Gastrocolic fistula presented as an early complication of gastric surgery in a 42-year-old man

Currently, surgery is less needed for the treatment of refractory peptic ulcer disease [PUD] or its complications. So, the complications of PUD surgery have been clearly declined. Here in, we present a 42-year-old man with chronic watery diarrhea and significant weight loss during 2 years after gastrojejunostomy for the treatment of obstructive PUD. Small bowel gastrointestinal series showed rapid transit without passage of contrast in the parts of small bowel. The patient was scheduled for exploratory laparotomy. During the surgery a large fistula was detected between the stomach and transverse colon, which was repaired. At the follow-up 6 months after the surgery, the patient did not have any history of recurrence of diarrhea and had 10 kg weight gain. Gastrocolic fistula is a very rare complication of surgical management of PUD. Barium enema is the most helpful imaging procedure for the diagnosis of gastrocolic fistula and surgery after correction of nutritional status is suggested especially for malnourished patients

[Assessment of quality of life in patients with irritable bowel syndrome: a cross-sectional study in south-east Iran]

Background: Improving life is the main goal of therapeutic interventions for chronic diseases. Although we needed to determine quality of life by various variables. This study aimed to determine quality of life in patients with Irritable Bowel Syndrome [IBS] in Kerman

Materials and Methods: This is a cross sectional study of 143 patients with IBS referred to a specialist, assessed by IBS-QOL.34. Data analyzed by descriptive statistics, Pearson correlation coefficients, t-test and ANOVA, using SPSS software. p.Value <0.05 was considered as statistically significant

Results: In this study from 143 samples, 82 were females [57.3%] and 61 males [42.7%]. Quality of life score in patients was 37.16 +/- 16.72, and there was significant difference in terms of employment and education level [p.value<0.05]

Conclusion: Among patients with IBS, quality of life is far from desired. Therefore, health care providers should consider psychosocial support alongside medical management for achieving better quality of life in these patients

Prevalence of helicobacter pylori-negative, non-steroidal anti-inflammatory drug related peptic ulcer disease in patients referred to afzalipour hospital

Although Helicobacter pylori and non-steroidal anti-inflammatory drugs [NSAIDs] are the main causes of peptic ulcers disease [PUD], recently the prevalence of idiopathic peptic ulcer [IPU] is increasing in most parts of the world. The aim of this study was to assess the prevalence of IPU in Kerman, the center of largest province in south-east Iran. We included 215 patients with peptic ulcer in our study. Combined methods rapid urease test [RUT], histology, and real time polymerase chain reaction [PCR] was performed on endoscopic samples of peptic ulcers. NSAID use was determined by medical history. SPSS software version 16 was used for data analysis, p value<0.05 was considered as statistically significant. Of 215 consecutive patients with peptic ulcer, four [1.8%] had H.pylori-negative and NSAID-negative PUD. There were not significant differences between patients with IPU and patients with peptic ulcer associated with H.pylori or NSAIDs regarding the sex, age, cigarette smoking, and opioid abuse. Our study showed that in contrast to other reports from western and some Asian countries, the prevalence of IPU is low in Kerman and H.pylori infection is still the major cause of PUD. We recommend a large and multi-central study to determine the prevalence of IPU in Iran

[ assessment prevalence of functional constipation and associated factors in adults: a community-based study from Kerman, Southeast, Iran [2011-2012]]

Chronic constipation is a common problem worldwide that negatively impacts quality of life. Because of the effects of psychological and cultural factors on the function of the bowel tract and the vast variety of ethnicities and diet among the Iranian people, the present study describes the occurrence of constipation and its associated factors in Kerman, the largest city in Southeast Iran. This was a cross-sectional study conducted in Kerman, Iran from 2011 to 2012 that included 2191 adults who were randomly selected and interviewed face to face using a validated questionnaire based on Rome III criteria. Demographics, cigarette smoking, opium dependence, amount of fiber consumption, physical activity and psychological factors were assessed. Inclusion criteria was ages 15 to 85 years old. Exclusion criteria was the presence of any metabolic and/or neuro-muscular disease that caused constipation. All data were analyzed with Stata11 software, with a confidence interval of 95%. A p-value of 0.2]. Although the prevalance of constipation in Iran is estimated to be lower than Western countries, new changes in life style can cause an increase in the burden of constipation in the future

incidence rate of inflammatory bowel disease in an urban area of Iran: a developing country

The incidence of inflammatory bowel disease [IBD] varies among different societies. The aim of this study is to determine the incidence rate of IBD in Kerman, a city in Southeast Iran. All medical records that indicated a new diagnosis of ulcerative colitis [UC] or Crohn's disease [CD] were retrieved from the gastrointestinal endoscopy and pathology departments of 12 centers from October 2011 to September 2012. The incidence rate of UC in Kerman was estimated at 4.98/100,000 [95% CI: 2.44-6.94]. The mean age of patients was 39.4 years and male to female ratio was 0.89:1.0. UC patients had the following prevalence: cigarette smoking [30%], appendectomy [36%] and oral contraceptive [OCP] use [78.9%]. The incidence rate of CD was 0.8/100,000 [95% CI: 0.6 4-1.14]. The mean age at diagnosis was 33.3 years and male to female ratio was 0.5:1.0. Cigarette smoking was reported in 33.3%, appendectomy in 66.6% and OCP useing in 75% of CD patients. Rectal and distal colitis, left side colitis and extensive colitis was seen in 20 [55.4%], 12 [33.3%] and 4 [11.1%] of patients with UC, respectively. All patients with CD had large intestinal involvement and one case [16.6%] had ileocolonic disease. Our study has shown that the incidence rate of both UC and CD in Kerman is lower than Western populations but it is the same as some Asian countries. Characteristics of disease involvement in this study are similar to other studies that have been conducted in Iran and elsewhere.

Blue Rubber Bleb Nevus Syndrome as a rare cause of iron deficiency anemia: a case report and review of literature

Blue Rubber Bleb Nevus Syndrome is a rare disorder that is characterized by multiple recurrent vascular malformations of skin and gastrointestinal tract. The affected patients may present with diverse manifestations including iron deficiency anemia. We report this syndrome in a 22-year-old man that was referred to our hospital for iron deficiency anemia with unknown cause and vascular malformations in the skin and gastrointestinal tract. Because of stable hemoglobin level, we decided to treatment him by iron supplementation and close follow up. We report this case along with a review of literature