Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Preventions
A. The do and do not's list
1. Although infect millioms people every day, Infectious colitis as a
result of bacterial and viral infection are difficault to inthird world
due poor sanitation, poor hand washing and poor kitchen hygiene.
Wash your hands before handle food.
2. Enhance your inmmune system
Excercise, proper diet, eating foods contain high amounts of antioxidant can be helpful.
3. Quit smoking
Although the incidence and severity of ulcerative colitis (UC) are higher in nonsmokers than in smokers(44), it
is a remarkable risk factor for inflammatory bowel disease (IBD),
aggravating Crohn's disease (CD)(45). Smoking can suppress the inmune
system and enhance the production of free radicals of that can lead to
infectous causes of colitis.
4. Although inflammatory bowel disease (IBD), in most case as a
result of heredity. According to the study by Vanderbilt University
Medical Center, intake of semi-essential amino acid, L-arginine (L-Arg),
a complementary medicine purported to be an enhancer of immunity may improves responses to injury and inflammation in dextran sulfate sodium colitis(46).
5. Protect youself from chronic diseases such as high blood
pressure, high cholesterol levels, and diabetes(47)(48) as tthey
increase the risk of reducing blood circulation, cauisng ischemic
colitis by eating plenty fruits and vegetibles and reducing intake of
fat and transfat.
6. Take your herbs with care
there is a severe, progressive case of acute ischaemic colitis
related temporally to the recent ingestion of a sibutramine-containing
herbal slimming agent procured on-line without prescription or medical
indication in a young female that ultimately required emergency
laparoscopic total colectomy with end ileostomy to prevent end organ
failure(49).
7. Protect your arteries
Narrowing of the blood vessels to the bowel can increase the risk of
venous thrombosis and colitis. There is a report of case of a
22-year-old woman is reported who presented with an exacerbation of
ulcerative colitis and developed
extensive arterial and venous thrombosis. Good clinical improvement was
achieved after treatment with steroids, sulfasalazine, and
anticoagulation with enoxaparin followed by long-term warfarin(50).
8. Others
According to the study by Ninewells Hospital and Medical School, high
FSS foods were characterized by high levels of the anti-thiamin additive
sulfite (Mann-Whitney, p < 0.001), i.e. bitter, white wine, burgers,
soft drinks from concentrates, sausages, lager and red wine. Caffeine also has anti-thiamin properties and decaffeinated coffee was associated with a better clinical state than the caffeine
containing version. Beneficial foods (average intake per week) included
pork (210 g), breakfast cereals (200 g), lettuce (110 g), apples and
pears (390 g), milk (1250 ml), melon (350 g), bananas (350 g), bacon
(120 g), beef and beef products (500 g), tomatoes (240 g), soup (700 g),
citrus fruits (300 g), fish (290 g), yogurt (410 g), cheese (110 g),
potatoes (710 g) and legumes (120 g)(51).
8. Etc.
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Sources
(46) http://www.ncbi.nlm.nih.gov/pubmed/22428068
(47) http://www.ncbi.nlm.nih.gov/pubmed/10494609
(48) http://www.ncbi.nlm.nih.gov/pubmed/23290973
(49) http://www.ncbi.nlm.nih.gov/pubmed/23240285
(50) http://www.ncbi.nlm.nih.gov/pubmed/16369389
(51) http://www.ncbi.nlm.nih.gov/pubmed/15705205
Tuesday, 3 December 2013
Colitis - The Diet
Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Diet to prevent colitis
1. Glutamine, dietary fiber, and Oligosaccharide (GFO)
According to the study to whether GFO has suppressive effects on mucosal damage in ulcerative colitis in an experimental mouse model, showed that intestinal inflammation was significantly attenuated in mice treated with GFO. Furthermore, treatment with GFO significantly inhibited the dextran sulfate sodium-induced increase in the mRNA expression of interleukin-1β. As GFO may have a potential therapeutic value as an adjunct therapy for ulcerative colitis(52).
2. Low-fat diets, medium-chain triglycerides, and perhaps omega-3 fatty acids and Fermentable fiber
According to the study by , in regarding the possible therapeutic role of some dietary components in IBD, low-fat diets seem to be particularly useful. Also, some lipid sources, such as olive oil, medium-chain triglycerides, and perhaps omega-3 fatty acids, might have a therapeutic effect. Fermentable fiber may have a role in preventing relapses in inactive UC(53).
3. Avoid Zinc deficiency
Zinc deficiency may cause a modulation of TNFα production of that can influence disease activity in DSS-induced colitis(54). Other study indicated that DSS induces colonic inflammation which is modulated by the administration of anti-TNFα. Combining anti-TNFα with Zn acetate offers marginal benefit in colitis severity(55).
4. Glutamine
In the study to investigate the role of L-glutamine and short-chain fatty acids, both via enema and oral administration, on mucosal healing in experimental colitis by Uludağ University, School of Medicine, Bursa, showed that L-glutamine enema can accelerate mucosal healing and regeneration in experimentally induced colitis in rats. When compared to glutamine in this study, short-chain fatty acids showed no beneficial effect on colitis(56).
5. Soybean and fish oil mixture
Soybean and fish oil mixture may be effective in improving colonic injury and DNA damage, and it could be an important complementary therapy in UC to reduce the use of anti-inflammatory drugs and prevent colorectal cancer, according to the study by the Universidade Federal de São Paulo(57). Other suggested that the soybean and fish oil mixture, more than the fish oil alone, could be a complementary therapy to achieve a cytokine balance in UC(58).
6. Nutritional and probiotic supplementation
Dietary supplementation with essential nutrients known to be in short supply in the diet in IBD patients and with other molecules believed to provide beneficial anti-inflammatory effects, as well as with probiotic organisms that stimulate immune functions and resistance to infection has been tested in colitis models(59).
7. Risk of colitis in Monotonous dietary intake
The relapsing nature and varying geographical prevalence of ulcerative colitis (UC) implicates environmental factors such as diet in its aetiology study showed that
monotonous dietary intake may decrease mammalian vulnerability against colitis in association with microbiota separation(60).
8. Blueberry husks, rye bran and multi-strain probiotics
Acombination of probiotics and blueberry husks or rye bran enhanced the anti-inflammatory effects compared with probiotics or dietary fibres alone. These combinations can be used as a preventive or therapeutic approach to dietary amelioration of intestinal inflammation(61).
In summerization, we would like to quote the study by Medical Department, Viborg Regional Hospital, "Established non-diet risk factors include family predisposition, smoking, appendectomy, and antibiotics. Retrospective case-control studies are encumbered with methodological problems. Prospective studies on European cohorts, mainly including middle-aged adults, suggest that a diet high in protein from meat and fish is associated with a higher risk of inflammatory bowel disease. Intake of the n-6 polyunsaturated fatty acid linoleic acid may confer risk of ulcerative colitis, whereas n-3 polyunsaturated fatty acids may be protective. No effect was found of intake of dietary fibres, sugar, macronutrients, total energy, vitamin C, D, E, Carotene, or Retinol (vitamin A) on risk of ulcerative colitis. No prospective data was found on risk related to intake of fruits, vegetables or food microparticles (titanium dioxide and aluminium silicate)"(61a).
8. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
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Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(52) http://www.ncbi.nlm.nih.gov/pubmed/23274091
(53) http://www.ncbi.nlm.nih.gov/pubmed/22876032
(54) http://www.ncbi.nlm.nih.gov/pubmed/23268956
(55) http://www.ncbi.nlm.nih.gov/pubmed/22039323
(56) http://www.ncbi.nlm.nih.gov/pubmed/17602355
(57) http://www.ncbi.nlm.nih.gov/pubmed/20615224
(58) http://www.ncbi.nlm.nih.gov/pubmed/20363597
(59) http://www.ncbi.nlm.nih.gov/pubmed/22736018
(60) http://www.ncbi.nlm.nih.gov/pubmed/23085891
(61) http://www.ncbi.nlm.nih.gov/pubmed/19670079
(61a) http://www.ncbi.nlm.nih.gov/pubmed/22055893
Diet to prevent colitis
1. Glutamine, dietary fiber, and Oligosaccharide (GFO)
According to the study to whether GFO has suppressive effects on mucosal damage in ulcerative colitis in an experimental mouse model, showed that intestinal inflammation was significantly attenuated in mice treated with GFO. Furthermore, treatment with GFO significantly inhibited the dextran sulfate sodium-induced increase in the mRNA expression of interleukin-1β. As GFO may have a potential therapeutic value as an adjunct therapy for ulcerative colitis(52).
2. Low-fat diets, medium-chain triglycerides, and perhaps omega-3 fatty acids and Fermentable fiber
According to the study by , in regarding the possible therapeutic role of some dietary components in IBD, low-fat diets seem to be particularly useful. Also, some lipid sources, such as olive oil, medium-chain triglycerides, and perhaps omega-3 fatty acids, might have a therapeutic effect. Fermentable fiber may have a role in preventing relapses in inactive UC(53).
3. Avoid Zinc deficiency
Zinc deficiency may cause a modulation of TNFα production of that can influence disease activity in DSS-induced colitis(54). Other study indicated that DSS induces colonic inflammation which is modulated by the administration of anti-TNFα. Combining anti-TNFα with Zn acetate offers marginal benefit in colitis severity(55).
4. Glutamine
In the study to investigate the role of L-glutamine and short-chain fatty acids, both via enema and oral administration, on mucosal healing in experimental colitis by Uludağ University, School of Medicine, Bursa, showed that L-glutamine enema can accelerate mucosal healing and regeneration in experimentally induced colitis in rats. When compared to glutamine in this study, short-chain fatty acids showed no beneficial effect on colitis(56).
5. Soybean and fish oil mixture
Soybean and fish oil mixture may be effective in improving colonic injury and DNA damage, and it could be an important complementary therapy in UC to reduce the use of anti-inflammatory drugs and prevent colorectal cancer, according to the study by the Universidade Federal de São Paulo(57). Other suggested that the soybean and fish oil mixture, more than the fish oil alone, could be a complementary therapy to achieve a cytokine balance in UC(58).
