Recommendation of surgical treatment in patients with inflammatory bowel diseases – part 3: ulcerative colitis, indications for surgery

Westernization and today’s changing life style is resulting in various health problems like Inflammatory Bowel diseases, which is a common entity encountered in surgical practise. Ulcerative colitis is the most common among them. Though it is believed to have auto immune and genetic origin, today’s life style, environment, diet and stress plays an important role in aetiology. The disease is prevalent in middle aged western and northern people characterised by abdominal pain with bloody diarrhoea, weight loss, anaemia and general debility. This condition has remissions and exacerbations. One should always keep in mind that inflammatory bowel diseases can have anorectal manifestations. Diagnosis is made on the basis of symptoms, stool exam. and endoscopy. Management is symptomatic i.e. antibiotics, anti-inflammatory, anti-spasmodic, multivitamins, immune suppression and if required admission, intravenous fluids. if no response colectomy. As such there is no satisfactory treatment till date, so it remains the difficult issue. Here we need to have an alternative, safe, convenient treatment. Ayurveda has an answer for such cases.

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Recurrent myocarditis in a patient with active ulcerative colitis: a case report and review of the literature

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000587 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000587

Author(s):

Giacomo Caio ◽

Lisa Lungaro ◽

Fabio Caputo ◽

Maria Muccinelli ◽

Maria Caterina Marcello ◽

...

Keyword(s):

Ulcerative Colitis ◽

Case Report ◽

Inflammatory Bowel Diseases ◽

Drug Toxicity ◽

Active Ulcerative Colitis ◽

Extraintestinal Manifestations ◽

Review Of The Literature ◽

Extraintestinal Manifestation ◽

Bowel Diseases ◽

Inflammatory Bowel

Inflammatory bowel diseases such as ulcerative colitis (UC) may be complicated by several extraintestinal manifestations. These involve joints, skin, eyes and less commonly lungs and heart. Myocarditis may result from the toxic effect of drugs (ie, mesalazine) commonly used for the treatment of UC or due to infections (eg, Coxsackieviruses, enteroviruses, adenovirus). Here, we report a case of a 26-year old man affected by UC and complicated by two episodes of myocarditis. Both episodes occurred during two severe exacerbations of UC. However, in both cases the aetiology of myocarditis remains uncertain being ascribable to extraintestinal manifestation, drug toxicity or both.

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Innate Immunity Modulation by the IL-33/ST2 System in Intestinal Mucosa

BioMed Research International ◽

10.1155/2013/142492 ◽

2013 ◽

Vol 2013 ◽

pp. 1-13 ◽

Cited By ~ 4

Author(s):

Marina García-Miguel ◽

M. Julieta González ◽

Rodrigo Quera ◽

Marcela A. Hermoso

Keyword(s):

Ulcerative Colitis ◽

Innate Immunity ◽

Intestinal Mucosa ◽

Inflammatory Bowel Diseases ◽

The Body ◽

Unknown Etiology ◽

Adequate Food ◽

Bowel Diseases ◽

Surface Contact Area ◽

Inflammatory Bowel

Innate immunity prevents pathogens from entering and spreading within the body. This function is especially important in the gastrointestinal tract and skin, as these organs have a large surface contact area with the outside environment. In the intestine, luminal commensal bacteria are necessary for adequate food digestion and play a crucial role in tolerance to benign antigens. Immune system damage can create an intestinal inflammatory response, leading to chronic disease including inflammatory bowel diseases (IBD). Ulcerative colitis (UC) is an IBD of unknown etiology with increasing worldwide prevalence. In the intestinal mucosa of UC patients, there is an imbalance in the IL-33/ST2 axis, an important modulator of the innate immune response. This paper reviews the role of the IL-33/ST2 system in innate immunity of the intestinal mucosa and its importance in inflammatory bowel diseases, especially ulcerative colitis.

