MedWorm: Colonoscopy

Improving adherence to surveillance and screening recommendations for people with colorectal cancer and their first degree relatives: A randomized controlled trial

BMC Cancer — Wed, 08 Feb 2012 05:00:00 +0100

DiscussionResults of this study will contribute to the evidence base about effective strategies to a) improve adherence to surveillance recommendation for people with CRC; and b) improve adherence to screening recommendation for FDRs of people with CRC. The use of a population-based cancer registry to access the target population may have significant advantages in increasing the reach of the intervention. (Source: BMC Cancer)

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How should individuals with a false‐positive fecal occult blood test for colorectal cancer be managed? A decision analysis

International Journal of Cancer — Sun, 05 Feb 2012 05:00:00 +0100

In conclusion, the ContinueFOBT_long strategy was advantageous regarding both clinical benefit and required resources. Specifying an appropriate management strategy for individuals with a prior fpFOBT may substantially reduce required resources within a FOBT‐based CRC screening program without limiting its effectiveness. © 2012 Wiley‐Liss, Inc. (Source: International Journal of Cancer)

Intestinal obstruction caused by colonic metastasis from intrahepatic cholangiocarcinoma 6 years after removal of the primary tumor: report of a case

Surgery Today — Fri, 03 Feb 2012 17:11:08 +0100

We report a case of intestinal obstruction caused by metastasis that manifested 6 years after surgery for intrahepatic cholangiocarcinoma (ICC). The patient, a 57-year-old man, had undergone resection of the hepatic left lobe, Spiegel lobe, and extrahepatic bile duct, following which histopathological examination had confirmed the diagnosis of ICC and that the resection margins were free from disease. There had been no signs of recurrence until an increase in the CA19-9 level was detected 6 years later. Colonoscopy revealed an ulcer-like lesion and stenosis at the level of the hepatic flexure. The patient was subsequently admitted to our hospital with abdominal pain and underwent right hemicolectomy with partial resection of hepatic segment V. Based on the immunohistologica...

Ascites due to lupus peritonitis: a rare form of onset of systemic lupus erythematosus

Revista Brasileira de Reumatologia — Fri, 03 Feb 2012 10:19:07 +0100

O lúpus eritematoso sistêmico (LES) frequentemente cursa com serosites. Cerca de 16% dos pacientes lúpicos apresentam acometimento de pleura e pericárdio. O acometimento peritoneal, no entanto, é especialmente raro, ocorrendo clinicamente em pequeno grupo de pacientes. O presente estudo trata do caso de uma paciente de 47 anos com diagnóstico de lúpus discoide que evoluiu com manifestações sistêmicas da doença, caracterizadas por distensão e dor abdominal significativas, astenia, emagrecimento, sinais propedêuticos de ascite e diarreia aguda baixa e não invasiva. Foi realizada exaustiva investigação diagnóstica por meio de exames laboratoriais, de imagem, colonoscopia e análise do líquido ascítico. A investigação, além de descartar a possibilidade de etiologia infecc...

Higher adenoma detection rates with cap-assisted colonoscopy: a randomised controlled trial

Gut — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions CAC detected a 13% higher number of subjects with at least one adenoma and 59% higher adenomas per subject. CAC is a safe, effective and practical means to improve adenoma detection rates. Clinical Trial Registration NCT 01211132. (Source: Gut)

Polyp surveillance after surgery for colorectal cancer

International Journal of Colorectal Disease — Thu, 02 Feb 2012 06:54:29 +0100

Conclusions From our data, age over 60, synchronous adenomas or CRCs and DM were the potential risk factors for the postoperative formation of adenoma or CRC, and they should be taken into consideration when defining the appropriate interval of postoperative colonoscopy. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00384-012-1420-zAuthors Kazushige Kawai, Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, JapanEiji Sunami, Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, JapanNelson H. Tsuno, Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 11...

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virtualcolon

About.com Colon Cancer — Thu, 02 Feb 2012 05:00:00 +0100

The virtual colonoscopy is a screening exam used to detect colon cancer. Learn more about this minimally invasive, fast test that detects colon cancer. (Source: About.com Colon Cancer)

The risk of advanced histology in small-sized colonic polyps: are non-invasive colonic imaging modalities good enough?

International Journal of Colorectal Disease — Wed, 01 Feb 2012 17:11:43 +0100

Conclusions A non-negligible fraction of small polyps harbor advanced histology. This finding suggests that expectant follow-up by non-invasive colonic imaging modalities for small polyps or not reporting them may put more than 5% of patients at risk of dysplasia progression. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00384-012-1409-7Authors Ron Shapiro, Department of Surgery C, Sheba Medical Center, Tel-Hashomer, IsraelShomron Ben-Horin, Department of Gastroenterology and Hepatology, Sheba Medical Center, Tel-Hashomer, 52621 IsraelSimon Bar-Meir, Department of Gastroenterology and Hepatology, Sheba Medical Center, Tel-Hashomer, 52621 IsraelBenjamin Avidan, Department of Gastroenterology and Hepatology, Sheba Medical Center, Tel-Hashom...

Alternative to Colonoscopy Spots Cancers, Too

MedicineNet Cancer General — Wed, 01 Feb 2012 07:00:00 +0100

Title: Alternative to Colonoscopy Spots Cancers, TooCategory: Health NewsCreated: 1/31/2012 6:06:00 PMLast Editorial Review: 2/1/2012 (Source: MedicineNet Cancer General)

Real‐time deformation of colon and endoscope for colonoscopy simulation

The International Journal of Medical Robotics and Computer Assisted Surgery — Wed, 01 Feb 2012 05:00:00 +0100

ConclusionsThe proposed method allows real‐time simulation of colon and endoscope deformation while maintaining a visually plausible result and realistic haptic sensation. Copyright © 2012 John Wiley & Sons, Ltd. (Source: The International Journal of Medical Robotics and Computer Assisted Surgery)

Cecal Intubation Rate During Colonoscopy in Sedated PatientsCecal Intubation Rate During Colonoscopy in Sedated Patients

Medscape Today Headlines — Wed, 01 Feb 2012 04:00:00 +0100

What is the best way to ensure a high cecal intubation rate in patients undergoing a colonoscopy? Journal of Gastroenterology and Hepatology (Source: Medscape Today Headlines)

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Alternative to Colonoscopy Spots Cancers, Too

The Doctors Lounge - Oncology — Tue, 31 Jan 2012 22:00:00 +0100

Study examines repeat sigmoidoscopy, a somewhat less-invasive screening method (Source: The Doctors Lounge - Oncology)

Eating fish tied to lower risk of colon polyps

Reuters: Health — Tue, 31 Jan 2012 18:25:07 +0100

NEW YORK (Reuters Health) - Women who eat about three servings of fish per week have a somewhat lower chance of having polyps found during a routine colonoscopy than women who eat just one serving every two weeks, according to a new study. (Source: Reuters: Health)

Eating Fish Tied to Lower Risk of Colon Polyps

MedlinePlus Health News — Tue, 31 Jan 2012 18:25:04 +0100

Women who eat about three servings of fish per week have a somewhat lower chance of having polyps found during a routine colonoscopy than women who eat just one serving every two weeks, according to a new study. Source: Reuters Health Related MedlinePlus Pages: Colonic Polyps, Dietary Fats, Nutrition (Source: MedlinePlus Health News)

A comparison between colonic submucosa and mucosa to detect Lewy pathology in Parkinson’s disease

Neurogastroenterology and Motility — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions & Inferences The parallel analysis of colonic mucosa, along with the SMP, can help detect Lewy pathology in PD. (Source: Neurogastroenterology and Motility)

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Evaluation of iron deficiency anaemia in tertiary hospital settings – room for improvement?

Internal Medicine Journal — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions: Almost 1 in 2 patients with IDA were not documented as undergoing GI endoscopy. More intense guideline promulgation, improved endoscopy access and ongoing practice audits are required to improve endoscopy rates. (Source: Internal Medicine Journal)

Natural Language Processing Improves Identification of Colorectal Cancer Testing in the Electronic Medical Record

Medical Decision Making — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions. Applying NLP to EHR records detected more CRC tests than either manual chart review or billing records review alone. NLP had better precision but marginally lower recall to identify patients who were due for CRC screening than billing record review. (Source: Medical Decision Making)

Primary Care Colorectal Cancer Screening Recommendation Patterns: Associated Factors and Screening Outcomes

Medical Decision Making — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions. Specialty, the influence of guidelines, test concerns, and the "jointness" of the test selection decision distinguished CRC screening recommendation patterns. All patterns were associated with similar overall screening rates. (Source: Medical Decision Making)

Alternative to Colonoscopy Spots Cancers, Too

Cancercompass News: Other Cancer — Tue, 31 Jan 2012 00:00:00 +0100

Study examines repeat sigmoidoscopy, a somewhat less-invasive screening method (Source: Cancercompass News: Other Cancer)

Making endoscopy mobile: a novel initiative for public healthcare.

Rural Remote Health — Sun, 29 Jan 2012 06:06:13 +0100

Authors: Talukdar R, Nageshwar Reddy D Abstract Public healthcare has progressed immensely in the past few decades. However, the rural masses in the developing and underdeveloped countries very often have limited access to the advanced healthcare technology. At the Asian Institute of Gastroenterology, Hyderabad, India, the Rural Health Care Project has been initiated in an attempt to provide cost-effective gastrointestinal care to the rural population. The Project was implemented by traveling to remote rural areas in a bus that had been converted into a mobile hospital and equipped with basic diagnostic facilities including a custom-made endoscopy unit. The mobile hospital and endoscopy unit is accompanied by a telemedicine vehicle that transmits all procedures and data to the main...

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Physicians Need Better Understanding of Factors that Patients Use to Decide about Colorectal Cancer Screening

MedlinePlus Health News — Sat, 28 Jan 2012 13:09:29 +0100

Source: Agency for Healthcare Research and Quality Related MedlinePlus Pages: Colonoscopy, Colorectal Cancer (Source: MedlinePlus Health News)

The clinical significance of incidental intra-abdominal findings on positron emission tomography performed to investigate pulmonary nodules

World Journal of Surgical Oncology — Fri, 27 Jan 2012 05:00:00 +0100

Conclusion: Incidental abdominal findings in the colon on FDG-PET scan for work-up of pulmonary nodules need to be further investigated by colonoscopy. (Source: World Journal of Surgical Oncology)

Narrow band imaging versus conventional white light colonoscopy for the detection of colorectal polyps.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: We could not find convincing evidence that NBI is significantly better than high definition WLC for the detection of patients with colorectal polyps, or colorectal adenomas. We found evidence that NBI might be better than standard definition WLC and equal to high definition WLC for detection the patients with colorectal polyps, or colorectal adenomas. PMID: 22258983 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Anticipating implementation of colorectal cancer screening in The Netherlands: a nation wide survey on endoscopic supply and demand

BioMed Central — Thu, 26 Jan 2012 05:00:00 +0100

Conclusions: Over the last years, endoscopic procedures increased markedly in The Netherlands without a corresponding increase in manpower. A FIT-based CRC screening program requires an additional 15% increase in endoscopic procedures. It is very likely, that current colonoscopy density varies widely across European countries.Word count: 244 including headers (Source: BioMed Central)

Role of Radiologic Imaging in Irritable Bowel Syndrome: Evidence-based Review [Evidence-based Practice]

Radiology — Thu, 26 Jan 2012 05:00:00 +0100

Conclusion: Although widely used, there is a surprising paucity of evidence guiding radiologic imaging in IBS. Radiologic imaging may not be required in patients with IBS without potentially concerning symptoms but should be considered where such symptoms exist, and choice of imaging study should be influenced by predominant symptoms. Definitive recommendations must await further research. © RSNA, 2011 (Source: Radiology)

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Intensive Radiographic and Biomarker Surveillance in Stage II and III Colorectal Cancer.

