PURPOSE: To prospectively evaluate the diagnostic performance of magnetic resonance (MR) colonography by using limited bowel preparation in patients with polyps of 10 mm or larger in diameter in a population at increased risk for colorectal cancer, with optical colonoscopy as the reference standard. MATERIALS AND METHODS: The institutional review ...

BACKGROUND: The differentiation between constipation due to rectal inertia and that due to outlet obstruction from non-relaxing puborectalis muscle (PRM) is problematic and not easily achieved with one diagnostic test. Therefore, we studied the hypothesis that the rectal cooling test (RCT) can effectively be used to differentiate between those two ...

One of the most frequent subtypes of constipation is represented by obstructed defecation, and it has recently been reported that these patients may have colonic motor abnormalities in addition to alterations of the anorectal area. However, it is unknown whether these patients display abnormalities of the enteric nervous system, as ...

BACKGROUND: Appendicitis is encountered predominantly in Western, industrialized countries. Animal experiments and clinical studies have suggested an obstructive fecalith as a cause of acute appendicitis. It was hypothesized that patients with acute appendicitis would have a longer colonic transit time and more fecal retention reservoirs (coprostasis) than healthy control persons, ...

The physiopathology of idiopathic chronic constipation is complex and yet to be investigated. In the manometric studies of the patients with severe chronic constipation, we noticed that some patients with megacolon show very slow periodical (< 2/min) pressure change in the anal canal, namely ultra slow waves (USWs). USWs are ...

Chronic constipation is a frequent symptom in patients with dementia, especially in those institutionalized. However, few data are available on the neuropathological aspects of the colon in such patients. We investigated the enteric neuropathology of the colon in two patients with longstanding dementia and intractable constipation, requiring surgery to alleviate ...

OBJECTIVE: Colonic propagating sequences are important for normal colonic transit and defecation. The frequency of these motor patterns is reduced in slow-transit constipation. Sacral nerve stimulation (SNS) is a useful treatment for fecal and urinary incontinence. A high proportion of these patients have also reported altered bowel function. The effects ...

BACKGROUND: A standard contrast enema for Hirschsprung's disease can sometimes be inconclusive in delineating a transition zone especially in neonates and infants. The aim of this study was to determine the utility and diagnostic accuracy of a plain abdominal radiograph transition zone (PARTZ) in predicting the level of aganglionosis. METHODS: ...

BACKGROUND: Colonic diverticular disease is a bothersome condition with an unresolved pathogenesis. It is unknown whether a neuroepithelial dysfunction is present. The aim of the study was two-fold; (1) to investigate colonic epithelial ion transport in patients with diverticulosis and (2) to adapt a miniaturized Modified Ussing Air-Suction (MUAS) chamber ...

BACKGROUND: Vancomycin-resistant entrococci (VRE) are increasing in prevalence at many institutions, and are often reported in dialysis patients. The aim of this cross-sectional prevalence study was to determine the prevalence and risk factors of VRE colonization in chronic hemodialysis patients in two hemodialysis centers in Shiraz, Iran. METHODS: Rectal swabs ...

BACKGROUND/AIMS: Anastomotic failure occurs in up to 10% of patients following anterior resection. Selective use of a loop ileostomy may reduce the septic consequences of anastomotic leak. The use of gastrograffin enema to confirm the anastomotic integrity prior to ileostomy closure is still controversial. Our aim was to determine the ...

Case-control studies and short term prospective studies have suggested that selected groups of patients with precursors of colorectal cancer may benefit from colonoscopic surveillance after initial removal of adenomas. The aim of the present study was to demonstrate such a possible benefit from long term (1-24 years) colonoscopic surveillance in ...

OBJECTIVES: Virtual colonoscopy is less invasive than conventional colonoscopy and does not require a conscious sedation. BACKGROUND: Virtual colonoscopy using the abdominal spiral computed tomography scanning allows a total colonic evaluation with minimal invasiveness. METHODS: We studied 48 patients with a virtual colonoscopy using oral iodinated contrast. Colonic lavage was ...

