142 results on '"Diarrhea diagnostic imaging"'
Search Results
2. Use of shear wave imaging with intestinal ultrasonography in patients with chronic diarrhea.
- Author
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Kapoor A, Singh A, Kapur A, Mahajan G, and Sharma S
- Subjects
- Humans, Constriction, Pathologic, Retrospective Studies, Ultrasonography methods, Diarrhea diagnostic imaging, Crohn Disease complications, Crohn Disease diagnostic imaging, Elasticity Imaging Techniques methods, Colitis, Ulcerative
- Abstract
Objective: A retrospective study was designed to determine the role of shear wave elastography (SWE) and intestinal ultrasonography to differentiate between inflammatory and fibrotic bowel strictures by determining Young's modulus (E) and shear wave dispersion (SWD) and to compare its role with contrast-enhanced computed tomography (CECT) in patients with chronic diarrhea and pain abdomen., Methods: Seventy-six patients who had increased small bowel thickness (SBWT) >3 mm, and large bowel wall thickness (LBWT) >4 mm on intestinal ultrasonography (IUS) were evaluated in a two-step manner. The first step involved classifying patients with increased SBWT >3 mm and LBWT >4 mm by use of SWE and dispersion into three groups that is group I (fibrotic), group II (inflammatory) thickening, and group III (mixed-fibrosis and inflammatory) wall thickening. In the second step, etiological classification was done using six gray scale features of IUS that is length and degree of bowel thickening, presence of bowel stratification, Limberg grade of vascularity, status of mesenteric fat, juxta bowel status-nodes, fluid, and fistula formation to reach to a definitive diagnosis. These findings were compared with findings on CECT. Twenty-three patients had diagnosis confirmed by biopsy while 18 underwent surgery with histologic confirmation of operative findings. The sensitivity, specificity and AUROC for both modalities were compared., Results: Group I that is fibrotic group had 33 patients with fibrotic strictures of which fibrotic Crohn's disease (CD)and tuberculosis of the bowel were the dominant types followed by neoplastic and infective causes. In Group II that is inflammatory there were 32 patients with predominantly infective ileo-colitis, and ulcerative colitis patients while 11 patients were present in group III that is (mixed fibrotic and inflammatory) type of bowel wall thickening and were patients of inflammatory CD, infective ileo-colitis. The presence of length of bowel involvement, Limberg grade, mesenteric fat proliferation, and SBWT>9 mm were the statistically significant parameters on IUS which helped to reach to final diagnosis. The sensitivity and specificity of combined SWE with SWD and IUS were 100% and 99% while that of CECT was 78% and 96% respectively with AUROC of 100% and 64%., Conclusion: SWI combined with IUS in a two-step manner is an accurate way to evaluate patients with chronic diarrhea who have increased SBWT and is not only able to differentiate inflammatory from fibrotic bowel wall thickening but also helps to form an etiological diagnosis., (© 2023 Wiley Periodicals LLC.)
- Published
- 2024
- Full Text
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3. Expansion of the ophthalmic phenotype of SPINT2-related syndromic congenital sodium diarrhea.
- Author
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Ernst J, Hiasat J, Alabek ML, Scanga HL, Motley W, and Nischal KK
- Subjects
- Abnormalities, Multiple diagnosis, Abnormalities, Multiple diagnostic imaging, Abnormalities, Multiple pathology, Child, Preschool, Cornea metabolism, Cornea pathology, Diarrhea diagnosis, Diarrhea diagnostic imaging, Diarrhea genetics, Diarrhea pathology, Humans, Metabolism, Inborn Errors diagnosis, Metabolism, Inborn Errors diagnostic imaging, Metabolism, Inborn Errors pathology, Mutation genetics, Phenotype, Tomography, Optical Coherence methods, Abnormalities, Multiple genetics, Diarrhea congenital, Membrane Glycoproteins genetics, Metabolism, Inborn Errors genetics, Sodium metabolism
- Abstract
A 5-year-old girl presented with treatment-refractory dry eye and recurrent episodes of eye pain. She had been previously diagnosed with syndromic congenital sodium diarrhea (SCSD) caused by a pathogenic variant in SPINT2. Her local pediatric ophthalmologist had made the diagnosis of severe dry eye with corneal erosions, based on which, we arranged an eye exam under anesthesia (EUA) and punctal plug placement. Anterior segment optical coherence tomography (OCT) and corneal photographs were taken during the procedure. There are reports describing similar ophthalmic findings in this syndrome. However, to the best of our knowledge, this is the first case report to document OCT imaging and corneal photographs in a patient with SCSD, which we feel expands the ophthalmic phenotype of this rare genetic disorder., (© 2021 Wiley Periodicals LLC.)
- Published
- 2021
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4. Colonoscopic evaluation of diarrhea/colitis occurring as an immune-related adverse event.
- Author
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Yamauchi Y, Arai M, Akizue N, Ohta Y, Okimoto K, Matsumura T, Fan MM, Imai C, Tawada A, Kato J, Kato N, and Takiguchi Y
- Subjects
- Colitis drug therapy, Colitis pathology, Diarrhea drug therapy, Dose-Response Relationship, Drug, Feces, Female, Humans, Male, Middle Aged, Retrospective Studies, Severity of Illness Index, Steroids therapeutic use, Treatment Outcome, Colitis chemically induced, Colitis diagnostic imaging, Colonoscopy, Diarrhea chemically induced, Diarrhea diagnostic imaging, Immune Checkpoint Inhibitors adverse effects
- Abstract
Objective: Diarrhea is often observed as an immune-related adverse event. In this study, we conducted a retrospective review of the severity of diarrhea, its treatment and the endoscopic findings in patients developing diarrhea as an immune-related adverse event., Methods: From August 2015 to June 2019, a total of 369 patients received treatment with immune checkpoint inhibitors at our hospital. For this study, development of grade 2 or more diarrhea in these patients was defined as an immune-related adverse event. We analyzed the histopathological severity of the bowel lesions according to the Nancy histological index for ulcerative colitis., Results: Of the 369 patients, 27 (7.3%) developed diarrhea as an immune-related adverse event. Of these 27 patients, 18 received steroid treatment. Colonoscopy was performed in 17 patients and culture of the feces in 18. The tests revealed evidence of bacterial colitis (Aeromonas hydrophila) in two patients. The Nancy histological index was 4, 3, 2, 1 and 0 in two, three, two, two and seven patients, respectively. No findings on colonoscopy were observed in 7 of the 17 patients (41%) who underwent colonoscopy, and most of these patients recovered without steroid treatment. Patients with lower values of the Nancy histological index tended to show better responses to steroid treatment., Conclusions: To avoid unnecessary steroid administration, colonoscopic evaluation is essential in patients receiving treatment with immune checkpoint inhibitors who present with diarrhea as an immune-related adverse event. In addition, the endoscopic findings could be useful to predict the response to steroid treatment., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2021
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5. Posthematopoietic stem cell transplant COVID-19 infection in a pediatric patient with IPEX syndrome.
- Author
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Alicea Marrero MM, Silio M, McQueen-Amaker K, Español M, Velez M, and LeBlanc Z
- Subjects
- Allografts, COVID-19 blood, COVID-19 diagnostic imaging, COVID-19 microbiology, COVID-19 therapy, Child, Diabetes Mellitus, Type 1 blood, Diabetes Mellitus, Type 1 diagnostic imaging, Diabetes Mellitus, Type 1 microbiology, Diabetes Mellitus, Type 1 therapy, Fatal Outcome, Hematopoietic Stem Cell Transplantation, Humans, Immune System Diseases blood, Immune System Diseases diagnostic imaging, Immune System Diseases microbiology, Immune System Diseases therapy, Male, Diabetes Mellitus, Type 1 congenital, Diarrhea blood, Diarrhea diagnostic imaging, Diarrhea microbiology, Diarrhea therapy, Genetic Diseases, X-Linked blood, Genetic Diseases, X-Linked diagnostic imaging, Genetic Diseases, X-Linked microbiology, Genetic Diseases, X-Linked therapy, Graft Rejection blood, Graft Rejection diagnostic imaging, Graft Rejection microbiology, Graft Rejection therapy, Immune System Diseases congenital, SARS-CoV-2 metabolism
- Published
- 2021
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6. Life-Threatening Diarrhea in an Elderly Patient.
- Author
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Soldera J, Coelho GP, and Heinrich CF
- Subjects
- Celiac Disease therapy, Diarrhea diagnostic imaging, Diarrhea pathology, Humans, Male, Middle Aged, Celiac Disease complications, Celiac Disease diagnosis, Diarrhea etiology
- Published
- 2021
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7. Larger regional volume of the thalamus in diarrhea-predominant irritable bowel syndrome: a cross-sectional study.
