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Carlos Augusto Real Martinez - One of the best experts on this subject based on the ideXlab platform.
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Effects of anti-TNF-α in experimental Diversion Colitis.
Acta cirurgica brasileira, 2019Co-Authors: Ronaldo Parisi Buanaim, José Aires Pereira, Danilo Toshio Kanno, Fábio Guilherme Campos, Paulo Gustavo Kotze, E.f.k. Goto, Roberta Laís Da Silva Mendonça, Carlos Augusto Real MartinezAbstract:Purpose To evaluate the effects of infliximab on the inflammation of the colonic mucosa devoid from fecal stream. Methods Twenty-four rats were submitted to a Hartmann's procedure. They remained for 12 weeks with the fecal derivation to development of Diversion Colitis on excluded colorectal stump. After this period, they were divided into 3 groups: one group received intervention with saline (2.0 mL / week), other group infliximab at doses of 5 mg/kg/week and the other 10 mg/kg/week for five consecutively weeks. Concluded the intervention period, the animals were euthanized to remove colon segments with and without fecal stream. Colitis was diagnosed by histological analysis and the degree of inflammation by validated score. The neutrophilic infiltrate was evaluated by tissue expression of myeloperoxidase identified by immunohistochemical. The tissue content of myeloperoxidase was measured by computer-assisted image analysis. Results The inflammatory score was high in colonic segments without fecal stream. The intervention with infliximab reduced the inflammatory score in excluded colonic segments. The content of myeloperoxidase was reduced in colonic segments of animals treated with infliximab mainly in high concentrations. Conclusion Intervention with infliximab reduced the inflammation and the neutrophil infiltrate in colonic segments devoid of the fecal stream.
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[RETRACTED ARTICLE]: EVALUATION OF ENEMAS CONTAINING SUCRALFATE IN TISSUE CONTENT OF MUC-2 PROTEIN IN EXPERIMENTAL MODEL OF Diversion Colitis
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2018Co-Authors: Oscar Orlando Araya Fernandez, José Aires Pereira, Fábio Guilherme Campos, Carolina Mardegan Araya, Gabriele Escocia Marinho, Rafaela De Souza Novo, Thais Silva De Oliveira, Yara Tinoco Franceschi, Carlos Augusto Real MartinezAbstract:The effects of topical application of sucralfate (SCF) on the tissue content of MUC-2 protein have not yet been evaluated in experimental models of Diversion Colitis. To measure the tissue content of MUC-2 protein in the colonic mucosa diverted from fecal stream submitted to the SCF intervention. Thirty-six rats underwent derivation of intestinal transit through proximal colostomy and distal mucous fistula. The animals were divided into three groups which were submitted application of enemas with saline, SCF 1 g/kg/day and SCF 2 g/kg/day. Each group was divided into two subgroups, according to euthanasia was done after two or four weeks. The Colitis diagnosis was established by histopathological study and the inflammatory intensity was evaluated by previously validated scale. The MUC-2 protein was identified by immunohistochemistry and the tissue content was measured computerized morphometry). The application of enemas with SCF in the concentration of 2 g/kg/day reduced inflammatory score of the segments that were diverted from fecal stream. The content of MUC-2 in diverted colon of the animals submitted to the intervention with SCF, independently of intervention period and the used concentration, was significantly greater than animals submitted to the application of enemas containing saline (p< 0.01). The content of MUC-2 after the intervention with SCF in the concentration of 2 g/kg/day was significantly higher when compared to the animals submitted to the application containing SCF at concentration of 1.0 g/kg/day (p<0.01). The tissue content of MUC-2 reached the highest values after intervention with SCF in the concentration of 2 g/kg/day for four weeks (p<0.01). The preventive application of enemas containing SCF reduces the inflammatory score and avoids the reduction of tissue content of MUC-2, suggesting that the substance is a valid therapeutic strategy to preserve the mucus layer that covers the intestinal epithelium.