AIM: The hyperplastic polyposis syndrome (HPS) has been described in a subset of patients with multiple or large hyperplastic polyps. HPS is associated with an increased risk of colorectal cancer (CRC). In this report, we review the presentation and management of a series of individuals with HPS. METHODS: From 2001, ...

BACKGROUND: The aim of this study was is to investigate the outcomes of endoscopic sinus surgery (ESS) when performed for chronic rhinosinusitis associated with sinonasal polyps. METHODS: Forty-three patients with polyps were compared with 76 patients without polyps before and after ESS. Mean follow-up was 1.5 years. Patients were analyzed ...

OBJECTIVE: Surveillance of patients treated for adenoma or colorectal cancer (CRC) is intended to reduce the incidence of CRC. Responsibility for the adherence to surveillance advice is often left to the patients and family physician. It is not known whether this type of passive policy affects the efficacy of surveillance. ...

BACKGROUND: The aim of the LIFELAX randomised controlled trial (diet and lifestyle vs. laxatives in the management of chronic constipation) is to develop and evaluate a cost effective intervention to promote diet and lifestyle in the treatment and management of chronic constipation for older people in Primary Care. Constipation affects ...

AIM: To relate the endoscopic findings in patients with hematochezia with regard to age in "low and average risk" for colorectal cancer (CRC) and to localize significant lesions in order to identify patients who need sigmoidoscopy or total colonoscopy. METHODS: This prospective study was performed in an open access GI ...

BACKGROUND: In many regions, the demand for colonoscopy exceeds its availability. Patients undergoing repeat examinations comprise a significant proportion of those on waiting lists. OBJECTIVE: To assess the yield of repeat colonoscopy in varied clinical settings. DESIGN: Cohort study. SETTING: Endoscopic database of an Australian tertiary referral hospital. PATIENTS: Adults ...

Background Effects of long-term administration of non-steroidal anti-inflammatory drugs (NSAIDs) on the colon have not been well characterized. Aim To investigate colonoscopic findings and prevalence of adverse events following long-term use of NSAIDs. Methods The study included 425 patients (mean 66.4 years) treated for over one year with NSAIDs, and ...

AIM: Obstructed defecation syndrome (ODS) represents a very common clinical problem. The aim of this study was to analyze the cinedefecographic findings in a group of patients with ODS. METHODS: All patients with ODS were prospectively introduced into a database and underwent cinedefecography (CD). The grade of the syndrome was ...

BACKGROUND: The Rome criteria serve as gold standard for establishing a diagnosis of irritable bowel syndrome (IBS), but only represent a cluster of symptoms. On the other hand, measurement of colonic transit time (CTT) with radiopaque markers is a solid and more objective method to quantify functional abnormalities. The goal ...

BACKGROUND: To assess the usefulness of air-inflated magnetic resonance colonography (MRC) in patients with incomplete conventional colonoscopy (CC). METHODS: From September 2001 to December 2004, 51 patients (25 male and 26 female, age range 32 to 85 years) with incomplete colonoscopy were recruited to have MRC performed. Half-fourier single short ...

OBJECTIVE: The objective of our study was to assess the efficacy of a new positive oral contrast agent's ability to reach the colon during CT evaluation of acute appendicitis. SUBJECTS AND METHODS: Eighty adult emergency department patients who underwent abdominal CT to evaluate for appendicitis were studied. Forty patients received ...

Chronic diarrhea and malabsorption are uncommon in immunocompetent patients with visceral leishmaniasis. We report two immunocompetent patients with visceral leishmaniasis where the predominant presentation was chronic diarrhea. One of them had clinically overt malabsorption and duodenal mucosa was loaded with Leishmania donovani bodies. The other patient had diffuse colonic aphthous ...

