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R Balfour Sartor, Gary D Wu
Intestinal microbiota are involved in the pathogenesis of Crohn's disease, ulcerative colitis, and pouchitis. We review the mechanisms by which these gut bacteria, fungi, and viruses mediate mucosal homeostasis, via their composite genes (metagenome) and metabolic products (metabolome). We explain how alterations to their profiles and functions under conditions of dysbiosis contribute to inflammation and effector immune responses that mediate inflammatory bowel diseases (IBD) in humans and enterocolitis in mice...
October 18, 2016: Gastroenterology
Roberta E Rossi, Tara Whyand, Charles D Murray, Mark I Hamilton, Dario Conte, Martyn E Caplin
Inflammatory bowel diseases (IBD) are chronic immune disorders of unclear aetiology. Dietary deficiencies may be a potential pathogenic factor in their development. Patients often take food supplements without knowledge of any evidence base. We have therefore assessed the evidence for food supplementation in the management of IBD. A PubMed search was performed for the terms Inflammatory bowel disease; nutritional deficiencies; dietary supplements; curcumin; green tea; vitamin D/other vitamins; folic acid; iron; zinc; probiotics; andrographis paniculata; and boswellia serrate...
December 2016: European Journal of Gastroenterology & Hepatology
Abdel-Naser Elzouki
Probiotics are live, nonpathogenic bacteria capable of colonizing the colonic mucosa. The most common probiotics include strains of Lactobacillus or Bifidobacteria, which are part of the normal gastrointestinal microbiota. Initial studies of selected probiotic species have suggested potential efficacy in several gastrointestinal diseases including inflammatory bowel diseases (particularly pouchitis), antibiotic-related diarrhea, Clostridium difficile toxin-induced colitis, infectious diarrhea, irritable bowel syndrome, and allergy...
November 2016: Journal of Clinical Gastroenterology
V A van der Ploeg, Y Maeda, O D Faiz, A L Hart, S K Clark
AIM: Chronic peri-pouch sepsis (CPPS) may be mistaken for antibiotic-dependent or refractory primary idiopathic pouchitis (ADRP), but requires different treatment such as drainage. The study aimed to identify the prevalence of CPPS in patients thought to have ADRP. The secondary aims were to identify any specific features on pouchoscopy suggesting CPPS and to determine the results of treatment for CPPS. METHOD: The records of patients who had been treated for ADRP between March 2006 and June 2015 were reviewed retrospectively...
September 30, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Gentilini Lorenzo, Coscia Maurizio, Lombardi Pietro Maria, Marta Tanzanu, Laureti Silvio, Podda Mariangela, Poggioli Gilberto
PURPOSE: Short-term results after ileo-pouch anal anastomosis (IPAA) are well established; data are conflicting in long-standing patients. We retrospectively evaluated long-term complications and functional results after follow-up longer than 20 years. METHODS: Two hundred five patients with follow-up longer than 20 years have been identified out of 1112 IPAA performed in our institution; of these, 20 cases were lost at follow-up or decline to take part at the study...
September 28, 2016: International Journal of Colorectal Disease
Keisuke Hata, Soichiro Ishihara, Hiroaki Nozawa, Kazushige Kawai, Tomomichi Kiyomatsu, Toshiaki Tanaka, Junko Kishikawa, Hiroyuki Anzai, Toshiaki Watanabe
Restorative proctocolectomy with ileal pouch-anal anastomosis has been the surgical treatment of choice for patients with ulcerative colitis who require surgery. The quality of life after this procedure is satisfactory in most cases; however, pouchitis is a troublesome condition involving inflammation of the ileal pouch. When a patient presents with symptoms of pouchitis, such as increased bowel movements, mucous and/or bloody exudates, abdominal cramps, and fever, endoscopy is essential for a precise diagnosis...
