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Assessment of small intestinal bacterial overgrowth in uncomplicated acute diverticulitis of the colon

World Journal of Gastroenterology 2005年第18期11卷 2773-2776页

作者： Antonio Tursi Giovanni Brandimarte Gian Marco Giorgetti walter elisei Digestive Endoscopy Unit "Lorenzo Bonomo" Hospital Andria Italy Department of Internal Medicine Division of Gastroenterology "Cristo Re" Hospital Rome Italy Clinical Nutrition Unit "S. Eugenio" Hospital Rome Italy

AIM: Small intestinal bacterial overgrowth (SIBO) maycontribute to the appearance of several gastrointestinal nonspecific symptoms. Acute diverticulitis is affected by some similar symptoms and bacterial colonic overgrowth. We assessed the prevalence of SIBO in acute uncomplicated diverticulitis and evaluated its influence on the clinical course of the ***: We studied 90 consecutive patients (39 males, 51 females, mean age 67.2 years, range 32-91 years). Sixty-one patients (67.78%) and 29 patients (32.22%) were affected by constipation-or diarrhea-prevalent diverticulitis respectively. All subjects were investigated by lactulose H2-breath test at the entry and at the end of treatment. We also studied a control group of 20 healthy subjects (13 males, 7 females, mean age 53 years, range 22-71 years).RESULTS: Oro-cecal transit time (OCTT) was delayed in67/90 patients (74.44%) (range 115-210 min, mean 120 min). Fifty-three of ninety patients (58.88%) showed SIBO, while OCTT was normal in 23/90 patients (25, 56%). In the control group, the mean OCTT was 88.2 min (range 75-135 min). The difference between diverticulitic patients and healthy subjects was statistically significant (P＜0.01). OCTT was longer in constipation-prevalent disease than in diarrheaprevalent disease [180.7 min (range 150-210 min) vs 121 min (range 75-180 min) (P＜0.001)], but no difference in bacterial overgrowth was found between the two forms of *** treatment with rifaximin plus mesalazine for 10 d, followed by mesalazine alone for 8 wk, 70 patients (81.49%) were completely asymptomatic, while 16 patients (18.60%) showed only slight symptoms. Two patients (2.22%) had recurrence of diverticulitis, and two other patients (2.22%) were withdrawn from the study due to side-effects. Seventy-nine of eighty-six patients (91.86%) showed normal OCTT (range 75-105 min, mean 83 min), while OCTT was longer, but it was shorter in the remaining seven (8.14%) patients (range 105-115 min

关键词： Small intestinal bacterial overgrowth Oro-oecal transit time

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Heterotopic gastric mucosa in the anus and rectum:first case report of endoscopic submucosal dissection and systematic review

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Gastroenterology Report 2016年第3期4卷 196-205,I0001页

作者： Federico Iacopini Takuji Gotoda walter elisei Patrizia Rigato Fabrizio Montagnese Yutaka Saito Guido Costamagna Giampaolo Iacopini Gastroenterology and Endoscopy Unit Ospedale S.GiuseppeAlbano L.RomeItaly Division of Gastroenterology and Hepatology Nihon University School of MedicineTokyoJapan Pathology Unit Ospedale S.GiuseppeMarinoItaly Endoscopy Division National Cancer Center HospitalTokyoJapan Digestive Endoscopy Unit Policlinico GemelliCatholic UniversityRomeItaly Gastroenterology Clinic RomeItaly

