Appendicitis: Complications and Diseases associated to Appendicitis

Appendicitis is defined as a condition of inflammation of Appendix. It is classified as an emergency, in many required the removal of the appendix. If burst, or perforate, spilling infectious materials into the abdominal cavity can be life threatening.
III. Complications and Diseases associated to Appendicitis
A. Complications
1. Pyogenic liver abscess [PLA]
Pyogenic liver abscess [PLA] is a rare and life-threatening disease in children. Appendicitis was the leading source of PLA in the pre-antibiotic era, but it essentially has been eliminated in recent times. There is a report of a 12-year old girl with PLA after laparotomy for perforated appendix. She developed persistent fever and respiratory distress post operatively. Physicians had an impression of pneumonia but abdominal ultrasound showed cystic mass with mobile internal echoes within the right lobe of the liver suggesting an abscess. Patient was successfully managed by percutaneous drainage under ultrasound guidance(16).
2. A ruptured appendix
Although the finding of appendiceal duplication is uncommon, its misdiagnosis and mismanagement may yield poor clinical outcomes and serious medicolegal consequences. Laparoscopic surgical exploration was performed on a 17-year-old male patient with right lower quadrant pain and a history of a previous appendectomy. Inspection of the cecum revealed a second appendix, which was retrocecal, ruptured, and gangrenous(17). Other study found that appendicitis is the most common abdominal condition leading to urgent surgery in children. With the goal of identifying signs and symptoms that will allow prompt diagnosis of rupture of the appendix and thus decrease associated morbidities, our aim was to determine factors associated with ruptured appendicitis in children diagnosed with appendicitis(17).
B. Diseases associated to Appendicitis
1. Thoracic empyema
Appendicitis and thoracic empyema are rarely presented together. There is a report of a thoracic empyema due to bacterial translocation in a patient, after she underwent appendicectomy for nonperforated acute appendicitis, according tp the Ankara Training and Research Hospital(18).
2. De Garengeot hernia
he presence of the appendix within a femoral hernia sac is a rare condition known as De Garengeot hernia. There is a report of a case of De Garengeot hernia with concomitant appendicitis, according to the University of Cagliari(19).
3. Simultaneous Meckel’s diverticulitis
There is a report a case of a 24-year-old woman who was delivered via cesarean section at 39 weeks and presented in the puerperium with symptoms of worsening abdominal pain and septicaemia. Preoperative ultrasonography suggested the presence of a pelvic collection. Explorative laparotomy revealed the simultaneous presence of Meckel’s diverticulitis and appendicitis without bowel perforation(20).
4. Acute myeloid leukemia
There is a report of a 59-year-old Caucasian female was admitted to the surgical service with acute right lower quadrant pain, nausea, and anorexia. She was noted to have leukocytosis, anemia, and thrombocytopenia. Abdominal imaging demonstrated appendicitis with retroperitoneal and mesenteric lymphadenopathy for which she underwent laparoscopic appendectomy. Peripheral smear, bone marrow biopsy, and surgical pathology of the appendix demonstrated acute myeloid leukemia (AML) with nonsuppurative appendicitis(21).
5. Leukemia and lymphoma of the appendix
There is a report of a first detailed description of acute myeloid leukaemia involving the appendix, and three cases of lymphomatous infiltration of the appendix presenting with appendicitis(22).
6. Adenocarcinoma
Acute inflammation of the appendix secondary to luminal obstruction is the chief reason for appendectomy. The rare association of a malignant neoplastic process with the inflammatory process is usually an unexpected finding and is often not diagnosed until the histologic study has been completed. There is a report of two patients with adenocarcinoma of the appendix(23).
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Sources
(16) http://www.ncbi.nlm.nih.gov/pubmed/19606202
(17) http://www.ncbi.nlm.nih.gov/pubmed/22531191
(18) http://www.ncbi.nlm.nih.gov/pubmed/23581268
(19) http://www.ncbi.nlm.nih.gov/pubmed/23578413
(20) http://www.ncbi.nlm.nih.gov/pubmed/23578408
(21) http://www.ncbi.nlm.nih.gov/pubmed/23840984
(22) http://www.ncbi.nlm.nih.gov/pubmed/9393590
(23) http://www.ncbi.nlm.nih.gov/pubmed/7069092

