The large bowel is an amazing recycling and repurposing centre for the body.
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This slows the passage of food through the large bowel, which can lead to constipation.
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These are a key nutritional source for the trillions of bacteria that inhabit the large bowel (the gut microbiota).
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The cause for his ruptured colon — also known as the large bowel or large intestine — has yet to be confirmed.
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On the way, these short-chain fatty acids strengthen, grow, and repair the cell layers that line the large bowel.
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The longer it takes for digested food to pass through the large bowel, the more water gets reclaimed and the drier the stool becomes.
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The feces—or stools—we produce can provide a valuable real-time window into the health of your large bowel (or colon) and gastrointestinal tract.
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"In between, it fans out, like a Chinese fan, to span the length of the intestine from the upper small intestine to the end of the large bowel," Coffey said.
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According to the U.S. National Library of Medicine, an enema is the "injection of a liquid through the anus into the large bowel," also known as the large intestine or the colon.
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One of these short-chain fatty acids, butyrate (which is also the food acid that gives parmesan cheese its haunting aroma), reduces transit time by strengthening contraction of muscles lining the large bowel.
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While arguably easier to clean up, the drier stool forms (types 1 and 2) tend to compact into large stool that can apply long term pressure to and abrade the lining of the large bowel.
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When researchers looked only at patients who did not receive surgery, death rates were higher in England for four conditions: aortic dissection, peptic ulcer perforation, small bowel or large bowel perforation and incarcerated or strangulated hernias.
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Basically that means they're removing my large bowel, and I'll be a Ken doll from behind, and I'll have this new thing that I've nicknamed a bionic bumhole, which is a little stoma that sticks out the side, and they attach a bag to me.
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Perry's reps confirmed to TMZ that the former "Friends" star recently had surgery in an L.A. hospital to repair a gastrointestinal perforation, which is essentially a hole that forms anywhere between the throat and the rectum -- but typically in the stomach, large bowel or small intestine.
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Vomiting may occur before constipation. In large bowel obstruction, the pain is felt lower in the abdomen and the spasms last longer. Constipation occurs earlier and vomiting may be less prominent. Proximal obstruction of the large bowel may present as small bowel obstruction.
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Double-contrast barium enemas are less invasive than a colonoscopy and have comparatively fewer issues in a viable large bowel.
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Outcomes depend on the amount of bowel remaining and whether or not the small bowel remains connected with the large bowel.
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A sigmoidoscopy only examines up to the sigmoid, the most distal part of the colon, while colonoscopy examines the whole large bowel.
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Gastroenteritis is defined as vomiting or diarrhea due to inflammation of the small or large bowel, often due to infection. The changes in the small bowel are typically noninflammatory, while the ones in the large bowel are inflammatory. The number of pathogens required to cause an infection varies from as few as one (for Cryptosporidium) to as many as 108 (for Vibrio cholerae).
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An enterocutaneous fistula (ECF) is an abnormal communication between the small or large bowel and the skin that allows the contents of the stomach or intestines to leak through an opening in the skin.
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Cutaneous manifestation of blue rubber bleb nevus syndrome. BRBNS is a venous malformation, formerly, though incorrectly, thought to be related to the hemangioma. It carries significant potential for serious bleeding. Lesions are most commonly found on the skin and in the small intestine and distal large bowel.
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Clinical Oncology, v.2, 1976, pp. 339‐342. Abdomino‐perineal resection – a 15‐year review. Clinical Oncology, v.6, 1980, pp. 231‐236. . Colonoscopy in the detection of polyps of the large bowel. Journal of the Royal College of Surgeons of Edinburgh, v.26, 1981, pp. 150‐152.
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Risk factors include pregnancy, childbirth, obesity, constipation, and chronic coughing. Diagnosis is based on examination. It is a form of pelvic organ prolapse, together with bladder prolapse, large bowel prolapse, and small bowel prolapse. Preventive efforts include managing chronic breathing problems, not smoking, and maintaining a healthy weight.
