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Your search term(s) "diverticul*" returned 121 results.

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Meckel's Diverticulum in Crohn's Disease. Canadian Journal of Gastroenterology. 15(5): 308-311. May 2001.

This article discussed Meckel's diverticulum, a congenital (present at birth) abnormality of the distal ileum (the far section of the small intestine, which opens into the large intestine) associated with failed vitelline duct (the umbilical duct) closure. The article focuses on Meckel's diverticulum in patients with Crohn's disease. Detailed pathological studies have estimated its frequency to be about 2 percent of the general population, and it has been anecdotally recorded in patients with Crohn's disease. Most patients with Crohn's disease have imaging studies of the small intestine during the course of their disease, and often, an intestinal resection. Thus, it seems possible to estimate the prevalence of Meckel's diverticula in Crohn's disease. In addition, patient characteristics may be important, especially if management of Crohn's disease is altered. The author reports on a series of 877 patients with Crohn's disease, of whom 10 (approximately 1 percent) had a Meckel's diverticulum diagnosed (6 men, 4 women). All were diagnosed with Crohn's disease before age 50 years and seven were diagnosed before age 30 years. There were five with ileocolonic disease, two with colon only disease, and three with ileum only disease. The clinical behavior of five patients could be classified as penetrating and two as stricturing. A total of 311 patients had an ileocolonic resection, including eight (about 2 percent) with a Meckel's diverticulum. In contrast to some case reports, no heterotopic mucosa was detected and the Meckel's diverticulum was incidental and, apparently, an unexpected finding. In each case, the diverticulum was not involved with Crohn's disease but was included in the ileal resection. These results suggest that the overall prevalence of a Meckel's diverticulum is not increased in Crohn's disease patients, but may result in resection of additional small intestine. 1 table. 20 references.

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Meckel's Diverticulum. Journal of the American College of Surgeons. 192(5): 658-662. May 2001.

This article reviews the condition of Meckel's diverticulum (MD), a diverticulum in the small intestine. An average MD is approximately 3 centimeters long, with nearly 90 percent ranging from 1 to 10 centimeters. MD is considered the most prevalent congenital (present at birth) anomaly of the gastrointestinal tract, affecting 2 percent of the general population. MD may be more common in patients with Crohn's disease than in the general population. The total lifetime complication rate has been reported to be around 4 percent. Most patients with MD are asymptomatic, but in those that develop symptoms, it has been estimated that more than 50 percent are less than 10 years of age. Long, narrow based diverticula are thought to be more prone to obstruction or inflammation; short, large based diverticula are subject to foreign body entrapment. The location of an MD does not appear to affect the complication rate. Bleeding occurs in more than 50 percent of symptomatic MD in patients less than 18 years old. Surgical treatment of MD may be by open or laparoscopic procedures. Principles of resection include the removal of MD and associated bands, and small bowel management. Laparoscopic treatment of MD has been increasingly reported, with techniques including intraabdominal wedge resection or extracorporeal or intracorporeal bowel segment resection. The authors conclude that because the risk of complications of an MD has not been found to decrease with age, the benefits of surgery outweigh its attending morbidity and mortality. 3 tables. 36 references.

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Nonsteroidal Anti-Inflammatory Drugs, Enterocolonic Ulceration, and Inflammatory Bowel Disease. In: Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 625-629.

Nonsteroidal antiinflammatory drugs (NSAIDs) cause damage through the gastrointestinal tract. This chapter on NSAIDS, enterocolonic (small bowel) ulceration and inflammatory bowel disease (IBD) is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn's disease (CD) and ulcerative colitis (UC), together known as IBD. The authors outline an approach to treatment of the damage of NSAIDs to the small bowel and the management of patients with IBD who require NSAIDs. The authors caution that the use of NSAIDs in patients with IBD is challenging because the drugs may cause relapse of disease. Specific issues addressed include iron deficiency anemia, hypoalbuminemia (reduced levels of protein in the blood), strictures (narrowing of the intestine), NSAID induced colon damage, and the use of NSAIDs in patients with IBD. Rarely, NSAIDs actually cause colitis, but their use is associated with an enhanced risk of appendicitis in the elderly and diverticular complications (fistulae and abscesses). 6 references.

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Pubovaginal Sling Surgery for Simple Stress Urinary Incontinence: Analysis by an Outcome Score. Journal of Urology. 165(5): 1597-1600. May 2001.