Oncology — Thu, 26 Jan 2012 05:00:00 +0100

Conclusions: In this retrospective study, intensive radiographic screening was associated with a high salvage resection rate, which led to favorable clinical outcomes. Randomized clinical trials are urgently needed to define the optimal duration and schedule of radiographic screening in stage II and III colorectal cancer. PMID: 22286543 [PubMed - as supplied by publisher] (Source: Oncology)

The Quality Of Colonoscopy Reporting And Performance Examined By Study

Health News from Medical News Today — Wed, 25 Jan 2012 08:00:00 +0100

Researchers in the Netherlands assessed the quality of colonoscopy reporting in daily clinical practice and evaluated the quality of colonoscopy performance. They found that colonoscopy reporting varied significantly in clinical practice. Colonoscopy performance met the suggested standards, however, considerable variability between endoscopy departments was found... (Source: Health News from Medical News Today)

Prospective Description of Coughing, Hemodynamic Changes, and Oxygen Desaturation During Endoscopic Sedation

Digestive Diseases and Sciences — Tue, 24 Jan 2012 06:48:48 +0100

Conclusions We have described procedural predictors of cough that may help clinicians reduce the risk of aspiration during endoscopy. Hemodynamic changes during endoscopy are common but largely clinically insignificant. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s10620-012-2057-zAuthors Abdul Hamid El Chafic, Division of Gastroenterology, Department of Medicine, Indiana University School of Medicine, 550 N. University Boulevard, IU Hospital #4100, Indianapolis, IN 46202, USAGeorge Eckert, Division of Gastroenterology, Department of Medicine, Indiana University School of Medicine, 550 N. University Boulevard, IU Hospital #4100, Indianapolis, IN 46202, USADouglas K. Rex, Division of Gastroenterology, Department of Medicine, Indiana Univer...

A pilot study evaluating a new low-volume colon cleansing procedure for capsule colonoscopy

Endoscopy — Tue, 24 Jan 2012 05:00:00 +0100

Conclusion: A colon cleansing procedure using PEG + ascorbic acid for capsule colonoscopy yielded an adequate cleansing level in > 80 % of patients, a completion rate of 76 %, and good accuracy for detecting polyps. This procedure may be considered as an alternative, particularly for patients in whom sodium phosphate-based preparations are contraindicated. [...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Endoscopy)

High-Fiber Diet No Help for Diverticulosis (CME/CE)

MedPage Today Primary Care — Mon, 23 Jan 2012 21:34:05 +0100

(MedPage Today) -- A high-fiber diet afforded no protection against asymptomatic diverticulosis, findings from more than 2,000 colonoscopy exams showed. (Source: MedPage Today Primary Care)

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Study examines quality of colonoscopy reporting and performance

EurekAlert! - Medicine and Health — Mon, 23 Jan 2012 05:00:00 +0100

(American Society for Gastrointestinal Endoscopy) Researchers in the Netherlands assessed the quality of colonoscopy reporting in daily clinical practice and evaluated the quality of colonoscopy performance. They found that colonoscopy reporting varied significantly in clinical practice. Colonoscopy performance met the suggested standards, however, considerable variability between endoscopy departments was found. Researchers concluded that the results of the study underline the importance of the implementation of quality indicators and guidelines. The study appears in the January issue of GIE: Gastrointestinal Endoscopy. (Source: EurekAlert! - Medicine and Health)

The role of carbon dioxide insufflation in colonoscopy: a systematic review and meta-analysis

Endoscopy — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions: Insufflation with CO2 in colonoscopy could decrease abdominal discomfort during and following the procedure, without any additional adverse reactions, warranting routine clinical use.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Endoscopy)

Colonic mucosal biopsies obtained during confocal endomicroscopy are pre-stained with fluorescein in vivo and are suitable for histologic evaluation

Endoscopy — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions: This study shows for the first time that standard colonic biopsies obtained during CLE retain fluorescein, show excellent delineation of mucosal structures without additional staining, allow the evaluation of mucosal microvasculature and vascular permeability, and are suitable for immunostaining. [...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Endoscopy)

Making endoscopy mobile: a novel initiative for public healthcare

Endoscopy — Mon, 23 Jan 2012 05:00:00 +0100

Endoscopy 2012; 44: 186-189DOI: 10.1055/s-0031-1291612Public healthcare has progressed immensely in the past few decades. However, the rural masses in the developing and underdeveloped countries very often have limited access to the advanced healthcare technology. At the Asian Institute of Gastroenterology, Hyderabad, India, the Rural Health Care Project has been initiated in an attempt to provide cost-effective gastrointestinal care to the rural population. The Project was implemented by traveling to remote rural areas in a bus that had been converted into a mobile hospital and equipped with basic diagnostic facilities including a custom-made endoscopy unit. The mobile hospital and endoscopy unit is accompanied by a telemedicine vehicle that transmits all procedures and data to the main t...

Intestinal spirochaetosis associated with hyperplastic and adenomatous colonic polyps.

Pathology, Research and Practice — Mon, 23 Jan 2012 05:00:00 +0100

This report could stimulate microbiological investigations during the follow-up of colonic polyps in order to explain whether the persistence of abdominal symptoms in such patients could be caused by a colonic spirochaetosis susceptible to eradication by a targeted therapy. PMID: 22277793 [PubMed - as supplied by publisher] (Source: Pathology, Research and Practice)

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Use of computed tomography colonography to detect a synchronous early colorectal cancer in a patient with obstructive colorectal tumour

Surgical Practice — Sat, 21 Jan 2012 10:52:13 +0100

In patients with obstructive colorectal cancer, it is difficult to evaluate the oral site of the large bowel by colonoscopy. Instead of colonoscopy, previous studies have shown that computed tomography (CT) colonography is effective for detection of neoplastic lesions in the large bowel. In the present case, we carried out CT colonography and found superficial early cancer at the oral side of the obstructive cancer, and carried out surgical resection for both lesions. A 60‐year‐old man was admitted with complaints of abdominal pain and distension. Total colonoscopy could not be carried out because of the stricture of the lesion. To evaluate the proximal site of the large bowel, we carried out CT colonography, which showed a superficial lesion in the transverse colon suggestive of early...

[Intussusception of the appendix : A rare cause of acute abdominal pain in childhood.]

Der Chirurg — Sat, 21 Jan 2012 05:00:00 +0100

We report the case of a 12-year-old girl with right-sided abdominal pain and concomitant peranal bleeding. Preoperative abdominal ultrasound showed partial appendicular intussusception which was confirmed by laparotomy. Appendectomy was carried out including a wide peripheral cecal ring. Peranal bleeding restarted 7 weeks after discharge and colonoscopy revealed ulcerative colitis. The etiology, clinical manifestations, diagnostic and therapeutic approaches for appendicular intussusception are discussed. PMID: 22271057 [PubMed - as supplied by publisher] (Source: Der Chirurg)

Early Diagnosis and Treatment of Postoperative Endoscopic Recurrence of Crohn’s Disease: Partial Benefit by Infliximab—A Pilot Study

Digestive Diseases and Sciences — Wed, 18 Jan 2012 06:59:19 +0100

Conclusions Treatment of postsurgical endoscopic lesions by infliximab appears superior to mesalamine. However, a sizeable proportion of patients did not fully benefit from this strategy. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s10620-011-2025-zAuthors Dario Sorrentino, Department of Clinical and Experimental Pathology, University of Udine School of Medicine, Udine, ItalyGiovanni Terrosu, Department of Digestive Surgery, University of Udine School of Medicine, Udine, ItalyAlberto Paviotti, Department of Clinical and Experimental Pathology, University of Udine School of Medicine, Udine, ItalyMarco Geraci, MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UKClaudio Avellini, Department of Pathology, Un...

Association Between Plasma 25-Hydroxyvitamin D and Colorectal Adenoma According to Dietary Calcium Intake and Vitamin D Receptor Polymorphism

American Journal of Epidemiology — Wed, 18 Jan 2012 05:00:00 +0100

The anticarcinogenic potential of vitamin D might be mediated by not only calcium metabolism but also other mechanisms initiated by vitamin D receptor (VDR). The authors measured plasma 25-hydroxyvitamin D in healthy volunteer examinees who underwent total colonoscopy in Tokyo, Japan, 2004–2005, and evaluated its influence on colorectal adenoma, both alone and in interaction with VDR polymorphisms, which correspond to the FokI and TaqI restriction sites. The main analysis of plasma 25-hydroxyvitamin D included 737 cases and 703 controls. Compared with the lowest quintile of plasma 25-hydroxyvitamin D, only the highest was related to a significantly decreased odds ratio of colorectal adenoma (odds ratio = 0.64, 95% confidence interval: 0.45, 0.92). In contrast, all but the lowest quin...

The ins and outs of diverticular bleeding

Gastrointestinal Endoscopy — Tue, 17 Jan 2012 22:04:55 +0100

I have several goals in this editorial. The first is to compliment Dr. Ishii and his colleagues for their interest in diverticular hemorrhage and for reporting a large cumulative experience of patients with definitive diverticular hemorrhage from Japan. The diagnosis of definitive diverticular hemorrhage made during urgent colonoscopy is based on finding major stigmata of recent hemorrhage (SRH) in a diverticulum (ie, active bleeding, a nonbleeding visible vessel, or an adherent clot), as my CURE Hemostasis Research Group previously reported. The second goal is to review the vascular anatomy of colonic diverticula and provide some insight on blood flow related to SRH of diverticular hemorrhage with Doppler US probe, which is very useful in risk stratification, deciding where to treat, and ...