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Inflammatory bowel disease (IBD), a collection of systemic diseases involving inflammation of the gastrointestinal tract, includes two (or three) diseases of unknown causation: ulcerative colitis, which affects only the large bowel; Crohn's disease, which can affect the entire gastrointestinal tract; and indeterminate colitis, which consists of large bowel inflammation that shows elements of both Crohn's disease and ulcerative colitis. Although the causes of these diseases are unknown, genetic, environmental, immune, and other mechanisms have been proposed. Of these, the immune system plays a large role in the development of symptoms. Given this, a variety of biological therapies (such as TNF inhibitors and interleukin antagonists) have been developed for the treatment of these diseases.
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Stercoral ulcer is an ulcer of the colon due to pressure and irritation resulting from severe, prolonged constipation due to a large bowel obstruction. It is most commonly located in the rectum. Prolonged constipation leads to production of fecoliths. These hard lumps irritate the rectum and lead to the formation of these ulcers.
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Colectomy (col- + -ectomy) is bowel resection of the large bowel (colon). It consists of the surgical removal of any extent of the colon, usually segmental resection (partial colectomy). In extreme cases where the entire large intestine is removed, it is called total colectomy, and proctocolectomy (procto- + colectomy) denotes that the rectum is included.
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Intussusception is a medical condition in which a part of the intestine folds into the section immediately ahead of it. It typically involves the small bowel and less commonly the large bowel. Symptoms include abdominal pain which may come and go, vomiting, abdominal bloating, and bloody stool. It often results in a small bowel obstruction.
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Serrated polyposis syndrome is a rare condition that has been defined by the World Health Organization as either: :#≥5 serrated lesions/polyps proximal to the rectum, all ≥ 5 mm in size, with two lesions ≥10 mm :#>20 serrated lesions/polyps of any size distributed throughout the large bowel with 5 proximal to the rectum.
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Large bowel obstruction also known as colonic obstruction include acute colonic obstruction where a blockage is formed in the colon. Colonic obstructions frequently happen within elder population, often accompanied with significant 'comorbidities'. Although colonic malignancy is revealed as the major cause of the colonic obstruction, 'volvulus' has also been founded as a secondary common cause around the world.
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Forty-eight-hour whole body images are appropriate. Delayed imaging can be obtained even 1 week or longer after injection if bowel is confounding. SPECT can be performed as needed. Oral laxatives or enemas can be given before imaging to reduce bowel activity and reduce dose to large bowel; however, the usefulness of bowel preparation is controversial.
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Colorectal cancer (CRC), also called colon cancer or large bowel cancer, is the third leading cause of cancer-related death in the western world. An estimated 1.6 million people are diagnosed with the disease worldwide every year. An estimated 50% of CRC patients will show liver metastases. It is this form of metastatic colorectal cancer (mCRC) Sirtex targets with SIR-Spheres microspheres.
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Often these eggs are in the soil in areas where people defecate outside and where untreated human feces is used as fertilizer. These eggs originate from the feces of infected people. Young children playing in such soil and putting their hands in their mouths also become infected easily. The worms live in the large bowel and are about four centimetres in length.
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Sodium picosulfate (INN, also known as sodium picosulphate) is a contact stimulant laxative used as a treatment for constipation or to prepare the large bowel before colonoscopy or surgery. It is sold under the trade names Sodipic Picofast, Laxoberal, Laxoberon,Website of Merck Pakistan Purg-Odan, Picolax, Guttalax, Namilax, Pico-Salax,PICO SALAX Product Information PicoPrep, and Prepopik, among others.
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A sentinel loop is a sign seen on a radiograph that indicates localized ileus from nearby inflammation. Simply put, it is the dilatation of a segment of small intestine. to be differentiated from colonic cutoff sign which is a dilatation of a segment of large bowel. An isolated distended loop of bowel is seen near the site of injured viscus or inflamed organ.
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Sigmoid colon volvulus, also known as sigmoid volvulus, is volvulus affecting the sigmoid colon. It is a common cause of bowel obstruction and constipation. It is common in Asia, India (7% of intestinal obstruction) and especially South India because of the high fibre diet. It is a very common cause of large bowel obstruction in Peru and Bolivia due to high altitude.
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Sometimes, use of the fingers or hand (manual evacuation) is required. Although peristalsis in the colon delivers material to the rectum, laxatives such as bisacodyl or senna that induce peristalsis in the large bowel do not appear to initiate peristalsis in the rectum. They induce a sensation of rectal fullness and contraction that frequently leads to defecation, but without the distinct waves of activity characteristic of peristalsis.