Background:Heterotopic gastric mucosa(HGM)is the most reported epithelial heterotopia,but it is very rare in the rectum and ***:The first case of an asymptomatic adult male with a large nonpolypoid HGM in the low rectum underwent complete resection by endoscopic submucosal dissection(ESD)is *** systematic review was based on a comprehensive search of MEDLINE,EMBASE and Google *** on humans were identified with the term‘heterotopic gastric mucosa in the rectum and/or anus.’Results:The search identified 79 citations,and 72 cases were evaluated comprising the present *** malformations were observed in 17(24%)patients;rectal duplication accounted for most of the *** HGM was located in the anus and perineal rectum in 25 cases(41%)and low,middle and proximal pelvic rectum in 20(33%),five(8%)and 11 cases(18%),*** was nonpolypoid in 37 cases(51%),polypoid in 26 cases(36%)and ulcerated in nine cases(13%).Specific anorectal symptoms were reported by 50(69%)patients of the whole study population,and by 33(97%)of 34 patients≤18 *** were observed in 23 cases(32%).The HGM was excised in 50 cases(83%).Endoscopic resection was performed in 17 cases(34%);resection was piecemeal in five of 12 lesions≥5mm,required argon plasma coagulation in two cases and was associated with residual tissue in two(17%).Intestinal metaplasia and an adenoma with lowgrade dysplasia were described in three adults(4%).Discussion:This systematic review shows that the HGM in the rectum and anus may be associated with specific rectal symptoms and serious complications,mainly in the pediatric population,and a risk of malignancy in *** complete excision should be recommended,and the ESD can overcome the technical limits of conventional endoscopic snare resection and avoid unnecessary surgery.

关键词： heterotopic gastric mucosa endoscopic submucosal dissection review rectum

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Clinical and epidemiological features of ulcerative colitis patients in Sardinia,Italy:Results from a multicenter study

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World Journal of Clinical Cases 2022年第30期10卷 10921-10930页

作者： Salvatore Magrì Mauro Demurtas Maria Francesca Onidi Marcello Picchio walter elisei Manuela Marzo Federica Miculan Roberto Manca Maria Pina Dore Bianca Maria Quarta Colosso Antonio Cicu Luigi Cugia Monica Carta Laura Binaghi Paolo Usai Mariantonia Lai Fabio Chicco Massimo Claudio Fantini Alessandro Armuzzi Giammarco Mocci Department of Medical Sciences and Public Health University of CagliariMonserrato 09042Italy Endoscopy Unit Humanitas Istituto Clinico CataneseCatania 95045Italy Endoscopy Unit San Martino HospitalOristano 09170Italy Gastroenterology Unit Brotzu HospitalCagliari 09121Italy Division of General Surgery Ospedale Civile P ColomboVelletri 00049Italy Gastroenterology Unit San Camillo Forlanini HospitalRome 00152Italy Internal Medicine and Gastroenterology Department Cardinale Panico HospitalTricase 73039Italy Department of Surgery San Martino HospitalOristano 09170Italy Division of Gastroenterology Santissima TrinitàHospitalCagliari 09121Italy Dipartimento di Medicina Clinica e Sperimentale University of SassariSassari 07100Italy Department of Medical Science and Public Health University of SassariSassari 07100Italy Unit of Gastroenterology ASL SassariSassari 07100Italy Gastroenterology Unit Santissima Annunziata HospitalSassari 07100Italy Medical Science and Public Health University of CagliariCagliari 09042Italy Medical Sciences and Public health Presidio Policlinico of MonserratoCagliariMonserrato 09042CagliariItaly Department of Internal Medicine University of Rome Tor VergataRome 00133Italy IBD Unit Policlinico Universitario GemelliRome 00168Italy

BACKGROUND There are little data on the epidemiological and clinical features of adult patients with ulcerative colitis(UC) in the different Italian regions,mainly derived from the absence of a national *** prevents correct interpretation of the disease *** To assess the main clinical and epidemiological features of adult patients diagnosed with UC in Sardinia,*** We performed a multicenter,observational,cross-sectional study that included adult patients with UC enrolled in seven gastroenterology unit centers in *** were obtained from the patients’ medical records and from a questionnaire administered at the inclusion *** Four hundred and forty-two patients with UC were *** median age at diagnosis was 39years(interquartile range 28-48).After a median disease duration of 10 years,53 patients experienced proximal extension of proctitis or left-sided ***-five patients developed extraintestinal *** patients(4.3%) developed cancer:two with colorectal cancer and seventeen with extracolonic ***(5-ASA) remains the mainstay of treatment for ***,95 patients(21.5%) were treated with one or more biologic agents,whereas 15 patients(3.4%) underwent surgery,mostly *** Our results provide important insights into the clinical and epidemiological features of patients with UC,and while waiting for a national Italian registry,present eligible data on the UC population in Sardinia.

关键词： Inflammatory bowel disease-basic Inflammatory bowel disease-clinical Ulcerative colitis Epidemiology Natural history Treatment

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