6. Nutritional and probiotic supplementation
Dietary supplementation with essential nutrients known to be in short supply in the diet in IBD patients and with other molecules believed to provide beneficial anti-inflammatory effects, as well as with probiotic organisms that stimulate immune functions and resistance to infection has been tested in colitis models(59).
7. Risk of colitis in Monotonous dietary intake
The relapsing nature and varying geographical prevalence of ulcerative colitis (UC) implicates environmental factors such as diet in its aetiology study showed that
monotonous dietary intake may decrease mammalian vulnerability against colitis in association with microbiota separation(60).
8. Blueberry husks, rye bran and multi-strain probiotics
Acombination of probiotics and blueberry husks or rye bran enhanced the anti-inflammatory effects compared with probiotics or dietary fibres alone. These combinations can be used as a preventive or therapeutic approach to dietary amelioration of intestinal inflammation(61).
In summerization, we would like to quote the study by Medical Department, Viborg Regional Hospital, "Established non-diet risk factors include family predisposition, smoking, appendectomy, and antibiotics. Retrospective case-control studies are encumbered with methodological problems. Prospective studies on European cohorts, mainly including middle-aged adults, suggest that a diet high in protein from meat and fish is associated with a higher risk of inflammatory bowel disease. Intake of the n-6 polyunsaturated fatty acid linoleic acid may confer risk of ulcerative colitis, whereas n-3 polyunsaturated fatty acids may be protective. No effect was found of intake of dietary fibres, sugar, macronutrients, total energy, vitamin C, D, E, Carotene, or Retinol (vitamin A) on risk of ulcerative colitis. No prospective data was found on risk related to intake of fruits, vegetables or food microparticles (titanium dioxide and aluminium silicate)"(61a).
8. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(52) http://www.ncbi.nlm.nih.gov/pubmed/23274091
(53) http://www.ncbi.nlm.nih.gov/pubmed/22876032
(54) http://www.ncbi.nlm.nih.gov/pubmed/23268956
(55) http://www.ncbi.nlm.nih.gov/pubmed/22039323
(56) http://www.ncbi.nlm.nih.gov/pubmed/17602355
(57) http://www.ncbi.nlm.nih.gov/pubmed/20615224
(58) http://www.ncbi.nlm.nih.gov/pubmed/20363597
(59) http://www.ncbi.nlm.nih.gov/pubmed/22736018
(60) http://www.ncbi.nlm.nih.gov/pubmed/23085891
(61) http://www.ncbi.nlm.nih.gov/pubmed/19670079
(61a) http://www.ncbi.nlm.nih.gov/pubmed/22055893
Colitis - Diseases associated with colitis
Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Diseases associated with colitis
1. Cholelithiasis (gallstone disease)
Cholelithiasis is considered an extraintestinal manifestation of Crohn's ileitis but has not been associated with ulcerative colitis. In the study to evaluate if an increased risk of cholelithiasis exists in patients with ulcerative colitis, biliary ultrasonography was performed on 159 patients with inflammatory bowel disease, 114 patients with ulcerative colitis, and 45 patients with Crohn's disease, indicated that there is an increased risk of gallstones in both patients with Crohn's disease (odds ratio = 3.6; 95 percent confidence limits = 1.2 - 10.4; P = 0.02) and patients with ulcerative colitis (odds ratio = 2.5; 95 percent confidence limits = 1.2 - 5.2; P = 0.01). The risk was highest in patients with Crohn's disease involving the distal ileum (odds ratio = 4.5; 95 percent confidence limits = 1.5 - 14.1; P = 0.009) and in patients with total ulcerative colitis extending to the cecum (odds ratio = 3.3; 95 percent confidence limits = 1.3 - 8.6; P = 0.01). These results confirm that there is an increased risk of gallstones in Crohn's ileitis but they show that there also exists an increased risk in patients with total ulcerative colitis(31).
2. Liver disorders
Disorders of the hepatobiliary system are relatively common extraintestinal manifestations of inflammatory bowel disease (IBD). According to the study by Department of Pediatric Gastroenterology and Hepatology, these disorders are sometimes due to a shared pathogenesis with IBD as seen in primary sclerosing cholangitis (PSC) and small-duct primary sclerosing cholangitis (small-duct PSC). There are also hepatobiliary manifestations such as cholelithiasis and portal vein thrombosis that occur due to the effects of chronic inflammation and the severity of bowel disease. Lastly, medications used in IBD such as sulfasalazine, thiopurines, and methotrexate can adversely affect the liver(32).
3. Primary sclerosing cholangitis
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease that is associated with inflammatory bowel disease (IBD), particularly chronic ulcerative colitis and, to a lesser degree, Crohn's disease. But according to the study by Hacettepe University, in contrast to findings in Western Europe and the USA, in Turkey: 1) PSC is not regularly associated with idiopathic IBD; 2) most patients with PSC are female; 3) PSC accounts for only 18% of patients with a primary disorder of the biliary tree; 4) the incidence of small-duct primary sclerosing cholangitis is greater than that reported in the literature; and, 5) the incidence of IBD and PSC in Turkey is relatively lower than in other countries(33).
4. Eczema
In the study of nineteen mothers and babies took part in a double blind crossover trial of exclusion of egg and cows' milk, and 18 took part in open exclusion of 11 foods followed by double blind challenge to those mothers whose infants seemed to respond, indicated that the eczema improved in six infants when their mothers avoided egg and cows' milk and worsened again when these were reintroduced. Two infants suffered gastrointestinal reactions after maternal ingestion of egg and cows' milk, one developing colitis. Maternal dietary exclusion seems to benefit some breast fed babies with eczema(34).
5. Chronic polyarthritis and collagenous colitis
There is a report of a 26-year-old woman simultaneously developed chronic seronegative non-destructive polyarthritis and chronic watery diarrhoea. Biopsies from the colorectal mucosa showed a thickened subepithelial collagen layer consistent with collagenous colitis(35).
6. Atopic disease
In the study of three hundred patients with ulcerative colitis, 200 with Crohn's disease and matched control subjects completed questionnaires about atopic disease, indicated that in ulcerative colitis asthma, hay fever, allergic rhinitis or eczema; occurred with twice the frequency, but in Crohn's disease only eczema was more common than in controls(36).
7. Asthma
Recent attention has been devoted to the respiratory manifestations that may be associated with diseases of distant organs. According to the study by Osaka City University, showed that airway microvascular hyper-permeability induced by VEGF may have a profound effect on airway function and can explain the heightened airway hyper-responsiveness characteristic of asthma associated with ulcerative colitis (UC)(37).
8. Thyroid diseases
In the study to assess the prevalence of abnormalities in the structure of the thyroid gland in IBD patients and to compare it to the control group, found that in patients with inflammatory bowel diseases focal lesions relating to tumors of the thyroid gland are more common than in the control group. In patients with ulcerative colitis enlargement of the thyroid gland is more frequent than in the control group. Initial assessments of IBD patients should include ultrasound examinations of the thyroid gland(38).
9. Psoriasis
Numerous reports have demonstrated the epidemiological, pathogenic, and genetic association between psoriasis and Crohn's disease. According to the study by Clalit Health Services, Tel Aviv, Hod Hasharon, indicated that psoriasis is associated both with Crohn's disease and ulcerative colitis. Future studies on comorbidities in patients with psoriasis should focus on ulcerative colitis(39).
10. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(31) http://www.ncbi.nlm.nih.gov/pubmed/2202567
(32) http://www.ncbi.nlm.nih.gov/pubmed/22474447
(33) http://www.ncbi.nlm.nih.gov/pubmed/9951867
(34) http://www.ncbi.nlm.nih.gov/pubmed/3089466
(35) http://www.ncbi.nlm.nih.gov/pubmed/6857179
(36) http://www.ncbi.nlm.nih.gov/pubmed/466750
(37) http://www.ncbi.nlm.nih.gov/pubmed/16297138
(38) http://www.ncbi.nlm.nih.gov/pubmed/23214298
(39) http://www.ncbi.nlm.nih.gov/pubmed/19207663
Diseases associated with colitis
1. Cholelithiasis (gallstone disease)
Cholelithiasis is considered an extraintestinal manifestation of Crohn's ileitis but has not been associated with ulcerative colitis. In the study to evaluate if an increased risk of cholelithiasis exists in patients with ulcerative colitis, biliary ultrasonography was performed on 159 patients with inflammatory bowel disease, 114 patients with ulcerative colitis, and 45 patients with Crohn's disease, indicated that there is an increased risk of gallstones in both patients with Crohn's disease (odds ratio = 3.6; 95 percent confidence limits = 1.2 - 10.4; P = 0.02) and patients with ulcerative colitis (odds ratio = 2.5; 95 percent confidence limits = 1.2 - 5.2; P = 0.01). The risk was highest in patients with Crohn's disease involving the distal ileum (odds ratio = 4.5; 95 percent confidence limits = 1.5 - 14.1; P = 0.009) and in patients with total ulcerative colitis extending to the cecum (odds ratio = 3.3; 95 percent confidence limits = 1.3 - 8.6; P = 0.01). These results confirm that there is an increased risk of gallstones in Crohn's ileitis but they show that there also exists an increased risk in patients with total ulcerative colitis(31).
2. Liver disorders
Disorders of the hepatobiliary system are relatively common extraintestinal manifestations of inflammatory bowel disease (IBD). According to the study by Department of Pediatric Gastroenterology and Hepatology, these disorders are sometimes due to a shared pathogenesis with IBD as seen in primary sclerosing cholangitis (PSC) and small-duct primary sclerosing cholangitis (small-duct PSC). There are also hepatobiliary manifestations such as cholelithiasis and portal vein thrombosis that occur due to the effects of chronic inflammation and the severity of bowel disease. Lastly, medications used in IBD such as sulfasalazine, thiopurines, and methotrexate can adversely affect the liver(32).
