ascorbic-acid and Colitis--Ulcerative

Recent research studies have shown that vitamin C (ascorbic acid) may affect bone mineral density and that a deficiency of ascorbic acid leads to the development of osteoporosis. Patients suffering from an inflammatory bowel disease are at a risk of low bone mineral density. It is vital to notice that patients with Crohn's disease and ulcerative colitis also are at risk of vitamin C deficiency which is due to factors such as reduced consumption of fresh vegetables and fruits, i.e., the main sources of ascorbic acid. Additionally, some patients follow diets which may provide an insufficient amount of vitamin C. Moreover, serum vitamin C level also is dependent on genetic factors, such as

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Bone Density; Colitis, Ulcerative; Crohn Disease; Diet; Female; Gastrointestinal Microbiome; Glutathione S-Transferase pi; Glutathione Transferase; Humans; Inflammatory Bowel Diseases; Male; Osteoporosis; Risk Factors; Sodium-Coupled Vitamin C Transporters

Topics: Ascorbic Acid; Celiac Disease; Citrates; Colitis, Ulcerative; Crohn Disease; Dietary Fats; Gastrointestinal Diseases; Humans; Hyperparathyroidism; Ileostomy; Intestine, Small; Liver Diseases; Malabsorption Syndromes; Oxalates; Solubility; Urinary Calculi

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Agranulocytosis; Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune; Ascorbic Acid; Autoantibodies; Autoimmune Diseases; Blood Transfusion; Chloroquine; Colitis; Colitis, Ulcerative; Drug Hypersensitivity; Drug Therapy; Hemoglobinuria; Hemoglobinuria, Paroxysmal; Humans; Internal Medicine; Leukopenia; Lupus Erythematosus, Systemic; Neutrophils; Purpura; Purpura, Thrombocytopenic; Purpura, Thrombotic Thrombocytopenic; Splenectomy; Thrombocytopenia; Thyroiditis; Toxicology; Vitamins

Low-volume preparations for colonoscopy are gaining attention for their higher acceptability. However, the efficacy and safety of oral sulfate solution (OSS) preparations in patients with ulcerative colitis (UC) has not been well known. Therefore, we aimed to compare OSS and 2-L polyethylene glycol with ascorbic acid (PEG+Asc) for bowel preparation in inactive UC.. A multicenter, randomized, single-blind study was conducted at six tertiary referral hospitals in Korea. Outpatients with UC who had stable disease activity were randomly allocated to the OSS group or the 2-L PEG+Asc group for bowel preparation before colonoscopy. The study outcomes included treatment efficacy, safety, tolerability, and acceptability. Bowel cleansing was assessed using the Boston Bowel Preparation Scale and rated as successful cleansing if the score was ≥6. Patient acceptance and tolerability were assessed using a 4-point ordinal scale. Additionally, disease activity and laboratory data before and after colonoscopy were evaluated to check for safety.. The OSS and 2-L PEG+Asc groups included 92 and 93 participants, respectively. No significant between-group difference was noted in successful cleansing (OSS [96.7%] vs 2-L PEG+Asc [97.8%], p=0.64). Moreover, the safety, acceptance, and tolerability were not significantly different (all p>0.05). Furthermore, no significant changes were found in serum electrolytes or disease activity in either group.. OSS is effective for colonoscopy cleansing, has acceptable tolerability, and does not affect disease activity; thus, it can be used safely for bowel preparation in patients with inactive UC.

Topics: Ascorbic Acid; Cathartics; Colitis, Ulcerative; Colonoscopy; Humans; Polyethylene Glycols; Single-Blind Method; Sulfates

