SEARCH · PubMed Health

Results for “Colitis, Ulcerative”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources

PubMed1994

Surgical management of ulcerative colitis in childhood.

Ulcerative colitis (UC) is a more severe disease in children than in adults and is less likely to be cured without surgery. Total colectomy and rectal mucosectomy provide a permanent cure for children who have UC. Reconstruction with an endorectal ileal pull-through procedure with ileal reservoir is an excellent alternative to a permanent ileostomy. This operation can be performed with low morbidity and with an approximately 94% expectation of good-to-excellent function based on our clinical experience with 94 children and 273 adults.

Adolescent↗

PubMedDate not supplied

[Ulcerative colitis: medical treatment].

Ulcerative colitis is a chronic inflammatory disease of unknown etiology, affecting the mucosa of the rectum and a variable length of colon. There is no medical cure for this disease, however medical therapy offers comfort to the majority of patients and improves their lives. Medical therapy including newer drugs is here reviewed.

Anti-Inflammatory Agents↗

PubMedDate not supplied

Pancreatic islet cell hyperplasia associated with experimental ulcerative colitis in rats.

Ulcerative colitis in Buffalo rats was induced by acetic acid introduced into sigmoid colon. In specimens of the colon and head of the pancreas obtained via laparotomy after seven-day colitis ulcerosa and simultaneously the pancreatic islet cell hyperplasia were histologically observed. Further investigations, especially immunological studies, of these amazing findings are necessary to elucidate the mechanism of the abore relationship.

Animals↗

PubMed1998

High Fas ligand expression on lymphocytes in lesions of ulcerative colitis.

BACKGROUND: The pathogenesis of ulcerative colitis is unclear, but cytotoxic T lymphocytes infiltrating the mucosa have been implicated in mucosal damage. The Fas ligand (FasL), expressed on cytotoxic T lymphocytes, induces apoptosis in cells expressing Fas. AIM: To analyse FasL expression in affected colonic mucosa to ascertain Fas-FasL interaction in ulcerative colitis. METHODS: FasL mRNA was quantified in colonic mucosal specimens from healthy subjects and patients with ulcerative colitis or Crohn's disease, using the competitive reverse transcription polymerase chain reaction. FasL mRNA localisation was determined by in situ hybridisation. Expression of Fas in colonic mucosa was analysed immunohistochemically. Phenotypes of lamina propria lymphocytes that expressed FasL were analysed by flow cytometry. RESULTS: FasL mRNA was strongly expressed in active ulcerative colitis lesions, but not in those associated with active Crohn's disease or active proctitis-type ulcerative colitis. In situ hybridisation showed that FasL mRNA expression occurred in mononuclear cells infiltrating lesions. Fas was expressed in epithelial cells in ulcerative colitis and Crohn's disease, and in normal subjects. Cytometry showed that FasL was expressed in CD3 lymphocytes infiltrating the lamina propria in active lesions. CONCLUSIONS: FasL is expressed in CD3 lymphocytes infiltrating into ulcerative colitis but not Crohn's disease lesions, suggesting that Fas-FasL induced apoptosis participates in the mucosal damage of ulcerative colitis.

Acute Disease↗

PubMed1999

Increased expression of proliferative Ki-67 nuclear antigen is correlated with dysplastic colorectal epithelium in ulcerative colitis.