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Unsedated colonoscopy: an option for some but not for all

Gastrointestinal Endoscopy — Tue, 17 Jan 2012 22:04:55 +0100

Conclusion: The acceptance rate of unsedated colonoscopy is clinically relevant, and the procedure can be completed without sedation in the majority of patients. Subject-related factors may help to identify patients willing to undergo and potentially complete unsedated procedures. (Source: Gastrointestinal Endoscopy)

Weck clip migration into the rectum

Gastrointestinal Endoscopy — Tue, 17 Jan 2012 22:04:55 +0100

A 70-year-old man was referred for further evaluation of a submucosal rectal nodule ( ), discovered incidentally on routine colonoscopy. Three years before the procedure, the patient underwent an uncomplicated robot-assisted laparoscopic prostatectomy for localized prostate cancer. Careful endoscopic inspection revealed a penetrating foreign body–type lesion (). Snare extraction of the lesion revealed an eroded hemostatic Weck clip. The unused Weck clips are shown (). (Source: Gastrointestinal Endoscopy)

New Colonoscopy Device

Medical Headlines From Ivanhoe.com — Mon, 16 Jan 2012 05:00:00 +0100

(Ivanhoe Newswire) -- In the next twelve months, 150, 000 people will be told they have colorectal cancer and 50,000 will die from it. (Source: Medical Headlines From Ivanhoe.com)

Letter 1: Routine colonoscopy following acute uncomplicated diverticulitis (Br J Surg 2011; 98: 1630-1634).

The British Journal of Surgery — Sun, 15 Jan 2012 10:49:16 +0100

Authors: Page AA, Khan A, Davies RJ Abstract The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses should be sent electronically via the BJS website (www.bjs.co.uk). All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 22222807 [PubMed - in process] (Source: The British Journal of Surgery)

Authors' reply: Routine colonoscopy following acute uncomplicated diverticulitis (Br J Surg 2011; 98: 1630-1634).

The British Journal of Surgery — Sun, 15 Jan 2012 10:48:51 +0100

Authors: Westwood DA, Eglinton TW, Frizelle FA PMID: 22222808 [PubMed - in process] (Source: The British Journal of Surgery)

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Letter 2: Routine colonoscopy following acute uncomplicated diverticulitis (Br J Surg 2011; 98: 1630-1634).

The British Journal of Surgery — Sun, 15 Jan 2012 10:48:30 +0100

Authors: Colvin HS, Velineni R, Robertson AG, Yalamarthi S, Driscoll PJ PMID: 22222809 [PubMed - in process] (Source: The British Journal of Surgery)

Incidental focal colonic lesions found on 18Fluorodeoxyglucose positron emission tomography/computed tomography scan: further support for a national guideline on definitive management

Colorectal Disease — Sat, 14 Jan 2012 06:26:29 +0100

Conclusion Incidental abnormal colonic uptake of 18FDG, determined by a PET/CT scan requires definitive colonic investigation in patients suitable for further treatment because significant colonic pathology is frequently identified. The benefit of this approach should be discussed in specialist MDT meetings and tailored to each patient; however, national guidelines for management are required. (Source: Colorectal Disease)

Clinical significance of incidental focal colorectal 18F‐fluorodeoxyglucose uptake: our experience and a review of the literature

Colorectal Disease — Sat, 14 Jan 2012 06:25:31 +0100

Conclusion Focal incidental colorectal uptake of [18F]FDG is observed in about 1% of PET/CT studies and carries a high risk of neoplastic disease. A PET‐CT report should suggest colonoscopy when abnormal findings are reported. (Source: Colorectal Disease)

The first 3 years of national bowel cancer screening at a single UK tertiary centre

Colorectal Disease — Sat, 14 Jan 2012 06:25:28 +0100

Conclusions At this bowel cancer screening single centre, colonoscopy completion rates were high (unadjusted caecal intubation rate of 96%) and complication rates were low. In contrast to other published data, the uptake and cancer‐detection rates were lower. (Source: Colorectal Disease)

Impact of Comorbidity on Colorectal Cancer Screening Cost-Effectiveness Study in Diabetic Populations

Journal of General Internal Medicine — Thu, 12 Jan 2012 06:42:14 +0100

CONCLUSION Benefits of CRC screening differ substantially for patients with and without diabetes. Screening for CRC in patients diagnosed with diabetes at age 50 or younger is not cost-effective beyond age 70. Screening recommendations should be individualized based on the presence of comorbidities. Content Type Journal ArticleCategory ReviewsPages 1-9DOI 10.1007/s11606-011-1972-6Authors Tuan A. Dinh, Archimedes Inc., 201 Mission St., 29th floor, San Francisco, CA 94105, USAPeter Alperin, Archimedes Inc., 201 Mission St., 29th floor, San Francisco, CA 94105, USALouise C. Walter, Division of Geriatrics, San Francisco VA Medical Center and University of California, San Francisco, USARobert Smith, Cancer Control Department, American Cancer Society, 250 Williams Street ...

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Health care providers' acceptance of unsedated colonoscopy before and after a state-of-the-art lecture on the feasibility of the option

The Saudi Journal of Gastroenterology — Thu, 12 Jan 2012 05:00:00 +0100

Conclusions: The mean±SEM credibility score (maximum possible score=50) was 25.8 ± 1.8 before and 33.3 ± 2.1 after the lecture, with a significant improvement in mean score of 7.5 ± 1.3 (P=0.001, paired t test). Nineteen (39%) respondents were not willing to consider unsedated colonoscopy for themselves before the lecture. This number decreased to 13 (27%) after the lecture. Before the lecture only 4 (8%) respondents were willing to consider unsedated colonoscopy for themselves. After the lecture this number increased to 8 (16%). The data suggest education of healthcare professionals regarding the feasibility of unsedated colonoscopy appears to enhance its acceptance as a credible patient care option at a Pan-Arab ...

Barriers to enrollment in inflammatory bowel disease randomized controlled trials: An investigation of patient perspectives

Inflammatory Bowel Diseases — Thu, 12 Jan 2012 05:00:00 +0100

Conclusions:Elements of study design negatively and positively influence willingness to participate. Invasive procedures, randomization, and frequent visits negatively influenced willingness to participate and as each of these components are added, a significant additive percent of potential subjects are lost. Strategies to further identify barriers to enrollment within IBD study populations should be pursued. (Inflamm Bowel Dis 2012;) (Source: Inflammatory Bowel Diseases)

Transverse colon volvulus presenting as 'inverted' coffee-bean sign

Archives of Disease in Childhood — Wed, 11 Jan 2012 05:00:00 +0100

A 12-year-old boy with cerebral palsy had a history of fever, diarrhoea and progressive bilious vomiting for 2 days. Physical examination revealed absent bowel sounds and peritoneal sign. An abdominal plain film showed a ‘V-shaped’ loop of the dilated large intestine with the apex pointing ‘downward’ (figure 1), rather than the typical coffee-bean sign of sigmoid volvulus, which is characterised by an upward-pointing apex. Fluid challenge and broad-spectrum antibiotics were prescribed due to the status of septic shock. Sigmoid volvulus was suspected initially and colonoscopy revealed a transverse colon volvulus about 120 cm from anus. Emergency surgery was arranged due to failed reduction by colonoscopy. Segmental resection of the transverse colon to about 34 cm in ...

Colonoscopy: New Approaches to Better OutcomesColonoscopy: New Approaches to Better Outcomes

Medscape Today Headlines — Wed, 11 Jan 2012 04:00:00 +0100

This new article outlines the latest colonoscopy methods in the diagnosis of colorectal cancer. Current Opinion in Gastroenterology (Source: Medscape Today Headlines)

Synchronous primary cancer of the rectum and lung: a case report

The Chinese-German Journal of Clinical Oncology — Mon, 09 Jan 2012 19:27:48 +0100

Abstract Multiple primary cancers refer to the condition where more than two cancers occur independently in an individual. The incidence of lung cancer in cases of colorectal cancer is rare and synchronous rectal cancer and lung cancer is even rare. A 61-year-old man was referred to our hospital with a 2-month history of blood in his stool, tenesmus, and mucous discharge in July 2010. Colonoscopy showed an irregular ulcerated rectal mass and histological examination of biopsy material showed a poorly differentiated adenocarcinoma. Computed tomography (CT) scan of the chest and abdomen showed a mass in the posterior segment of the right upper lobe of the lung and a mass in the right rectal wall of upper rectum. The rectal tumor was diagnosed as primary cancer based on the f...

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Less Advanced Stages of Colon Cancer in Patients with Type 2 Diabetes Mellitus: an Unexpected Finding?

Experimental and Clinical Endocrinology and Diabetes — Mon, 09 Jan 2012 05:00:00 +0100

Exp Clin Endocrinol DiabetesDOI: 10.1055/s-0031-1299704Epidemiological studies have found an increased risk for colon cancer and faster disease progression in patients with type 2 diabetes mellitus (T2DM). We aimed to determine whether patients with T2DM are diagnosed with more advanced stages of colorectal cancer, i. e., metastasized disease (UICC III and IV), at the time of diagnosis, since such a finding may have an impact on future guidelines for patients with T2DM.A cross-sectional analysis of colorectal cancer patients was performed. Stages at diagnosis in patients with (18.0%) or without (82%) T2DM were compared using logistic regression analysis to correct for confounders.Patients with T2DM were older, more obese, and more often male (each p<0.05). Unexpectedly, patients with ...

Association of GSTM1, GSTT1, GSTP1 and CYP2E1 Single Nucleotide Polymorphisms with Colorectal Cancer in Iran.

Pathology Oncology Research — Sun, 08 Jan 2012 05:00:00 +0100

Authors: Ebrahimkhani S, Asgharian AM, Nourinaier B, Ebrahimkhani K, Vali N, Abbasi F, Zali MR Abstract Colorectal cancer is a major cause of morbidity and mortality both globally and in Iran. The aim of this study was to determine the association between genetic polymorphisms of glutathione S-transferases P1, M1 and T1 (GSTP1, M1, T1) and susceptibility to colorectal cancer (CRC). Genotyping of GSTP1, GSTM1 and GSTT1 was performed by the use of pyrosequencing. One hundred cases and healthy controls were enrolled into this study. Mean GSTT1 polymorphism type was significantly (P < 0.01) higher in cases as compared to controls (P < 0.0001: OR, 2.43: 95% CI, 1.47-4). On the other hand there is no significant association between GSTM1, GSTP1 and colorectal cancer. GSTs m...

Laparoscopic Ventral Rectopexy for Internal Rectal Prolapse Using Biological Mesh: Postoperative and Short-Term Functional Results

Journal of Gastrointestinal Surgery — Sat, 07 Jan 2012 06:44:48 +0100

Conclusions Laparoscopic ventral mesh rectopexy using biological mesh for internal rectal prolapse is safe and effective in ameliorating symptoms of obstructed defaecation and faecal incontinence. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s11605-011-1793-2Authors Pierpaolo Sileri, Department of Surgery, Policlinico Tor Vergata, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, ItalyLuana Franceschilli, Department of Surgery, Policlinico Tor Vergata, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, ItalyElisabetta de Luca, Department of Surgery, Policlinico Tor Vergata, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, ItalySara Lazzaro, Department of Surgery, Policlinico Tor Vergata, University of Rome...