Appendicitis:The Causes and risk factors

Appendicitis is defined as a condition of inflammation of Appendix. It is classified as an emergency, in many required the removal of the appendix. If burst, or perforate, spilling infectious materials into the abdominal cavity can be life threatening.
II. Causes and risk factors
A. Causes
The cause of appendicitis is the result of blockage by stool, a foreign body, or cancer of that can lead to infection.
1, Bacterial, viral and parasitic infiection
According to the study by the, the pathologic spectrum of the inflamed appendix encompasses a wide range of infectious entities, some with specific histologic findings, and others with nonspecific findings that may require an extensive diagnostic evaluation. The appendix is exclusively involved in some of these disorders, and in others may be involved through extension from other areas of the gastrointestinal tract(4). Other sin the study to investigate the role of parasitic infestation in the etiology of acute pediatric appendicitis, indicated that parasites were present in 5.5% (88 patients), and of those 88 parasitic infestations, 45 (51.1%) were Enterobaisis, 8 (9.1%) were Schistosomiasis, 23 (26.1%) were Ascariasis, 7 (8%) Trichuriasis, and 5 (5.7%) were Teania Saginata. The percentage of patients with suppurative, gangrenous or perforated appendicitis was similar in both groups with no statistical significance, irrespective of the presence or absence of parasitic infestation(5).
2. Foreign objects
Appendicitis and its complications remain a common problem affecting patients of all age groups. Appendicitis due to foreign bodies is rare and carries an estimated frequency of 0.0005%. But Aaccording to the Department of Surgery, Heilig Hart Tienen, ther is case of a 44-year-old man with appendicitis induced by an appendicolith containing eight steel shotgun pellets. The man was a recreational hunter and for the past 20 years he consumed wild game on a regular basis(6).
B. Risk factors
1. Age 10 × 103/mm
In the study to evaluate the impact of timing of appendectomy and other potential risk factors on progression of acute appendicitis, by searching the relevant databases of a tertiary medical center identified 1,604 patients with verified acute appendicitis who underwent appendectomy in 2004-2007with demographic and clinical data and time from symptom onset to emergency room admission (“patient interval”) and from emergency room admission to surgery (“hospital interval”) and their combination were analyzed by pathological grade, indicated that on multivariate analyses, independent risk factors for appendiceal perforation were age 50 years (OR = 2.84, 95 % CI 1.82-4.45) (relative to 20-50 years), white cell count >10 × 103/mm(3) (OR = 4.45, 95 % CI 2.05-9.67), body temperature >37.8 °C (OR = 2.23, 95 % CI 1.45-3.41), hospital interval >24 h (OR = 2.84, 95 % CI 1.49-5.4), patient interval >48 h (OR = 3.84, 95 % CI 2.35-6.29), and combined interval >48 h (OR = 4.29, 95 % CI 2.2-8.36)(7).
2. Gender different, among young
According to study appendicitis is common among young, healthy populations; appendectomy is one of the most common surgical procedures performed in the United States. Among active and reserve component members, there were 31,610 cases of appendicitis and 30,183 appendectomies during 2002 to 2011. The overall incidence rate of appendicitis in the active component was 18.4 per 10,000 person-years (p-yrs). Active component males reported greater rates of perforated appendicitis (2.6 per 10,000 p-yrs). Active component females had higher rates of incidental appendectomies (2.6 per 10,000 p-yrs)(8).
3. Race, increased over time and is higher in the summer months
Appendicitis is most common in whites and Hispanics and less common in African Americans and Asians and incidence has increased over time and is higher in the summer months, according to the study by the University of California San Diego(9).
4. Prior antibiotic administration
Prior treatment with antibiotics was an independent risk factor for therapeutic delay in pediatric AA, according to the study by the National Center for Child Health and Development, Tokyo(10).
5. Decreased bowel sounds; rebound tenderness; and presence of psoas, obturator, or Rovsing’s signs
Factors associated with an increased likelihood of appendicitis included decreased bowel sounds; rebound tenderness; and presence of psoas, obturator, or Rovsing’s signs(11).
6. In patients with end-stage renal disease
The independent risk factors were atrial fibrillation (hazard ratio [HR], 2.08), severe liver disease (HR, 1.74), diabetes mellitus (HR, 1.58), and hemodialysis (HR, 1.74), according to the study by the Taipei Medical University(12).
7. Severity of inflammation
CRP concentration may be a potent objective predictor of pathological severity in appendicitis. Combination with the other diagnostic modalities may improve the diagnostic accuracy in predicting the severity of appendicitis(13).
8. Other risk factors
The principal factors contributing to perforation of appendix are: age of children, delays of surgical intervention, family anamnesis, social group and late recognition of symptoms of appendicitis(14).
9. Appendicolith
Presence of an appendicolith was associated with a 72% rate of recurrent appendicitis compared with a recurrence rate of 26% in those with no appendicolith (chi2 test, P < .004)(15).
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Sources
(5) http://www.ncbi.nlm.nih.gov/pubmed/23599875
(6) http://www.ncbi.nlm.nih.gov/pubmed/23397832
(7) http://www.ncbi.nlm.nih.gov/pubmed/23374326
(8) http://www.ncbi.nlm.nih.gov/pubmed/23311330
(9) http://www.ncbi.nlm.nih.gov/pubmed/22948195
(10) http://www.ncbi.nlm.nih.gov/pubmed/22858754
(11) http://www.ncbi.nlm.nih.gov/pubmed/22849662
(12) http://www.ncbi.nlm.nih.gov/pubmed/22777056
(13) http://www.ncbi.nlm.nih.gov/pubmed/22234068
(14) http://www.ncbi.nlm.nih.gov/pubmed/10965688
(15) http://www.ncbi.nlm.nih.gov/pubmed/16226993

