The value of double-contrast barium enema in amebic colitis

We report here our findings on the double-contrast barium enema given to 8 patients with amebic colitis and a comparison is made with endoscopic features. A definite diagnosis of amebic colitis was made by fecal examination or by endoscopic biopsy. Radiologic findings included fine marginal serration, aphthoid ulcers, minute barium flecks, marginal defects, loss of haustration, and deformities of the bowel. Aphthoid ulcers and marginal defects are both characteristic of amebic colitis. The double-contrast barium enema is most useful for differentiating amebiasis from other forms of colitis.     

Double-contrast enema in antibiotic-related pseudomembranous colitis

Pseudomembranous colitis (PMC) is a potentially fatal disease often associated with antibiotic therapy. The condition is now known to be due to an enterotoxin produced by Clostridium difficile. Diagnosis is based on the endoscopic finding of the typical pseudomembranes, stool culture, and assay of the stools for the specific toxin. Radiography with double-contrast medium (DCE), which can be performed in patients not critically ill, often yields pathognomonic findings and permits early diagnosis.     

硫酸锌溶液对大鼠三硝基苯硫酸实验性结肠炎治疗作用的研究

目的 动物实验表明硫酸锌具有抗炎作用，但对结肠炎的作用仍不十分清楚。现评估硫酸锌灌肠对大鼠2，4，6三硝基苯硫酸(TNB)结肠炎的抗炎作用，并探讨其机制。方法Spragur—Dawley雌性大鼠直肠内给予TNB制备成结肠炎模型，第1天开始每天给予硫酸锌溶液灌肠1次，共6d，第8天处死大鼠，与对照组比较，评价硫酸锌灌肠对TNB结肠炎黏膜病变面积、黏膜髓过氧化物酶(MPO)及超氧化物歧化酶(SOD)活性、黏膜前列腺素E2(PGE2)及白三烯B4(LTB4)水平的影响。结果 大鼠TNB结肠炎黏膜病变面积、黏膜MPO活性、黏膜PGE2和LTB4水平均明显升高，硫酸锌灌肠可以改善这些异常，但是对黏膜SOD活性没有影响。结论 硫酸锌灌肠对大鼠实验性结肠炎具有一定的抗炎及促黏膜修复作用。     

Basic fibroblast growth factor enema improves experimental colitis in rats

BACKGROUND/AIMS: Growth factors have a potential role in gastrointestinal mucosal repair. Although basic fibroblast growth factor (bFGF) is known to contribute to wound healing, however, the role of bFGF in the treatment of inflammatory bowel disease has not been established. The aim of this study is to investigate the therapeutic effects of intracolonic bFGF administration on both the clinical symptoms and histological mucosal repair in an experimental model of colitis in rats. METHODOLOGY: Acute colitis was induced with 5% dextran sulfate sodium (DSS) given for one week in drinking water. The rats were treated daily with recombinant human bFGF enema (400 microg/kg/day) or vehicle once daily from day 1 to day 7. Clinical score (stool consistency, weight loss and hemoccult/gross rectal bleeding), colon length and histological score of mucosal injury in colonic tissue samples were analyzed. RESULTS: Administration of bFGF enema significantly reduced clinical score (p < 0.01) and histological score (p < 0.01). No specific side effect of bFGF was noted. CONCLUSIONS: These results suggest that bFGF enema is clinically safe and useful in the treatment of inflammatory bowel disease. BFGF enema may contribute as a novel therapy of IBD.     

The indenture sign in acute exudative colitis

Summary The significance of the indenture pattern has been stressed as a sign of acute exudative colonic infection, regardless of etiology.     

Zinc sulphate solution enema decreases inflammation in experimental colitis in rats

BACKGROUND: It has been reported that zinc sulphate contributes an anti-inflammatory action in many animal models; however, the impact of zinc in colitis remains unclear. The aim of the present study was to examine the role of zinc sulphate in experimental colitis. METHODS: Colitis was induced by 2,4,6-trinitrobenzenesulphonic acid (TNB) in rats. Beginning at the first day of TNB colitis, the rats were treated with a zinc sulphate enema once daily for 6 days. The rats were examined 8 days later. RESULTS: The TNB induced severe colitis as evidenced by increased mucosal lesion area, mucosal myeloperoxidase (MPO) activity and prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) levels. Six days after the application of the zinc sulphate enema, the mucosal lesion area, MPO activity, PGE2 and LTB4 levels all decreased significantly. Mucosal superoxide dismutase activity remained unchanged after zinc treatments. CONCLUSIONS: Our data suggest that zinc sulphate enemas have an anti-inflammatory action on experimental colitis.     