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evaluation of enemas containing sucralfate in tissue content of muc 2 protein in experimental model of Diversion Colitis
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2017Co-Authors: Oscar Orlando Araya Fernandez, José Aires Pereira, Fábio Guilherme Campos, Carolina Mardegan Araya, Gabriele Escocia Marinho, Rafaela De Souza Novo, Thais Silva De Oliveira, Yara Tinoco Franceschi, Carlos Augusto Real MartinezAbstract:BACKGROUND The effects of topical application of sucralfate (SCF) on the tissue content of MUC-2 protein have not yet been evaluated in experimental models of Diversion Colitis. AIM To measure the tissue content of MUC-2 protein in the colonic mucosa diverted from fecal stream submitted to the SCF intervention. METHODS Thirty-six rats underwent derivation of intestinal transit through proximal colostomy and distal mucous fistula. The animals were divided into three groups which were submitted application of enemas with saline, SCF 1 g/kg/day and SCF 2 g/kg/day. Each group was divided into two subgroups, according to euthanasia was done after two or four weeks. The Colitis diagnosis was established by histopathological study and the inflammatory intensity was evaluated by previously validated scale. The MUC-2 protein was identified by immunohistochemistry and the tissue content was measured computerized morphometry). RESULTS The application of enemas with SCF in the concentration of 2 g/kg/day reduced inflammatory score of the segments that were diverted from fecal stream. The content of MUC-2 in diverted colon of the animals submitted to the intervention with SCF, independently of intervention period and the used concentration, was significantly greater than animals submitted to the application of enemas containing saline (p< 0.01). The content of MUC-2 after the intervention with SCF in the concentration of 2 g/kg/day was significantly higher when compared to the animals submitted to the application containing SCF at concentration of 1.0 g/kg/day (p<0.01). The tissue content of MUC-2 reached the highest values after intervention with SCF in the concentration of 2 g/kg/day for four weeks (p<0.01). Conclusion: The preventive application of enemas containing SCF reduces the inflammatory score and avoids the reduction of tissue content of MUC-2, suggesting that the substance is a valid therapeutic strategy to preserve the mucus layer that covers the intestinal epithelium.
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anti inflammatory effects of enemas containing an oily extract of curcumin in an experimental model of Diversion Colitis
Histology and Histopathology, 2017Co-Authors: Caled Jaoudat Kadri, José Aires Pereira, Fábio Guilherme Campos, Manoela M. Ortega, Celene Benediti Bragion, Carlos Augusto Real MartinezAbstract:Curcumin has powerful anti-inflammatory and antioxidant effects and it has been used for treatment of distal ulcerative Colitis. The therapeutic effects of curcumin have not yet been evaluated in Diversion Colitis. The aim of the present study was to evaluate the anti-inflammatory effects of curcumin on colonic mucosa devoid of a faecal stream. Thirty-six rats were subjected to a proximal colostomy and distal colonic fistulation. They were divided into two groups, which were sacrificed two or four weeks after the intervention. Each group was divided into three subgroups treated with the daily application of enemas containing saline or an oily extract of curcumin at 50 mg/kg/day or 200 mg/kg/day. Colitis was diagnosed by histological analysis. Inflammatory grades were assessed using a previously validated scoring system. The infiltration of neutrophils was evaluated based on the tissue expression of myeloperoxidase (MPO), as determined by immunohistochemistry, and a computer-assisted image analysis program. The Mann-Whitney test was used to compare inflammation grades and myeloperoxidase levels among groups, and ANOVA was used to verify the variance over time, with the level of significance set at 5% (p<0.05) for both tests. Enemas containing curcumin improved the inflammation of the mucosa without a faecal stream and reduced the tissue contents of MPO. MPO tissue levels did not vary with time or between the concentrations of curcumin used. Enemas with curcumin improved the inflammation of the colonic mucosa, reduced the inflammatory grade and decreased the tissue content of MPO in colon segments without a faecal stream.
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EVALUATION OF ENEMAS CONTAINING SUCRALFATE IN TISSUE CONTENT OF MUC-2 PROTEIN IN EXPERIMENTAL MODEL OF Diversion Colitis
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2017Co-Authors: Oscar Orlando Araya Fernandez, José Aires Pereira, Fábio Guilherme Campos, Carolina Mardegan Araya, Gabriele Escocia Marinho, Rafaela De Souza Novo, Thais Silva De Oliveira, Yara Tinoco Franceschi, Carlos Augusto Real MartinezAbstract:BACKGROUND The effects of topical application of sucralfate (SCF) on the tissue content of MUC-2 protein have not yet been evaluated in experimental models of Diversion Colitis. AIM To measure the tissue content of MUC-2 protein in the colonic mucosa diverted from fecal stream submitted to the SCF intervention. METHODS Thirty-six rats underwent derivation of intestinal transit through proximal colostomy and distal mucous fistula. The animals were divided into three groups which were submitted application of enemas with saline, SCF 1 g/kg/day and SCF 2 g/kg/day. Each group was divided into two subgroups, according to euthanasia was done after two or four weeks. The Colitis diagnosis was established by histopathological study and the inflammatory intensity was evaluated by previously validated scale. The MUC-2 protein was identified by immunohistochemistry and the tissue content was measured computerized morphometry). RESULTS The application of enemas with SCF in the concentration of 2 g/kg/day reduced inflammatory score of the segments that were diverted from fecal stream. The content of MUC-2 in diverted colon of the animals submitted to the intervention with SCF, independently of intervention period and the used concentration, was significantly greater than animals submitted to the application of enemas containing saline (p< 0.01). The content of MUC-2 after the intervention with SCF in the concentration of 2 g/kg/day was significantly higher when compared to the animals submitted to the application containing SCF at concentration of 1.0 g/kg/day (p
José Aires Pereira - One of the best experts on this subject based on the ideXlab platform.