Appendicitis: The Signs and Symptoms

Appendicitis is defined as a condition of inflammation of Appendix. It is classified as an emergency, in many required the removal of the appendix. If burst, or perforate, spilling infectious materials into the abdominal cavity can be life threatening.
I. Signs and Symptoms
1. Abdominal pain and upper respiratory tract infection
Although appendicitis is the condition that most commonly requires emergent abdominal surgery in the paediatric population, less than 2% of the disease occurs in infants and it is even more uncommon in neonates. There is report of a rare case of a 14-month-old child presenting with abdominal pain first diagnosed with upper respiratory tract infection and then admitted to our Paediatric Surgery Department with a final diagnosis of acute appendicitis, according to the FONDAZIONE IRCCS CA’ GRANDA – Ospedale Maggiore Policlinico(1).
2. Vomiting,fever, pain, anorexia, diarrhea, abdominal tenderness, peritonitis, temperature 38.0 degrees C or more, abdominal distension, Leukocytosis, small-bowel obstruction (SBO), Contrast enemas and Perforated appendicitis
In the study to identify the presenting symptoms and signs in this age group and examine their subsequent management and outcome, by the The Scarborough Hospital, indicated that in 27 children less than 3 years old (mean 23 months) comprised 2.3% of all children with appendicitis in the series, the most common presenting symptoms were vomiting (27), fever (23), pain (21), anorexia (15), and diarrhea (11). The average duration of symptoms was 3 days, with 4 or more days in 9 children. Eighteen children were seen by a physician before the correct diagnosis was made; 14 were initially treated for an upper respiratory tract infection, otitis media, or a urinary tract infection. The most common presenting signs were abdominal tenderness (27), peritonitis (24), temperature 38.0 degrees C or more (21), abdominal distension (18), Leukocytosis (<12.0 x 10(3)/mm(3)) was found in 18, tenderness was localized to the right lower quadrant (RLQ) in 14 and was diffuse in 10. Abdominal radiographs demonstrated findings of a small-bowel obstruction (SBO) in 14 of 21 patients, a fecalith in 2, and a pneumoperitoneum in 1. Contrast enemas were performed in 6 children, 5 of whom had a phlegmon or an abscess. Perforated appendicitis was found in all 27 patients. An appendectomy was performed in 25 and a RLQ drain was placed in 18(2).
3. An abdominal mass, guarding, rebound tenderness, rigidity, diffuse or focal tenderness, diarrhea, emesis, fever, pain, and anorexia
According to the Children's Hospital of Philadelphia, the common physical signs of an abdominal mass, guarding, rebound tenderness, rigidity, and diffuse or focal tenderness and common symptoms are diarrhea, emesis, fever, pain, and anorexia with the most common presenting symptom was abdominal pain (94%); the most common sign was abdominal tenderness (95.8%)(3)
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(1) http://www.ncbi.nlm.nih.gov/pubmed/22878766
(2) http://www.ncbi.nlm.nih.gov/pubmed/14730382
(3) http://www.ncbi.nlm.nih.gov/pubmed/10888451

