ABSTRACT
Background: A dramatic rise in the rate of clostridium difficile infection [CDI] in patients with inflammatory bowel disease [IBD] has been reported in recent years
Methods: In this observational case control study, 65 patients were included and were divided into two groups of IBD+CDI as case group and IBD without CDI as control group
Results: 35 patients who had positive test for clostridium difficile were assigned to the case group. The control group consisted of 30 patients with negative test for clostridium difficile. Pancolitis was seen in the cases more statistically significant than the controls and proctitis was seen more among the controls than the cases [p =0.001]. The cases were on immunosuppressive [p=0.001] and antibiotic [p =0.02] therapy more than the controls. Colonoscopic findings revealed more severe and extensive inflammation among the cases versus milder inflammation among the controls, but these differences were not statistically significant [p =0.2]. Colectomy was seen in 10% of controls and none of the cases and this difference was statistically significant [p value=0.05]. More fecal calprotectin were seen among the cases than the controls and this difference was statistically significant [p <0.05]
Conclusion: This study showed more clostridium difficile infection among the patients on antibiotic or immunosuppressive therapy. Pathological investigation revealed more severe and extensive inflammation among the cases than the controls. Cases had clinically more severe signs and symptoms with higher mayo scores than the controls. ESR[erythrocyte sedimentation rate] and fecal calprotectin were higher in patients with positive clostridium difficile infection and serum albumin was lower in such patients
ABSTRACT
Upper gastrointestinal bleeding [UGIB] is a common medical condition that presents with hematemesis [vomiting of blood or coffee ground -like material] and/or melena [black, tarry stools]. Gastroduodenal ulcer disease, erosive esophagitis, esophagogastric varices, and erosive gastritis/duodenitis account for most of the cases. Ectopic varices are varices develop at sites other than the esophagus and stomach for example duodenal, rectal, and peristomal varices. Ectopic varices are relatively rare; however, approximately 5 percent are related to gastrointestinal bleeding. Duodenal variceal bleeding is a rare cause of gastrointestinal bleeding. Here we report a case of UGIB due to duodenal varices in a 44-year-old woman who admitted to the hospital because of melena, nausea, and vomiting from 3 weeks earlier. Two esophagogastroduodenoscopic examination and one colonoscopic examination were normal. Computed tomography [CT] of the abdomen revealed ectopic varices in the duodenum. Endoscopic cyanoacrylate was injected and bleeding was controlled. The patient did not experience rebleeding after one month
ABSTRACT
Background: In patients with cirrhosis use of proton pump inhibitors [PPIs) may increase the risk of infection including spontaneous bacterial peritonitis. Also, in some studies PPIs usage had significant relationship with the severity of cirrhosis and development of hepatocellular carcinoma. In recent studies the relationship between PPIs usage and hepatic encephalopathy had been considered. The aim of this study was to assess the relationship between PPIs and hepatic encephalopathy for investigating their effects in the treatment of patients with cirrhosis
Materials and Method: In this study, 61 patients with liver cirrhosis were evaluated. The patients were followed up in two groups: patients with hepatic encephalopathy and patients with other complications
Result: PPIs usage and also the type and dosage of these drugs were not statistically different between the two groups. The duration of PPIs usage in the patients with hepatic encephalopathy was 23+/-5.72 months and in the second group was 13.04+/-3.061 months [p=0.039)
Conclusion: In patients with cirrhosis, PPIs consumption for a long period, increases the risk of hepatic encephalopathy