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At least 19 recordsLinked to original sources
PubMed1979

Sigmoidoscopic examinations with rigid and flexible fiberoptic sigmoidoscopes in the surgeon's office: a comparative prospective study of effectiveness in 1,012 cases.

The results obtained from 1,012 examinations in an on-going, cooperative study indicate that the overall yield provided by use of the flexible fiberoptic sigmoidoscope is 3.2 times greater than that of examinations with the rigid sigmoidoscope. More than twice (2.4 times) the number of polyps and more than three times the number of cancers were detected with the flexible fiberoptic sigmoidoscope. Experienced endoscopists can perform an examination with the flexible fiberoptic sigmoidoscope expeditiously in the office with minimal patient preparation, a high level of patient and physician acceptance, and relative safety when the usual mandatory colonoscopic precautions and guidelines are obeyed. The extraordinary advantages demonstrated by this study warrant wide clinical application of the flexible fiberoptic sigmoidoscope. We strongly recommend provision be made for appropriate training of physicians in the use of the instrument.

Colon, Sigmoid↗
PubMedDate not supplied

[A flexible Russian sigmoidoscope with fiber optics].

A brief characteristics of endoscopes manufactured by the leading specialized firms is given. At the same time optical and mechanical systems of the Soviet-made sigmoidoscope, model CBO-1, an apparatus equipped with fibrous optical elements for transmission of ligh and image, now in batch production, are described. Data derived from a comparative investigation of the resolving power of the CBO-1 unit and of the analogous devices manufactured by the firm "Olympus" are presented.

Biomedical Engineering↗
PubMed1977

Rectal biopsy in patients with Crohn's disease. Normal mucosa on sigmoidoscopic examination.

Of 99 patients with Crohn's disease whose rectal segment appeared normal on sigmoidoscopy, there was histologic inflammation in 45% and features characteristic of Crohn's disease in 30% of rectal biopsy specimens. Granulomas were found in 18% of patients, including 13% of those with ileitis, 13% of those with ileocolitis, and 37% of those with colitis. Eleven of the 17 granulomas were small undermarcated microgranulomas. Rectal biopsy specimens are of value to confirm the diagnosis in Crohn's disease and to determine the state of clinical activity even when the sigmoidoscopic appearance is normal.

Biopsy↗
PubMed1992

Flexible sigmoidoscopy in asymptomatic patients with negative fecal occult blood tests.

BACKGROUND: Although the American Cancer Society and others have established guidelines for colorectal cancer screening, questions of who and how to screen still exist. METHODS: A 60-cm flexible sigmoidoscopy was performed on 1000 asymptomatic patients, 45 years of age or older, with negative fecal occult blood tests, who presented for routine physical examinations. Patients with clinically significant lesions were referred for colonoscopy. The proportion of lesions that would not have been found if the 24-cm rigid or the 30-cm flexible sigmoidoscope had been used was identified. RESULTS: Using the 60-cm flexible sigmoidoscope, lesions were found in 3.6% of the patients. Eighty percent of the significant lesions were beyond the reach of the 24-cm rigid sigmoidoscope and 37% were beyond the reach of the 30-cm sigmoidoscope. Thirty-six patients with lesions were referred for colonoscopy; additional lesions were found in 14%. A total of 62 lesions were discovered, including tubular adenomas, villous adenomas, tubular villous adenomas (23 of the adenomas with atypia), and one adenocarcinoma. The highest percentage of lesions discovered were in the sigmoid colon and the second highest percentage were in the ascending colon. CONCLUSIONS: The 60-cm flexible sigmoidoscope was able to detect more lesions than either the 24-cm or 30-cm sigmoidoscope when used in asymptomatic patients, 45 years of age and over, with negative fecal occult blood tests. When significant lesions are discovered by sigmoidoscopy, colonoscopy should be performed.

Adenocarcinoma↗
PubMed1992

Significance of distal polyps detected with flexible sigmoidoscopy in asymptomatic patients.