3. Primary sclerosing cholangitis
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease that is associated with inflammatory bowel disease (IBD), particularly chronic ulcerative colitis and, to a lesser degree, Crohn's disease. But according to the study by Hacettepe University, in contrast to findings in Western Europe and the USA, in Turkey: 1) PSC is not regularly associated with idiopathic IBD; 2) most patients with PSC are female; 3) PSC accounts for only 18% of patients with a primary disorder of the biliary tree; 4) the incidence of small-duct primary sclerosing cholangitis is greater than that reported in the literature; and, 5) the incidence of IBD and PSC in Turkey is relatively lower than in other countries(33).
4. Eczema
In the study of nineteen mothers and babies took part in a double blind crossover trial of exclusion of egg and cows' milk, and 18 took part in open exclusion of 11 foods followed by double blind challenge to those mothers whose infants seemed to respond, indicated that the eczema improved in six infants when their mothers avoided egg and cows' milk and worsened again when these were reintroduced. Two infants suffered gastrointestinal reactions after maternal ingestion of egg and cows' milk, one developing colitis. Maternal dietary exclusion seems to benefit some breast fed babies with eczema(34).
5. Chronic polyarthritis and collagenous colitis
There is a report of a 26-year-old woman simultaneously developed chronic seronegative non-destructive polyarthritis and chronic watery diarrhoea. Biopsies from the colorectal mucosa showed a thickened subepithelial collagen layer consistent with collagenous colitis(35).
6. Atopic disease
In the study of three hundred patients with ulcerative colitis, 200 with Crohn's disease and matched control subjects completed questionnaires about atopic disease, indicated that in ulcerative colitis asthma, hay fever, allergic rhinitis or eczema; occurred with twice the frequency, but in Crohn's disease only eczema was more common than in controls(36).
7. Asthma
Recent attention has been devoted to the respiratory manifestations that may be associated with diseases of distant organs. According to the study by Osaka City University, showed that airway microvascular hyper-permeability induced by VEGF may have a profound effect on airway function and can explain the heightened airway hyper-responsiveness characteristic of asthma associated with ulcerative colitis (UC)(37).
8. Thyroid diseases
In the study to assess the prevalence of abnormalities in the structure of the thyroid gland in IBD patients and to compare it to the control group, found that in patients with inflammatory bowel diseases focal lesions relating to tumors of the thyroid gland are more common than in the control group. In patients with ulcerative colitis enlargement of the thyroid gland is more frequent than in the control group. Initial assessments of IBD patients should include ultrasound examinations of the thyroid gland(38).
9. Psoriasis
Numerous reports have demonstrated the epidemiological, pathogenic, and genetic association between psoriasis and Crohn's disease. According to the study by Clalit Health Services, Tel Aviv, Hod Hasharon, indicated that psoriasis is associated both with Crohn's disease and ulcerative colitis. Future studies on comorbidities in patients with psoriasis should focus on ulcerative colitis(39).
10. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(31) http://www.ncbi.nlm.nih.gov/pubmed/2202567
(32) http://www.ncbi.nlm.nih.gov/pubmed/22474447
(33) http://www.ncbi.nlm.nih.gov/pubmed/9951867
(34) http://www.ncbi.nlm.nih.gov/pubmed/3089466
(35) http://www.ncbi.nlm.nih.gov/pubmed/6857179
(36) http://www.ncbi.nlm.nih.gov/pubmed/466750
(37) http://www.ncbi.nlm.nih.gov/pubmed/16297138
(38) http://www.ncbi.nlm.nih.gov/pubmed/23214298
(39) http://www.ncbi.nlm.nih.gov/pubmed/19207663
Colitis - Misdiagnosis and delay diagnosis
Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Misdiagnosis and delay diagnosis
1. Delay diagnosis
According to the study by University Central Hospital, patients with ischaemic colitis often delay from admission to the correct diagnosis in 8 days on the average (range 2-15 days). The reasons for delayed diagnosis included suspicion of diverticulitis, Crohn's disease and bowel obstruction as well as poor general condition in one case because of which early colonoscopy was not done. It is concluded that in patients with abdominal pain, rectal bleeding and diarrhoea associated with typical clinical findings, ischaemic colitis should be suspected. This suspicion should be followed by early colonoscopy to detect the gangrenous form of the disease as early as possible(26).
2. Takayasu arteritis
Takayasu arteritis is a chronic inflammatory disease that primarily affects large arteries such as the aorta and its proximal branches. The association between Takayasu arteritis and ulcerative colitis is an extremely rare condition. Herein we report a case of Takayasu arteritis who had been misdiagnosed and treated as ulcera, according to the study by Ankara Education and Research Hospital, Department of Nephrology(27). Other study also report a case of a 17-year-old Chinese male developed upper limb sourness and a sensation of fatigue, and his upper limb pulses were absent. He was diagnosed with TA and underwent an axillary artery bypass with autologous great saphenous vein on the left subclavian artery. After the surgery, he regained the normal blood pressure. This patient also had years of diarrhea and developed an anal canal ulcer, and was diagnosed with inflammatory bowel disease and ulcerative colitis before. Five months after the TA surgery, he was hospitalized for severe stomachache and diarrhea and was finally diagnosed with Crohn's disease(28).
3. Schistosoma-related colitis
Schaumann bodies are inclusion bodies, first described by Schaumann in 1941, typically seen in granulomatous diseases such as tuberculosis, sarcoidosis and chronic beryllium diseases. Williams WJ, in 1964, reported Schaumann bodies to occur in 10% of Crohn's disease (CD). There is a report of a case of Crohn's disease, initially misdiagnosed as a schistosoma-related colitis for the presence of numerous calcified bodies resembling calcified ova and scattered granulomas. Subsequent biopsies showed more typical histological features and, in combination with a more complete clinical history, diagnosis of Crohn's disease was made, according to the study by A.O. Spedali Civili di Brescia, Brescia(29).
4. Others
Clinical parameters helpful in differentiating intestinal tuberculosis from Crohn's disease included chest radiographic features of tuberculosis (56% v 0%), perianal fistulae (0% v 40%) and extraintestinal manifestations of Crohn's disease (0% v 40%). Histopathological features that seemed to reliably differentiate between intestinal tuberculosis and Crohn's disease included confluent granulomas, > or =10 granulomas per biopsy site and caseous necrosis (in biopsy samples of 50%, 33% and 22% of patients with intestinal tuberculosis, respectively, v 0% of patients with Crohn's disease). Features that were observed more often in patients with intestinal tuberculosis than in those with Crohn's disease included granulomas exceeding 0.05 mm(2) (67% v 8%), ulcers lined by conglomerate epithelioid histiocytes (61% v 8%) and disproportionate submucosal inflammation (67% v 10%), according to the study by University of Cape Town(30).
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(26) http://www.ncbi.nlm.nih.gov/pubmed/1759791
(27) http://www.ncbi.nlm.nih.gov/pubmed/23311124
(28) http://www.ncbi.nlm.nih.gov/pubmed/19650203
(29) http://www.ncbi.nlm.nih.gov/pubmed/22503169
(30) http://www.ncbi.nlm.nih.gov/pubmed/16873564
Misdiagnosis and delay diagnosis
1. Delay diagnosis
According to the study by University Central Hospital, patients with ischaemic colitis often delay from admission to the correct diagnosis in 8 days on the average (range 2-15 days). The reasons for delayed diagnosis included suspicion of diverticulitis, Crohn's disease and bowel obstruction as well as poor general condition in one case because of which early colonoscopy was not done. It is concluded that in patients with abdominal pain, rectal bleeding and diarrhoea associated with typical clinical findings, ischaemic colitis should be suspected. This suspicion should be followed by early colonoscopy to detect the gangrenous form of the disease as early as possible(26).
2. Takayasu arteritis
Takayasu arteritis is a chronic inflammatory disease that primarily affects large arteries such as the aorta and its proximal branches. The association between Takayasu arteritis and ulcerative colitis is an extremely rare condition. Herein we report a case of Takayasu arteritis who had been misdiagnosed and treated as ulcera, according to the study by Ankara Education and Research Hospital, Department of Nephrology(27). Other study also report a case of a 17-year-old Chinese male developed upper limb sourness and a sensation of fatigue, and his upper limb pulses were absent. He was diagnosed with TA and underwent an axillary artery bypass with autologous great saphenous vein on the left subclavian artery. After the surgery, he regained the normal blood pressure. This patient also had years of diarrhea and developed an anal canal ulcer, and was diagnosed with inflammatory bowel disease and ulcerative colitis before. Five months after the TA surgery, he was hospitalized for severe stomachache and diarrhea and was finally diagnosed with Crohn's disease(28).
3. Schistosoma-related colitis
Schaumann bodies are inclusion bodies, first described by Schaumann in 1941, typically seen in granulomatous diseases such as tuberculosis, sarcoidosis and chronic beryllium diseases. Williams WJ, in 1964, reported Schaumann bodies to occur in 10% of Crohn's disease (CD). There is a report of a case of Crohn's disease, initially misdiagnosed as a schistosoma-related colitis for the presence of numerous calcified bodies resembling calcified ova and scattered granulomas. Subsequent biopsies showed more typical histological features and, in combination with a more complete clinical history, diagnosis of Crohn's disease was made, according to the study by A.O. Spedali Civili di Brescia, Brescia(29).
4. Others
Clinical parameters helpful in differentiating intestinal tuberculosis from Crohn's disease included chest radiographic features of tuberculosis (56% v 0%), perianal fistulae (0% v 40%) and extraintestinal manifestations of Crohn's disease (0% v 40%). Histopathological features that seemed to reliably differentiate between intestinal tuberculosis and Crohn's disease included confluent granulomas, > or =10 granulomas per biopsy site and caseous necrosis (in biopsy samples of 50%, 33% and 22% of patients with intestinal tuberculosis, respectively, v 0% of patients with Crohn's disease). Features that were observed more often in patients with intestinal tuberculosis than in those with Crohn's disease included granulomas exceeding 0.05 mm(2) (67% v 8%), ulcers lined by conglomerate epithelioid histiocytes (61% v 8%) and disproportionate submucosal inflammation (67% v 10%), according to the study by University of Cape Town(30).
