ABSTRACT
Phlebosclerotic colitis is a rare form of intestinal ischemia. It is caused by calcified peripheral mesenteric veins and a thickened colonic wall. These characteristic findings can be identified on CT and colonoscopy. A 37-year-old female with a history of long-term herbal medicine use presented with acute lower abdominal pain and vomiting of sudden onset. Colonoscopic findings showed dark-blue discolored edematous mucosa and multiple ulcers from the ascending colon to the sigmoid colon. Abdominal CT findings showed diffuse thickening of the colonic wall and calcifications of the peripheral mesenteric veins from the ascending colon to the sigmoid colon. Based on these findings, the patient was diagnosed with phlebosclerotic colitis. We report this rare case of phlebosclerotic colitis in a healthy young female patient with a history of long-term herbal medicine use and include a review of the relevant literature.
ABSTRACT
Background/Aims@#Previous studies have reported an association between Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD). Our study examined whether eradication for H. pylori infection reduces the risk of incident NAFLD. @*Materials and Methods@#This retrospective cohort study examined 3,780 adults who had no NAFLD at baseline but were infected with H. pylori. The study population was followed from January 1995 until January 2020. H. pylori infection was determined by an H. pylori-specific IgG antibody test. Fatty liver was diagnosed by ultrasound. @*Results@#During a median follow-up of 7.9 years, 1,294 participants developed NAFLD. In a multivariable model adjusted for age, sex, BMI, smoking status, alcohol intake, and metabolic variables, the uneradicated (for H. pylori) group exhibited a higher risk of incident NAFLD than the eradicated group (hazard ratio [HR], 1.36; 95% CI, 1.18~1.56). The multivariable analysis also demonstrated that higher BMI, current smoking and several metabolic abnormalities were significant risk factors for NAFLD. Subgroup analyses revealed that persistent H. pylori infection correlated with an increased risk of NAFLD. H. pylori eradication was associated with a decreased risk of NAFLD development. @*Conclusions@#H. pylori infection may have a pathophysiological role in NAFLD development. Hence, successful eradication of H. pylori decreases the risk of incident NAFLD.
ABSTRACT
Colonoscopy is commonly used to screen for and diagnose colorectal disease, and adequate bowel preparation is crucial to its quality. As bowel preparation regimens vary, it is important that clinicians understand each and select the proper one for each patient.Accordingly, here we investigated recent studies and describe how to choose the optimal bowel preparation regimen. We detail composition, dosages, efficacy, contraindications, and precautions of commonly used regimens including 4 L polyethylene glycol (PEG), 2 L PEG+ascorbic acid, 1 L PEG+ascorbic acid, trisulfate (oral sulfate solution/ tablets), and sodium picosulfate/magnesium citrate. Here we describe that the most recently introduced 1 L PEG and oral sulfate tablets, which were developed to improve convenience and compliance, differ in composition and efficacy between South Korea and foreign countries. This review presents new evidence of and differences among products to increase clinician understanding.