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Effects of anti-TNF-α in experimental Diversion Colitis.
Acta cirurgica brasileira, 2019Co-Authors: Ronaldo Parisi Buanaim, José Aires Pereira, Danilo Toshio Kanno, Fábio Guilherme Campos, Paulo Gustavo Kotze, E.f.k. Goto, Roberta Laís Da Silva Mendonça, Carlos Augusto Real MartinezAbstract:Purpose To evaluate the effects of infliximab on the inflammation of the colonic mucosa devoid from fecal stream. Methods Twenty-four rats were submitted to a Hartmann's procedure. They remained for 12 weeks with the fecal derivation to development of Diversion Colitis on excluded colorectal stump. After this period, they were divided into 3 groups: one group received intervention with saline (2.0 mL / week), other group infliximab at doses of 5 mg/kg/week and the other 10 mg/kg/week for five consecutively weeks. Concluded the intervention period, the animals were euthanized to remove colon segments with and without fecal stream. Colitis was diagnosed by histological analysis and the degree of inflammation by validated score. The neutrophilic infiltrate was evaluated by tissue expression of myeloperoxidase identified by immunohistochemical. The tissue content of myeloperoxidase was measured by computer-assisted image analysis. Results The inflammatory score was high in colonic segments without fecal stream. The intervention with infliximab reduced the inflammatory score in excluded colonic segments. The content of myeloperoxidase was reduced in colonic segments of animals treated with infliximab mainly in high concentrations. Conclusion Intervention with infliximab reduced the inflammation and the neutrophil infiltrate in colonic segments devoid of the fecal stream.
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[RETRACTED ARTICLE]: EVALUATION OF ENEMAS CONTAINING SUCRALFATE IN TISSUE CONTENT OF MUC-2 PROTEIN IN EXPERIMENTAL MODEL OF Diversion Colitis
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2018Co-Authors: Oscar Orlando Araya Fernandez, José Aires Pereira, Fábio Guilherme Campos, Carolina Mardegan Araya, Gabriele Escocia Marinho, Rafaela De Souza Novo, Thais Silva De Oliveira, Yara Tinoco Franceschi, Carlos Augusto Real MartinezAbstract:The effects of topical application of sucralfate (SCF) on the tissue content of MUC-2 protein have not yet been evaluated in experimental models of Diversion Colitis. To measure the tissue content of MUC-2 protein in the colonic mucosa diverted from fecal stream submitted to the SCF intervention. Thirty-six rats underwent derivation of intestinal transit through proximal colostomy and distal mucous fistula. The animals were divided into three groups which were submitted application of enemas with saline, SCF 1 g/kg/day and SCF 2 g/kg/day. Each group was divided into two subgroups, according to euthanasia was done after two or four weeks. The Colitis diagnosis was established by histopathological study and the inflammatory intensity was evaluated by previously validated scale. The MUC-2 protein was identified by immunohistochemistry and the tissue content was measured computerized morphometry). The application of enemas with SCF in the concentration of 2 g/kg/day reduced inflammatory score of the segments that were diverted from fecal stream. The content of MUC-2 in diverted colon of the animals submitted to the intervention with SCF, independently of intervention period and the used concentration, was significantly greater than animals submitted to the application of enemas containing saline (p< 0.01). The content of MUC-2 after the intervention with SCF in the concentration of 2 g/kg/day was significantly higher when compared to the animals submitted to the application containing SCF at concentration of 1.0 g/kg/day (p<0.01). The tissue content of MUC-2 reached the highest values after intervention with SCF in the concentration of 2 g/kg/day for four weeks (p<0.01). The preventive application of enemas containing SCF reduces the inflammatory score and avoids the reduction of tissue content of MUC-2, suggesting that the substance is a valid therapeutic strategy to preserve the mucus layer that covers the intestinal epithelium.