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Sources
(26) http://www.ncbi.nlm.nih.gov/pubmed/1759791
(27) http://www.ncbi.nlm.nih.gov/pubmed/23311124
(28) http://www.ncbi.nlm.nih.gov/pubmed/19650203
(29) http://www.ncbi.nlm.nih.gov/pubmed/22503169
(30) http://www.ncbi.nlm.nih.gov/pubmed/16873564
Colitis - The Complications
Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Complications
1. Congenital abnormalities
Women who are pregnant with Ulcerative colitis are associated with significantly increased risk of some selected congenital abnormalities (limb deficiencies, obstructive urinary and multiple congenital abnormalities) according to the birth outcomes in women with ulcerative colitis examined in a nationwide, Danish, cohort of women based on data from the Danish National Hospital Discharge Registry and the Danish Medical Birth Registry, and within a Hungarian case-control data set(22).
2. Nutritional deficiency
It is reported that malnutrition is not a feature of Ulcerative Colitis (UC), but according to the study by the Institute of Drug Research, Faculty of Medicine, University of Toronto, ulcerative colitis and Crohn's disease are the two main entities of inflammatory bowel disease (IBD). There is an intricate relationship between IBD features in human patients, in vitro and animal colitis models, mechanisms and possible therapeutic approaches in these models, and strategies that can be extrapolated and applied in humans. Malnutrition, particularly protein-energy malnutrition and vitamin and micronutrient deficiencies, as well as dysregulation of the intestinal microbiota, are common features of IBD(23).
3. Rectovaginal fistulas
Patients with Crohn's disease are at increased risk to develop fistulas
According to the study by Kaiser Permanente Medical Center, during a 9-year period, six women with ulcerative colitis (UC) and rectovaginal fistulas were surgically treated. Three underwent ileoanal pull-through procedures with simultaneous repair of the rectovaginal fistulas. Two patients had Kock pouches, and one had a Brooke ileostomy because extensive destruction of the rectal sphincter prohibited ileoanal procedures. The three patients who had ileoanal procedures all had excellent functional results. There has been no evidence of Crohn's disease or fistula recurrence(24)
3. Other complications
Microscopic forms of colitis have been described, including collagenous colitis, a possibly heterogeneous disorder. Collagenous colitis most often appears to have an entirely benign clinical course that usually responds to limited treatment. Acording to the study by University of British Columbia, significant extracolonic disorders, especially arthritis, spondylitis, thyroiditis and skin disorders, such as pyoderma gangrenosum, dominate the clinical course and influence the treatment strategy. Colitis and toxic megacolon may develop. Concomitant gastric and small intestinal inflammatory disorders have been described including celiac disease and more extensive collagenous inflammatory disease. Colonic ulceration has been associated with the use of nonsteroidal anti-inflammatory drugs, while other forms of inflammatory bowel disease, including ulcerative colitis and Crohn disease, may evolve directly from collagenous colitis. Submucosal 'dissection', colonic fractures, or mucosal tears and perforation, possibly from air insufflation during colonoscopy, have been reported. Similar changes may result from increased intraluminal pressures that may occur during radiological imaging of the colon. Neoplastic disorders of the colon may also occur during the course of collagenous colitis, including colon carcinoma and neuroendocrine tumours (ie, carcinoids). Finally, lymphoproliferative disease has been reported(25).
4. Etc.
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Sources
(22) http://www.ncbi.nlm.nih.gov/pubmed/22142578
(23) http://www.ncbi.nlm.nih.gov/pubmed/22736018
(24) http://www.ncbi.nlm.nih.gov/pubmed/1914728
(25) http://www.ncbi.nlm.nih.gov/pubmed/22993735
Complications
1. Congenital abnormalities
Women who are pregnant with Ulcerative colitis are associated with significantly increased risk of some selected congenital abnormalities (limb deficiencies, obstructive urinary and multiple congenital abnormalities) according to the birth outcomes in women with ulcerative colitis examined in a nationwide, Danish, cohort of women based on data from the Danish National Hospital Discharge Registry and the Danish Medical Birth Registry, and within a Hungarian case-control data set(22).
2. Nutritional deficiency
It is reported that malnutrition is not a feature of Ulcerative Colitis (UC), but according to the study by the Institute of Drug Research, Faculty of Medicine, University of Toronto, ulcerative colitis and Crohn's disease are the two main entities of inflammatory bowel disease (IBD). There is an intricate relationship between IBD features in human patients, in vitro and animal colitis models, mechanisms and possible therapeutic approaches in these models, and strategies that can be extrapolated and applied in humans. Malnutrition, particularly protein-energy malnutrition and vitamin and micronutrient deficiencies, as well as dysregulation of the intestinal microbiota, are common features of IBD(23).
3. Rectovaginal fistulas
Patients with Crohn's disease are at increased risk to develop fistulas
According to the study by Kaiser Permanente Medical Center, during a 9-year period, six women with ulcerative colitis (UC) and rectovaginal fistulas were surgically treated. Three underwent ileoanal pull-through procedures with simultaneous repair of the rectovaginal fistulas. Two patients had Kock pouches, and one had a Brooke ileostomy because extensive destruction of the rectal sphincter prohibited ileoanal procedures. The three patients who had ileoanal procedures all had excellent functional results. There has been no evidence of Crohn's disease or fistula recurrence(24)
3. Other complications
Microscopic forms of colitis have been described, including collagenous colitis, a possibly heterogeneous disorder. Collagenous colitis most often appears to have an entirely benign clinical course that usually responds to limited treatment. Acording to the study by University of British Columbia, significant extracolonic disorders, especially arthritis, spondylitis, thyroiditis and skin disorders, such as pyoderma gangrenosum, dominate the clinical course and influence the treatment strategy. Colitis and toxic megacolon may develop. Concomitant gastric and small intestinal inflammatory disorders have been described including celiac disease and more extensive collagenous inflammatory disease. Colonic ulceration has been associated with the use of nonsteroidal anti-inflammatory drugs, while other forms of inflammatory bowel disease, including ulcerative colitis and Crohn disease, may evolve directly from collagenous colitis. Submucosal 'dissection', colonic fractures, or mucosal tears and perforation, possibly from air insufflation during colonoscopy, have been reported. Similar changes may result from increased intraluminal pressures that may occur during radiological imaging of the colon. Neoplastic disorders of the colon may also occur during the course of collagenous colitis, including colon carcinoma and neuroendocrine tumours (ie, carcinoids). Finally, lymphoproliferative disease has been reported(25).
4. Etc.
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Sources
(22) http://www.ncbi.nlm.nih.gov/pubmed/22142578
(23) http://www.ncbi.nlm.nih.gov/pubmed/22736018
(24) http://www.ncbi.nlm.nih.gov/pubmed/1914728
(25) http://www.ncbi.nlm.nih.gov/pubmed/22993735
Colitis - The Risk Factors
Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Risk factor
1. Medical conditions
a. Ischemic colitis is the most common type of intestinal ischemia and has a clinical spectrum of injury that ranges from mild and transient ischemia to acute fulminant colitis. Patients with medicals condition such as hypertension, diabetes, hyperlipidemia, and atrial fibrillation are associated with increased risk to develop ischemic colitis(IC), according to the study by Beijing Hospital, Ministry of Health(16)
b.. Ischemic colitis is one of the most often seen disorders of the large intestine in the elderly. Common predisposing factors are atherosclerosis, shock, and congestive heart failure, but often, elderly patients have no obvious predisposing or precipitating factors(17).
2. Age
If you are over 50, you are at increased to develop colitis. According to the study of the records of 81 patients with colitis whose symptoms began after the age of 50 years, ischemia is the most common cause of colitis beginning in patients older than 50 years of age. Moreover, the incorrect diagnosis of idiopathic inflammatory bowel disease in a large proportion of these patients may explain why colitis has been reported to behave differently in the elderly than in the young(18).
3. Depression and psychosocial stress
In the study to analyze the data from 152,461 women (aged 29-72 years) enrolled since 1992-1993 in the Nurses' Health Study cohorts I and II, conducted by Massachusetts General Hospital and Harvard Medical School, found that On the basis of data from the Nurses' Health Study, depressive symptoms increase the risk for CD, but not UC, among women. Psychological factors might therefore contribute to development of CD(19).
4. Gender and smoking
In the study of the medical charts of 1784 adult consecutive patients (978 patients, ulcerative colitis; 118 patients, indeterminate colitis; and 688 patients, Crohn's colitis), whose smoking habits were specified by direct interview, showed that The proportion of ever smokers was 42% in ulcerative colitis, 43% in indeterminate colitis, and 61% in Crohn's colitis. Smoking cessation preceded the onset of colitis in 279 patients with ulcerative colitis or indeterminate colitis (61%) and only 52 patients (12%) with Crohn's colitis. In ulcerative colitis and indeterminate colitis, current smoking delayed mean age at disease onset in men (from 32 to 41 yr; P < 0.001), but not women (from 33 to 33 yr), and decreased the need for immunosuppressants in men (10-yr cumulative risk, 26% +/- 4% in nonsmokers vs. 8% +/- 4% in smokers; P < 0.01), but not significantly in women. Conversely, in Crohn's colitis, current smoking hastened disease onset in women (from 35 to 29 yr; P < 0.001), but not men (from 32 to 31 yr), and increased the need for immunosuppressants in women (10-yr cumulative risk, 48% +/- 5% in nonsmokers vs. 58% +/- 4% in smokers; P < 0.01), but not men(20).