BACKGROUND [color=black]Bowel preparation is an important factor for an optimal outcome of colonoscopy. Recently, polyethylene glycol (PEG) solution has been in common use for bowel cleansing for colonoscopy, but some patients are intolerant of PEG because of taste or volume. A low-volume PEG administered with ascorbic acid solution (PEG-Asc) was designed to improve tolerability, but the administration of this method is more complex than that with PEG alone. This study aimed to compare bowel cleansing efficacy, safety, and tolerability of 1 L PEG-Asc with a 2 L PEG preparation with use of sennosides and mosapride.[/color] MATERIAL AND METHODS [color=black]This was a prospective, single-center, non-inferiority trial that included 112 patients (PEG-Asc group, 68; PEG group, 44). The primary endpoint was the efficacy of colon cleansing assessed by endoscopists using a validated 4-point scale according to the Aronchick scale and was verified by a blinded investigator. Acceptability, tolerability, and adenoma detection rate (ADR) of these 2 regimens were secondary endpoints.[/color][color=black] [/color] RESULTS [color=black]We found no statistically significant differences between the groups in colon-cleansing efficacy or in the adenoma detection rate (ADR). Moreover, overall, patients significantly favored PEG-Asc over PEG, reflecting better acceptance of PEG-Asc. Additionally, more patients favored PEG-Asc over PEG for a hypothetical future colonoscopy. [/color] CONCLUSIONS [color=black]The alternate 1 L PEG-Asc regimen and standard 2 L PEG regimen were clinically equivalent with respect to cleansing efficacy, safety, and ADR, and more patients favored PEG-Asc than PEG. This alternate regimen may improve patient compliance and acceptance of surveillance colonoscopy.[/color].

Topics: Adenoma; Adult; Aged; Ascorbic Acid; Benzamides; Colitis, Ulcerative; Colonic Neoplasms; Colonoscopy; Female; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Morpholines; Polyethylene Glycols; Senna Extract; Sennosides; Surveys and Questionnaires; Young Adult

Although colonoscopy preparation may cause symptom flares in patients with ulcerative colitis (UC), little is known about the standard preparation regimen in this population.. We aimed to compare 4L polyethylene glycol (4L-PEG) with 2L polyethylene glycol plus ascorbic acid (2L-PEG-Asc) in quiescent UC patients.. Patients with inactive UC undergoing colonoscopy for surveillance or checkup of mucosal healing were prospectively enrolled at 5 tertiary hospitals. They were randomly assigned to 4L-PEG and 2L-PEG-Asc groups. The Boston Bowel Preparation Scale (BBPS) was used for the preparation quality. Symptoms were assessed using the Simple Clinical Colitis Activity Index (SCCAI) before colonoscopy, at 1 and 4 weeks after the procedure.. Overall, 109 patients were included in the study (4L-PEG group 53, 2L-PEG-Asc group 56, the mean age at diagnosis 42.25 years, male 77). The quality of preparation was comparable between the groups (BBPS ≥ 6, 96.2 vs. 92.9%, p = 0.679). Although 26 patients (23.8%) had increased SCCAI scores within 4 weeks after colonoscopy, resulting in a medication dose-up or add-on in 3 patients (2.7%), the rise in scores was not different between the groups. No serious adverse events during preparation were observed in either group. However, the 2L-PEG-Asc group was more likely to be willing to repeat the preparation with the same agent than the 4L-PEG group (82.1 vs. 64.2%, respectively, p = 0.034).. PEG-based regimens with different volumes are equally effective and safe in inactive UC patients. 2L-PEG-Asc is more acceptable in this population as indicated by the willingness for further usage.

Topics: Adult; Aged; Ascorbic Acid; Cathartics; Colitis, Ulcerative; Colonoscopy; Female; Humans; Male; Middle Aged; Polyethylene Glycols; Prospective Studies; Single-Blind Method