September 28, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Ganglei Liu, Xianrui Wu, Yi Li, Yuanyi Rui, Luca Stocchi, Feza H Remzi, Bo Shen
BACKGROUND: There are no published studies on the impact of visceral adipose tissue (VAT) change on outcomes of restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA). The aim of this historic cohort study was to evaluate the impact of excessive VAT gain on the outcomes of inflammatory bowel disease (IBD) patients with IPAA. METHODS: We evaluated all eligible patients with at least two sequential CT scans after pouch construction from our prospectively maintained Pouchitis Registry between 2002 and 2014...
September 25, 2016: Gastroenterology Report
Gabriel Olveira, Inmaculada González-Molero
The concept of prebiotics, probiotics, and symbiotics and their use in different situations of daily clinical practice related to clinical nutrition is reviewed, as well as their role in the treatment/prevention of diarrhea (acute, induced by antibiotics, secondary to radiotherapy), inflammatory bowel disease (ulcerative colitis and pouchitis), in colonic health (constipation, irritable bowel), in liver disease (steatosis and minimum encephalopathy), and in intensive care, surgical, and liver transplantation...
November 2016: Endocrinología y Nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición
Antonella Gallo, Giovanna Passaro, Antonio Gasbarrini, Raffaele Landolfi, Massimo Montalto
Alterations of intestinal microflora may significantly contribute to the pathogenesis of different inflammatory and autoimmune disorders. There is emerging interest on the role of selective modulation of microflora in inducing benefits in inflammatory intestinal disorders, by as probiotics, prebiotics, synbiotics, antibiotics, and fecal microbiota transplantation (FMT). To summarize recent evidences on microflora modulation in main intestinal inflammatory disorders, PubMed was searched using terms microbiota, intestinal flora, probiotics, prebiotics, fecal transplantation...
August 28, 2016: World Journal of Gastroenterology: WJG
Nitsan Maharshak, Nathaniel Aviv Cohen, Leah Reshef, Hagit Tulchinsky, Uri Gophna, Iris Dotan
OBJECTIVE: To examine whether patients with a mature normal pouch (>1 year post-ileostomy closure) have microbial stool characteristics that can predict pouch inflammation. DESIGN: Patients undergoing pouch surgery were recruited prospectively. Microbiota analysis of fecal samples was by 16S rRNA gene pyrosequencing. All patients had a normal pouch at baseline (T1). Those without pouchitis during the first year of follow-up (T2) comprised the "Normal Pouch-sustained" group and those who had experienced an episode of pouchitis comprised the "Pre-Pouchitis" group...
September 9, 2016: Journal of Crohn's & Colitis
Keiichi Uchida, Yoshiki Okita, Toshimitsu Araki, Masato Kusunoki
No abstract text is available yet for this article.
September 6, 2016: Journal of Pediatric Gastroenterology and Nutrition
Rajmohan Dharmaraj, Mahua Dasgupta, Pippa Simpson, Joshua Noe
No abstract text is available yet for this article.
August 27, 2016: Journal of Pediatric Gastroenterology and Nutrition
Xiao-Bo Feng, Jun Jiang, Min Li, Gang Wang, Jin-Wei You, Jian Zuo
OBJECTIVE: To discuss the role of intestinal flora imbalance in the pathogenesis of pouchitis. METHODS: The pouchitis rat model was established and the faeces sample and the mucous membrane sample were collected regularly, in which the bacterial nucleic acids were extracted for quantitative analysis of the intestinal flora in the samples through using the real-time quantitative PCR technique and high energy sequencing technology. RESULTS: The disorder phenomenon of the intestinal flora appeared at the 7th day of the experiment, and the pouchitis was presented at the 21st day of the experiment...
August 2016: Asian Pacific Journal of Tropical Medicine
Greg S Cohen, Meena Prasad
An unusual case of campylobacter pouchitis resembling the endoscopic appearance of Crohn's disease is reported.
