Abstract:
:Severely ill patients with ulcerative colitis are usually treated with parenteral corticoids. Those with signs of systemic toxicity usually receive antibiotics as well. However, the role of antibiotics in patients without high fever, profound leukocytosis, peritoneal signs or megacolon is not clear. Since 1985, seven patients who were admitted to the hospital with severe ulcerative colitis but without signs of toxicity have received broad spectrum antibiotics. The patients ranged in age from 21 to 65 years: four were male; all were white. Stools for infectious agents were negative. Each patient received intravenous prednisolone at a dose of 60 mg/24 h. After 7 days, each patient continued to have eight to 10 bloody stools per day with low-grade fever and leukocytosis. Institution of broad-spectrum antibiotics was associated with a striking resolution of bloody diarrhea and normalization of temperature. No patient has required colectomy in follow-up of 2-9 years. Whether the antibiotics are treating an undetected pathogen or eliminating non-pathogenic bacteria contributing to the inflammatory process is not clear. I suggest that severely ill patients with ulcerative colitis deserve a trial of antibiotics before being considered failures of medical therapy.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Peppercorn MAdoi
10.1097/00004836-199307000-00005subject
Has Abstractpub_date
1993-07-01 00:00:00pages
14-7issue
1eissn
0192-0790issn
1539-2031journal_volume
17pub_type
杂志文章abstract::Helicobacter pylori infects only human gastric epithelium, causes gastritis, and is strongly associated with gastroduodenal ulceration and gastric cancer. Colonization of the stomach with H. pylori is accompanied in the acute stage by an increased number of neutrophils in the lamina propria, indicative of gastric infl...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199800001-00021
更新日期:1998-01-01 00:00:00
abstract::We compared eleven patients in whom symptoms of Crohn's disease appeared at age greater than or equal to 65 with a younger group in whom symptoms had appeared earlier. Only 64% of the older patients were initially recognized as having Crohn's disease, as compared with 96% of the younger patients even though clinical c...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198908000-00013
更新日期:1989-08-01 00:00:00
abstract::Diverticular disease of the colon is quite common in developed countries, and its prevalence increases with age. Although present in perhaps two thirds of the elderly population, the large majority of patients will remain entirely asymptomatic. Nonetheless, an estimated 20% of those affected may manifest clinical illn...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199910000-00004
更新日期:1999-10-01 00:00:00
abstract:GOALS:Our aim was to study the prevalence of dysplasia and progression to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in African Americans (AA) with Barrett's esophagus (BE) and compare it with that of non-Hispanic white (NHW) controls. BACKGROUND:BE, a precursor of EAC, is a disease of predominantl...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000559
更新日期:2017-05-01 00:00:00
abstract:GOALS:The goal of this study was to elucidate the most important predictors for elevation of gastrin in patients on long-term PPI therapy through analysis of data from 2 published studies in Icelandic patients with erosive GERD. BACKGROUND:Gastrin elevation is a known but variable consequence of proton pump inhibitor ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001200
更新日期:2020-03-01 00:00:00
abstract::Fulminant hepatic failure as a result of hepatitis A is a rarely diagnosed complication entity in developed countries. With the advent of specific serologic markers for acute hepatitis A virus infection, the incidence and pathology of fulminant hepatitis A can be more clearly defined. We describe four patients (one ad...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199309000-00014
更新日期:1993-09-01 00:00:00
abstract::Functional abdominal bloating is a condition dominated by a feeling of abdominal fullness or bloating and without sufficient criteria for another functional gastrointestinal disorder. The currently used therapeutic approaches aim to reduce the volume of intestinal gas, thus increasing intestinal gas elimination or red...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/01.mcg.0000128939.40458.25
更新日期:2004-07-01 00:00:00
abstract::Magnetic resonance cholangiopancreatography (MRCP) is a novel imaging technique used for noninvasive work-up of patients with pancreaticobiliary disease. Magnetic resonance cholangiopancreatography is useful in the evaluation of a host of pancreaticobiliary disorders, such as congenital disorders, calculus disease, bi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200111000-00004
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:For patients with Crohn's disease (CD) who have colonoscopy during periods of clinical remission, the utility of taking ileocolonic biopsy specimens to assess disease activity is disputed. GOALS:We explored the clinical implications of histologic disease activity in such patients. STUDY:We reviewed medical...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000507
更新日期:2017-01-01 00:00:00
abstract::Pyogenic abscesses of the liver occur in association with a variety of diseases. Sometimes they are caused by anaerobic infections of liver metastases. Uncommonly, however, multiple hepatic abscesses caused by anaerobic bacteria are the presenting signs of unsuspected colonic cancer in the absence of liver metastases....