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Colonoscopy () or coloscopy () is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It can provide a visual diagnosis (e.g., ulceration, polyps) and grants the opportunity for biopsy or removal of suspected colorectal cancer lesions. Colonoscopy can remove polyps smaller than one millimeter.
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Endoscopy of the esophagus, stomach, and duodenum or endoscopy of the large bowel are generally recommended within 24 hours and may allow treatment as well as diagnosis. An upper GI bleed is more common than lower GI bleed. An upper GI bleed occurs in 50 to 150 per 100,000 adults per year. A lower GI bleed is estimated to occur in 20 to 30 per 100,000 per year.
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The ilium is connected right into the large intestine. The ileum is connected right into the ileum cecum valve which is the beginning of the large intestine. The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system. One disease that affects the lining of the GI tract. _Crohn’s disease_ is a chronic inflammatory condition of the gastrointestinal tract.
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For a long time, Nuray Hafiftaş had been treated for large bowel cancer at Emsey Hospital. Some famous names such as Seda Sayan, Ceylan and Belkıs Akkale visited her during her time at the hospital. After a long treatment, she died in Istanbul on 14 February 2018 at the age of 55. On 15 February she was buried at Zincirlikuyu Cemetery after a funeral ceremony in Teşvikiye Mosque.
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Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas. Mechanical obstruction is the cause of about 5 to 15% of cases of severe abdominal pain of sudden onset requiring admission to hospital.
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Causes of bowel obstruction include adhesions, hernias, volvulus, endometriosis, inflammatory bowel disease, appendicitis, tumors, diverticulitis, ischemic bowel, tuberculosis and intussusception. Small bowel obstructions are most often due to adhesions and hernias while large bowel obstructions are most often due to tumors and volvulus. The diagnosis may be made on plain X-rays; however, CT scan is more accurate. Ultrasound or MRI may help in the diagnosis of children or pregnant women.
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Cecal bascule is a cause of large bowel obstruction where there is folding of the cecum anteriorly over the ascending colon. It is one of two types of cecal volvulus, the other being axial ileocolic. It is caused by rotational torsion of the cecum or ascending colon along its own axis. In cecal bascule, the base of the cecum folds anteriorly over the ascending colon, creating a flap-valve, obstructing emptying of the cecum.
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Ulcerative colitis mainly affects the function of the large bowel, and its incidence rate is three times larger than the Crohn's disease. In terms of clinical features, over 90% of patients exhibited constant diarrhoea, 'rectal bleeding, softer and mucus in the stool, tenesmus and abdomen pain'. At the same time, patient also reported to be having 'arthralgia, episcleritis and erythema nodosum'. The symptoms can continue for around 6 weeks or even more than that.
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10% to 25% of the dose of gallium-67 is excreted within 24 hours after injection (the majority of which is excreted through the kidneys). After 24 hours the principal excretory pathway is colon. The "target organ" (organ that receives the largest radiation dose in the average scan) is the colon (large bowel). In a normal scan, uptake of gallium is seen in wide range of locations which do not indicate a positive finding.
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The terminal portion of the small bowel (ileum) is where bile acids are reabsorbed. When this section is removed, the bile acids pass into the large bowel and cause diarrhea due to stimulation of chloride/fluid secretion by the colonocytes resulting in a secretory diarrhea. Colestyramine prevents this increase in water by making the bile acids insoluble and osmotically inactive. Colestyramine is also used in the control of other types of bile acid diarrhea.
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The unavailable carbohydrates (dietary fibre) are degraded to a variable extent in the large bowel. The products of this microbial digestion are fatty acids, CO2 (carbon dioxide), methane and hydrogen. The fatty acids (acetate, butyrate and propionate) are absorbed in the large intestine and provide some metabolisable energy. The extent of degradation depends on the source of the dietary fibre (its composition and state of division), and the individual consuming the dietary fibre.
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The removal of the entire large intestine, known as a proctocolectomy, results in a permanent ileostomy – where a stoma is created by pulling the terminal ileum through the abdomen. Intestinal contents are emptied into a removable ostomy bag which is secured around the stoma using adhesive. Another surgical option for ulcerative colitis that is affecting most of the large bowel is called the ileal pouch- anal anastomosis (IPAA). This is a two- or three-step procedure.