Because patients with ulcerative colitis have an increased long-term risk of colorectal cancer, colonoscopic surveillance with multiple biopsies is commonly performed for histopathological detection of dysplasia to select high-risk patients for prophylactic colectomy. Improved differentiation between neoplastic vs. nonneoplastic changes is needed because active inflammation may cause significant misinterpretation of nonneoplastic reactive/regenerative changes in the epithelium. We investigated whether the expression of proliferative antigens is correlated with various degrees of epithelial dysplasia and inflammatory changes in biopsy specimens from patients with long-standing ulcerative colitis. Colorectal biopsy specimens from patients undergoing colonoscopic surveillance were analyzed immunohistochemically using two types of monoclonal antibodies: MIB-1 against Ki-67 and NCL-PCNA against proliferating cell nuclear antigen for structural, active inflammatory, and dysplastic changes. Specimens from patients without inflammatory bowel disease or neoplasia were used as controls; these showed no increased proliferation. However, increased staining with the MIB-1 monoclonal antibody was detected in 9% of the specimens from patients with long-standing ulcerative colitis without active inflammation or dysplasia; this was significantly more common in specimens indefinite for dysplasia, probably positive (24%), and in those with definite dysplasia of low (47%) or high grade (67%; P = 0.008). For increased PCNA staining, there was a non-significant correlation (P = 0.30) with increasing degrees of dysplasia. Increased MIB-1 immunostaining was found in 50% and increased PCNA immunostaining in 75% of the specimens displaying mild inflammation. Both antibodies had a 100% increased staining in specimens with moderate or severe inflammation. Increased proliferation as expressed by MIB-1 is thus better correlated with increasing degree of dysplasia than is PCNA. Neither staining method is able to differentiate neoplastic from inflammatory epithelial changes. However, in the absence of active inflammation, immunostaining for MIB-1 may be a valuable adjunct in the confirmation of dysplastic epithelial changes in long-standing ulcerative colitis, particularly in the indefinite changes category.

Biopsy↗

PubMed1998

[Ulcerative colitis and intestinal bleeding].

Ulcerative colitis is a nonspecific inflammatory disease of large intestine. Its inflammation is limited to intestinal mucosa. The most essential symptom is hematochezia, bloody stool and intestinal bleeding. Differential diagnosis among diseases having intestinal bleeding is clinically important. These diseases include Crohn disease, ischemic colitis, intestinal Behçet disease, Enterohemorrhagic E. coli including O157, antibiotics associated hemorrhagic colitis and so on. Drugs for the treatment of ulcerative colitis are sulphapyridine, 5-aminosalicylic acid, prednisolone, betamethasone and immunosuppressive drugs. Recently, leukocytapheresis and massive immunoglobulin 7S treatment are available for the treatment of ulcerative colitis.

Anti-Infective Agents↗

PubMed2003

[Ulcerative colitis with segmental involvement].

INTRODUCTION: Ulcerative colitis is a chronic inflammatory disease affecting areas of the colon or the full length. From the endoscopic point of view, ulcerative colitis presents lesions that stretch continuously from the rectum to variable colon segments, a characteristic that is of great value when distinguishing it from Crohn's disease. Continuous involvement, without healthy patches, justifies ending endoscopic exploration once the distal end of the lesion has been reached. OBJECTIVE: To retrospectively study the frequency of segmental lesions in the colonoscopies performed in patients with ulcerative colitis. METHODS: Diagnosis of ulcerative colitis and proctitis was established by clinical, endoscopic, histologic, analytical, and radiological criteria. The indication and number of endoscopies was made on the basis of the clinical criteria of diagnosis, acute episodes, refractoriness or dysplasia screening. The extent of the examination also depended on clinical criteria: the severity of the episode, tolerance to colonoscopy or the degree of cleansing. RESULTS: A total of 155 coloscopies were performed. In 113 colonoscopies (73%) the distal end of the lesion was reached and in 70 (45%) the cecum was reached. Of the 80 patients, 27 (33%) presented ulcerative proctitis at diagnosis. Nine of the 80 patients (11.3%) biopsies were performed in healthy colonic patches, which confirmed histological normality. Six of the 9 patients were receiving no treatment. In all patients except two, the cecum was reached in one or more of the colonoscopies. The distribution of the segmental lesions varied but these were mainly found in the periappendicular region and in the cecum in 6 of the 7 patients in whom the cecum was reached. Of the 80 patients, endoscopic evidence of rectal sparing was found in 5 (6.3%); of these, 4 were receiving systemic or topical treatment. Histological analysis confirmed the absence of inflammatory lesions in these patients. The only patient who was not receiving treatment presented microscopic lesions compatible with ulcerative colitis. CONCLUSIONS: Endoscopic segmental lesions in ulcerative colitis were present in 11.3% of patients. Segmental lesions were most frequently found in the cecum and periappendicular region. Endoscopic and histologic evidence of rectal sparing may be the result of systemic or topical treatment.

