Tag Archives: Ulcerative colitis

Ulcerative colitis

Definition:
Ulcerative colitis (Colitis ulcerosa, UC) is a form of inflammatory bowel disease (IBD). Ulcerative colitis is a form of colitis, a disease of the colon (the largest portion of the large intestine), that includes characteristic ulcers, or open sores. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset. IBD is often confused with irritable bowel syndrome (IBS).
CLICK & SEE THE PICTURES
It is a disease that causes inflammation and sores (ulcers) in the lining of the large intestine (colon ). It usually affects the lower section (sigmoid colon) and the rectum. But it can affect the entire colon. In general, the more of the colon that’s affected, the worse the symptoms will be.

CLICK & SEE THE PICTURE OF  CHRONIC ULCERARIVE COLITIS

Ulcerative colitis shares much in common with Crohn’s disease, another form of IBD, but Crohn’s disease can affect the whole gastrointestinal tract while ulcerative colitis only attacks the large intestine, and while ulcerative colitis can be treated by performing a total colectomy (i.e., removing the entire large intestine), surgery for Crohn’s disease involves removing the damaged parts of the intestine and reconnecting the healthy parts, which does not cure Crohn’s, as it can recur after surgery, mostly at the site of the intestinal anastomosis (connection) or in other areas. Ulcerative colitis is an intermittent disease, with periods of exacerbated symptoms, and periods that are relatively symptom-free. Although the symptoms of ulcerative colitis can sometimes diminish on their own, the disease usually requires treatment to go into remission. Ulcerative colitis has an incidence of 1 to 20 cases per 100,000 individuals per year, and a prevalence of 8 to 246 per 100,000 individuals.

The disease is more prevalent in northern countries of the world, as well as in northern areas of individual countries or other regions. Rates tend to be higher in more affluent countries, which may indicate the increased prevalence is due to increased rates of diagnosis. It may also indicate that an industrial or Western diet and lifestyle increases the prevalence of this disease, including symptoms which may or may not be related to ulcerative colitis. Although UC has no known cause, there is a presumed genetic component to susceptibility. The disease may be triggered in a susceptible person by environmental factors. Although dietary modification may reduce the discomfort of a person with the disease, ulcerative colitis is not thought to be caused by dietary factors.

Ulcerative colitis, like its sister condition Crohn’s disease, is treated as an autoimmune disease. Treatment is with anti-inflammatory drugs, immunosuppression, and biological therapy targeting specific components of the immune response. Colectomy (partial or total removal of the large bowel through surgery) is occasionally necessary if the disease is severe, does not respond to treatment, or if significant complications develop. A total proctocolectomy (removal of the entirety of the large bowel and rectum) can cure ulcerative colitis (extraintestinal symptoms will remain), as the disease only affects the large bowel and rectum. While extra intestinal symptoms will remain, complications may develop.

Symptoms:
As ulcerative colitis is believed to have a systemic (i.e., autoimmune) origin, patients may present with comorbidities leading to symptoms and complications outside the colon. The frequency of such extraintestinal manifestations has been reported as anywhere between 6 and 47 percent. These include the following:

*Aphthous ulcer of the mouth
*Ophthalmic (involving the eyes):
*Iritis or uveitis, which is inflammation of the iris Episcleritis

*Musculoskeletal:
#Seronegative arthritis, which can be a large-joint oligoarthritis (affecting one or two joints), or may affect many small joints of the hands and feet
#Ankylosing spondylitis, arthritis of the spine
#Sacroiliitis, arthritis of the lower spine

*Cutaneous (related to the skin):CLICK & SEE
#Erythema nodosum, which is a panniculitis, or inflammation of subcutaneous tissue involving the lower extremities
#Pyoderma gangrenosum, which is a painful ulcerating lesion involving the skin

*Deep venous thrombosis and pulmonary embolism
*Autoimmune hemolytic anemia
*Clubbing, a deformity of the ends of the fingers.
*Primary sclerosing cholangitis, a distinct disease that causes inflammation of the bile ducts

Gastrointestinal:
The clinical presentation of ulcerative colitis depends on the extent of the disease process. Patients usually present with diarrhea mixed with blood and mucus, of gradual onset that persists for an extended period (weeks). They may also have weight loss and blood on rectal examination. The inflammation caused by the disease along with chronic loss of blood from the GI tract leads to increased rates of anaemia. The disease may be accompanied with different degrees of abdominal pain, from mild discomfort to painful bowel movements or painful abdominal cramping with bowel movements.

Ulcerative colitis is associated with a general inflammatory process that affects many parts of the body. Sometimes these associated extra-intestinal symptoms are the initial signs of the disease, such as painful arthritic knees in a teenager and may be seen in adults also. The presence of the disease may not be confirmed immediately, however, until the onset of intestinal manifestations.

Extent of Involvement:
Ulcerative colitis is normally continuous from the rectum up the colon. The disease is classified by the extent of involvement, depending on how far up the colon the disease extends:

*Distal colitis, potentially treatable with enemas:
#Proctitis: Involvement limited to the rectum.
#Proctosigmoiditis: Involvement of the rectosigmoid colon, the portion of the colon adjacent to the rectum.
#Left-sided colitis: Involvement of the descending colon, which runs along the patient’s left side, up to the splenic flexure and the beginning of the transverse colon.

*Extensive colitis, inflammation extending beyond the reach of enemas:
#Pancolitis: Involvement of the entire colon, extending from the rectum to the cecum, beyond which the small intestine begins.

Severities of the diseases:..>...click & see   
In addition to the extent of involvement, people may also be characterized by the severity of their disease.

#Mild disease correlates with fewer than four stools daily, with or without blood, no systemic signs of toxicity, and a normal erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP). There may be mild abdominal pain or cramping. Patients may believe they are constipated when in fact they are experiencing tenesmus, which is a constant feeling of the need to empty the bowel accompanied by involuntary straining efforts, pain, and cramping with little or no fecal output. Rectal pain is uncommon.

#Moderate disease correlates with more than four stools daily, but with minimal signs of toxicity. Patients may display anemia (not requiring transfusions), moderate abdominal pain, and low grade fever, 38 to 39 °C (100 to 102 °F).
Severe disease, correlates with more than six bloody stools a day or observable massive and significant bloody bowel movement, and evidence of toxicity as demonstrated by fever, tachycardia, anemia or an elevated ESR or CRP.

#Fulminant disease correlates with more than ten bowel movements daily, continuous bleeding, toxicity, abdominal tenderness and distension, blood transfusion requirement and colonic dilation (expansion). Patients in this category may have inflammation extending beyond just the mucosal layer, causing impaired colonic motility and leading to toxic megacolon. If the serous membrane is involved, colonic perforation may ensue. Unless treated, fulminant disease will soon lead to death.
Causes:
Experts aren’t sure what causes it. They think it might be caused by the immune system overreacting to normal bacteria in the digestive tract. Or other kinds of bacteria and viruses may cause it.