5. Family history
Approximately 5 to 10 percent of patients undergoing ileal pouch-anal anastomosis with a diagnosis of ulcerative colitis are subsequently diagnosed with Crohn's disease. Acoording to the study by Cedars-Sinai Medical Center, Los Angeles, patients with ulcerative colitis and indeterminate colitis with a family history of Crohn's disease or preoperative anti-Saccharomyces cerevisiae immunoglobulin-A seropositivity are more likely to be diagnosed with Crohn's disease after ileal pouch-anal anastomosis(21).
6. Other risk factors
According to the study by, in a multivariate model, familial history of inflammatory bowel disease (odds ratio (OR) 4.3 (95% confidence interval 2.3-8)), breast feeding (OR 2.1 (1.3-3.4)), bacille Calmette-Guerin vaccination (OR 3.6 (1.1-11.9)), and history of eczema (OR 2.1 (1-4.5)) were significant risk factors for Crohn's disease whereas regular drinking of tap water was a protective factor (OR 0.56 (0.3-1)). Familial history of inflammatory bowel disease (OR 12.5 (2.2-71.4)), disease during pregnancy (OR 8.9 (1.5-52)), and bedroom sharing (OR 7.1 (1.9-27.4)) were risk factors for ulcerative colitis whereas appendicectomy was a protective factor (OR 0.06 (0.01-0.36))(21a). Also in the study by University Hospital of Heraklion, found that the logistic regression analysis showed that appendectomy and tonsillectomy have no independent association with the risk of developing ulcerative colitis, whereas in Crohn's disease both appendectomy and tonsillectomy have positive associations. Well-established risk factors, such as family history and smoking status(21b). Appendicectomy is also an environmental factors that are known to influence ulcerative colitis (UC)(21c).
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
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Sources
(16) http://www.ncbi.nlm.nih.gov/pubmed/23290973
(17) http://www.ncbi.nlm.nih.gov/pubmed/10223095
(18) http://www.ncbi.nlm.nih.gov/pubmed/7315820
(19) http://www.ncbi.nlm.nih.gov/pubmed/22944733
(20) http://www.ncbi.nlm.nih.gov/pubmed/15017631
(21) http://www.ncbi.nlm.nih.gov/pubmed/18085333
(21a) http://www.ncbi.nlm.nih.gov/pubmed/15710983
(21b) http://www.ncbi.nlm.nih.gov/pubmed/10211500
(21c) http://www.ncbi.nlm.nih.gov/pubmed/15194646
Risk factor
1. Medical conditions
a. Ischemic colitis is the most common type of intestinal ischemia and has a clinical spectrum of injury that ranges from mild and transient ischemia to acute fulminant colitis. Patients with medicals condition such as hypertension, diabetes, hyperlipidemia, and atrial fibrillation are associated with increased risk to develop ischemic colitis(IC), according to the study by Beijing Hospital, Ministry of Health(16)
b.. Ischemic colitis is one of the most often seen disorders of the large intestine in the elderly. Common predisposing factors are atherosclerosis, shock, and congestive heart failure, but often, elderly patients have no obvious predisposing or precipitating factors(17).
2. Age
If you are over 50, you are at increased to develop colitis. According to the study of the records of 81 patients with colitis whose symptoms began after the age of 50 years, ischemia is the most common cause of colitis beginning in patients older than 50 years of age. Moreover, the incorrect diagnosis of idiopathic inflammatory bowel disease in a large proportion of these patients may explain why colitis has been reported to behave differently in the elderly than in the young(18).
3. Depression and psychosocial stress
In the study to analyze the data from 152,461 women (aged 29-72 years) enrolled since 1992-1993 in the Nurses' Health Study cohorts I and II, conducted by Massachusetts General Hospital and Harvard Medical School, found that On the basis of data from the Nurses' Health Study, depressive symptoms increase the risk for CD, but not UC, among women. Psychological factors might therefore contribute to development of CD(19).
4. Gender and smoking
In the study of the medical charts of 1784 adult consecutive patients (978 patients, ulcerative colitis; 118 patients, indeterminate colitis; and 688 patients, Crohn's colitis), whose smoking habits were specified by direct interview, showed that The proportion of ever smokers was 42% in ulcerative colitis, 43% in indeterminate colitis, and 61% in Crohn's colitis. Smoking cessation preceded the onset of colitis in 279 patients with ulcerative colitis or indeterminate colitis (61%) and only 52 patients (12%) with Crohn's colitis. In ulcerative colitis and indeterminate colitis, current smoking delayed mean age at disease onset in men (from 32 to 41 yr; P < 0.001), but not women (from 33 to 33 yr), and decreased the need for immunosuppressants in men (10-yr cumulative risk, 26% +/- 4% in nonsmokers vs. 8% +/- 4% in smokers; P < 0.01), but not significantly in women. Conversely, in Crohn's colitis, current smoking hastened disease onset in women (from 35 to 29 yr; P < 0.001), but not men (from 32 to 31 yr), and increased the need for immunosuppressants in women (10-yr cumulative risk, 48% +/- 5% in nonsmokers vs. 58% +/- 4% in smokers; P < 0.01), but not men(20).
5. Family history
Approximately 5 to 10 percent of patients undergoing ileal pouch-anal anastomosis with a diagnosis of ulcerative colitis are subsequently diagnosed with Crohn's disease. Acoording to the study by Cedars-Sinai Medical Center, Los Angeles, patients with ulcerative colitis and indeterminate colitis with a family history of Crohn's disease or preoperative anti-Saccharomyces cerevisiae immunoglobulin-A seropositivity are more likely to be diagnosed with Crohn's disease after ileal pouch-anal anastomosis(21).
6. Other risk factors
According to the study by, in a multivariate model, familial history of inflammatory bowel disease (odds ratio (OR) 4.3 (95% confidence interval 2.3-8)), breast feeding (OR 2.1 (1.3-3.4)), bacille Calmette-Guerin vaccination (OR 3.6 (1.1-11.9)), and history of eczema (OR 2.1 (1-4.5)) were significant risk factors for Crohn's disease whereas regular drinking of tap water was a protective factor (OR 0.56 (0.3-1)). Familial history of inflammatory bowel disease (OR 12.5 (2.2-71.4)), disease during pregnancy (OR 8.9 (1.5-52)), and bedroom sharing (OR 7.1 (1.9-27.4)) were risk factors for ulcerative colitis whereas appendicectomy was a protective factor (OR 0.06 (0.01-0.36))(21a). Also in the study by University Hospital of Heraklion, found that the logistic regression analysis showed that appendectomy and tonsillectomy have no independent association with the risk of developing ulcerative colitis, whereas in Crohn's disease both appendectomy and tonsillectomy have positive associations. Well-established risk factors, such as family history and smoking status(21b). Appendicectomy is also an environmental factors that are known to influence ulcerative colitis (UC)(21c).
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(16) http://www.ncbi.nlm.nih.gov/pubmed/23290973
(17) http://www.ncbi.nlm.nih.gov/pubmed/10223095
(18) http://www.ncbi.nlm.nih.gov/pubmed/7315820
(19) http://www.ncbi.nlm.nih.gov/pubmed/22944733
(20) http://www.ncbi.nlm.nih.gov/pubmed/15017631
(21) http://www.ncbi.nlm.nih.gov/pubmed/18085333
(21a) http://www.ncbi.nlm.nih.gov/pubmed/15710983
(21b) http://www.ncbi.nlm.nih.gov/pubmed/10211500
(21c) http://www.ncbi.nlm.nih.gov/pubmed/15194646
Colitis - The Causes
Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Causes
A.1. Causes The causes of colitis as a result of types
A.1.1. Inflammatory bowel disease (IBD)(Ulcerative colitis and Crohn's disease)
1. Ulcerative colitis
The pathogenesis of inflammatory bowel disease (IBD) is multifactorial, with some patients presenting additional autoimmune symptoms.. In the study to describe these features, in order to differentiate a subgroup of colitis associated with autoimmunity (CAI) from CUC and 28 consecutive children with inflammatory colitis associated with primary sclerosing cholangitis (PSC), celiac disease, or AI hepatitis were compared with a matched control group of 27 children with isolated UC., by the Hôpital Necker-Enfants Malades, Service de Gastroentérologie pédiatrique, showed that in CAI the main digestive symptoms at disease onset were abdominal pain (12/28) and bloody strings in the stool (12/28), along with a high prevalence of autoimmune diseases in relatives, as compared with bloody diarrhea in the ulcerative colitis (CUC) group (26/27)(9a).
2. Crohn's disease
Crohn's disease and ulcerative colitis evolve with a relapsing and remitting course. In the study of included 63 ulcerative colitis (UC) and 41 Crohn's disease (CD) patients. Forty-seven healthy patients were included as the control group for the determination of the frequency and factors of prolonged QT dispersion that may lead to severe ventricular arrhythmias in patients with inflammatory bowel disease (IBD), indicated that prolonged QTcd was found in 12.2% of UC patients, and in 14.5% of CD patients compared with the control group (P < 0.05). A significant difference was found between the insulin values (CD: 10.95 ± 6.10 vs 6.44 ± 3.28, P < 0.05; UC: 10.88 ± 7.19 vs 7.20 ± 4.54, P < 0.05) and HOMA (CD: 2.56 ± 1.43 vs 1.42 ± 0.75, P < 0.05; UC: 2.94 ± 1.88 vs 1.90 ± 1.09, P < 0.05) in UC and CD patients with and without prolonged QTcd(9b).
A.1.2. Microscopic colitis (Collagenous and lymphocytic colitis)
Microscopic colitis may be defined as a clinical syndrome, of unknown etiology, consisting of chronic watery diarrhea, with no alterations in the large bowel at the endoscopic and radiologic evaluation. According to the study by University of Sacred Heart, the epidemiological impact of this disease has become increasingly clear in the last years, with most data coming from Western countries. Microscopic colitis includes two histological subtypes [collagenous colitis (CC) and lymphocytic colitis (LC)] with no differences in clinical presentation and management(10).