- Author
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Mao CP, Chen FR, Sun HH, Shi MJ, Yang HJ, Li XH, and Ding D
- Subjects
- Cross-Sectional Studies, Humans, Magnetic Resonance Imaging, Diarrhea diagnostic imaging, Diarrhea pathology, Irritable Bowel Syndrome diagnostic imaging, Irritable Bowel Syndrome pathology, Thalamus diagnostic imaging, Thalamus pathology
- Abstract
As a relay center between the cerebral cortex and various subcortical brain areas, the thalamus is repeatedly associated with the dysfunction of brain-gut interaction in patients with irritable bowel syndrome (IBS). However, the regional morphological alterations of the thalamus in IBS are not well defined. We acquired structural magnetic resonance data from 34 patients with IBS and 34 demographically similar healthy subjects. Data processing was performed using FMRIB's Integrated Registration and Segmentation Tool (FIRST). Volumetric analysis and surface-based vertex analysis were both carried out to characterize the morphology of the thalamus and other subcortical structures. Our results suggested that the majority (31 cases) of the patients with IBS had diarrhea-predominant symptoms. Volumetric analysis revealed a larger normalized volume of the right thalamus and left caudate nucleus in patients with IBS than in healthy controls. Surface analysis indicated that the difference arose mainly from the laterodorsal nucleus of the right thalamus, and the body of the left caudate nucleus. In addition, patients with IBS had different hemispheric asymmetries of the thalamus (rightward) and caudate nucleus (leftward) from controls (leftward for the thalamus and rightward for the caudate nucleus). In general, our results indicated that patients with diarrhea-predominant IBS had enlarged thalamus and caudate nucleus volumes, as well as altered hemispheric asymmetries of these two structures, compared with healthy controls. The neuroimaging evidence of these structural alterations helps clarify the underlying pathophysiology of diarrhea-predominant IBS.
- Published
- 2020
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8. Is It Crohn's Disease?
- Author
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Parigi TL, Bonifacio C, and Danese S
- Subjects
- Betacoronavirus, COVID-19, Crohn Disease drug therapy, Diagnosis, Differential, Diarrhea diagnostic imaging, Female, Humans, Pandemics, Recurrence, SARS-CoV-2, Young Adult, Coronavirus Infections complications, Coronavirus Infections diagnosis, Crohn Disease diagnosis, Diarrhea virology, Pneumonia, Viral complications, Pneumonia, Viral diagnosis
- Published
- 2020
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9. Adrenal Paracoccidioidomycosis.
- Author
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Cataño J and Porras J
- Subjects
- Adrenal Glands drug effects, Adrenal Glands microbiology, Adrenal Glands pathology, Amphotericin B therapeutic use, Asthenia drug therapy, Asthenia microbiology, Asthenia pathology, Diarrhea drug therapy, Diarrhea microbiology, Diarrhea pathology, Fludrocortisone therapeutic use, Humans, Hydrocortisone therapeutic use, Itraconazole therapeutic use, Male, Middle Aged, Paracoccidioides drug effects, Paracoccidioides growth & development, Paracoccidioides pathogenicity, Paracoccidioidomycosis drug therapy, Paracoccidioidomycosis microbiology, Paracoccidioidomycosis pathology, Tomography, X-Ray Computed, Vomiting drug therapy, Vomiting microbiology, Vomiting pathology, Adrenal Glands diagnostic imaging, Asthenia diagnostic imaging, Diarrhea diagnostic imaging, Paracoccidioidomycosis diagnostic imaging, Vomiting diagnostic imaging
- Published
- 2020
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10. An Unusual Cause of Chronic Diarrhea.
- Author
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Rowan DJ, Welle CL, and Said S
- Subjects
- Abdominal Pain etiology, Biopsy, Chronic Disease, Colon microbiology, Diarrhea diagnostic imaging, Diarrhea pathology, Endoscopy, Gastrointestinal, Humans, Male, Tomography, X-Ray Computed, Colon pathology, Diarrhea microbiology, Syphilis complications, Syphilis diagnosis
- Published
- 2020
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11. A rare case of diarrhea and ascites.
- Author
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Pereira F, Ferreira AI, Linhares M, Paulo S, Tristan J, Pereira E, Sousa R, and Banhudo A
- Subjects
- Abdomen diagnostic imaging, Ascites blood, Ascites diagnostic imaging, Ascites pathology, Ascitic Fluid pathology, Diarrhea blood, Diarrhea diagnostic imaging, Diarrhea pathology, Endoscopy, Humans, Male, Ultrasonography, Young Adult, Ascites complications, Diarrhea complications
- Abstract
Background: Eosinophilic enterocolitis is a rare condition included in the spectrum of the eosinophilic gastrointestinal disorders. Diagnosis is based on clinical presentation combined with an increase infiltration of eosinophils in the gastrointestinal tract, in the absence of other secondary causes of eosinophilic infiltration., Case Presentation: We report a case of a 22-year-old male with eosinophilic enterocolitis presenting with malabsorption syndrome (diarrhea, vomiting, weight loss), bowel wall thickening, and ascites. Secondary causes of intestinal eosinophilia were excluded, and diagnosis was established in a timely manner. Treatment plan included a 6-food elimination diet and corticosteroid therapy, with clinical remission after 2 weeks of therapy. The patient remains asymptomatic after 12 months of follow-up, with no relapse.
- Published
- 2020
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12. Use of X-ray to Assess Fecal Loading in Patients with Gastrointestinal Symptoms.
- Author
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Pleasant V, Sammarco A, Keeney-Bonthrone G, Bell S, Saad R, and Berger MB
- Subjects
- Adult, Aged, Cross-Sectional Studies, Female, Humans, Logistic Models, Male, Middle Aged, Radiography, Abdominal, Retrospective Studies, Colon diagnostic imaging, Constipation diagnostic imaging, Diarrhea diagnostic imaging, Fecal Incontinence diagnostic imaging, Feces
- Abstract
Background/aims: There is currently no gold standard for evaluating stool burden in the colon for patients with gastrointestinal symptoms. We aim to examine the relationship between fecal loading on single view abdominal X-ray imaging and gastrointestinal symptoms such as constipation, diarrhea, bloating, and accidental bowel leakage in adult outpatients., Methods: This retrospective, cross-sectional study examined patients seen at University of Michigan from 2005 to 2017. Chart review of demographic information, reported gastrointestinal symptoms, past medical history, and abdominal radiographic imaging was performed. Bivariate analysis was performed to assess associations between these characteristics and fecal loading. Factors independently associated with fecal loading were identified using logistic regression. Significance was established at p < 0.05., Results: In total, 319 patients who had an X-ray were included in the final analysis, with 84.0% demonstrating fecal loading on the initial X-ray and most reporting constipation as a symptom (n = 214, 84.3%, p = 0.0334). In logistic regression, a chief complaint of constipation had higher odds of being associated with fecal loading on X-ray compared to diarrhea (adjusted OR 6.41; CI 1.51-27.24, p = 0.0118). Bloating as a reported symptom was statistically significant with an adjusted OR of 2.56 (CI 1.10-5.96, p = 0.0286)., Conclusions: Constipation (as a chief complaint) and bloating (as a symptom) were associated with fecal loading on X-ray imaging, while accidental bowel leakage and diarrhea were not.
- Published
- 2019
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13. Male With Diarrhea and Decreased Urine Output.
- Author
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Smith CY and Bitter CC
- Subjects
- Adenocarcinoma surgery, Colostomy adverse effects, Cystectomy adverse effects, Diarrhea diagnostic imaging, Humans, Male, Middle Aged, Postoperative Complications, Rectal Fistula diagnostic imaging, Rectal Neoplasms surgery, Tomography, X-Ray Computed, Urinary Bladder Fistula diagnostic imaging, Diarrhea etiology, Oliguria etiology, Rectal Fistula etiology, Urinary Bladder Fistula etiology
- Published
- 2019
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14. Prevalence of, and predictors of, bile acid diarrhea in outpatients with chronic diarrhea: A follow-up study.
- Author
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Lim SJ, Gracie DJ, Kane JS, Mumtaz S, Scarsbrook AF, Chowdhury FU, Ford AC, and Black CJ
- Subjects
- Adult, Aged, Chronic Disease, Diarrhea metabolism, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Prevalence, Prospective Studies, Radionuclide Imaging methods, Retrospective Studies, Taurocholic Acid administration & dosage, Bile Acids and Salts metabolism, Diarrhea diagnostic imaging, Diarrhea epidemiology, Selenium Radioisotopes administration & dosage, Taurocholic Acid analogs & derivatives
- Abstract
Background: 23-seleno-25-homo-tauro-cholic acid (SeHCAT) scanning to rule out bile acid diarrhea (BAD) in patients with chronic diarrhea has a high yield. Our previous study showed that patients with terminal ileal (TI) Crohn's disease, TI resection, or cholecystectomy were highly likely to have an abnormal scan. As a result, we encouraged clinicians to use a therapeutic trial of a bile acid sequestrant in these patients, instead of scanning. This may have reduced diagnostic yield of the test, so we examined this issue, as well as factors predicting an abnormal scan, in a large cohort of patients referred subsequently., Methods: We retrospectively identified 1,071 consecutive patients with chronic diarrhea undergoing SeHCAT scanning at Leeds Teaching Hospitals Trust from 2012 to 2016. We reviewed electronic patient records to obtain information on presenting gastrointestinal symptoms and any proposed risk factors for BAD. BAD was categorized according to subtype and severity., Key Results: As expected, indications for scanning changed between 2012 and 2016, with a significant reduction in referrals with TI Crohn's disease or resection year-on-year (P < 0.001). Despite this, 457 (42.7%) patients had BAD and there was no downward trend in yield of SeHCAT during the 5 year period (P = 0.39). Overall, 51.6% had type II BAD, 36.1% type III, and 12.3% type I. BAD was mild in 31.7%, moderate in 34.4%, and severe in 33.9%. In total, 653 (61.0%) patients had no known risk factors, other than chronic diarrhea, but 233 (35.7%) of these individuals had BAD, and in 143 (61.4%), this was moderate or severe., Conclusions and Inferences: Despite reduced referrals for SeHCAT scanning in those with clear risk factors for BAD, the yield remained > 40%. One-third of those without known risk factors had BAD., (© 2019 John Wiley & Sons Ltd.)
- Published
- 2019
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15. 75 Se-Homocholic acid taurine scintigraphy ( 75 SeHCAT ® ), a standard benchmark test in bile acid malabsorption?