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Quality of Life Considering Patients with Chronic Inflammatory Bowel Diseases - Natural and Parenteral Nutrition

Polish Journal of Surgery ◽

10.2478/pjs-2014-0073 ◽

2014 ◽

Vol 86 (9) ◽

Cited By ~ 1

Author(s):

Aneta Raczkowska ◽

Michał Ławiński ◽

Aleksandra Gradowska ◽

Urszula Zielińska-Borkowska

Keyword(s):

Quality Of Life ◽

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Parenteral Nutrition ◽

Inflammatory Bowel Diseases ◽

Nutritional Therapy ◽

Bowel Diseases ◽

Inflammatory Bowel

AbstractOne of the elements of treatment considering inflammatory bowel diseases is nutritional therapy. The duration of the above-mentioned depends on the prevalence of such symptoms as fever, bowel move-ments, length of the functioning gastrointestinal tract, stoma and intestinal fistula presence. Nutritional therapy is an essential element of successful treatment alongside pharmacological, surgical, and biological therapy, as well as other methods. Crohn's disease and ulcerative colitis considered as chronic diseases, lead towards physical and biopsychosocial disability, being responsible for the reduction in the quality of life.was to determine the quality of life after surgical procedures in case of patients diagnosed with Crohn's disease and ulcerative colitis, subjected to natural and parenteral nutrition.The study group comprised 52 patients from the Department of Gastroen-terology, Military Medical Institute, and Department of Surgery and Clinical Nutrition, Clinical Hospital in Warsaw. The study was performed between October, 2011 and April, 2012. The World Health Organization Quality of Life Instrument - Bref (WHOQOL-BREF) questionnaire was used to deter-mine the patients’ quality of life.A lower quality of life was observed in case of patients subjected to parenteral nutrition, poor education, disease symptoms exacerbation, in the majority-rural inhabitants. The quality of life does not depend on gender, type of disease, family status, and additional medical care.

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FECAL CALPROTECTIN: levels for the ethiological diagnosis in Brazilian patients with gastrointestinal symptoms

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000100011 ◽

2015 ◽

Vol 52 (1) ◽

pp. 50-54 ◽

Cited By ~ 8

Author(s):

Lorete Maria da Silva KOTZE ◽

Renato Mitsunori NISIHARA ◽

Sandra Beatriz MARION ◽

Murilo Franco CAVASSANI ◽

Paulo Gustavo KOTZE

Keyword(s):

Ulcerative Colitis ◽

Irritable Bowel Syndrome ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Inflammatory Bowel Diseases ◽

Fecal Calprotectin ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Irritable Bowel ◽

Active Disease

Background Determination of fecal calprotectin can provide an important guidance for the physician, also in primary care, in the differential diagnosis of gastrointestinal disorders, meanly between inflammatory bowel diseases and irritable bowel syndrome. Objectives The aims of the present study were to prospectively investigate, in Brazilian adults with gastrointestinal complaints, the value of fecal calprotectin as a biomarker for the differential diagnosis between functional and organic disorders and to correlate the concentrations with the activity of inflammatory bowel diseases. Methods The study included consecutive patients who had gastrointestinal complaints in which the measurement levels of fecal calprotectin were recommended. Fecal calprotectin was measured using a Bühlmann (Basel, Switzerland) ELISA kit Results A total of 279 patients were included in the study, with median age of 39 years (range, 18 to 78 years). After clinical and laboratorial evaluation and considering the final diagnosis, patients were allocated into the following groups: a) Irritable Bowel Syndrome: 154 patients (102 female and 52 male subjects). b) Inflammatory Bowel Diseases group: 112 patients; 73 with Crohn’s disease; 38 female and 35 male patients; 52.1% (38/73) presented active disease, and 47.9% (35/73) had disease in remission and 39 patients with ulcerative colitis;19 female and 20 male patients; 48.7% (19/39) classified with active disease and 49.3% (20/39) with disease in remission. A significant difference (P<0.001) was observed between the median value of fecal calprotectin in Irritable Bowel Syndrome group that was 50.5 µg/g (IQR=16 - 294 µg/g); 405 µg/g (IQR=29 - 1980 µg/g) in Crohn’s disease patients and 457 µg/g (IQR=25 - 1430 µg/g) in ulcerative colitis patients. No difference was observed between the values found in the patients with Crohn’s disease and ulcerative colitis. Levels of fecal calprotectin were significantly lower in patients with inflammatory bowel diseases in remission when compared with active disease (P<0.001). Conclusions The present study showed that the determination of fecal calprotectin assists to differentiate between active and inactive inflammatory bowel diseases and between inflammatory bowel diseases and irritable bowel syndrome.