Some factors are indicative:
Genetic factors:
*A genetic component to the etiology of ulcerative colitis can be hypothesized based on the following:

#Aggregation of ulcerative colitis in families.
#Identical twin concordance rate of 10% and dizygotic twin concordance rate of 3%
#Ethnic differences in incidence
#Genetic markers and linkages

There are 12 regions of the genome that may be linked to ulcerative colitis, including, in the order of their discovery, chromosomes 16, 12, 6, 14, 5, 19, 1, and 3, but none of these loci have been consistently shown to be at fault, suggesting that the disorder arises from the combination of multiple genes. For example, chromosome band 1p36 is one such region thought to be linked to inflammatory bowel disease.

Some of the putative regions encode transporter proteins such as OCTN1 and OCTN2. Other potential regions involve cell scaffolding proteins such as the MAGUK family. There may even be human leukocyte antigen associations at work. In fact, this linkage on chromosome 6 may be the most convincing and consistent of the genetic candidates.

Multiple autoimmune disorders have been recorded with the neurovisceral and cutaneous genetic porphyrias including ulcerative colitis, Crohn’s disease, celiac disease, dermatitis herpetiformis, diabetes, systemic and discoid lupus, rheumatoid arthritis, ankylosing spondylitis, scleroderma, Sjogren’s disease and scleritis. Physicians should be on high alert for porphyrias in families with autoimmune disorders and care must be taken with potential porphyrinogenic drugs, including sulfasalazine.

Environmental factors:
Many hypotheses have been raised for environmental contributants to the pathogenesis of ulcerative colitis. They include the following:

#Diet: as the colon is exposed to many dietary substances which may encourage inflammation, dietary factors have been hypothesized to play a role in the pathogenesis of both ulcerative colitis and Crohn’s disease. There have been few studies to investigate such an association, but one study showed no association of refined sugar on the prevalence of ulcerative colitis. High intake of unsaturated fat and vitamin B6 may enhance the risk of developing ulcerative colitis. Other identified dietary factors that may influence the development and/or relapse of the disease include meat protein and alcoholic beverages. Specifically, sulfur has been investigated as being involved in the etiology of ulcerative colitis, but this is controversial. Sulfur restricted diets have been investigated in patients with UC and animal models of the disease. The theory of sulfur as an etiological factor is related to the gut microbiota and mucosal sulfide detoxification in addition to the diet.

#Breastfeeding: There have been conflicting reports of the protection of breastfeeding in the development of inflammatory bowel disease. One Italian study showed a potential protective effect.

Several scientific studies have posited that Accutane is a possible trigger of Crohn’s disease and ulcerative colitis in some individuals. Three cases in the United States have gone to trial thus far, with all three resulting in multi-million dollar judgements against the makers of isotretinoin.

Autoimmune disease:
Ulcerative colitis is an autoimmune disease characterized by T-cells infiltrating the colon. In contrast to Crohn’s disease, which can affect areas of the gastrointestinal tract outside of the colon, ulcerative colitis usually involves the rectum and is confined to the colon, with occasional involvement of the ileum. This so-called “backwash ileitis” can occur in 10–20% of patients with pancolitis and is believed to be of little clinical significance. Ulcerative colitis can also be associated with comorbidities that produce symptoms in many areas of the body outside the digestive system. Surgical removal of the large intestine often cures the disease.

Alternative theories:
Levels of sulfate-reducing bacteria tend to be higher in persons with ulcerative colitis. This could mean that there are higher levels of hydrogen sulfide in the intestine. An alternative theory suggests that the symptoms of the disease may be caused by toxic effects of the hydrogen sulfide on the cells lining the intestine.

Pathophysiology:
An increased amount of colonic sulfate-reducing bacteria has been observed in some patients with ulcerative colitis, resulting in higher concentrations of the toxic gas hydrogen sulfide. Human colonic mucosa is maintained by the colonic epithelial barrier and immune cells in the lamina propria. N-butyrate, a short-chain fatty acid, gets oxidized through the beta oxidation pathway into carbon dioxide and ketone bodies. It has been shown that N-butyrate helps supply nutrients to this epithelial barrier. Studies have proposed that hydrogen sulfide plays a role in impairing this beta oxidation pathway by interrupting the short chain acetyl CoA dehydrogenase, an enzyme within the pathway. Furthermore, it has been suggested that the protective benefit of smoking in ulcerative colitis is due to the hydrogen cyanide from cigarette smoke reacting with hydrogen sulfide to produce the nontoxic isothiocyanate, thereby inhibiting sulfides from interrupting the pathway. An unrelated study suggested that the sulphur contained in red meats and alcohol may lead to an increased risk of relapse for patients in remission.

Diagnosis:
The doctor will likely diagnose ulcerative colitis after ruling out other possible causes for your signs and symptoms. To help confirm a diagnosis of ulcerative colitis, he or she may want to have one or more of the following tests and procedures:

*Blood tests.The doctor may suggest blood tests to check for anemia — a condition in which there aren’t enough red blood cells to carry adequate oxygen to the patient’s tissues — or to check for signs of infection.

*Stool sample. White blood cells in  stool can indicate ulcerative colitis. A stool sample can also help rule out other disorders, such as infections caused by bacteria, viruses and parasites.

*Colonoscopy. This exam allows the doctor to view the entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure,the doctor can also take small samples of tissue (biopsy) for laboratory analysis. Sometimes a tissue sample can help confirm a diagnosis.

*Flexible sigmoidoscopy.The doctor uses a slender, flexible, lighted tube to examine the sigmoid, the last portion of the patient’s colon. If the colon is severely inflamed, the doctor may perform this test instead of a full colonoscopy.

*X-ray. If the patient have severe symptoms, the doctor may use a standard X-ray of the abdominal area to rule out serious complications, such as a perforated colon.

*CT scan. A CT scan of your abdomen or pelvis may be performed if the doctor suspects a complication from ulcerative colitis or inflammation of the small intestine. A CT scan may also reveal how much of the colon is inflamed.

Treatment:
Treatment for ulcerative colitis depends on the severity of the disease. Most people are treated with medication. If there is significant bleeding, infection, or complications, surgery may be required to remove the diseased colon. Surgery is the only cure for ulcerative colitis.

Ulcerative colitis may affect patients in different ways, and treatment is adjusted to meet the needs of the specific patient. Emotional and psychological support is also important.

The symptoms of ulcerative colitis come and go. Periods of remission, in which symptoms resolve, may last for months or years before relapsing. Patients and physicians need to decide together whether medications will be continued during remission times. In some patients, it may be the case that the medications keep the disease under control, and stopping them will cause a relapse.