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evaluation of enemas containing sucralfate in tissue content of muc 2 protein in experimental model of Diversion Colitis
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2017Co-Authors: Oscar Orlando Araya Fernandez, José Aires Pereira, Fábio Guilherme Campos, Carolina Mardegan Araya, Gabriele Escocia Marinho, Rafaela De Souza Novo, Thais Silva De Oliveira, Yara Tinoco Franceschi, Carlos Augusto Real MartinezAbstract:BACKGROUND The effects of topical application of sucralfate (SCF) on the tissue content of MUC-2 protein have not yet been evaluated in experimental models of Diversion Colitis. AIM To measure the tissue content of MUC-2 protein in the colonic mucosa diverted from fecal stream submitted to the SCF intervention. METHODS Thirty-six rats underwent derivation of intestinal transit through proximal colostomy and distal mucous fistula. The animals were divided into three groups which were submitted application of enemas with saline, SCF 1 g/kg/day and SCF 2 g/kg/day. Each group was divided into two subgroups, according to euthanasia was done after two or four weeks. The Colitis diagnosis was established by histopathological study and the inflammatory intensity was evaluated by previously validated scale. The MUC-2 protein was identified by immunohistochemistry and the tissue content was measured computerized morphometry). RESULTS The application of enemas with SCF in the concentration of 2 g/kg/day reduced inflammatory score of the segments that were diverted from fecal stream. The content of MUC-2 in diverted colon of the animals submitted to the intervention with SCF, independently of intervention period and the used concentration, was significantly greater than animals submitted to the application of enemas containing saline (p< 0.01). The content of MUC-2 after the intervention with SCF in the concentration of 2 g/kg/day was significantly higher when compared to the animals submitted to the application containing SCF at concentration of 1.0 g/kg/day (p<0.01). The tissue content of MUC-2 reached the highest values after intervention with SCF in the concentration of 2 g/kg/day for four weeks (p<0.01). Conclusion: The preventive application of enemas containing SCF reduces the inflammatory score and avoids the reduction of tissue content of MUC-2, suggesting that the substance is a valid therapeutic strategy to preserve the mucus layer that covers the intestinal epithelium.
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anti inflammatory effects of enemas containing an oily extract of curcumin in an experimental model of Diversion Colitis
Histology and Histopathology, 2017Co-Authors: Caled Jaoudat Kadri, José Aires Pereira, Fábio Guilherme Campos, Manoela M. Ortega, Celene Benediti Bragion, Carlos Augusto Real MartinezAbstract:Curcumin has powerful anti-inflammatory and antioxidant effects and it has been used for treatment of distal ulcerative Colitis. The therapeutic effects of curcumin have not yet been evaluated in Diversion Colitis. The aim of the present study was to evaluate the anti-inflammatory effects of curcumin on colonic mucosa devoid of a faecal stream. Thirty-six rats were subjected to a proximal colostomy and distal colonic fistulation. They were divided into two groups, which were sacrificed two or four weeks after the intervention. Each group was divided into three subgroups treated with the daily application of enemas containing saline or an oily extract of curcumin at 50 mg/kg/day or 200 mg/kg/day. Colitis was diagnosed by histological analysis. Inflammatory grades were assessed using a previously validated scoring system. The infiltration of neutrophils was evaluated based on the tissue expression of myeloperoxidase (MPO), as determined by immunohistochemistry, and a computer-assisted image analysis program. The Mann-Whitney test was used to compare inflammation grades and myeloperoxidase levels among groups, and ANOVA was used to verify the variance over time, with the level of significance set at 5% (p<0.05) for both tests. Enemas containing curcumin improved the inflammation of the mucosa without a faecal stream and reduced the tissue contents of MPO. MPO tissue levels did not vary with time or between the concentrations of curcumin used. Enemas with curcumin improved the inflammation of the colonic mucosa, reduced the inflammatory grade and decreased the tissue content of MPO in colon segments without a faecal stream.