Adolescent↗

PubMed2006

[Association lichen planus and ulcerative colitis. A case report].

Ulcerative colitis is a frequent chronic inflammatory boxel disease. Its cutaneous manifestation are varied. Some of them are frequent like pyoderma gangrenosum, erethema nodosum and oral ulceration. We report the case of an exceptional association of ulcerative colitis with lichen planus in a 40-year old woman with a 2 year history of ulcerative colitis, who had lesions on the buccal mucosa and the lower lip for which the diagnosis of lichen planus was made and confirmed histologically.

Adult↗

PubMed1998

Appendicectomy and ulcerative colitis.

The aetiology of ulcerative colitis (UC) is unknown. However, much interest has been devoted recently to the relationship between appendicectomy and ulcerative colitis. A case-control study was conducted, comparing appendicectomy rates between 110 patients with UC (group 1) and 136 patients attending an orthopaedic clinic free from UC (group 2). The appendicectomy rates were 0.9% (group 1) and 10.3% (group 2), respectively (P < 0.002). The present study shows that patients with ulcerative colitis had rarely undergone appendicectomy before the first manifestation of colitis. Further research on this relationship is called for.

Adolescent↗

PubMed1987

Airway involvement in ulcerative colitis.

Two patients with ulcerative colitis developed progressive obstructive pulmonary disease. In one, the abnormality was a sclerosing peribronchiolitis confined to small airways, while the other demonstrated a large airway fibrotic obliterative bronchitis. A review of airway involvement in ulcerative colitis and a discussion of the possible similarity to another extraintestinal manifestation of ulcerative colitis, sclerosing cholangitis, are presented.

Adult↗

PubMed1988

What sequence of pathogenetic events leads to acute ulcerative colitis?

The etiology of ulcerative colitis remains unresolved despite new immunologic, biochemical, and microbiologic observations made in this disease. A sequence of pathogenetic events has been adduced from abnormalities reported from human and experimental colitis with the express purpose of establishing priority of factors that may lead to an attack of acute ulcerative colitis. The presence of undefined bacterial metabolites in the colonic lumen causing specific breakdown of fatty acid oxidation in colonic epithelial cells is proposed to be the initiating event of the disease process that leads to an immune response and eicosanoid response perpetuating epithelial cell damage. The proposals embody the thesis that primary metabolic damage to colonocytes determines the clinical and pathologic manifestations of ulcerative colitis.

Acute Disease↗

PubMed1998

Listeria monocytogenes in the colon in a case of fulminant ulcerative colitis.

A case of ulcerative colitis in which the presence of Listeria monocytogenes was confirmed in the resected colon with polymerase chain reaction and subsequent Southern blot analysis and immunohistochemistry using antibody against Listeria is presented. The patient developed ulcerative colitis at the age of 59 years. Prednisolone, 50 mg/day, was given for severe ulcerative colitis. Later the disease became fulminating, indicating colectomy 4 months after the onset. Multiple sealed colonic perforations were observed. Numerous L. monocytogenes were found at the site of perforation, in fissures, and in cracks in the submucosa. This case indicates the possibility that L. monocytogenes contributes to the exacerbation of colitis to fulminating and colonic perforation.

Colectomy↗

PubMed1977

The leucocyte chemotactic function in patients with ulcerative colitis.

The intermittent course of ulcerative colitis could hypothetically be be caused by fluctuations of the patients' natural systems of resistance. To evaluate this hypothesis the chemotactic function of leucocytes in ulcerative colitis patients has been investigated. The patient group comprised 59 patients, 24 men and 35 women. All activity stages were represented. The control group comprised 25 normal subjects, 10 men and 15 women. The chemotactic reaction was investigated in a double chamber with a cellulose-ester-micropore filter with a pore size of 3 mum as a diaphragm in which the migration takes place. The variable applied was the ratio between the number of cells 50 mum down in the filter and at the surface, calculated as a chemotactic Index. Casein was used as chemotactic agents. The corrected chemotactic was defined as the difference between stimulated and unstimulated Chemotactic Index. The chemotactic as well as the corrected chemotactic response of leucocytes from ulcerative colitis patients was significantly lower than in control subjects. The subgroup, active ulcerative colitis,showed the lowest corrected Chemotactic Index, whereas the unstimulated Control Index was significantly higher than in normal subjects. The results did not correlate with treatment. The investigation has shown that leucocytes in active ulcerative colitis cases have a high spontaneous mobility, whereas their chemotactic function after stimulation is significantly subnormal. Further investigation is needed to demonstrate whether this phenomenon plays a major role in the pathogenesis of ulcerative colitis.

