Ileocecal junction

By administering both sizes of formulation simultaneously, a better discrimination of relative transit of the two phases can be made. In a cohort of 22 healthy young volunteers, an enteric-coated capsule was administered which contained tablets ("mTc-labeled 5 mm or 8.4 mm diameter) together with pellets (mIn-labeled 0.2 mm ion-exchange resin particles). The unit delivered the radiopharmaceuticals simultaneously to the ileocecal junction [44]. Under control conditions, no difference was observed between the rate of transit through the ascending colon of 0.2-mm particles versus 5-mm tablets, or 0.2-mm particles versus 8.4-mm tablets. The mean period of residence of 50% of the administered 0.2-mm particles in the ascending colon was 11.0 + 4.0 h. 

In contrast, Adkin et al. compared the transit of 3-, 6- and 12-mm nondisintegrating 111 In-labeled tablets in eight healthy male volunteers. The transit of tablets through the ileocecal junction was unaffected by tablet size, and all tablets entered the colon as a bolus. The 3-mm and 6-mm tablets were retained in the ascending colon for the longest period of time [45]. 

Release results with this method are shown in Figure 11. The BioDis method enables the release pattern to be interpreted in terms of release at sites of inflammation. In Crohn s disease, the inflammation often starts at the ileocecal junction and spreads from there in the proximal and/or distal direction and may affect the entire GI tract in severe cases, whereas in colitis the inflammation is restricted to the large bowel. The release patterns in Figure 11 can be used in combination with a knowledge of the sites of inflammation in a given patient to choose the most suitable dosage form available on the market for that patient (Klein, 18). 

The problem with the aforementioned monolithic unit system is that it tends to be detained at the ileocecal junction, leading to drug loss before entry in the colon. To circumvent this problem, multiparticulate dosage forms were devised that passed freely through the ileocecal junction. In a recent study, a multiparticulate system, which was based on amidated pectin, was tested. ° Coating of the amidated pectin beads with chitosan significantly reduced the release of sulfamethoxazole and indomethacin in simulated gastric and intestinal juice compared with non-coated beads. 

As phase III of one cycle reaches the end of the distal ileum (ileocecal junction), phase I of the next cycle begins in the stomach (proximal) or esophagus (lower esophageal sphincter). However, sometimes MMC may originate in the duodenum or jejunum and some MMC may not have action potentials strong enough to traverse through the entire small intestine. Phase... 

Small bowel ulceration with thickening of the bowel wall and stricture formation in the terminal ileum and the ileocecal junction occurred in a patient with rheumatoid arthritis taking long-term indometacin (SEDA-12, 84). This is one reason why prolonged courses of indometacin should be avoided whenever possible, especially in elderly women. 

A blind sac or pouch located at the junction of the small and large intestines, often considered to be part of the large intestine. A valve at the ileocecal junction allows the products of digestion to flow from the ileum to the cecum, but... 

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