Monday, November 14, 2016

General Health: Diverticulitis - The Diseases associated with Diverticulitis

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

                 
                       Diverticulitis

 Diverticulitis is defined as a condition of inflammation of the small, bulging sacs or pouches of the inner lining of the intestine that bulge outward through weak spots as a result of small pieces of stool (feces) trapped in these pouches. In most cases, the disease is found in the large intestine (colon). According to the statistic, approximately, About 10 percent of Americans older than 40 have diverticulitis.

                              The Diseases associated with Diverticulitis

 In the examination of the data fom January 2004 to June 2005 of 796 consecutive patients referred for total colonoscopy to 17 physicians included age, gender, presence and localization of diverticula. This population was compared with a cohort of 133 consecutive patients who were admitted for colonic diverticular bleeding, showed that the prevalence of colonic diverticula increased from less than 10% in adults under 40 to about 75% in those over 75 years. Of these patients, nearly one third presented with right-sided involvement(1).

1. Stenosis
The incidence of colonic diverticulosis with or without diverticulitis has increased in the Japanese population due to the modernization of food and aging. The rate of diverticulitis in colon diverticulosis ranges from 8.1% to 9.6%. However, few cases of stenosis due to diverticulitis have been reported(26).

2. Advanced colonic neoplasia
According to the study of 1,326 patients-56% male (n=741), 44% female (n=585), mean age 64 (+/-11.83 SD)-with a resection due to colonic cancer, the documented findings of colonoscopy, colonic contrast enema, and/or histopathology were analysed with regard to the prevalence of colonic diverticulosisby, showed that the diverticulitis group revealed a statistically significant decreased rate of advanced colonic neoplastic lesion in nearly all age categories and all age-stratified analyses (corresponding OR 0.13-0.43)(27).

3. Obesity
There is an association between diverticular disease and obesity exists, there is no evidence suggesting that obese patients should be managed any differently from the non-obese(28).

4. Bacteremia
There is a report of two cases of bacteraemia with the anaerobic bacterium Ruminococcus gnavus. In both cases the bacteraemia was associated with diverticular disease. Preliminary conventional identification suggested peptostreptococci and MALDI-TOF analysis did not produce scores high enough for species identification. Finally the bacteria were identified with 16S rRNA gene sequencing(29).

5. Segmental colitis
Diverticular disease-associated segmental colitis is a unique variant of chronic colitis limited to segments of the left colon that harbor diverticula, according to the study by the University of Arkansas for Medical Sciences(30).

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General Health: Diverticulitis - The Complications

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

                 
                       Diverticulitis

 Diverticulitis is defined as a condition of inflammation of the small, bulging sacs or pouches of the inner lining of the intestine that bulge outward through weak spots as a result of small pieces of stool (feces) trapped in these pouches. In most cases, the disease is found in the large intestine (colon). According to the statistic, approximately, About 10 percent of Americans older than 40 have diverticulitis.

                               The Complications

 In the examination of the data fom January 2004 to June 2005 of 796 consecutive patients referred for total colonoscopy to 17 physicians included age, gender, presence and localization of diverticula. This population was compared with a cohort of 133 consecutive patients who were admitted for colonic diverticular bleeding, showed that the prevalence of colonic diverticula increased from less than 10% in adults under 40 to about 75% in those over 75 years. Of these patients, nearly one third presented with right-sided involvement(1).

Diverticulosis and its complications, particularly diverticulitis, are extremely common in western countries. The major factor in the development of diverticulosis is a lack of adequate fiber intake. Diverticulitis may be complicated by abscess formation, fistula formation, peritonitis, or obstruction(19).
Other study indicated that diverticular disease is a common problem in the western population and sometimes leads to serious complications such as hemorrhage, bowel stenosis, obstruction, abscesses, fistulae, bowel perforation, and peritonitis. The severity of these complications can differ, and it is not always clear which procedure is indicated in each case and what measures should be followed before bringing the patient into the operating room(19a).

