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Diverticulitis
Published in Charles Theisler, Adjuvant Medical Care, 2023
To understand diverticulitis, it is necessary to first understand diverticulosis. Diverticulosis is the development of small pouches in the wall at the last part of the large intestine (sigmoid colon). If a local pouch, or diverticulum, gets inflamed or infected, this is known as diverticulitis. Approximately 1%-10% of patients with diverticulosis may develop diverticulitis. Some literature states the number could be as high as 25%, but studies have not confirmed this.1 Typical symptoms include lower left-sided, crampy abdominal pain, bloating, tenderness, possible low grade fever, nausea with vomiting, and constipation or sometimes diarrhea.
Collaborative Improvement of Cancer Services in Southeastern Sweden
Published in Paul Batalden, Tina Foster, Sustainably Improving Health Care, 2022
Johan Thor, Charlotte Lundgren, Paul Batalden, Boel Andersson Gäre, Göran Henriks, Rune Sjödahl, Felicia Gabrielsson Järhult
So, without population-based screening, what might clinicians in the southeastern region do to detect colorectal cancers as early as possible? A group of four nurses and four family physicians (FPs), with support from the primary care research and development unit in Jönköping, took on this question from their vantage point, seeking to develop ways to optimize the chance of early detection. One challenge in primary care is to distinguish signs and symptoms of cancer from the “noise” of much more common and benign causes. In a population-based survey,27 respondents reported the following incidence of symptoms potentially indicative of colon cancer over the preceding 3 months: feeling tired (35.8%); stomach pain (23.6%); diarrhea (10.0%); constipation (5.8%); poor appetite (5.3%). With an incidence of three cases per 10 000 residents, a Swedish FP will, on average, come across one patient with colorectal cancer once every 3 years. The group developed the “Stålhammar Score”28 to manage this challenge. In short, patients aged 50 years or over who seek care with certain symptoms – for example, “subileus (intermittent, increasing abdominal pain)” – are considered high risk and are seen within 3 days by their FP who initiates the assessment and refers the patient to the department of surgery where the remaining diagnostic workup is expediently coordinated.
Do I Have IBS?
Published in Melissa G. Hunt, Aaron T. Beck, Reclaim Your Life From IBS, 2022
Melissa G. Hunt, Aaron T. Beck
Colorectal cancer (or colon cancer) occurs when cells in the large intestine start to multiply in an out-of-control way. Usually, the tumors begin as polyps – little bumps or growths inside the lining of the large intestine. Most polyps are benign. They usually don’t cause symptoms and are not dangerous. But, sometimes, polyps become cancerous over time. The symptoms of colon cancer vary and depend on the location and size of the tumor and whether cancer has metastasized (or spread) to other parts of the body, such as the liver. If the tumor is close to the anus, there may be a change in bowel habits – either diarrhea or constipation. If the tumor begins to block the flow of stools (called a bowel obstruction), the patient may experience abdominal pain, constipation, and/or vomiting. There may also be evidence of blood in the stools. The single best way to diagnose colon cancer is with a colonoscopy. If caught early, colon cancer is almost always curable. The American Gastroenterological Association advises people who have no risk factors to be tested starting at age 50, while people with a family history of colon cancer should have their first colonoscopy at age 40, or ten years before the age that their relative got cancer, whichever comes first. If you are struggling with GI symptoms, a colonoscopy can certainly bring peace of mind if it rules out this potentially fatal disease, but if you are under 50 and have no family history of colon cancer, it’s probably not worth doing, unless your doctor suspects an inflammatory bowel disease.
Cyanidin-3-O-glucoside protects intestinal epithelial cells from palmitate-induced lipotoxicity
Published in Archives of Physiology and Biochemistry, 2023
Romina Bashllari, Maria Sofia Molonia, Claudia Muscarà, Antonio Speciale, Peter J. Wilde, Antonella Saija, Francesco Cimino
Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine defined as either Crohn’s disease (CD) or ulcerative colitis (UC). The clinical development of IBD begins with an altered mucosal barrier which lets the intestinal bacteria to enter. This in turn induces an immune response and consequently a chronic inflammation (Michielan and D'inca 2015). IBD is a multifactorial condition and involves both genetic and environmental factors. Recent findings reported a link between obesity or metabolic dysfunctions and IBD indicating that adipose tissue dysregulation could be involved in gastrointestinal inflammatory disorders (Michalak et al. 2016, Eder et al. 2019). In fact, higher Body Mass Index (BMI) has been associated with shorter time to first surgery in CD patients, and obese patients have a greater tendency to develop active disease and require hospitalisation (Singh et al. 2017). In addition, it has been demonstrated that high fat diet-induced obesity significantly increased the severity of IBD in the genetically susceptible Mdr1a-/- mouse model (Paik et al. 2013), suggesting that local and systemic low-grade chronic inflammation found in obesity may adversely influence IBD progression in susceptible individuals.
CC-CLEAR (Colon Capsule Cleansing Assessment and Report): the novel scale to evaluate the clinical impact of bowel preparation in capsule colonoscopy – a multicentric validation study
Published in Scandinavian Journal of Gastroenterology, 2022
Rui de Sousa Magalhães, Carolina Chálim Rebelo, Bernardo Sousa-Pinto, José Pereira, Pedro Boal Carvalho, Bruno Rosa, Maria J. Moreira, Maria A. Duarte, José Cotter
The majority of polyps detected in the colon are classified as diminutive (<5 mm), and they are associated with low potential of malignant progression, rendering a negative cost-effective resection [27–30]. In our study, 22 post-CC colonoscopies required at least one polypectomy, for a total of 39 polypectomies. From 39 polyps resected, 6 (15.4%) were hyperplastic, 32 presented low-grade dysplasia (82.1%) and 1 (2.6%) presented high-grade dysplasia, which reflects a good accuracy of CC for the detection of polyps with malignant potential. Furthermore, we took a step further proving the benefit of CC-CLEAR classification in the actual requirement for endoscopic treatment in the post-CC colonoscopy, reporting that CC-CLEAR was statistically associated with the need for endoscopic treatment in post-CC colonoscopy, since, per point increase in the classification, the indication for endoscopic treatment increased 1.40 times (OR 1.40 95% IC [1.07–1.84], p-value .015), and, when comparing the CC-CLEAR grades excellent to inadequate, 4 times more colonoscopies required a treatment procedure (OR 4.16 95% IC [1.15–15.06], p-value .03).
Adaptation Processes of the Remaining Jejunum or Ileum after Extensive Intestinal Resection
Published in Journal of Investigative Surgery, 2022
Affonso Flávio Jorge Mussolino, Ana Cristina Aoun Tannuri, Josiane de Oliveira Gonçalves, Suellen Serafini, Uenis Tannuri
The present study findings were similar and showed higher expression of both Bax and Bcl-XL in the ileum vs. jejunum groups, probably reflecting the high turnover of enterocytes during the exacerbated proliferation process consistent with intestinal adaptation. Recent studies have stressed the importance of distal intestinal adaptation in cases of short bowel syndrome as a driving factor for weaning from parenteral nutrition. The colon is responsible for the uptake of sodium and water as well as the absorption of energy from short-chain fatty acids. SBS patients have an increased absorptive surface in the remaining colon, evidencing a significant adaptive process. It has been shown that colon resection predicted dependence on parenteral nutrition for more than 2 years [27] in neonates with SBS, and the maintenance of more than half of the colon is a strong predictor of enteral autonomy in children with SBS [28].