BACKGROUND: Colorectal cancer is a frequent cause of death from cancer. To reduce the mortality associated with this disease, regular flexible sigmoidoscopy is recommended. However, the significance of diminutive polyps (adenomatous or hyperplastic) detected during flexible sigmoidoscopy remains controversial, as does the appropriate endoscope length (35 vs 60 cm) for colorectal cancer screening. METHODS: One hundred one consecutive patients with no history of colonic disease, gastrointestinal tract symptoms, or positive results of fecal occult blood testing underwent flexible sigmoidoscopy as part of a colorectal cancer screening program. All patients with distal polyps detected during flexible sigmoidoscopy underwent colonoscopy. RESULTS: More than 25% of these asymptomatic, predominantly male subjects had colonic neoplasms or polyps detected. Fifty percent more lesions could be detected with a 60-cm sigmoidoscope than with a 35-cm sigmoidoscope, and detection of any distal polyp, whether adenomatous or hyperplastic, was associated with at least one proximal colon adenoma in 20% of patients. "Extended flexible sigmoidoscopy" for colorectal cancer screening was well tolerated by patients, as evidenced by insertion to the hepatic flexure in 25% of patients, and provided significantly more information than could be obtained with a 35-cm sigmoidoscope. CONCLUSIONS: Colorectal cancer screening should be performed with a 60-cm flexible sigmoidoscope, and distal colonic polyps or neoplasms will be detected in 25% of asymptomatic patients.

Aged↗
PubMed1992

Placebo-controlled trial of ulcerative colitis with oral 4-aminosalicylic acid.

Forty patients with active ulcerative colitis were randomly assigned to receive either 4 g of oral enterically coated 4-aminosalicylic acid (para-aminosalicylic acid) or placebo. The duration of treatment was 12 weeks. Disease activity was assessed by grading clinical symptoms of blood, mucus, urgency, sigmoidoscopic findings, and degree of histological inflammation in rectal biopsy specimens. At 12 weeks, 11 of 20 patients (55%) who received 4-aminosalicylic acid showed improvement in clinical and sigmoidoscopic variables. In contrast, only 1 of 20 patients (5%) who had received placebo showed improvement (P less than 0.005). Eighteen of the 19 patients in the placebo group who showed no improvement were treated subsequently with open-label 4-aminosalicylic acid. Of the 18, 11 showed clinical and sigmoidoscopic improvement. Patients allergic or intolerant to sulfasalazine with extensive disease were more likely to respond to 4-aminosalicylic acid.

Administration, Oral↗
PubMed1975

Mucosal-cell counts in ulcerative and granulomatous colitis.

Epithelial and connective-tissue cells were counted in rectal mucosal biopsies from 215 patients with ulcerative colitis, 98 patients with granulomatous colitis, and 50 controls. The results were analyzed statistically. Significantly decreased mucous goblet cells were found both in sigmoidoscopically abnormal ulcerative colitis and in granulomatous colitis, and they increased during the healing process. More pyknotic and karyorrhectic epithelial cells occurred in active ulcerative colitis than in granulomatous colitis. Inactive ulcerative colitis still manifested histologic evidence of acute and chronic inflammation, while sigmoidoscopically normal granulomatous colitis biopsies after previous gross rectal disease showed significantly increased macrophages in the lamina propria. Cell counts were valuable for differential diagnosis after the sigmoidoscopic appearance became normal. The acute inflammation of ulcerative colitis, as indicated by neutrophils, was decreased most notably following therapy with prednisone or 6-mercaptopurine. Chronic inflammation associated with fewer plasma cells was decreased after salicylazosulfapyridine as well as either of the other two drugs; macrophages, indicators of healing, increased most after 6-mercaptopurine combined with another anti-inflammatory agent.

Biopsy↗
PubMed1977

Rectal potential difference and histology in Crohn's disease.

The rectal potential difference (PD) was measured in 27 patients with Crohn's disease, and in 16 subjects without gastrointestinal disease to establish a normal range. Sigmoidoscopic assessment and rectal biopsy were performed in all patients with Crohn's disease, and the mean resting rectal PD was significantly reduced in patients with sigmoidoscopically active disease and in those with abnormalities of the superficial epithelium on rectal biopsy. Patients with diarrhoea had a significantly lower mean resting PD than those with normal bowel habit, suggesting that an abnormality of rectal sodium transport may be contributing to the diarrhoea in these patients. The response of rectal PD to mineralocorticoid stimulation with oral fludrocortisone was measured in 13 patients. The PD failed to rise only with patients with sigmoidoscopically active disease, and the test proved to be a less sensitive indication of minor mucosal abnormalities than sigmoidoscopy of biopsy.