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EVALUATION OF ENEMAS CONTAINING SUCRALFATE IN TISSUE CONTENT OF MUC-2 PROTEIN IN EXPERIMENTAL MODEL OF Diversion Colitis
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2017Co-Authors: Oscar Orlando Araya Fernandez, José Aires Pereira, Fábio Guilherme Campos, Carolina Mardegan Araya, Gabriele Escocia Marinho, Rafaela De Souza Novo, Thais Silva De Oliveira, Yara Tinoco Franceschi, Carlos Augusto Real MartinezAbstract:BACKGROUND The effects of topical application of sucralfate (SCF) on the tissue content of MUC-2 protein have not yet been evaluated in experimental models of Diversion Colitis. AIM To measure the tissue content of MUC-2 protein in the colonic mucosa diverted from fecal stream submitted to the SCF intervention. METHODS Thirty-six rats underwent derivation of intestinal transit through proximal colostomy and distal mucous fistula. The animals were divided into three groups which were submitted application of enemas with saline, SCF 1 g/kg/day and SCF 2 g/kg/day. Each group was divided into two subgroups, according to euthanasia was done after two or four weeks. The Colitis diagnosis was established by histopathological study and the inflammatory intensity was evaluated by previously validated scale. The MUC-2 protein was identified by immunohistochemistry and the tissue content was measured computerized morphometry). RESULTS The application of enemas with SCF in the concentration of 2 g/kg/day reduced inflammatory score of the segments that were diverted from fecal stream. The content of MUC-2 in diverted colon of the animals submitted to the intervention with SCF, independently of intervention period and the used concentration, was significantly greater than animals submitted to the application of enemas containing saline (p< 0.01). The content of MUC-2 after the intervention with SCF in the concentration of 2 g/kg/day was significantly higher when compared to the animals submitted to the application containing SCF at concentration of 1.0 g/kg/day (p
Antoine Cortot - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Diversion Colitis by short-chain fatty acids
Diseases of the Colon & Rectum, 1991Co-Authors: FranÇois Guillemot, Jean-frederic Colombel, Christelle Neut, Nathalie Verplanck, Martine Lecomte, Claude Romond, Jean Claude Paris, Antoine CortotAbstract:Diminished production of short-chain fatty acids (SCFA) by altered flora has been suggested in the pathogenesis of Diversion Colitis (DC). We evaluated prospectively the effectiveness of SCFA irrigation in 13 patients with excluded colon (eight males, five females; mean age, 48 years). The causes of Diversion were inflammatory bowel disease (n=4), colonic cancer (n=2), sigmoid diverticulitis with perforation (n=3), ischiorectal abscess (n=2), and miscellaneous (n=2). Patients were given, twice a day for 14 days in a double-blind manner, a 60-ml enema containing either SCFA (acetate: 60 mmol/liter; proprionate: 30 mmol/liter; and N-butyrate: 40 mmol/ liter) (Group 1; n=7) or isotonic NaCl (Group 2; n=6). Endoscopy with biopsies was performed before starting the trial (D1) and 14 days later (D14). On D1 all patients had endoscopic and histologic findings suggestive of DC. No endoscopic or histologic changes were observed on D14 in either group. We conclude that endoscopic and histologic lesions of DC were not improved by SCFA irrigation during the 14 days .
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Treatment of Diversion Colitis by short-chain fatty acids. Prospective and double-blind study.
Diseases of the colon and rectum, 1991Co-Authors: Guillemot F, Jean-frederic Colombel, Christelle Neut, Nathalie Verplanck, Martine Lecomte, Claude Romond, Jean Claude Paris, Antoine CortotAbstract:Diminished production of short-chain fatty acids (SCFA) by altered flora has been suggested in the pathogenesis of Diversion Colitis (DC). We evaluated prospectively the effectiveness of SCFA irrigation in 13 patients with excluded colon (eight males, five females; mean age, 48 years). The causes of Diversion were inflammatory bowel disease (n=4), colonic cancer (n=2), sigmoid diverticulitis with perforation (n=3), ischiorectal abscess (n=2), and miscellaneous (n=2). Patients were given, twice a day for 14 days in a double-blind manner, a 60-ml enema containing either SCFA (acetate: 60 mmol/liter; proprionate: 30 mmol/liter; and N-butyrate: 40 mmol/ liter) (Group 1; n=7) or isotonic NaCl (Group 2; n=6). Endoscopy with biopsies was performed before starting the trial (D1) and 14 days later (D14). On D1 all patients had endoscopic and histologic findings suggestive of DC. No endoscopic or histologic changes were observed on D14 in either group. We conclude that endoscopic and histologic lesions of DC were not improved by SCFA irrigation during the 14 days.
