• Title/Summary/Keyword: screening colonoscopy

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Juvenile Polyps in Bangladeshi Children and Their Association with Fecal Calprotectin as a Biomarker

  • Das, Subarna Rani;Karim, ASM Bazlul;RukonUzzaman, Md;Mazumder, Md Wahiduzzaman;Alam, Rubaiyat;Benzamin, Md;Marjan, Parisa;Sarker, Mst. Naznin;Akther, Hazera;Mondal, Mohuya
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.1
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    • pp.52-60
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    • 2022
  • Purpose: Colonoscopy is considered the most reliable method for the diagnosis of juvenile polyps. However, colonoscopic screening is an invasive and expensive procedure. Fecal calprotectin (FCP), a marker of intestinal inflammation, has been shown to be elevated in patients with polyps. Therefore, this study aimed to evaluate FCP as a screening biomarker for the diagnosis of juvenile polyps. Methods: This cross-sectional, observational study was conducted at the Pediatric Gastroenterology and Nutrition Department, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. For children with polyps, colonoscopic polypectomy and histopathology were performed. FCP levels were analyzed before and 4 weeks after polypectomy in all patients. Information was recorded in a datasheet and analyzed using the computer-based program SPSS. Results: The age of the children was between 2.5 and 12 years. Approximately 93% of the polyps were found in the rectosigmoid region. Children with juvenile polyps had elevated levels of FCP before polypectomy that subsequently normalized after polypectomy. The mean FCP levels before and after polypectomy were 277±247 ㎍/g (range, 80-1,000 ㎍/g) and 48.57±38.23 ㎍/g (range, 29-140 ㎍/g) (p<0.001), respectively. The FCP levels were significantly higher in patients with multiple polyps than in those with single polyps. Moreover, mean FCP levels in patients with single and multiple polyps were 207.6±172.4 ㎍/g and 515.4±320.5 ㎍/g (p<0.001), respectively. Conclusion: Colonic juvenile polyps were found to be associated with elevated levels of FCP that normalized after polypectomy. Therefore, FCP may be recommended as a noninvasive screening biomarker for diagnosis of colonic juvenile polyps.

Severe hyponatremia and seizures after bowel preparation with low-volume polyethylene glycol plus ascorbic acid solution (저용량 polyethylene glycol 용액에 아스코르빈산을 첨가한 장정결제로 대장내시경 전처치 후 발생한 발작을 동반한 저나트륨혈증)

  • Lee, Jae Young;Jang, Byung Ik;Nam, Yoon Jeong;Song, Jay;Kim, Min Cheol;Chung, Seung Min;Jang, Jong Geol;Cho, Jae Ho
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.55-59
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    • 2015
  • The widely used polyethylene glycol (PEG)-based solutions have been proven effective for bowel preparation when 4 L of the solution is administered before colonoscopy. However, large volumes of the solutions are generally poorly tolerated. A new PEG-based solution consisting of 2 L of PEG and a high dose of ascorbic acid has recently become available. Electrolyte abnormalities caused by PEG-based solutions have rarely been reported. We report on a case of acute severe hyponatremia with associated generalized tonic-clonic seizures after bowel preparation with a low-volume PEG plus ascorbic acid solution in a 74-year-old woman with no history of seizures. She took a beta blocker, an angiotensin-converting enzyme inhibitor, and glimepiride for hypertension and diabetes mellitus. She showed general weakness, nausea, agitation, muscle cramping, and seizures after ingestion of the PEG plus ascorbic acid solution. Her serum sodium level was 112 mEq/L. Her symptoms improved after intravenous administration of hypertonic saline. Physicians should pay attention to screening for electrolytes and development of neurological symptoms during bowel preparation.

Access of Anti-cancer Treatment for Advanced Colon Cancer with Metastasis (전이를 동반한 진행성대장암의 항암 치료에 대한 접근)

  • Hyun Gun Kim
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.6-16
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    • 2013
  • Recent estimates for colon cancer incidence in Korea have been increased and continue to rank as the second most common in male and the third in female. Although colonoscopy has been known as the best screening tool for colon cancer, 20-25% of patients with colon cancer was diagnosed with stage IV cancer. During the past 10 years, intensive clinical studies helped to establish the value of palliative treatment for colon cancer with metastasis. The introduction of new chemotherapeutic agents such as irinotecan and oxaliplatin has led to a significant increase in tumor response and median survival. In advanced colon cancer, impressive prolongation or overall survival can be achieved through sequential application of combined systemic chemotherapy. In addition, targeted manipulation of molecular tumor mechanisms with new substances such as monoclonal antibodies against the epidermal growth factor receptor or vascular endothelial growth factor shows promising effects. Progress in the systemic treatment of colon cancer is evident, not only because of the significant increase in life expectancy in advanced colon cancer.

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