Proctitis – Proctitis Treatments In Herbal medicine perspective

Proctitis is is defined as a condition of inflammation of the anus and the lining of the rectum (i.e., the distal 10–12 cm) of that can lead to bowl discomfort, bleeding, a discharge of mucus or pus, etc.
VI. Treatments
B. In Herbal medicine perspective
The aim of herbal treatment is strenghten the immune sytem of the body to fight off the invasion of bacterial causes of the diseases
1. Echinacea, Ashwagandha and Brahmi
Herbs, as food or medicine, can strengthen the body and increase its resistance to illnesses by acting on various components of the immune system. In the study to compare the efficacy of Echinacea, Ashwagandha and Brahmi in strenghten the immune system, showed that Herbal remedies based on Echinacea, Brahmi, or Ashwagandha can enhance immune function by increasing immunoglobulin production. Furthermore, these herbal medicines might regulate antibody production by augmenting both Th1 and Th2 cytokine production(49).
2. Cinnamon
In administration of popular herb used in traditional medicine to treat various disorders such as chronic gastric symptoms, arthritis, and the common cold and its immunomodulatory effect found that observations provided evidence that CWE was able to down-regulate IFN-γ expression in activated T cells without altering IL-2 production, involving inhibition of p38, JNK, ERK1/2, and STAT4, according to the study of “Immunomodulatory effect of water extract of cinnamon on anti-CD3-induced cytokine responses and p38, JNK, ERK1/2, and STAT4 activation” by Lee BJ, Kim YJ, Cho DH, Sohn NW, Kang H. (50)
. Other in the observation of three natural essential oils (i.e., clove bud oil, cinnamon oil, and star anise oil) and their antimicrobal effects found that the cinnamon oil-chitosan film had also better antimicrobial activity than the clove bud oil-chitosan film. The results also showed that the compatibility of cinnamon oil with chitosan in film formation was better than that of the clove bud oil with chitosan, according to the study of “Synergistic Antimicrobial Activities of Natural Essential Oils with Chitosan Films” by Wang L, Liu F, Jiang Y, Chai Z, Li P, Cheng Y, Jing H, Leng X.(51)
3. Green Tea
In the assessment of unregulated activity of these receptors could lead to autoimmune diseases and the effects of green tea catechin, epigallocatechin gallate of the study of “Green tea catechin, epigallocatechin gallate, suppresses signaling by the dsRNA innate immune receptor RIG-I.” by Ranjith-Kumar CT, Lai Y, Sarisky RT, Cheng Kao C., researchers found that EGCG and its derivatives could have potential therapeutic use as a modulator of RIG-I mediated immune responses by binding RIG-I and inhibits its signaling at low micromolar concentrations in HEK293T cells(52)
Other In the observation of green tea and rosemary leaf powders on the growth of microorganisms of the study of “Inhibitory effect of commercial green tea and rosemary leaf powders on the growth of foodborne pathogens in laboratory media and oriental-style rice cakes’ by Lee SY, Gwon SY, Kim SJ, Moon BK.[13c], researchers indicated that 1 or 3% green tea or rosemary to rice cakes did not significantly reduce total aerobic counts; however, levels of B. cereus and S. aureus were significantly reduced in rice cakes stored for 3 days at room temperature (22 degrees C) and that suggested the use of natural plant materials such as green tea and rosemary could improve the microbial quality of foods in addition to their functional properties(53).
4. Turmeric
Turmeric is a perennial plant in the genus Curcuma, belonging to the family Zingiberaceae, native to tropical South Asia. The herb has been used in trditional medicine as anti-oxidant, hypoglycemic, colorant, antiseptic, wound healing agent, and to treat flatulence, bloating, and appetite loss, ulcers, eczema, inflammations, etc.
In the explore more systematically in various diseases of curcumin’s therapeutic promise,
indicated that curcumin may be particularly suited to be developed to treat gastrointestinal diseases. This review summarizes some of the current literature of curcumin’s anti-inflammatory, anti-oxidant and anti-cancer potential in inflammatory bowel diseases, hepatic fibrosis and gastrointestinal cancers, according to “Therapeutic potential of curcumin in gastrointestinal diseases” by Rajasekaran SA(54).
Other In the research of a literature search (PubMed) of almost 1500 papers dealing with curcumin, most from recent years, with ll available abstracts were read and pproximately 300 full papers were reviewed, found that curcumin, a component of turmeric, has been shown to be non-toxic, to have antioxidant activity, and to inhibit such mediators of inflammation as NFkappaB, cyclooxygenase-2 (COX-2), lipooxygenase (LOX), and inducible nitric oxide synthase (iNOS). Significant preventive and/or curative effects have been observed in experimental animal models of a number of diseases, including arteriosclerosis, cancer, diabetes, respiratory, hepatic, pancreatic, intestinal and gastric diseases, neurodegenerative and eye diseases, “Curcumin, an atoxic antioxidant and natural NFkappaB, cyclooxygenase-2, lipooxygenase, and inducible nitric oxide synthase inhibitor: a shield against acute and chronic diseases” by Bengmark S(55).
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(49) http://www.ncbi.nlm.nih.gov/pubmed/21619924
(50) http://www.ncbi.nlm.nih.gov/pubmed/22053946
(51) http://www.ncbi.nlm.nih.gov/pubmed/22034912
(52) http://www.ncbi.nlm.nih.gov/pubmed/20877565
(53) http://www.ncbi.nlm.nih.gov/pubmed/19517743
(54) http://www.ncbi.nlm.nih.gov/pubmed/21607160
(55) http://www.ncbi.nlm.nih.gov/pubmed/16387899