Crohn Disease↗
PubMed1978

A clinicopathologic study on patients suffering from "chronic dysentery".

Fifty adult patients with the self diagnosis of "chronic dysentery" were studied. Their faeces were examined microscopically; they were sigmoidoscoped and their rectal mucosa were examined histologically. Most of them had irritable bowel syndrome. Their sigmoidoscopic appearances were normal and the histology showed only mild increase in the numbers of round cells in the lamina propria. This was regarded as normal for the local population. Ten patients showed cysts of Entamoeba histolytica in the faeces. This was thought to be unrelated to the symptoms. Only four patients had sigmoidoscopic as well as histologic evidence of moderate to severe proctocolitis. One of them was proven to be a case of amoebic colitis. These findings have been discussed.

Adult↗
PubMed1979

Flexible sigmoidoscopy as a screening procedure for neoplasia of the colon.

Two hundred asymptomatic United States veterans older than 40 years of age were evaluated with a flexible sigmoidoscope plus Hemoccult stool tests. Mean distance and time for the former were 56.4 centimeters and 7.4 minutes, respectively. There were no complications. Polyps greater than or equal to 0.5 centimeter in diameter were found in 11.9 per cent of those older than 50 years. No polyps of this size were found in patients younger than 50 year of age. Results of Hemoccult tests were negative in 83.3 per cent of those with polyps. A flexible sigmoidoscope is a safe, rapid and effective means of identifying that portion of the asymptomatic adult population having colonic polyps. For this purpose, it is vastly more sensitive than Hemoccult stool testing. Because of the relationship between colonic polyps and carcinoma, this technique may prove invaluable in the identification of those patients with an increased potential for the development of carcinoma of the colon.

Adult↗
PubMed1976

The double contrast enema in ulcerative and Crohn's colitis.

One hundred double contrast enema examinations using a colonic activator (veripaque in the preliminary cleansing enema and 51 conventional barium enema examinations without a preliminary veripaque enema have been performed on 94 patients with either ulcerative colitis or Crohn's disease of the colon. The severity of the disease at barium enema examinations has been graded and compared with the severity of the disease found at sigmoidoscopy. In the double contrast examination, there was agreement between the radiological and sigmoidoscopic findings in 77% of cases and a disagreement of one grade in the remaining 23% of cases. The double contrast enema demonstrated lesions in the colon proximal to the range of the sigmoidoscope of a greater severity than that seen at sigmoidoscopy in 30% of cases. It was not found possible to use the same grading method with the conventional enema, and unless frank ulceration is present, it is considered that the conventional enema is unreliable in assessing the state of the colonic mucosa. It is concluded that the double contrast enema, using a colonic activator in the preliminary cleansing enema, causes no greater risk of complications than either the conventional enema or sigmoidoscopy.

Barium Sulfate↗
PubMed1976

Therapeutic evaluation of oxantel pamoate (1, 4, 5, 6-tetrahydro-1-methyl-2-[trans-3-hydroxystyryl] pyrimidine pamoate) in severe Trichuris trichiura infection.

The efficacy of oxantel pamoate (1, 4, 5, 6-tetrahydro-2-[trans-3-hydroxystyryl]-1-methyl pyrimidine pamoate) was evaluated in 25 children with severe Trichuris infection. The presence of chronic dysentery and sigmoidoscopic demonstration of whipworms in the intestinal mucosa were the criteria for inclusion in the trial. Most of these patients had severe anemia, rectal prolapse, digital clubbing, hypoproteinemia, and growth retardation. There were a high incidence of concomitant parasitism with other intestinal helminths and with Entamoeba histolytica and Giardia lamblia. Sigmoidoscopic grading of Trichuris load and egg count in the feces were carried out prior to treatment and 2 days after each course of oxantel therapy. Oxantel was administered at a dose of 10 mg/kg body weight twice daily for a 3-day course. Satisfactory response, as judged by relief of dysentery and absence of whipworms from the mucosa at sigmoidoscopy, was achieved in 17 patients after the first course and in the remaining 8 patients after a second course of oxantel. The drug was well tolerated and no side effects were noted during or after treatment. It is concluded that oxantel is a safe and effective anthelmintic for severe clinical trichuriasis.

Child↗