Ulcerative colitis is a lifelong illness and cannot be ignored. Routine medical check-ups are necessary and scheduled colonoscopies are important to monitor the health of the patient and to make certain that the ulcerative colitis is under control and not spreading.

Modern medication:
Ulcerative colitis can be treated with a number of medications including 5-ASA drugs such as sulfasalazine and mesalazine. Corticosteroids such as prednisone can also be used due to their immunosuppressing and short term healing properties, but due to the risks outweighing the benefits, they are not used long term in treatment. Immunosuppressive medications such as azathioprine, and biological agents such as infliximab and adalimumab are given lastly, only if people cannot achieve remission with 5-ASA and corticosteroids, due to their possible risk factors, including, but not limited to increased risk of cancers in teenagers and adults, TB and new or worsening heart failure (these side effects are rare). A formulation of budesonide was approved by the FDA for treatment of active ulcerative colitis in January 2013.The evidence on methotrexate does not show a benefit in producing remission in those with ulcerative colitis.

Alternative medicine and experimental treatment avenues:
About 21% of inflammatory bowel disease patients use alternative treatments. A variety of dietary treatments show promise, but they require further research before they can be recommended.

In vitro research, animal evidence, and limited human study suggest that melatonin may be beneficial.

Dietary fiber, meaning indigestible plant matter, has been recommended for decades in the maintenance of bowel function. Of peculiar note is fiber from brassica, which seems to contain soluble constituents capable of reversing ulcers along the entire human digestive tract before it is cooked. Oatmeal is also commonly prescribed.

Fish oil, and eicosapentaenoic acid (EPA) derived from fish oil, inhibits leukotriene activity, the latter which may be a key factor of inflammation. As an IBD therapy, there are no conclusive studies in support and no recommended dosage. But dosages of EPA between 180 to 1500 mg/day are recommended for other conditions, most commonly cardiac.

Short chain fatty acid (butyrate) enema. The colon utilizes butyrate from the contents of the intestine as an energy source. The amount of butyrate available decreases toward the rectum. Inadequate butyrate levels in the lower intestine have been suggested as a contributing factor for the disease. This might be addressed through butyrate enemas. The results however are not conclusive.

Herbal medications are used by patients with ulcerative colitis. Compounds that contain sulfhydryl may have an effect in ulcerative colitis (under a similar hypothesis that the sulfa moiety of sulfasalazine may have activity in addition to the active 5-ASA component). One randomized control trial evaluated the over-the-counter medication S-methylmethionine and found a significant decreased rate of relapse when the medication was used in conjunction with oral sulfasalazine.

Boswellia is an Ayurvedic (Indian traditional medicine) herb. One study has found its effectiveness similar to sulfasalazine.
helminthic therapy is the use of intestinal parasitic nematodes to treat ulcerative colitis, and is based on the premises of the hygiene hypothesis. Studies have shown that helminths ameliorate and are more effective than daily corticosteroids at blocking chemically induced colitis in mice, and a trial of intentional helminth infection of rhesus monkeys with idiopathic chronic diarrhea (a condition similar to ulcerative colitis in humans) resulted in remission of symptoms in 4 out of 5 of the animals treated. A randomised controlled trial of Trichuris suis ova in humans found the therapy to be safe and effective, and further human trials are currently on going. Yoga and meditation may help a lot.

CLICK TO SEE : Homeopathic treatment of ulcerative colitis

Research:
Helminthic therapy using the whipworm Trichuris suis has been shown in a randomized control trial from Iowa to show benefit in patients with ulcerative colitis. The therapy tests the hygiene hypothesis which argues that the absence of helminths in the colons of patients in the developed world may lead to inflammation. Both helminthic therapy and fecal bacteriotherapy induce a characteristic Th2 white cell response in the diseased areas, which was unexpected given that ulcerative colitis was thought to involve Th2 overproduction.

Alicaforsen is a first generation antisense oligodeoxynucleotide designed to bind specifically to the human ICAM-1 messenger RNA through Watson-Crick base pair interactions in order to subdue expression of ICAM-1. ICAM-1 propagates an inflammatory response promoting the extravasation and activation of leukocytes (white blood cells) into inflamed tissue. Increased expression of ICAM-1 has been observed within the inflamed intestinal mucosa of ulcerative colitis sufferers, where ICAM-1 over production correlated with disease activity. This suggests that ICAM-1 is a potential therapeutic target in the treatment of ulcerative colitis

Prognosis:
Ulcerative colitis is a form of inflammatory bowel disease for which there is no cure. For the first 10 years after diagnosis, the prognosis for most people with ulcerative colitis is good — the rate of colectomy is low, and most patients achieve remission.

Patients with ulcerative colitis usually have an intermittent course, with periods of disease inactivity alternating with “flares” of disease. Patients with proctitis or left-sided colitis usually have a more benign course: only 15% progress proximally with their disease, and up to 20% can have sustained remission in the absence of any therapy. Patients with more extensive disease are less likely to sustain remission, but the rate of remission is independent of the severity of disease.

Other long-term features and Mortality:
Changes that can be seen in chronic ulcerative colitis include granularity, loss of the vascular pattern of the mucosa, loss of haustra, effacement of the ileocecal valve, mucosal bridging, strictures and pseudopolyps.

Research has not revealed any difference in overall risk of dying in patients with Ulcerative colitis from that of the background population. The cause-of-death distribution may be different from that of the background population. It is thought that the disease primarily affects quality of life, and not lifespan.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/ulcerative-colitis-topic-overview
http://en.wikipedia.org/wiki/Ulcerative_colitis
http://www.emedicinehealth.com/ulcerative_colitis/page6_em.htm
http://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/basics/treatment/con-20043763
http://ibdcrohns.about.com/od/ucbeyondbasics/f/ulcerative-colitis-prognosis.htm

Blueberries Can Help Counteract Intestinal Diseases

Blueberries are rich in antioxidants and vitamins. But new research shows that blueberry fiber is also important and can alleviate and protect against intestinal inflammations, such as ulcerative colitis.


The protective effect is even better if the blueberries are eaten together with probiotics.

Blueberries are rich in polyphenols, which have an antimicrobial and antioxidative effect. The combination of blueberries and probiotics reduced inflammation-inducing bacteria in the intestine at the same time as the number of health-promoting lactobacilla increased.

Resources:
Science Daily February 9, 2010
Scandinavian Journal of Gastroenterology 2009;44(10):1213-25

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Crohn’s Disease

Definition:-
Crohn’s disease is an inflammatory bowel disease (IBD). It causes inflammation of the lining of your digestive tract, which can lead to abdominal pain, severe diarrhea and even malnutrition.