This article reports on a study that assessed the results of pubovaginal sling surgery in women with simple stress urinary incontinence (SUI) using strict subjective and objective criteria. Simple incontinence was defined as sphincteric (bladder opening) incontinence with no concomitant urge incontinence, pipe stem or fixed scarred urethra, urethral or vesicovaginal fistula, urethral diverticulum, grade 3 or 4 cystocele, or neurogenic bladder. A total of 67 consecutive women (mean age 56 years plus or minus 11 years) who underwent pubovaginal sling surgery for simple sphincteric incontinence were prospectively followed for 12 to 50 months. Cure was defined as no urinary loss due to urge or stress incontinence, as documented by 24 hour diary and pad test, with the patient considering herself cured. Failure was defined as poor objective results with the patient considering surgery to have failed. Of the 67 patients, 46 (69 percent) had type II and 21 (31 percent) had type III incontinence. Preoperative diary and pad tests revealed a mean of 5.9 (plus or minus 3.6) stress incontinence episodes and a mean urinary loss of 91.8 grams (plus or minus 81.9 grams) per 24 hours. There were no major intraoperative, perioperative, or postoperative complications. Two patients (3 percent) had persistent minimal stress incontinence and 7 (10 percent) had new onset urge incontinence within 1 year after surgery. Overall using the strict criteria of the outcome score, 67 percent of the cases were classified as cured, and the remaining 33 percent were classified as improved. The degree of improvement was defined as a good, fair, and poor response in 21 percent, 9 percent, and 3 percent, respectively. Midterm outcome results defined by strict subjective and objective criteria confirm that the pubovaginal sling is highly effective and safe surgery for simple sphincteric incontinence. A followup of more than 5 years is required to establish the long term durability of this procedure. 2 tables. 11 references.

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Review of the Causes of Lower Gastrointestinal Tract Bleeding in Children. Gastroenterology Nursing. 24(2): 77-83. March-April 2001.

Bleeding may occur anywhere along the gastrointestinal (GI) tract, which covers a large surface area and is highly vascularized. Pediatric patients who present with blood in their stools (bowel movements) are a special challenge for the health care team. Seeing blood in the child's stools, the caregiver and child may become extremely anxious, fearing a devastating diagnosis. This article reviews the causes of lower GI tract bleeding in children. The differential diagnosis of this symptoms in infants and children includes numerous possibilities ranging from benign disorders, which require little or no treatment at all, to serious diseases that require immediate intervention. A complete history, including progression, duration, frequency, and severity of symptoms, is essential in assessing GI bleeding. Associated symptoms that help define the diagnosis include vomiting, diarrhea, constipation, abdominal pain, anorexia (lack of appetite), rash, joint pain or swelling, weight loss, fever, irritability, history of GI bleeding, or history of hematological or immunological disorders. Constipation with fissure (a tear in the anus) formation is the most common cause for rectal bleeding in toddlers and school age children. Infection is one of the more common causes of bleeding from the lower GI tract; infections can be due to Salmonella, Shigella, Campylobacter jejuni; Yersinia enterocolitica, Escherichia coli, Clostridium difficile, or Entamoeba histolytica. Other causes include swallowed blood, hemorrhoids, inflammatory bowel disease (IBD), intussusception (a portion of the bowel turns in on itself, creating an obstruction), polyps, lymphonodular hyperplasia, Meckel's diverticulum, allergic colitis, Henoch Schonlein purpura, hemolytic uremic syndrome (HUS), enterocolitis, child sexual abuse, and Munchausen syndrome by proxy.

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Trials of the Aging Gut. Digestive Health and Nutrition. 3(6): 16-18. November-December 2001.

This health education article reviews the impact of aging on the gastrointestinal (GI) tract, notably in the areas of motility (movement through the system) and absorption of nutrients. Both men and women report problems with constipation, diarrhea, and fecal incontinence with greater frequency after age 50 and an increased number of potentially serious diseases, such as diverticulosis and colon cancer. Most of the GI changes that occur in older individuals can be pinned on small physiological changes and responses within the GI tract itself, on medications that must be taken for other conditions such as heart disease or depression, and on gastrointestinal diseases that occur in greater numbers after age 50. A lesser number of people have consequences of other diseases that either make them less mobile and prone to constipation or that affect the nerves of the intestinal system, such as diabetic neuropathy (nerve damage associated with diabetes mellitus). The GI tract of older individuals may not have the same ability to absorb nutrients, such as vitamin B12 (which helps the body to produce blood cells) and calcium (which helps maintain bone density). The author also considers the issues of malnutrition, swallowing disorders and choking, fecal incontinence, constipation, lack of fiber in the diet, drug side effects, diverticular diseases, gallbladder disease, and cancer of the colon or rectum. The article concludes with five related websites for readers who want additional information.