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Nutrition Research Reviews 31 (1): 1-15. He developed the fiber hypothesis in a series of books and papers with Burkitt in the 1970s and 80s. Their research showed that diets low in fiber increase the risk of coronary heart disease, diabetes, obesity and large bowel conditions such as colorectal cancer, appendicitis and diverticulosis. The British Medical Journal describes Trowell as "probably the first person to link diets deficient in fibre with obesity, diabetes and coronary heart disease."H.
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In the United States, more than half a million people have PKD, making it the fourth leading cause of kidney failure. PKD affects all races and genders equally and those with PKD have a possibility of developing cysts in other organs such as liver, pancreas, spleen, ovaries, and large bowel. Usually, these latter cysts do not impose a problem. Half of patients have no manifestation of symptoms, but symptoms may include: hematuria, back or abdominal pain, or the development of hypertension.
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Metchnikoff, at that time a professor at the Pasteur Institute in Paris, proposed the hypothesis that the aging process results from the activity of putrefactive (proteolytic) microbes producing toxic substances in the large bowel. Proteolytic bacteria such as clostridia, which are part of the normal gut microbiota, produce toxic substances including phenols, indols, and ammonia from the digestion of proteins. According to Metchnikoff, these compounds were responsible for what he called "intestinal autointoxication", which would cause the physical changes associated with old age.Arteriosclerosis and intestinal poisons.
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In the vast majority of cases, infection is asymptomatic and the carrier is unaware they are infected. However, in an estimated 10% of cases E. histolytica causes disease. Once the trophozoites are excysted in the terminal ileum region, they colonize the large bowel, remaining on the surface of the mucus layer and feeding on bacteria and food particles. Occasionally, and in response to unknown stimuli, trophozoites move through the mucus layer where they come in contact with the epithelial cell layer and start the pathological process.
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The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system in vertebrates. Water is absorbed here and the remaining waste material is stored as feces before being removed by defecation. The colon is the largest portion of the large intestine, so many mentions of the large intestine and colon overlap in meaning whenever precision is not the focus. Most sources define the large intestine as the combination of the cecum, colon, rectum, and anal canal.
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Some causes of bowel obstruction may resolve spontaneously; many require operative treatment. In adults, frequently the surgical intervention and the treatment of the causative lesion are required. In malignant large bowel obstruction, endoscopically placed self- expanding metal stents may be used to temporarily relieve the obstruction as a bridge to surgery, or as palliation. Diagnosis of the type of bowel obstruction is normally conducted through initial plain radiograph of the abdomen, luminal contrast studies, computed tomography scan, or ultrasonography prior to determining the best type of treatment.
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Whole bowel irrigation was originally developed to cleanse the large bowel before surgery or colonoscopy. Initially a solution of sodium chloride, potassium chloride, and sodium bicarbonate was used but this electrolyte solution was shown to be absorbed by the body, sometimes leading to complications. To solve this problem a specialized irrigation fluid was developed consisting mainly of an iso-osmolar solution of macrogol. With the macrogol solution there is negligible fluid or electrolyte absorption and several studies have shown the overall safety of the procedure.
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The small bowel obstruction can result in severe renal damage and hypovolemia. while evolving into 'mucosal ischemia and perforation'. Patients with small bowel obstruction were found experiencing constipation, strangulation and abdominal pain and vomiting. Surgery intervention is primarily used to cure severe small bowel obstruction condition. Nonoperative therapy included ‘nasogastric tube decompression', 'water-soluble-contrast medium process' or symptomatic management can be applied to treat less severe symptoms According to research, large bowel obstruction is less common than small bowel obstruction, but is still associated with high mortality rate.
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Prebiotics are compounds in food that induce the growth or activity of beneficial microorganisms such as bacteria and fungi. The most common example is in the gastrointestinal tract, where prebiotics can alter the composition of organisms in the gut microbiome. Dietary prebiotics are typically nondigestible fiber compounds that pass undigested through the upper part of the gastrointestinal tract and stimulate the growth or activity of advantageous bacteria that colonize the large bowel by acting as substrate for them. They were first identified and named by Marcel Roberfroid in 1995.
