169,926 research outputs found
Serine proteases: new players in diarrhoea-predominant irritable bowel syndrome
No full textComment on: "Increased faecal serine protease activity in diarrhoeic
IBS patients: a colonic lumenal factor impairing
colonic permeability and sensitivity". Gecse K, Róka R,
Ferrier L, Leveque M, Eutamene H, Cartier C, Ait-
Belgnaoui A, Rosztóczy A, Izbéki F, Fioramonti J, et al.
Gut 2008; 57:591-9
A rare cause of melena in lung cancer
No full textA 67-year-old woman was admitted to our department for one-month duration of asthenia. She was previously operated of upper right lobectomy for a high-grade sarcomatoid carcinoma. The patient was hemodynamically stable. Hemoglobin was 5.4 g/dL, and she was transfused with three blood units. An upper gastrointestinal endoscopy was carried out and it was unremarkable; a colonoscopy was then performed and a voluminous ulcerated polyp with a large base of implantation of the proximal descending colon was seen and removed without complications ( Fig. 1a). The pathological examination of the polyp was compatible with a metastasis of the lung cancer ( Fig. 1b). Because the appearance of melena requiring further hemotrasfusions, the patient underwent capsule endoscopy that showed a bleeding spontaneously large ulceration of the jejunum ( Fig. 2). She was operated and 9 cm of jejunum were resected ( Fig. 2); after surgical exploration another segment of ileum of 12 cm was resected ( Fig. 2). The pathological examination of the surgical specimens demonstrated metastases of the lung cancer ( Fig. 2)
A role for inflammation in irritable bowel syndrome?
No full textAttention has been directed to the putative role of low grade mucosal inflammation in irritable bowel syndrome (IBS) on the basis of evidence showing that some patients with IBS have an increased number of inflammatory cells in the colonic and ileal mucosa. Previous episodes of infectious enteritis, genetic factors, undiagnosed food allergies, and changes in bacterial microflora may all play a role in promoting and perpetuating this low grade inflammatory process. Human and animal studies support the concept that inflammation may perturb gastrointestinal reflexes and activate the visceral sensory system even when the inflammatory response is minimal and confined to the mucosa. Thus abnormal neuroimmune interactions may contribute to the altered gastrointestinal physiology and hypersensitivity that underlies IBS. A brief review of the human and animal studies that have focused on the putative role of intestinal inflammation and infections in the pathogenesis of IBS is given
La sindrome dell'intestino irritabile.
No full textLa sindrome dell’intestino irritabile (dall'inglese "irritable bowel syndrome" o IBS) è un disordine funzionale intestinale in cui il dolore (o il “fastidio”) addominale si associa all’evacuazione o ad alterazioni dell’alvo. La prevalenza dell’IBS in Europa e negli USA risulta, in media attorno al 10% (in Italia 12%) , sebbene sia molto variabile (dal 2% al 22%), anche in rapporto ai criteri diagnostici utilizzati. La frequenza dell’IBS risulta più elevata fra la seconda e la quarta decade di vita, con una predominanza per il sesso femminile (rapporto F:M pari a circa 2:1). L’incidenza è stimata attorno a 2-70/1000 pazienti all’anno. Sebbene una consistente proporzione dei pazienti affetti da IBS (fra il 33% e il 90%) non consulti il medico per i propri disturbi, l’IBS rappresenta la patologia di più frequente riscontro nella pratica clinica gastroenterologia e fino al 10% dell’attività dei medici di medicina generale
Almost all irritable bowel syndromes are post-infectious and respond to probiotics: controversial issues.
No full textAcute infectious gastroenteritis is the strongest known risk factor for the development of irritable bowel syndrome (IBS), one of the most common functional gastrointestinal disorders. However, knowledge about the incidence and prevalence of post-infectious IBS (PI-IBS) in the general population is still limited. Some of the published epidemiological studies on PI-IBS lack an appropriate control population, and were limited by a short follow-up symptom assessment post-infection. A number of risk factors have been associated with the development of PI-IBS, including the virulence of the pathogen, younger age, female sex, the long duration of the initial illness and the presence of psychological disturbances. However, much work has to be done to establish whether multifactorial mechanisms actually concur to the pathophysiology of PI-IBS. The discovery that an infective episode may trigger the development of IBS has not substantially changed the clinical management of this subset of patients compared to the classical (non-infective) form of IBS. Probiotics have been claimed to be of some benefit in IBS, but the majority of studies have been performed in non-specific IBS rather than in PI-IBS and a number of issues still remain to be elucidated. 2007 S. Karger AG, Base
New insights into human enteric neuropathies.
No full textThe functioning of enteric neuronal circuitries has been elucidated in the recent past. Evidence is now gathering to explain how dysfunction of the enteric nervous system (ENS) may lead to human gastrointestinal motor disorders. These conditions include achalasia, congenital hypertrophic pyloric stenosis, chronic intestinal pseudo-obstruction, Hirschsprung's disease, chronic idiopathic constipation, and probably irritable bowel syndrome. Degenerative, inflammatory and genetic mechanisms exert a critical role in ENS dysfunction underlying gut dysmotility. The study of the ENS abnormalities in gut dysmotility provides a framework to better understand the mechanisms involved in degeneration and neuronal loss and fosters the development of targeted therapeutic options
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