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Urethral Diverticula: Evolving Diagnostics and Improved Surgical Management. Current Urology Reports. 2(5): 373-378. October 2001.

Urethral diverticula in females remain problematic from both diagnostic and therapeutic standpoints. Recent developments in pelvic imaging with computed tomography (CT scan), sensitive ultrasonography, and magnetic resonance imaging (MRI) have greatly advanced diagnostic accuracy and improved the clinician's ability to stage lesions as to location, size, and coexistent pathology. Coupled with improved recognition has come advancements in surgical technique, reflective of improved understanding of urethral anatomy and function. Better use of concomitant procedures, such as pubovaginal sling or soft tissue interposition, has continued a steady trend toward improved surgical outcomes when considering urethral function and urinary continence. This article reviews these mutually complementary trends. 4 figures. 16 references.

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Use of Endoscopy in Patients with Gastrointestinal Motility Problems. Journal of Clinical Gastroenterology. 33(3): 185-190. 2001.

Gastrointestinal motility (movement) disorders are a commonly encountered problem. Although some are associated with organic alterations, others are defined by their symptoms, and no anatomic or histological organic changes are to be found. In most cases, the etiology (cause) is completely unclear. This article reviews the use of endoscopy in patients with gastrointestinal motility problems. Endoscopy, with the option of obtaining biopsies for histopathologic evaluation, plays the most important role in the diagnostic workup, as it can exclude such lesions as tumors, ulcers, inflammatory processes, and diverticula and it helps to define the grade and extent of motility-associated diseases (such as gastroesophageal reflux disease or GERD). Furthermore, endoscopic interventional procedures offer sufficient treatment of several motility-related disorders, including achalasia, GERD, and secondary constipation. The authors discuss the use of endoscopy for cricopharyngeal dysfunction, spastic disorders of the esophagus, achalasia, GERD, gastroparesis (delay in gastric emptying, often a complication of diabetes mellitus), functional dyspepsia (heartburn), irritable bowel syndrome (IBS), and chronic constipation. 6 figures. 57 references.

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Why Certain Foods May Be Upsetting Your Stomach. Digestive Health and Nutrition. 3(3): 28-30. May-June 2001.

Special diets, specifically those intended to alleviate disease symptoms (as opposed to those for weight reduction), are a way of life for many individuals with gastrointestinal (GI) illnesses such as irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), peptic ulcers, diverticulosis, celiac sprue, gallbladder disease, and inflammatory bowel disease (IBD, including Crohn's disease and ulcerative colitis). This article reviews this phenomenon of avoiding or incorporating certain foods to alleviate the symptoms of GI diseases. The author stresses the fact that each person's diet will vary, even when they have the same disease, because certain foods may affect people differently. Many physicians recommend avoiding certain foods but ultimately leave the patient to experiment with trial and error. While diets vary from condition to condition, all diets should have the common goal of maintaining good health and proper weight through a diet rich in fruits and vegetables, moderate in the consumption of alcohol, and low in fat. The article concludes with a list of websites for additional information.

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Acute Abdominal Pain in the Elderly: Guide to a Cost-Effective Work-Up. Consultant. 40(1): 25-27, 31-35, 39. January 2000.

This article explains how physicians can use an 11 question analysis to get an immediate bearing on the source of a patient's abdominal pain. The authors focus on acute abdominal pain in the elderly. Clues to diagnosis include location and characteristics of the pain, as well as patterns of radiation; color, content, and volume of vomitus; stool consistency, frequency, and color. Every abdominal examination should be followed by a rectal examination and, in women, a vaginal examination. Laboratory studies usually include serum electrolyes, glucose and amylase levels, liver and kidney function tests, and a complete blood count with differential analysis. Guidelines are available to help determine the need for hospitalization based on test results. Radiographic films and ultrasonography (now available at bedside) are often enough to confirm diagnoses, but CT scan and MRI (magnetic resonance imaging) also play important roles. The authors review cost effective approaches for suspected appendicitis, bowel obstruction, diverticulitis, peptic ulcer disease, mesenteric ischemia, pancreatitis, and biliary disease. 5 figures. 4 tables. 15 references.

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