Patients with inflammatory bowel disease (IBD) are prone to several nutritional deficiencies. However, data are lacking on vitamin C deficiency in Crohn's disease (CD) and ulcerative colitis (UC) patients, as well as the impact of clinical, biomarker and endoscopic disease severity on the development of vitamin C deficiency.. To determine proportions and factors associated with vitamin C deficiency in CD and UC patients.. In this retrospective study, we obtained clinical, laboratory and endoscopic data from CD and UC patients presenting to the IBD clinic at a single tertiary care center from 2014 to 2019. All patients had an available plasma vitamin C level. Of 353 subjects who met initial search criteria using a cohort discovery tool, 301 ultimately met criteria for inclusion in the study. The primary aim described vitamin C deficiency (≤ 11.4 μmol/L) rates in IBD. Secondary analyses compared proportions with deficiency between active and inactive IBD. Multivariate logistic regression analysis evaluated factors associated with deficiency.. Of 301 IBD patients, 21.6% had deficiency, including 24.4% of CD patients and 16.0% of UC patients. Patients with elevated C-reactive protein (CRP) (39.1%. Vitamin C deficiency was common in IBD. Patients with elevated inflammatory markers and penetrating disease had higher rates of vitamin C deficiency.

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Biological Products; Biomarkers; C-Reactive Protein; Chronic Disease; Colitis, Ulcerative; Crohn Disease; Humans; Inflammatory Bowel Diseases; Leukocyte L1 Antigen Complex; Prevalence; Retrospective Studies; Scurvy; Vitamin D Deficiency

The effectiveness of bowel cleansing is a key element for high-quality colonoscopy. Recently, a 1 L polyethylene glycol plus ascorbate (PEG-ASC) solution has been introduced, but effectiveness and safety of this preparation have not been assessed in IBD patients. This study aims to evaluate effectiveness and safety of 1 L PEG-ASC solution in patients with IBD compared to controls.. We retrospectively analysed prospectively collected data on a cohort of 411 patients performing a colonoscopy after preparation with 1 L PEG-ASC, consecutively enrolled in 5 Italian centres.. Overall, 185/411 (45%) were patients with IBD and 226/411 (55%) served as controls. A significantly higher cleansing success was achieved in IBD patients (92.9% vs 85.4%, p = 0.02). The multiple regression model showed that presence of IBD (OR=2.514, 95%CI=1.165-5.426; P = 0.019), lower age (OR=0.981, 95%CI=0.967-0.996; P = 0.014), split preparation (OR=2.430, 95%CI=1.076-5.492; P = 0.033), absence of diabetes (OR=2.848, 95%CI=1.228-6.605; P = 0.015), and of chronic constipation (OR=3.350, 95%CI=1.429-7.852; P = 0.005), were independently associated with cleansing success. The number of treatment-emergent adverse events (TEAEs) (51 vs 62%, p = 0.821), and of patients with TEAEs (22.2% vs 21.2%, p = 0.821), were similar in IBD patients and in controls, respectively.. Results from this study support the effectiveness and safety of 1 L PEG-ASC solution in IBD patients, which may improve the definition of endoscopic outcomes both in Crohn's disease and ulcerative colitis.

Topics: Adult; Ascorbic Acid; Cathartics; Colitis, Ulcerative; Colonoscopy; Crohn Disease; Female; Humans; Male; Middle Aged; Phosphatidylethanolamines; Retrospective Studies

Vitamin C is a natural nutrient with antioxidant properties and is used as a health supplement. In this study, we examined the effects of intraperitoneal administration of high-dose vitamin C (4 g/kg) on dextran sodium sulfate (DSS)-induced ulcerative colitis. We prepared a mouse ulcerative colitis model by administering DSS for 7 d along with high-dose vitamin C each day during DSS treatment. Ulcerative colitis induced by DSS was ameliorated by high-dose vitamin C administration. Blood levels of interleukin-6, tumor necrosis factor-α, hydrogen peroxide (H

Topics: Animals; Antioxidants; Ascorbic Acid; Colitis, Ulcerative; Collagen Type I; Collagen Type II; Colon; Dextran Sulfate; Disease Models, Animal; Fibroblasts; Hydrogen Peroxide; Interleukin-6; Male; Mice, Hairless; Tumor Necrosis Factor-alpha; Vitamins

Topics: Adolescent; Adult; Alleles; Animals; Antioxidants; Ascorbic Acid; Cohort Studies; Colitis, Ulcerative; Crohn Disease; Dehydroascorbic Acid; Diet; Female; Genetic Predisposition to Disease; Genotype; Glucose; Glucose Transport Proteins, Facilitative; Humans; Male; Manitoba; Middle Aged; Polymorphism, Single Nucleotide; Protein Isoforms; Xenopus; Young Adult