Authors' reply: Routine colonoscopy following acute uncomplicated diverticulitis (Br J Surg 2011; 98: 1630–1634)

British Journal of Surgery — Fri, 06 Jan 2012 14:12:05 +0100

(Source: British Journal of Surgery)

Letter 2: Routine colonoscopy following acute uncomplicated diverticulitis (Br J Surg 2011; 98: 1630–1634)

British Journal of Surgery — Fri, 06 Jan 2012 14:12:03 +0100

(Source: British Journal of Surgery)

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Letter 1: Routine colonoscopy following acute uncomplicated diverticulitis (Br J Surg 2011; 98: 1630–1634)

British Journal of Surgery — Fri, 06 Jan 2012 14:12:02 +0100

AbstractThe Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses should be sent electronically via the BJS website (www.bjs.co.uk). All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Predictive factors of local recurrence after endoscopic piecemeal mucosal resection

Journal of Gastroenterology — Thu, 05 Jan 2012 17:06:15 +0100

Conclusion The removal of 5 or more neoplasm specimens is an independent risk factor for local recurrence after EPMR. Careful colonoscopic surveillance should be performed after multiple piecemeal resection. Content Type Journal ArticleCategory Original Article—Alimentary TractPages 1-6DOI 10.1007/s00535-011-0524-5Authors Taku Sakamoto, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, JapanTakahisa Matsuda, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, JapanYosuke Otake, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, JapanTakeshi Nakajima, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, JapanYutaka Saito, Endoscopy Divisi...

Prevention of Colorectal Cancer by Aspirin and/or Calcium: Efficacy, Mechanisms, and Cost Effectiveness

Current Colorectal Cancer Reports — Wed, 04 Jan 2012 17:02:35 +0100

Abstract Chemoprevention of colorectal cancer (CRC) by aspirin use or calcium supplementation has been studied for almost two decades. Recently, the use of aspirin has been reported to be efficacious for the chemoprevention of CRC at the lowest dose ever, one that corresponds to that recommended for the primary prevention of cardiovascular disease. There is also new evidence that aspirin at higher doses may be helpful in controlling familial adenomatous polyposis (FAP). Several cost effectiveness studies have emerged to demonstrate that use of aspirin in combination with colonoscopy is cost-effective compared with colonoscopy alone in prevention of CRC. Likewise, calcium supplementation in a chemoprevention strategy also has been shown to be cost-effective when used alone ...

bowel prep

About.com Colon Cancer — Wed, 04 Jan 2012 05:00:00 +0100

The colonoscopy bowel prep may be the most dreaded part of this vital screening exam. Learn how to mitigate the discomfort, what the prep entails and breeze through your bowel prep. (Source: About.com Colon Cancer)

Colon Cancer: Q&A with John Strickler, MD, and Fatima Rangwala, MD

DukeHealth.org: Duke Health Features — Mon, 02 Jan 2012 19:02:08 +0100

Oncologists John Strickler, MD, and Fatima Rangwala, MD, answer frequently asked questions about colon cancer prevention and detection. Can screening really prevent colon cancer? Fatima Rangwala, MDRangwala: Yes. Tumors in the colon begin as non-cancerous growths called polyps. The detection and removal of colon polyps can prevent colon cancer. Therefore, screening for colon cancer is very important, not only because it is so effective, but also because colon cancer tumors may not produce any detectable symptoms until they’ve advanced to a life-threatening stage. Can changing my diet help prevent colon cancer? Rangwala: Yes. Studies have shown that diets full of folate, calcium, and vitamin D are associated with lower rates of colon cancer. Exercise is important as well, and can cut your...

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[Comment] Strong evidence in support of CT colonography screening

The Lancet Oncology — Sun, 01 Jan 2012 05:00:00 +0100

Findings from the randomised controlled trial reported by Esther M Stoop and colleagues in The Lancet Oncology provide important new data for adherence rates and overall programmatic yield for screening with optical colonoscopy and CT colonography. Particularly, results from this trial show a significant 55% improvement in screening participation with CT colonography over colonoscopy, which is a crucial component to the overall success of a screening programme. The overall programmatic yield (per invitee) for advanced neoplasia, which represents the optimum target of colorectal screening, was similar for CT colonography and colonoscopy. (Source: The Lancet Oncology)

[Articles] Participation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: a randomised controlled trial

The Lancet Oncology — Sun, 01 Jan 2012 05:00:00 +0100

SummaryBackgroundScreening for colorectal cancer is widely recommended, but the preferred strategy remains unidentified. We aimed to compare participation and diagnostic yield between screening with colonoscopy and with non-cathartic CT colonography.MethodsMembers of the general population, aged 50–75 years, and living in the regions of Amsterdam or Rotterdam, identified via the registries of the regional municipal administration, were randomly allocated (2:1) to be invited for primary screening for colorectal cancer by colonoscopy or by CT colonography. (Source: The Lancet Oncology)

How to Prove You Are Qualified When You Need to

The Journal for Nurse Practitioners — Sun, 01 Jan 2012 05:00:00 +0100

No one learns all they need to know in a master—s or DNP program. Most nurse practitioners (NPs) acquire skills such as suturing, colonoscopy, and chest tube insertion throughout their careers. Some continuing education (CE) programs offer programs teaching NPs how to perform specified procedures. Often, these skills come through the “see one, do one, teach one” method. Some NPs become expert in diagnosing and treating certain conditions, such as attention deficit disorder (ADD) or depression. They acquire their expertise through CE courses, reading, discussions with other clinicians, and analyzing the cases they handle. (Source: The Journal for Nurse Practitioners)

A computerized intervention to promote colorectal cancer screening for underserved populations: Theoretical background and algorithm development.

Technology and Health Care — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: The results of this study suggest that appropriate reminders, explanations of procedures, and patient understanding of temporary life disruptions, help patients develop and accept a detailed screening plan. PMID: 22297711 [PubMed - in process] (Source: Technology and Health Care)

Five year colorectal cancer outcomes in a large negative CT colonography screening cohort

European Radiology — Sat, 31 Dec 2011 06:37:54 +0100

Conclusions Clinically presenting colorectal adenocarcinoma is rare in the 5 years following negative screening CTC, suggesting that current strategies, including non-reporting of diminutive lesions, are appropriate. Key Points • CT colonography (CTC) screening is increasingly used to identify potential colorectal cancer. • Clinically presenting cancers are rare for 5 years following negative CTC screening. • The practice of setting a 6 mm polyp size threshold seems safe. • An interval of 5 years for routine CTC screening is appropriate. Content Type Journal ArticleCategory GastrointestinalPages 1-7DOI 10.1007/s00330-011-2365-2Authors David H. Kim, Department of Radiology, University of Wisc...

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Prevalence and risk factors for colonic perforation during colonoscopy in hospitalized end-stage renal disease patients on hemodialysis

International Journal of Colorectal Disease — Thu, 29 Dec 2011 06:42:41 +0100

Conclusions There appeared no increased risk of colonic perforation during colonoscopy among inpatients who received HD in our study. Increasing age and female patients appeared to be associated with procedure-related colonic perforation. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00384-011-1400-8Authors Udayakumar Navaneethan, Digestive disease Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USASravanthi Parasa, Department of Epidemiology, University of Washington, Seattle, WA, USAPreethi G. K. Venkatesh, Digestive disease Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USABo Shen, Digestive disease Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, ...

Stop questionnaire to screen for hypoxemia in deep sedation for young and middle‐aged colonoscopy

Digestive Endoscopy — Thu, 29 Dec 2011 05:00:00 +0100

Conclusions: STOP Questionnaire is a validated and easy‐to‐use screening tool for hypoxemia in outpatient colonoscopy. It has high sensitivity, specificity and negative predictive value. (Source: Digestive Endoscopy)

Deeper and deeper into the pediatric small bowel

Gastrointestinal Endoscopy — Wed, 28 Dec 2011 12:50:19 +0100

Over the past decade, advances in endoscopic equipment and techniques have allowed diagnostic and therapeutic advancements in the treatment of small-bowel disorders previously unreachable by standard upper GI endoscopy and colonoscopy. Single-balloon enteroscopy has been used in both adult and pediatric patients, and multiple case series have demonstrated its effectiveness and safety. In this issue of Gastrointestinal Endoscopy, 2 independent reports demonstrate the efficacy and safety of single-balloon enteroscopy in pediatric Crohn's disease. (Source: Gastrointestinal Endoscopy)

Quality benchmarking for colonoscopy: how do we pick products from the shelf?

Gastrointestinal Endoscopy — Wed, 28 Dec 2011 12:50:19 +0100

We all make multiple choices on a daily basis, be they for the selection of a product for purchase, a food (or fine wine) for consumption, or perhaps even an investment of time or resources. When we make medical choices for our patients, we typically do so based on a selection bias of favorable evidence showing higher quality for performance or outcomes, based on comparative data, typically from controlled clinical trials. The rules of evidence have clearly taken on new standards for acceptability given the requirements/rigor for scientific reporting in the era of evidence-based medicine. The term validated instrument is a cornerstone of this refined evidentiary reporting. This means that the tools used (eg, questionnaires, reports) must be applicable across trial designs and provide a rep...

Looking over your shoulder during colonoscopy: potential roles for videorecording colonoscopy withdrawals

Gastrointestinal Endoscopy — Wed, 28 Dec 2011 12:50:19 +0100

The adenoma detection rate (ADR), defined as the percentage of patients age 50 and older undergoing screening colonoscopy with 1 or more adenomas detected, is currently the primary recommended measure of the quality of mucosal inspection during colonoscopy. The rationale for measuring the ADR is remarkably consistent evidence that adenoma detection is highly variable and operator dependent. The original and subsequent recommendations for ADR targets (at least 25% in men and 15% in women) were set below the observed mean levels of adenoma prevalence in screening colonoscopy studies and thus well below the true prevalence of adenomas of 50% or more as defined by autopsy studies and numerous high-level colonoscopic detectors. Thus, the goal conceived by the proposers of the ADR concept was no...

