Intestinal Research

Case Report

Chronic intractable diarrhea caused by gastrointestinal mastocytosis: Hyungil Seo, Sang Hyoung Park, Jeong-Sik Byeon, Chang Gok Woo, Seung-Mo Hong, Kiju Chang, Hoonsub So, Minseob Kwak, Wan Soo Kim, Jeong-Mi Lee, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang; Intest Res 2016;14(3):280-284. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.280

As mast cells have been highlighted in the pathogenesis of diarrhea-predominant irritable bowel syndrome, a new term "mastocytic enterocolitis" was suggested by Jakate and colleagues to describe an increase in mucosal mast cells in patients with chronic intractable diarrhea and favorable response to treatment with antihistamines. Although it is not an established disease entity, two cases have been reported in the English medical literature. Here, for the first time in Asia, we report another case of chronic intractable diarrhea caused by gastrointestinal mastocytosis. The patient was a 70-year-old male with chronic intractable diarrhea for 3 months; the cause of the diarrhea remained obscure even after exhaustive evaluation. However, biopsy specimens from the jejunum were found to have increased mast cell infiltration, and the patient was successfully treated with antihistamines.

Citations

Citations to this article as recorded by

Mastocytic Enterocolitis: An Overlooked Diagnosis for Unexplained Chronic Diarrhea in a Patient With Colon Polyps and a Family History of Colon Cancer
Leeann Hu, Liliana Franco, Jignesh Parikh, Vania Zayat
Cureus.2023;[Epub] CrossRef
Systemic Mastocytosis: A Rare Cause of Diarrhea
Leonard Hamera, Andrew M Santos, Sean-Patrick A Prince, Sreekanth Chandrupatla, Jeffrey Jordan
Cureus.2020;[Epub] CrossRef
Gastrointestinal Manifestations of Hypereosinophilic Syndromes and Mast Cell Disorders: a Comprehensive Review
Vivian C. Nanagas, Anna Kovalszki
Clinical Reviews in Allergy & Immunology.2019; 57(2): 194. CrossRef
Mastocytosis
Jingtao Chen, Patrick Brady, Jay Mamel
The Nurse Practitioner.2019; 44(8): 17. CrossRef
The roles of mast cells in allergic inflammation and mast cell-related disorders
Hee-Kyoo Kim
Allergy, Asthma & Respiratory Disease.2017; 5(5): 248. CrossRef

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Original Article

Patient Descriptions of Rectal Effluents May Help to Predict the Quality of Bowel Preparation With Photographic Examples: Hoonsub So, Sun-Jin Boo, Hyungil Seo, Ho-Su Lee, Hyojeong Lee, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Seungbong Han, Dong-Hoon Yang; Intest Res 2015;13(2):153-159. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.153

Abstract PDF PubReader

<b>Background/Aims</b><br/>

Previous studies have suggested a weak correlation between self-reported rectal effluent status and bowel preparation quality. We aim to evaluate whether photographic examples of rectal effluents could improve the correlation between patient descriptions of rectal effluents and bowel preparation quality.

Methods

Before colonoscopy, patients were asked to describe the nature of their last three rectal effluents. Photographic examples of rectal effluents were provided as a reference for scoring. Bowel preparation was subsequently assessed by a single endoscopist using a global preparation assessment scale. Preparation outcomes were grouped into two levels (excellent to good vs. fair to inadequate). Both univariate and multivariate logistic regression models were used to find any association between bowel preparation quality and patient characteristics.

Results

A total of 138 patients completed the questionnaires. The mean age was 56.5±10.4 years. The mean sum of the last three rectal effluent scores was 5.9±2.0. Higher rectal effluent scores (odds ratio [OR], 0.82; P=0.043) and the presence of diverticula (OR, 0.16; P<0.001) were risk factors for suboptimal preparation.

Conclusions

Photographic example-guided patient descriptions of rectal effluents showed a statistically significant association with bowel preparation quality. However, clinical significance seemed to be low. The presence of diverticula was an independent predictive factor for suboptimal bowel preparation quality.