Jean-frederic Colombel - One of the best experts on this subject based on the ideXlab platform.
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Nitrate-Reducing Bacteria in Diversion Colitis (A Clue to Inflammation?)
Digestive diseases and sciences, 1997Co-Authors: Christel Neut, Guillemot F, Jean-frederic ColombelAbstract:A pathogenic role of nitric oxide has been suggested in acute and chronic intestinal inflammation. We took the opportunity offered by studies in patients with excluded colon, which represents a model of chronic intestinal inflammation with no exogenous nitrite or nitrate supply, to evaluate the quantity and the quality of nitrate reducers in Diversion Colitis. Thirty patients (17 men, 13 women, mean age 45 years) having an excluded colon for various reasons were sampled by rectal swabs and compared to 30 healthy controls (11 men, 19 women, mean age 28 years). The percentage of nitrate-reducers among the total count of subcultured bacteria was 46 +/- 41% (mean +/- SD) in patients with Diversion Colitis as compared to 19 +/- 24% in healthy controls. This difference was significant (P < 0.05) despite great heterogeneity in individual values. In patients with Diversion Colitis, 75/254 (29.5%) different isolated bacterial strains were nitrate-reducers as compared to 61/294 (21%) (P < 0.05) in controls. Among the 75 nitrate-reducing strains isolated from patients with Diversion Colitis, 55 were aerobes. Pseudomonas species were only encountered in this population. The predominant group was enterobacteria with a high isolation rate of species belonging to the genera Proteus, Providencia, and Morganella. In healthy controls nitrate-reducing anaerobes were nearly as frequent as aerobes. The most frequent species was Eubacterium lentum, followed by Clostridium perfringens. It could be suggested that nitric oxide synthase might produce a bacterial substrate increasing the growth of bacteria with a high pathogenic potential, creating conditions for chronic inflammation and infection in patients with excluded colon.
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Treatment of Diversion Colitis by short-chain fatty acids
Diseases of the Colon & Rectum, 1991Co-Authors: FranÇois Guillemot, Jean-frederic Colombel, Christelle Neut, Nathalie Verplanck, Martine Lecomte, Claude Romond, Jean Claude Paris, Antoine CortotAbstract:Diminished production of short-chain fatty acids (SCFA) by altered flora has been suggested in the pathogenesis of Diversion Colitis (DC). We evaluated prospectively the effectiveness of SCFA irrigation in 13 patients with excluded colon (eight males, five females; mean age, 48 years). The causes of Diversion were inflammatory bowel disease (n=4), colonic cancer (n=2), sigmoid diverticulitis with perforation (n=3), ischiorectal abscess (n=2), and miscellaneous (n=2). Patients were given, twice a day for 14 days in a double-blind manner, a 60-ml enema containing either SCFA (acetate: 60 mmol/liter; proprionate: 30 mmol/liter; and N-butyrate: 40 mmol/ liter) (Group 1; n=7) or isotonic NaCl (Group 2; n=6). Endoscopy with biopsies was performed before starting the trial (D1) and 14 days later (D14). On D1 all patients had endoscopic and histologic findings suggestive of DC. No endoscopic or histologic changes were observed on D14 in either group. We conclude that endoscopic and histologic lesions of DC were not improved by SCFA irrigation during the 14 days .
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Treatment of Diversion Colitis by short-chain fatty acids. Prospective and double-blind study.
Diseases of the colon and rectum, 1991Co-Authors: Guillemot F, Jean-frederic Colombel, Christelle Neut, Nathalie Verplanck, Martine Lecomte, Claude Romond, Jean Claude Paris, Antoine CortotAbstract:Diminished production of short-chain fatty acids (SCFA) by altered flora has been suggested in the pathogenesis of Diversion Colitis (DC). We evaluated prospectively the effectiveness of SCFA irrigation in 13 patients with excluded colon (eight males, five females; mean age, 48 years). The causes of Diversion were inflammatory bowel disease (n=4), colonic cancer (n=2), sigmoid diverticulitis with perforation (n=3), ischiorectal abscess (n=2), and miscellaneous (n=2). Patients were given, twice a day for 14 days in a double-blind manner, a 60-ml enema containing either SCFA (acetate: 60 mmol/liter; proprionate: 30 mmol/liter; and N-butyrate: 40 mmol/ liter) (Group 1; n=7) or isotonic NaCl (Group 2; n=6). Endoscopy with biopsies was performed before starting the trial (D1) and 14 days later (D14). On D1 all patients had endoscopic and histologic findings suggestive of DC. No endoscopic or histologic changes were observed on D14 in either group. We conclude that endoscopic and histologic lesions of DC were not improved by SCFA irrigation during the 14 days.
