Search results for "Short Bowel Syndrome"
showing 9 items of 9 documents
GLP-2: What do we know? What are we going to discover?
2014
Glucagon-like peptide 2 [GLP-2] is a 33-amino acid peptide released from the mucosal enteroendocrine L-cells of the intestine. The actions of GLP-2 are transduced by the GLP-2 receptor [GLP-2R], which is localized in the neurons of the enteric nervous system but not in the intestinal epithelium, indicating an indirect mechanism of action. GLP-2 is well known for its trophic role within the intestine and interest in GLP-2 is now reviving based on the approval of the GLP-2R agonist for treatment of short bowel syndrome [SBS]. Recently it also seems to be involved in glucose homeostasis. The aim of this review is to outline the importance of neuroendocrine peptides, specifically of GLP-2 in th…
Cytokine Gene Transcription By NF-kappaB Family Members in Patients with Inflammatory Bowel Disease
1998
We examined the expression of the transcription factor NF-kappa B, a nuclear trans-acting factor known to play a key role in cytokine gene regulation, in patients with inflammatory bowel disease (IBD). It was found that LP macrophages in Crohn's disease (CD) and ulcerative colitis (UC) display high levels of NF-kappa B DNA-binding activity accompanied by an increased production of interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF) alpha. Western blot studies showed an increased expression of the p50 and c-rel subunits of NF-kappa B; however, the most striking finding was an increased expression level of NF-kappa B p65 in patients with CD and UC. Selective downregulation of p65 in IBD…
Surgical Emergencies in Crohn’s Disease
2015
Crohn’s disease, as a chronic inflammatory disease of unknown etiology that can affect any part of the alimentary canal from the mouth to the anus, has a highly variable course and a very unpredictable evolution. Even surgery does not cure CD, it has however a relevant role in its treatment in combination to medical therapy during the large course of the disease; indeed almost each patient is submitted to a surgical intervention during his life. Nowadays, surgery is considered the last treatment to use whenever medical therapy is insufficient to control symptoms; this choice involves an intervention on more serious patients with more surgical complications. Surgery finds in the Crohn’s dise…
Surgery and Crohn’s Disease
2015
It is known that the treatment of Crohn’s disease (CD) absolutely needs a multidisciplinary approach with an important relationship between gastroenterologist and surgeon. CD, in fact, is a chronic inflammatory bowel disease interesting all segments of alimentary tract showing extreme variability of clinical presentations. Medical therapy when ineffective will give way to surgical treatment, and the last one isn’t possible without adequate pharmacological support. Synthetically, it’s possible to affirm that gastroenterologist treats CD and the surgeon its complications.
Clinical Presentation of Crohn’s Disease
2015
Crohn’s disease is an idiopathic chronic inflammatory disease of the gut, which may involve the entire gastrointestinal tract from the mouth to the perianal area, though preferring in most cases the distal small bowel and the proximal large bowel. Its heterogeneous nature is reflected in a number of different phenotypes. Approximately 80 % of patients have small bowel involvement, usually in the distal ileum, with one-third of patients having exclusively ileitis. Approximately 50 % of patients have ileocolitis which refers to involvement of both the ileum and colon. From 20 to 25 % of patients have disease confined to the colon. Involvement of the esophagus, stomach, or duodenum is rare and…
Jejunoileal bypass as the main procedure in the onset of immune-related conditions: the model of BADAS
2013
Bariatric surgery represents a common approach for the control of severe morbid obesity, reducing caloric intake by modifying the anatomy of the gastrointestinal tract. Following jejunoileal bypass, a large spectrum of complications has been described, with rheumatic manifestation present in up to 20% of cases. Although bowel bypass syndrome, also called blind loop syndrome, is a well-recognized complication of jejunoileal bypass, the same syndrome was recognized in patients who had not had intestinal bypass surgery, and the term the 'bowel-associated dermatosis-arthritis syndrome' (BADAS) was coined. The pathogenesis of BADAS is as yet poorly understood and only few data concerning this is…
Clinical case and short review of extreme short bowel syndrome: an update 21 years after
2016
Short bowel syndrome refers to the malabsorptive state caused by loss of significant portions of the small intestine, whose clinical framework is characterized by malnutrition, diarrhea, dehydration, weight loss, and low-weight-related symptoms/signs. These clinical conditions seem to be related to the length of resection. Twenty-one years ago we reported the clinical case of an infant, who underwent a massive resection of the loops of the small intestine, of the cecum and of part of the ascending colon, due to intestinal malrotation with volvulus. The residual small intestine measured just 11 cm and consisted of the duodenum and a small part of jejunum, in the absence of the ileocecal valv…
Pharmacokinetics of dabigatran etexilate and rivaroxaban in patients with short bowel syndrome requiring parenteral nutrition: The PDER PAN study
2017
Background and aims: Patients on parenteral nutrition for short bowel syndrome (SBS) have a high risk of thrombotic complications and are often treated with parenteral anticoagulation. Direct oral anticoagulants are absorbed proximally in the digestive tract and may represent alternative regimens in selected SBS patients. In our pilot study, we provided pharmacokinetics parameters of dabigatran etexilate and rivaroxaban in this setting and compared peak (Cmax), trough (Ctrough) concentrations, and areas-under-the-concentration-time-curve (AUC(0) (-) (t)) to reference values retrieved from phase I-III studies. Methods: We enrolled 6 adults with a remaining small bowel length <= 200 cm, norma…
Ureteroiliac Artery Fistula in a Young Woman with Short Bowel Syndrome for Radiation Enteritis
2010
Ureteral-iliac artery fistula is a rare and potentially life-threatening complication, typically occurring after radiation therapy in already surgically treated cancer patients. This case report describes the diagnostic challenges and the successful management, with the positioning of an intra-arterial prosthesis, of a fistula between the internal iliac artery and the left ureter presenting as massive hematuria in a young woman with history of total colectomy and pelvic radiotherapy for rectal cancer and subsequent wide ileal resections and bilateral ureteral stent positioning for radiation enteritis. Ureteroiliac artery fistulas require a prompt diagnosis and intervention, to avoid life th…