Citations

Citations to this article as recorded by

Individualized intervention based on a preparation-related prediction model improves adequacy of bowel preparation: A prospective, multi-center, randomized, controlled study
Long Chen, Xiaoyu Kang, Gui Ren, Hui Luo, Linhui Zhang, Limei Wang, Jianghai Zhao, Rongchun Zhang, Xiaoying Zhang, Lina Zhao, Yanglin Pan
Digestive and Liver Disease.2024; 56(3): 436. CrossRef
Comparison of Objectively Assessed Versus Patient-Reported Clarity of Last Rectal Effluent for the Prediction of Quality of Bowel Preparation for Colonoscopy: A Prospective, Case-Control Study
Ajay Patwa, Satish Kumar, Deepak Bhagchandani, Amit Kumar, Virendra Atam, Navneet Anil, Priya Mishra, Abhishek Singh, Archana Devi, Ajay K Pal
Cureus.2024;[Epub] CrossRef
Development and validation of a novel scoring system based on a nomogram for predicting inadequate bowel preparation
Xiaxia Zhao, Yanglin Pan, Jinyong Hao, Jie Feng, Zhongyuan Cui, Huimin Ma, Xiaojun Huang
Clinical and Translational Oncology.2024; 26(9): 2262. CrossRef
Patients' Description of Rectal Effluents Help Predict the Quality of Colonoscopy Preparation
Manuel Antonio Lescano Lescano, Rodrigo Strehl Machado, Maria Rachel Rohr, Sender Jankiel Miszputen
Journal of Coloproctology.2024; 44(02): e106. CrossRef
Superiority of a preparation‐related model for predicting inadequate bowel preparation in patients undergoing colonoscopy: A multicenter prospective study
Long Chen, Gui Ren, Hui Luo, Linhui Zhang, Limei Wang, Jianghai Zhao, Rongchun Zhang, Xiaoying Zhang, Xiaoyu Kang, Yanglin Pan
Journal of Gastroenterology and Hepatology.2022; 37(12): 2297. CrossRef
Comparison of bowel-cleansing efficacy of split-dose and same-day dose bowel preparation for afternoon colonoscopy in patients with gastrectomy: a prospective randomized study
Tae-Geun Gweon, Cheal Wung Huh, Jeong Seon Ji, Chang Hyun Kim, Jin-Jo Kim, Seung-Man Park
Surgical Endoscopy.2020; 34(10): 4413. CrossRef
Evaluating the practice of canceling colonoscopies for presumed inadequate bowel preparation
Reid L. Hopkins, David Parsons, Leonie Hoyo, Brian C. Jacobson
Gastrointestinal Endoscopy.2020; 92(2): 382. CrossRef
A Randomized Controlled Trial Comparing Colonoscopic Enema With Additional Oral Preparation as a Salvage for Inadequate Bowel Cleansing Before Colonoscopy
Hyo-Joon Yang, Dong Il Park, Soo-Kyung Park, Sunyong Kim, Taeheon Lee, Yunho Jung, Chang Soo Eun, Dong Soo Han
Journal of Clinical Gastroenterology.2019; 53(8): e308. CrossRef
Comparison of Bowel Cleansing Efficacy, Safety, Bowel Movement Kinetics, and Patient Tolerability of Same-Day and Split-Dose Bowel Preparation Using 4 L of Polyethylene Glycol: A Prospective Randomized Study
Myeongsook Seo, Tae-Geun Gweon, Cheal Wung Huh, Jeong Seon Ji, Hwang Choi
Diseases of the Colon & Rectum.2019; 62(12): 1518. CrossRef
Randomized trial comparing oral sulfate solution with 4‐L polyethylene glycol administered in a split dose as preparation for colonoscopy
Hyo‐Joon Yang, Soo‐Kyung Park, Jee Hyun Kim, Jong Pil Im, Dong Han Yeom, Geom Seog Seo, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(1): 12. CrossRef
Patient Description of Rectal Effluents With Photographic Examples as a Predictive Indicator for the Quality of Bowel Preparation
Hyoun Woo Kang
Intestinal Research.2015; 13(4): 362. CrossRef
Author's Reply
Hoonsub So, Seungbong Han, Dong-Hoon Yang
Intestinal Research.2015; 13(4): 364. CrossRef

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