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Hirschsprung's disease is a congenital disorder of the colon in which nerve cells of the myenteric plexus in its walls, also known as ganglion cells, are absent. Hirschsprung's disease is a form of functional low bowel obstruction due to failure of caudal migration of neuroblasts within developing bowel – this results in an absence of parasympathetic intrinsic ganglion cells in both Auerbach's and Meissner's plexuses. The distal large bowel from the point of neuronal arrest to the anus is continuously aganglionic. It is a rare disorder (1:5000), with prevalence among males being four times that of females.
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The diagnosis of serrated polyposis syndrome is achieved when either one of two criteria are met: ≥5 serrated lesions/polyps proximal to the rectum (all ≥ 5 mm in size, with two lesions ≥10 mm), or >20 serrated lesions/polyps of any size distributed throughout the large bowel with 5 proximal to the rectum. Any serrated polyp is counted towards the diagnosis, including sessile serrated lesions, hyperplastic polyps, and traditional serrated adenomas. In addition, the cumulative number of serrated lesions is cumulative over time and includes multiple colonoscopies. The diagnosis of SPS is often overlooked, and requires lifelong tracking of cumulative serrated polyps.
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Colonic irrigation also known as colon hydrotherapy, colonic hydrotherapy, or a "colonic", is a treatment which is used "to wash out the contents of the large bowel by means of copious enemas using water or other medication." During a cleansing enema, liquid is introduced into the colon and retained for five to fifteen minutes. During a colonic, liquid is introduced into the colon and then it is flushed out and this is repeated until the entire colon is cleared. Colonic irrigation has been described as an "unwise" procedure as it carries the risk of serious harm and has no proven benefit.
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The disadvantage of metabolomics is that it only provides the user with steady-state level information, while fluxomics determines the reaction rates of metabolic reactions and can trace metabolites in a biological system over time. Nutrigenomics is a generalised term which links genomics, transcriptomics, proteomics and metabolomics to human nutrition. In general a metabolome in a given body fluid is influenced by endogenous factors such as age, sex, body composition and genetics as well as underlying pathologies. The large bowel microflora are also a very significant potential confounder of metabolic profiles and could be classified as either an endogenous or exogenous factor.
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Some drugs reduce the effect of the pill and can cause breakthrough bleeding, or increased chance of pregnancy. These include drugs such as rifampicin, barbiturates, phenytoin and carbamazepine. In addition cautions are given about broad spectrum antibiotics, such as ampicillin and doxycycline, which may cause problems "by impairing the bacterial flora responsible for recycling ethinylestradiol from the large bowel" (BNF 2003).The effects of broad- spectrum antibiotics on Combined contraceptive pills is not found on systematic interaction metanalysis (Archer, 2002), although "individual patients do show large decreases in the plasma concentrations of ethinylestradiol when they take certain other antibiotics" (Dickinson, 2001).
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In a three- step procedure, the first surgery is a sub-total colectomy, in which the large bowel is removed, but the rectum remains in situ, and a temporary ileostomy is made. The second step is a proctecomy and formation of the ileal pouch (commonly known as a "j-pouch"). This involves removing the large majority of the remaining rectal stump and creating a new "rectum" by fashioning the end of the small intestine into a pouch and attaching it to the anus. After this procedure, a new type of ileostomy is created (known as a loop ileostomy) to allow the anastomoses to heal.
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This is caused by an impaction of food material (water, grass, hay, grain) at a part of the large bowel known as the pelvic flexure of the left colon where the intestine takes a 180 degree turn and narrows. Impaction generally responds well to medical treatment, usually requiring a few days of fluids and laxatives such as mineral oil, but more severe cases may not recover without surgery. If left untreated, severe impaction colic can be fatal. The most common cause is when the horse is on box rest and/or consumes large volumes of concentrated feed, or the horse has dental disease and is unable to masticate properly.
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The cell membrane aldosterone receptor has shown to increase the activity of the basolateral Na/K ATPase, ENaC sodium channels and ROMK potassium channels of the principal cell in the distal tubule and cortical collecting duct of nephrons (as well as in the large bowel and possibly in sweat glands). There is some evidence that certain steroid hormone receptors can extend through lipid bilayer membranes at the surface of cells and might be able to interact with hormones that remain outside cells. Steroid hormone receptors can also function outside the nucleus and couple to cytoplasmic signal transduction proteins such as PI3k and Akt kinase.