Crohn disease (CD) and ulcerative colitis (UC) are 2 common inflammatory bowel diseases (IBDs) associated with intestinal inflammation and tissue damage. Oxidative stress is suggested to play a major role in the initiation and progression of IBD. Vitamin C (ascorbate, ascorbic acid) supplementation has reduced oxidative stress in persons with IBD. The role of ascorbate transporters in IBD remains to be determined. SLC23A1 is a major ascorbate transporter in the intestinal tract, and some of its genetic variants have been associated with severely decreased ascorbate transport and lower systemic concentrations.. This study aimed to determine whether common genetic variants in the vitamin C transporter SLC23A1 are associated with the risk of IBD.. Genomic DNA samples from patients with CD (n = 162) and UC (n = 149) from the Manitoba IBD Cohort Study and ethnically matched controls (n = 142) were genotyped for 3 SLC23A1 polymorphisms (rs6596473, rs33972313, and rs10063949) by using TaqMan assays.. Variation at rs10063949 (G allele for heterozygote and homozygote) was associated with increased susceptibility to CD (OR: 2.54; 95% CI: 1.38, 4.66; OR: 4.72; 95% CI: 2.53, 8.81; P < 0.0001; respectively). A strong linkage disequilibrium (LD) was observed across the SLC23A1 region (variation rs6596473 with rs10063949) for CD and UC (D' = 0.94 and 0.96, respectively). The risk alleles confirmed a haplotype (CGG) that is carried more in CD patients (65.3%, P < 0.0001) than in controls (43.5%).. A genetic variant (rs10063949-G) in the SLC23A1 ascorbate transporter locus was identified and is associated with an increased risk of CD in a white Canadian IBD cohort. The presented evidence that SLC23A1 variations can modulate the risk of CD has implications for understanding ascorbate transport in CD patients and provides a novel opportunity toward individualized nutritional therapy for patients carrying the disease-associated genotype.

Topics: Adolescent; Adult; Alleles; Ascorbic Acid; Canada; Cohort Studies; Colitis, Ulcerative; Crohn Disease; Dietary Supplements; Female; Gene Frequency; Genetic Loci; Genetic Predisposition to Disease; Genome, Human; Haplotypes; Humans; Linkage Disequilibrium; Logistic Models; Male; Oxidative Stress; Phenotype; Polymorphism, Single Nucleotide; Sodium-Coupled Vitamin C Transporters; White People; Young Adult

Ulcerative colitis (UC) is often associated with nutritional deficiency, which appears to contribute to the progression of UC severity. The present study aimed to evaluate nutritional status and dietary intake in UC remission patients.. The present study comprised a cross-sectional study in which variables such as extent of disease (distal colitis, left-sided colitis, pancolitis), remission period, sex and age were recorded. Extent of disease was assessed by the results of a colonoscopy and dietary intake was evaluated by using 3-day, 24-h recalls. A Kruskall-Wallis test was used to compare the intake of macro- and micronutrients among the three study groups. The analysis was complemented by the Mann-Whitney test. A logistic regression analysis was performed to identify predictive factors of extent of disease (pancolitis versus left-sided colitis versus distal colitis).. The median (range) age of the 59 patients was 49.0 (37.0-63.0) years and 53.3% were female. Twenty-six (44.1%) patients had distal colitis, 11 (18.6%) patients had left-sided colitis and 22 (37.3%) patients had pancolitis. A high probability of an inadequate intake of fibre (100%), fat soluble vitamins (>40% for vitamin A and >95% for vitamin E), vitamin C (>34%), calcium (>90%) and magnesium (>50%) was identified in the study group. Vitamin D intake (odds ratio = 0.60; 95% confidence interval = 0.39-0.94; P < 0.05) was significantly associated with increased intestinal damage.. A large number of individuals showed an inadequate intake of nutrients. In addition, the consumption of vitamin D was significantly associated with extent of disease.

