Proctitis
Colitis, Ulcerative
Diagnosis and treatment of sexually acquired proctitis and proctocolitis: an update. (1/24)
Sexually transmitted gastrointestinal syndromes include proctitis, proctocolitis, and enteritis. These syndromes can be caused by one or multiple pathogens. Routes of sexual transmission and acquisition include unprotected anal intercourse and oral-fecal contact. Evaluation should include appropriate diagnostic procedures such as anoscopy or sigmoidoscopy, stool examination, and culture. When laboratory diagnostic capabilities are sufficient, treatment should be based on specific diagnosis. Empirical therapy for acute proctitis in persons who have recently practiced receptive anal intercourse should be chosen to treat Neisseria gonorrhoeae and Chlamydia trachomatis infections. In individuals infected with human immunodeficiency virus (HIV), other infections that are not usually sexually acquired may occur, and recurrent herpes simplex virus infections are common. The approach to gastrointestinal syndromes among HIV-infected patients, therefore, can be more comprehensive and will not be discussed in this article. (+info)Colonic motility in chronic ulcerative proctosigmoiditis and the effects of nicotine on colonic motility in patients and healthy subjects. (2/24)
BACKGROUND: Nicotine decreases diarrhoea and pain in ulcerative colitis without reducing inflammation. AIMS: (i) To evaluate the effect of ulcerative proctosigmoiditis on motor functions of an uninflamed segment of descending colon; and (ii) to assess nicotine's effects on colonic motor functions in patients and healthy subjects. METHODS: In healthy subjects (n=30) and patients with ulcerative colitis (13; 11 active, two quiescent colitis), we studied the effects of intravenous nicotine on colonic transit of solid residue by scintigraphy (healthy subjects) and on colonic motility in healthy subjects and 11 patients. RESULTS: In ulcerative colitis, fasting colonic motility was increased, whereas motor response to a meal was significantly reduced; compliance was unchanged. In healthy subjects, high-dose nicotine induced transient high amplitude propagated contractions and relaxation of the descending colon followed by decreased phasic contractions. This dose also accelerated colonic transit. Low-dose nicotine (mimicking a transdermal nicotine patch) reduced colonic compliance in healthy subjects, but did not affect motor function in ulcerative colitis. CONCLUSIONS: Ulcerative proctosigmoiditis increases fasting colonic motility and reduces tone response to a meal in the descending colon without affecting colonic compliance, suggesting changes in physiological responses but not intrinsic wall properties. Nicotine has dose-dependent effects on colonic motor activity in healthy subjects. (+info)Cryptal lymphocytic coloproctitis: a new phenotype of lymphocytic colitis? (3/24)
BACKGROUND/AIMS: Lymphocytic colitis is a clinicopathological entity characterised by protracted watery diarrhoea and an increased number of intraepithelial lymphocytes (IELs) in the surface epithelium of the colonic mucosa. This report describes two patients with symptoms similar to those of lymphocytic colitis and an increased number of IELs, but within the cryptal epithelium. METHODS: The numbers of IELs were assessed in colorectal biopsies from the two patients. Sections were stained immunohistochemically for CD3, CD8, CD20, and TIA1. RESULTS: The colorectal biopsies had an abnormally high number of IELs in the epithelium of the crypts but not in the surface epithelium. The IELs in the crypts were CD3+++, CD8+, TIA1+, and CD20-. CONCLUSIONS: The histological diagnosis in these two patients was cryptal lymphocytic coloproctitis. Patients with similar symptoms and an increased number of IELs in the surface epithelium are now filed at this department as having surface lymphocytic coloproctitis. Immunohistochemistry showed that the cryptal IELs were cytotoxic suppressor T cells. Interestingly, a case of cryptal lymphocytic colitis was recently recorded in a non-human primate dying after years of protracted chronic diarrhoea. It is possible that antigens present in the lumen of the crypts elicit a lymphocytic reaction within the cryptal cells. (+info)Blood pH: a test for assessment of severity in proctocolitis. (4/24)
Acid base balance was studied in 58 patients with active idiopathic proctocolitis; the condition of 10 of them was complicated by toxic megacolon. Arterial blood pH increased progressively with increased severity of the colitis and as the lesions became more widespread. Statistically significant differences were observed in pH values between the mild/moderate and severe forms and between the severe and complicated forms ('toxic megacolon'). A linear correlation was found between pH and the amount of intestinal gas, pulse rate, and plasma albumin. (+info)Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis. (5/24)
