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Colonoscopy
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Ian D. Sugarman, Jonathan R. Sutcliffe
The indications for colonoscopy can be divided into diagnostic, screening, surveillance, and therapeutic. In diagnostic cases, the commonest indication is to investigate symptoms suggestive of inflammatory bowel disease (IBD). These include failure to thrive or weight loss, chronic diarrhea, anemia, bleeding, mucous per rectum (PR), or when there is radiologic abnormality (e.g. narrowed terminal ileal abnormality on ultrasound, small bowel follow-through, or magnetic resonance imaging (MRI)). The second commonest indication is the investigation of painless rectal bleeding to exclude the presence of rectal/colonic polyps with the next commonest being screening and surveillance of children with polyposis syndromes until a plan for surgical intervention is required. Rarely, the indications include the investigation of tenesmus in order to exclude a solitary rectal ulcer and non-specific abdominal pain (with a very low pick-up rate).
Principles of Surgery
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Tenesmus➢ Feeling of not fully emptying bowels after a bowel motion. Suggests low rectal tumour.
Management of Locally Advanced and Recurrent Rectal Cancer
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Patients with LARC usually present similarly to other primary rectal cancers. Symptoms may include rectal bleeding, altered bowel habits or tenesmus. However, depending on the local extent of the cancer, patients may also present with symptoms similar to that of patients with LRRC, and these may be related to the mass effect of the tumour on adjacent structures such as ureteric obstruction, referred pain from sacral nerve root irritation or the result of direct infiltration resulting in fistulae, sepsis or pain.
The Rhei radix rhizoma-based carbon dots ameliorates dextran sodium sulphate-induced ulcerative colitis in mice
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2023
Yifan Zhang, Jie Zhao, Yusheng Zhao, Xue Bai, Yumin Chen, Yuhan Liu, Yue Zhang, Hui Kong, Huihua Qu, Yan Zhao
Ulcerative colitis (UC) was first named by Samuel Wilks in 1859 [1]. It is a chronic, relapsing disease that begins with inflammation of the rectal mucosa and continues to invade the submucosa while extending proximally until it involves all parts of the whole large intestine [2]. According to incomplete statistics, there are currently 8.8–23.1 cases per 100,000 people in North America, 0.6–24.3 cases per 100,000 people in Europe, and China has steadily increased from 1.2 per 100,000 people. With the change in habits and increase in social pressure, the incidence of UC has risen rapidly and gradually evolves into a global intractable disease [3]. Patients often suffer from clinical symptoms such as abdominal pain, pus, and blood in the stool, tenesmus, and weight loss. The pathogenesis of UC is still unclear, but it is often caused by a combination of several factors. Among them, oxidative stress, the inflammatory response, and intestinal mucosal barrier function play an important role in the occurrence and development of UC. Intestinal mucosal barrier function is jointly maintained by important membrane proteins, such as ZOs (zonula occludens), occludins and claudins, and the actin cytoskeleton, and is the first line of defense to protect the intestinal epithelium from harmful substances [4]. However, increased oxidative stress and inflammatory responses can cause alterations in intestinal mucosal permeability by disrupting the structure of tight junctions (TJs) [5]. Therefore, reducing oxidative stress and the inflammatory response and protecting mucosal integrity are of great significance for the treatment of UC.
Association between Streptococcus gallolyticus and colorectal cancer in Mansoura University hospitals
Published in Egyptian Journal of Basic and Applied Sciences, 2021
Heba E. Eldegla, Mohamed Abdel-Wahhab, Dalia Moemen
Forty-eight cases and 48 controls who underwent colonoscopy in GISC, Faculty of Medicine, Mansoura University were enrolled in the study. The mean age of the included subjects was 55.98 and 46.83 years for cases and controls, respectively. Age was significantly older in cases compared to controls. As regard gender, females represented 50 and 45.8% of the included subjects in both groups, respectively. Also, most of the included subjects were from rural areas (72.9 and 70.8% o in both groups, respectively). Both gender and residence did not significantly differ between the study groups. Occupational contact with animals was significantly higher in cases compared to control (43.8 and 31.2%, respectively). Nevertheless, handling raw meat and raw milk products did not significantly differ between the two groups (Table 1). The incidence of rectal bleeding, weight loss, and crampy abdominal pain showed a significant increase in cases compared to controls; however, the incidence of diarrhea and anorexia was significantly increased in controls. There was no significant difference between cases and controls regarding the prevalence of tenesmus, nausea, vomiting, and fever (Table 2).
Long-Term Functional Outcome after Internal Delorme's Procedure for Obstructed Defecation Syndrome, and the Role of Postoperative Rehabilitation
Published in Journal of Investigative Surgery, 2018
C. A. Leo, P. Campennì, J. D. Hodgkinson, P. Rossitti, F. Digito, G. De Carli, L. D'Ambrosi, P. Carducci, L. Seriau, G. Terrosu
Between October 2006 and September 2013, 170 patients with a diagnosis of ODS underwent IDP. Male to female ratio was 18:152 (10.59%:89.41%). Median age was 60.41 yearsTABLE 2 (SD: ±13.27). A predominant preoperative reported symptom in 165 patients (97%) was feeling of incomplete evacuation. Sixty-three patients (37%) reported incomplete evacuation. Thirty-eight patients (22%) reported digitating via rectum or vagina to aid defecation. Eighty-five patients (50%) had tenesmus. Sixty-seven patients (38%) had a diagnosis of rectocele with mucosal prolapse. Fifty-nine (33%) had mucosal prolapse and rectal intussusception. Rectocele with mucosal prolapse and intussusception was found in 44 patients (24.8%). Of the 170 patients, 23.5% had perineal descent >4 cm. Twenty-six patients (15%) had a previous colorectal surgical procedure (including left/right hemicolectomy, hemorrhoidectomy, and hemorrhoid banding). Seventy patients (41%) had anorectal manometry studies within the normal range values. Fifty-one (30%) patients were found to have a low resting pressure, with normal other manometry pressures. Forty-nine patients (29%) had a significant alteration in rectal volumes tolerated. Results of this cohort are shown in Table 2.