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Computer-aided system for predicting the histology of colorectal tumors by using narrow-band imaging magnifying colonoscopy (with video)

Gastrointestinal Endoscopy — Wed, 28 Dec 2011 12:50:19 +0100

Conclusion: Our new computer-aided system is reliable for predicting the histology of colorectal tumors by using NBI magnifying colonoscopy. (Source: Gastrointestinal Endoscopy)

Improving the quality of colonoscopy

Gastrointestinal Endoscopy — Wed, 28 Dec 2011 12:50:19 +0100

We read with interest the article by Lee et al, which investigated the relationship among colonoscopy withdrawal technique, withdrawal times, and adenoma detection rates (ADR). The authors demonstrated that colonoscopists with a lower ADR had significantly lower scores for the components of withdrawal technique but not for withdrawal times, compared with those with moderate and high ADRs. We agree that good colonoscopy withdrawal technique is vital to ensure a thorough colonic examination. The use of dynamic position change has been shown to improve luminal distension and adenoma detection, and the use of antispasmodics, such as hyoscine butylbromide, increases the visible mucosal area by reducing spasm, thereby improving lesion detection. The use of these measures was not reported in this...

Response

Gastrointestinal Endoscopy — Wed, 28 Dec 2011 12:50:19 +0100

We appreciate Dr Rajasekhar's comments on behalf of the QIC Study Group regarding our article on colonoscopy withdrawal technique and adenoma detection rates. In particular, we appreciate the author's thoughts regarding the potential importance of dynamic position change and the use of antispasmodic agents in optimizing luminal distension during mucosal inspection. In our study, none of the endoscopists used these methods during the recorded colonoscopy withdrawals. To the best of our knowledge, none of the endoscopists regularly used these approaches in their everyday practices of colonoscopy. (Source: Gastrointestinal Endoscopy)

Splenic rupture following routine colonoscopy

Digestive Endoscopy — Wed, 28 Dec 2011 12:34:04 +0100

(Source: Digestive Endoscopy)

Role of colonoscopy in the diagnosis of acute appendicitis

Digestive Endoscopy — Wed, 28 Dec 2011 12:34:02 +0100

(Source: Digestive Endoscopy)

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Ischemic colitis masquerading as colonic tumor: Case report with review of literature.

World Journal of Gastroenterology : WJG — Wed, 28 Dec 2011 05:00:00 +0100

Authors: Deepak P, Devi R Abstract Ischemic colitis can mimic a carcinoma on computed tomographic (CT) imaging or endoscopic examination. A coexisting colonic carcinoma or another potentially obstructing lesion has also been described in 20% of the cases of ischemic colitis. CT scan can differentiate it from colon cancer in 75% of cases. However, colonoscopy is the preferred method for diagnosing ischemic colitis as it allows for direct visualization with tissue sampling. Varied presentations of ischemic colitis have been described as an ulcerated or submucosal mass or as a narrowed segment of colon with ulcerated mucosa on colonoscopy. Awareness and early recognition of such varied presentations of a common condition is necessary to differentiate from a colonic carcinoma, and to a...

Teleradiology brings VC to island outpost

AuntMinnie.com Headlines — Tue, 27 Dec 2011 21:34:42 +0100

Virtual colonoscopy outperformed optical colonoscopy in an unusual teleradiology (more) (Source: AuntMinnie.com Headlines)

Colonoscopy correlation of abnormal PET/CT uptake.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Conclusion: Overall, 58.3% of the patients who had focal FDG colonic activity had a correlating abnormality on the colonoscopy. Our results confirm the figures quoted in the literature and outline the importance of further diagnostic tests to exclude significant colonic pathology. PMID: 22185867 [PubMed - in process] (Source: Cancer Imaging)

Practice guidance on the management of acute and chronic gastrointestinal problems arising as a result of treatment for cancer

Gut — Sat, 24 Dec 2011 05:00:00 +0100

Conclusions All cancer units must develop simple methods to identify the many patients who need help and establish routine referral pathways to specialist gastroenterologists where patients can receive safe and effective treatment. Early contact with oncologists and/or specialist surgeons with input from the patient's family and friends often helps the gastroenterologist to refine management strategies. Increased training in the late effects of cancer treatment is required. (Source: Gut)

Prevention by daily soluble aspirin of colorectal adenoma recurrence: 4-year results of the APACC randomised trial

Gut — Sat, 24 Dec 2011 05:00:00 +0100

Conclusion Daily low-dose aspirin decreased adenoma recurrence significantly at 1 year but not at year 4. This discrepancy might be explained by a differential effect of aspirin according to the natural history of the polyp. Trial Registration Number NCT 00224679. (Source: Gut)

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Guidelines for an Optimum Screening Colonoscopy

Current Colorectal Cancer Reports — Fri, 23 Dec 2011 16:53:45 +0100

Abstract Effective colonoscopy requires a high rate of excellent and good bowel preparations, which can be achieved by split dose or same day dosing. Cecal intubation rates in screening patients should exceed 95%, and experts frequently achieve 99% or more. Cecal intubation should be documented by photographs of the appendiceal orifice and ileocecal valve and notation of landmark visualization. Withdrawal technique must include meticulous inspection of the proximal sides of the folds, clean-up of residual fluid and feces, adequate luminal distension, and adequate withdrawal time. The endoscopist must be familiar with the full spectrum of endoscopic lesions, including flat and depressed lesions and serrated lesions. Optimal screening colonoscopy includes documentation of hi...

Test sequence in the management of gastrointestinal bleeding

Endoscopy — Fri, 23 Dec 2011 05:00:00 +0100

Conclusions: A low threshold indicated a preferred management option that should be used early rather than late in a sequence of multiple possible test procedures to work up instances of gastrointestinal bleeding. [...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Endoscopy)

Scheduled Out-Patient Endoscopy and Lack of Compliance in a Minority Serving Tertiary Institution.

The American Journal of the Medical Sciences — Fri, 23 Dec 2011 05:00:00 +0100

CONCLUSIONS: This study suggests a high rate of noncompliance with scheduled out-patient endoscopy, particularly for colonoscopy. Because this may be a contributing factor to colorectal cancer disparities, increased community outreach on colorectal cancer education is needed and may help to reduce noncompliance. PMID: 22197978 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

Bleeding Polyps?

Gastroenterology — Fri, 23 Dec 2011 05:00:00 +0100

Question: A 60-year-old Caucasian woman presented with melena of 3 days' duration. It was the second episode of gastrointestinal (GI) bleeding. Fourteen days ago, colonoscopy done in another hospital revealed diverticulosis and 3 small polypoid lesions in the cecum without signs of acute bleeding. Biopsies of the lesions have been taken. Gastroscopy was normal. At admission to our hospital, the patient was hemodynamically stable. Laboratory findings showed hemoglobin level of 80 g/L (normal limits, 121–154 g/L) and thrombocytes of 34 g/L (normal limits, 140–380 g/L). (Source: Gastroenterology)

Functional polymorphisms in XRCC-1 and APE-1 contribute to increased apoptosis and risk of ulcerative colitis

Inflammation Research — Thu, 22 Dec 2011 12:51:10 +0100

Conclusion Polymorphisms in XRCC1 Arg399Gln and APE1 Asp148Glu significantly increased the rate of apoptosis and risk of ulcerative colitis. Content Type Journal ArticleCategory Original Research PaperPages 1-7DOI 10.1007/s00011-011-0418-2Authors Avinash Bardia, Centre for Liver Research and Diagnostics, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, 500 058 Andhra Pradesh, IndiaSantosh K. Tiwari, Centre for Liver Research and Diagnostics, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, 500 058 Andhra Pradesh, IndiaSivaram Gunisetty, Centre for Liver Research and Diagnostics, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, 500 058 Andhra Pradesh, IndiaFarha Anjum, Centre for Liver Research and Diagnostics, Deccan College of Medic...

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Pros and Cons of Virtual Colonoscopy

About.com Colon Cancer — Thu, 22 Dec 2011 05:00:00 +0100

Image © Kodym/Dreamstime Virtual colonoscopy - it sounds like a not-so-fun video game found in sale bins after the holidays. A virtual colonoscopy, officially referred to as a computed tomographic colonography (CTC), is a screening exam used to detect colon cancer. This advanced CT scan makes a high-resolution three-dimensional image of the inside of your colon using radiography instead of a colonoscope. The CTC is generally considered to be more comfortable, cost effective, and faster than the traditional colonoscopy....Read Full Post (Source: About.com Colon Cancer)

To Snare a Snare, or Not to Snare?

Gastroenterology — Thu, 22 Dec 2011 05:00:00 +0100

Question: A 79-year-old man presented with a 1-year history of intermittent colicky abdominal pain, without rectal blood loss or fever. On physical examination, the abdomen was not distended, there were normal bowel sounds and no rebound tenderness or peritoneal guarding. The laboratory results were all normal. Colonoscopy revealed mild diverticulosis of the sigmoid colon. Additionally, we observed a thin, stalk-like lesion, the distal end of which seemed to be trapped in a peristaltic wave, resulting in considerable strain to the tissue, not unlike a stretched snare (). At that moment, the patient experienced abdominal pain. After the peristaltic wave had passed, the colicky pain resolved, and the entire lesion became visible (): Arising from a wide pseudo-pedicle, a 10-cm-long stalk with...

Study finds happier patients with laxative-free VC prep

AuntMinnie.com Headlines — Wed, 21 Dec 2011 07:00:00 +0100

A laxative-free virtual colonoscopy bowel preparation significantly improved (more) (Source: AuntMinnie.com Headlines)

Acute Lower Intestinal Bleeding: Feasibility and Diagnostic Performance of CT Angiography [Emergency Radiology]

Radiology — Wed, 21 Dec 2011 05:00:00 +0100

Conclusion: CT angiography performed in the emergency setting in patients with acute lower intestinal bleeding is feasible and correctly depicts the presence and location of active or recent hemorrhage, as well as the potential cause, in the majority of patients. © RSNA, 2011 (Source: Radiology)

Aberrant crypt foci as predictors of colorectal neoplasia on repeat colonoscopy

Cancer Causes and Control — Tue, 20 Dec 2011 16:48:00 +0100

Conclusions Increased number of ACF in the distal colorectum was independently associated with substantial risk for future advanced neoplasia. This relationship was observed in patients undergoing surveillance for previous adenomas. Thus, ACF may serve as potential biomarkers in patients with adenomas to help identify patients who may need additional surveillance. Content Type Journal ArticleCategory Original paperPages 1-7DOI 10.1007/s10552-011-9884-7Authors Joseph C. Anderson, Carole and Ray Neag Comprehensive Cancer Center, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-1845, USAHelen Swede, Carole and Ray Neag Comprehensive Cancer Center, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-18...

