The gastrointestinal (GI) tract is colonized by a dense community of commensal microorganisms referred to as the gut microbiota. The gut microbiota and the host have co-evolved, and they engage in a myriad of immunogenic and metabolic interactions. The gut microbiota contributes to the maintenance of host health. However, when healthy microbial structure is perturbed, a condition termed dysbiosis, the altered gut microbiota can trigger the development of various GI diseases including inflammatory bowel disease, colon cancer, celiac disease, and irritable bowel syndrome. There is a growing body of evidence suggesting that multiple intrinsic and extrinsic factors, such as genetic variations, diet, stress, and medication, can dramatically affect the balance of the gut microbiota. Therefore, these factors regulate the development and progression of GI diseases by inducing dysbiosis. Herein, we will review the recent advances in the field, focusing on the mechanisms through which intrinsic and extrinsic factors induce dysbiosis and the role a dysbiotic microbiota plays in the pathogenesis of GI diseases.
Celiac Disease ; Colon ; Colonic Neoplasms ; Diet ; Dysbiosis ; Gastrointestinal Diseases* ; Genetic Variation ; Inflammatory Bowel Diseases ; Irritable Bowel Syndrome ; Microbiota*

Patients with ulcerative colitis (UC) have the increased risk of colorectal cancer. The risk of colorectal cancer development in UC is associated with the extent of colitis and duration of disease. It is generally agreed that there is little or no increased risk associated with proctitis or proctosigmoiditis. A dysplasia-associated lesion or mass (DALM) is difficult to distinguish from sporadic adenoma. The DALM indicate a high association with colon cancer. The presence of DALM as a premalignant lesion has been considered as an indication for colectomy because of the high risk of progression to malignancy within a short period. We report a case of polyp with high grade dysplasia in a 27-year-old man of ulcerative colitis confined to rectum and sigmoid colon.
Adenoma ; Adult ; Colectomy ; Colitis ; Colitis, Ulcerative* ; Colon, Sigmoid ; Colonic Neoplasms ; Colorectal Neoplasms ; Humans ; Polyps* ; Proctitis ; Proctocolitis ; Rectum ; Ulcer*

No abstract availble.
Colonic Diseases, Functional/diagnosis/physiopathology ; Humans ; *Irritable Bowel Syndrome/diagnosis/physiopathology

Dysfunction of gut immune regulation is involved in mucosal damage in inflammatory bowel disease (IBD). However, there is still no efficacious immune-regulator for the treatment of IBD. Alloferon is a novel immune-modulatory peptide that was originally isolated from infected insects. It shows anti-inflammatory effects by the regulation of cytokine production by immune cells and their activities. Therefore, we investigated the effect of alloferon in a mouse model of colitis using dextran sulfate sodium (DSS). Colitis was induced by administration of DSS in drinking water for 7 consecutive days. It was confirmed by the presence of weight loss, diarrhea, hematochezia, and colon contraction. Alloferon was injected 4 days after DSS administration. We found that alloferon improved the pathogenesis of IBD based on the reduced disease activity index (DAI) and colon contraction. Edema, epithelial erosion, and immune cell infiltration were found in mice administered DSS, but the phenomena were reduced following alloferon treatment. The plasma level of IL-6, a classical pro-inflammatory cytokine in colitis, was also decreased by alloferon. Moreover, alloferon inhibited the TNF-alpha-induced degradation and phosphorylation of IkappaB in Colo205 colon cancer cells. Taken together, these results show that alloferon has anti-inflammatory effects and attenuates DSS-induced colitis.
Animals ; Colitis* ; Colon ; Colonic Neoplasms ; Dextran Sulfate* ; Diarrhea ; Drinking Water ; Edema ; Gastrointestinal Hemorrhage ; Inflammatory Bowel Diseases ; Insects ; Interleukin-6 ; Mice ; Phosphorylation ; Plasma ; Weight Loss