- Author
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Baena García A, Partida Palma F, García Martínez S, de Bonilla Candau M, and Pajares Vinardell M
- Subjects
- Algorithms, Benchmarking, Humans, Radionuclide Imaging, Bile Acids and Salts metabolism, Diarrhea diagnostic imaging, Steatorrhea diagnostic imaging, Taurocholic Acid analogs & derivatives
- Abstract
Chronic diarrhoea due to bile acid malabsorption (BAM) is an underdiagnosed pathology. Different diagnostic tools are available. However, there is currently no consensus on which of these would be the benchmark test or gold standard. This review evaluates the possibility of using
75 Se-taurocholic acid (75 SeHCAT® ) scintigraphy as a benchmark diagnostic test and its perspective for the future. A literature review was conducted in Pubmed and OVID obtaining a total of 57 papers, 26 of which were finally used after being selected under the concepts of gold standard, diagnostic accuracy and other biomarkers. We evaluated the advantages and disadvantages of the different diagnostic tools:14 C-glycocholate, measurement of bile acids in faeces, C4 in serum, FGF19 in serum, cholestyramine, and75 Se-tauroselcolic acid scintigraphy. We consider that the75 SeHCAT® scan is the most recommended diagnostic test in Europe for diagnosing BAM as it presents the highest values of sensitivity and specificity. It has a significant cost-benefit ratio, making it the test with the highest degree of recommendation. However, it is still not possible to use it in a recognised way as a gold standard due to the lack of studies that provide conclusive data that allow consensus. In the meantime, the combined use of cholestyramine testing in all patients we want to evaluate, regardless of the scintigraphy result, could be encouraged as a benchmark standard., (Publicado por Elsevier España, S.L.U.)- Published
- 2019
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16. Transthyretin Val122Ile amyloidosis associated with isolated gastrointestinal disease and bowel rupture in a Caucasian woman.
- Author
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Sirdesai S, Hosking P, Stewart G, Ting S, Booth D, Fong E, and Gibbs SDJ
- Subjects
- Aged, 80 and over, Amino Acid Substitution, Amyloid Neuropathies, Familial diagnostic imaging, Amyloid Neuropathies, Familial genetics, Amyloid Neuropathies, Familial pathology, Diarrhea diagnostic imaging, Diarrhea genetics, Diarrhea pathology, Female, Gastrointestinal Diseases diagnostic imaging, Gastrointestinal Diseases genetics, Gastrointestinal Diseases pathology, Humans, White People, Amyloid Neuropathies, Familial complications, Diarrhea complications, Gastrointestinal Diseases complications, Prealbumin genetics
- Published
- 2019
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17. A 19 F magnetic resonance imaging-based diagnostic test for bile acid diarrhea.
- Author
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Raufman JP, Metry M, Felton J, Cheng K, Xu S, and Polli J
- Subjects
- Animals, Biological Transport, Diagnostic Tests, Routine, Female, Fibroblast Growth Factors metabolism, Gallbladder drug effects, Humans, Intestines, Male, Materials Testing, Mice, Mice, Knockout, Organic Anion Transporters, Sodium-Dependent metabolism, Selenium Radioisotopes chemistry, Symporters metabolism, Taurocholic Acid chemistry, Bile Acids and Salts chemistry, Diarrhea diagnostic imaging, Fluorine-19 Magnetic Resonance Imaging
- Abstract
In up to 50% of people diagnosed with a common ailment, diarrhea-predominant irritable bowel syndrome, diarrhea results from excess spillage of bile acids into the colon-data emerging over the past decade identified deficient release of a gut hormone, fibroblast growth factor 19 (FGF19), and a consequent lack of feedback suppression of bile acid synthesis as the most common cause.
75 Selenium homotaurocholic acid (SeHCAT) testing, considered the most sensitive and specific means of identifying individuals with bile acid diarrhea, is unavailable in many countries, including the United States. Other than SeHCAT, tests to diagnose bile acid diarrhea are cumbersome, non-specific, or insufficiently validated; clinicians commonly rely on a therapeutic trial of bile acid binders. Here, we review bile acid synthesis and transport, the pathogenesis of bile acid diarrhea, the reasons clinicians frequently overlook this disorder, including the limitations of currently available tests, and our efforts to develop a novel19 F magnetic resonance imaging (MRI)-based diagnostic approach. We created19 F-labeled bile acid analogues whose in vitro and in vivo transport mimics that of naturally occurring bile acids. Using dual1 H/19 F MRI of the gallbladders of live mice fed19 F-labeled bile acid analogues, we were able to differentiate wild-type mice from strains deficient in intestinal expression of a key bile acid transporter, the apical sodium-dependent bile acid transporter (ASBT), or FGF15, the mouse homologue of FGF19. In addition to reviewing our development of19 F-labeled bile acid analogue-MRI to diagnose bile acid diarrhea, we discuss challenges to its clinical implementation. A major limitation is the paucity of clinical MRI facilities equipped with the appropriate coil and software needed to detect19 F signals.- Published
- 2019
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18. Bile acid malabsorption in patients with chronic diarrhea and Crohn's disease.
- Author
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Mena Bares LMª, Benítez Cantero JM, Iglesias Flores E, Gros Alcalde B, Moreno Ortega E, Maza Muret FR, Carmona Asenjo E, García Sánchez MªV, and Vallejo Casas JA
- Subjects
- Adult, Capsule Endoscopy, Chronic Disease, Crohn Disease complications, Crohn Disease metabolism, Cross-Sectional Studies, Diarrhea etiology, Female, Humans, Malabsorption Syndromes classification, Male, Middle Aged, Selenium Radioisotopes, Young Adult, Bile Acids and Salts, Crohn Disease diagnostic imaging, Diarrhea diagnostic imaging, Malabsorption Syndromes diagnostic imaging
- Abstract
Introduction and Aim: Crohn's disease (CD) is a form of inflammatory bowel disease and is mainly characterized by diarrhea and abdominal pain. The aim of our study was to analyze the usefulness of performing a 75SeHCAT scan in CD patients with chronic diarrhea and suspected bile acid malabsorption (BAM). In addition, we aimed to determine whether there was a relationship with the clinical features of the disease and a previous bowel resection., Patients and Methods: this was an observational cross-sectional study of 39 patients with a diagnosis of CD and chronic diarrhea. All cases underwent a 75SeHCAT scan for BAM diagnosis, after discarding disease activity., Results: the study cohort included 19 females and 20 males. The median age was 44 years and the majority of patients were A2 L1 B1 according to the Montreal classification; 84.6% of patients had undergone a previous bowel resection. BAM was present in 97.4% of patients (100% and 83.3% of patients with and without previous surgery, respectively), which was severe in 92.1% of cases. Treatment with bile acid sequestrants was initiated and a favorable response was obtained in 72.2% of patients. The relationship between BAM degree (moderate or severe), bowel surgery and the response to bile acid sequestrant treatment was also analyzed but not statistically significant., Conclusion: BAM is a frequent cause of diarrhea in CD patients in endoscopic or radiological remission. This condition was present in all patients with a history of a bowel resection. A response to bile acid sequestrants treatment was observed in 73% of patients.
- Published
- 2019
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19. Attenuated Accumulation of Novel Fluorine ( 19 F)-Labeled Bile Acid Analogues in Gallbladders of Fibroblast Growth Factor-15 (FGF15)-Deficient Mice.
- Author
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Metry M, Felton J, Cheng K, Xu S, Ai Y, Xue F, Raufman JP, and Polli JE
- Subjects
- Animals, Bile Acids and Salts administration & dosage, Bile Acids and Salts chemistry, Diarrhea genetics, Disease Models, Animal, Fibroblast Growth Factors genetics, Fibroblast Growth Factors metabolism, Fluorine chemistry, Gallbladder diagnostic imaging, Gallbladder metabolism, Humans, Male, Mice, Mice, Inbred C57BL, Mice, Transgenic, Molecular Probes administration & dosage, Molecular Probes chemistry, Tissue Distribution, Bile Acids and Salts pharmacokinetics, Diarrhea diagnostic imaging, Magnetic Resonance Imaging methods, Molecular Imaging methods, Molecular Probes pharmacokinetics
- Abstract
Our work has focused on defining the utility of fluorine (
19 F)-labeled bile acid analogues and magnetic resonance imaging (MRI) to identify altered bile acid transport in vivo. In the current study, we explored the ability of this approach to differentiate fibroblast growth factor-15 (FGF15)-deficient from wild-type (WT) mice, a potential diagnostic test for bile acid diarrhea, a commonly misdiagnosed disorder. FGF15 is the murine homologue of human FGF19, an intestinal hormone whose deficiency is an underappreciated cause of bile acid diarrhea. In a pilot and three subsequent pharmacokinetic studies, we treated mice with two19 F-labeled bile acid analogues, CA-lys-TFA and CA-sar-TFMA. After oral dosing, we quantified19 F-labeled bile acid analogue levels in the gallbladder, liver, small and large intestine, and plasma using liquid chromatography mass spectrometry (LC-MS/MS). Both19 F bile acid analogues concentrated in the gallbladders of FGF15-deficient and WT mice, attaining peak concentrations at approximately 8.5 h after oral dosing. However, analogue levels in gallbladders of FGF15-deficient mice were several-fold less compared to those in WT mice. Live-animal19 F MRI provided agreement with our LC-MS/MS-based measures; we detected robust CA-lys-TFA19 F signals in gallbladders of WT mice but no signals in FGF15-deficient mice. Our finding that19 F MRI differentiates FGF15-deficient from WT mice provides additional proof-of-concept for the development of19 F bile acid analogues and19 F MRI as a clinical test to diagnose bile acid diarrhea due to FGF19 deficiency and other disorders.- Published
- 2018
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20. Gastrointestinal: Olmesartan-induced enteropathy.