1. Bowel obstruction
there is a report of a neonate who presented with acute intestinal obstruction secondary to a large, mobile Meckel’s diverticulum which due to a direct compression effect on the adjacent small bowel caused mechanical intestinal obstruction(20). Other study reported the clinical case of a 65-year-old female patient with a diagnosis on hospital admittance of acute appendicitis and a intraoperative finding of diverticular disease of the small intestine, accompanied by complications such as intestinal perforation, bleeding and abdominal sepsis(21).

2. Peritonitis
Peritonitis is defined as an inflammation of the peritoneum, the thin tissue that lines the inner
wall of the abdomen covering most of the abdominal organs. According to the study of Thirty-eight patients (3.7%) were pathologically diagnosed with acute appendiceal diverticulitis among 1,029 cases of appendectomy. The mean age of patients in the diverticulitis group was significantly older than that of the appendicitis group (49.0 ± 15.2 years vs. 25.4 ± 14.2 years, P < 0.05). Mean duration of preoperative symptoms was longer in the diverticulitis group (3.6 ± 3.8 days vs. 1.8 ± 3.2 days, P < 0.05). The site of abdominal pain, fever, signs of localized peritonitis, accompanying gastrointestinal symptoms, and white blood cell count showed no differences between the two groupsby(22).

3. Abscess
According to the study by Westfälischen Wilhelms Universität, Münster, Normally colonic diverticulitis presents itself clinically with symptoms. Pyogenic liver abscess was the primary finding of a concealed perforation of sigma colon diverticulitis(23).

4. Fistula
Colouterine fistula is an extremely rare condition because the uterus is a thick, muscular organ. There is a report of an 81-year-old woman was referred to the emergency department with abdominal pain and vaginal discharge. Computed tomography showed a myometrial abscess cavity in the uterus adherent to the thick sigmoid wall. Upon contrast injection via the cervical os for fistulography, we observed spillage of the contrast into the sigmoid colon via the uterine fundus(24).

5. Bleeding
Colonic diverticular bleeding cases account for 30-40% of the lower gastrointestinal bleeding, among which, 3-5% appear to be massive bleeding, according to the study by Seoul National University Bundang Hospital(25).

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Saturday, November 12, 2016

General Health: Diverticulitis - The Causes and Risk Factors

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

                 
                       Diverticulitis

 Diverticulitis is defined as a condition of inflammation of the small, bulging sacs or pouches of the inner lining of the intestine that bulge outward through weak spots as a result of small pieces of stool (feces) trapped in these pouches. In most cases, the disease is found in the large intestine (colon). According to the statistic, approximately, About 10 percent of Americans older than 40 have diverticulitis.

                               The Causes and Risk Factors
In the examination of the data fom January 2004 to June 2005 of 796 consecutive patients referred for total colonoscopy to 17 physicians included age, gender, presence and localization of diverticula. This population was compared with a cohort of 133 consecutive patients who were admitted for colonic diverticular bleeding, showed that the prevalence of colonic diverticula increased from less than 10% in adults under 40 to about 75% in those over 75 years. Of these patients, nearly one third presented with right-sided involvement(1).

A. Causes
Accoutring to the study by Dr. Ryan P, in the study in Changing concepts in diverticular disease, Conventionally, acquired diverticular disease of the colon has been regarded as a single entity, so far as complications go. Experience at St. Vincent’s Hospital, Melbourne, suggests that there are two kinds of diverticular disease, one with the classic muscle abnormality, chiefly confined to the left colon and characterized by inflammatory and perforative complications and the other without muscle abnormality, but with diverticula throughout the colon, in which bleeding is common, perhaps due to a connective-tissue abnormality which, on the one hand, allows development of diverticula in the absence of abnormal intraluminal pressure and, on the other, provides inadequate support for vessels in the diverticular wall or for vascular malformations, which are therefore likely to bleed(11).
Others, according to the srticle by C-health, It’s believed that most diverticula are caused by unnoticed muscle spasms, or by pairs of muscles that don’t contract in a synchronized manner. This puts brief but intense pressure on the mucosal layer, causing pressure at the weakest points. The weakest points are the areas around blood vessels that pass through the inside of the wall of the large intestine (also called the colon). Older people have frailer tissue lining the bowel – this is probably why they have more diverticula(12).