OBJECTIVE: To determine the prevalence of tonsillar actinomycetes colonization in patients with and without recurrent tonsillitis and to study the association of this condition with recurrent tonsillitis and tonsillar hypertrophy. STUDY DESIGN AND SETTING: A retrospective study of 834 patients who had undergone tonsillectomy for recurrent tonsillitis (group A) and ...

OBJECTIVES: Acromegalics have an increased risk of colorectal neoplasm. The aim of this study was to establish the association between acromegaly and colorectal lesions. MATERIALS AND METHODS: The study included 51 patients with active acromegaly: 30 women and 21 men (average age 52.95 +/- 13.49 years). Growth hormone (GH), insulin-like ...

BACKGROUND & AIMS: Bloating represents a frequent gastrointestinal symptom, but the pathophysiologic mechanism responsible for its onset is still largely unknown. Patients very frequently attribute the sensation of bloating to the presence of excessive bowel gas, but not all patients with gas-related symptoms exhibit increased intestinal production of gas. It ...

We report two additional cases of colonic xanthomatosis associated with persistent rectal symptoms. Disordered colonic motility in the areas of lipid infiltration was documented in one patient. We conclude these lesions may have a pathophysiologic role in the alteration of intestinal motility which appears to be the cause of our ...

Among most patients attending a rectal clinic, rectal bleeding is a common presenting feature. In most patients, the cause is attributed to a benign lesion. In a small percentage, the cause is neoplastic, and for this reason, rectal bleeding merits further study. Left-sided tumors account for the majority of these ...

BACKGROUND: To determine whether IBS patients develop organic lesions compared to those without IBS, and to determine type and frequency of these organic colonic lesions. MATERIAL/METHODS: Retrospective review of medical records of 622 IBS patients, ages 19-91 years, over fifteen years that underwent colonoscopy for new gastrointestinal symptoms during the ...

The duodenum is the main site for (pre-) malignant extracolonic manifestations in patients with familial adenomatous polyposis (FAP). Changes in the E-cadherin/beta-catenin complex play a pivotal role in the development of malignancies. Loss of E-cadherin has been described in association with loss of SMAD4. To elucidate the pathways leading to ...

BACKGROUND AND AIM: Constipation may be present in ulcerative proctitis (UP), but its pathogenesis has not yet been evaluated. The aim of this article is to investigate functional and morphologic features of the anorectal region in patients with UP and constipation. MATERIALS AND METHODS: Eleven patients with quiescent clinical, endoscopic, ...

Slow-transit constipation is usually considered a colonic motor disorder. However, there is some evidence that abnormalities may be present in locations other than the colon. In particular, several studies have reported abnormal motor activity of the small bowel in these patients. We evaluated the neuropathological aspects of the terminal ileum ...

BACKGROUND: The use of an endoloop may minimize the risk for bleeding after endoscopic polypectomy of large colorectal polyps. This study aimed to assess the safety and efficacy of colonoscopic ligation of the stalk of large pedunculated polyps by means of an endoloop technique, and to focus particular attention on ...

PURPOSE: To assess colonic anastomoses in patients after surgical treatment by means of MR colonography (MRC) in comparison with conventional colonoscopy (CC). MATERIALS AND METHODS: A total of 39 patients who had previously undergone colonic resection and end-to-end-anastomosis were included in the study. MRI was based on a dark-lumen approach. ...

BACKGROUND: Vaginal construction is necessary for the patients with aplasia of Mullerian ducts, testicular feminisation and androgen insensitivity syndromes. Many methods of vaginal construction have been described. We report here the outcomes of six adolescent patients who underwent sigmoid colon vaginoplasty with special emphasis on the surgical technique and outcomes. ...

BACKGROUND: British Society of Gastroenterology guidelines recommend that gastrointestinal investigations should be considered in males and post-menopausal women presenting with iron-deficiency anaemia (IDA). AIM: To compare the diagnostic yields and clinical effectiveness of upper and lower gastrointestinal (GI) investigation in detecting malignancy among patients presenting with IDA. DESIGN: Retrospective review ...