Topics: Adult; Ascorbic Acid; Body Mass Index; Calcium, Dietary; Colitis, Ulcerative; Colonoscopy; Cross-Sectional Studies; Dietary Carbohydrates; Dietary Fats; Dietary Fiber; Dietary Proteins; Energy Intake; Female; Humans; Male; Malnutrition; Micronutrients; Middle Aged; Nutritional Status; Vitamin A; Vitamin D; Vitamin K

UC (ulcerative colitis) patients have an increased risk of developing colorectal cancer compared with the normal population. The cause underlying this higher risk is not fully defined but includes nutritional and environmental factors concomitant with genetic alterations. We aimed to evaluate genetic stability in the colonic tissue of UC patients in clinical remission compared with the healthy population, and to establish a possible correlation between nutritional habits and these molecular assessments. UC patients (n 42) and healthy controls (n 37) participated in the study. All participants were histopathologically and medically diagnosed. Participants completed five separate 7 d dietary records, food-frequency questionnaires and validated 24 h recalls for nutritional assessment. The extent of chromosome 17 loss and the calculated chromosome index was determined in colon tissue biopsies by fluorescence in situ hybridisation. Correlations between the molecular and nutritional assessments were performed using Pearson's correlation coefficients. Significant differences in the nutritional intake of total fat (65 (SD 15) v. 89 (SD 25) g), cholesterol (330 (SD 168) v. 464 (SD 177) mg), dietary fibre (32 (SD 4.7) v. 9 (SD 4) g), vitamin A (1009 (SD 209) v. 506 (SD 204) microg), vitamin C (308 (SD 108) v. 72 (SD 53) mg) and folic acid (412 (SD 89 microg) v. 187 (SD 107)) were recorded for UC patients compared with controls. Significant correlations were found for the consumption of different food groups and the chromosome index for chromosome 17. The results of our study suggest that the nutritional habits adopted by UC patients during clinical remission may affect key cellular components of the colonic tissue, inducing a high degree of aneuploidy and genetic instability, and probably affecting the development of colon cancer.

Topics: Adult; Aged; Aneuploidy; Ascorbic Acid; Calcium, Dietary; Chromosomes, Human, Pair 17; Colitis, Ulcerative; Colon; Colorectal Neoplasms; Dietary Fats; Dietary Fiber; Energy Intake; Fabaceae; Feeding Behavior; Female; Folic Acid; Genetic Predisposition to Disease; Humans; In Situ Hybridization, Fluorescence; Male; Middle Aged; Nutritional Status; Risk Factors; Vitamin A

To evaluate the role of dietary factors in the etiology of inflammatory bowel disease (IBD), we conducted a multicenter hospital-based case-control study in a Japanese population. Cases were IBD patients aged 15 to 34 years [ulcerative colitis (UC) 111 patients; Crohn's disease (CD) 128 patients] within 3 years after diagnosis in 13 hospitals. One control subject was recruited for each case who was matched for sex, age, and hospital. A semiquantitative food frequency questionnaire was used to estimate preillness intakes of food groups and nutrients. All the available control subjects (n = 219) were pooled, and unconditional logistic models were applied to calculate odds ratios (ORs). In the food groups, a higher consumption of sweets was positively associated with UC risk [OR for the highest versus lowest quartile, 2.86; 95% confidence interval (CI), 1.24 to 6.57], whereas the consumption of sugars and sweeteners (OR, 2.12; 95% CI, 1.08 to 4.17), sweets (OR, 2.83; 95% CI, 1.38 to 5.83), fats and oils (OR, 2.64; 95% CI, 1.29 to 5.39), and fish and shellfish (OR, 2.41; 95% CI, 1.18-4.89) were positively associated with CD risk. In respect to nutrients, the intake of vitamin C (OR, 0.45; 95% CI, 0.21 to 0.99) was negatively related to UC risk, while the intake of total fat (OR, 2.86; 95% CI, 1.39 to 5.90), monounsaturated fatty acids (OR, 2.49; 95% CI, 1.23 to 5.03) and polyunsaturated fatty acids (OR, 2.31; 95% CI, 1.12 to 4.79), vitamin E (OR, 3.23; 95% CI, 1.45 to 7.17), and n-3 (OR, 3.24; 95% CI, 1.52 to 6.88) and n-6 fatty acids (OR, 2.57; 95% CI, 1.24 to 5.32) was positively associated with CD risk. Although this study suffers from the shortcoming of recall bias, which is inherent in most retrospective studies (prospective studies are warranted to confirm the associations between diet and IBD risk), the present findings suggest the importance of dietary factors for IBD prevention.