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199206000-00013
更新日期:1992-06-01 00:00:00
abstract:GOALS:The aim of this study was to analyze the incidence and associated charges of fecal impaction for trends in hospital and patient demographics in emergency departments (ED) across the United States. BACKGROUND:In 2010, an ICD-9-CM code (560.32) for fecal impaction was introduced, allowing for assessment of fecal i...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000458
更新日期:2016-08-01 00:00:00
abstract::Microbial signals stimulate development and maintenance of the neonatal immune system. The process begins in utero, with limited exposure to microbes in the intrauterine environment, as well as maternal immune signals priming the developing immune system. After birth and initial colonization, the immune system must be...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0000000000000355
更新日期:2015-11-01 00:00:00
abstract::Esophageal manometry is a specialized procedure used to evaluate lower and upper esophageal sphincter pressure, esophageal body contraction amplitude, and peristaltic sequence. The procedure is clinically useful in evaluation of a patient with nonstructural dysphagia, unexplained or noncardiac chest pain, a compendium...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e3181653a5c
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Guidelines recommend upper endoscopic screening of cirrhotic patients for gastroesophageal varices. Cirrhosis is not always distinguishable from chronic hepatitis. GOALS:To identify low-risk patients who can be spared upper endoscopy irrespective of a diagnosis of cirrhosis. STUDY:We evaluated 13 nonendosc...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318157464b
更新日期:2009-01-01 00:00:00
abstract::Bacterial overgrowth is frequent in patients with Crohn's disease (CD) and can contribute to symptoms. Motility abnormalities can predispose to bacterial overgrowth. The hydrogen (H2) and methane (CH4) breath test is a sensitive and simple tool for the diagnosis of bacterial overgrowth and for the evaluation of orocec...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200007000-00015
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:There has been constant speculation about the association between metabolic syndrome (MetS) and colorectal neoplasia (CN); however, the published results are conflicting. The aims of this study are to conduct a systematic search, and assess the literature to determine the available evidence on the associatio...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MCG.0b013e3182688c15
更新日期:2013-01-01 00:00:00
abstract:GOALS:Our study reexamines the prevalence of interval colorectal cancer (I-CRC) by manually reviewing CRC cases at a single institution. BACKGROUND:In 2% to 8% of patients with CRC, diagnosis occurs during the interval 6 to 36 months after a cancer-free colonoscopy. Rates are often determined by linking the date of co...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000183
更新日期:2015-07-01 00:00:00
abstract::Upper gastrointestinal endoscopy is the most sensitive diagnostic test in patients with upper gastrointestinal symptoms. Endoscopy performed by trained examiners, however, still misses lesions. Single-contrast upper gastrointestinal x-ray adds little new information to a complete endoscopic examination by a trained en...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::Physicians sometimes forget nongastrointestinal causes of abdominal pain. Yet, abdominal pain was the major complaint of three patients with ureteropelvic junction obstruction (UPJ). Definitive diagnosis can be made either by a "hydration" intravenous pyelogram or by an intravenous pyelogram during an attack. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-197912000-00011
更新日期:1979-12-01 00:00:00
abstract::Antacids, cimetidine, carbenoxolone, colloidal bismuth, and prostaglandins promote healing of gastric and duodenal ulcer at a rate nearly twice that of healing during placebo administration. These short-term, 4-12 week healing rates are nearly the same for each agent, with a 65 to 85% range. Drugs that appear to produ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::The aim of this paper (presented in Rome, Italy, at the 2nd Congress of Probiotics, Prebiotics, and New Food, September 7-9, 2003) was to provide an objective view of the regulatory trends at the European level specifically referring to probiotics, because until now they have never been directly mentioned nor official...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000128733.79515.c4
更新日期:2004-07-01 00:00:00
abstract::We report a patient with long-standing ulcerative colitis who developed carcinoma of the colon, sclerosing cholangitis, pericholangitis, and bronchiectasis over the course of 10-15 years. Occurrence of these rare conditions in the same patient supports their reported association and reemphasizes that there may be mult...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract::Crohn's disease (CD) is now accepted as a systemic illness. The importance of extraintestinal manifestations is underlined by the fact that such "complications" can be more prominent and even more difficult to control than the intestinal disease itself. Lately, evidence for a more than accidental association of pancre...
journal_title:Journal of clinical gastroenterology
pub_type: 社论
doi:
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:The cure for hepatitis B is defined as the hepatitis B surface antigen (HBsAg) seroclearance and/or seroconversion. Predictors of spontaneous seroconversion are not well described. The objective of this study is to identify predictors of spontaneous HBsAg seroconversion from community practice. METHODS:We p...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001324
更新日期:2020-07-01 00:00:00
abstract::Thirty-five consecutive patients with acute hematochezia, negative gastric aspirates, and negative sigmoidoscopy underwent urgent colonoscopy after Golytely purgation. Mucosal visualization was excellent. Colonic bleeding lesions were identified in 24 of 35 patients, and hemorrhage originating proximal to the ileoceal...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198602000-00010
更新日期:1986-02-01 00:00:00
abstract:GOALS:To evaluate the incidence of extraesophageal malignancies among patients with Barrett esophagus (BE). BACKGROUND:Gastroesophageal reflux disease has been reported to be associated with upper aerodigestive malignancies. BE is considered a consequence of long-standing gastroesophageal reflux disease; however, the ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31828bf26f
更新日期:2014-01-01 00:00:00
abstract::Forty-two patients underwent flexible sigmoidoscopy in the radiology department. After maximal insertion of the sigmoidoscope, a supine abdominal film documented the position of the tip of the instrument. Correlation with barium enema in all patients determined the extent of visualization of the colon relative to the ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198208000-00009
更新日期:1982-08-01 00:00:00
abstract::We observed jejunal water and sodium secretion in two patients with chronic idiopathic intestinal pseudo-obstruction by standard perfusion techniques. The ability of glucose to reverse this secretory state was impaired. These observations suggest that a jejunal secretory state may contribute to the diarrhea in chronic...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199004000-00008
更新日期:1990-04-01 00:00:00
abstract::Acid-reducing drugs can cause increased growth of microbes, including fungus, because of high gastric pH. Our purpose was to evaluate the occurrence of mycotic infection in patients with duodenal ulcer on anti-ulcer therapy and to compare the effects of cimetidine, famotidine, and omeprazole. Eighty patients with duod...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-199607000-00003
更新日期:1996-07-01 00:00:00
abstract::The benefit of early endoscopy in the management of peptic ulcer bleeding remains controversial. In this study we looked at the role of early endoscopy in bleeding peptic ulcer patients with clear, "coffee grounds," or bloody nasogastric aspirate. A consecutive series of 325 patients with peptic ulcer bleeding were in...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-199606000-00005
更新日期:1996-06-01 00:00:00