Functional gastrointestinal (GI) symptoms are common in the general population. Especially, motor dysfunction of the GI tract and visceral hypersensitivity are important. Acupuncture has been used to treat GI symptoms in China for thousands of years. It is conceivable that acupuncture may be effective in patients with functional GI disorders ...

BACKGROUND: In patients with colorectal cancer, a preoperative colonoscopy is recommended to exclude synchronous lesions. Unfortunately, between 7% and 29% of patients with colorectal cancer present with acute colonic obstruction, making complete colonoscopy impossible. OBJECTIVE: The aim of our study was to evaluate the feasibility of a preoperative colonoscopy after ...

BACKGROUND AND STUDY AIMS: Several factors predict difficult or incomplete colonoscopy with a standard colonoscope, including female gender, low body mass index, extensive diverticulosis, and prior pelvic surgery. PATIENTS AND METHODS: A push-and-pull enteroscopy device and a single-balloon technique was used in 14 patients (six men, eight women; mean age ...

Rehbein's procedure for Hirschsprung's disease has been questioned because several centimetres of aganglionic bowel are left behind, considered to result in obstructive symptoms. However, the reported outcome is similar to that after operations with other techniques. The purpose of this study was to review our experience of Rehbein's procedure during ...

BACKGROUND: Detection of faecal occult blood is recommended for colorectal cancer screening in average risk populations. However, many subjects do not have any cause found in the colon to account for the occult blood loss. AIMS: To determine the prevalence of upper gastrointestinal tract disease in faecal occult blood-positive, colonoscopy-negative ...

BACKGROUND: Patients with hyperplastic polyposis coli syndrome (HPCS) have a propensity to develop colorectal carcinoma (CRC). PATIENTS AND METHODS: Details were retrieved from the files of patients attending our hospital between 1988 and 2004 who fulfilled the World Health Organization criteria for HPCS. RESULTS: Over a period of 16 years, ...

Ulceronecrotic Mucha-Habermann disease is a severe, febrile form of pityriasis lichenoides et varioliformis acuta. The condition may sometimes have a fatal outcome, especially in elderly patients. In this paper, we are reporting on a 60-year-old male patient who suffered from the eruption of erythematous, haemorrhagic, ulceronecrotic papules accompanied by high ...

AIM: To determine the real association between serum lipid levels and colonic polyp formation. METHODS: We performed a large scale retrospective study to analyze the correlation between the incidence of colorectal adenoma or carcinoma and the fasting serum levels of total cholesterol (TC) and triglycerides (TG) in patients who underwent ...

OBJECTIVE: To study the local host response in patients with colonic and ileal neobladders, with or without bacteriuria. METHODS: Twenty-three patients with colonic neobladders and 19 with ileal neobladders were included. Eleven radical prostatectomy patients and seven healthy male volunteers were used as controls. Six urine samples were obtained from ...

Megacolon is the second most frequent and most important digestive manifestation of Chagas' disease. It is characterized by motor disorders and dilatation of the distal segments of the colon. Several theories have been presented to explain the physiopathology of chagasic megacolon, e.g. the plexus theory. Objective: In the present study ...

BACKGROUND: Solitary rectal ulcer syndrome (SRUS) is a behavioral disorder whose pathophysiology is incompletely understood. Likewise, its treatment, particularly the role of biofeedback therapy (BT) is unclear. AIM: To evaluate anorectal function and morphology and to assess efficacy of BT. METHODS: Eleven patients (8f) with refractory SRUS underwent symptom assessments, ...

AIM: To summarize our experience with the application of self-expanding metallic stent (SEMS) in the management of acute left-sided colorectal malignant obstruction. METHODS: A retrospective chart review of all patients undergoing placement of SEMS between April 2000 and January 2004 was performed. RESULTS: Insertion of SEMS was attempted in 26 ...