The inflammation caused by Crohn’s disease often spreads deep into the layers of affected bowel tissue. Like ulcerative colitis, another common IBD, Crohn’s disease can be both painful and debilitating and sometimes may lead to life-threatening complications.
click & see the pictures
It  may affect any part of the gastrointestinal tract from anus to mouth, causing a wide variety of symptoms. It primarily causes abdominal pain, diarrhea (which may be bloody), vomiting, or weight loss, but may also cause complications outside of the gastrointestinal tract such as skin rashes, arthritis and inflammation of the eye.

Crohn’s disease is an autoimmune disease, in which the body’s immune system attacks the gastrointestinal tract, causing inflammation; it is classified as a type of inflammatory bowel disease. There has been evidence of a genetic link to Crohn’s disease, putting individuals with siblings afflicted with the disease at higher risk. It is understood to have a large environmental component as evidenced by the higher number of cases in western industrialized nations. Males and females are equally affected. Smokers are three times more likely to develop Crohn’s disease. Crohn’s disease affects between 400,000 and 600,000 people in North America. Prevalence estimates for Northern Europe have ranged from 27–48 per 100,000. Crohn’s disease tends to present initially in the teens and twenties, with another peak incidence in the fifties to seventies, although the disease can occur at any age.

While there’s no known medical cure for Crohn’s disease, therapies can greatly reduce the signs and symptoms of Crohn’s disease and even bring about long-term remission. With these therapies, many people with Crohn’s disease are able to function well.

Symptoms :-
Many people with Crohn’s disease have symptoms for years prior to the diagnosis. The usual onset is between 15 and 30 years of age but can occur at any age. Because of the ‘patchy’ nature of the gastrointestinal disease and the depth of tissue involvement, initial symptoms can be more vague than with ulcerative colitis. People with Crohn’s disease will go through periods of flare-ups and remission.

Crohn’s disease can range from mild to severe and may develop gradually or come on suddenly, without warning. You may also have periods of time when you have no signs or symptoms (remission). When the disease is active, signs and symptoms may include:

#Diarrhea. The inflammation that occurs in Crohn’s disease causes cells in the affected areas of your intestine to secrete large amounts of water and salt. Because the colon can’t completely absorb this excess fluid, you develop diarrhea. Intensified intestinal cramping also can contribute to loose stools. Diarrhea is the most common problem for people with Crohn’s.

#Abdominal pain and cramping. Inflammation and ulceration may cause the walls of portions of your bowel to swell and eventually thicken with scar tissue. This affects the normal movement of contents through your digestive tract and may lead to pain and cramping. Mild Crohn’s disease usually causes slight to moderate intestinal discomfort, but in more-serious cases, the pain may be severe and include nausea and vomiting.

#Blood in your stool. Food moving through your digestive tract may cause inflamed tissue to bleed, or your bowel may also bleed on its own. You might notice bright red blood in the toilet bowl or darker blood mixed with your stool. You can also have bleeding you don’t see (occult blood)…..click & see

Endoscopy image of colon showing serpiginous ulcer

#Ulcers. Crohn’s disease can cause small sores on the surface of the intestine that eventually become large ulcers that penetrate deep into — and sometimes through — the intestinal walls. You may also have ulcers in your mouth similar to canker sores.

#Reduced appetite and weight loss. Abdominal pain and cramping and the inflammatory reaction in the wall of your bowel can affect both your appetite and your ability to digest and absorb food.
Erythema nodosum due to CD….…click & see

Other signs and symptoms :-
People with severe Crohn’s disease may also experience:

#Fever
#Fatigue
#Arthritis
#Eye inflammation
#Skin disorders
#Inflammation of the liver or bile ducts
#Delayed growth or sexual development, in children

When to see a doctor :-
See your doctor if you have persistent changes in your bowel habits or if you have any of the signs and symptoms of Crohn’s disease, such as:

#Abdominal pain
#Blood in your stool
#Ongoing bouts of diarrhea that don’t respond to over-the-counter (OTC) medications
#Unexplained fever lasting more than a day or two.

Cause:-
Although the exact cause of Crohn’s disease is still unknown.  Previously, diet and stress were suspect, but now doctors know that although these factors may aggravate existing Crohn’s disease, they don’t cause it. A combination of environmental factors and genetic predisposition seems cause the disease. The genetic risk factors have now more or less been comprehensively elucidated, making Crohn’s disease the first genetically complex disease of which the genetic background has been resolved. The relative risks of contracting the disease when one has a mutation in one of the risk genes, however, are actually very low (approximately 1:200). Broadly speaking, the genetic data indicate that innate immune systems in patients with Crohn’s disease malfunction, and direct assessment of patient immunity confirms this notion. This had led to the notion that Crohn’s disease should be viewed as innate immune deficiency, chronic inflammation being caused by adaptive immunity trying to compensate for the reduced function of the innate immune system.Now, researchers believe that a number of factors, such as heredity and a malfunctioning immune system, play a role in the development of Crohn’s disease.

#Immune system. It’s possible that a virus or bacterium may cause Crohn’s disease. When your immune system tries to fight off the invading microorganism, the digestive tract becomes inflamed. Currently, many investigators believe that some people with the disease develop it because of an abnormal immune response to bacteria that normally live in the intestine.

#Heredity. Mutations in a gene called NOD2 tend to occur frequently in people with Crohn’s disease and seem to be associated with a higher likelihood of needing surgery for the disease. Scientists continue to search for other genetic mutations that might play a role in Crohn’s.

Complications:
Crohn’s disease can lead to several mechanical complications within the intestines, including obstruction, fistulae, and abscesses. Obstruction typically occurs from strictures or adhesions which narrow the lumen, blocking the passage of the intestinal contents. Fistulae can develop between two loops of bowel, between the bowel and bladder, between the bowel and vagina, and between the bowel and skin. Abscesses are walled off collections of infection, which can occur in the abdomen or in the perianal area in Crohn’s disease sufferers.

Crohn’s disease also increases the risk of cancer in the area of inflammation. For example, individuals with Crohn’s disease involving the small bowel are at higher risk for small intestinal cancer. Similarly, people with Crohn’s colitis have a relative risk of 5.6 for developing colon cancer.[26] Screening for colon cancer with colonoscopy is recommended for anyone who has had Crohn’s colitis for at least eight years. Some studies suggest that there is a role for chemoprotection in the prevention of colorectal cancer in Crohn’s involving the colon; two agents have been suggested, folate and mesalamine preparations.

Individuals with Crohn’s disease are at risk of malnutrition for many reasons, including decreased food intake and malabsorption. The risk increases following resection of the small bowel. Such individuals may require oral supplements to increase their caloric intake, or in severe cases, total parenteral nutrition (TPN). Most people with moderate or severe Crohn’s disease are referred to a dietitian for assistance in nutrition.

Crohn’s disease can cause significant complications including bowel obstruction, abscesses, free perforation and hemorrhage.