Ileal pouch-anal anastomosis was an important advancement in the treatment of ulcerative colitis. The aim of this study was to determine whether early complications of ileal pouch-anal anastomosis in patients with ulcerative colitis are associated with poor late functional results. PATIENTS AND METHODS: Eighty patients were operated on from 1986 to 2000, 62 patients with ileostomy and 18 without. The early and late complications were recorded. Specific emphasis has been placed on the incidence of pouchitis with prolonged follow-up. RESULTS: The ileostomy was closed an average of 9.2 months after the first operation. Fourteen patients were excluded from the long-term evaluation; 6 patients were lost to regular follow-up, 4 died, and 4 patients still have the ileostomy. Of the 4 patients that died, 1 died from surgical complications. Early complications after operation (41) occurred in 34 patients (42.5%). Late complications (29) occurred in 25 patients as follows: 16 had pouchitis, 3 associated with stenosis and 1 with sexual dysfunction; 5 had stenosis; and there was 1 case each of incisional hernia, ileoanal fistula, hepatic cancer, and endometriosis. Pouchitis occurred in 6 patients (9.8%) 1 year after ileal pouch-anal anastomosis, 9 (14.8%) after 3 years, 13 (21.3%) after 5 years, and 16 (26.2%) after more than 6 years. The mean daily stool frequency was 12 before and 5.8 after operation. One pouch was removed because of fistulas that appeared 2 years later. CONCLUSIONS: Ileal pouch-anal anastomosis is associated with a considerable number of early complications. There was no correlation between pouchitis and severe disease, operation with or without ileostomy, or early postoperative complications. The incidence of pouchitis was directly proportional to duration of time of follow-up. (+info)Use of coculture of colonic mucosal biopsies to investigate the release of eicosanoids by inflamed and uninflamed mucosa from patients with inflammatory bowel disease. (6/24)
Eicosanoid production was measured in cultured biopsies of colonic mucosa from control patients, with the irritable bowel syndrome, and from patients with proctosigmoiditis and with colonic Crohn's disease. Cultured inflamed colonic mucosa from patients with proctosigmoiditis and Crohn's disease produced more prostaglandin E2 and leukotrienes C4 than control tissues. In addition, eicosanoid production by macroscopically uninflamed or 'quiescent' mucosa from the right colon was examined in patients with proctosigmoiditis and between skip lesions in Crohn's disease patients. In the proctosigmoiditis group quiescent mucosa produced eicosanoids in similar quantities to control tissue. Coculture of quiescent plus inflamed tissue however, generated a marked increase in eicosanoid output in 12 of 20 of the patients and this was similar to the quantity obtained from two pieces of inflamed tissue. In the Crohn's disease group, quiescent mucosa produced more eicosanoids than control mucosa but production was markedly stimulated by coculture with inflamed mucosa in all patients. These findings suggest that in some patients with proctosigmoiditis and in all patients with Crohn's disease quiescent mucosa appears to be sensitised. A small but significant increase in the macrophage population may be partly responsible but it is likely that these and other cells are primed to release eicosanoids, and may be induced to do so by soluble mediators produced by actively inflamed tissue. (+info)Colonic spread and serum pharmacokinetics of budesonide foam in patients with mildly to moderately active ulcerative colitis. (7/24)
BACKGROUND: Local treatment with foams in patients suffering from ulcerative proctitis or proctosigmoiditis is considered a rational treatment option. AIMS: To investigate colonic spread, safety, tolerability and acceptance of a newly developed budesonide foam formulation. METHODS: Twelve patients (four females, eight males) with acute proctosigmoiditis or left-sided ulcerative colitis were rectally administered a single dose of [99Tcm]-labelled budesonide foam (Budenofalk; Dr Falk Pharma GmbH, Freiburg, Germany) containing 2 mg budesonide in 20 mL foam after diagnostic colonoscopy. Thereafter, the colonic spread was assessed by means of gamma-scintigraphy for 6 h. Serum samples were taken simultaneously. RESULTS: Budesonide foam spread with a maximum between 11 and 40 cm, thus reaching the sigmoid colon in all patients. In some patients, the foam even extended into the distal third and the middle of the descending colon with maximum radioactivity at 4 h. Systemic budesonide absorption was rapid and pharmacokinetic data were comparable with published data on marketed budesonide enemas, with mean serum C(max) and AUC(0-8 h) values of 0.8 +/- 0.5 ng/mL and 3.7 +/- 1.9 ng h/mL, respectively. The new formulation was well accepted by all patients, who could retain the foam for at least 4 h. CONCLUSIONS: In the majority of patients, budesonide foam effectively spread up to the left-sided colon and thus qualifies for the local treatment of proctosigmoiditis. (+info)Budesonide foam versus budesonide enema in active ulcerative proctitis and proctosigmoiditis. (8/24)