B. Risk factors
1. Deficiency of dietary fiber diet, obesity and red meat intake
Deficiency of dietary fiber diet such as American typical diet, obesity and red meat intake are associated to increased risk of diverticolosis(13).

2. Smoking
Although the finding in inconsistence, but researchers suggested that smokers are at increased risk for complications, particularly perforation(14).

3. Alcohol
Alcohol may increase the risk of asymptomatic diverticulosis and diverticulitis(15).

4. Physical inactive and over weight
In the study to investigate the association between obesity and physical inactivity and diverticular disease in a population-based cohort of women, conducted by the Danderyd University Hospital, The National Institute of Environmental Medicine, showed that Overweight, obesity, and physical inactivity among women increase diverticular disease requiring hospitalization(16).

5. Age and race
The disease prevalence is largely age-dependent: the disease is uncommon in those under the age of 40, the prevalence of which is estimated at approximately 5%; this increases to 65% in those > or =65 years of age. Of patients with diverticula, 80-85% remain asymptomatic, while, for unknown reasons, only three-fourths of the remaining 15-20% of patients develop symptomatic diverticular disease, according to the study by University of Parma, Parma(17). Other study indicated that in Western countries diverticular disease predominantly affects the left colon, its prevalence increases with age and its causation has been linked to a low dietary fibre intake. Right-sided diverticular disease is more commonly seen in Asian populations and affects younger patients(18).

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Friday, November 11, 2016

General Health: Diverticulitis - The Symptoms

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

                 
                       Diverticulitis

 Diverticulitis is defined as a condition of inflammation of the small, bulging sacs or pouches of the inner lining of the intestine that bulge outward through weak spots as a result of small pieces of stool (feces) trapped in these pouches. In most cases, the disease is found in the large intestine (colon). According to the statistic, approximately, About 10 percent of Americans older than 40 have diverticulitis.

                               The Symptoms
In the examination of the data fom January 2004 to June 2005 of 796 consecutive patients referred for total colonoscopy to 17 physicians included age, gender, presence and localization of diverticula. This population was compared with a cohort of 133 consecutive patients who were admitted for colonic diverticular bleeding, showed that the prevalence of colonic diverticula increased from less than 10% in adults under 40 to about 75% in those over 75 years. Of these patients, nearly one third presented with right-sided involvement(1).

Most people with diverticulitis are experience no symptoms, but in some bloating and cramping in the lower part of the belly. Although, it is rarely, but some may notice blood in their stool or on toilet paper, as right-sided localization was associated with a significant risk of bleeding independent of the patients’ age, accordingto the study by University Hospital, Grenoble, France(1).
1. Tenderness
Symptom of tenderness in some cases is resemble to acute appendicitis. According to the study by the Erciyes University Medical Faculty, Department of Radiology, there is a report of 2 case of right-sided diverticulitis that presented with marked right iliac fossa tenderness with guarding and rebound and laboratory parameters resembling acute appendicitis. The imaging findings suggested diverticulitis in both cases(6).

2. Abdominal discomfort, bloating, and altered bowel habit
Patients with diverticular disease may experience a variety of chronic symptoms, including abdominal discomfort, bloating, and altered bowel habit, according to the McMaster University(7).

3. Abdominal pain, fever and chills, melena, vomiting
In the study to determine the management guidelines for symptomatic duodenal diverticulum, by reviewing medical records of 26 patients.with the Complicated duodenal diverticulum was the only possible cause of symptoms-abdominal pain, fever and chills, melena, vomiting-in 18 patients(8).

4. Painful constipation, painful abdominal distension, abdominal cramps, and frequent painful diarrhea
Others after elective sigmoid resection for diverticulitis, according to the study by University of Bern, the persistent symptoms, including painful constipation, painful abdominal distension, abdominal cramps, and frequent painful diarrhea((9).

