ISSN:0267-1379    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;The most prevalent symptoms arising from disordered colonic function are altered bowel habits, commonly associated with abdominal discomfort. These symptoms can arise from a variety of different disorders that are traditionally classified into those of organic and those of functional etiology. In principle, disorders are referred to as functional when no specific structural, physiologic, or biochemical marker can be identified, although in practice, the search for markers is limited to endoscopic, radiologic, or histologic evidence. Generally, it is assumed that patients with functional colonic disorders suffer primarily from psychologic distress or psychiatric “comorbidity.” Due to a lack of specific biologic markers, symptom criteria have been developed that are thought to define distinct syndromes. I propose that in view of recent breakthroughs in our understanding of how the neuroendocrine control systems respond to perturbations of the external and internal environment of the organism in the form of the generalized stress response, the traditional separation into organic and functional is no longer appropriate. Instead, a concept is proposed in which disorders of the colon range from distinct patterns of alterations in the bidirectional dialogue between the central nervous system and the colon.

ISSN:0267-1379    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;This article reviews the past year's advances concerning the genetics of colon cancer. Previous to this year, the genetic events involved in the adenoma‐carcinoma sequence were characterized and the genes responsible for familial adenomatous polyposis and hereditary nonpolyposis coli syndromes identified. Genetic research has made possible the molecular diagnosis of syndromic colon cancer, provided clues to the cellular mechanisms of cancer pathogenesis, and suggested approaches to novel gene‐based therapies. The past year has added to this knowledge base in two major areas: the inherited predisposition or familial risk for colorectal cancer and the molecular biology of colon cancer pathogenesis.

ISSN:0267-1379    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;Recent advances in the biology of colorectal polyposis may permit the evolution of strategies for the management of colorectal polyps. Molecular genetic studies have identified mutations in both inherited and sporadic polyps. Epidemiologic studies suggest personal habits and characteristics that may predispose individuals to higher risk of developing polyposis. Better understanding of the adenoma‐to‐carcinoma sequence suggests guidelines for screening, treatment, and follow‐up. Research in the area of pharmacotherapy offers options for prevention and treatment. These advances may contribute to the reduction of morbidity and mortality from colorectal carcinoma.

ISSN:0267-1379    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;A number of motility disorders in children are associated with intestinal neuronal malformations and other anatomic defects. These disorders include Hirschsprung's disease, neuronal intestinal dysplasia, chronic intestinal pseudo‐obstruction, and anorectal malformations. Hirschsprung's disease is now linked to specific genetic mutations, and laparoscopic techniques hold promise for less invasive surgical treatment. Neuronal intestinal dysplasia is now considered an important cause of postoperative bowel dysfunction in Hirschsprung's disease patients. Chronic intestinal pseudo‐obstruction is characterized by recurrent bouts of abdominal distension, pain, and constipation. The surgical treatment of these patients is relegated to the placement of feeding and decompression tubes. For the past decade, posterior sagittal anorectoplasty has been the preferred approach in the repair of anorectal malformations. Long‐term assessments of bowel function after the use of this procedure are now being published and show generally good outcome.

ISSN:0267-1379    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;Incremental gains continue to be made in the medical management of colorectal Crohn's disease. No longer are we solely dependent on steroids and the limited efficacy of antibiotics and sulfasalazine. The mesalamine drugs in their various forms are proving to be useful for both active disease and maintenance of remission. The immunosuppressive drugs methotrexate and cyclosporine and new topical steroids such as budesonide offer alternatives to azathioprine, 6‐mercaptopurine, and conventional steroids. This review discusses these and other nonsurgical therapies for Crohn's disease in the context of active disease, maintenance of remission, and prophylaxis after “curative” resection. These therapies are presented in the context of both ileal and colonic involvement consistent with the typical anatomic pattern of Crohn's disease.

ISSN:0267-1379    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;Irritable bowel syndrome (IBS) is the most commonly encountered functional colonic disorder and presents with chronic abdominal pain associated with diarrhea or constipation (or both) without a documented organic etiology. Although the majority of patients with normal transit constipation have IBS, those with slow transit constipation have colonic inertia. The pathogenesis and treatment options of both of these functional disorders are reviewed. Although the pathogenesis of IBS is not completely understood, potential mechanisms include altered colonic motility, altered visceral perception, psychosocial factors, and intestinal handling of fluid and electrolytes. Although no single medical treatment has been shown to be truly efficacious in IBS, multiple treatment options directed at the potential pathophysiologic mechanisms of IBS have been investigated and may be effective if used appropriately.

ISSN:0267-1379    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;Health‐related quality of life assessment is receiving increasing attention as health care providers, health services researchers, and policy makers seek effective and affordable health care delivery systems in an era of economic constraints. Healthrelated quality of life measurement is particularly important when evaluating interventions for chronic diseases, such as diabetes, hypertension, and rheumatoid arthritis, because of the large cumulative impact of chronic conditions over the course of a patient's life spent in a diseased state. Healthrelated quality of life in chronic diseases of the large intestine, including inflammatory bowel disease and functional bowel disease, has only recently drawn the attention of medical researchers. However, this situation is changing rapidly because of widespread recognition of the high incidence and prevalence of these conditions in the population, the early age of disease onset, and the duration of disease that often lasts for the remainder of a patient's life.

ISSN:0267-1379    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;Physiologic regulation of colonic function depends on the interaction among three systems: enteric, autonomic (sympathetic and parasympathetic), and immune. Visceral sensory information is transmitted via primary afferents and integrated at central (spinal and supraspinal) sites. Changes in the activity of these primary afferents are an important component in pathophysiologic alterations of colonic motor and secretory functions and seem to be a common mechanism underlying functional disorders of the gastrointestinal tract. Increased colorectal sensitivity to distention in irritable bowel syndrome may involve alterations of thoracolumbar afferents and the immune system in the colonic wall. Alterations in the properties of the enteric nervous system, epithelial transport, and somatic and visceral responses to visceral pain have been characterized during immune challenges and experimental colitis.

ISSN:0267-1379    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1996

数据来源: OVID