Regularities of endoscopic anatomy of the ileocecal intestine and their clinical signifi cance

The purpose of the study. Obtaining a set of new data, identifying patterns in the endoscopic anatomy of the ileocecal intestine and, on this basis, improving the diagnosis of its pathology.Materials and methods. The present study was conducted in 182 patients (men — 84, women — 98) who were examined and treated in the polyclinic and in the hospital of the Orenburg Regional Clinical Hospital. The age of all the examined patients is from 18 to 75 years. A set of methods was used: endoscopic (videocolonoscopy, videoileoscopy, examination of the mucous membrane in white light and in the NBI mode, the method of taking material for morphological examination), morphometric, morphological examination of biopsies, X-ray (irrigoscopy, irrigography), variational and statistical data processing.Results. In this work, a set of new data was obtained and patterns of the in vivo anatomy of the ileocecal department were revealed based on the results of colonoscopies. It was found that the endoscopic anatomy of the ileocecal region consists of individually variable parameters determined during intravital endoscopy: the shape, external structure and direction of the ileocecal valve, the internal relief and shape of the cecum, the projection and width of the tapes, the intraluminal morphometric parameters of the elements of the ileocecal valve and the cecum. Changes in the endoscopic anatomy of the ileocecal region in ulcerative colitis and Crohn’s disease were quantifi ed and presented. A rational set of studies based on endoscopic and X-ray anatomy is presented, which is necessary for improving the methods of colonoscopy, diagnosis of ulcerative colitis and Crohn’s disease, and various types of surgical treatment of pathology of this department.Conclusion. The new set of data obtained and the revealed regularities of the endoscopic anatomy of the ileocecal region expand the understanding of its clinical anatomy and the possibilities of in vivo study.

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Creatine Supplementation for Patients with Inflammatory Bowl Diseases: A Scientific Rationale for a Clinical Trial

Nutrients ◽

10.3390/nu13051429 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1429

Author(s):

Theo Wallimann ◽

Caroline H. T. Hall ◽

Sean P. Colgan ◽

Louise E. Glover

Keyword(s):

Ulcerative Colitis ◽

Clinical Trial ◽

Crohn’S Disease ◽

Pilot Study ◽

Crohn's Disease ◽

Single Case ◽

Initial Period ◽

Creatine Supplementation

Based on theoretical considerations, experimental data with cells in vitro, animal studies in vivo, as well as a single case pilot study with one colitis patient, a consolidated hypothesis can be put forward, stating that “oral supplementation with creatine monohydrate (Cr), a pleiotropic cellular energy precursor, is likely to be effective in inducing a favorable response and/or remission in patients with inflammatory bowel diseases (IBD), like ulcerative colitis and/or Crohn’s disease”. A current pilot clinical trial that incorporates the use of oral Cr at a dose of 2 × 7 g per day, over an initial period of 2 months in conjunction with ongoing therapies (NCT02463305) will be informative for the proposed larger, more long-term Cr supplementation study of 2 × 3–5 g of Cr per day for a time of 3–6 months. This strategy should be insightful to the potential for Cr in reducing or alleviating the symptoms of IBD. Supplementation with chemically pure Cr, a natural nutritional supplement, is well tolerated not only by healthy subjects, but also by patients with diverse neuromuscular diseases. If the outcome of such a clinical pilot study with Cr as monotherapy or in conjunction with metformin were positive, oral Cr supplementation could then be used in the future as potentially useful adjuvant therapeutic intervention for patients with IBD, preferably together with standard medication used for treating patients with chronic ulcerative colitis and/or Crohn’s disease.

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