Background: There is no established therapy for maintaining remission in patients with Crohn's disease. Following different suggestions from the literature, two potential interventions for maintaining remission were tested against placebo, using either 5 g/day of a highly concentrated omega-3 fatty acid compound or a carbohydrate-reduced diet (84 g/day).
Methods: A total of 204 patients were recruited after they had had an acute relapse.
Background And Aims: To evaluate the efficacy and safety of the topical corticosteroid budesonide, given in an oral controlled release formulation for maintenance of remission in patients with ileal and ileocaecal Crohn's disease (CD).
Patients And Methods: Out of 176 patients with active CD who had achieved remission (CD activity index score < or = 150) after 10 weeks' treatment with either budesonide or prednisolone, 90 were randomised to continue with once daily treatment of 6 mg budesonide, or 3 mg budesonide or placebo for up to 12 months in a double blind, multicentre trial. Time to symptomatic relapse was calculated using Kaplan-Meier estimates.
N Engl J Med
September 1994
Background: Patients with active Crohn's disease are often treated with corticosteroids, but the treatment has many side effects. Budesonide is a potent, well-absorbed corticosteroid, but because of a high rate of first-pass metabolism in the liver, its systemic bioavailability is low.
Methods: We conducted a randomized, double-blind, 10-week trial comparing the efficacy and safety of an oral controlled-release form of budesonide with the efficacy and safety of prednisolone in 176 patients with active ileal or ileocecal Crohn's disease (88 patients in each treatment group).
In a randomized multicenter trial the efficacy of treatment of active Crohn's disease by means of a liquid defined formula diet (DFD) was tested and compared with a combination of 6-methyl-prednisolone and sulfasalazine. A total of 95 patients participated in the study. By the end of 6 weeks, among 44 patients randomized to drug treatment, 32 showed improvement of the Crohn's disease activity index (CDAI) as compared with 21 of 51 patients receiving oral DFD (p less than 0.
View Article and Find Full Text PDFCoeliac disease or Gluten enteropathy is a well-defined, but in its pathogenesis poorly understood syndrome. Diarrhoea, steatoroea and malnutrition due to damage and transformation of the small intestinal mucosa are induced by cereal proteins (gliadin) in genetically predisposed children and adults. Local interactions between immunocompetent cells and structural elements of the small intestinal mucosa have been investigated by immunochemical, ultrastructural and cell biological methods.
View Article and Find Full Text PDFThe following study examines the correlation of psychosocial stress and disease activity in patients suffering from chronic inflammatory bowel diseases. 70 patients with Crohn's disease and 44 patients with ulcerative colitis took part in this study. Using an inventory for the registration of life-changing events, psychosocial life-events of the last 24 months were inquired.
View Article and Find Full Text PDFIntestinal enzyme activities were investigated in mice with spontaneously occurring exocrine pancreatic insufficiency (EPI), in rats after induction of pancreatic insufficiency by intraductal injection of oleic acid, and in rats after feeding a proteinase inhibitor (Camostate) which induced a marked pancreatic hypertrophy. An increase in saccharase activity and in vitro uptake of L-phenylalanine was found in EPI mice, while activities of alkaline phosphatase and lactase were not altered. In oleic acid induced pancreatic insufficiency and in pancreatic hypertrophy no alterations in enzyme activities were observed.
View Article and Find Full Text PDF174 patients with chronic pancreatic diseases, 30 patients with pancreatic carcinoma and 144 with chronic relapsing pancreatitis, 50 of them with calcifications, were observed in the Department of Internal Medicine of the University of Marburg/FRG between 1972 and 1982. In order to differentiate between carcinoma and relapsing pancreatitis the data of these patients were analysed retrospectively with regard to patient history, actual complaints, findings of laboratory, sonography, ERCP and X-ray investigations. The following results were obtained: Of discriminating value are steatorrhoe, local palpatory pain, alcohol ingestion, a history of earlier attacks and relapsing pain situations; however, general abdominal pain, nausea, vomiting and weight loss (if not exactly specified) are not.
View Article and Find Full Text PDFBeitr Infusionther Klin Ernahr
November 1986
The effect of a high osmotic solution on active and passive sugar permeation was investigated in 19 healthy volunteers. The reduced rate of active sugar absorption (3-O-MG and xylose) out of a high osmotic solution was interpreted as a consequence of an impaired emptying of the stomach. The increased passive permeation of intact disaccharides applied in hyperosmolar solution demonstrates an increased gastrointestinal permeability.
View Article and Find Full Text PDFEur J Clin Invest
August 1985
The lectins wheat germ agglutinin (WGA) and Concanavalin A (ConA) were perfused into an isolated small intestinal segment alone or after prior perfusion with neuraminidase for a 10 day period in the rat. Intestinal morphometry, intraepithelial Lymphocyte (IEL) and round cell content as well as digestive capacity was measured in the loop and in the adjacent segments. Both lectins induce a mucosal transformation in all segments but ConA is more effective than WGA.
View Article and Find Full Text PDFA postmortem study by ductography and histology was performed on 69 human pancreata with no clinical or histological signs of chronic pancreatitis. The ductograms, supplemented by five postmortem ductograms of chronic pancreatitis, were independently evaluated by six clinicians, skilled in ERCP; the degree of alteration was estimated by simple rating, forced choice rating, and by determination of the grade of chronic pancreatitis, Histologically, the amount of intraductal epithelial proliferation, periductal, intralobular and perilobular fibrosis, intraductal protein plugs, and fat necrosis was determined by semiquantitative methods. The six ductographical evaluations significantly differed in the level of their data, but corresponded in the range of distribution.
View Article and Find Full Text PDF130 patients with Crohn's disease were colonoscopied in a multicenter trial. The obtained data were analyzed with respect to gathering information on the inflammation pattern, as well as on the importance and prognostic value of special lesions in Crohn's colitis. In 52 patients a second endoscopy was performed at the end of the 2-year study period.
View Article and Find Full Text PDFAntrectomy reduced the levels of circulating gastrin but did not change jejunal morphology. In vitro and in vivo absorption as well as the activity of some brush border enzymes were increased. The observed alterations are discussed on the basis of antrectomy-induced alterations in the release of gastrointestinal hormones, gastric and pancreatic secretion and gastric emptying.
View Article and Find Full Text PDFJejunal suction biopsies of 18 chronic alcoholics (alcohol intake of more than 100 g of ethanol per day for several years) and 10 nonalcoholic control subjects were analyzed quantitatively using the microdissection technique described by Clarke. Both groups were comparable concerning age, body weight and sex. The duration of alcohol withdrawal in the alcoholics before the biopsy was taken ranged from 2 to 7 days.
View Article and Find Full Text PDFSix patients had total gastrectomy because of carcinoma followed by jejunum isoperistaltic interposition according to Longmire. A jejunal biopsy was taken in every case during operation and three and six months later endoscopically for morphometric and functional evaluation of small bowel mucosa. Three months after the operation a rise of L-phenylalanin in vitro uptake, an increase in villus height, surface area and a deepening of the crypts with raised mitotic activity of the crypt cells was found.
View Article and Find Full Text PDFSince several studies have shown that patients with Crohn's disease have an increased consumption of refined carbohydrates, the influence of a diet excluding refined sugar on the course of the disease was examined. In a randomised control trial, 20 patients (10 patients in each group) with Crohn's disease were treated for an average of 18 months with two different diets. The patients used in the study had a low or middle activity of the disease.
View Article and Find Full Text PDFScand J Gastroenterol Suppl
February 1982