- Author
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Shahzad MA, Harding D, Ruszkiewicz A, Tran E, England G, and Philpott H
- Subjects
- Aged, Chronic Disease, Diarrhea diagnostic imaging, Diarrhea pathology, Endoscopy, Gastrointestinal, Female, Gastroenteritis diagnostic imaging, Gastroenteritis pathology, Humans, Antihypertensive Agents adverse effects, Diarrhea chemically induced, Gastroenteritis chemically induced, Imidazoles adverse effects, Tetrazoles adverse effects
- Published
- 2018
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21. A Rare Cause of Recurrent Abdominal Pain and Diarrhea.
- Author
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Allamneni C, Nelson G, and Weber F
- Subjects
- Abdominal Pain blood, Abdominal Pain diagnostic imaging, Abdominal Pain therapy, Aged, Angioedema blood, Angioedema diagnostic imaging, Anti-Infective Agents therapeutic use, Clostridioides difficile isolation & purification, Colonoscopy, Diarrhea blood, Diarrhea diagnostic imaging, Diarrhea therapy, Enterocolitis, Pseudomembranous diagnostic imaging, Enterocolitis, Pseudomembranous microbiology, Enterocolitis, Pseudomembranous therapy, Fecal Microbiota Transplantation, Female, Humans, Intestine, Small blood supply, Intestine, Small diagnostic imaging, Intestine, Small microbiology, Intestine, Small pathology, Irritable Bowel Syndrome diagnostic imaging, Irritable Bowel Syndrome microbiology, Irritable Bowel Syndrome therapy, Lymphocytosis diagnosis, Recurrence, Tomography, X-Ray Computed, Abdominal Pain etiology, Angioedema etiology, B-Lymphocytes, Diarrhea etiology, Lymphocytosis complications
- Published
- 2018
- Full Text
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22. Cholescintigraphic patterns in a IBS patient with postprandial diarrhea.
- Author
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Bortolotti M, Zanoni L, Levorato M, and Fanti S
- Subjects
- Humans, Male, Middle Aged, Organotechnetium Compounds, Postprandial Period, Radionuclide Imaging, Diarrhea diagnostic imaging, Irritable Bowel Syndrome diagnostic imaging
- Published
- 2018
- Full Text
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23. Congenital duodenocolic fistula in a dog.
- Author
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Lecoindre A, Saade D, Barthez P, Cadoré JL, and Lecoindre P
- Subjects
- Animals, Colonic Diseases congenital, Colonic Diseases surgery, Diarrhea diagnostic imaging, Diarrhea veterinary, Dog Diseases surgery, Dogs, Duodenal Diseases congenital, Duodenal Diseases surgery, Endoscopy, Gastrointestinal veterinary, Female, Intestinal Fistula congenital, Intestinal Fistula surgery, Tomography, X-Ray Computed veterinary, Colonic Diseases veterinary, Dog Diseases congenital, Duodenal Diseases veterinary, Intestinal Fistula veterinary
- Abstract
A one-year-old female cocker spaniel presented with a 6-month history of persistent diarrhoea. Abdominal ultrasonographic examination revealed mild diffuse thickening of the intestinal wall coupled with mesenteric lymphadenopathy. A connection between the duodenum and the colon was observed during an endoscopic procedure and confirmed by computed tomography. Surgical resection of the communication allowed remission of the diarrhoea. Histology showed a normal duodenal epithelium and muscular layer. A duodenocolic fistula is an abnormal connection within the digestive tract, which in humans is usually considered a complication of a local pathological condition. Due to the absence of a predisposing cause and, in view of the dog's age and histological results, a congenital origin was suspected., (© 2017 British Small Animal Veterinary Association.)
- Published
- 2018
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24. Prenatal Bowel Findings in Male Siblings With a Confirmed FOXP3 Mutation.
- Author
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Griswold C, Durica AR, Dennis LG, and Jewell AF
- Subjects
- Adult, Bone Marrow Transplantation, Diabetes Mellitus, Type 1 diagnostic imaging, Diabetes Mellitus, Type 1 genetics, Diabetes Mellitus, Type 1 therapy, Diarrhea therapy, Fatal Outcome, Female, Genetic Diseases, X-Linked therapy, Humans, Immune System Diseases diagnostic imaging, Immune System Diseases genetics, Immune System Diseases therapy, Infant, Infant, Newborn, Intestines diagnostic imaging, Male, Pregnancy, Siblings, Diabetes Mellitus, Type 1 congenital, Diarrhea diagnostic imaging, Diarrhea genetics, Forkhead Transcription Factors genetics, Genetic Diseases, X-Linked diagnostic imaging, Genetic Diseases, X-Linked genetics, Immune System Diseases congenital, Mutation genetics, Ultrasonography, Prenatal methods
- Abstract
There are multiple etiologies for fetal dilated bowel loops on ultrasonography (US), and we present a unique case of male siblings with a forkhead box P3 (FOXP3) mutation. Both children presented with fetal bowel anomalies on prenatal US. Family histories of cystic fibrosis and immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome were reported. Amniocentesis in both pregnancies identified a normal male karyotype and the familial mutation associated with IPEX syndrome. IPEX syndrome is one of a group of conditions known as congenital diarrhea disorders. Other congenital diarrhea disorder cases have presented with similar prenatal US findings. As a result of these associations, we suggest considering IPEX syndrome as a potential cause of fetal bowel anomalies, particularly with a known family history. However, continued research into the phenotypic and genotypic correlations for IPEX syndrome is likely needed to better understand this possible prenatal presentation., (© 2017 by the American Institute of Ultrasound in Medicine.)
- Published
- 2018
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25. The Capsule Endoscopy Findings in S-1-induced Enteritis with Severe Diarrhea during Adjuvant Chemotherapy for Gastric Cancer (with Video).
- Author
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Ota K, Takeuchi T, Kodama K, Ozaki H, Harada S, Kojima Y, Nouda S, Goto M, and Higuchi K
- Subjects
- Adult, Antimetabolites, Antineoplastic therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Chemotherapy, Adjuvant, Diarrhea diagnostic imaging, Drug Combinations, Enteritis diagnostic imaging, Female, Gastrectomy, Humans, Oxonic Acid therapeutic use, Severity of Illness Index, Stomach Neoplasms surgery, Tegafur therapeutic use, Antimetabolites, Antineoplastic adverse effects, Antineoplastic Combined Chemotherapy Protocols adverse effects, Capsule Endoscopy, Diarrhea chemically induced, Enteritis chemically induced, Oxonic Acid adverse effects, Stomach Neoplasms drug therapy, Tegafur adverse effects
- Abstract
Although S-1 chemotherapy is used widely as postoperative adjuvant chemotherapy for gastric cancer, some patients experience diarrhea during treatment. The patient was a 39-year-old woman who underwent distal gastrectomy for gastric cancer and who had started S-1 chemotherapy as postoperative adjuvant chemotherapy 1 week before her presentation. She experienced severe diarrhea immediately after starting the course of S-1 tablets. Capsule endoscopy revealed severe S-1-induced enteritis with extensive mucosal injury in the ileum and red intestinal fluid due to the oozing of blood in the ileum. After reducing the dosage of S-1, her diarrhea became milder, and she was able to continue S-1 chemotherapy.
- Published
- 2018
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26. How useful is abdominal ultrasonography in dogs with diarrhoea?
- Author
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Mapletoft EK, Allenspach K, and Lamb CR
- Subjects
- Animals, Cross-Sectional Studies, Diarrhea diagnostic imaging, Dogs, Female, Intestinal Diseases diagnostic imaging, Intestinal Diseases veterinary, Male, Retrospective Studies, Abdomen diagnostic imaging, Diarrhea veterinary, Dog Diseases diagnostic imaging, Ultrasonography veterinary
- Abstract
Objective: To assess the utility of abdominal ultrasonography in the diagnostic work-up of dogs with diarrhoea., Methods: Retrospective cross-sectional study based on a referral population of dogs with diarrhoea. Associations between the clinical signs, use of abdominal ultrasonography, results of abdominal ultrasonography and subsequent work-up were examined. The utility of abdominal ultrasonography was scored as high, moderate, none or counterproductive based on review of medical records., Results: Medical records of 269 dogs were reviewed, of which 149 (55%) had abdominal ultrasonography. The most frequent result was no ultrasonographic abnormalities affecting the intestine in 65 (44%) dogs. Ultrasonography results were associated with subsequent work-up as follows: (1) no detected abnormalities and dietary trial; (2) focal thickening of the intestinal wall, loss of intestinal wall layers or enlarged abdominal lymph nodes and ultrasound-guided fine-needle aspirates; (3) diffuse thickening of the intestinal wall or hyperechoic striations in the small intestinal mucosa and endoscopy; and (4) small intestinal foreign body and coeliotomy. Abdominal ultrasonography was considered to be diagnostic without further testing in only four (3%) dogs: two had a portosystemic shunt identified ultrasonographically, one had a linear foreign body and one had a perforated pyloric ulcer. Abdominal ultrasonography had moderate utility in 56 (38%) dogs and no utility in 79 (53%) dogs. Abdominal ultrasonography was considered counterproductive in 10 (7%) dogs because results were either falsely negative or falsely positive., Clinical Significance: These results should prompt clinicians to reconsider routine use of abdominal ultrasonography in dogs with diarrhoea., (© 2017 British Small Animal Veterinary Association.)