Crohn’s disease can be problematic during pregnancy, and some medications can cause adverse outcomes for the fetus or mother. Consultation with an obstetrician and gastroenterologist about Crohn’s disease and all medications allows preventative measures to be taken. In some cases, remission can occur during pregnancy. Certain medications can also impact sperm count or may otherwise adversely affect a man’s ability to conceive.

Risk factors:-
Risk factors for Crohn’s disease may include:

#Age. Crohn’s disease can occur at any age, but you’re likely to develop the condition when you’re young. Most people are diagnosed with Crohn’s between the ages of 20 and 30.

#Ethnicity. Although whites have the highest risk of the disease, it can affect any ethnic group. If you’re of Ashkenazi Jewish descent, your risk is even higher.

#Family history. You’re at higher risk if you have a close relative, such as a parent, sibling or child, with the disease. As many as 1 in 5 people with Crohn’s disease has a family member with the disease.

#Cigarette smoking. Cigarette smoking is the most important controllable risk factor for developing Crohn’s disease. Smoking also leads to more severe disease and a greater risk of surgery. If you smoke, stop. Discuss this with your doctor and get help. There are many smoking-cessation programs available if you are unable to quit on your own.

#Where you live. If you live in an urban area or in an industrialized country, you’re more likely to develop Crohn’s disease. Because Crohn’s disease occurs more often among people living in cities and industrial nations, it may be that environmental factors, including a diet high in fat or refined foods, play a role in Crohn’s disease. People living in northern climates also seem to have a greater risk of the disease.

#Isotretinoin (Accutane) use. Isotretinoin (Accutane) is a powerful medication sometimes used to treat scarring cystic acne or acne that doesn’t respond to other treatments. Although cause and effect hasn’t been proved, studies have reported the development of inflammatory bowel disease with isotretinoin use.

#Nonsteroidal anti-inflammatory drugs (NSAIDs). Although these medications — ibuprofen (Advil, Motrin, others), naproxen (Aleve), diclofenac (Cataflam, Voltaren), piroxicam (Feldene), and others — haven’t been shown to cause Crohn’s disease, they can cause similar signs and symptoms. Additionally, theses medications can make existing Crohn’s disease worse.

Diagnosis:-
The diagnosis of Crohn’s disease can sometimes be challenging, and a number of tests are often required to assist the physician in making the diagnosis. Even with a full battery of tests it may not be possible to diagnose Crohn’s with complete certainty; a colonoscopy is approximately 70% effective in diagnosing the disease with further tests being less effective. Disease in the small bowel is particularly difficult to diagnose as a traditional colonoscopy only allows access to the colon and lower portions of the small intestines; introduction of the capsule endoscopy aids in endoscopic .

Your doctor will likely diagnose Crohn’s disease only after ruling out other possible causes for your signs and symptoms, including irritable bowel syndrome (IBS), diverticulitis and colon cancer. To help confirm a diagnosis of Crohn’s disease, you may have one or more of the following tests and procedures:

#Blood tests. Your doctor may suggest blood tests to check for anemia — a condition in which there aren’t enough red blood cells to carry adequate oxygen to your tissues — or to check for signs of infection. Two tests that look for the presence of certain antibodies can sometimes help diagnose which type of inflammatory bowel disease you have, but not everyone with Crohn’s disease or ulcerative colitis has these antibodies. While your doctor may order these tests, a positive finding doesn’t mean you have Crohn’s disease and a negative finding doesn’t mean that you’re free of the disease.

#Fecal occult blood test (FOBT). You may need to provide a stool sample so that your doctor can test for blood in your stool.

#Colonoscopy. This test allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, your doctor can also take small samples of tissue (biopsy) for laboratory analysis, which may help confirm a diagnosis. Some people have clusters of inflammatory cells called granulomas, which help confirm the diagnosis of Crohn’s disease because granulomas don’t occur with ulcerative colitis. In the majority of people with Crohn’s, granulomas aren’t present and diagnosis is made through biopsy and the location of the disease. Risks of colonoscopy include perforation of the colon wall and bleeding.

#Flexible sigmoidoscopy. In this procedure, your doctor uses a slender, flexible, lighted tube to examine the sigmoid, the last section of your colon.

#Barium enema. This diagnostic test allows your doctor to evaluate your large intestine with an X-ray. Before the test, your receive an enema with a contrast dye containing barium. Sometimes, air also is added. The barium dye coats the lining of the bowel, creating a silhouette of your rectum, colon and a portion of your small intestine that’s visible on an X-ray.

#Small bowel imaging. This test looks at the part of the small bowel that can’t be seen by colonoscopy. After you drink a solution containing barium, X-ray, CT or MRI images are taken of your small intestine. The test can help locate areas of narrowing or inflammation in the small bowel that are seen in Crohn’s disease. The test can also help your doctor determine which type of inflammatory bowel disease you have.

#Computerized tomography (CT). Sometimes you may have a CT scan, a special X-ray technique that provides more detail than a standard X-ray does. This test looks at the entire bowel as well as at tissues outside the bowel that can’t be seen with other tests. Your doctor may order this scan to better understand the location and extent of your disease or to check for complications such as a partial blockages, abscesses or fistulas. Although not invasive, a CT scan exposes you to more radiation than a conventional X-ray does.

#Capsule endoscopy.
If you have signs and symptoms that suggest Crohn’s disease but other diagnostic tests are negative, your doctor may perform capsule endoscopy. For this test you swallow a capsule that has a camera in it. The camera takes pictures, which are transmitted to a computer that you wear on your belt. The images are then downloaded, displayed on a monitor and checked for signs of Crohn’s disease. Once it’s made the trip through your digestive system, the camera exits your body painlessly in your stool. Capsule endoscopy is generally very safe, but if you have a partial blockage in the bowel, there’s a slight chance the capsule may become lodged in your intestine.

Treatments:-

Modern Treatment:-
The goal of medical treatment is to reduce the inflammation that triggers your signs and symptoms. In the best cases, this may lead not only to symptom relief but also to long-term remission. Treatment for Crohn’s disease usually involves drug therapy or, in certain cases, surgery.

Doctors use several categories of drugs that control inflammation in different ways. But drugs that work well for some people may not work for others, so it may take time to find a medication that helps you. In addition, because some drugs have serious side effects, you’ll need to weigh the benefits and risks of any treatment.

Medication:-
Acute treatment uses medications to treat any infection (normally antibiotics) and to reduce inflammation (normally aminosalicylate anti-inflammatory drugs and corticosteroids). When symptoms are in remission, treatment enters maintenance with a goal of avoiding the recurrence of symptoms. Prolonged use of corticosteroids has significant side-effects; as a result they are generally not used for long-term treatment. Alternatives include aminosalicylates alone, though only a minority are able to maintain the treatment, and many require immunosuppressive drugs.

Medications used to treat the symptoms of Crohn’s disease include 5-aminosalicylic acid (5-ASA) formulations, prednisone, immunomodulators such as azathioprine, mercaptopurine, methotrexate, infliximab, adalimumab[15], certolizumab  and natalizumab. Hydrocortisone should be used in severe attacks of Crohn’s disease.