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Inadvertent Percutaneous Endoscopic Gastrostomy Tube Placement through the Transverse Colon to the Stomach Causing Intractable Diarrhea: A Case Report

Journal of Biomedicine and Biotechnology — Tue, 20 Dec 2011 11:04:20 +0100

Background. Among patients with chronic disease, percutaneous endoscopic gastrostomy (PEG) tubes are a common mechanism to deliver enteral feedings to patients unable to feed by mouth. While several cases in the literature describe difficulties with and complications of the initial placement of the PEG, few studies have documented the effects of a delayed diagnosis of a misplaced tube. Methods. This case study reviews the hospitalization of an 82 year old male with an inadvertent placement of a PEG tube through the transverse colon. Photos of the placement in the stomach as well as those of the follow up colonoscopy, and a recording of the episodes of diarrhea during the hospitalization were made. Results. The records of this patient reveal complaints of gastrointestinal distress and diarr...

Transcript levels of Toll-like receptors 5, 8 and 9 correlate with inflammatory activity in Ulcerative Colitis

BMC Gastroenterology — Tue, 20 Dec 2011 05:00:00 +0100

Background: Dysregulation of innate immune response by Toll-Like Receptors (TLRs) is a key feature in Ulcerative Colitis (UC). Most studies have focused on TLR2, TLR3, and TLR4 participation in UC. However, few studies have explored other TLRs. Therefore, the aim of this study was to evaluate the mRNA profiles of TLR1 to 9 in colonic mucosa of UC patients, according to disease activity. Methods: Colonic biopsies were taken from colon during colonoscopy in 51 patients with Ulcerative Colitis and 36 healthy controls. mRNA levels of TLR1 to 9, Tollip, inflammatory cytokines IL6 and TNF were assessed by RT-qPCR with hydrolysis probes. Characterization of TLR9 protein expression was performed by Immunohistochemistry. Results: Toll-like receptors TLR8, TLR9, and IL6 mRNA levels were significant...

Impact of a Family History of Colorectal Cancer on the Prevalence of Advanced Neoplasia at Colonoscopy in 4,967 Asymptomatic Patients

Digestive Diseases and Sciences — Mon, 19 Dec 2011 16:51:04 +0100

Conclusions A family history of one first-degree relative with colorectal cancer did not predict a significantly higher prevalence of advanced neoplasia at screening colonoscopy in this Southwestern cohort. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s10620-011-2015-1Authors Franklin C. Tsai, Division of Gastroenterology, Scripps Clinic and the Scripps Clinic Research Institute, Torrey Pines, 10666 North Torrey Pines Road, La Jolla, CA 92037, USAWilliamson B. Strum, Division of Gastroenterology, Scripps Clinic and the Scripps Clinic Research Institute, Torrey Pines, 10666 North Torrey Pines Road, La Jolla, CA 92037, USA Journal Digestive Diseases and SciencesOnline ISSN 1573-2568Print ISSN 0163-2116 (Source: Digestive Diseases and...

A comparative case study of bowel cancer screening in the UK and Australia: evidence lost in translation?

Journal of Medical Screening — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions Insufficient funding has forced programme administrators to make trade-offs that may undermine the potential net population benefits achieved in randomized controlled trials. Such policy compromise contravenes the principle of evidence-based practice which is dependent on adequate funding being made available. (Source: Journal of Medical Screening)

Erratum to “Participation in colorectal cancer screening with FOBT and colonoscopy: An Italian, multicentre, randomized population study” [Dig. Liver Dis. 42 (2010) 371–376]

Digestive and Liver Disease — Mon, 19 Dec 2011 05:00:00 +0100

The publisher regrets that an error appeared in the author listing of the original article. The corrected list appears above. (Source: Digestive and Liver Disease)

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MUTYH hotspot mutations in unselected colonoscopy patients

Colorectal Disease — Sun, 18 Dec 2011 05:00:00 +0100

Conclusions:MUTYH‐associated disease, and hence genetic counselling and MUTYH genetic testing, should be considered in the clinical routine of an endoscopy unit, but the wide range of phenotypes represents a challenge for patient identification. The clinical significance of p.Q338H should be evaluated in future case‐control studies, since compound heterozygotes for pathogenic mutations and p.Q338H may be at increased risk for mild polyposis or CRC. In addition MUTYH should be assessed as a potential susceptibility gene for the development of colitis‐associated CRC in future. (Source: Colorectal Disease)

Is Whole Colonic Imaging Necessary for Symptoms of Change in Bowel Habit and/or Rectal Bleeding?

Colorectal Disease — Sun, 18 Dec 2011 05:00:00 +0100

Conclusion: 12 patients who had left sided polyposis and one patient with a strong family history would have undergone WCI based on current CRC management guidelines. The remaining seven patients with right‐sided cancer would have been missed if FS were the only investigation used. Patients presenting on the 2ww with symptoms of a CIBH and or RB can be adequately investigated with a FS with a 3% chance of missing a proximal cancer. (Source: Colorectal Disease)

More Docs No Help for Racial Colonoscopy Gap (CME/CE)

MedPage Today Public Health — Sat, 17 Dec 2011 14:00:00 +0100

(MedPage Today) -- Communities that have more physicians available to perform colonoscopies actually have bigger -- not smaller -- disparities in screening rates between minority and white patients, according to a recent study of Texas Medicare claims data. (Source: MedPage Today Public Health)

Magnetic air capsule robotic system: proof of concept of a novel approach for painless colonoscopy

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:35 +0100

Conclusions Use of the proposed platform in ex vivo and preliminary animal studies indicates that it is safe and operates effectively in a manner similar to a standard colonoscope. These studies served to demonstrate the platform’s added advantages of reduced size, front-wheel drive strategy, and robotic control over locomotion and orientation. Content Type Journal ArticlePages 1-9DOI 10.1007/s00464-011-2054-xAuthors P. Valdastri, STORM Lab, Mechanical Engineering Department, Vanderbilt University, 2301 Vanderbilt Place PMB 351592, Nashville, TN 37235-1592, USAG. Ciuti, The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, ItalyA. Verbeni, The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, ItalyA. Menciassi, The BioRobotics Institute, Scuola S...

Oncologic surveillance for subjects with biallelic mismatch repair gene mutations: 10 year follow‐up of a kindred

Pediatric Blood and Cancer — Fri, 16 Dec 2011 05:00:00 +0100

ConclusionsWe report on the long‐term outcome in patients with biallelic MMR mutations who benefited from prophylactic cancer surveillance. Genetic screening and subsequent surveillance led to earlier recognition of asymptomatic tumors at stages more amenable to resection and probable cure. Multicenter collaboration and implementation of surveillance guidelines is necessary to further determine genotype–phenotype correlations. Pediatr Blood Cancer © 2011 Wiley Periodicals, Inc. (Source: Pediatric Blood and Cancer)

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Ileoscopy

Springer Medicine titles — Fri, 16 Dec 2011 00:05:50 +0100

Technique, Diagnosis, and Clinical ApplicationsIleoscopy has proven to be very useful for the diagnosis of celiac, inflammatory, and infectious diseases of the small intestine. This endoscopic procedure is one of the most technically challenging steps of diagnostic colonoscopy but it also represents the best documented proof of a complete examination. This book covers all aspects of the endoscopic exploration of the terminal ileum, from ... (Source: Springer Medicine titles)

Impact of previous gastric or colonic resection on polyethylene glycol bowel preparation for colonoscopy

Surgical Endoscopy — Thu, 15 Dec 2011 06:44:13 +0100

Conclusions Previous bowel resection was an independent predictor of unsatisfactory PEG bowel preparation. More attention is needed for patients with previous bowel resection, especially for obese patients. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-2068-4Authors Seong Woo Lim, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul, KoreaYong Woo Seo, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul, KoreaDong Hyun Sinn, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul, KoreaJin Yong Kim, Department of Medicine, Samsung Medical Center,...

[Large Adenomas of the Colon and Rectum - Specific Features of the Diagnostics.]

Zentralblatt fur Chirurgie — Thu, 15 Dec 2011 05:00:00 +0100

Authors: Bertolini J, Wittekind C Abstract Carcinomas mostly originate from preneoplastic lesion of different origin, namely serrated and non-serrated adeonomas. The probability of malignant transformation correlates to the size of the adenoma. The determining diagnostic method is colonoscopy with collection of tissue samples or endoscopic biopsies for histological investigations. For the necessary identification of the pathology some specific features of the treatment are to be followed. In future, other information, such as for example, molecular characeristics are expected from carcinoma pathways. Premalignant and malignant changes carry a row of DNA changes (e. g., a mutation in K-ras proto-oncogen). The 7 (th) edition of the TNM classification of colorectal tumours shows m...

Diagnosis and management of Crohn's disease.

American Family Physician — Thu, 15 Dec 2011 05:00:00 +0100

Authors: Wilkins T, Jarvis K, Patel J Abstract Crohn's disease is a chronic inflammatory condition affecting the gastrointestinal tract at any point from the mouth to the rectum. Patients may experience diarrhea, abdominal pain, fever, weight loss, abdominal masses, and anemia. Extraintestinal manifestations of Crohn's disease include osteoporosis, inflammatory arthropathies, scleritis, nephrolithiasis, cholelithiasis, and erythema nodosum. Acute phase reactants, such as C-reactive protein level and erythrocyte sedimentation rate, are often increased with inflammation and may correlate with disease activity. Levels of vitamin B12, folate, albumin, prealbumin, and vitamin D can help assess nutritional status. Colonoscopy with ileoscopy, capsule endoscopy, computed tomography enterog...

Septin 9 methylated DNA is a sensitive and specific blood test for colorectal cancer

BMC Medicine — Wed, 14 Dec 2011 05:00:00 +0100

The biomarker septin 9 methylated DNA, which can be detected in blood plasma, provides a promising diagnostic test for colorectal cancer (CRC) of all stages, and can be used to screen for CRC in patients unable to undergo colonoscopy. (Source: BMC Medicine)

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Racial Disparities in Colon Cancer Screening Persist Despite Insurance, Access

Health Behavior News Service — Tue, 13 Dec 2011 14:41:38 +0100

12/12/2011, Health Services Research, Public health researchers have long attributed the disparity in colonoscopy rates between whites and minorities to a lack of health insurance or access to doctors. Now, a new study in the journal Health Services Research suggests the reasons for the differences are more complex. (Source: Health Behavior News Service)

First results for English bowel cancer screening revealed

MedWire News - Gastroenterology — Tue, 13 Dec 2011 09:46:46 +0100

Information on the first million patients participating in the Bowel Cancer Screening Programme in England suggests that uptake of guaiac fecal occult blood tests and colonoscopy referrals is largely following predicted patterns. (Source: MedWire News - Gastroenterology)

Magnetic resonance colonography without bowel cleansing or water enema: a pilot study.

