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Biomedical subjects

E T Swarbrick

Publications and source records attributed to E T Swarbrick.

At least 37 records · Page 2Linked to original sources

Colonoscopic diagnosis of minimal change colitis in patients with a normal sigmoidoscopy and normal air-contrast barium enema.

8 patients with normal sigmoidoscopic appearances and normal results by high-quality air contrast barium enema had substantial or total colitis diagnosed for the first time at colonoscopy performed within a month of the radiological examination. Colitis was confirmed in all 8 patients by histological examination of biopsy specimens. Barium enema radiographs were independently reviewed by three experienced observers who also reviewed other normal and abnormal radiographs. One observer regarded all 8 sets of radiographs from the patients with colitis as being of normal appearance, and 4 patients were reported as having normal radiographs by all three observers. All 7 of the rectal biopsy specimens taken showed histological features of inflammatory bowel disease. This emphasises the importance of performing a rectal biopsy in patients with gastrointestinal symptoms of unknown cause.

Adult↗

Treatment of chronic erosive gastritis with prednisolone.

Short-term oral prednisolone was successfully used in the treatment of four patients with chronic erosive gastritis which had failed to respond to conventional therapies. Symptomatic improvement occurred in all patients during the first week of treatment. Gastroduodenoscopy after two weeks showed that the erosions had healed. Remission has continued in these four patients for two, seven, eight, and nine months without maintenance therapy. This limited uncontrolled study suggests the corticosteroids may be of benefit in patients with chronic erosive gastritis who fail to respond to conventional treatment.

Aged↗

Site of pain from the irritable bowel.

The distribution of pain from the colon was examined in normal subjects and in patients with irritable bowel syndrome (IBS). Colonic pain was induced by inflating a balloon (introduced during colonoscopy) at several sites throughout the colon. The pain was felt predominantly in the central, lower, and left abdomen in nine patients presenting with rectal bleeding and no spontaneous pain. Pain was felt in any part of the abdomen in 48 patients with painful IBS. Distension of the ascending and transverse colon often produced right-sided or upper abdominal pain in patients with IBS and in 29 of the 48 the pain induced was the same in quality and site as their presenting complaint. In addition pain was referred to several, previously undescribed, extra-abdominal sites. Wider recognition of the distribution of colonic pain could prevent unnecessary investigations including laparotomy.

Abdomen↗

Dapsone and severe hypoalbuminaemia. A report of two cases.

Severe hypoalbuminaemia developed in two patients on long-term dapsone treatment for dermatitis herpetiformis. The patients had been treated with dapsone for 3 and 11 years before the syndrome developed and both recovered completely when dapsone was withdrawn. Albumin-turnover studies revealed a great increase in intravascular albumin catabolism and a modest decrease in synthesis.

Adult↗

Chlamydia, cytomegalovirus, and Yersinia in inflammatory bowel disease.

The relationship of three infectious agents, Chlamydia, cytomegalovirus, and Yersinia enterocolitica, to the aetiology, clinical course, and diagnosis of Crohn's disease was studied. There was no evidence of chlamydial infection in Crohn's disease and no indication either that cytomegalovirus alters the outcome of acute attacks or that infection with Y. enterocolitica is being misdiagnosed as Crohn's disease.

Acute Disease↗

Absorption of antigens after oral immunisation and the simultaneous induction of specific systemic tolerance.

Antigenic proteins may be absorbed intact. We report here results from in vivo experiments in mice showing that the prior feeding of protein antigen may reduce the subsequent absorption of that antigen without altering its elimination from the circulation. This may be a function of local immunity. We have also shown that the same feeding regime can paradoxically induce a state of systemic tolerance and suggest that the two phenomena contribute to the safe handling of these antigens.

Administration, Oral↗

Pericarditis and inflammatory bowel disease.

Pericarditis is an uncommon but important complication of inflammatory bowel disease. Five new cases are described and the published literature on nine other cases is reviewed. The pericarditis occurred during an active phase of the colitis in all our cases and was associated with other extra-colonic manifestations of colitis in three. No other cause for the pericarditis was identified and in all five cases it responded promptly to the administration of corticosteroid drugs.

Adolescent↗

Colonoscopy for unexplained rectal bleeding.

Two hundred and thirty-nine patients underwent colonoscopy for unexplained rectal bleeding. Local anorectal conditions were excluded by digital and proctosigmoidoscopic examinations and results of barium studies were negative for all patients. A cause for bleeding was found in 95 patients. Thirty-nine had adenomatous polyps, 24 had unrecognised inflammatory bowel disease, and most importantly 23 (10% of series) had carcinomas. Forty patients had diverticular disease, but nine of them were found to have an adenomatous polyp and four a carcinoma. Colonoscopy can contribute positively to the investigation and treatment of unexplained rectal bleeding and may prevent unnecessary laparotomy.

Colitis↗

Colonoscopy in management of colonic strictures.

A total of 160 strictures were examined in 154 patients with the fibreoptic colonoscope. When it was possible to make a pre-examination diagnosis colonoscopy proved it wrong in 52% of cases. Unnecessary laparotomy was probably avoided in over half this series. All strictures of the large bowel should be examined colonoscopially whenever possible before considering surgery.

Colitis, Ulcerative↗

A study of peripheral leucocyte migration in agarose medium in inflammatory bowel disease.

THE MIGRATION OF PERIPHERAL LEUCOCYTES FROM PATIENTS WITH INFLAMMATORY BOWEL DISEASE WAS INVESTIGATED USING AN AGAROSE PLATE TECHNIQUE AND THREE ANTIGENIC MATERIALS: (1) the enterobacterial common antigen of Kunin; (2) extract from germ-free rat faeces; and (3) Kveim suspension from a sarcoid spleen K19. Inhibition of migration was obtained only with Kunin antigen. It was present in 11 out of 20 patients with ulcerative colitis and in four out of 20 patients with Crohn's disease but in only one out of 33 control subjects. These findings suggest the possibility that a state of cellular immunity to enterobacterial common antigen may exist in inflammatory bowel disease. Lack of cellular reactivity to extract from germ-free faeces and Kveim suspension is in contrast with the results obtained by others by means of the capillary tube method and requires further investigation.

Adolescent↗