A randomized controlled trial comparing a low-residue diet versus clear liquids for colonoscopy preparation: impact on tolerance, procedure time, and adenoma detection rate.

Objective: To achieve an excellent bowel preparation, it is routine to require a clear liquid diet on the day before the procedure. Unfortunately, this dietary modification may be poorly tolerated. We examine whether a change in precolonoscopy dietary restriction can lead to better patient tolerance without compromising examination quality.

Small-bowel imaging in Crohn's disease: a prospective, blinded, 4-way comparison trial.

Background: With the introduction of new techniques to image the small bowel, there remains uncertainty about their role for diagnosing Crohn's disease.

Objective: To assess the sensitivity and specificity of capsule endoscopy (CE), CT enterography (CTE), ileocolonoscopy, and small-bowel follow-through (SBFT) in the diagnosis of small bowel Crohn's disease.

Methods: Prospective, blinded trial.

Active Crohn disease: CT findings and interobserver agreement for enteric phase CT enterography.

Purpose: To retrospectively evaluate small-bowel enhancement characteristics and the sensitivity, specificity, and interobserver agreement of computed tomographic (CT) findings by using histologic and endoscopic results as a reference standard in patients undergoing enteric phase CT enterography.

Materials And Methods: The institutional review board approved this retrospective HIPAA-compliant study, which included patients who consented to having their medical records used for research purposes. Enteric phase CT enterographic and ileoscopic findings with or without ileal histologic results were examined in 42 patients (24 women, 18 men).

Crohn Disease: mural attenuation and thickness at contrast-enhanced CT Enterography--correlation with endoscopic and histologic findings of inflammation.

Purpose: To determine retrospectively if quantitative measures of small-bowel mural attenuation and thickness at computed tomographic (CT) enterography correlate with endoscopic and histologic findings of small-bowel inflammation and to estimate the performance of these measures in predicting inflammatory Crohn disease.

Materials And Methods: The institutional review board approved this HIPAA-compliant retrospective study, which was conducted with patient informed consent. CT enterography data in 96 patients (31 male patients and 65 female patients) who underwent ileoscopy with or without biopsy were examined for CT signs of active Crohn disease.

Correlation of C-reactive protein with clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease.

Introduction: We sought to examine the relationship between C-reactive protein (CRP) and clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease (IBD).

Methods: All IBD patients at our institution between January 2002 and August 2003 who had a CRP, colonoscopy, and either small bowel follow-through (SBFT) or CT enterography (CTE) performed within 14 days were identified. Clinical activity was assessed retrospectively through review of the medical record.

Chronic antral ulcer associated with gastroduodenal lymphocytic phlebitis.

Enterocolic lymphocytic phlebitis (ELP) is a rare cause of gastrointestinal ischemia. Unlike most vasculitic diseases affecting the gastrointestinal tract, ELP involves only the mural and mesenteric veins, which are surrounded by a lymphocytic and sometimes granulomatous infiltrate. The mesenteric arterial system and the systemic vasculature are characteristically spared.

Management of refractory inflammatory bowel disease.

One of the most challenging aspects of the management of inflammatory bowel disease is the high frequency of incomplete or absent response to medical therapy. Although many patients may be truly refractory to medical therapy, a lack of response may indicate several possibilities, including incorrect diagnosis, progression of disease extent, intestinal complication, superinfection, underdosing of therapy, monotherapy instead of combination therapy, or medication intolerance. This article provides a practical general approach to refractory inflammatory bowel disease patients encountered in clinical practice.

Small intestinal adenocarcinoma in Crohn's disease: a case-control study.

Background: Small bowel adenocarcinoma is an uncommon complication of Crohn's disease. We sought to describe the clinical features, outcomes, and risk factors of small bowel adenocarcinoma in Crohn's disease.

Methods: A centralized diagnostic index identified all patients with Crohn's disease with small bowel adenocarcinoma evaluated at our institution between 1976 and 2000, and the medical records were abstracted.

Venous thromboembolism in inflammatory bowel disease.

Objectives: Venous thromboembolism has been associated with inflammatory bowel disease (IBD). We sought to describe the clinical features, acquired and congenital risk factors, and outcomes of venous thromboembolism in IBD.

Methods: All patients with confirmed IBD and deep venous thrombosis (DVT) or pulmonary embolism (PE) at our institution between 1991 and 2000 were identified.

Fistulas to the urinary system in Crohn's disease: clinical features and outcomes.

Objectives: Most reports of fistulas to the urinary system in Crohn's disease are relatively small. We sought to describe the clinical features and outcomes of these patients.

Methods: A centralized diagnostic index identified all Crohn's disease patients with urinary tract fistulas who were evaluated at our institution between 1976 and 2000.