Topics: Adolescent; Adult; Ascorbic Acid; Case-Control Studies; Colitis, Ulcerative; Crohn Disease; Diet; Dietary Fats; Dietary Sucrose; Female; Humans; Japan; Male; Mental Recall; Odds Ratio; Reproducibility of Results; Risk Factors; Seafood

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Chronic Disease; Colitis, Ulcerative; Diagnosis, Differential; Dietary Proteins; Ecchymosis; Fruit; Gastritis; Humans; Male; Middle Aged; Purpura

The mechanisms by which inflammatory bowel disease causes chronic injury to the gastrointestinal tract are poorly understood. To determine whether antioxidant defenses might be altered, we evaluated plasma antioxidant concentrations in 24 children with inflammatory bowel disease (12 with Crohn disease and 12 with ulcerative colitis) and in 23 healthy control subjects. Anthropometric measurements and disease activity scores were obtained. The groups were of similar age and sex distribution; most children had quiescent or mild disease. The children with Crohn disease were malnourished compared with the ulcerative colitis and control groups. Children with inflammatory bowel disease had decreased plasma ascorbic acid and increased glutathione peroxidase, glutathione, and alpha-tocopherol (vitamin E) concentrations compared with control subjects. These differences were found primarily in the children with Crohn disease. This study provides evidence that children with Crohn disease have alterations in circulating antioxidant defenses, possibly related to an ongoing oxidant stress.

Topics: Adolescent; Antioxidants; Ascorbic Acid; Child; Colitis, Ulcerative; Crohn Disease; Glutathione; Glutathione Peroxidase; Humans; Inflammatory Bowel Diseases; Vitamin E

Attempts to establish the presence of oxidant stress and tissue damage in inflammatory bowel disease (IBD) have relied on determining the capacity of peripheral blood inflammatory cells to produce reactive oxygen species (ROS) and other indirect indices. These approaches have failed to address whether or not there are adequate chemical antioxidant defences to prevent oxidative injury in the inflamed mucosa. In this investigation we have determined the mucosal concentrations of reduced and total ascorbic acid and the redox status in paired non-inflamed and inflamed mucosa using colonic biopsies from IBD patients. In inflamed mucosa from Crohn's disease (CD) patients, reduced and total ascorbic acid content decreased by 35% (p = 0.014 and p = 0.009, respectively). In ulcerative colitis (UC) patients, mucosal total ascorbic acid content decreased by 73% (p = 0.069) and reduced ascorbic acid by 41% (p = 0.014). The proportion of total ascorbic acid present in its reduced form in histologically normal mucosa from CD patients was unusually low at approximately 30%. In the paired-inflamed mucosa from CD patients, the redox ratio was also approximately 30% despite the loss of 35% of total ascorbate. In UC patients, the ascorbate redox ratio in the non-inflamed mucosa was 23% which increased to 51% in paired inflamed mucosa. This increase reflected the loss (73%) of total ascorbate. Reduction of dehydroascorbic acid by GSH/NADPH dependent dehydroascorbic acid reductase decreased significantly (p = 0.046) in inflamed mucosa from UC patients, suggesting that the capacity of the inflamed mucosa to maintain the concentration of reduced ascorbic acid is also diminished. HPLC analysis of mucosal preparations for diketogulonic acid, the decomposition product of dehydroascorbic acid, did not account for the loss of total ascorbate in the inflamed mucosa suggesting that ascorbate equivalents underwent further decomposition reactions or were excreted to the colonic lumen. We conclude that the normal luminal environment is strongly oxidising in character and that oxidant stress derived from inflammatory cells contributes to the loss of 35-73% total and reduced ascorbate. In absolute terms, the overall loss of this antioxidant buffering capacity would decrease the capacity of the inflamed mucosa to prevent oxidative tissue damage and hinder recovery of the inflamed mucosa.