Adolescent↗

PubMed2006

Differential expression in histologically normal crypts of ulcerative colitis suggests primary crypt disorder.

Ulcerative colitis is characterized by crypt infiltration particularly of neutrophils. However, it is not known whether it reflects a primary crypt disorder or a secondary inflammatory response. In this study, we analyzed the expression profiles of histologically normal crypts microdissected from formalin-fixed biopsies of early stage ulcerative colitis. Total RNAs were extracted, amplified, and applied to Affymetrix GeneChip(R) X3P Array. For the control, similar crypts from nonspecific colitis biopsies were applied. A total of 353 (4.3%) and 111 (1.4%) genes were >3 times up-, and down-regulated in ulcerative colitis. Up-regulated genes included FCGBP (Fc fragment of IgG binding protein), cyclophilin A, chemokine (C-X-C motif) ligand 3, and genes associated with lipid metabolism. Down-regulated genes included APOA4 (apolipoprotein A-IV), cylindromatosis, BCL2-like 10, claudin 8, and numerous transcriptional regulators. FCGBP and APOA4 have been implicated in ulcerative colitis previously. Our data show differential expression in the crypt epithelia of ulcerative colitis before active inflammation is initiated, suggesting primary crypt abnormalities that might be implicated in the pathogenesis of ulcerative colitis.

Adult↗

PubMed1999

Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial.

BACKGROUND: Ulcerative colitis has been suggested to be caused by infection and there is circumstantial evidence linking Escherichia coli with the condition. Our aim was to find out whether the administration of a non-pathogenic strain of E. coli (Nissle 1917) was as effective as mesalazine in preventing relapse of ulcerative colitis. We also examined whether the addition of E. coli to standard medical therapy increased the chance of remission of active ulcerative colitis. METHODS: This was a single-centre, randomised, double-dummy study in which 120 patients with active ulcerative colitis were invited to take part. 116 patients accepted; 59 were randomised to mesalazine and 57 to E. coli. All patients also received standard medical therapy together with a 1-week course of oral gentamicin. After remission, patients were maintained on either mesalazine or E. coli and followed up for a maximum of 12 months. A two-stage, conditional, intention-to-treat analysis was done. FINDINGS: 44 (75%) patients in the mesalazine group attained remission compared with 39 (68%) in the E. coli group. Mean time to remission was 44 days (median 42) in the mesalazine group and 42 days (median 37) for those treated with E. coli. In the mesalazine group, 32 (73%) patients relapsed compared with 26 (67%) in the E. coli group. Mean duration of remission was 206 days in the mesalazine group (median 175) and 221 days (median 185) in the E. coli group. INTERPRETATION: Our results suggest that treatment with a non-pathogenic E. coli has an equivalent effect to mesalazine in maintaining remission of ulcerative colitis. The beneficial effect of live E. coli may provide clues to the cause of ulcerative colitis.

Adult↗

PubMed2005

Trial of trefoil factor 3 enemas, in combination with oral 5-aminosalicylic acid, for the treatment of mild-to-moderate left-sided ulcerative colitis.