- Published
- 2018
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27. Bowel Dilation Diagnosed Prenatally.
- Author
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Chouikh T, Mottet N, Lenoir M, and Chaussy Y
- Subjects
- Adult, Cesarean Section methods, Colon abnormalities, Colon diagnostic imaging, Conservative Treatment, Diarrhea diagnostic imaging, Diarrhea genetics, Diarrhea therapy, Dilatation, Female, Follow-Up Studies, Gestational Age, Humans, Infant, Newborn, Magnetic Resonance Imaging methods, Metabolism, Inborn Errors genetics, Pregnancy, Pregnancy Outcome, Prenatal Diagnosis methods, Chloride-Bicarbonate Antiporters genetics, Diarrhea congenital, Gene Expression Regulation, Developmental, Metabolism, Inborn Errors diagnostic imaging, Metabolism, Inborn Errors therapy, Sulfate Transporters genetics, Ultrasonography, Prenatal methods
- Published
- 2017
- Full Text
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28. Clinical and endoscopic features in patients with hospital-acquired diarrhea associated with Clostridium difficile infection.
- Author
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Velarde Ruiz-Velasco JA, Aldana-Ledesma JM, Ibarra-Estrada MA, Aguirre Díaz SA, Fernández-Ramírez JA, Cárdenas-Lara F, Álvarez López F, Rodríguez-Noriega LE, Pérez-Gómez HR, and Morfín-Otero MR
- Subjects
- Adult, Aged, Clostridium Infections etiology, Clostridium Infections microbiology, Cross Infection etiology, Cross Infection microbiology, Diarrhea diagnostic imaging, Endoscopy, Gastrointestinal, Enterocolitis, Pseudomembranous diagnosis, Enterocolitis, Pseudomembranous etiology, Enterocolitis, Pseudomembranous microbiology, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Clostridioides difficile classification, Clostridium Infections diagnosis, Cross Infection diagnosis, Diarrhea microbiology
- Abstract
Introduction and Aims: Clostridium difficile infection is the main cause of hospital-acquired diarrhea, and the clinical and endoscopic findings in those patients have been studied very little in Mexico. The aim of the present study was to describe those findings., Materials and Methods: A prospective cohort study was conducted that included patients with hospital-acquired diarrhea associated with Clostridium difficile diagnosed through polymerase chain reaction. The hypervirulent NAP027 strain was also determined. The clinical and endoscopic findings in the study patients, as well as the variables associated with severity, were analyzed., Results: Of the 127 patients with hospital-acquired diarrhea, 97 were excluded from the study due to lack of colonoscopy. The remaining 39 study patients had a mean age of 48 years, and their most common signs/symptoms were abdominal pain (49%), mucus in stools (41%), and blood in stools (10%). The most common alterations in the laboratory results were leukocytosis in 49%, fecal leukocytes (61%), and hypoalbuminemia (67%). The main risk factor was antibiotic use in 62%, and ceftriaxone was the most widely used. The hypervirulent strain was present in 54% of the cases. Endoscopic abnormalities were found in 87% of the patients. Thirty-eight percent presented with pseudomembranous colitis, with lesions in the left colon in 53%, and in the right colon in 13%. No association was found between proton-pump inhibitor use and Clostridium difficile-associated diarrhea. There was a significant association between hypoalbuminemia (< 3.3g/dL) and a greater risk for severe colitis, with a RR of 8.2 (p=0.008)., Conclusions: Pseudomembranous colitis lesions associated with the hypervirulent Clostridium difficile strain were predominant in the left colon. Hypoalbuminemia was a significant severity predictor., (Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.)
- Published
- 2017
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29. The efficacy of a low-fat diet to manage the symptoms of bile acid malabsorption - outcomes in patients previously treated for cancer.
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Jackson A, Lalji A, Kabir M, Muls A, Gee C, Vyoral S, Shaw C, and Andreyev HJN
- Subjects
- Abdominal Pain, Adult, Aged, Aged, 80 and over, Diarrhea complications, Diarrhea diagnostic imaging, Female, Humans, Male, Middle Aged, Neoplasms complications, Neoplasms therapy, Prospective Studies, Steatorrhea complications, Steatorrhea diagnostic imaging, Taurocholic Acid analogs & derivatives, Taurocholic Acid therapeutic use, Tomography, X-Ray Computed, Treatment Outcome, Young Adult, Bile Acids and Salts metabolism, Diarrhea diet therapy, Diet, Fat-Restricted, Steatorrhea diet therapy
- Abstract
Dietary fat ingestion triggers bile secretion into the gastrointestinal tract. Bile acid malabsorption affects >1% of the population, causing loose stool and other gastrointestinal symptoms. The diagnosis is frequently missed. Treatments are often considered ineffective. We evaluated low-fat diets for managing gastrointestinal symptoms in these patients. All patients reporting type 6 or 7 stool were offered a selenium-75 homocholic acid taurine (SeHCAT) scan. Prospective data in patients with 7-day scan retention <20% were analysed. -Patients requiring a bile acid sequestrant were given this before receiving dietary advice. Patients completed a 7-day food diary before dietetic consultations. Personalised dietary interventions, providing 20% of daily energy from fat, were prescribed. Symptoms were assessed using a modified gastrointestinal symptom rating scale questionnaire before and 4-12 weeks after dietary intervention. A total of 114 patients (49 male, median age 64 years, median body mass index 27 kg/m
2 ) were evaluated. 44% of these patients were taking colesevelam. After dietary intervention, there was statistically significant improvement in abdominal pain and nocturnal defecation (0.2% alpha, p=0.001). Improvement in bowel frequency, urgency, flatulence, belching, borborygmi and stool consistency were seen, but did not reach statistical significance (p≤0.004-0.031). Dietary intervention is an effective treatment option for patients with symptomatic bile acid malabsorption and should be routinely considered., (© Royal College of Physicians 2017. All rights reserved.)- Published
- 2017
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30. Prolonged intestinal transit and diarrhea in patients with an activating GUCY2C mutation.
- Author
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von Volkmann HL, Brønstad I, Gilja OH, R Tronstad R, Sangnes DA, Nortvedt R, Hausken T, Dimcevski G, Fiskerstrand T, and Nylund K
- Subjects
- Adult, Aged, Body Fluids, Capsule Endoscopy, Diarrhea blood, Diarrhea diagnostic imaging, Female, Hormones blood, Humans, Hydrogen-Ion Concentration, Intestines pathology, Intestines physiopathology, Male, Middle Aged, Muscle Contraction, Observer Variation, Pressure, Receptors, Enterotoxin, Time Factors, Young Adult, Diarrhea genetics, Diarrhea physiopathology, Gastrointestinal Transit physiology, Mutation genetics, Receptors, Guanylate Cyclase-Coupled genetics, Receptors, Peptide genetics
- Abstract
Introduction: Increased intestinal hydration by activation of the epithelial enzyme linked receptor guanylate cyclase C (GC-C) is a pharmacological principle for treating constipation. Activating mutations in the GUCY2C gene encoding GC-C cause Familial GUCY2C diarrhea syndrome (FGDS) which has been diagnosed with severe dysmotility., Aim: To investigate gut motility and hormones before and after a meal in FGDS patients and compare with healthy controls (HC)., Subjects and Methods: Bristol stool chart and stool frequency was assessed. Before and after a meal occlusive and non-occlusive contractions were obtained using ultrasound. A wireless motility capsule (WMC) recorded gut transit time, pH, contractions and pressure. Plasma levels of selected gut hormones were measured at different time points., Results: The FGDS patients had 4 (range 1-10) loose stools/day and prolonged total gut transit time compared to HC, 55.5 h vs 28.5 h, respectively,with significantly increased colon transit time. In FGDS patients, pH in duodenum, small bowel and colon was increased and the number of contractions and the intraluminal pressure were significantly decreased, measured by WMC. Ultrasound showed in small bowel increased number of non-occlusive contractions in the FGDS patients. Serotonin (5-HT) plasma levels in the HC peaked 30 min after the meal, while the FGDS patients had no response., Conclusion: Despite having diarrhea, the FGDS patients have prolonged transit time through the gut compared to HC, particularly in colon. The reduced number of intestinal contractions and lack of 5-HT release after a meal in FGDS patients surprisingly resemble colonic motility disturbances seen in patients with constipation.
- Published
- 2017
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31. Proof of Concept: Design and Initial Evaluation of a Device to Measure Gastrointestinal Transit Time.
- Author
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Wagner RH, Savir-Baruch B, Halama JR, Venu M, Gabriel MS, and Bova D
- Subjects
- Administration, Oral, Adolescent, Adult, Citrates administration & dosage, Citrates chemistry, Equipment Design, Equipment Failure Analysis, Feasibility Studies, Female, Gallium administration & dosage, Gallium chemistry, Humans, Male, Middle Aged, Oryza chemistry, Pilot Projects, Young Adult, Citrates analysis, Constipation diagnostic imaging, Constipation physiopathology, Diarrhea diagnostic imaging, Diarrhea physiopathology, Drug Carriers chemistry, Gallium analysis, Gastrointestinal Transit
- Abstract
Chronic constipation and gastrointestinal motility disorders constitute a large part of a gastroenterology practice and have a significant impact on a patient's quality of life and lifestyle. In most cases, medications are prescribed to alleviate symptoms without there being an objective measurement of response. Commonly used investigations of gastrointestinal transit times are currently limited to radiopaque markers or electronic capsules. Repeated use of these techniques is limited because of the radiation exposure and the significant cost of the devices. We present the proof of concept for a new device to measure gastrointestinal transit time using commonly available and inexpensive materials with only a small amount of radiotracer. Methods: We assembled gelatin capsules containing a
67 Ga-citrate-radiolabeled grain of rice embedded in paraffin for use as a point-source transit device. It was tested for stability in vitro and subsequently was given orally to 4 healthy volunteers and 10 patients with constipation or diarrhea. Imaging was performed at regular intervals until the device was excreted. Results: The device remained intact and visible as a point source in all subjects until excretion. When used along with a diary of bowel movement times and dates, the device could determine the total transit time. The device could be visualized either alone or in combination with a barium small-bowel follow-through study or a gastric emptying study. Conclusion: The use of a point-source transit device for the determination of gastrointestinal transit time is a feasible alternative to other methods. The device is inexpensive and easy to assemble, requires only a small amount of radiotracer, and remains inert throughout the gastrointestinal tract, allowing for accurate determination of gastrointestinal transit time. Further investigation of the device is required to establish optimum imaging parameters and reference values. Measurements of gastrointestinal transit time may be useful in managing patients with dysmotility and in selecting the appropriate pharmaceutical treatment., (© 2017 by the Society of Nuclear Medicine and Molecular Imaging.)- Published
- 2017
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32. Study to determine guidelines for pediatric colonoscopy.