BACKGROUND: Rectal budesonide is an effective treatment of active ulcerative proctitis or proctosigmoiditis. AIM: To compare the therapeutic efficacy, tolerability and safety, and patient's preference of budesonide foam vs. budesonide enema. METHODS: Patients with active ulcerative proctitis or proctosigmoiditis (clinical activity index > 4 and endoscopic index > or = 4) were eligible for this double-blind, double-dummy, randomized, multicentre study. They received 2 mg/25 mL budesonide foam and placebo enema (n = 265), or 2 mg/100 mL budesonide enema and placebo foam (n = 268) for 4 weeks. Primary endpoint was clinical remission (clinical activity index < or = 4) at the final/withdrawal visit (per protocol). RESULTS: A total of 541 patients were randomized--533 were evaluable for intention-to-treat analysis and 449 for per protocol analysis. Clinical remission rates (per protocol) were 60% for budesonide foam and 66% for budesonide enema (P = 0.02362 for non-inferiority of foam vs. enema within a predefined non-inferiority margin of 15%). Both formulations were safe and no drug-related serious adverse events were observed. Because of better tolerability and easier application most patients preferred foam (84%). CONCLUSION: Budesonide foam is as effective as budesonide enema in the treatment of active ulcerative proctitis or proctosigmoiditis. Both budesonide formulations are safe, and most patients prefer foam. (+info)Proctocolitis is an inflammatory condition that affects both the colon (large intestine) and rectum, often characterized by symptoms such as diarrhea, abdominal pain, and tenesmus (straining during bowel movements).
Proctocolitis is a medical condition that refers to inflammation of both the rectum (proctitis) and the colon (colitis). It can cause symptoms such as diarrhea, abdominal cramps, and urgency to have a bowel movement. The inflammation can be caused by various factors, including infections, immune-mediated disorders, or irritants. In some cases, the specific cause of proctocolitis may not be identified (known as idiopathic proctocolitis). Treatment for proctocolitis depends on the underlying cause and may include medications to reduce inflammation, manage symptoms, and treat any underlying infections.
Proctitis is a medical condition characterized by inflammation of the lining of the rectum, often causing symptoms such as pain, rectal bleeding, discharge, and urgency.
Proctitis is a medical condition that refers to inflammation of the lining of the rectum, which is the lower end of the colon. The symptoms of proctitis may include rectal pain, discomfort, or a feeling of fullness; rectal bleeding, often in the form of mucus or blood; diarrhea; and urgency to have a bowel movement.
Proctitis can be caused by a variety of factors, including infections (such as sexually transmitted infections, foodborne illnesses, or inflammatory bowel diseases like Crohn's disease or ulcerative colitis), radiation therapy, trauma, or autoimmune disorders. The diagnosis of proctitis typically involves a physical examination, medical history, and sometimes endoscopic procedures to visualize the rectum and take tissue samples for further testing. Treatment depends on the underlying cause but may include antibiotics, anti-inflammatory medications, or other therapies.
Ulcerative colitis is a chronic inflammatory condition that primarily affects the mucosal lining of the colon and rectum, leading to recurrent ulcers, diffuse inflammation, and abnormal gastrointestinal symptoms such as diarrhea, abdominal pain, and bloody stools.
Ulcerative colitis is a type of inflammatory bowel disease (IBD) that affects the lining of the large intestine (colon) and rectum. In ulcerative colitis, the lining of the colon becomes inflamed and develops ulcers or open sores that produce pus and mucous. The symptoms of ulcerative colitis include diarrhea, abdominal pain, and rectal bleeding.
The exact cause of ulcerative colitis is not known, but it is thought to be related to an abnormal immune response in which the body's immune system attacks the cells in the digestive tract. The inflammation can be triggered by environmental factors such as diet, stress, and infections.
Ulcerative colitis is a chronic condition that can cause symptoms ranging from mild to severe. It can also lead to complications such as anemia, malnutrition, and colon cancer. There is no cure for ulcerative colitis, but treatment options such as medications, lifestyle changes, and surgery can help manage the symptoms and prevent complications.
Colitis is a general term that refers to inflammation of the colon or large intestine, which can lead to symptoms such as diarrhea, abdominal pain, and bloody stools, and can be caused by various factors including infections, autoimmune disorders, and inflammatory bowel disease.
Colitis is a medical term that refers to inflammation of the inner lining of the colon or large intestine. The condition can cause symptoms such as diarrhea, abdominal cramps, and urgency to have a bowel movement. Colitis can be caused by a variety of factors, including infections, inflammatory bowel disease (such as Crohn's disease or ulcerative colitis), microscopic colitis, ischemic colitis, and radiation therapy. The specific symptoms and treatment options for colitis may vary depending on the underlying cause.