Low doses of the opiate receptor antagonist Naltrexone (also Low dose naltrexone) have been found to be effective in inducing remission in 67% of patients with Crohn’s disease in a small study conducted at Pennsylvania State University. Dr. Jill Smith, Professor of Gastroenterology at Pennsylvania State University’s College of Medicine concluded that “LDN therapy appears effective and safe in subjects with active Crohn’s disease.”  Smith and her colleagues have since received a NIH grant and are proceeding with a definitive Phase II placebo-controlled clinical trial.

Lifestyle changes:-
Certain lifestyle changes can reduce symptoms, including dietary adjustments, proper hydration and smoking cessation. Eating small meals frequently instead of big meals may also help with a low appetite. To manage symptoms have a balanced diet with proper portion control. Fatigue can be helped with regular exercise, a healthy diet and enough sleep. A food diary may help with identifying foods that trigger symptoms. Some patients should follow a low dietary fiber diet to control symptoms especially if fiberous foods cause symptoms.

Surgery:
Crohn’s cannot be cured by surgery, though it is used when partial or a full blockage of the intestine occurs. Surgery may also be required for complications such as obstructions, fistulas and/or abscesses, or if the disease does not respond to drugs. After the first surgery, Crohn’s usually shows up at the site of the resection though it can appear in other locations. After a resection, scar tissue builds up which can cause strictures. A stricture is when the intestines become too small to allow excrement to pass through easily which can lead to a blockage. After the first resection, another resection may be necessary within five years.  For patients with an obstruction due to a stricture, two options for treatment are strictureplasty and resection of that portion of bowel. There is no statistical significance between strictureplasty alone versus strictureplasty and resection in cases of duodenal involvement. In these cases, re-operation rates were 31% and 27%, respectively, indicating that strictureplasty is a safe and effective treatment for selected patients with duodenal involvement

Short bowel syndrome (SBS, also short gut syndrome or simply short gut) can be caused by the surgical removal of the small intestines. It usually develops if a person has had half or more of their small intestines removed.  Diarrhea is the main symptom of short bowel syndrome though other symptoms may include cramping, bloating and heartburn. Short bowel syndrome is treated with changes in diet, intravenous feeding, vitamin and mineral supplements and treatment with medications. Another complication following surgery for Crohn’s disease where the terminal ileum has been removed is the development of excessive watery diarrhea. This is due to an inability to reabsorb bile acids after resection of the terminal ileum.

In some cases of SBS, intestinal transplant surgery may be considered; though the number of transplant centres offering this procedure is quite small and it comes with a high risk due to the chance of infection and rejection of the transplanted intestine

Prospective treatments:
Researchers at University College London have questioned the wisdom of suppressing the immune system in Crohn’s, as the problem may be an under-active rather than an over-active immune system: their study found that Crohn’s patients showed an abnormally low response to an introduced infection, marked by a poor flow of blood to the wound, and the response improved when the patients were given sildenafil citrate.

Recent studies using helminthic therapy or hookworms to treat Crohn’s Disease and other (non-viral) auto-immune diseases seem to yield promising results.

Complementary and alternative medicine:-
More than half of Crohn’s disease sufferers have tried complementary or alternative therapy. These include diets, probiotics, fish oil and other herbal and nutritional supplements. The benefit of these medications is uncertain.

#Acupuncture is used to treat inflammatory bowel disease in China, and is being used more frequently in Western society. However, there is no evidence that acupuncture has benefits beyond the placebo effect.

#Methotrexate is a folate anti-metabolite drug which is also used for chemotherapy. It is useful in maintenance of remission for those no longer taking corticosteroids.

#Metronidazole and ciprofloxacin are antibiotics which are used to treat Crohn’s that have colonic or perianal involvement, although, in the United States, this use has not been approved by the Food and Drug Administration. They are also used for treatment of complications, including abscesses and other infections accompanying Crohn’s disease.

#Thalidomide has shown response in reversing endoscopic evidence of disease.

#Cannabis-derived drugs may be used to treat Crohn’s Disease with its anti-inflammatory properties. Cannabis-derived drugs may also help to heal the gut lining.

#Soluble Fiber has been used by some to treat symptoms.^ a b c Tungland BC, Meyer D, Nondigestible oligo- and polysaccharides (dietary fiber): their physiology and role in human health and food, Comp Rev Food Sci Food Safety, 3:73-92, 2002 (Table 3)

#Probiotics include Sacchromyces boulardii   and E. coli Nissle 1917.

#Boswellia is an ayurvedic (Indian traditional medicine) herb, used as a natural alternative to drugs. One study has found that the effectiveness of H-15 extract is not inferior to mesalazinesimilar, and suggests it that its safety makes it superior in benefit-risk evaluations.

Lifestyle and home remedies:-
Sometimes you may feel helpless when facing Crohn’s disease. But changes in your diet and lifestyle may help control your symptoms and lengthen the time between flare-ups.

Diet
There’s no firm evidence that what you eat actually causes inflammatory bowel disease. But certain foods and beverages can aggravate your signs and symptoms, especially during a flare-up in your condition. If you think there are foods that make your condition worse, try keeping a food diary to keep track of what you’re eating as well as how you feel. If you discover certain foods are causing your symptoms to flare, it’s a good idea to try eliminating those foods. Here are some suggestions that may help:

#Limit dairy products. Like many people with inflammatory bowel disease, you may find that problems, such as diarrhea, abdominal pain and gas, improve when you limit or eliminate dairy products. You may be lactose intolerant — that is, your body can’t digest the milk sugar (lactose) in dairy foods. If so, limiting dairy or using an enzyme product, such as Lactaid, will help break down lactose.

#Try low-fat foods. If you have Crohn’s disease of the small intestine, you may not be able to digest or absorb fat normally. Instead, fat passes through your intestine, making your diarrhea worse. Foods that may be especially troublesome include butter, margarine, cream sauces and fried foods.

#Experiment with fiber. For most people, high-fiber foods, such as fresh fruits and vegetables and whole grains, are the foundation of a healthy diet. But if you have inflammatory bowel disease, fiber may make diarrhea, pain and gas worse. If raw fruits and vegetables bother you, try steaming, baking or stewing them. You may also find that you can tolerate some fruits and vegetables, but not others. In general, you may have more problems with foods in the cabbage family, such as broccoli and cauliflower, and nuts, seeds, corn and popcorn. Consult your doctor prior to starting a high-fiber diet.

#Avoid problem foods. Eliminate any other foods that seem to make your signs and symptoms worse. These may include “gassy” foods such as beans, cabbage and broccoli, raw fruit juices and fruits — especially citrus fruits, spicy food, popcorn, alcohol, and foods and drinks that contain caffeine, such as chocolate and soda.