- Author
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Yoshioka S, Takedatsu H, Fukunaga S, Kuwaki K, Yamasaki H, Yamauchi R, Mori A, Kawano H, Yanagi T, Mizuochi T, Ushijima K, Mitsuyama K, Tsuruta O, and Torimura T
- Subjects
- Adolescent, Age Factors, Child, Child, Preschool, Citric Acid administration & dosage, Colon diagnostic imaging, Colon drug effects, Colonoscopes, Colonoscopy adverse effects, Colonoscopy instrumentation, Colonoscopy methods, Female, Humans, Infant, Infant, Newborn, Japan, Male, Organometallic Compounds administration & dosage, Polyethylene Glycols administration & dosage, Practice Guidelines as Topic, Propofol administration & dosage, Retrospective Studies, Abdominal Pain diagnostic imaging, Cathartics administration & dosage, Colonoscopy standards, Diarrhea diagnostic imaging, Gastrointestinal Hemorrhage diagnostic imaging, Hypnotics and Sedatives administration & dosage
- Abstract
Aim: To investigated characteristics, diagnosis, bowel-cleansing preparation, sedation, and colonoscope length and diameter in Japanese pediatric patients receiving total colonoscopy., Methods: The present study evaluated consecutive patients aged ≤ 15 years who had undergone their first colonoscopy in Kurume University between January 2007 and February 2015. Data were retrospectively analyzed. We identified 110 pediatric patients who had undergone colonoscopy that had reached the cecum, allowing the observation of the total colon., Results: Hematochezia, abdominal pain, and diarrhea were the most common symptoms. For bowel-cleansing preparation, pediatric patients aged ≤ 12 years were treated with magnesium citrate, and patients aged 13-15 years were treated with polyethylene glycol 4000. For sedation, thiamylal with pentazocine, which has an analgesic effect, was used in patients aged ≤ 6 years, and midazolam with pentazocine was used in patients aged ≥ 7 years. Regarding the choice of endoscope, short and thin endoscopes were selected for younger patients, particularly patients aged ≤ 3 years. Positive diagnoses were made in 78 patients (70.9%). Inflammatory bowel disease ( n = 49, 44.5%), including ulcerative colitis ( n = 37, 33.6%) and Crohn's disease ( n = 12, 10.9%), was the most common diagnosis., Conclusion: Colonoscopy offers a high diagnostic capability for pediatric patients with gastrointestinal symptoms. The selection of appropriate management the performance of colonoscopy is important in pediatric patients., Competing Interests: Conflict-of-interest statement: None of the authors have any conflict of interest disclosures to make.
- Published
- 2017
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33. Clinicopathological and Ileocolonoscopic Characteristics in Patients with Nodular Lymphoid Hyperplasia in the Terminal Ileum.
- Author
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Lin R, Lu H, Zhou G, Wei Q, and Liu Z
- Subjects
- Adult, Aged, B-Lymphocytes pathology, Colonoscopy, Crohn Disease diagnosis, Crohn Disease diagnostic imaging, Crohn Disease physiopathology, Diarrhea diagnosis, Diarrhea diagnostic imaging, Female, Humans, Hyperplasia diagnosis, Hyperplasia diagnostic imaging, Ileum diagnostic imaging, Lymph Nodes diagnostic imaging, Lymph Nodes pathology, Lymphoma, Follicular diagnosis, Lymphoma, Follicular diagnostic imaging, Male, Middle Aged, Diarrhea pathology, Hyperplasia pathology, Ileum pathology, Lymphoma, Follicular pathology
- Abstract
Nodular lymphoid hyperplasia (NLH) in the small intestine is a rare benign lesion, characterized by the presence of multiple small nodules on the surface of the intestine. To define the clinicopathological and colonoscopic characteristics in Chinese patients with ileal NLH, we collected 65 patients with NLH in the terminal ileum from the endoscopic database in our hospital and clinical data from medical records. Histology and immunohistochemical staining were performed in the biopsies. The results demonstrated that the main symptoms included diarrhea (70.8%), abdominal pain (60.0%), hematochezia (46.2%), anemia (40.0%), and hypoproteinemia (21.5%). Enteroscopy revealed multiple, sporadic, granular or round-shaped nodules with diameters between 2 and 5 mm in the terminal ileum. The histology revealed the nodules consisted of mass lymphoid follicles in the lamina propria and submucosa of the terminal ileum. The follicles contained mitotically active germinal centers surrounded by well-defined lymphocyte mantles and composed predominantly of CD20
+ B cells. The diseases found in patients with NLH included chronic diarrhea, Crohn's disease, ischemic enterocolitis and allergic purpura. The level of hemoglobin in NLH patients who had diarrhea and hematochezia remarkably decreased as compared with those in patients with chronic diarrhea. In conclusion, ileocolonoscopic screening is an important step to find the NLH in terminal ileum patients with diarrhea, abdominal pain, hematochezia, and hypoproteinemia. Histological examination is necessary for the exclusion of malignancy and chronic inflammation., Competing Interests: Competing Interests: The authors have declared that no competing interest exists.- Published
- 2017
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34. Salmonella colitis as an unusual cause of elevated serum lipase.
- Author
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Dean R, Gill D, and Buchan D
- Subjects
- Abdominal Pain blood, Abdominal Pain diagnostic imaging, Abdominal Pain microbiology, Anti-Bacterial Agents therapeutic use, Ciprofloxacin therapeutic use, Colitis diagnosis, Colitis drug therapy, Diagnosis, Differential, Diarrhea blood, Diarrhea diagnostic imaging, Diarrhea microbiology, Humans, Male, Middle Aged, Nausea, Pancreatitis, Radiography, Abdominal, Salmonella Infections drug therapy, Salmonella Infections microbiology, Tomography, X-Ray Computed, Treatment Outcome, Vomiting, Colitis blood, Colitis microbiology, Lipase blood, Salmonella Infections blood, Salmonella Infections diagnosis
- Abstract
Authors and clinicians advocate lipase as the preferred serological test for the diagnosis for acute pancreatitis. While acute pancreatitis is among the differential diagnosis for elevated lipase levels, several other causes of elevated lipase levels have been identified including several reports Salmonella species as a causative agent. There also have been retrospective studies that have reported clinical pancreatitis associated with Salmonella infection. These studies concluded that clinical pancreatitis should be considered as a complication of Salmonella infections. However, Salmonella infections may induce elevated pancreatic enzyme levels without clinical pancreatitis or morphological pancreatic abnormalities through a variety of proposed mechanisms. The following is a case that describes a patient who developed Salmonella colitis and demonstrated elevated serum lipase levels without clinical pancreatitis., (Published by Elsevier Inc.)
- Published
- 2017
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35. Distinct Abnormalities of Small Bowel and Regional Colonic Volumes in Subtypes of Irritable Bowel Syndrome Revealed by MRI.
- Author
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Lam C, Chaddock G, Marciani Laurea L, Costigan C, Cox E, Hoad C, Pritchard S, Gowland P, and Spiller R
- Subjects
- Adolescent, Adult, Aged, Area Under Curve, Case-Control Studies, Colon pathology, Colon physiopathology, Constipation classification, Constipation etiology, Constipation physiopathology, Diarrhea classification, Diarrhea etiology, Diarrhea physiopathology, Fasting, Female, Gastrointestinal Transit physiology, Humans, Intestine, Small pathology, Intestine, Small physiopathology, Irritable Bowel Syndrome classification, Irritable Bowel Syndrome complications, Irritable Bowel Syndrome physiopathology, Magnetic Resonance Imaging, Male, Middle Aged, Organ Size, Postprandial Period, Severity of Illness Index, Young Adult, Colon diagnostic imaging, Constipation diagnostic imaging, Diarrhea diagnostic imaging, Intestine, Small diagnostic imaging, Irritable Bowel Syndrome diagnostic imaging
- Abstract
Objectives: Non-invasive biomarkers which identify different mechanisms of disease in subgroups of irritable bowel syndrome (IBS) could be valuable. Our aim was to seek useful magnetic resonance imaging (MRI) parameters that could distinguish each IBS subtypes., Methods: 34 healthy volunteers (HV), 30 IBS with diarrhea (IBS-D), 16 IBS with constipation (IBS-C), and 11 IBS with mixed bowel habit (IBS-M) underwent whole-gut transit and small and large bowel volumes assessment with MRI scans from t=0 to t=360 min. Since the bowel frequency for IBS-M were similar to IBS-D, IBS-M and IBS-D were grouped together and labeled as IBS non-constipation group (IBS-nonC)., Results: Median (interquartile range): fasting small bowel water content in IBS-nonC was 21 (10-42), significantly less than HV at 44 ml (15-70), P<0.01 as was the postprandial area under the curve (AUC) P<0.01. The fasting transverse colon volumes in IBS-C were significantly larger at 253 (200-329) compared with HV, IBS-nonC whose values were 165 (117-255) and 198 (106-270) ml, respectively, P=0.02. Whole-gut transit time for IBS-C was prolonged at 69 (51-111), compared with HV at 34 (4-63) and IBS-D at 34 (17-78) h, P=0.03. Bloating score (VAS 0-10 cm) correlated with transverse colon volume at t=405 min, Spearman r=0.21, P=0.04., Conclusions: The constricted small bowel in IBS-nonC and the dilated transverse colon in IBS-C point to significant differences in underlying mechanisms of disease.