Other researchers indicated that Collagenous and lymphocytic colitis are well-described conditions causing chronic watery diarrhoea. A peak incidence from 60 to 70 years of age with a female predominance mainly in collagenous colitis is observed. Both conditions are characterised by a (near) normal colonoscopy, but with specific histologic findings on colonic biopsies. Histopathologically, both conditions are characterised by distinct epithelial abnormalities and a dense lymphoplasmocytic infiltrate. Distinct features consist of a characteristic collagen band deposition in the subepithelial layer in collagenous colitis and a markedly increased number of intra-epithelial lymphocytes in lymphocytic colitis(10a)
a. Collagenous colitis (CC)
Collagenous colitis (CC), a form of microscopic colitis, is characterized by a thick subepithelial collagen layer in the colon in the presence of chronic nonbloody watery diarrhoea and macroscopically normal-appearing colonic mucosa. According to the Hepatology and Nutrition, The Hospital for Sick Children, typically affecting elderly adults, CC is rare in children with only 12 cases previously reported in the literature, but we report a case of a 4-year-old girl with CC associated with eosinophilic gastritis(10b).
b. Lymphocytic colitis
In the study to evaluate the biopsy specimens from the terminal ileum of 32 patients with the histopathological diagnosis of lymphocytic colitis or collagenous colitis and 11 control individuals for the presence or absence of ileal mucosal abnormalities and for the number of intraepithelial lymphocytes, assessed by immunohistochemical stains for the pan T-cell marker, CD3, showed that the mean CD3 counts in patients with lymphocytic/collagenous colitis were significantly higher than those in the control group. Seven of 14 patients with collagenous colitis and 14 of 18 patients with lymphocytic colitis revealed an increase in intraepithelial T lymphocytes when compared with the control group (P =.001). Other notable changes included ileal villous atrophy in one case of lymphocytic colitis and in three cases of collagenous colitis and epithelial damage with thickened subepithelial collagen in two cases of collagenous colitis(10c).
A.1.3. Iatrogenesis
May be as a result of chance, medical error, negligence, social control, unexamined instrument design, etc.
1. Diversion colitis
Diversion colitis frequently develops in segments of the colorectum after surgical diversion of the fecal stream; it persists indefinitely unless the excluded segment is reanastomosed. The disease is characterized by bleeding from inflamed colonic mucosa that mimics the bleeding of idiopathic inflammatory bowel disease, and it may culminate in stricture formation. Histologic observation revealed a distinctive type of mucosal inflammation that resolved more slowly and less completely than the gross appearance of the inflamed mucosa. From these preliminary studies we infer that diversion colitis may represent an inflammatory state resulting from a nutritional deficiency in the lumen of the colonic epithelium, which is effectively treated by local application of short-chain fatty acids, the missing nutrients, according to the study by Department of Medicine, Medical College of Wisconsin(10d)
2. Chemical colitis
Chemical colitis can occur as a result of accidental contamination of endoscopes or by intentional or accidental administration of enemas containing various chemicals. Most cases have occurred after accidental contamination of endoscopes with glutaraldehyde and/or hydrogen peroxide. There have been multiple case reports of chemical colitis resulting from unintentional administration of caustic chemicals. Intentional administration of corrosive enemas has been implicated in sexual practices, bowel cleansing, or in suicide attempts. Patients present with nonspecific symptoms including abdominal pain, rectal bleeding, and/or diarrhea, according to the study byStanford University School of Medicine, Stanford(10e).
A.1.4. Ischemic colitis
Ischemic colitis is the most common form of ischemic injury of the gastrointestinal tract and can present either as an occlusive or a non-occlusive form. It accounts for 1 in 1000 hospitalizations but its incidence is underestimated because it often has a mild and transient nature. The etiology of ischemic colitis is multifactorial and the clinical presentation variable, according to the study by
Gastroenterology Unit Venizelion General Hospital of Heraklion(10f). Other study indicated that ischemic colitis is the most common manifestation of gastrointestinal ischemia. The presumed etiologies are numerous; however, it typically develops spontaneously. It is classified into the transient type, stricture type, and gangrenous type. The majority of patients with ischemic colitis, excluding the gangrenous type, follow a benign clinical course in the absence of major vasculature occlusion. It usually presents as an acute abdominal illness with bloody diarrhea(10g).
A.1.5. Infectious colitis (Clostridium difficile colitis)
In the study of diagnosis of Clostridium difficile colitis is increasing in frequency, with worsening patient outcomes of the data of one hundred fifty-seven patients diagnosed with C difficile colitis between 1994-2000., conducted by University of Washington, showed that the frequency of C difficile colitis remains high and seems to be associated with increasing mortality. Among patients with positive C difficile toxin assay results, immunocompromise and delayed diagnosis no longer seem to be associated with higher risk for death. All patients taking antibiotics are at risk and require early recognition and aggressive medical intervention(10h). Also according to the study by Baylor College of Medicine and Kelsey Research Foundation, infectious colitis is diagnosed in someone with diarrhea and one or more of the following: fever and/or dysentery, stools containing inflammatory markers such as leukocytes, lactoferrin, or calprotectin, or positive stool culture for an invasive or inflammatory bacterial enteropathogen including Shigella, Salmonella, Campylobacter, Shiga toxin-producing Escherichia coli (STEC) or Clostridium difficile, or colonic inflammation by endoscopy(10i).
A.1.6. Indeterminate colitis and Atypical colitis
1. Indeterminate colitis(IC)
The term indeterminate colitis (IC) is an interim, or preliminary, descriptive term used by pathologists for cases of inflammatory bowel disease (IBD) in which a definite diagnosis of ulcerative colitis (UC) or Crohn's disease (CD) cannot be established based on the information available at the time of surgical sign-out. Most cases are due to fulminant ulcerative colitis, a condition in which the classic pathologic features of UC are often obscured and may overlap with CD. For instance, fulminant UC may show early superficial fissuring ulceration, transmural lymphoid aggregates and relative rectal sparing, simulating CD. Other common causes for establishing a diagnosis of IC include confusion of backwash ileitis in UC for terminal ileal involvement in CD, failure to accept hard criteria, such as granulomas, or segmental disease, as representative of CD, and failure to recognize unusual variants of UC that can cause CD-like patchiness of disease(10k).
Approximately 4% to 5% of all patients with inflammatory bowel disease will be left with the diagnosis of IC. A diagnosis of indeterminate colitis (IC) is based on endoscopic, histologic, and radiologic findings when the criteria for either Crohn's colitis or ulcerative colitis (UC) cannot be definitively established. Population-based studies have demonstrated that the average annual incidence of IC ranges 1.6 to 2.4/100,000 versus 7.3 to 13.6/100,000 for UC. At the time of initial diagnosis of inflammatory bowel disease, up to 10% to 15% of patients will be diagnosed as having IC, according to the study by Brigham and Women's Hospital(10j).
2. Atypical colitis
Atypical colitis is a phrase used to define a colitis that does not conform to criteria for accepted types of colitis. By considering the clinical history and symptoms, the pathologist should be able to reach the correct diagnosis in most cases. However, the spectrum of morphologic changes associated with watery diarrhea syndrome appears to be broader than originally thought. Morphologic changes more often associated with chronic inflammatory bowel disease or even chronic ischemic or infectious colitis have been noted in patients with clinically established microscopic colitis, according to the study by St. Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust(10l).
A.1.7. Fulminant colitis
Fulminant colitis is defined as any colitis that has become worse rapidly.
There is a report of a 33-yr-old white male presented with bloody diarrhea, leukocytosis, and left lower quadrant direct and rebound tenderness after a self-administered concentrated hydrofluoric acid enema while intoxicated from intranasal cocaine administration. Intraoperative flexible sigmoidoscopy and a gastrografin enema revealed severe mucosal ulceration and edema in the rectum and sigmoid colon. Laparotomy revealed an ulcerated, necrotic, and purulent sigmoid colon and intraperitoneal pus(10m).
Other in the review of the records of 4796 inpatients diagnosed as having C difficile colitis from January 1, 1996, to December 31, 2007, and identified 199 (4.1%) with fulminant C difficile colitis, as defined by the need for colectomy or admission to the intensive care unit for C difficile colitis, showed that the inhospital mortality rate for fulminant C difficile colitis was 34.7%. Independent predictors of mortality included the following: (1) age of 70 years or older, (2) severe leukocytosis or leukopenia (white blood cell count, >or=35 000/microL or <4000/microL) or bandemia (neutrophil bands, >or=10%), and (3) cardiorespiratory failure (intubation or vasopressors). When all 3 factors were present, the mortality rate was 57.1%; when all 3 were absent, the mortality rate was 0%. Patients who underwent colectomy had a trend toward decreased mortality rates (odds ratio, 0.49; 95% confidence interval, 0.21-1.1; P = .08). Among patients admitted primarily for fulminant C difficile colitis, care in the surgical department compared with the nonsurgical department resulted in a higher rate of operation (85.1% vs 11.2%; P < .001) and lower mortality rates (12.8% vs 39.3%; P = .001). Patients admitted directly to the surgical department had a shorter mean (SD) interval from admission to operation (0 vs 1.7 [2.8] days; P = .001)(10n).
A.2. Other causes
2. Sarcoidosis
Although clinically recognizable gastrointestinal (GI) system involvement with sarcoidosis is extremely rare, we report a case of a 51-year-old Caucasian male granulomatous as a result of Sarcoidosis. Enterocolitis Colonoscopy showed scattered right colon ulcerations and erythema. The terminal ileum appeared normal. Biopsies from the duodenum, terminal ileum, and colon showed intramucosal non-caseating granulomas with focal multinucleate giant cell formation in a background of chronic active duodenitis, ileitis, and colitis. Liver biopsy showed moderate non-specific chronic hepatitis with non-caseating granulomas present within portal and lobular parenchyma. The clinical presentations, along with biopsy results were suggestive of sarcoidosis(11).
