Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
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Clin. Gastroenterol. Hepatol. · May 2006
The Manitoba Inflammatory Bowel Disease Cohort Study: prolonged symptoms before diagnosis--how much is irritable bowel syndrome?
The Manitoba Inflammatory Bowel Disease (IBD) Cohort Study is a population-based prospective cohort study of recently diagnosed IBD (n=396). At enrollment, 162 (41%) indicated gastrointestinal symptom>or=3 years before diagnosis. We aimed to determine whether coexistence of irritable bowel syndrome (IBS) had a role in symptoms before IBD diagnosis. ⋯ These data suggest that older patients and those with likely and possible preexisting IBS are more likely to experience longer symptom duration before diagnosis of IBD. The prevalence rate of IBS was similar to estimated base rates in the general population.
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Clin. Gastroenterol. Hepatol. · Apr 2006
Prevalence of occult gastrointestinal bleeding in celiac disease.
By using colorimetric tests, reports have indicated that occult gastrointestinal bleeding is common in celiac disease. These results suggest that bleeding is a significant contributor to iron deficiency in this disorder and imply a significant inflammatory hemorrhagic component. Both these concepts are contrary to previous understanding of pathology of celiac disease. Furthermore, colorimetric tests provide an indirect and nonspecific assessment of blood loss. We therefore hypothesized that an accurate, quantitative, and specific method for blood loss, rather than a guaiac test, might give different findings. We report the results of stool blood loss measurement by using such a method. ⋯ Colorimetric tests give a high prevalence of positive results for occult gastrointestinal blood loss in celiac disease, whereas the more specific and direct radiochromium method gives a low prevalence. These results suggest that bleeding is uncommon in celiac disease, and that positive results with colorimetric tests might be due to excess loss of intestinal cells and/or malabsorption of peroxidase-containing foods. Our results suggest that bleeding is not an important contributor to the iron deficiency often found in these subjects.
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Clin. Gastroenterol. Hepatol. · Mar 2006
Randomized Controlled Trial Multicenter StudyOral p38 mitogen-activated protein kinase inhibition with BIRB 796 for active Crohn's disease: a randomized, double-blind, placebo-controlled trial.
The p38 mitogen-activated protein kinase (MAPK) regulates the expression of proinflammatory cytokines, which play a critical role in the pathophysiology of Crohn's disease (CD). This study investigated the efficacy and safety of BIRB 796, a highly potent inhibitor of p38 MAPK, in chronic active CD. ⋯ There was no evidence for clinical efficacy of BIRB 796 in CD. A remarkable difference in the course of CD exists between Russia and non-Russian centers.
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Clin. Gastroenterol. Hepatol. · Feb 2006
Randomized Controlled TrialSafety of celecoxib in patients with ulcerative colitis in remission: a randomized, placebo-controlled, pilot study.
The safety of selective cyclooxygenase-2 inhibitors in patients with ulcerative colitis in remission is unknown. ⋯ Therapy with celecoxib for up to 14 days did not have a greater relapse rate than placebo in patients with ulcerative colitis in remission who had a present or past history of nonspecific arthritis, arthralgia, or other condition amenable to nonsteroidal anti-inflammatory drug therapy.