About kylenorton

All rights reserved. Any reproducing of this article must have the author name and all the links intact. "Let Take Care Your Health, Your Health Will Take Care You" Kyle J. Norton I have been studying natural remedies for disease prevention for over 20 years and working as a financial consultant since 1990. Master degree in Mathematics, teaching and tutoring math at colleges and universities before joining insurance industries. Part time Health, Insurance and Entertainment Article Writer.

Proctitis – Proctitis Treatments In traditional Chinese medicine perspective

Proctitis is is defined as a condition of inflammation of the anus and the lining of the rectum (i.e., the distal 10–12 cm) of that can lead to bowl discomfort, bleeding, a discharge of mucus or pus, etc.
VI. Treatments
C. In traditional Chinese medicine perspective
1. Xilei-san
Xilei-san is a traditional Chinese herbal medicine that has proven to be of possible use in the treatment of ulcerative proctitis. In the study to compare the efficacy of Xilei-san with dexamethasone enemas in subjects with mild-to-moderate active UP, showed that Xilei-san enemas are comparable to dexamethasone enemas in this study. This medicine is safe, well accepted, and may be an alternative drug in the treatment of mild-to-moderate active UP(56).
2. The Erkang capsule
Shi-Quan-Da-Bu-Tang is a traditional Chinese herbal medicine formula used to increase vital energy, and strengthen health and immunity. The Erkang capsule is a modified formula of Shi-Quan-Da-Bu-Tang, with the addition of four other herbs to increase the adaptogen effects and ergogenic properties. In mice study, the Erkang treated group had significant differences in mortality, body weight change, fatigue, cold temperature endurance, and immune function related organ weight change, compared to the control animals(57).
3. Lingzhi
Reishi mushroom or Lingzhi is a fungal species in the genus Ganoderma, belonging to the family Ganodermataceae, native to Asia. The herb has been use in traditional medicine as anti-caners and anti inflammatory, antioxdant agent and to enhance immune function, treat hepatitis B virus, protect against neuron degeneration, etc. In the demonstration of Ganoderma lucidum, a medicinal fungus is thought to possess and enhance a variety of human immune functions, found that Our current results of analyzing rLZ-8-mediated signal transduction in T cells might provide a potential application for rLZ-8 as a pharmacological immune-modulating agent, according to “Reishi immuno-modulation protein induces interleukin-2 expression via protein kinase-dependent signaling pathways within human T cells” by Hsu HY, Hua KF, Wu WC, Hsu J, Weng ST, Lin TL, Liu CY, Hseu RS, Huang CT(58). Other In the investigation of the water-soluble, polysaccharide components of Reishi (designated as MAK) in murine colitis induced by trinitrobenzene sulphonic acid (TNBS), found that MAK-stimulated PMs produced GM-CSF in a dose-dependent manner. Intestinal inflammation by TNBS was improved by feeding with MAK. MLNs of mice treated with TNBS produced IFN-γ, which was inhibited by feeding with MAK. In contrast, MLNs of mice treated with TNBS inhibited GM-CSF production, which was induced by feeding with MAK and conculded that that the induction of GM-CSF by MAK may provide the anti-inflammatory effect, according to “The water-soluble extract from cultured medium of Ganoderma lucidum (Reishi) mycelia (Designated as MAK) ameliorates murine colitis induced by trinitrobenzene sulphonic acid” by Hanaoka R, Ueno Y, Tanaka S, Nagai K, Onitake T, Yoshioka K, Chayama K(59).