Topics: 2,3-Diketogulonic Acid; Ascorbic Acid; Chromatography, High Pressure Liquid; Colitis, Ulcerative; Crohn Disease; Female; Humans; Inflammatory Bowel Diseases; Intestinal Mucosa; Male; Oxidation-Reduction; Oxidoreductases

Adhesion, random migration and chemotactic migration, phagocytosis, and spontaneous nitroblue tetrazolium-dye reduction (NBT) capacity of polymorphonuclear leukocytes (PMNs) were analysed in 38 patients with ulcerative colitis before and during therapy with sulphasalazine (12 months), corticosteroids (6 months), levamisole (12 months), ascorbic acid (6 months) and sulphasalazine plus levamisole (12 months). Remission was achieved by levamisole in as many patients as by sulphasalazine and by sulphasalazine and levamisole used together. Nevertheless, the only function of PMNs affected by levamisole therapy was a depression of chemotaxis, whereas other functions as well as chemotaxis were altered by sulphasalazine, whether used alone or in combination with levamisole. Of patients treated with corticosteroids, all were in remission at 6 months and the most marked decrease in chemotaxis was seen. No clinical benefits were observed after 6 months of treatment with ascorbic acid and PMNs function was unaltered. The depression of chemotaxis occurred whether or not remission was achieved, suggesting a direct drug-induced effect. The apparent discrepancies of the "in vivo" drug effects in comparison with previously reported findings may reflect abnormal reactivity of PMNs in UC.

Topics: Adrenal Cortex Hormones; Adult; Aged; Ascorbic Acid; Cell Adhesion; Cell Movement; Chemotaxis, Leukocyte; Colitis, Ulcerative; Female; Humans; Levamisole; Male; Middle Aged; Neutrophils; Nitroblue Tetrazolium; Phagocytosis; Sulfasalazine

Traditional methods for prevention of large bowel cancer rely on surveillance of patients with known precursors of bowel cancer, namely ulcerative colitis and those genetically linked polyposis syndromes that have malignant potential. Identification of heritable bowel cancer families and solitary polyp--cancer families provide additional populations that merit intensive scrutiny. Persuasive, if circumstantial, evidence suggests that maintaining patients free of large bowel polyps reduces the risk of developing large bowel cancer. Prospects for prevention of large bowel cancer are extended by recognition that a diet low in fat may reduce the risk of large bowel cancer. Furthermore, there is considerable evidence in animals that a variety of antioxidants limit large bowel carcinogenesis and preliminary evidence in man that these agents may control large bowel neoplasia.

Topics: Adenoma; Ascorbic Acid; Colitis, Ulcerative; Colonic Neoplasms; Diet; Humans; Polyps; Precancerous Conditions

Topics: Administration, Oral; Adolescent; Adult; Aged; Ascorbic Acid; Child; Colitis, Ulcerative; Drug Therapy, Combination; Enema; Female; Humans; Hydrocortisone; Infusions, Parenteral; Injections, Intravenous; Male; Middle Aged; Parenteral Nutrition; Phosphates; Prednisolone; Remission, Spontaneous; Sulfasalazine; Tetracycline; Vitamin B Complex

Topics: Ascorbic Acid; Colitis, Ulcerative; Duodenal Ulcer; Gastrointestinal Diseases; Hernia, Diaphragmatic; Humans; Leukocytes; Liver Cirrhosis

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Anti-Bacterial Agents; Antibiotics, Antitubercular; Ascorbic Acid; Blood Transfusion; Colitis; Colitis, Ulcerative; Diet; Diet Therapy; Ergocalciferols; Humans; Isoniazid; Surgical Procedures, Operative