Omeprazole v ranitidine
نویسنده
چکیده
stool samples and rectal biopsy showed a moderately active non-specific proctitis. Two weeks after his admission discrete ulceration and a thickened polypoid mucosa were evident in the descending and distal transverse colon at a limited colonoscopy. The appearances were thought to favour Crohn's disease and the histology was equivocal. He was treated with corticosteroids and was discharged feeling well three weeks after admnission on maintenance sulphasalazine. Six months after presentation repeat colonoscopy showed a pancolitis which histologically looked more like Crohn's disease than ulcerative colitis. He remained asymptomatic until four years after his initial admission to hospital when diarrhoea recurred. A sigmoidoscopy showed a granular mucosa and barium enema showed a pancolitis. Rectal biopsy favoured the diagnosis of ulcerative colitis. This patient had no bowel symptoms before his infective diarrhoea and it seems likely, as in the cases reported by Willoughby et al, that the chronic colitis was triggered by the enteric infection. There is much evidence to link the onset of chronic colitis to enteric infection with a variety of pathogens which more usually cause a self-limiting inflammatory colitis like Aer-onimonas hi'tlrophila. Examples other than those referred to by Willoughby et al include cases where chronic disease was linked to infections with Staph' lococcuis aureus, ELntamoeba histolYtica,l and salmotnella sp. Furthermore in a prospective study of acute colitis F coli with characteristics associated with pathogenicity were found in patients in their first attack of ulcerative colitis.4 We agree that wide ranging microbiological studies are necessary eairly in the course of chronic colitis to elucidate this relationship more fully.
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تاریخ انتشار 2006