4. Ren Shen
Ren Shen is also known as Gingshen. The smells aromatic, tastes sweet and slightly warm herbs had been used in TCM as improved immune system, Anti Cancer, Anti aging, Anti stress, etc. agent and to generates fluids and reduce thirst, for xinqixu (heart qi deficient) palpitations with instant sweating and anxiety, insomnia, dizziness/headache, forgetfulness, impotence, diabetes, bleeding in the vagina not during period, seizures in children, chronic weakness, etc. as it strongly tonifies Original Qi, tonifies the Spleen and the Lungs, promotes generation of Body Fluids, calms thirs and the Mind, etc. by enhancing the functions of spleen and lung. In the study of Water-soluble ginseng oligosaccharides (designated as WGOS) with a degree of polymerization ranging from 2 to 10 were obtained from warm-water extract of Panax ginseng roots, found that WGOS were potent B and T-cell stimulators and WGOS-1 has the highest immunostimulating effect on lymphocyte proliferation among those purified fractions. It is hoped that the WGOS will be developed into functional food or medicine, according to “Structural characterization and immunological activities of the water-soluble oligosaccharides isolated from the Panax ginseng roots” by Wan D, Jiao L, Yang H, Liu S(60). Other In the evaluation of the extraction conditions of polysaccharides from the rhizomes of Panax japonicus C.A. Meyer and its antioxidant effect found that antioxidant activity exhibited Panax japonicus polysaccharides (PJP) had a good potential for antioxidant, according to “Optimization of polysaccharides from Panax japonicus C.A. Meyer by RSM and its anti-oxidant activity” by Wang R, Chen P, Jia F, Tang J, Ma F(61).
5. Qingre Buyi Decoction
In the study to investigate the efficiency, safety, and possible mechanisms of Qingre Buyi Decoction (QBD) in the treatment of acute radiation proctitis (ARP), showed that Addition of QBD to the conventional treatment can effectively alleviate the damage of intestinal mucosal barrier function and improve all main clinical symptoms and signs of the ARP. The combination of conventional treatment with Chinese herbal medicine QBD is effective and safe for ARP.(62).
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(56) http://www.ncbi.nlm.nih.gov/pubmed/23383973
(57) http://www.ncbi.nlm.nih.gov/pubmed/9683346
(58) http://www.ncbi.nlm.nih.gov/pubmed/18189229
(59) http://www.ncbi.nlm.nih.gov/pubmed/21973321
(60) http://www.ncbi.nlm.nih.gov/pubmed/22183124
(61) http://www.ncbi.nlm.nih.gov/pubmed/22214823
(62) http://www.ncbi.nlm.nih.gov/pubmed/19688315

About kylenorton

All rights reserved. Any reproducing of this article must have the author name and all the links intact. "Let Take Care Your Health, Your Health Will Take Care You" Kyle J. Norton I have been studying natural remedies for disease prevention for over 20 years and working as a financial consultant since 1990. Master degree in Mathematics, teaching and tutoring math at colleges and universities before joining insurance industries. Part time Health, Insurance and Entertainment Article Writer.