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Pathogenetic mechanisms of anemic syndrome formation in patients with inflammatory bowel diseases

Medical alphabet ◽

10.33667/2078-5631-2021-20-29-34 ◽

2021 ◽

pp. 29-34

Author(s):

Yu. P. Uspenskiy ◽

Yu. A. Fominykh ◽

K. N. Nadzhafova ◽

O. I. Veduta

Keyword(s):

Public Health ◽

Ulcerative Colitis ◽

Health Problem ◽

Inflammatory Bowel Diseases ◽

Public Health Problem ◽

Significant Progress ◽

Pathogenetic Mechanisms ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Made In

Inflammatory bowel diseases are an urgent public health problem and are often complicated by the development of anemic syndrome. Significant progress has been made in the treatment of ulcerative colitis and Crohn's disease, but the correction of associated anemia in most cases remains insufficient. This article describes in detail the pathogenetic mechanisms of the formation of anemic syndrome in inflammatory bowel diseases, as well as possible ways to correct this condition.

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Cytomegalovirus and Inflammatory Bowel Diseases (IBD) with a Special Focus on the Link with Ulcerative Colitis (UC)

Microorganisms ◽

10.3390/microorganisms8071078 ◽

2020 ◽

Vol 8 (7) ◽

pp. 1078

Author(s):

Alexandre Jentzer ◽

Pauline Veyrard ◽

Xavier Roblin ◽

Pierre Saint-Sardos ◽

Nicolas Rochereau ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Diseases ◽

Viral Reactivation ◽

Steroid Resistance ◽

Mucosal Inflammation ◽

Special Focus ◽

Close Relationship ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Cmv Colitis

Cytomegalovirus (CMV) infects approximately 40% of adults in France and persists lifelong as a latent agent in different organs, including gut. A close relationship is observed between inflammation that favors viral expression and viral replication that exacerbates inflammation. In this context, CMV colitis may impact the prognosis of patients suffering from inflammatory bowel diseases (IBDs), and notably those with ulcerative colitis (UC). In UC, the mucosal inflammation and T helper cell (TH) 2 cytokines, together with immunomodulatory drugs used for controlling flare-ups, favor viral reactivation within the gut, which, in turn, increases mucosal inflammation, impairs corticoid and immunosuppressor efficacy (the probability of steroid resistance is multiplied by more than 20 in the case of CMV colitis), and enhances the risk for colectomy. This review emphasizes the virological tools that are recommended for exploring CMV colitis during inflammatory bowel diseases (IBD) and underlines the interest of using ganciclovir for treating flare-ups associated to CMV colitis in UC patients.

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Characterization of stable RNAs from the resected intestinal tissues of individuals with either Crohn's disease or ulcerative colitis

Biochemistry and Cell Biology ◽

10.1139/o97-065 ◽

1997 ◽

Vol 75 (6) ◽

pp. 789-794 ◽

Cited By ~ 2

Author(s):

Guylaine Roy ◽

Stéphane Mercure ◽

Frédéric Beuvon ◽

Jean-Pierre Perreault

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Ribosomal Rna ◽

Inflammatory Bowel Diseases ◽

Molecular Diagnostic ◽

Diagnostic Tools ◽

Circular Rnas ◽

Bowel Diseases ◽

Inflammatory Bowel

Circular RNAs reminiscent of viroids and the human hepatitis delta virus have been proposed as possible nonconventional pathogens responsible for Crohn's disease and ulcerative colitis, two inflammatory bowel diseases. Consequently, RNA was extracted from various areas of intestinal tissues from individuals with either Crohn's disease or ulcerative colitis as well as several appropriate control diseases, and analyzed by two-dimensional gel electrophoresis. No circular viroid-like RNAs (<1500 nucleotides) were detected, confirming a previous report that was limited to the investigation of small RNAs (<300 nucleotides). However, three small, unusually stable, linear RNAs were shown to be associated to both Crohn's disease and ulcerative colitis tissues: a specific 28S ribosomal RNA cleavage product characterized previously; a 5.8S ribosomal RNA conformer; and a fragment homologous to transcripts from DNA CpG islands. The two last RNAs were detected prior to visible morphological tissue alterations, suggesting that they are produced early during the inflammation and that they have value as molecular diagnostic tools for the inflammatory bowel diseases. The potential cellular mechanisms producing these RNAs and their involvement in inflammatory bowel disease are discussed. Key words: ribosomal RNA, inflammatory bowel diseases, human intestine, inflammation, viroids.

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