[The changing spectrum of lower gastrointestinal haemorrhages]. / Evolutia spectrului etiologic al hemoragiilor digestive inferioare (HDI).

UNLABELLED: Lower gastrointestinal haemorrhage (LGH) is a frequent reason for medical referral. It has an annual incidence ranging between 17 and 20.5 cases per 100,000 adults and represents 20-30% of all gastrointestinal haemorrhages. OBJECTIVE: To evaluate the evolution of the etiologic spectrum of lower gastrointestinal bleeding. METHODS: All the files of patients with lower gastrointestinal bleeding admitted in our unit between 1990 and 2001 were reviewed retrospectively. The annual admission and annual admission rates for each disease (disease/total LGH in a specific year) were analysed using linear regression. RESULTS: We identified 2565 patients with LGH (mean age 50.8+/-8.7 years, 1338 (52%) men and 1227 (48%) women). The annual number of patients had a linear increase (p<0.05) from 103 in 1990 to 399 in 2001. The mean age of the patients increased linearly from 48.5 to 53 years (p<0.05). The annual rate for some specific diseases has changed over time. There was a trend of increase for the colorectal cancer and polyps, which reach statistical significance for diverticular disease and haemorrhoids (p<0.05). While the annual incidence for ulcerative colitis remained constant the annual rates decrease. For Crohn disease, angiodysplasia and radiation colitis no changes was found.

[Functional digestive disorders and the relationship with psychiatric diseases]. / Afectiunile digestive functionale si relatia lor cu antecedentele psihiatrice.

UNLABELLED: Functional gastrointestinal disorders are frequent causes for medical consultations. Features related to disease, patient or the environment could influence the medical referral. The aim of the study was to estimate the importance of psychiatric disorders in patients with functional gastrointestinal disorders. MATERIAL AND METHOD: The study was designed to have two phases. Phase I consisted in studying the prevalence of Irritable Bowel Syndrome (IBS) and psychiatric past history in a random sample of 338 from an urban community of 18000 people. Phase II consisted in studying the presence of psychiatric history in patients referred for IBS symptoms. RESULTS: The prevalence of IBS symptoms in the general population was: 14.4% (8.4% in males and 17.7% in females). Psychiatric positive history was present in 6.2% of the general population and in 6.1% of IBS subjects (p > 0.05). Psychiatric disorders were more common in the IBS subjects who were seeking medical assistance (18%) than in subjects with same symptoms from the general population (6.2%) (p < 0.05). CONCLUSIONS: Psychiatric disorders may influence the medial referral for patients with IBS.

[Clinical and epidemiological aspects in patients with colorectal cancer]. / Aspecte clinice si epidemiologice la pacientii cu cancer colorectal.

UNLABELLED: The aim of this study was to evaluate the clinical factors of the patients with CCR histologically confirmed. PATIENTS AND METHODS: In the study group there were included 117 patients (females: 49-41%, males: 68-59%, range: 39-88 years) with CCR confirmed (rectosigmoidoscopy/colonoscopy + biopsy, X-ray) hospitalized in the Second Medical Clinic Gastroenterology during January 2000-May 2001. RESULTS: For 56 (47.86%) patients the principal sign was rectal bleeding, intestinal disorders (diarrhoea--constipation) in 24 (20.51%) patients, anemia in 19 (16.23%) patients and abdominal pain in 18 (15.38%) patients. The time interval between the onset and the diagnosis of CCR was 1 month up to 2.5 years. For 83 patients (71%) was possible surgical treatment and for 34 patients (29%) palliative method. CONCLUSIONS: At diagnosis the clinical data suggested a malignant disease for most of the patients. The delay of diagnosis was associated with advanced staging of the disease, with limiting therapeutic possibilities. Using the screening for CCR may give the possibility for a curative treatment.