赛霉安保留灌肠治疗溃疡性结肠炎近期疗效观察

目的 观察赛霉安保留灌肠治疗轻、中度溃疡性结脾性炎的疗效。方法 对３２例轻、中度未端溃疡性结肠炎病人随机分赛霉安治疗组（２０例）和地塞米松治疗组（１２例）中肠治疗１疗程后评估疗效。结果 症状缓解率和内镜缓解率赛霉安治疗组均迷９０％（１８／２０）,地塞米松治疗组为３８．３％（１０／１２）,两组差异无显著性意义（Ｐ〉０．０５）。结论 赛霉安是一种纯中药制剂,局部治疗轻、中度溃疡性结肠炎有较好疗效。与地     

A case of idiopathic colitis developed after barium enema]

It has been reported that colitis may be associated with intrarectally administered drugs or chemicals. Colonotoxicity may results from conventional medical therapy, herbal or other illicit drugs, contrast materials, and detergents. Clues that a colitis may be due to an intrarectally administered agent include perianal excoriation, segmental distal colitis due to a concentration gradient from enema administration, and recent diagnostic or therapeutic administration of high risk solutions such as hypertonic contrast agents or detergent enemas. Barium is a highly viscous contrast agent that is insoluble in water. Barium enemas are usually very safe. Also, no case report of barium-induced chemical colitis has been reported yet. We report a case of chemical colitis with colonic stricture occurring after the barium enema for diagnostic purpose.     

A case of chemical colitis caused by hydrogen peroxide enema

Hydrogen peroxide is commonly used as a disinfectant that has been reported to cause chemical colitis. We report a case of 49 year-old man who presented with chemical colitis caused by self-inflicted hydrogen peroxide enema. In the sigmoidoscopic examination, diffuse erythematous and edematous mucosal change with multiple ulcerations and easy touch bleeding was noted from the rectum to the proximal sigmoid colon. Abdominal computed tomography showed diffuse wall thickening of the rectum and the sigmoid colon with inflammatory and reactive change at surrounding. The patient was treated with NPO, intravenous fluid, and antibiotic therapy. On 5th hospital day, abdominal pain and bloody stool disappeared, and the patient started oral feeding. He discharged on 6th hospital day with fully recovered state.     

Therapeutic benefits from a poorly absorbed prednisolone enema in distal colitis.

A double blind controlled trial has been conducted in 40 patients to compare the therapeutic effects of prednisolone metasulphobenzoate enemas with those of prednisolone-21-phosphate enemas. Both enemas brought about improvement in symptoms and sigmoidoscopic appearances in more than 70% of patients treated. The absorption of prednisolone from the metasulphobenzoate enema in three patients was less than from the 21-phosphate enema. In view of the low plasma prednisolone concentrations obtained, there are theoretical advantages in using a poorly absorbed enema to avoid the possibility of systemic steroid effects in patients requiring long term steroid treatment.     

Butyrate enema therapy stimulates mucosal repair in experimental colitis in the rat.

BACKGROUND--The short chain fatty acid (SCFA) butyrate provides energy for colonocytes, stimulates colonic fluid and electrolyte absorption and is recognised as an effective treatment for multiple types of colitis. AIM--To examine the impact of butyrate enema therapy on the clinical course, severity of inflammation, and SCFA stimulated Na+ absorption in a chronic experimental colitis. METHODS--Distal colitis was induced in rats with a trinitrobenzenesulphonic acid (TNBS) enema. Five days after induction, rats were divided into groups to receive: no treatment, saline enemas, or 100 mM Na-butyrate enemas daily. On day 24, colonic damage score and tissue myeloperoxidase (MPO) activity were evaluated. Colon was mounted in Ussing chambers and Na+ transport and electrical activities were measured during a basal period and after stimulation with 25 mM butyrate. RESULTS--In the untreated and the saline enema treated TNBS groups, diarrhoea and extensive colonic damage were seen, associated with increased tissue MPO activities and absent butyrate stimulated Na+ absorption. In contrast, in the butyrate enema treated TNBS group, diarrhoea ceased, colonic damage score improved, and tissue MPO activity as well as butyrate stimulated Na+ absorption recovered to control values. CONCLUSION--Butyrate enema therapy stimulated colonic repair, as evidenced by clinical recovery, decreased inflammation, and restoration of SCFA stimulated electrolyte absorption.     

Computed tomographic air enema technique to demonstrate colonic neoplasms

The use of intravenous glucagon and the judicious introduction of air into a clean colon offer additional help in the confirmation of the larger intracolonic tumors on computed tomographic examination. The procedure is simple and may aid in the differentiation of an intrinsic colonic tumor from other pathologic conditions, particularly those that are extracolonic in origin.     

Portal venous gas following a barium enema in a patient with Crohn's colitis

Hepatic portal venous gas occurring during an air-contrast bariumenema examination in patients with inflammatory bowel disease is a benign finding. Patients with chronic ulcerative colitis have experienced some morbidity, while those with Crohn's colitis have not. It may not be necessary to treat all of these patients with antibiotics, especially asymptomatic patients with Crohn's colitis.