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Chapter 8, with the full title Common cancers: Breast, prostate, large bowel (colon and rectal) begins by noting that these three cancers represent a broader range of cancers for which similar analyses apply. Breast cancer is associated with risk factors including early age of menarche, late age of menopause, high levels of female hormones (including estrogen and progesterone), and high blood cholesterol. All these factors are worsened by a diet high in animal proteins and refined carbohydrates. However, the medical establishment has focussed most of its attention on genetic mutations BRCA1 and BRCA2, which are rare; screening, which can lead to earlier treatment but may not improve survival rate; and anti-estrogen drugs such as tamoxifen that do not address the causes of high estrogen.
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A new technique, pill enteroscopy, has been a major advance in diagnosis, especially in the small bowel which is difficult to reach with traditional endoscopy. With this technique a pill that contains a video camera and radio transmitter is swallowed, and pictures of the small intestine are sent to a receiver worn by the patient. Recently, multiphase CT angiography (without positive oral contrast) has been shown to play a promising role in the diagnoses of small and large bowel angiodysplasia, especially when associated with active hemorrhage. Angiodysplasiae in the small bowel can also be diagnosed and treated with double-balloon enteroscopy, a technique involving a long endoscopic camera and overtube, both fitted with balloons, that allow the bowel to be accordioned over the camera.
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A bowel resection or enterectomy (enter- + -ectomy) is a surgical procedure in which a part of an intestine (bowel) is removed, from either the small intestine or large intestine. Often the word enterectomy is reserved for the sense of small bowel resection, in distinction from colectomy, which covers the sense of large bowel resection. Bowel resection may be performed to treat gastrointestinal cancer, bowel necrosis, severe enteritis, diverticular disease, Crohn's disease, endometriosis, ulcerative colitis, or bowel obstruction due to scar tissue. Other reasons to perform bowel resection include traumatic injuries and to remove polyps when polypectomy is insufficient, either to prevent polyps from ever becoming cancerous or because they are causing or threatening bowel obstruction, such as in familial adenomatous polyposis, Peutz–Jeghers syndrome, or other polyposis syndromes.
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In 1982 while on reserve duty he was severely injured at Beirut Airport and was honorably discharged with the rank of Major. After serving in the Israeli Defense Forces, he began in 1978 his urology residency at the Sheba Medical Center in Tel Hashomer, finishing it in 1984. In 1984 he spent a year at Duke University Medical Center as a post-graduate fellow, and in the following year he attended another fellowship at the Mayo Clinic where he developed a technique of replacing the urinary bladder with a reconstructed segment of large bowel for patients whose bladder was removed due to invasive cancer. Immediately upon his return to Israel in 1987 Goldwasser was appointed the Chairman of the Urology Department at the Chaim Sheba Medical Center and Professor of Surgery at Tel Aviv University.
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Vascular disorders are more likely to affect the small bowel than the large bowel. Arterial supply to the intestines is provided by the superior and inferior mesenteric arteries (SMA and IMA respectively), both of which are direct branches of the aorta. The superior mesenteric artery supplies: # Small bowel # Ascending and proximal two-thirds of the transverse colon The inferior mesenteric artery supplies: # Distal one-third of the transverse colon # Descending colon # Sigmoid colon Of note, the splenic flexure, or the junction between the transverse and descending colon, is supplied by the most distal portions of both the inferior mesenteric artery and superior mesenteric artery, and is thus referred to medically as a watershed area, or an area especially vulnerable to ischemia during periods of systemic hypoperfusion, such as in shock. Acute abdomen of the ischemic variety is usually due to: # A thromboembolism from the left side of the heart, such as may be generated during atrial fibrillation, occluding the SMA.
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Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged. It is indicated for the treatment of Wilson's disease in adults, adolescents and children five years of age or older who are intolerant to D-penicillamine therapy. Trientine dihydrochloride (brand name Cufence) was approved for medical use in the European Union in July 2019. Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged. It is indicated for the treatment of Wilson's disease in adults, adolescents and children five years of age or older who are intolerant to D-penicillamine therapy. The most common side effects include nausea (feeling sick), especially when starting treatment, skin rash, duodenitis (inflammation of the duodenum, the part of the gut leading out of the stomach), and severe colitis (inflammation in the large bowel causing pain and diarrhea).
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