- Published
- 2017
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36. 75 SeHCAT scan in bile acid malabsorption in chronic diarrhoea.
- Author
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Mena Bares LM, Carmona Asenjo E, García Sánchez MV, Moreno Ortega E, Maza Muret FR, Guiote Moreno MV, Santos Bueno AM, Iglesias Flores E, Benítez Cantero JM, and Vallejo Casas JA
- Subjects
- Algorithms, Bile Acids and Salts classification, Biomarkers, Cholestyramine Resin therapeutic use, Chronic Disease, Colesevelam Hydrochloride therapeutic use, Colestipol therapeutic use, Diarrhea classification, Diarrhea complications, Diarrhea drug therapy, Diarrhea etiology, Enterohepatic Circulation, Fasting, Feces chemistry, Fibroblast Growth Factors blood, Humans, Ileum metabolism, Intestinal Absorption, Sensitivity and Specificity, Steatorrhea classification, Steatorrhea complications, Steatorrhea drug therapy, Whole Body Imaging, Bile Acids and Salts metabolism, Diarrhea diagnostic imaging, Ileum diagnostic imaging, Positron-Emission Tomography, Selenium Radioisotopes pharmacokinetics, Steatorrhea diagnostic imaging, Taurocholic Acid pharmacokinetics
- Abstract
Chronic diarrhoea is a common entity in daily clinical practice and it leads to a loss in these patients quality of life. It may be the main symptom of multiple ethiologies including bile acid malabsorption (BAM) which has a comparable prevalence to celiac disease. The BAM results from imbalances in the homeostasis of bile acids in the enterohepatic circulation. It can be a consequence of ileal disease or ileal dysfunction (BAM type i), it can be considered idiopathic or primary (BAM type ii) or associated with other gastrointestinal entities (BAM type iii). Among the different diagnostic methods available,
75 SeHCAT study is the primary current method due to its sensitivity, specificity, safety and low cost. The main disadvantage is that it's not available in all countries, so other diagnostic methods have appeared, such as serum measurement of FGF19 and C4, however they are significantly more complex and costly. The first-line treatment of bile acid diarrhoea is bile acid sequestrant, such as cholestyramine, which can be difficult to administer due to its poor tolerability and gastrointestinal side effects. These are less prominent with newer agents such as colesevelam. In summary, the BAM is a common entity underdiagnosed and undertreated, so it is essential to establish a diagnosis algorithm of chronic diarrhoea in which the75 SeHCAT study would be first or second line in the differential diagnosis of these patients., (Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.)- Published
- 2017
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37. Mesalazine-induced enteritis causing refractory diarrhea.
- Author
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Otani I, Oka S, and Tanaka S
- Subjects
- Aged, Diarrhea diagnostic imaging, Diarrhea pathology, Endoscopy, Enteritis pathology, Female, Humans, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Diarrhea etiology, Enteritis diagnostic imaging, Enteritis etiology, Mesalamine adverse effects
- Published
- 2017
- Full Text
- View/download PDF
38. Honeycomb fetal abdomen: characteristic sign of congenital chloride diarrhea.
- Author
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Mustafa OM and Al-Aali WY
- Subjects
- Adult, Diarrhea diagnostic imaging, Disease Management, Female, Humans, Pregnancy, Pregnancy Trimester, Third, Prenatal Diagnosis, Diarrhea congenital, Metabolism, Inborn Errors diagnostic imaging, Ultrasonography, Prenatal methods
- Published
- 2016
- Full Text
- View/download PDF
39. Submucosal lipoma of the sigmoid colon as a rare cause of mucoid diarrhea: a case report.
- Author
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Dassanayake SUB, Dinamithra NP, and Nawarathne NMM
- Subjects
- Aged, Colonic Neoplasms diagnostic imaging, Colonic Neoplasms surgery, Diarrhea diagnostic imaging, Humans, Lipoma diagnostic imaging, Lipoma surgery, Male, Tomography, X-Ray Computed, Treatment Outcome, Colon, Sigmoid pathology, Colonic Neoplasms complications, Colonoscopy, Diarrhea etiology, Lipoma complications
- Abstract
Background: Symptomatic presentations of colonic lipomas are very rare in clinical practice, and may mimic colonic malignancy. The likelihood of presenting symptoms has been shown to depend on the size of the lesion., Case Presentation: We describe the case of a 72-year-old Sinhalese man presenting with worsening mucoid diarrhea who was subsequently diagnosed to have a lipoma of the sigmoid colon. His disease was successfully managed with endoscopic resection., Conclusion: Confidently establishing the rare diagnosis of a colonic lipoma usually requires a combination of endoscopic, radiological, and histological evaluation, and is therefore very challenging. With the advancement of endoscopic procedures, endoscopic resection is widely practiced as the definitive management of these cases.
- Published
- 2016
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40. Point of Care Ultrasound Accurately Distinguishes Inflammatory from Noninflammatory Disease in Patients Presenting with Abdominal Pain and Diarrhea.
- Author
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Novak KL, Jacob D, Kaplan GG, Boyce E, Ghosh S, Ma I, Lu C, Wilson S, and Panaccione R
- Subjects
- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Young Adult, Abdominal Pain diagnostic imaging, Diarrhea diagnostic imaging, Inflammatory Bowel Diseases diagnostic imaging, Point-of-Care Systems statistics & numerical data, Ultrasonography methods
- Abstract
Background. Approaches to distinguish inflammatory bowel disease (IBD) from noninflammatory disease that are noninvasive, accurate, and readily available are desirable. Such approaches may decrease time to diagnosis and better utilize limited endoscopic resources. The aim of this study was to evaluate the diagnostic accuracy for gastroenterologist performed point of care ultrasound (POCUS) in the detection of luminal inflammation relative to gold standard ileocolonoscopy. Methods. A prospective, single-center study was conducted on convenience sample of patients presenting with symptoms of diarrhea and/or abdominal pain. Patients were offered POCUS prior to having ileocolonoscopy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with 95% confidence intervals (CI), as well as likelihood ratios, were calculated. Results. Fifty-eight patients were included in this study. The overall sensitivity, specificity, PPV, and NPV were 80%, 97.8%, 88.9%, and 95.7%, respectively, with positive and negative likelihood ratios (LR) of 36.8 and 0.20. Conclusion. POCUS can accurately be performed at the bedside to detect transmural inflammation of the intestine. This noninvasive approach may serve to expedite diagnosis, improve allocation of endoscopic resources, and facilitate initiation of appropriate medical therapy.
- Published
- 2016
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41. [Ultrasonography 67. Abdominal pain].
- Author
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Müller K, Schmidt J, and Tuma J
- Subjects
- Diagnosis, Differential, Female, Humans, Middle Aged, Ultrasonography, Campylobacter Infections diagnostic imaging, Colic diagnostic imaging, Colic etiology, Diarrhea diagnostic imaging, Diarrhea etiology, Diverticulitis diagnostic imaging, Enterocolitis diagnostic imaging, Nausea diagnostic imaging, Nausea etiology, Typhlitis diagnostic imaging
- Published
- 2015
- Full Text
- View/download PDF
42. Images in emergency medicine. Woman With Abdominal Pain and Diarrhea. Colitis.
- Author
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Gilbert AJ, Frasure SE, and Stone MB
- Subjects
- Abdominal Pain diagnostic imaging, Colitis complications, Colitis diagnostic imaging, Diarrhea diagnostic imaging, Emergency Service, Hospital, Female, Humans, Middle Aged, Tomography, X-Ray Computed, Abdominal Pain etiology, Colitis diagnosis, Diarrhea etiology
- Published
- 2015
- Full Text
- View/download PDF
43. Ultrasonographic imaging of abomasal milk clotting and abomasal diameter in healthy and diarrheic calves.
- Author
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Kirchner D, Schwedhelm L, Wenge J, Steinhöfel I, Heinrich C, Coenen M, and Bachmann L
- Subjects
- Abomasum anatomy & histology, Abomasum pathology, Administration, Oral, Animal Feed, Animals, Diarrhea pathology, Gastric Emptying physiology, Hydrogen-Ion Concentration, Rehydration Solutions administration & dosage, Ultrasonography, Abomasum physiology, Abomasum ultrastructure, Cattle physiology, Diarrhea diagnostic imaging, Diarrhea physiopathology, Milk metabolism
- Abstract
In case of diarrhea calves are treated with oral rehydration solutions (ORS), which are known to increase abomasal pH and inhibit milk clotting in vitro. Nevertheless, recent studies have shown that ORS with HCO3(-) ≤ 62 mmol/L do not interfere with abomasal milk clotting in healthy calves. However, in diarrheic calves, feeding ORS and milk simultaneously may disturb abomasal curd formation and exacerbate diarrhea due to faster abomasal passage of ingesta. Therefore, the aim of the present study was to ultrasonographically examine abomasal milk clotting and diameter after feeding milk and milk replacer (MR) with and without ORS to healthy and diarrheic calves. Abomasal curd formation and diameter in healthy and diarrheic calves were ultrasonographically imaged before and after feeding milk, MR and ORS prepared in milk or MR. Feeding mixtures of milk or MR with ORS did not cause any remarkable differences in the ultrasonographic images of abomasal content. Moreover, abomasal milk clotting was not disturbed due to diarrhea. Statistically significant differences of abomasal diameter after feeding between healthy and diarrheic calves indicated that abomasal emptying is delayed in diarrheic calves. Hence, further studies are needed to determine reasons for decelerated abomasal passage in calves suffering from diarrhea., (© 2015 Japanese Society of Animal Science.)