2016: Case Reports in Gastrointestinal Medicine
K M Schieffer, E D Williams, G S Yochum, W A Koltun
BACKGROUND: A total proctocolectomy followed by ileal pouch-anal anastomosis is a potentially curative surgery for ulcerative colitis or familial adenomatous polyposis. About 5-35% of patients with ulcerative colitis and 0-11% of patients with familial adenomatous polyposis develop subsequent inflammation of the ileal pouch termed pouchitis. AIM: To provide a comprehensive analysis of the research studying the possible pathogenesis of pouchitis. The goals were to identify promising areas of investigation, to help focus clinicians, researchers and patients on how to better understand and then potentially manage ileal pouchitis, and to provide avenues for future research investigations...
October 2016: Alimentary Pharmacology & Therapeutics
Patrizia Kump, Christoph Högenauer
Fecal microbiota transplantation (FMT) is a novel therapeutic procedure aiming at restoring a normal intestinal microbiota by application of fecal microorganisms from a healthy subject into the gastrointestinal tract of a patient. FMT is the most effective treatment for recurrent Clostridium difficile infections (CDI). These infections also occur in patients with inflammatory bowel diseases (IBDs), where case series demonstrated a successful treatment of CDI by FMT in 83-92% of patients. The effect of FMT on the activity of IBD has mainly been investigated in ulcerative colitis (UC) patients, including 3 randomized controlled trials...
2016: Digestive Diseases
Shay Ben-Shachar, Henit Yanai, Hadas Sherman Horev, Hofit Elad, Liran Baram, Ofer Issakov, Hagit Tulchinsky, Metsada Pasmanik-Chor, Noam Shomron, Iris Dotan
BACKGROUND: Gene expression alterations are associated with disease behavior in inflammatory bowel disease (IBD). microRNAs (miRNAs) are dominant in the regulation of gene expression, and may affect IBD phenotype. Our aim was to assess mucosal miRNA expression in IBD and the correlation with intestinal inflammation. METHODS: We performed a large-scale analysis of ileal mucosal miRNA. Biopsies were retrieved from patients with ileal Crohn's disease (CD), unoperated ulcerative colitis (UC) patients, UC patients after pouch surgery, and normal controls (NC)...
2016: PloS One
L Peyrin-Biroulet, A Germain, A S Patel, J O Lindsay
BACKGROUND: Colectomy for ulcerative colitis is associated with short- and long-term complications. Estimates of the frequency of such complications are variable and may have changed since the introduction of biological therapy. Understanding the true burden of surgical complications is important to clinicians in assessing risks and benefits of colectomy vs. continued medical therapy. AIM: To ascertain the outcomes of colectomy and ileal pouch surgery in patients with ulcerative colitis in the biologics era...
October 2016: Alimentary Pharmacology & Therapeutics
J Leslie Knod, Monica Holder, Alexander R Cortez, Bruno Martinez-Leo, Patricia Kern, Shehzad Saeed, Brad Warner, Belinda Dickie, Richard A Falcone, Daniel von Allmen, Jason S Frischer
PURPOSE: We aim to investigate the postoperative outcomes, bowel habits and quality of life (QoL) of younger pediatric ulcerative colitis (UC) patients following surgical intervention compared to an older pediatric population. METHODS: Medical records of UC patients after colectomy with ileoanal reconstruction (2002-2013) at our institution were reviewed. Patients/parents completed a QoL, bowel habits and disease course questionnaire. Surgical outcomes, bowel habits and QoL were reported comparing the younger (≤11years old, n=26) to older (>11years old, n=38) cohorts...
August 2016: Journal of Pediatric Surgery
Elizabeth S John, Kristina Katz, Mark Saxena, Sita Chokhavatia, Seymour Katz
A substantial and growing proportion of patients with inflammatory bowel disease (IBD) are elderly, and these patients require tailored treatment strategies. However, significant challenges exist in the management of this population due to the paucity of data. Establishing the initial diagnosis and assessing the etiology of future symptoms and flares can be challenging as several other prevalent diseases can masquerade as IBD, such as ischemic colitis, diverticular disease, and infectious colitis. Important pharmacologic considerations include reduced glomerular filtration rate and drug-drug interactions in the elderly...
September 2016: Current Treatment Options in Gastroenterology
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