BACKGROUND/AIMS: Few studies are available that have investigated the risk factors for overlapping irritable bowel syndrome (IBS)-like symptoms in patients with inactive inflammatory bowel disease (IBD). The present study has 3 objectives: (1) to assess the prevalence of IBS-like symptoms in Japanese patients with inactive IBD using Rome III criteria, (2) to examine the relationship of IBS-like symptoms to health related quality of life (HR-QOL), and (3) to investigate associations for developing IBS-like symptoms in patients with inactive IBD. METHODS: IBS-like symptoms were evaluated using the Rome III questionnaire for functional gastrointestinal disorders. HR-QOL and hospital anxiety and depression scale were evaluated. RESULTS: IBS-like symptoms were found in 17.5% (7/40) of patients with inactive ulcerative colitis, 27.1% (29/107) of patients with inactive Crohn’s disease (CD), and 5.3% (23/438) of healthy control subjects. The QOL level was significantly lower and anxiety score was significantly higher in inactive CD patients with IBS-like symptoms than in those without such symptoms (P = 0.003, P = 0.009). Use of anti-anxiety drugs was associated with the presence of IBS symptoms (P = 0.045). HR-QOL score was lower and anxiety score was higher in patients with inactive ulcerative colitis, but the difference was not statistically significant. CONCLUSIONS: The prevalence of IBS-like symptoms in inactive IBD patients was significantly higher than in healthy controls. Inactive CD patients with IBS-like symptoms has low QOL and anxiety; suggesting that anxiety may be associated with symptom development in such patients.
Anti-Anxiety Agents ; Anxiety ; Asian Continental Ancestry Group* ; Colitis, Ulcerative ; Depression ; Gastrointestinal Diseases ; Humans ; Inflammatory Bowel Diseases* ; Irritable Bowel Syndrome ; Prevalence* ; Quality of Life ; Risk Factors

The prevalence of intestinal tuberculosis has been markedly decreased with the development of anti-tuberculous chemotherapy, preventive medicine, vaccinations, early detection and treatment of pulmonary tuberculosis, and improved eeonomic conditions. Nowadays, intestinal tuberculosis is a disease that should be differentiated from the inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, Behcet's disease, and colon cancer and amebic colitis. This disease also has a new clinical significance in that it has an increased infection rate and unfavorable outcomes in patients infected by HIV or in those who undergo organ transplantation or receive immunosuppressive agents. Tuberculosis of the duodenum was a rare disease and was not reported in the last decade. Moreover Intestinal tuberculosis extensively involving the small bowel including the duodenum and colon was very rarely reported in the various relateid literature. Recently we experienced a case of advanced intestinal tuberculosis involving the duodenum, jejunum, ileum, and colon accompanied by tuberculous cervical and abdominal lymphadenopathies, in a 49-year-old woman who manifested profound general weakness, diarrhea, and marked weight loss. She was diagnosed pathologically by upper gastrointestinal endoscopy, colonoscopy, and fine needle aspiration cytology as well as by roentgenologic examination. The patient was given antituberculous medication which resulted in dramatic clinical improvement. In this report, we present this case with review of the related literature.
Biopsy, Fine-Needle ; Colitis, Ulcerative ; Colon ; Colonic Neoplasms ; Colonoscopy ; Crohn Disease ; Diarrhea ; Drug Therapy ; Duodenum ; Dysentery, Amebic ; Endoscopy, Gastrointestinal ; Female ; HIV ; Humans ; Ileum ; Immunosuppressive Agents ; Inflammatory Bowel Diseases ; Jejunum ; Middle Aged ; Organ Transplantation ; Prevalence ; Preventive Medicine ; Rare Diseases ; Transplants ; Tuberculosis* ; Tuberculosis, Lymph Node* ; Tuberculosis, Pulmonary ; Vaccination ; Weight Loss

PURPOSE: Non-specific ulceration of colon is a rare disease of unknown etiology. To establish correctly the diagnosis of nonspecific colon ulcer preoperatively is difficult, but with more wide spread use of colonoscopy and complementary diagnostic aids, this lesion may be accurately diagnosed more often. The presentating symptoms were mainly lower abdominal pain, which mimic such conditions as acute appendicitis, diverticulitis, intestinal obstruction, and colon cancer. If its serious complications (perforation, abscess formation, or uncontrolled bleeding) were developed, resection of ulcerated segment or more extensive colectomy was recommended. The purpose of this study was to establish correctly the diagnosis of nonspecific colon ulcer preoperatively and to identify definitive treatment of complicated colon ulcer. METHODS: 6 cases, surgically treated as non-specific colon ulcer at Chosun University hospital from January 1995 to December 1999 were studied retrospectively. RESULTS: The ages of the patient ranged from 35 to 70 years; the ratio of male to female is 2: 1. The main clinical symptoms were abdominal pain (6 cases), nausea and vomiting (4 cases), hematochezia (3 cases), constipation (2 cases) and palpable mass (1 case). The preoperative diagnosis was generalized peritonitis (2 cases), colon cancer (2 cases), acute appendicitis (1 case), mechanical obstruction (1 case). 3 cases had past medication history, one was anti-hypertensive drug and the two were nonsteroidal anti-inflammatory drug. The preoperative diagnostic study were simple abdomen (6 cases), abdominal CT (6 cases), colon study (3 cases), abdominal sonograph (4 cases) and selective angiogram (1 cases), The location of ulcer were cecum (2 cases), sigmoid colon (2 cases), transversecolon (1 case) and descending colon (1 case). The methods of operation were hemicolectomy (3 cases), segmental resection (1 case) and anterior resection (2 case). There was one death, but 5 cases were completely recovered. CONCLUSIONS: Non-specific ulcer of the colon is not detected until complicated by bleeding, perforation, or obstruction. The patient who has chronic abdominal pain and rectal bleeding can be diagnosed preoperatevely by colonoscopy and colon study. The recommended therapy of complicated cases is resection of the ulcerated segment or more extensive colectomy. Non-specific colonic ulcer should be suspected as one of colonic disease in the patients with complications.
Abdomen ; Abdominal Pain ; Abscess ; Appendicitis ; Cecum ; Colectomy ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Colonic Diseases ; Colonic Neoplasms ; Colonoscopy ; Constipation ; Diagnosis ; Diverticulitis ; Female ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intestinal Obstruction ; Male ; Nausea ; Peritonitis ; Rare Diseases ; Retrospective Studies ; Tomography, X-Ray Computed ; Ulcer* ; Vomiting

