Iranian Journal of Colorectal Research
Year:2016 | Volume:4 | Issue:4|Papers Count:5

Introduction: The restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is currently the preferred surgical method for most patients with ulcerative colitis and familial adenomatous polyposis and sometimes, functional bowel diseases.Infection around the pouch, remaining rectal stump, stricture at anastomosis site, pouch dysfunction and refractory pouchitis can lead to pouch failure. Pouch salvage surgery could prevent pouch failure in some cases.Case Presentation: In this report, five patients were introduced, who underwent pouch salvage surgery after RPC/IPAA surgery failure. Two of the patients were male and three were female and the relevant age range was 16 to 41. Initially, RPC/IPAA surgery was performed on these five patients. Four of the patients underwent RPC/IPAA surgery as a result of ulcerative colitis and, one of the patients as a result of familial adenomatous polyposis. However, due to pouch failure from the RPC/IPAA surgery, pouch-salvage surgery was performed on each of these five patients. Two of the patients underwent pouch-salvage surgery due to infection and pouch fistula, and the other three underwent this surgery due to the remaining rectal stump, anastomosis stenosis and pouch dysfunction. The average time for when pouch-salvage surgery was performed was 3.5 years (three months to five years) after the initial operation and the patients were under follow-up care for two to seven years.Conclusions: After performing pouch salvage operation, pouch function was acceptable in all patients and we could close ileostomies of all of them.

Background: Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) that is characterized by acute and chronic inflammation.The etiology and pathophysiology of IBD is unidentified, and there are many obstacles on the definite treatment of this disease. Recently, the useful effects of some herbal medicine on improving UC have been studied. Melillotus officinalis L. (M.officinalis) is an herb with antioxidant and anti-inflammatory effects used as food, forage and medicine.Objectives: This study evaluated the antioxidant effects of M. officinalis aqueous extracts in the acetic acid- induced ulcerative colitis in rats.Methods: Fifty rats were randomly divided into five equal groups. Group I (Control healthy group) received 1 mL/kg of normal saline orally. Group II (control colitis group) received 1 mL/kg of normal saline orally. Group III (positive control) received 3 mg/kg prednisolone orally. Group IV received 1000 mg/kg M. officinalis aqueous extracts orally. Group V received 2000 mg/kg M. officinalis aqueous extracts orally. Ulcerative colitis was induced by intra-rectal acetic acid (3% v/v) administration. All treatments were done 24 hours after induction of colitis and continued for seven days. On the eighth day, the rats were sacrificed and colonic biopsies were taken for histopathological and biochemical studies. Data analysis was performed, using SPSS software and significance level was set at P0.05.Results: Treatment with M. officinalis aqueous extract could enhance colonic antioxidant capacity and decrease inflammation and acute colonic injury induced by acetic acid, which is dose-dependent. In addition, administrating the extract significantly (P£0.05) reduced the colonic level of malondialdehyde and myeloperoxidase, and significantly (P£0.05) increased the level of reduced glutathione (P£0.05). The extract had more effects at the dose of 2000 mg/kg than 1000 mg/kg dosage and prednisolone.Conclusions: This study revealed that M. officinalis had apparent curative effects on treating UC because of its antioxidant and antiinflammatory activities.

Colon microbiota, as a complex and diverse population, has been shown to be either pro- or anti-tumorigenic, depending on its content. The composition of microbiota critically determines the differentiation, activation, and expansion of T cells by which proor anti-tumorigenic effects of microbes are frequently reported to be mediated. In this review study, we specified an imbalance in microbiota and T cells in particular regulatory T cells and Th17 cells in colon cancer. We also aimed to discuss evidence, suggesting the contribution of microbiota to carcinogenesis or anti-carcinogenesis through influencing T cells.

Dear Editor: Anal sphincter injury is a severe complication in vaginal delivery and is the leading cause of anal incontinence. The association between third and fourth degree anal sphincter tears and fecal incontinence has been reported for many years (1). Sphincter tears occur in up to 18% of deliveries (2).

Background: Post-operative adhesions are the most common cause of small bowel obstruction. The management of small bowel obstruction is surgical and non-surgical. Some studies are conducted to show the efficacy of non-surgical management of adhesive small bowel obstruction such as sesame oil, water - soluble contrasts such as gastrographin.Objectives: The current study aimed to evaluate the effect of oral olive oil on themanagement of adhesive small bowel obstruction.Methods: All the patients admitted with adhesive bowel obstruction in the hospital affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, from October 2012 to September 2013 that had inclusion criteria were evaluated by general surgeon. The patients were separated into two groups and standard management was done. Then 12 hours after admission, 150 mL olive oil was given by nasogastric (NG) tube to the first group.Results: The spontaneous resolution time of small bowel obstruction was significantly longer in the control group than the treatment group (59 hours vs.35 hours). The hospital stay was shorter in the treatment group than the control (three days vs. six days).Conclusions: The study results demonstrated that olive is an effective and safe adjunct to the conservative management of small bowel obstruction and markedly reduces the time of resolution of symptoms and length of hospital stay.