The British Journal of Radiology — Tue, 13 Dec 2011 05:00:00 +0100

Conclusion: This pilot study has demonstrated the feasibility of performing MR colonography without bowel preparation or water enema. This would seem to be a promising modality for colorectal cancer screening. Larger studies are required to determine the accuracy of this modality for the detection of colorectal neoplasia. PMID: 22167505 [PubMed - as supplied by publisher] (Source: The British Journal of Radiology)

Racial Disparities in Colon Cancer Screenings Persist Despite Insurance, Access

RWJF News Digest - Quality/Equality — Mon, 12 Dec 2011 05:00:00 +0100

Public health researchers have long attributed the disparity in colonoscopy rates between whites and minorities to a lack of health insurance or access to doctors. (Source: RWJF News Digest - Quality/Equality)

Ischemic colitis with diverticular sparing

Gastrointestinal Endoscopy — Mon, 12 Dec 2011 05:00:00 +0100

A 78-year-old man presented with a 2-day history of abdominal pain and diarrhea mixed with blood. On physical examination, his temperature was 37.6°C, blood pressure was 110/65 mm Hg, and pulse rate was irregular at 70 beats per minute. His abdomen was slightly distended with normal bowel sounds and without rebound tenderness or peritoneal guarding. The hemoglobin level was normal. Colonoscopy revealed erythema with ulcers throughout the sigmoid colon and multiple diverticula that were all surrounded by normal-appearing mucosa ( and ); the rectum and descending colon were normal. Biopsy specimens of the erythematous mucosa showed edema, inflammatory infiltration of the lamina propria, and intravascular platelet thrombi, all consistent with acute ischemic colitis. Biopsy specimens of the m...

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Complete closure of a colonic bleeding diverticulum using endoscopic hemoclip and band ligation

Gastrointestinal Endoscopy — Mon, 12 Dec 2011 05:00:00 +0100

A 66-year-old woman visited our emergency department after having 6 episodes of hematochezia. Initial laboratory data included a Hb level of 12.1g/dL (normal range, 12-16 g/dL), white blood cell count of 7900/mm3 (4000-10,000/mm3), and platelet count of 374,000/mm3 (130,000-450,000/mm3). Colonoscopy revealed diverticulosis from the sigmoid to ascending colon. After extensive washing and instillation of water in the general area of diverticulosis, a 0.4-cm diverticulum was visualized 36 cm from the anal verge, with fresh blood trickling out; no visible vessel was seen. The bleeding site was clipped by using a hemoclip ( ). Despite what we believed to be good placement of the hemoclip, we could not achieve hemostasis ( ). Because of ongoing bleeding, the lesion was gently aspirated into the ...

Colonoscopy essential read

About.com Colon Cancer — Fri, 09 Dec 2011 05:00:00 +0100

Know what to expect and how to prepare for your upcoming colonoscopy. (Source: About.com Colon Cancer)

Good results for bowel cancer testing

NHS News Feed — Thu, 08 Dec 2011 17:30:00 +0100

Conclusion This analysis of a relatively new screening programme demonstrates that the programme has been effective in detecting bowel cancers at an early stage. This is extremely important in this disease, as in the absence of an effective screening programme most cases would not be diagnosed until they have progressed considerably. At this point treatment becomes more difficult, and survival is less likely than those cases diagnosed at an early stage. The researchers say that uptake of the programme outside of London was very good, and high by international standards. The study also revealed unexpected variations in participation across regions and socioeconomic levels. Knowledge of such variation is essential, as it allows programme administrators to alter their recruitment and invitat...

Colonoscopist and Primary Care Physician Supply and Disparities in Colorectal Cancer Screening

Health Services Research — Thu, 08 Dec 2011 05:00:00 +0100

Conclusions. Greater area availability of colonoscopists and PCPs is associated with increased use of colonoscopy in whites but decreased use in minorities, resulting in larger racial/ethnic disparities. (Source: Health Services Research)

Methylene blue MMX® tablets for chromoendoscopy. Safety tolerability and bioavailability in healthy volunteers

Contemporary Clinical Trials — Thu, 08 Dec 2011 05:00:00 +0100

Abstract: Methylene blue-MMX® tablets are proposed as colonic diagnostic staining. Methylene blue taken prior to colonoscopy is expected to provide an effective staining of colonic and rectal mucosa leaving unstained the dysplastic or polypoid areas.The present single dose, open-label study investigated the safety of methylene blue after single oral doses of 200 and 400mg in healthy volunteers. The absolute bioavailability was also investigated after the intake of 2L of bowel cleansing preparation in 2h and by comparing the dose of 200mg with a single iv dose of 100mg in the same subjects.Only non-serious adverse events occurred. Related events occurred to 8/22 subjects. Most of the events were mild and transient. Abnormal transaminases, gastrointestinal disorders and dysuria frequency we...

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The Family Health Promotion Project (FHPP): Design and baseline data from a randomized trial to increase colonoscopy screening in high risk families

Contemporary Clinical Trials — Thu, 08 Dec 2011 05:00:00 +0100

Abstract: Colorectal cancer (CRC) is a significant cause of mortality and morbidity in the United States, much of which could be prevented through adequate screening. Consensus guidelines recommend that high-risk groups initiate screening earlier with colonoscopy and more frequently than average risk persons. However, a large proportion of high risk individuals do not receive regular colonoscopic screening. The Family Health Promotion Project (FHPP) is a randomized-controlled trial to test the effectiveness of a telephone-based counseling intervention to increase adherence to risk-appropriate colonoscopy screening in high risk individuals. Unaffected members of CRC families from two national cancer family registries were enrolled (n=632) and randomized to receive either a single session te...

Prevalence of Colorectal Polyps in Pediatric Colonoscopy

Digestive Diseases and Sciences — Tue, 06 Dec 2011 16:59:15 +0100

Conclusions Colorectal polyps are detected in 6.1% overall and in 12.0% among those with lower gastrointestinal bleeding during pediatric colonoscopy. Approximately 26% are multiple juvenile or adenoma. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s10620-011-1972-8Authors Kalpesh Thakkar, The Section of Pediatric Gastroenterology, Hepatology and Nutrition, Texas Children’s Hospital and Baylor College of Medicine, 6621 Fannin St CCC 1010, Houston, TX 77030, USAAbeer Alsarraj, The Sections of Gastroenterology and Health Services Research, The Houston Veterans Affairs Medical Center and the Department of Medicine at Baylor College of Medicine, Houston, TX, USAEmily Fong, Baylor University, Waco, TX, USAJennifer L. Holub, Department of Gast...

Fecal Occult Blood Testing Effective in Colonoscopy Screenings

JNCI — Tue, 06 Dec 2011 05:00:00 +0100

(Source: JNCI)

Fecal Occult Blood Testing When Colonoscopy Capacity is Limited

JNCI — Tue, 06 Dec 2011 05:00:00 +0100

Conclusions FIT should be used at higher hemoglobin cutoff levels when colonoscopy capacity is limited compared with unlimited and is more effective in terms of health outcomes and cost compared with guaiac FOBT at all colonoscopy capacity levels. Increasing the colonoscopy capacity substantially increases the health benefits of FIT screening. (Source: JNCI)

Current and past cigarette smoking significantly increase risk for microscopic colitis

Inflammatory Bowel Diseases — Tue, 06 Dec 2011 05:00:00 +0100

Conclusions:In our study population, cigarette smoking is a risk factor for the development of both forms of microscopic colitis. There were no significant differences between LC and CC, and current smoking and the development of microscopic colitis affected men and women similarly. We feel that these data are sufficient to discuss the potential risks of tobacco use in patients with microscopic colitis. (Inflamm Bowel Dis 2011;) (Source: Inflammatory Bowel Diseases)

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Predicting Colorectal Cancer in People Sent for ColonoscopyPredicting Colorectal Cancer in People Sent for Colonoscopy

Medscape Today Headlines — Tue, 06 Dec 2011 04:00:00 +0100

This study explains. BMC Gastroenterology (Source: Medscape Today Headlines)

Double-balloon endoscopy versus magnet-imaging enhanced colonoscopy for difficult colonoscopies, a randomized study

Endoscopy — Mon, 05 Dec 2011 05:00:00 +0100

Conclusion: DBE is more useful for complete examination of the colon than MEI–Cap in patients with incomplete or technically difficult colonoscopy. [...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Endoscopy)

Compression anastomoses in colon and rectal surgery with the NiTi ColonRing™

Techniques in Coloproctology — Fri, 02 Dec 2011 18:09:35 +0100

Conclusions NiTi ColonRing™ is reliable, safe and efficacious for large bowel anastomoses. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s10151-011-0794-1Authors C. Avgoustou, 2nd Department of Surgery, General Hospital of N. Ionia “Constantopoulion—Aghia Olga”, Athens, GreeceP. Penlidis, 2nd Department of Surgery, General Hospital of N. Ionia “Constantopoulion—Aghia Olga”, Athens, GreeceA. Tsakpini, 2nd Department of Surgery, General Hospital of N. Ionia “Constantopoulion—Aghia Olga”, Athens, GreeceC. Sioros, 2nd Department of Surgery, General Hospital of N. Ionia “Constantopoulion—Aghia Olga”, Athens, GreeceD. Giannousis, 2nd Department of Surgery, General Hospital of N. Ionia “Constantopoulion—Aghia Olga”, A...

Is KRAS Mutation Associated with Interval Colorectal Cancers?

Digestive Diseases and Sciences — Fri, 02 Dec 2011 17:26:36 +0100

Conclusions KRAS mutation is inversely associated with interval cancers and with MSI, suggesting that it is a marker of the chromosomal instability pathway associated with slow tumor growth, and distinct from MSI rapidly growing cancers. Molecular characterization of colorectal cancers is helpful in determining underlying pathway and may determine therapy. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s10620-011-1974-6Authors Aasma Shaukat, Division of Gastroenterology, VA Medical Center, University of Minnesota, One-Veterans Drive, 111-D, Minneapolis, MN 55417, USAMustafa Arain, Division of Gastroenterology, VA Medical Center, University of Minnesota, One-Veterans Drive, 111-D, Minneapolis, MN 55417, USARuth Anway, Division of Gastroen...

Primary sclerosing cholangitis and malignancy

Best Practice and Research. Clinical Gastroenterology — Thu, 01 Dec 2011 05:00:00 +0100

Cholangiocarcinoma complicates primary sclerosing cholangitis (PSC) in approximately 10% of cases, but no risk factor that can identify this subgroup of patients is known. No imaging modalities or serum tumour markers that can diagnose early cholangiocarcinoma are available, but endoscopic retrograde cholangiography with brush cytology is recommended when clinically indicated. Liver transplantation with neoadjuvant therapy is carried out in specialist centres in cases of limited stage cancer. Transplantation should also be considered in patients with biliary dysplasia without evident tumour. Gallbladder polyps in PSC are often malignant, and liberal indication for cholecystectomy is recommended. Hepatocellular carcinoma develops in 2%–4% of patients with end-stage liver disease. Patients...