BACKGROUND: Current treatment of ulcerative colitis is imperfect. Trefoil peptides are known to stimulate repair in many models of injury, including animal models of colitis. AIM: To assess the efficacy of trefoil factor family-3 enema treatment in a clinical trial. METHODS: A total of 16 patients with mild-to-moderate left sided ulcerative colitis were recruited into a double-blind randomized placebo-controlled study. Patients taking steroids or with proctitis only were excluded. Patients received 75 mL enemas containing either human recombinant trefoil factor family-3 (10 mg/mL) or saline alone once a day for 14 days. All patients also received an oral dose-increment of 1.2 g of mesalazine daily above their normal usage. Patients were assessed at 0, 2, 4 and 12 weeks. Remission was defined as Ulcerative Colitis Disease Activity Index of 0 or 1 with no blood in stool. Individual clinical improvement was defined as a Ulcerative Colitis Disease Activity Index reduction of >3. Data was analysed using chi-square test and anova. RESULTS: Median Ulcerative Colitis Disease Activity Index at entry were 8.5 (trefoil factor family-3 group) and 8 (placebo group). Analysed on an intention-to-treat basis, only one patient went into remission (in trefoil factor family-3 group at day 28). Clinical improvement was seen in two trefoil factor family-3 and three placebo patients on day 14 and two patients in each group on day 28. CONCLUSION: Increasing the dose of 5-aminosalicylic acid was moderately effective in reducing the Ulcerative Colitis Disease Activity Index but was insufficient to induce remission. Trefoil factor family-3 enemas were well-tolerated but did not provide additional benefit above that of adding additional 5-aminosalicylic acid alone.

Administration, Oral↗

PubMed2000

Limited exposure of the healthy distal colon to orally-dosed formulation is further exaggerated in active left-sided ulcerative colitis.

BACKGROUND: Active distal ulcerative colitis is often resistant to topically acting oral formulations. We speculated that the left side of the colon is underexposed to orally-dosed topical agents in patients with active distal colitis. METHODS: Twenty-two healthy volunteers (12 males, aged 22-47 years), and 10 patients (6 males, aged 33-73 years) with active left-sided ulcerative colitis ingested a Eudragit-coated gelatine capsule containing 111In-labelled amberlite resin on four successive days. Regional colonic distribution, transit times and percentage of daily dose resident were calculated from the average of four serial gamma camera images on the 4th day. RESULTS: (mean [95% CI]). When compared to controls, patients with colitis had significantly faster total colon transit (24.3 h [9.5-39.1] vs. 51.7 h [41.1-62.3]) as well as faster proximal colon transit (18.7 h [9.1-28.3] vs. 36.7 [28.5-44.9]), and distal colon transit (3.1 h [-0.5 to 6.8] vs. 15.0 h [10.5-19.5]), respectively (all P < 0.01). Material was asymmetrically distributed in health (proximal colon 69% [63-76] vs. distal colon 31% [24-37]). This asymmetry was more extreme in colitis, with corresponding values of 91% [85-96] vs. 9% [4-15]. As a result colitics had less material in the left-sided colon (9% [4-15] vs. 31% [24-37]), P < 0. 001. Colitics had a significantly lower percentage of the daily dose resident within the left side of the colon compared to controls (13% [-2 to 28] vs. 63% [44-81]), P < 0.01. CONCLUSIONS: Delayed release oral formulation is asymmetrically distributed within the colon in health. This asymmetry is exaggerated in active left-sided ulcerative colitis and, together with faster colonic transit, results in reduced exposure of the distal colon to orally-dosed topical agents.

Administration, Oral↗

PubMed1998

Leukocytapheresis therapy for severe ulcerative colitis.

Severe attacks of ulcerative colitis are medical emergencies, and surgical treatment is indicated when glucocorticoid therapy is not effective. We have carried out an open clinical study of patients with severe attacks of ulcerative colitis to find out whether leukocytapheresis (LCAP) therapy can improve their outcomes. Nine patients were enrolled in this study. Seven of the nine patients had failed to respond to an intensive intravenous regimen before LCAP. LCAP was performed once a week for 4-5 weeks as intensive therapy using a leukocyte apheresis filter. Six of the 9 patients had an overall improvement after intensive therapy. Three patients reached the remission stage. The percentages of HLA-DR+, HLA-DR+ CD3+, HLA-DR+ CD4+, and HLA-DR+ CD8+ cells in the peripheral blood were higher in the responders than in the nonresponders, but there were no significant differences. In conclusion, LCAP therapy is useful for patients with severe attacks of ulcerative colitis, even those patients who failed to respond to glucocorticoid therapy.

Adult↗