Large bowel

Castor oil is a cathartic only after Hpolysis in the small intestine Hberating ricinoleic acid. Ricinoleic acid inhibits the absorption of water and electrolytes. It is commonly used for preparation of the large bowel for diagnostic procedures. 

Diagnosis and alleviation of the cause, if possible, is of primary importance. Often, however, this is not possible and therapy is used to alleviate the inconvenience and pain of diarrhea. These compounds usually only mask the underlying factors producing the problem. Diarrhea may cause significant dehydration and loss of electrolytes and is a particularly serious problem in infants. Antidiarrheals do not usually prevent the loss of fluids and electrolytes into the large bowel and, although these may prevent frequent defecation, often the serious imbalance of body electrolytes and fluids is not significantly affected. 

In 1936, biotin was isolated from egg yolks (8), in 1939 from beef Hver (9), and in 1942 from milk concentrates (10). Biotin-producing microorganisms exist in the large bowel but the extent and significance of this internal synthesis is unknown. 

NB There is some evidence of an inverse relationship between coffee drinking and cancer of the large bowel coffee drinking could not be classified as to its carcinogenicity to other organs)... 

Campylobacter JeJurii Small and large bowel Invasion... 

Shigella spp. Escherichia coll Large bowel Invasion toxin... 

HAGUE A, MANNING A M, HANLON K A, HUSCHTSCHA L I, HART D, PARASKEVA C (1993) Sodium butyrate induces apoptosis in human colonic tumour cell lines in a p53-independent pathway impUcations for the possible role of dietary fibre in the prevention of large-bowel cancer. /ni J Cancer. 55 498-505. 

MCINTYRE A, GIBSON p R YOUNG G p (1993) Butyrate production from dietary fiber and protection against large bowel cancer in a rat model. Gut 34 386-91. 

FAHEY G c Jr (2002a) Supplemental fructooligosaccharides andmannanoUgosaccharides influence immune function, ileal and total tract nutrient digestibilities, microbial populations and concentrations of protein catabolites in the large bowel of dogs. J Nutr 132 980-9. 

Rice bran fiber has fructo-oligosaccharides - a pre-biotic that helps friendly bacteria to proliferate in the gastrointestinal environment and improves intestinal and colon health (Tomlin and Read, 1988). Recent studies in humans (Kahlon and Chow, 1997) have revealed that rice bran fiber not only normalizes bowel function, but also helps in conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and Crohn s disease, and lowers the lipid levels. Rice bran fiber has been shown to significantly reduce renal stones (Jahnen et al., 1992). It is a good source of fiber in weight loss programs and therapeutic fiber diets for diabetics and heart patients. Fiber diets prevent cancer of the colon and large bowel, control obesity and improve bowel function. 

Prevention of colon and large bowel cancer (Cummings 1992). 

FOLINO M, MCINTYRE A, YOUNG G P (1995) Dietary fibers differ in their effect on large bowel epithelial proliferation-dependent events in rats. JNutr, 125(6) 1521-8. 

Formation of strictures, abscesses, fistulae, and obstructions in patients with CD is possible. Patients with CD may develop significant weight loss or nutritional deficiencies secondary to malabsorption of nutrients in the small intestine, or as a consequence of multiple small- or large-bowel resections. Common nutritional deficiencies encountered in IBD include vitamin B12, fat-soluble vitamins, zinc, folate, and iron. Malabsorption in children with CD may contribute to significant reductions in growth and development. 

O Primary peritonitis develops in up to 25% of patients with alcoholic cirrhosis.3 Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) average one episode of peritonitis every 2 years.4 Secondary peritonitis may be caused by perforation of a peptic ulcer traumatic perforation of the stomach, small or large bowel, uterus, or urinary bladder appendicitis pancreatitis diverticulitis bowel infarction inflammatory bowel disease cholecystitis operative contamination of the peritoneum or diseases of the female genital tract such as septic abortion, postoperative uterine infection, endometritis, or salpingitis. Appendicitis is one of the most common causes of intraabdominal infection. In 1998, 278,000 appendectomies were performed in the United States for suspected appendicitis.5... 

Small or large bowel E. coli, Klebsiella spp., Proteus spp. Bacteroides fragilis and other Bacteroides Clostridium. 

Although often treated similarly to colon cancer, there are some important differences in the treatment of rectal cancer compared with colon cancer, especially in the adjuvant setting and the role of radiation. Rectal cancer involves tumors found in distal 15 cm of the large bowel and, as such, is very distinct from colon cancer in that it may recur both locally and dis-tally. The higher incidence of local failure and poorer overall... 

Baron, J. A., Gerhardsson de Verdier, M., Ekbom, A., Coffee, tea, tobacco, and cancer of the large bowel, Cancer Epidemiol Biomed Prev, 3, 565, 1994. 

The idea that inulin-type fructans are fermented by bacteria colonising the large bowel is supported by many in vitro (both analytic and microbiological) and in vivo studies, which, in addition, confirm the production of lactic and short-chain carboxylic acids as end products of the fermentation (Tanner, 2005). Furthermore, it was shown inhuman in vivo studies that this fermentation leads to the selective stimulation of growth of the bifidobacteria population, making inulin-type fructans the prototypes of prebiotics (Roberfroid, 1997 Roberfroid, 2001). 

Van den Bogaard AE, Weidema WF, van Bo-ven CP, van der Waay D Recolonization and colonization resistance of the large bowel after three methods of preoperative preparation of the gastrointestinal tract for elective colorectal surgery. J Hyg(Lond) 1986 97 49-59. 

Chia JG, Wilde CC, Ngoi SS, Goh PM, Ong CL Trends of diverticular disease of the large bowel in a newly developed country. Dis Colon Rectum 1991 34 498-501. 

Table 1. Alternate approaches to bowel preparation in patients undergoing elective resection of the large bowel... 

Lindsey JT, Smith JW, McClugage SG, Nichols RL Effects of commonly used bowel preparations on the large bowel mucosal-associated and luminal microflora in the rat model. Dis Colon Rectum 1990,33 554-560. 

These surfactant agents, docusate in its various salts, work by facilitating the mixing of aqueous and fatty materials within the intestinal tract. They may increase water and electrolyte secretion in the small and large bowel. 

Abdominal radiographs may be useful because free air in the abdomen (indicating intestinal perforation) or distension of the small or large bowel is often evident Ultrasound, CT scan, or magnetic resonance imaging may be used to locate an abscess. 

The entire large bowel should be evaluated by colonoscopy or flexible sigmoidoscopy with double-contrast barium enema. 

The most surprising observations on Table II are the lack of a clear relationship between meat use and risk of fatal cancers of the large bowel and breast. Evidence from several other studies suggests that a direct positive association should be evident (10). However, data from a growing number of recent studies are not consistent with an association between meat use and risk of large bowel cancer or breast cancer (17-19). Meat use is also unrelated to all types of cancer combined. 

Unfortunately, the questionnaire did not distinguish between caffeinated versus decaffeinated coffee or instant versus brewed coffee. Positive associations with coffee use are seen for fatal large bowel cancer in both sexes, fatal coronary disease in males only, and possibly for all causes of death in males only. Both sexes were combined for large bowel cancer because the degree of association was essentially equivalent when examined separately for... 

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