#Eat small meals. You may find you feel better eating five or six small meals a day rather than two or three larger ones.

#Drink plenty of liquids. Try to drink plenty of fluids daily. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, while carbonated drinks frequently produce gas.

#Consider multivitamins. Because Crohn’s disease can interfere with your ability to absorb nutrients and because your diet may be limited, multivitamin and mineral supplements are often helpful. Check with your doctor before taking any vitamins or supplements.

#Talk to a dietitian. If you begin to lose weight or your diet has become very limited, talk to a registered dietitian.
Stress :-
Although stress doesn’t cause Crohn’s disease, it can make your signs and symptoms much worse and may trigger flare-ups. Stressful events can range from minor annoyances to a move, job loss or the death of a loved one.

When you’re stressed, your normal digestive process changes. Your stomach empties more slowly and secretes more acid. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself.

Although it’s not always possible to avoid stress, you can learn ways to help manage it. Some of these include:

#Exercise. Even mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that’s right for you.

#Biofeedback. This stress-reduction technique may help you reduce muscle tension and slow your heart rate with the help of a feedback machine. You’re then taught how to produce these changes without feedback from the machine. The goal is to help you enter a relaxed state so that you can cope more easily with stress. Biofeedback is usually taught in hospitals and medical centers.

#Regular relaxation and breathing exercises. One way to cope with stress is to regularly relax. You can take classes in yoga and meditation or use books, CDs or DVDs at home.

You may click to see this article :-Banana Plantain and Broccoli Fibers for Crohn’s Disease Treatment

Prognosis:
Crohn’s disease is a chronic condition for which there is currently no cure. It is characterised by periods of improvement followed by episodes when symptoms flare up. With treatment, most people achieve a healthy height and weight, and the mortality rate for the disease is relatively low. However, Crohn’s disease is associated with an increased risk of small bowel and colorectal carcinoma, including bowel cancer.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Crohn’s_disease
http://www.mayoclinic.com/health/crohns-disease/DS00104

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Mare’s Milk to Ease Gut Ache

Mare’s milk is being tested as a treatment for inflammatory bowel problems, such as ulcerative colitis.  …..CLICK & SEE

CLICK TO SEE
This follows an earlier study which showed that the milk from horses reduced eczema symptoms by an average of 30 per cent.
The same study found that the patients also had higher levels of ‘good’ bacteria after treatment. Good bacteria are thought to have an antiinflammatory effect, as well as boosting the immune system.
In the latest German trial, conducted at the University of Jena, patients were given either 250ml of mare’s milk or a placebo daily for two months. Those who had the milk suffered less abdominal pain and needed less medication.
It’s not clear what is in the milk that is beneficial, but the researchers believe it ‘could improve the well-being of patients with Crohn’s disease and ulcerative colitis’.

Other Health Benefits:

Toward the end of the 19th century, kumis had a strong enough reputation as a cure-all to support a small industry of “kumis cure” resorts, mostly in southeastern Russia, where patients were “furnished with suitable light and varied amusement” during their treatment, which consisted of drinking large quantities of kumis. W. Gilman Thompson’s 1906 Practical Diatetics reports that kumis has been cited as beneficial for a range of chronic diseases, including tuberculosis, bronchitis, catarrh, and anemia. Gilman also says that a large part of the credit for the successes of the “kumis cure” is due not to the beverage, but to favorable summer climates at the resorts. Among notables to try the kumis cure were writers Leo Tolstoy and Anton Chekhov. Chekhov, long-suffering from tuberculosis, checked into a kumis cure resort in 1901. Drinking four bottles a day for two weeks, he gained 12 pounds but no cure.

 

Nutritional properties of mare’s milk
87.9% of Inner Mongolians are lactose intolerant. During fermentation, the lactose in mare’s milk is converted into lactic acid, ethanol, and carbon dioxide, and the milk becomes an accessible source of nutrition for people who are lactose intolerant.

Before fermentation, mare’s milk has almost 40% more lactose than cow’s milk According to one modern source, “unfermented mare’s milk is generally not drunk”, because it is a strong laxative.    Varro’s On Agriculture, from the 1st century BC, also mentions this: “as a laxative the best is mare’s milk, then donkey’s milk, cow’s milk, and finally goat’s milk…”; drinking six ounces (190 ml) a day would be enough to give a lactose-intolerant person severe intestinal symptoms.

You may click to learn more about  Mare’s milk……(1)…….(2)……(3)


Resources:

Mail Online. Aug.21.2009
http://en.wikipedia.org/wiki/Kumis

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The Poop!


Stool – Healthy and Unhealthy Stool:-

Click to see the  pictures of ->
Bristol  Stool  Chart

This writing might “stink” a little, but this information might serve as an important revelation to many particularly for elderly and persons with contineus stomac problem!

Human poops or  stools, is the waste product of the human digestive system and varies significantly in appearance, depending on the state of the whole digestive system, influenced and found by diet and health.

Normally stools are semisolid, with a mucus coating. Small pieces of harder, less moist feces can sometimes be seen impacted on the distal (leading) end. This is a normal occurrence when a prior bowel movement is incomplete; and feces are returned from the rectum to the intestine, where water is absorbed.

Meconium (sometimes erroneously spelled merconium) is a newborn baby’s first feces. Human feces are a defining subject of humor.

Some persons have bloody stools on and off, usually accompanied by a sight tinch of discomfort. Many times, this doesn’t appear as a threat or danger to them as they often regard it as constipation though they may be passionate lover of fruits and vegetables. This might go  on for some time until one day, bloody stools became really “bloody” and the pain became increasingly painful. Alarmed and paranoid, they call their dear ones who will  recommend  to see the doctor over at his or her clinic.

Now let us see What Does an Ideal Bowel Movement Look Like?

Click to see the pictures

Click for different pictures

Alternative practitioners often ask clients about their stool as part of their assessment. Find out what normal stool should look like, and learn about the causes of green stool, pale stool, yellow stool, blood in stool, mucus in stool, pencil thin stool, infrequent stool, and more.

What Does an Ideal

Look Like?
An ideal bowel movement is medium brown, the color of plain cardboard. It leaves the body easily with no straining or discomfort. It should have the consistency of toothpaste, and be approximately 4 to 8 inches long. Stool should enter the water smoothly and slowly fall once it reaches the water. There should be little gas or odor.

Stool That Sinks Quickly
Rapidly sinking stool can indicate that a person isn’t eating enough fiber-rich foods, such as vegetables, fruits, and whole grains, or drinking enough water. This stool is often dark because they have been sitting in the intestines for a prolonged time. Click to learn 5 tips to boost your water intake.

Pale Stool
Stool that is pale or grey may be caused by insufficient bile output due to conditions such as cholecystitis, gallstones, giardia parasitic infection, hepatitis, chronic pancreatitis, or cirrhosis. Bile salts from the liver give stool its brownish color. If there is decreased bile output, stool is much lighter in color.

