Background: Chronic diarrhea is a common and challenging problem in all age groups particularly in the elderly. It accounts for signicant morbidity and mortality in adults. It can be caused by a number of both neoplastic and non neoplastic lesions. For accurate diagnosis of various colorectal lesions, colonoscopy is the gold standard, simple, convenient and cost effective procedure. The present study aims to scrutinize the clinical prole and colonoscopic ndings in patients with chronic diarrhea in a tertiary care centre in South India Method: st This is a hospital based prospective observational study conducted from 1 September 2018 to 30th September 2019 at Department of Gastroenterology, Government Kilpauk Medical College Chennai ,128 patients were included in the present study. Study was cleared by institutional ethics committee of the hospital. Results: We evaluated 128 patients (mean age 47.03,),66% of the patients were males, and majority of the patients were in the age group 50-59 years. The most common clinical presentation other than diarrhea was bleeding per rectum 42% followed by mass per abdomen (23%), abdominal pain (21%) and 14% had spurious diarrhea. Colonoscopy was normal in 13%, colorectal growth accounted for 32%, Mucosal ulceration in 23%, Ileocecal lesions in 17%, polyps in 15%. The most common diagnosis was carcinoma colon (34%), followed by IBD (UC-17%, Crohns-9%) Tuberculosis in 13%, Polyposis in 8%, SIBO and Chronic Pancreatitis in 5%each, Radiation proctitis and IBS in 3% each. Conclusion:Chronic diarrhea causes signicant mortality as age advances, the leading cause for which was found to be Carcinoma colon in this study. For accurate diagnosis of various colorectal lesions, colonoscopy is the gold standard, simple, convenient and cost-effective procedure.
Study performed surveillance endoscopy in a 23-year-old male patient with Peutz-Jeghers syndrome (PJS) who underwent right hemicolectomy with ileo-colic anastamosis for ileo-colic intussusception three years back. On evaluation, he found to have multiple upper gastrointestinal and ileal polyps. Subsequently he underwent polypectomies in three sessions by combined standard snare polypectomy and endoscopic mucosal resection (EMR) method without any complication. We present a case report that emphasizes the importance of surveillance and the role of prophylactic polypectomy in patients with PJS.
Background: Osteopenia and osteoporosis is a highly prevalent condition and presents a tremendous public health burden. The association of bone disease has been recognized in several diseases of the git, resulting in established guidelines for screening in patients with malabsorptive disorders such as inflammatory bowel disease (IBD) and celiac disease. Increasingly, the risk of bone disease has been recognized in patients with chronic pancreatitis, who share similar risk factors as patients with other gastrointestinal disorders.Methods: This single-centre study was carried out in Kilpauk medical college. This study population consisted of 47 patients who were image confirmed cases of chronic pancreatitis. History of smoking, alcohol use was taken, body mass index, fecal elastase was measured. Dual-energy X-ray absorptiometry scan was used to examine bone mineral density (BMD) for the lumbar spine and bilateral femoral neck.Results: Of the 47 patients, 19 patients were chronic smokers and 28 patients had history of significant alcohol use. The prevalence of osteoporosis in patient group was 29.8% in patients with CP compared to Indian prevalence of 18.3% in previous studies. The prevalence of osteopenia was 48.9% in patients with CP compared to Indian prevalence of 49.9% in previous studies.Conclusions: Bone disease in CP can be attributed to several risk factors which act synergistically in propagating abnormal bone metabolism. Osteoporosis and osteopenia are underappreciated sources of morbidity in patients with chronic pancreatitis. Bone health management guidelines are urgently required in patients with chronic pancreatitis.
Background: GIGastrointestinal injury may occur following irradiation of thoracic,abdominal,and pelvic malignancies limiting radiation doses that can be delivered as well as causing significant morbidity requiring intervention. Radiation proctocolitis, both acute and chronic, is one such complication requiring multidisciplinary management for good outcomes.We analyzed the injury with respect to spectrum of injury, severity, morbidity and compared endoscopic vs combined medical and surgical modalities of treatment. Methods: Patients with acute and chronic radiation proctocolitis defined as illness presenting before and after 3 months respectively,of radiation treatment were included in the study.The study period was five years. Results: Total number of patients studied were 75.Acute disease was seen in 5 patients,presenting predominantly with diarrhea, abdominal pain and acute intestinal pseudo-obstruction. Chronic radiation proctocolitis was seen in 70 patients. Bleeding per rectum was the most common symptom. Anemia was the commonest sign. Grade 2 injury was most commonly seen. Pharmacotherapy was equally effective in grade 1 injury whereas Endoscopic treatment was superior to pharmacotherapy in Grade 2,3. Surgery offered lesser rates of rehospitalization in grade 3 but was associated with higher complications. There were no deaths in endoscopic arm while there were 2 deaths in pts who required surgery. Surgical combined with medical was superior to endoscopic treatment in grade 4 while local agents were ineffective.Preventive strategies prior to radiation were associated with lower grade of injury. Conclusion: Radiation proctocolitis causes significant morbidity requiring prolonged treatment and hospitalization. Dose and duration of radiation had direct relation to the severity of injury. Concurrent chemotherapy had no effect on severity of injury.Our study showed acute proctocolitis required predominantly supportive medical treatment.Chronic form from grade 1 to 3 required predominantly endoscopic treatment with prolonged duration of treatment but less morbidity.Grade 4 required surgical and intensive care and local therapy was ineffective.
Background: Variceal bleeding is the most dangerous complication of liver cirrhosis. Endoscopy is recommended for diagnosis and surveillance of esophageal and gastric varices. We used a non-invasive scoring method of severity of liver disease and examined whether it can reliably predict the presence and severity of varices. Methods: Study was carried over a period of 12 months including all cirrhosis patients. Fibroscan and FIB-4 score were used to formulate a non-invasive score and compared with endoscopic findings Results: The presence of varices and its severity correlated with Fibroscan+FIB-4 score. Higher the score, higher the likelihood of varices requiring endoscopic intervention. A score of >6 can be used as cut off to stratify patients requiring endoscopy. Conclusions: Fibroscan + FIB-4 score can be reliably used as a marker of presence of varices, the severity and chances of bleeding from varices. This can be of importance in the present Covid-19 pandemic, where in upper GI endoscopic procedures carry the highest rate of infection to healthcare workers and patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.