisone or colectomy having been excluded.

Adult↗
PubMedDate not supplied

Pseudomembranous colitis: Presence of clostridial toxin.

A toxin was found in the faeces of nine out of nine patients with pseudomembranous colitis and two out of two with antibiotic-associated non-specific colitis. The toxin was neutralised by Clostridium sordellii antitoxin but not by a commercial mixture of C. welchii, oedematiens, and septicum antitoxins. The in-vitro and in-vivo properties of pseudomembranous-colitis toxin closely resemble those of the toxin of C. sordellii.

Adolescent↗
PubMed1978

Antibiotic-associated colitis: a retrospective study of fifteen cases.

Fifteen cases of antibiotic-associated colitis were reviewed in a retrospective study of all the cases seen in a general hospital in the period 1970--7. Nine of these cases were diagnosed as pseudomembranous colitis. This was found mostly in patients over 65 years of age, where it resulted in severe illness with 70% mortality. The antibiotics involved included ampicillin, penicillin, clindamycin, erythromycin and co-trimoxazole (Septrin). Pseudomembranous colitis is a serious hazard in the elderly and may be caused by a wide range of antibiotics in common use.

Adult↗
PubMed2025

Day 3 Oxford criteria predict steroid non-response for acute severe ulcerative colitis in the post biologic era.

BACKGROUND AND AIMS: Outcomes of patients admitted with acute severe ulcerative colitis (ASUC) in the post biologic era are under explored, as well as the ability of scoring indices to predict early steroid non-response. METHODS: This retrospective cohort study included adults hospitalized with ASUC (2010-2022) at London Health Sciences Centre, Canada. Steroid response, need for rescue therapy, colectomy during index hospitalization, and colectomy and hospitalization at 3- and 12-months following discharge was assessed. Logistic regression identified predictors of steroid non-response, defined as need for rescue therapy or colectomy during hospitalization. RESULTS: Of 261 adults hospitalized with ASUC (male: 51.7%, mean age: 40.6 years), 71.2% had extensive colitis. After intravenous corticosteroid therapy during index admission, 55.7% (n = 147) had a response, 37.9% (n = 99) received rescue therapy (infliximab: 98, tofacitinib: 1, and cyclosporine: 0), and 8% (21/261) underwent colectomy. Additionally, 11.6% (28/240) of patients discharged from hospital underwent colectomy within the first 12 months (8.3% at 3-months and 3.3% between 3 and 12 months). There was no difference between steroid responders and non-responders for colectomy (11% vs 12.6%) or hospitalization (33.5% vs 32.6%) at 12 months. The overall cumulative probabilities of colectomy for the entire cohort at 1 year, 3 years, and 5 years were 13.5%, 16.1%, and 17.4%, respectively. On multivariate analysis, Day 3 Oxford criteria was the only factor found to be statistically significant in predicting steroid non-response (odds ratio 4.70, 95%CI [1.06-20.80]). CONCLUSIONS: Day 3 Oxford criteria was an independent predictor of steroid non-response. The risk of colectomy remains substantial after discharge despite low in-hospital colectomy rates following an episode of ASUC. Initial steroid response did not affect long-term colectomy rate at 12 months.

Humans↗