5. Processed foods
Other in the study of suggested that factors previously uncommon in the area may now be operating to cause the disease in the population, and the highly processed food products of the supermarkets may be an important contributor to the development of this new disease entity(10).

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Thursday, November 10, 2016

General Health: Duodenitis Treatment In Traditional Chinese medicine perspective

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

                 
                       Duodenitis

 Duodenitis is defined as a condition of inflammation in the lining of the duodenum,the first section of the small intestine.

      Treatment In Traditional Chinese medicine perspective
According to the article of Herbs and Foods to Help Cure Naturally by NFA clinic of Oriental Medicine, epigastric pain including peptic ulcers is mostly the result of metabolic imbalance among liver, stomach and spleen. The function of one organ is depending on the function of another organs in Oriental medicine. They are understood not only by its function but also by its relationship with others. The article also suggested that Lu Hui, Yi Tang are ideal herbs to treat peptic ulcers
1. Lu Hui (Aloe Vera), the bitter and cold herb has been used in TCM to drain fire and guides out accumulation: for (chronic) constipation, strengthens the Stomach and kills parasites, clears heat and cools the Liver: for epigastric discomfort, enhancinmg the functions of Large Intestine, Liver, Stomach channels. Cautions: due to its cold property, dosage should be made considering the constitution of each patients. Some persons show allergy reaction to aloe vera

2. Yi tang (Honey), the sweet, slightly warm herb has been sued in TCM to tonifie the Spleen, the middle burner Qi (stomach and spleen), alleviate pain, moisten the Lungs and stops cough by enhancing the functions of Lung, Spleen, Stomach channels.

3. Gan Cao (Licorice) the sweet and neutral herb has been used in TCM to tonifie the Spleen, moisten the Lungs, stop coughing, clear heat and relieves fire toxicity, moderates spasms and alleviates pain, by enhancing the functions of all 12 channels(43).
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General Health: Duodenitis Treatment In Herbal medicine perspective

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

                 
                       Duodenitis

 Duodenitis is defined as a condition of inflammation in the lining of the duodenum,the first section of the small intestine.

                               Treatment In Herbal medicine perspective
1. Herbal combination of Symphitum officinalis and Calendula officinalis
In a study of a total of 170 patients were treated--137 only with the herb combination of Symphitum officinalis and Calendula officinalis of (78 with duodenal ulcer and 59 with gastroduodenitis), 33--with the herb combination together with antacid (21 with duodenal ulcer and 12 with gastroduodenitis), Dr. Chakŭrski I and the team found that the spontaneous pains disappeared in 90 per cent of the patients--in the group with and in the group without antacid, the dyspeptic complaints faded in over 85 per cent but in the patients, treated withherbs and antacid the mentioned complaints disappeared several days earlier. The palpitation pains, in both groups, disappeared in more than 90 per cent of the patients within the same time. Gastric acidity, in both groups, showed a statistically insignificant tendency to decrease prior and post treatment. The gastroscopically control revealed that the ulcer niche, in both groups, was healed in almost the same percentage of the patients(42)

2. Suggested Starting Formula(43)
Aloe vera juice 70 wt%
Cabbage juice 20 wt%
Honey 10 wt%
Dosage: 3 times a day before meal 
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Wednesday, November 9, 2016

General Health: Duodenitis Treatment In conventional medicine perspective

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

                 
                       Duodenitis

 Duodenitis is defined as a condition of inflammation in the lining of the duodenum,the first section of the small intestine.