3. Low level of both serum and tissue PON1
PON1 is known as an HDL-associated antioxidant enzyme that inhibits the oxidative modification of LDL and oxidative stress plays a role in the pathogenesis of mesenteric ischemia. According to the study to investigate the changes in PON1 activity and lipid profile in an experimental ischemic colitis model of 45male Wistar albino rats, showed that there was a significant decrease in both serum and tissue PON1 activity in ischemic colitis group (P < 0.01, for each). Similarly, arylesterase levels showed a parallel decrease in both tissue and serum of the experimental group (P < 0.01 and P < 0.001, retrospectively). MDA, an oxidative stress marker, was seen to increase in the experimental group (P < 0.01, tissue; P < 0.05, serum). In experimental group, there was a significant rise in serum total cholesterol and LDL levels (P < 0.001, for each). However, HDL level decreased significantly (P < 0.001). Triglycerides did not show any change between the groups (P > 0.05)(12).
4. Smoking, dehydration, NSAID (non-steroidal anti-inflammatory drugs) use, constipation and contraceptive use
Pathophysiology of ischemic colitis in young people is in most cases unknown. Possible contributing factors in our study were smoking, dehydration, NSAID (non-steroidal anti-inflammatory drugs) use, constipation and contraceptive use. (13a). But epidemiologic data suggest that smoking increases the risk and the severity of Crohn's disease (CD), although it may protect patients with ulcerative colitis (UC)(13), but others found no detrimental effects of smoking on the disease course of CD and no clear beneficial effects on the course of UC(14).
5. Anemia
Sickle cell-induced ischemic colitis is a rare yet potentially fatal complication of sickle cell anemia. there is a report of a 29-year-old female with sickle cell disease who was admitted with left lower quadrant abdominal pain. A diagnostic workup, including chemistries, complete blood count, blood cultures, chest x-ray, computerized tomography scanning, and colonoscopy, was performed to identify the etiology of her symptoms. This case highlights the importance of differentiating simple pain crisis from more serious and life-threatening ischemic bowel(15).
6. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
Sources
(9a) http://www.ncbi.nlm.nih.gov/pubmed/22238154
(9b) http://www.ncbi.nlm.nih.gov/pubmed/23326164
(10) http://www.ncbi.nlm.nih.gov/pubmed/23180940
(10a) http://www.ncbi.nlm.nih.gov/pubmed/20203510
(10b) http://www.ncbi.nlm.nih.gov/pubmed/17718794
(10c) http://www.ncbi.nlm.nih.gov/pubmed/12591963
(10d) http://www.ncbi.nlm.nih.gov/pubmed/2909876
(10e) http://www.ncbi.nlm.nih.gov/pubmed/18209577
(10f) http://www.ncbi.nlm.nih.gov/pubmed/19109863
(10g) http://www.ncbi.nlm.nih.gov/pubmed/10412155
(10h) http://www.ncbi.nlm.nih.gov/pubmed/12361411
(10i) http://www.ncbi.nlm.nih.gov/pubmed/22080825
(10j) http://www.ncbi.nlm.nih.gov/pubmed/15115931
(10k) http://www.ncbi.nlm.nih.gov/pubmed/15115930
(10l) http://www.ncbi.nlm.nih.gov/pubmed/16096382
(10m) http://www.ncbi.nlm.nih.gov/pubmed/8420252
(10n) http://www.ncbi.nlm.nih.gov/pubmed/19451485
(11) http://www.ncbi.nlm.nih.gov/pubmed/23256126
(12) http://www.ncbi.nlm.nih.gov/pubmed/23197980
(12a) http://www.ncbi.nlm.nih.gov/pubmed/19679899
(13) http://www.ncbi.nlm.nih.gov/pubmed/19170191
(14) http://www.ncbi.nlm.nih.gov/pubmed/21191306
(15) http://www.ncbi.nlm.nih.gov/pubmed/19634596
Causes
A.1. Causes The causes of colitis as a result of types
A.1.1. Inflammatory bowel disease (IBD)(Ulcerative colitis and Crohn's disease)
1. Ulcerative colitis
The pathogenesis of inflammatory bowel disease (IBD) is multifactorial, with some patients presenting additional autoimmune symptoms.. In the study to describe these features, in order to differentiate a subgroup of colitis associated with autoimmunity (CAI) from CUC and 28 consecutive children with inflammatory colitis associated with primary sclerosing cholangitis (PSC), celiac disease, or AI hepatitis were compared with a matched control group of 27 children with isolated UC., by the Hôpital Necker-Enfants Malades, Service de Gastroentérologie pédiatrique, showed that in CAI the main digestive symptoms at disease onset were abdominal pain (12/28) and bloody strings in the stool (12/28), along with a high prevalence of autoimmune diseases in relatives, as compared with bloody diarrhea in the ulcerative colitis (CUC) group (26/27)(9a).
2. Crohn's disease
Crohn's disease and ulcerative colitis evolve with a relapsing and remitting course. In the study of included 63 ulcerative colitis (UC) and 41 Crohn's disease (CD) patients. Forty-seven healthy patients were included as the control group for the determination of the frequency and factors of prolonged QT dispersion that may lead to severe ventricular arrhythmias in patients with inflammatory bowel disease (IBD), indicated that prolonged QTcd was found in 12.2% of UC patients, and in 14.5% of CD patients compared with the control group (P < 0.05). A significant difference was found between the insulin values (CD: 10.95 ± 6.10 vs 6.44 ± 3.28, P < 0.05; UC: 10.88 ± 7.19 vs 7.20 ± 4.54, P < 0.05) and HOMA (CD: 2.56 ± 1.43 vs 1.42 ± 0.75, P < 0.05; UC: 2.94 ± 1.88 vs 1.90 ± 1.09, P < 0.05) in UC and CD patients with and without prolonged QTcd(9b).
A.1.2. Microscopic colitis (Collagenous and lymphocytic colitis)
Microscopic colitis may be defined as a clinical syndrome, of unknown etiology, consisting of chronic watery diarrhea, with no alterations in the large bowel at the endoscopic and radiologic evaluation. According to the study by University of Sacred Heart, the epidemiological impact of this disease has become increasingly clear in the last years, with most data coming from Western countries. Microscopic colitis includes two histological subtypes [collagenous colitis (CC) and lymphocytic colitis (LC)] with no differences in clinical presentation and management(10).
Other researchers indicated that Collagenous and lymphocytic colitis are well-described conditions causing chronic watery diarrhoea. A peak incidence from 60 to 70 years of age with a female predominance mainly in collagenous colitis is observed. Both conditions are characterised by a (near) normal colonoscopy, but with specific histologic findings on colonic biopsies. Histopathologically, both conditions are characterised by distinct epithelial abnormalities and a dense lymphoplasmocytic infiltrate. Distinct features consist of a characteristic collagen band deposition in the subepithelial layer in collagenous colitis and a markedly increased number of intra-epithelial lymphocytes in lymphocytic colitis(10a)
a. Collagenous colitis (CC)
Collagenous colitis (CC), a form of microscopic colitis, is characterized by a thick subepithelial collagen layer in the colon in the presence of chronic nonbloody watery diarrhoea and macroscopically normal-appearing colonic mucosa. According to the Hepatology and Nutrition, The Hospital for Sick Children, typically affecting elderly adults, CC is rare in children with only 12 cases previously reported in the literature, but we report a case of a 4-year-old girl with CC associated with eosinophilic gastritis(10b).
b. Lymphocytic colitis
In the study to evaluate the biopsy specimens from the terminal ileum of 32 patients with the histopathological diagnosis of lymphocytic colitis or collagenous colitis and 11 control individuals for the presence or absence of ileal mucosal abnormalities and for the number of intraepithelial lymphocytes, assessed by immunohistochemical stains for the pan T-cell marker, CD3, showed that the mean CD3 counts in patients with lymphocytic/collagenous colitis were significantly higher than those in the control group. Seven of 14 patients with collagenous colitis and 14 of 18 patients with lymphocytic colitis revealed an increase in intraepithelial T lymphocytes when compared with the control group (P =.001). Other notable changes included ileal villous atrophy in one case of lymphocytic colitis and in three cases of collagenous colitis and epithelial damage with thickened subepithelial collagen in two cases of collagenous colitis(10c).
A.1.3. Iatrogenesis
May be as a result of chance, medical error, negligence, social control, unexamined instrument design, etc.
1. Diversion colitis
Diversion colitis frequently develops in segments of the colorectum after surgical diversion of the fecal stream; it persists indefinitely unless the excluded segment is reanastomosed. The disease is characterized by bleeding from inflamed colonic mucosa that mimics the bleeding of idiopathic inflammatory bowel disease, and it may culminate in stricture formation. Histologic observation revealed a distinctive type of mucosal inflammation that resolved more slowly and less completely than the gross appearance of the inflamed mucosa. From these preliminary studies we infer that diversion colitis may represent an inflammatory state resulting from a nutritional deficiency in the lumen of the colonic epithelium, which is effectively treated by local application of short-chain fatty acids, the missing nutrients, according to the study by Department of Medicine, Medical College of Wisconsin(10d)
2. Chemical colitis
Chemical colitis can occur as a result of accidental contamination of endoscopes or by intentional or accidental administration of enemas containing various chemicals. Most cases have occurred after accidental contamination of endoscopes with glutaraldehyde and/or hydrogen peroxide. There have been multiple case reports of chemical colitis resulting from unintentional administration of caustic chemicals. Intentional administration of corrosive enemas has been implicated in sexual practices, bowel cleansing, or in suicide attempts. Patients present with nonspecific symptoms including abdominal pain, rectal bleeding, and/or diarrhea, according to the study byStanford University School of Medicine, Stanford(10e).