Tuberculous involvement of the colon is an uncommon clinical entity. Other colonic disease which should be considered in the differential diagnosis include inflammatory bowel disease such as Crohn's disease, ulcerative colitis and colon cancer. Intestinal tuberculosis most frequently involves the ileocecal area. The common presenting symptoms are abdominal pain, fever, weight loss and malabsorption. Pathologically, tuberculous colitis may present as an ulcerative type, hypertrophic type or in combination. Massive bleeding is said to be very rare even in the ulcerative type because of an obliterative endarteritis. We report a case of colonic tuberculosis presenting with massive bleeding in 52-year-old man with alcoholic liver cirrhosis, which was diagnosed by colonoscopic biopsy and acid-fast stain.
Abdominal Pain ; Biopsy ; Colitis ; Colitis, Ulcerative ; Colon* ; Colonic Diseases ; Colonic Neoplasms ; Crohn Disease ; Diagnosis, Differential ; Endarteritis ; Fever ; Hemorrhage* ; Humans ; Inflammatory Bowel Diseases ; Liver Cirrhosis, Alcoholic ; Middle Aged ; Tuberculosis* ; Ulcer ; Weight Loss

No abstract availble
Adenocarcinoma/*diagnosis/radiography ; Aged ; Anus Diseases/complications ; Colon, Ascending ; Colonic Neoplasms/*diagnosis/radiography ; *Colonography, Computed Tomographic ; *Colonoscopy ; Constriction, Pathologic ; Humans ; Male ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Carbohydrate malabsorption is frequent in patients with functional gastrointestinal disorders and in healthy volunteers and can cause gastrointestinal symptoms mimicking irritable bowel syndrome (IBS). The aim of this study was to investigate the prevalence of symptomatic lactose and fructose malabsorption in a large population of patients with IBS-like symptoms based on Rome II criteria. METHODS: Patients with unclear abdominal discomfort (n = 2,390) underwent lactose (50 g) and fructose (50 g) hydrogen (H2) breath tests and depending on the results further testing with 25 g fructose or 50 g glucose, or upper endoscopy with duodenal biopsies. Additionally, this population was investigated regarding the prevalence of small intestinal bacterial overgrowth (SIBO) based on glucose breath test and celiac disease. RESULTS: Of the 2,390 patients with IBS-like symptoms, 848 (35%) were symptomatic lactose malabsorbers and 1,531 (64%) symptomatic fructose malabsorbers. A combined symptomatic carbohydrate malabsorption was found in 587 (25%) patients. Severe fructose malabsorbers (pathologic 25 g fructose test) exhaled significantly higher H2 concentrations in the 50 g test than patients with negative 25 g fructose test (P < 0.001). Out of 460/659 patients with early significant H2 increase in the lactose and fructose test who underwent a glucose breath test, 88 patients had positive results indicative of SIBO and they were significantly older than patients with negative test result (P < 0.01). Celiac disease was found in 1/161 patients by upper endoscopy. CONCLUSIONS: Carbohydrate malabsorption is a frequent but underestimated condition in patients with IBS-like symptoms although diagnosis can be easily confirmed by H2 breath testing.
Biopsy ; Breath Tests ; Celiac Disease ; Diagnosis ; Endoscopy ; Fructose ; Gastrointestinal Diseases ; Glucose ; Healthy Volunteers ; Humans ; Hydrogen ; Irritable Bowel Syndrome ; Lactose ; Prevalence