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Constipation and recurrent abdominal distension in a 39-year-old woman with irritable bowel syndrome

Gut — Thu, 01 Dec 2011 05:00:00 +0100

Clinical presentation A 39-year-old woman with a previous diagnosis of irritable bowel syndrome presented with progressively worsening episodes of marked abdominal distension and difficulties with defecation. She had a long history of constipation and had tried a variety of laxatives with an unsatisfactory response. Recent colonoscopy was unremarkable. Physical exam revealed a protuberant abdomen with tympany and high-pitched bowel sounds. Inspection of the anus showed no perianal lesions and absent perineal descent with straining at defecation. A digital rectal examination revealed high anal sphincter tone and absence of puborectalis relaxation with simulated defecation. There was no palpable stool in the rectum. Computed tomographic enterography with scout film showed a markedly dilated ...

Performance measures in three rounds of the English bowel cancer screening pilot

Gut — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions Performance measures are commensurate with expectations in a screening programme reaching its third round of screening, but a substantial ongoing effort is needed, particularly to address the effects of deprivation and ethnicity in relation to uptake. (Source: Gut)

Participation in colorectal cancer screening trials after first-time invitation: a systematic review

Endoscopy — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: Knowledge of identified factors affecting CRC screening participation can be used to improve screening programs.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Endoscopy)

Nitrous oxide for analgesia in colonoscopy without sedation

Gastrointestinal Endoscopy — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: Nitrous oxide given intermittently is not an effective substitution for intravenous on-demand sedation and analgesics in the setting of colonoscopy without sedation. (Clinical trial registration number: NCT00318825.) (Source: Gastrointestinal Endoscopy)

Endoscopic management of colonoscopic perforations (with videos)

Gastrointestinal Endoscopy — Thu, 01 Dec 2011 05:00:00 +0100

Colonoscopic perforation is a potentially life-threatening complication. Visual recognition of perforation or sites that are high risk to perforate at the time of the colonoscopy and its immediate closure offer the best potential for preventing any sequelae and for reducing its morbidity and mortality. Significant progress in endoscopic closure has been made since its first report by Yoshikane et al over a decade ago. Herein, we summarize the literature on the prevalence, mechanisms, and diagnosis of perforations; review the results of experimental and clinical studies; and offer practical tips on the endoscopic closure of colonoscopic perforations (). (Source: Gastrointestinal Endoscopy)

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Pneumatosis intestinalis after colonoscopy in a crohn's disease patient with mucosal healing

Inflammatory Bowel Diseases — Thu, 01 Dec 2011 05:00:00 +0100

(Source: Inflammatory Bowel Diseases)

Basal ganglia hyperintensity on T1‐weighted MRI in rendu–osler–weber disease

Journal of Magnetic Resonance Imaging — Tue, 29 Nov 2011 05:00:00 +0100

AbstractThe purpose of this study was to evaluate possible central nervous system (CNS) involvement in Rendu–Osler–Weber (ROW) disease in magnetic resonance imaging (MRI). Three patients with symptomatic ROW disease underwent brain MRI. Brain MRI depicted in all three of them increased signal intensity on T1‐weighted images involving the globus pallidus and cerebral crura bilaterally. Laboratory studies of the two men showed iron deficiency anemia, while all three of them had normal liver function tests and increased manganese blood concentration. Gastroscopy and colonoscopy revealed a gastric and a cecal arteriovenous malformation (AVM) in the first one, while pulmonary and hepatic computed tomography (CT) angiography did not detect any intrahepatic shunts. Liver ultrasound in the s...

Gastrointestinal cancer: A new dawn for CT scans in colon screening?

Nature Clinical Practice Oncology — Tue, 29 Nov 2011 05:00:00 +0100

Nature Reviews Clinical Oncology 9, 3 (2012). doi:10.1038/nrclinonc.2011.189 Author: Rebecca Kirk It is well established that screening for colorectal cancer is of paramount importance in the race to detect a malignancy while there is time for effective treatment. What is less clear is whether novel techniques can be used to supplement or replace colonoscopy. Investigators have (Source: Nature Clinical Practice Oncology)

Glycated hemoglobin A1c is superior to fasting plasma glucose as an independent risk factor for colorectal neoplasia

Cancer Causes and Control — Mon, 28 Nov 2011 16:59:07 +0100

Conclusion HbA1c as compared with fasting plasma glucose is more strongly and independently associated with colorectal neoplasia. Further research is warranted to elucidate the value of HbA1c in stratifying risk of colorectal cancer. Content Type Journal ArticleCategory Original paperPages 1-8DOI 10.1007/s10552-011-9880-yAuthors Yao-Chun Hsu, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanHan-Mo Chiu, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, 7, Chung-Shan S. Rd., Taipei 100, TaiwanJyh-Ming Liou, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, 7, Chung-Shan S. Rd., Taipei 100, TaiwanChun...

Colonoscopy‐associated perforation: a 7‐year survey of in‐hospital frequency, treatment and outcome in a German university hospital

Colorectal Disease — Mon, 28 Nov 2011 05:00:00 +0100

Conclusion: Death from perforation after colonoscopy is rare occurring in 1/3500 examinations.. The risk is increased in therapeutic colonoscopy and in the presence of previous gastrointestginal disease. Dilatation, SMR and APC appeared to confer higher risk of perforation than polypectomy or diagnostic colonoscopy. (Source: Colorectal Disease)

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Safety of cold polypectomy for

Endoscopy — Mon, 28 Nov 2011 05:00:00 +0100

Conclusions: The results from this study showed the high safety of a cold polypectomy approach for subcentimetric polyps. This was due to the low rate of postpolypectomy bleeding and to the high efficacy of endoscopic hemostasis in its treatment. The high rate of advanced neoplasia in polyps ≤ 5 mm should prompt some caution on the management of these lesions following detection at computed tomography colonography or colon capsule endoscopy.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Endoscopy)

Pneumatosis cystoides intestinalis.

World Journal of Gastroenterology — Mon, 28 Nov 2011 05:00:00 +0100

Authors: Azzaroli F, Turco L, Ceroni L, Galloni SS, Buonfiglioli F, Calvanese C, Mazzella G Abstract Pneumatosis cystoides intestinalis (PCI) is a rare condition that may be associated with a variety of diseases. The presenting clinical picture may be very heterogeneous and represent a challenge for the clinician. In the present paper we describe both a common and an uncommon clinical presentation of PCI and review the pertaining literature. Our cases confirm that, apart from asymptomatic cases, the clinical presentation of PCI may be widely different and suggest that a new onset of stipsis might be the presenting symptom. Diagnosis might be suggested by a simple X-ray of the digestive tract showing a change in the characteristics of the intestinal wall in two-thirds of these patie...

A randomized controlled trial evaluating a new 2-L PEG solution plus ascorbic acid vs 4-L PEG for bowel cleansing prior to colonoscopy

Digestive and Liver Disease — Mon, 28 Nov 2011 05:00:00 +0100

Conclusions: 2-L PEG+ascorbic acid, completed with an additional L of clear fluids, provided bowel cleansing which appeared to be more effective and acceptable than 4-L PEG. (Source: Digestive and Liver Disease)

AGA Standards for Gastroenterologists for Performing and Interpreting Diagnostic Computed Tomography Colonography: 2011 Update

Gastroenterology — Fri, 25 Nov 2011 09:23:55 +0100

Although multiple medical professional societies, governmental agencies, and third-party payers recommend colorectal cancer (CRC) screening for adults at average or increased risk for CRC, screening rates for these populations continue to lag behind those of other malignancies. There are multiple reasons why population-wide CRC screening compliance remains “low” (near 50%–55%), and chief among them is the inconvenient, invasive, and/or uncomfortable nature of commonly used screening tests such as fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy. In response, CRC screening technologies are constantly being developed and evaluated. (Source: Gastroenterology)

Acupuncture and a gluten-free diet relieve urticaria and eczema in a case of undiagnosed dermatitis herpetiformis and atypical or extraintestinal celiac disease: a case report

Journal of Chiropractic Medicine — Fri, 25 Nov 2011 03:17:44 +0100

Conclusion: Acupuncture and diet changes appeared to provide relief from the urticaria and eczema of dermatitis herpetiformis beyond that obtained by traditional treatment of a GFD alone. (Source: Journal of Chiropractic Medicine)

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Meta‐analysis: the relative efficacy of oral bowel preparations for colonoscopy 1985–2010

Alimentary Pharmacology and Therapeutics — Thu, 24 Nov 2011 05:00:00 +0100

Conclusions Although there is no compelling evidence favouring either of the two most commonly used bowel preparation regimens, this may reflect shortcomings in study design. Where studies have ensured comparable dosage, or the clinically relevant outcome of proximal bowel clearance is considered, PEG‐based regimens offer the most effective option. (Source: Alimentary Pharmacology and Therapeutics)

A randomized double-blind placebo-controlled trial to evaluate the value of a single bolus intravenous alfentanil in CT colonography

BMC Gastroenterology — Wed, 23 Nov 2011 05:00:00 +0100

This study will provide evidence whether a single bolus intravenous alfentanil gives a clinically relevant reduction in maximum pain during CT colonography.Trial registrationDutch trial register: NTR2902This trial will be conducted in accordance with the protocol and in compliance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989) and Good Clinical Practice (GCP). The department of radiology of the Academic Medical Center of Amsterdam is responsible for the design and conduct of the trial. (Source: BMC Gastroenterology)

Perception of Colonoscopy Benefits: A Gap in Patient Knowledge?

Journal of Community Health — Tue, 22 Nov 2011 17:59:45 +0100

Abstract Our study aimed to determine, for patients who had undergone recent colonoscopy, associations between specific colonoscopy patient characteristics, exam characteristics and patients’ perception of colonoscopy reducing their risk of dying from colorectal cancer. A cross-sectional analysis was conducted using data (2004–2008) from the New Hampshire Colonoscopy Registry, consisting of a Self-report Questionnaire, Colonoscopy Report form, and a Follow-up Questionnaire, which measured agreement responses to the statement, “Having a colonoscopy decreased my chances of dying from colon cancer”. Chi-square tests and logistic regression were used to assess differences in patient responses by patient and colonoscopy characteristics. A majority of patients (N =&n...

Racial, Gender Gaps In Use Of Colonoscopy Erased By Colon Cancer Screening Campaign

Health News from Medical News Today — Tue, 22 Nov 2011 08:00:00 +0100

Since the 1970s, U.S. mortality rates due to colorectal cancer have declined overall, yet among blacks and Hispanics, the death rates rose. Evidence suggests that underuse of colonoscopy screening among these groups is one reason for the large disparities. In 2003, New York City launched a multifaceted campaign to improve colonoscopy rates among racial and ethnic minorities and women. A new study conducted by researchers at Columbia University's Mailman School of Public Health and the NYC Department of Health and Mental Hygiene demonstrates the notable success of the campaign... (Source: Health News from Medical News Today)