A.1.4. Ischemic colitis
Ischemic colitis is the most common form of ischemic injury of the gastrointestinal tract and can present either as an occlusive or a non-occlusive form. It accounts for 1 in 1000 hospitalizations but its incidence is underestimated because it often has a mild and transient nature. The etiology of ischemic colitis is multifactorial and the clinical presentation variable, according to the study by
Gastroenterology Unit Venizelion General Hospital of Heraklion(10f). Other study indicated that ischemic colitis is the most common manifestation of gastrointestinal ischemia. The presumed etiologies are numerous; however, it typically develops spontaneously. It is classified into the transient type, stricture type, and gangrenous type. The majority of patients with ischemic colitis, excluding the gangrenous type, follow a benign clinical course in the absence of major vasculature occlusion. It usually presents as an acute abdominal illness with bloody diarrhea(10g).
A.1.5. Infectious colitis (Clostridium difficile colitis)
In the study of diagnosis of Clostridium difficile colitis is increasing in frequency, with worsening patient outcomes of the data of one hundred fifty-seven patients diagnosed with C difficile colitis between 1994-2000., conducted by University of Washington, showed that the frequency of C difficile colitis remains high and seems to be associated with increasing mortality. Among patients with positive C difficile toxin assay results, immunocompromise and delayed diagnosis no longer seem to be associated with higher risk for death. All patients taking antibiotics are at risk and require early recognition and aggressive medical intervention(10h). Also according to the study by Baylor College of Medicine and Kelsey Research Foundation, infectious colitis is diagnosed in someone with diarrhea and one or more of the following: fever and/or dysentery, stools containing inflammatory markers such as leukocytes, lactoferrin, or calprotectin, or positive stool culture for an invasive or inflammatory bacterial enteropathogen including Shigella, Salmonella, Campylobacter, Shiga toxin-producing Escherichia coli (STEC) or Clostridium difficile, or colonic inflammation by endoscopy(10i).
A.1.6. Indeterminate colitis and Atypical colitis
1. Indeterminate colitis(IC)
The term indeterminate colitis (IC) is an interim, or preliminary, descriptive term used by pathologists for cases of inflammatory bowel disease (IBD) in which a definite diagnosis of ulcerative colitis (UC) or Crohn's disease (CD) cannot be established based on the information available at the time of surgical sign-out. Most cases are due to fulminant ulcerative colitis, a condition in which the classic pathologic features of UC are often obscured and may overlap with CD. For instance, fulminant UC may show early superficial fissuring ulceration, transmural lymphoid aggregates and relative rectal sparing, simulating CD. Other common causes for establishing a diagnosis of IC include confusion of backwash ileitis in UC for terminal ileal involvement in CD, failure to accept hard criteria, such as granulomas, or segmental disease, as representative of CD, and failure to recognize unusual variants of UC that can cause CD-like patchiness of disease(10k).
Approximately 4% to 5% of all patients with inflammatory bowel disease will be left with the diagnosis of IC. A diagnosis of indeterminate colitis (IC) is based on endoscopic, histologic, and radiologic findings when the criteria for either Crohn's colitis or ulcerative colitis (UC) cannot be definitively established. Population-based studies have demonstrated that the average annual incidence of IC ranges 1.6 to 2.4/100,000 versus 7.3 to 13.6/100,000 for UC. At the time of initial diagnosis of inflammatory bowel disease, up to 10% to 15% of patients will be diagnosed as having IC, according to the study by Brigham and Women's Hospital(10j).
2. Atypical colitis
Atypical colitis is a phrase used to define a colitis that does not conform to criteria for accepted types of colitis. By considering the clinical history and symptoms, the pathologist should be able to reach the correct diagnosis in most cases. However, the spectrum of morphologic changes associated with watery diarrhea syndrome appears to be broader than originally thought. Morphologic changes more often associated with chronic inflammatory bowel disease or even chronic ischemic or infectious colitis have been noted in patients with clinically established microscopic colitis, according to the study by St. Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust(10l).
A.1.7. Fulminant colitis
Fulminant colitis is defined as any colitis that has become worse rapidly.
There is a report of a 33-yr-old white male presented with bloody diarrhea, leukocytosis, and left lower quadrant direct and rebound tenderness after a self-administered concentrated hydrofluoric acid enema while intoxicated from intranasal cocaine administration. Intraoperative flexible sigmoidoscopy and a gastrografin enema revealed severe mucosal ulceration and edema in the rectum and sigmoid colon. Laparotomy revealed an ulcerated, necrotic, and purulent sigmoid colon and intraperitoneal pus(10m).
Other in the review of the records of 4796 inpatients diagnosed as having C difficile colitis from January 1, 1996, to December 31, 2007, and identified 199 (4.1%) with fulminant C difficile colitis, as defined by the need for colectomy or admission to the intensive care unit for C difficile colitis, showed that the inhospital mortality rate for fulminant C difficile colitis was 34.7%. Independent predictors of mortality included the following: (1) age of 70 years or older, (2) severe leukocytosis or leukopenia (white blood cell count, >or=35 000/microL or <4000/microL) or bandemia (neutrophil bands, >or=10%), and (3) cardiorespiratory failure (intubation or vasopressors). When all 3 factors were present, the mortality rate was 57.1%; when all 3 were absent, the mortality rate was 0%. Patients who underwent colectomy had a trend toward decreased mortality rates (odds ratio, 0.49; 95% confidence interval, 0.21-1.1; P = .08). Among patients admitted primarily for fulminant C difficile colitis, care in the surgical department compared with the nonsurgical department resulted in a higher rate of operation (85.1% vs 11.2%; P < .001) and lower mortality rates (12.8% vs 39.3%; P = .001). Patients admitted directly to the surgical department had a shorter mean (SD) interval from admission to operation (0 vs 1.7 [2.8] days; P = .001)(10n).
A.2. Other causes
2. Sarcoidosis
Although clinically recognizable gastrointestinal (GI) system involvement with sarcoidosis is extremely rare, we report a case of a 51-year-old Caucasian male granulomatous as a result of Sarcoidosis. Enterocolitis Colonoscopy showed scattered right colon ulcerations and erythema. The terminal ileum appeared normal. Biopsies from the duodenum, terminal ileum, and colon showed intramucosal non-caseating granulomas with focal multinucleate giant cell formation in a background of chronic active duodenitis, ileitis, and colitis. Liver biopsy showed moderate non-specific chronic hepatitis with non-caseating granulomas present within portal and lobular parenchyma. The clinical presentations, along with biopsy results were suggestive of sarcoidosis(11).
3. Low level of both serum and tissue PON1
PON1 is known as an HDL-associated antioxidant enzyme that inhibits the oxidative modification of LDL and oxidative stress plays a role in the pathogenesis of mesenteric ischemia. According to the study to investigate the changes in PON1 activity and lipid profile in an experimental ischemic colitis model of 45male Wistar albino rats, showed that there was a significant decrease in both serum and tissue PON1 activity in ischemic colitis group (P < 0.01, for each). Similarly, arylesterase levels showed a parallel decrease in both tissue and serum of the experimental group (P < 0.01 and P < 0.001, retrospectively). MDA, an oxidative stress marker, was seen to increase in the experimental group (P < 0.01, tissue; P < 0.05, serum). In experimental group, there was a significant rise in serum total cholesterol and LDL levels (P < 0.001, for each). However, HDL level decreased significantly (P < 0.001). Triglycerides did not show any change between the groups (P > 0.05)(12).
4. Smoking, dehydration, NSAID (non-steroidal anti-inflammatory drugs) use, constipation and contraceptive use
Pathophysiology of ischemic colitis in young people is in most cases unknown. Possible contributing factors in our study were smoking, dehydration, NSAID (non-steroidal anti-inflammatory drugs) use, constipation and contraceptive use. (13a). But epidemiologic data suggest that smoking increases the risk and the severity of Crohn's disease (CD), although it may protect patients with ulcerative colitis (UC)(13), but others found no detrimental effects of smoking on the disease course of CD and no clear beneficial effects on the course of UC(14).
5. Anemia
Sickle cell-induced ischemic colitis is a rare yet potentially fatal complication of sickle cell anemia. there is a report of a 29-year-old female with sickle cell disease who was admitted with left lower quadrant abdominal pain. A diagnostic workup, including chemistries, complete blood count, blood cultures, chest x-ray, computerized tomography scanning, and colonoscopy, was performed to identify the etiology of her symptoms. This case highlights the importance of differentiating simple pain crisis from more serious and life-threatening ischemic bowel(15).
6. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
Sources
(9a) http://www.ncbi.nlm.nih.gov/pubmed/22238154
(9b) http://www.ncbi.nlm.nih.gov/pubmed/23326164
(10) http://www.ncbi.nlm.nih.gov/pubmed/23180940
(10a) http://www.ncbi.nlm.nih.gov/pubmed/20203510
(10b) http://www.ncbi.nlm.nih.gov/pubmed/17718794
(10c) http://www.ncbi.nlm.nih.gov/pubmed/12591963
(10d) http://www.ncbi.nlm.nih.gov/pubmed/2909876
(10e) http://www.ncbi.nlm.nih.gov/pubmed/18209577
(10f) http://www.ncbi.nlm.nih.gov/pubmed/19109863
(10g) http://www.ncbi.nlm.nih.gov/pubmed/10412155
(10h) http://www.ncbi.nlm.nih.gov/pubmed/12361411
(10i) http://www.ncbi.nlm.nih.gov/pubmed/22080825
(10j) http://www.ncbi.nlm.nih.gov/pubmed/15115931
(10k) http://www.ncbi.nlm.nih.gov/pubmed/15115930
(10l) http://www.ncbi.nlm.nih.gov/pubmed/16096382
(10m) http://www.ncbi.nlm.nih.gov/pubmed/8420252
(10n) http://www.ncbi.nlm.nih.gov/pubmed/19451485
(11) http://www.ncbi.nlm.nih.gov/pubmed/23256126
(12) http://www.ncbi.nlm.nih.gov/pubmed/23197980
(12a) http://www.ncbi.nlm.nih.gov/pubmed/19679899
(13) http://www.ncbi.nlm.nih.gov/pubmed/19170191
(14) http://www.ncbi.nlm.nih.gov/pubmed/21191306
(15) http://www.ncbi.nlm.nih.gov/pubmed/19634596
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