Proctitis – Autoimmune disease Cause of proctitis Treatments In conventional medicine perspective

Proctitis is is defined as a condition of inflammation of the anus and the lining of the rectum (i.e., the distal 10–12 cm) of that can lead to bowl discomfort, bleeding, a discharge of mucus or pus, etc.
VI. Treatments
A. In conventional medicine perspective
Medical treatment of proctitis depends on the etiology
A.1.5. Autoimmune disease
Non surgical and surgical interventions
The development of ischemic colitis in patients with SLE is an uncommon complication. But widespread fibrinoid vasculitis, typical of SLE, is thought to be a likely predisposing factor. If this vasculitis involves the colon, ischemic colitis occurs. Gastrointestinal vasculitis is one of the most serious complications of SLE, even though the occurrence of colonic lesions is rare (0.2%). The gastrointestinal vasculitis of SLE is consequence of tissue damage from vasculopathy mediated by immune complexes, and has been associated with SLE activity. There are no pathognomic and histopathologic findings in SLE; however, pathologic changes associated with gastrointestinal vasculitis occur in the small vessels of the intestinal wall rather than in medium-sized mesenteric arteries. Ischemic colitis in patients with SLE is caused by decreased blood perfusion of mesenteric vasculatures. The predisposing factors are embolism, thrombosis, vasospasm, drugs (steroids and immunosuppressive agents), vasculitis, performed colonoscopy, and enema. Management of abdominal manifestations of SLE, in the absence of compelling radiographic or clinical findings suggestive of infarction or perforation, are steroid, antibiotics, and fluid therapy, According to the study by the The Catholic University of Korea(79).
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(79) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716627/

Proctitis – Sexually transmitted proctitis Treatments In conventional medicine perspective

Proctitis is is defined as a condition of inflammation of the anus and the lining of the rectum (i.e., the distal 10–12 cm) of that can lead to bowl discomfort, bleeding, a discharge of mucus or pus, etc.
VI. Treatments
A. In conventional medicine perspective
Medical treatment of proctitis depends on the etiology
A.1.4. Sexually transmitted proctitis
1. Non surgical interventions(77)
Treatment can be started empirically while awaiting the microbiological results, thus reducing inflammation, infection duration and hence infectivity of the patient. The appropriate treatment of sexually transmitted proctitis has important implications in the control of HIV by reducing both HIV transmission and susceptibility.
a. Azithromycin (1 g as a single dose) or doxycycline (100 mg twice daily for a week) is an effective treatment for chlamydia.
b. HIV‐positive men with proctitis should be treated for LGV in the first instance. The preferred treatment is doxycycline 100 mg twice daily for 3 weeks; erythromycin may be used as an alternative.
c. Homosexual men with symptomatic rectal chlamydia should be given LGV treatment until the serovar is determined.
d. The treatment of gonorrhoea depends on local guidelines, based on surveillance of resistance patterns of the organism. A minimum criterion is that at least 95% of gonorrhoea prevalent in a population should be susceptible to the antibiotic used
e. Patients with recurrent symptoms of HSV may benefit from long‐term suppressive treatment. Early syphilis is treated with intramuscular procaine penicillin (10 days) or benzathine penicillin (2.4 g as a single dose). Doxycycline can be used in patients allergic to penicillin (100 mg twice daily for 2 weeks). Longer courses of antibiotics are used for latent syphilis.
2. Surgical interventions include Appendicectomy
In the report of a prospective case series of 30 adult patients (median age 35 years, range 17-70 years; male/female: 11/19) with ulcerative proctitis (median duration of symptoms 5 years, range 8 months to 30 years; median Simple Clinical Colitis Activity Index score 9, range 7-12), who underwent appendicectomy in the absence of any history suggestive of previous appendicitis, showed that the report so far provides rationale for controlled trials to properly evaluate the possible role of appendicectomy in the treatment of ulcerative proctitis(78).
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(77) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660501/
(78) http://www.ncbi.nlm.nih.gov/pubmed/19584834