ABSTRACT
Abstract Background and study aim: The term non-specific colitis refers to an inflammatory condition of the colon that microscopically lacks the characteristic features of any specific form of colitis and is commonly seen in pathology reports of colonoscopy biopsies. In fact, it has been questioned whether it is a separate pathological entity or it is merely an intermediate stage in the course of inflammatory bowel disease. This study was conducted to estimate the prevalence of non-specific colitis among patients with colitis and characterize its natural history over a 6 months year period. Patients and methods: Eighty adult patients presented for colonoscopy were enrolled. In the final analysis they were divided into Group A; the non-specific colitis Group and Group B; the inflammatory bowel disease Group. All patients were subjected to: full history taking, full clinical examination, laboratory investigations: which included stool analysis, CRP, ESR, complete colonoscopy and entire random colon biopsies for histopathological examination. Results: Group A included 67 patients (83.75%) while Group B included 13 (16.25%) patients. Patients with IBD had clinical and laboratory features of inflammation significantly higher than patients with non-specific colitis. Six patients (8.95%) of non-specific colitis group developed histologic features of florid inflammatory bowel disease after 6 months. There were no independent predictors of this conversion. Conclusion: Among our 80 patients with colonoscopy and biopsy 67 (83.75%) were diagnosed as non-specific colitis and out of them 6 patients (8.95%) were reexamined after 6 months and proved to have inflammtory bowel disese this change was not linked to predictive factors.
Resumo Introdução e objetivos: O termo colite inespecífica (CI) refere-se a uma condição inflamatória do cólon que microscopicamente não apresenta características de qualquer forma específica de colite; é comumente observada em relatórios patológicos de biópsias de colonoscopia. De fato, tem-se questionado se esta seria uma entidade patológica separada ou apenas um estágio intermediário no curso da DII. Este estudo foi realizado para estimar a prevalência de CI entre pacientes com colite e caracterizar seu curso durante um período de seis meses. Pacientes e métodos: O estudo incluiu 80 pacientes adultos que se apresentaram para colonoscopia. Na análise, os pacientes foram divididos em dois grupos: grupo A (CI) e grupo B (DII) Todos os pacientes foram submetidos a anamnese completa, exame clínico completo e investigações laboratoriais que incluíram análise de fezes, PCR, VHS, colonoscopia completa e biópsias aleatórias de cólon para exame histopatológico. Resultados: Do total de pacientes, 67 foram alocados no grupo A (83,75%) e 13 (16,25%) no grupo B. Os pacientes com DII apresentavam sinais clínicos e laboratoriais de inflamação significativamente maiores do que o observado em pacientes com CI. Seis pacientes (8,95%) do grupo CI desenvolveram características histológicas de DII florida após seis meses. Não foram identificados preditores independentes para essa conversão. Conclusão: Entre os 80 pacientes submetidos a colonoscopia e biópsia, o diagnóstico de CI foi feito em 67 (83,75%); destes, seis pacientes (8,95%) foram reexaminados após seis meses e apresentaram DII, sendo que essa conversão não foi associada a fatores preditivos.
Subject(s)
Humans , Male , Female , Inflammatory Bowel Diseases , Colonoscopy , Colitis/diagnosis , Colitis/epidemiology , Inflammatory Bowel Diseases/diagnosis , Colitis , Colitis/pathologyABSTRACT
Objective To observe the clinical efficacy and safety ofZhilou Lotion combined with modified Sihuang Ointment in treatment of anal cryptitis.MethodsOne hundred patients with anal cryptitis were randomly divided into observation group and control group, with 50 cases in each group. The control group was given propylene dispersible tablets oral and topicalHuazhi embolism. The observation group received steaming and hip bath with Zhilou Lotion combined with modifiedSihuang Ointment topical external application treatment, 7 days as a course of treatment and 2 courses successive. The TCM syndrome scores of two groups were compared before and after treatment to evaluate the clinical efficacy. The remission time of symptoms, hospitalization time, recurrence rate in 6 months and adverse reactions were observed.Results After treatment, the TCM syndrome scores of two groups were improved (P<0.01), and the scores in the observation group was lower than those in the control group (P<0.01). The total effective rate was 96.0% (48/50) in the observation group, and 80.0% (40/50) in the control group, with statistical significance (P<0.01). The remission time of anal edema, anal dampness, anal pain and anal fall-swell in observation group was obviously shorter than that in the control group, with statistical significance (P<0.01). The average hospitalization time was (15.25±2.78) days in the observation group and (18.46±3.41) days in the control group, the difference was significant (P<0.01). In the observation group, the recurrence rate was 0, 0 and 2.0% in 2, 4, 6 months follow-up, while that was 4.0%, 12.0% and 16.0% in the control group, respectively. The recurrence rates of the control group in 4 months and 6 months were higher than those of the observation group (P<0.05). No significant adverse reactions occurred in the two groups.Conclusion Zhilou Lotion combined with modifiedSihuang Ointment has good clinical efficacy in treatment of anal cryptitis, with low recurrence rate and high safety.
ABSTRACT
Introduction: The diagnosis of ulcerative colitis is based on combination of clinical, endoscopic and pathological findings. However cases have been reported showing atypical endoscopic and histological features in ulcerative colitis. Hence the objective of this study was to determine the atypical features of new onset ulcerative colitis in adult population. Methods: A total 110 newly diagnosed cases of ulcerative colitis were enrolled in the study over a period of five years. The diagnosis of ulcerative colitis was made by correlating clinical, endoscopic and histological features. Biopsies from representative areas were processed routinely. Endoscopic and histological evaluation was carried out for atypical features. Results: Majority of the patients (75.4%) were between 21-50 years of age with male to female ratio of 2.2:1. A significant number of patients showed atypical endoscopic findings in the form of rectal sparing in 12 (10.9%) and skip lesions in 24 (21.8%) patients. Atypical features noted on histology included normal surface epithelium in 8 (7.3%), predominant polymorphs in 42 (38%), predominant eosinophils in 7 (6.3%), normal crypt architecture in 1 (0.9%) and well preserved goblet cells in 30 (28%) cases. Conclusion: A significant number of patients with new onset ulcerative colitis showed atypical pattern of disease endoscopically as well as histologically. Pathologists should be aware of these atypical findings in cases of ulcerative colitis so as to avoid misdiagnosis.