                               Treatment In conventional medicine perspective
A.1. Antibiotics
If the causes of the disease is as a result of bacterial infection, then antibiotic is the primary choice of treatment such as, Amoxicillin, Clarithromycin (Biaxin), Metronidazole (Flagyl), etc. for 14 days to prevent re-infection or recurrence. In the study to assess the duodenal infection by Mycobacterium avium-intracellulare is a common opportunistic disease in HIV-infected patients (Individuals with CD4 counts <50 cells/mm3 are at highest risk) found that the patient was treated with rifampicine, isoniazide, ethambutol, and pyrazinamide in association with stavudine, lamuvidine and efavirenz. Despite improvement of general condition, fever persisted and the patient died after 40 days of treatment. The main symptoms are diarrhea, abdominal pain, weight loss, and fever(41a).
Other in the study of the prevalence of Helicobacter pylori infection in patients with erosive duodenitis (ED), the associated gastric histological lesions and their response to eradication therapy with omeprazole plus two antibiotics, showed that a 1-week twice daily therapy with omeprazole plus two antibiotics (clarithromycin plus amoxycillin or metronidazole) was very effective in H. pylori eradication, duodenal erosion healing, symptomatic improvement, and in disappearance of associated histological gastritis. These observations suggest that ED should be considered a variant form of duodenal ulcer disease and treated accordingly(41b).
Side effects include yeast overgrowth, gastrointestinal trouble, etc.

A.2. Of the causes of the disease is as a result of elevated stomach acid, then medication include
1. Proton pump inhibitors
According to the study by Uniwersytet Mikołaja Kopernika w Toruniu, Collegium Medicum w Bydgoszczy, Proton pump inhibitors (PPI), are characterized by high effectiveness, selectivity and few adverse events. Development of PPI was an important issue in aspect of acid-related diseases treatment. Nowadays following PPI are available on the market: omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole. In children these drugs are the most frequently use in gastritis and duodenitis, ulcer disease with coexistence of Helicobacter pylori infection and gastroesophageal reflux disease. Pharmacokinetics of PPI is slightly different in children than in adults and so far there is a lack of randomised studies assessing the efficacy of PPI i developmental period medicine on numerous groups of patients(41c).
Side effects include nausea, diarrhea, abdominal pain, fatigue, dizziness, etc.

2. Histamine H2-receptor antagonists
Histamine H2-receptor antagonists, such as, Cimetidine (Tagamet), Famotidine (Pepcid), Nizatidine (Axid), etc.
According to the study by Dr. Mackinnon M and research team, treatment with cimetidine for 6 weeks resulted in a significant improvement in symptoms and in the endoscopic appearance of the duodenitis when compared to treatment with placebo. The symptomatic and endoscopic improvement, however, was not associated with any significant change in the histological grading of the duodenitis.
Side effects include headache, tiredness, dizziness, confusion, diarrhea, constipation, rash, etc(41d).

According to the Department of Family Medicine, Cathay General Hospital, Taipei, Taiwan, in the study of all the patients aged ≥ 20 years with a diagnosis of cirrhosis hospitalized for variceal bleeding and non-variceal upper GI adverse events (oesophageal, gastric, duodenal ulcer, bleeding; gastritis and duodenitis) in 2006, using ICD-9-CM diagnosis codes from inpatient claims from the Taiwan National Health Insurance Database, found that Concomitant use of proton pump inhibitors and histamine-2 receptor antagonists tended to decrease the upper GI toxicity associated with non-selective NSAIDs and celecoxib(41f).

3. Proton pump inhibitors and low-dose aspirin
In the study to investigate the effect of histamin H₂ receptor antagonist (H₂RA) orproton pump inhibitor (PPI) for the prevention of upper gastrointestinal lesions associated with low-dose aspirin, found that suggest that the combined administration of low-dose aspirin and PPI is effective for the prevention of upper gastrointestinal lesions associated with low-dose aspirin. Also, the pharmacists should be especially careful for upper gastrointestinal lesions development within two years after administration of low-dose aspirin, regardless of combined whether H₂RA or PPI(41e).


Sources
(41a) http://www.ncbi.nlm.nih.gov/pubmed/20099679
(41b) http://www.ncbi.nlm.nih.gov/pubmed/9391784
(41c) http://www.ncbi.nlm.nih.gov/pubmed/17598663
(41d) http://www.ncbi.nlm.nih.gov/pubmed/7042248
(41e) http://www.ncbi.nlm.nih.gov/pubmed/21372542
(41f) http://www.ncbi.nlm.nih.gov/pubmed/22226322
(42) http://www.ncbi.nlm.nih.gov/pubmed/7336704

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