Other causes of pale stool is the use of antacids that contain aluminum hydroxide. Stool may also temporarily become pale after a barium enema test.

Pale stool may also be shiny or greasy, float, and be foul smelling, due to undigested fat in the stool (see soft and smelly stool).

Soft, Smelly Stool
Soft, foul-smelling stool that floats, sticks to the side of the bowl, or is difficult to flush away may mean there is increased fat in the stools, called steatorrhea. Stool is sometimes also pale. Click to Learn more about the causes of soft, foul-smelling stool.

Mucus in Stool
Whitish mucus in stool may indicate there is inflammation in the intestines. Mucus in stool can occur with either constipation or diarrhea. Click to Read more about the causes of mucus in stool.

Green Stool
The liver constantly makes bile, a bright green fluid, that is secreted directly into the small intestine or stored in the gallbladder. Continue reading about the causes of green stool.

Loose Stool
In traditional Chinese medicine, loose stools, abdominal bloating, lack of energy, and poor appetite can be signs of a condition known as spleen qi deficiency. It doesn’t necessarily involve your actual spleen, but it is linked to tiredness and weak digestion brought on by stress and poor diet. Learn more about the causes of loose stool.

Pencil Thin Stool
Like loose stools, stool that is pencil thin can be caused by a condition known in traditional Chinese medicine as spleen qi deficiency.

Other symptoms of spleen qi deficiency are: easy bruising, mental fogginess, bloating, gas, loose stools, fatigue, poor appetite, loose stools with little odor, symptoms that worsen with stress, undigested food in the stools, and difficulty ending the bowel movement. Spleen qi deficiency can be brought on by stress and overwork.

Eating certain foods in excess is thought to worsen spleen qi deficiency. Offending foods include fried or greasy foods, dairy, raw fruits and vegetables, and cold drinks, all believed to cause “cold” and “dampness” in the body. Dietary treatment of spleen qi deficiency involves eating warm, cooked foods. Ginger tea and cinnamon tea are also warming.

Pencil thin stool can also be caused by a bowel obstruction. Benign rectal polyps, prostate enlargement, colon or prostate cancer are some of the conditions that can cause obstruction.

Infrequent Stool
With constipation, infrequent or hard stool is passed with straining. Learn about the causes of infrequent stool.

Pellet Stool

Pellet stool is stool that comes out in small, round balls. In traditional Chinese medicine, pellet stool is caused by a condition known as liver qi stagnation. Liver qi stagnation can be brought on by stress. Lack of exercise can worsen the problem. Find out more about the causes of pellet stool.

Yellow Stool
Yellow stool can indicate that food is passing through the digestive tract relatively quickly. Yellow stool can be found in people with GERD (gastroesophageal reflux disease). Symptoms of GERD include heartburn, chest pain, sore throat, chronic cough, and wheezing. Symptoms are usually worse when lying down or bending. Foods that can worsen GERD symptoms include peppermint, fatty foods, alcohol, coffee, and chocolate.

Yellow stool can also result from insuffient bile output. Bile salts from the liver gives stool its brownish color. When bile output is diminished, it often first appears as yellow stool. If there is a greater reduction in bile output, stool lose almost all of its color, becoming pale or grey.

If the onset is sudden, yellow stool can also be a sign of a bacterial infection in the intestines.

Yellowing of stool can be caused by an infection known as Giardiasis, which derives its name from Giardia, an anaerobic flagellated protozoan parasite that can cause severe and communicable yellow diarrhea. Another cause of yellowing is a condition known as Gilbert’s Syndrome. This condition is characterized by jaundice and hyperbilirubinemia when too much bilirubin is present in the circulating blood.

Dark Stool
Stool that is almost black with a thick consistency may be caused by bleeding in the upper digestive tract. The most common medical conditions that cause dark, tar-like stool includes duodenal or gastric ulcer, esophageal varices, Mallory Weiss tear (which can be linked with alcoholism), and gastritis.

Certain foods, supplements, and medications can temporarily turn stool black. These include:

*Bismuth (e.g. Pepto bismol)

*Iron

*Activated charcoal

*Aspirin and NSAIDS (which can cause bleeding in the stomach)

*Dark foods such as black licorice and blueberries

Stool can be black due to the presence of red blood cells that have been in the intestines long enough to be broken down by digestive enzymes. This is known as melena (or melaena), and is typically due to bleeding in the upper digestive tract, such as from a bleeding peptic ulcer. The same color change (albeit harmless) can be observed after consuming foods that contain substantial proportion of animal bloods, such as Black pudding or Ti?t canh. The black color is caused by oxidation of the iron in the blood’s hemoglobin (haemoglobin). Black feces can also be caused by a number of medications, such as bismuth subsalicylate, and dietary iron supplements, or foods such as black liquorice, or blueberries. Hematochezia (also haemochezia or haematochezia) is similarly the passage of feces that are bright red due to the presence of undigested blood, either from lower in the digestive tract, or from a more active source in the upper digestive tract. Alcoholism can also provoke abnormalities in the path of blood throughout the body, including the passing of red-black stool.

Dark stool can also occur with constipation.

If you experience this type of stool, you should see your doctor as soon as possible.

Blue Stool
Prussian blue, used in the treatment of radiation cesium and thallium poisoning, can turn the feces blue. Also, substantial consumption of products containing blue food dye (things such as blue koolaid or grape soda)

Bright Red Stool
When there is blood in stool, the color depends on where it is in the digestive tract. Blood from the upper part of the digestive tract, such as the stomach, will look dark by the time it reaches exits the body as a bowel movement. Blood that is bright or dark red, on the other hand, is more likely to come from the large intestine or rectum.

Conditions that can cause blood in the stool include hemorrhoids, anal fissures, diverticulitis, colon cancer, and ulcerative colitis, among others.

Eating beets can also temporarily turn stools and urine red.

Blood in stool doesn’t always appear bright red. Blood may be also present in stool but not visible, called “occult” blood. A test called the Fecal Occult Blood Test is used to detect hidden blood in stool.

Silver Stool
A tarnished-silver or aluminum paint-like stool color characteristically results when biliary obstruction of any type (white stool) combines with gastrointestinal bleeding from any source (black stool). It can also suggest a carcinoma of the ampulla of Vater, which will result in gastrointestinal bleeding and biliary obstruction, resulting in silver stool.


You may click to see white stool:–>   : Should I be concerned

Note: Speak with your doctor about any change or abnormality concerning bowel movements.

Resources
http://gracemagg.blogspot.com/2008/07/poop.html
http://altmedicine.about.com/od/gettingdiagnosed/a/stools.htm
http://www.healingwatersaz.com/colon.html

http://en.wikipedia.org/wiki/Human_feces

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