A 30-year-old woman with a 10-year history of recurrent bloody diarrhea and documented colitis of the descending colon, consistent with Crohn&#x2019;s disease, presented with an exacerbation of her gastrointestinal disease and an 18-month history of recurrent facial and genital swelling. Her course evolved to include severe ear pain, dysphagia and colonic dysmotility. She was diagnosed with Melkersson-Rosenthal syndrome and treated with multiple agents. The neurological aspects of her presentation are highlighted, and the Melkersson-Rosenthal syndrome is reviewed.

Alexandra Ilnyckyj

Thomas AM Aldor

Richard Warrington

Charles N Bernstein

Crohn&#x2019;s Disease and the Melkersson-Rosenthal Syndrome

OBJECTIVE: To determine whether changing total parenteral nutrition fluid administration sets (TAS) every 48&#x2009;h rather than every 24&#x2009;h results in a greater infusate contamination rate.PATIENTS AND METHODS: Prospectively, 166 infants were assigned at random to have TAS changed either every 24&#x2009;h or every 48&#x2009;h. Samples of the infusate were cultured to determine contamination rates of the infusate in the sets and were tested from 149 of these infants. TAS was replaced every 24&#x2009;h in the control group, and 445 amino acid plus dextrose solutions (AADS) and 449 lipid emulsions samples were taken for bacterial culture. Fungal cultures were also performed on 449 samples. The study group had TAS replaced every 48&#x2009;h, and 454 samples of AADS were cultured for bacteria. The numbers of lipid emulsion samples sent for bacterial culture and fungal culture were 449 and 440, respectively. Information on type of intravenous access device, administration of antibiotics and blood cultures was also collected.RESULTS: There was no difference in bacterial contamination rates for AADS or lipid emulsion from TAS changed every 24 or 48&#x2009;h (&#x3a7;2, P&#x3e;0.05). Lipid emulsion sampled from the 24&#x2009;h group showed a statistically significant higher rate of fungal contamination than specimens from the 48&#x2009;h group (P&#x3c;0.01).CONCLUSIONS: Changing TAS every 48&#x2009;h versus 24&#x2009;h does not increase the contamination rate of infusate in newborns.

Miriam Fox

Marion Molesky

John E Van Aerde

Sarah Muttitt

Changing Parental Nutrition Administration Sets Every 24&#x2009;h versus Every 48&#x2009;h in Newborn Infants

Heliobacter pylori and nonsteroidal anti-inflammatory drugs (NSAIDs) cause ulcers by different mechanisms. Under some circumstances, patients infected with H pylori may be less prone to NSAID-associated ulcers than those who are H pylori-negative. Eradication trials have yielded differing results. However, those who have studied patients who have a past history of ulcer disease and are already established on NSAIDs have shown no benefit from H pylori eradication.

CJ Hawkey

What Do We Do about Helicobacter pylori?

One major cause of peptic ulceration is the use of nonsteroidal anti-inflammatory drugs (NSAIDs). The precise mechanisms through which NSAIDs cause peptic ulceration are unknown, but the discovery that they reduce the production of &#x2018;cytoprotective&#x2019; prostaglandins led to the hypothesis that coadministration of exogenous prostaglandins heals and prevents NSAID-induced gastroduodenal ulcers and other mucosal lesions. Studies using high doses of misoprostol have shown that it does have a protective effect; however, gastrointestinal intolerance of this prostaglandin E2 analogue is common. Early indications that acid suppression was effective in the management of NSAID-related peptic ulcers came from studies showing that gastric ulcers could be healed by omeprazole in patients who continued to take NSAIDs. Other studies suggested that acid suppression reduces the incidence of mucosal lesions but that standard dose ranitidine protects only against duodenal lesions. Subsequent studies reported that higher dose H2 receptor antagonist therapy can protect against both gastric and duodenal ulcers during continued NSAID therapy. An ideal therapeutic strategy would heal NSAID-related ulcers and prevent the development of new NSAID-related lesions and complications in patients who are unable to discontinue NSAID therapy. A number of recent studies indicate that effective acid-suppressive treatment with the proton pump inhibitor omeprazole can achieve these aims. Overall, data from recent studies show that acid suppression with the proton pump inhibitor omeprazole at a dose of 20 mg daily is the most effective means of healing NSAID-associated gastroduodenal lesions and that it is the most effective prophylactic therapy. In the long run, the role of omeprazole will have to be evaluated with respect to its cost effectiveness compared with other strategies and with respect to the development of less damaging NSAIDs.

R Lad

D Armstrong

Management of Nonsteroidal Anti-Inflammatory Drug-Induced Gastroduodenal Disease by Acid Suppression

BACKGROUND: Members of a subset of first-degree relatives of adults with Crohn&#x2019;s disease have been shown to have an increased baseline intestinal permeability and/or an exaggerated increase in intestinal permeability after the administration of acetylsalicylic acid.PURPOSE: To determine intestinal permeability in unaffected first-degree relatives of children with Crohn&#x2019;s disease before and after the administration of an ibuprofen challenge.METHODS: Lactulose-mannitol ratios, a measure of intestinal permeability, were determined in 14 healthy control families (41 subjects) and 14 families with a child with Crohn&#x2019;s disease (36 relatives, 14 probands) before and after ingestion of ibuprofen. An upper reference limit was defined using the control group as mean ± 2 SD.RESULTS: The proportion of healthy, first-degree relatives with an exaggerated response to ibuprofen (20&#x25;, 95&#x25; CI 7&#x25; to 33&#x25;) was significantly higher than controls (P=0.003). The exaggerated response was more common among siblings than among parents of pediatric probands.CONCLUSIONS: Members of a subset of first-degree relatives of children with Crohn&#x2019;s disease have an exaggerated increase in intestinal permeability after ibuprofen ingestion. These findings are compatible with there being a genetic link between abnormalities of intestinal permeability and Crohn&#x2019;s disease.

Samuel A Zamora

Robert J Hilsden

Jon B Meddings

J Decker Butzner

R Brent Scott

Lloyd R Sutherland

Intestinal Permeability before and after Ibuprofen in Families of Children with Crohn&#x2019;s Disease

About this journal

Canadian Journal of Gastroenterology and Hepatology publishes studies of areas related to medical, surgical, pathological, biochemical and physiological aspects of gastroenterology and hepatology.

Journal profile

Meet the editorial board

Canadian Journal of Gastroenterology and Hepatology maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.

Editor spotlight

Submit to Special Issue

We currently have a number of Special Issues open for submission. Special Issues highlight emerging areas of research within a field, or provide a venue for a deeper investigation into an existing research area.

Special Issues

Author guidelines

Editorial board

Databases and indexing

Canadian Journal of Gastroenterology and Hepatology - Table of contents 1999

Canadian Journal of Gastroenterology and Hepatology | Hindawi

title

Canadian Journal of Gastroenterology and Hepatology publishes studies of areas related to medical, surgical, pathological, biochemical and physiological aspects of gastroenterology and hepatology.

description

Canadian Journal of Gastroenterology and Hepatology

https://images.hindawi.com/journals/cjgh/cjgh.banner.jpg

Canadian Journal of Gastroenterology and Hepatology

Table of Contents

Table of Contents: 1999

Crohn’s Disease and the Melkersson-Rosenthal Syndrome

Changing Parental Nutrition Administration Sets Every 24 h versus Every 48 h in Newborn Infants

What Do We Do about Helicobacter pylori?

Management of Nonsteroidal Anti-Inflammatory Drug-Induced Gastroduodenal Disease by Acid Suppression

Intestinal Permeability before and after Ibuprofen in Families of Children with Crohn’s Disease