H. F. Hashmi - One of the best experts on this subject based on the ideXlab platform.
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Diversion Colitis
Surgical Endoscopy, 1994Co-Authors: R. L. Whelan, D. Abramson, H. F. HashmiAbstract:A prospective study of patients who had undergone fecal Diversion was performed in order to determine the incidence of and to characterize better the condition known as “Diversion Colitis.” A total of 53 patients were studied. All patients underwent endoscopic evaluation of the diverted large bowel. Evidence of Colitis was found in 48 patients (91%). The Colitis was mild in 52%, moderate in 44%, and severe in only 4%. Endoscopic findings included: contact irritation or bleeding, erythema, and mucosal nodularity. The proximal, “in continuity,” colon was examined in 86% of patients with colostomies; none were found to have Colitis. Biopsies were taken of the diverted segment in 94% of patients with Colitis and from the “in continuity” colon in 78% of patients with colostomies. Similar histologic findings were noted on these biopsies and included: mild chronic inflammation, lymphoid nodules, and crypt architectural changes. With the exception of lymphoid nodules, which were seen more frequently in the inflamed diverted colon ( P =0.035), there was no significant difference in the incidence of the various histologic changes when the biopsies from the diverted and “in continuity” large bowel were compared. Rectal washings and stool samples were sent for bacterial cultures, ova, and parasite analysis, and C. Diff . toxin titers in the majority of patients; all but 1 were negative. Symptoms relating to the diverted bowel were elicited in only 3 patients (6%). Stomal closure was carried out in 70% of patients. Postclosure endoscopy in 21 patients revealed full resolution of the Colitis in all. Diversion Colitis occurs in almost all diverted patients. It uniformly resolves following stomal closure. The vast majority of patients remain asymptomatic. There is no need for distal biopsies or other tests when this condition is found in asymptomatic patients. Furthermore, except in patients who have an indication for neoplastic screening, there is no need to examine the proximal “in continuity” colon in asymptomatic patients. Colostomy closure need not be delayed in these patients. However, those patients with significant symptoms or a history of Colitis or diarrhea should undergo a complete proximal and distal colonic evaluation prior to stomal closure. Biopsies appear to have little or no role in establishing the diagnosis of Diversion Colitis.
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Diversion Colitis. A prospective study.
Surgical endoscopy, 1994Co-Authors: R. L. Whelan, D. Abramson, D. S. Kim, H. F. HashmiAbstract:A prospective study of patients who had undergone fecal Diversion was performed in order to determine the incidence of and to characterize better the condition known as "Diversion Colitis." A total of 53 patients were studied. All patients underwent endoscopic evaluation of the diverted large bowel. Evidence of Colitis was found in 48 patients (91%). The Colitis was mild in 52%, moderate in 44%, and severe in only 4%. Endoscopic findings included: contact irritation or bleeding, erythema, and mucosal nodularity. The proximal, "in continuity," colon was examined in 86% of patients with colostomies; none were found to have Colitis. Biopsies were taken of the diverted segment in 94% of patients with Colitis and from the "in continuity" colon in 78% of patients with colostomies. Similar histologic findings were noted on these biopsies and included: mild chronic inflammation, lymphoid nodules, and crypt architectural changes. With the exception of lymphoid nodules, which were seen more frequently in the inflamed diverted colon (P = 0.035), there was no significant difference in the incidence of the various histologic changes when the biopsies from the diverted and "in continuity" large bowel were compared. Rectal washings and stool samples were sent for bacterial cultures, ova, and parasite analysis, and C. Diff. toxin titers in the majority of patients; all but 1 were negative. Symptoms relating to the diverted bowel were elicited in only 3 patients (6%). Stomal closure was carried in 70% of patients. Postclosure endoscopy in 21 patients revealed full resolution of the Colitis in all. Diversion Colitis occurs in almost all diverted patients. It uniformly resolves following stomal closure.(ABSTRACT TRUNCATED AT 250 WORDS)