ABSTRACT
Inflammatory bowel disease is broadly classified into Crohn's disease and ulcerative colitis. The standard criteria to distinguish between the two is the manner of the involvement of the bowel, with the former showing classical skip lesions and the latter having continuous involvement of the colon, most commonly affecting the rectum. However, some cases exhibit overlapping features. Herein, we report a treated case of ulcerative colitis presenting with patchy involvement of the colon in the form of peculiar segmental filiform polyposis spanned abruptly by an intervening normal mucosa. The clinico-radiologically suspicion of carcinoma colon with Crohn's colitis was considered. The clinicians and pathologists must be aware of such atypical presentations and should not be misled to change the diagnosis from ulcerative colitis to Crohn's colitis on the post-treatment resection specimens or endoscopic biopsies solely in view of the patchy filiform polyposis (FP), which poses a drastic impact on the patient's management.
ABSTRACT
The human gut is home to a variety of microbes, including bacteria, viruses, fungi, eukaryotes, and archaea, which together form a complex structure. In general, the microbiota that colonizes the gastrointestinal (GI) tract plays a significant role in maintaining human health and has been implicated in the pathogenesis of a number of GI illnesses. The structural integrity and metabolic processes of the alimentary canal are physiologically influenced by the dynamic interactions between the gut and bacteria. GI dysbiosis is a result of an imbalance brought on by a decline in microbial diversity, the loss of helpful bacteria, and an increase in pathobionts. It is crucial to restoring the gut microbiota. In order to regain the eubiotic state of the microbial flora, varied methods are being researched and implemented. The use of probiotics is one strategy for re-establishing healthy gut flora. Probiotics are “living microorganisms” that improve the health of the host when provided in adequate quantities. There are two types of probiotics—bacteria and yeast-based. The review will look at and summarize the information for yeast-based Saccharomyces probiotics regarding their effectiveness and safety in treating a variety of patient diseases, particularly irritable bowel syndrome (IBS), antibiotic-associated diarrhea, and Heliobacter pylori (HpSA) infection. The only commercially accessible yeast probiotic, the Saccharomyces strain, which consists of Saccharomyces cerevisae (S. cerevisiae) and Saccharomyces boulardii (Sb), provides a number of benefits over bacterial probiotics. The significance of Sb as a potent biotherapeutic medication that may be utilized to prevent or treat a variety of GI disorders has been substantiated by several experimental studies and clinical trials.
ABSTRACT
Background and Aims: Liver biopsy may be considered in patients with hepatitis C virus (HCV) infection to assess the severity of liver injury and stage of fibrosis, thereby guiding therapeutic decisions. In addition, advanced stage also necessitates surveillance for hepatocellular carcinoma. The aim of this study was to assess whether transaminase (alanine transaminase [ALT]) levels and RNA titers correlate with the histological activity index (HAI) and fibrosis (F) stage in asymptomatic patients with incidentally detected HCV (IDHCV). Patients and Methods: Retrospective evaluation of liver biopsies was done in 113 patients with IDHCV, diagnosed during routine screening. Decision of liver biopsy was made on the basis of age, genotype, acceptable clinical, hematological, and biochemical profiles, and willingness of the patients to undergo treatment. Serum ALT levels, HCV RNA titers, and genotypes were correlated with HAI and F stage. Results: Genotyping was done in 77 of the 113 patients, of which genotype 3 was seen in 43 and genotype 1 in 25 patients. A higher fibrosis stage (Ishak's >F2) was noted in 23.8% of the biopsies. Serum ALT showed a significant correlation with the HAI score on liver biopsy (P = 0.01) but not with the stage of fibrosis (P = 0.52). HCV RNA titers did not reveal any correlation with HAI score or fibrosis stage. Conclusion: Serum transaminases and HCV RNA titers are poor predictors of disease severity and fibrosis. Since HCV shows a slow disease progression, higher stage may predict a worse prognosis irrespective of the low viral RNA load. Liver biopsy may help guide therapeutic decisions in IDHCV infection.
ABSTRACT
Non-steroidal anti-inflammatory drugs induced diaphragm like lesions are a rare cause of small intestinal obstruction. They occur most commonly in elderly patients who have been consuming these drugs for prolonged periods for pain relief. We report the first case of ileal diaphragm disease from Asia. She responded well to localised resection of the diseased ileum. Intra-operative enteroscopy may be helpful in deciding the extent of intestinal resection.