- Published
- 2015
- Full Text
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44. Congenital Chloride Diarrhea: Accurate Prenatal Diagnosis Using Color Doppler Sonography to Show the Passage of Diarrhea.
- Author
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Hirakawa M, Hidaka N, Kido S, Fukushima K, and Kato K
- Subjects
- Diagnosis, Differential, Diarrhea embryology, Female, Humans, Male, Pregnancy, Young Adult, Diarrhea congenital, Diarrhea diagnostic imaging, Metabolism, Inborn Errors diagnostic imaging, Metabolism, Inborn Errors embryology, Ultrasonography, Doppler, Color methods, Ultrasonography, Prenatal methods
- Published
- 2015
- Full Text
- View/download PDF
45. Are bile acid malabsorption and bile acid diarrhoea important causes of loose stool complicating cancer therapy?
- Author
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Phillips F, Muls AC, Lalji A, and Andreyev HJ
- Subjects
- Adult, Aged, Aged, 80 and over, Diarrhea diagnostic imaging, Diarrhea metabolism, Feces, Female, Humans, Malabsorption Syndromes diagnostic imaging, Malabsorption Syndromes metabolism, Male, Middle Aged, Radionuclide Imaging, Radiopharmaceuticals, Retrospective Studies, Selenium Radioisotopes, Severity of Illness Index, Taurocholic Acid analogs & derivatives, Young Adult, Bile Acids and Salts metabolism, Breast Neoplasms therapy, Chemoradiotherapy adverse effects, Diarrhea etiology, Digestive System Neoplasms therapy, Hematologic Neoplasms therapy, Malabsorption Syndromes etiology, Urogenital Neoplasms therapy
- Abstract
Aim: Gastrointestinal (GI) symptoms during and after cancer therapy can significantly affect quality of life and interfere with treatment. This study assessed whether bile acid malabsorption (BAM) or bile acid diarrhoea (BAD) are important causes of diarrhoea associated with cancer treatment., Method: A retrospective analysis was carried out of consecutive patients assessed for BAM using ((75) Se) Selenium homocholic acid taurocholate (SeHCAT) scanning, after reporting any episodes of loose stool, attending a gastroenterology clinic in a cancer centre., Results: Between 2009 and 2013, 506 consecutive patients (54.5% male; age range: 20-91 years), were scanned. BAM/BAD was diagnosed in 215 (42.5%). It was mild in 25.6%, moderate in 29.3% and severe in 45.1%. Pelvic chemoradiation had induced BAM in > 50% of patients. BAM was also frequent after treatment for conditions not previously associated with BAM, such as anal and colorectal cancer, and was present in > 75% of patients referred after pancreatic surgery. It was also unexpectedly frequent in patients who were treated for malignancy outside the GI tract, such as breast cancer and haematological malignancy., Conclusion: BAM/BAD are very common and under-appreciated causes of GI symptoms after cancer treatment. Health professionals should have a low threshold in suspecting this condition, as diagnosis and treatment can significantly improve quality of life., (Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.)
- Published
- 2015
- Full Text
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46. Incidence of bowel wall oedema on computed tomography exams and association with diarrhoea in renal cell carcinoma patients treated with sunitinib.
- Author
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Cornelissen L, Claus F, Wolter P, Dumez H, De Keyzer F, Lerut E, Van Poppel H, and Beuselinck B
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Agents adverse effects, Antineoplastic Agents therapeutic use, Belgium epidemiology, Carcinoma, Renal Cell diagnosis, Diarrhea chemically induced, Diarrhea diagnostic imaging, Edema chemically induced, Edema diagnostic imaging, Female, Follow-Up Studies, Humans, Incidence, Indoles therapeutic use, Kidney Neoplasms complications, Male, Middle Aged, Pyrroles therapeutic use, Retrospective Studies, Sunitinib, Carcinoma, Renal Cell drug therapy, Diarrhea complications, Edema epidemiology, Indoles adverse effects, Intestines diagnostic imaging, Kidney Neoplasms drug therapy, Multidetector Computed Tomography methods, Pyrroles adverse effects
- Abstract
Objectives: The purpose of this study was to retrospectively assess the incidence of bowel wall oedema on computed tomography (CT) in patients with renal cell carcinoma (RCC) treated with sunitinib, and to investigate its association with diarrhoea., Methods: We conducted a retrospective analysis of all RCC patients treated with sunitinib at our hospital between December 2005 and December 2011. The presence or absence of bowel wall oedema on these CT examinations was scored. The presence of diarrhoea preceding, during, or after sunitinib treatment was identified from the patient files and retrospectively graded., Results: For 54 of 87 patients, bowel wall oedema was present on at least one CT examination. Of these 54 patients, the right-sided colonic segment was affected in 87%. Diarrhoea was the most common reported adverse event during treatment, with 58 patients (67%) having grade 1/2 diarrhoea and 9 patients (10%) having grade 3. There was a statistically significant correlation between the incidence of CT-scored bowel oedema and diarrhoea during sunitinib treatment (P = 0.004)., Conclusions: This study shows a very high incidence of bowel wall oedema and a strong correlation between the incidence of bowel wall oedema and diarrhoea in patients treated with sunitinib., Key Points: • Sunitinib is routinely used in patients with advanced renal cell carcinoma. • Diarrhoea is the most common reported adverse event during sunitinib treatment. • Incidence of bowel oedema and diarrhoea during sunitinib treatment is correlated. • Radiologists should avoid misinterpretation of bowel oedema as infectious colitis.
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- 2015
- Full Text
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47. Unknown multifocal ileal carcinoid revealed by (18)F-FDOPA PET/CT.
- Author
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Imperiale A, Averous G, Chilinseva-Natorov N, Hubelé F, Triki E, Bellocq JP, Namer IJ, and Brigand C
- Subjects
- Aged, Carcinoid Tumor complications, Diarrhea etiology, Humans, Ileal Neoplasms complications, Male, Radionuclide Imaging, Carcinoid Tumor diagnostic imaging, Diarrhea diagnostic imaging, Ileal Neoplasms diagnostic imaging
- Published
- 2014
- Full Text
- View/download PDF
48. Complication of a percutaneous endoscopic gastrostomy tube placement.
- Author
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Lee JK
- Subjects
- Child, Preschool, Device Removal, Diarrhea diagnostic imaging, Humans, Prosthesis Implantation adverse effects, Radiography, Treatment Failure, Diarrhea etiology, Endoscopy methods, Enteral Nutrition adverse effects, Enteral Nutrition instrumentation, Gastrostomy adverse effects, Gastrostomy instrumentation
- Published
- 2013
49. Computed tomography in patients with abdominal pain and diarrhoea: does the benefit outweigh the drawbacks?
- Author
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Aisenberg GM and Grimes RM
- Subjects
- Adult, Aged, Disease Management, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Assessment, Tomography, X-Ray Computed adverse effects, Tomography, X-Ray Computed standards, Abdominal Pain diagnostic imaging, Abdominal Pain therapy, Diarrhea diagnostic imaging, Diarrhea therapy, Tomography, X-Ray Computed methods
- Abstract
The role of computed tomography (CT) in the evaluation of abdominal pain is well established. However, concern exists in regard to procedure-related radiation levels, contrast-medium toxicity and costs. We sought to determine whether the use of abdominal CT caused major changes in the management of patients who had abdominal pain and diarrhoea. We reviewed all abdominal CT examinations that were performed at our hospital from October through December 2010. We selected 574 scans that had been performed in patients who presented with or without diarrhoea. We examined the selected medical records to determine whether the CT scan changed patients' management. A scan was considered to be management changing if a decisive intervention occurred on the basis of the scan results. Among 124 scans in patients with diarrhoea and 450 scans in patients without diarrhoea, the scan results changed management in 13 of the patients with diarrhoea (11%) and in 233 of those without diarrhoea (52%) (P < 0.001). When management changed, the changes resulted from findings unrelated to diarrhoea. Despite its defined role in the assessment of abdominal pain, CT of patients that also had diarrhoea seldom caused a major change in management. The probability of CT causing such a change does not outweigh the cost, radiation risk or potential for contrast-induced nephropathy., (© 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.)
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- 2013
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50. Three-pointed star sign of lupus enteritis.
- Author
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Kamata Y and Minota S
- Subjects
- Abdominal Pain drug therapy, Diarrhea drug therapy, Female, Glucocorticoids therapeutic use, Humans, Intestinal Diseases drug therapy, Lupus Erythematosus, Systemic drug therapy, Middle Aged, Prednisolone therapeutic use, Radiography, Treatment Outcome, Abdominal Pain diagnostic imaging, Diarrhea diagnostic imaging, Intestinal Diseases diagnostic imaging, Lupus Erythematosus, Systemic diagnostic imaging
- Published
- 2013
- Full Text
- View/download PDF
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