Segments Of Gastrointestinal Tract Research Articles

Ultrasound Imaging of Various Ingested Foreign Bodies in an Ex Vivo Intestinal Model.

Foreign body ingestion is an increasingly prevalent issue for children who are in the preverbal to early verbal stages of life. Foreign bodies lodged in the gastrointestinal tract can cause issues such as obstruction, perforation, and fistulae. Radiographic imaging can often locate most foreign bodies; however, radiolucent objects may be missed. Ultrasound is an alternative imaging modality that can be used to locate and track foreign objects as they pass through the bowel. The objective of this study was to characterize the sonographic appearance of various ingested foreign bodies of varying characteristics in an ex vivo gastrointestinal tract segment. A GE Logiq 9 ultrasound machine with a linear transducer at a frequency of 15 MHz was used to examine various ingested foreign bodies placed in a segment of pig intestinal tract. Imaged objects varied in visual appearance from echogenicity, texture, size, and shape; acoustic shadows and reverberation artifacts cast were particularly distinguishing characteristics. Ultrasound evaluation to assess foreign body ingestion in the pediatric population may provide a useful alternative or supportive imaging modality in confirming the location and real-time tracking of the ingested item. This may be especially useful for objects of varying radiodensities that cannot always be reliably seen in traditional radiographs.

Spatial profiles of the bacterial microbiota throughout the gastrointestinal tract of dairy goats

The gastrointestinal tract (GIT) is stationed by a dynamic and complex microbial community with functions in digestion, metabolism, immunomodulation, and reproduction. However, there is relatively little research on the composition and function of microorganisms in different GIT segments in dairy goats. Herein, 80 chyme samples were taken from ten GIT sites of eight Xinong Saanen dairy goats and then analyzed and identified the microbial composition via 16S rRNA V1-V9 amplicon sequencing. A total of 6669 different operational taxonomic units (OTUs) were clustered, and 187 OTUs were shared by ten GIT segments. We observed 264 species belonging to 23 different phyla scattered across ten GITs, with Firmicutes (52.42%) and Bacteroidetes (22.88%) predominating. The results revealed obvious location differences in the composition, diversity, and function of the GIT microbiota. In LEfSe analysis, unidentified_Lachnospiraceae and unidentified_Succinniclassicum were significantly enriched in the four chambers of stomach, with functions in carbohydrate fermentation to compose short-chain fatty acids. Aeriscardovia, Candidatus_Saccharimonas, and Romboutsia were significantly higher in the foregut, playing an important role in synthesizing enzymes, amino acids, and vitamins and immunomodulation. Akkermansia, Bacteroides, and Alistipes were significantly abundant in the hindgut to degrade polysaccharides and oligosaccharides, etc. From rumen to rectum, α-diversity decreased first and then increased, while β-diversity showed the opposite trend. Metabolism was the major function of the GIT microbiome predicted by PICRUSt2, but with variation in target substrates along the regions. In summary, GIT segments play a decisive role in the composition and functions of microorganisms.Key points• The jejunum and ileum were harsh for microorganisms to colonize due to the presence of bile acids, enzymes, faster chyme circulation, etc., exhibiting the lowest α-diversity and the highest β-diversity.• Variability in microbial profiles between the three foregut segments was greater than four chambers of stomach and hindgut, with a higher abundance of Firmicutes dominating than others.• Dairy goats dominated a higher abundance of Kiritimatiellaeota than cows, which was reported to be associated with fatty acid synthesis.

Duodenal-Jejunal Stenosis as a Manifestation of Eosinophilic Gastroenteritis: A Case Report

Introduction: Eosinophilic gastroenteritis (EGE) is a rare disorder characterized by eosinophilic infiltration of the stomach and small intestine. Its clinical manifestations depend on the extent, location, and depth of the inflammatory infiltrate. The pathogenesis remains unclear, but it may be related to food allergy or other hypersensitivity reactions in some patients. Untreated cases can cause intestinal stricture or perforation, making timely diagnosis and intervention essential. Clinical case: A 13-year-old male adolescent was hospitalized due to symptoms suggesting intestinal obstruction or alterations in intestinal motility. Medical imaging revealed significant gastric distension and delayed gastric emptying. An endoscopic study showed a “snake-skin” pattern, duodenitis due to food stasis, a 2 cm ulcer, and stenosis in the duodenum. The biopsy confirmed EGE with significant irregular eosinophilic infiltration of the lamina propria. A panendoscopy was performed after steroid treatment without being able to assess the site of stenosis and perform pneumatic dilation. After completing the immunomodulatory management, a contrast-enhanced abdominal tomography was performed showed a significant decrease in the intestinal lumen, therefore an exploratory laparotomy with a lateral to lateral jejune-jejunal anastomosis was performed. Discussion: EGE is a rare inflammatory disorder characterized by eosinophilic infiltration of the stomach and small intestine. Symptoms are based on the affected gastrointestinal tract segment. In this case, our patient presented intestinal obstruction symptoms with endoscopic biopsies and a histopathological study confirmed eosinophil infiltration. Treatment typically involves identifying potential triggers and corticosteroids to reduce inflammation and symptoms. However, in this case, a decrease in the intestinal lumen was observed, therefore an elective surgical resection was performed. Conclusion: Eosinophilic gastroenteritis is a rare disorder that requires strong clinical suspicion to be diagnosed, which is why its knowledge is important. In this case, gastrointestinal symptoms, radiological and endoscopic images, in addition to the histopathological report, were key tools for integrating the diagnosis. Although management with steroids and immunomodulators was not successful, surgical management became an appropriate option as definitive treatment.

Expression of Genes Encoding Selected Orexigenic and Anorexigenic Peptides and Their Receptors in the Organs of the Gastrointestinal Tract of Calves and Adult Domestic Cattle (Bos taurus taurus).

The regulation of food intake occurs at multiple levels, and two of the components of this process are orexigenic and anorexigenic peptides, which stimulate or inhibit appetite, respectively. The study of the function of these compounds in domestic cattle is essential for production efficiency, animal welfare, and health, as well as for economic benefits, environmental protection, and the contribution to a better understanding of physiological aspects that can be applied to other species. In this study, the real-time PCR method was utilized to determine the expression levels of GHRL, GHSR, SMIM20, GPR173, LEP, LEPR, and NUCB2 (which encode ghrelin, its receptor, phoenixin-14, its receptor, leptin, its receptor, and nesfatin-1, respectively) in the gastrointestinal tract (GIT) of Polish Holstein-Friesian breed cattle. In all analyzed GIT segments, mRNA for all the genes was present in both age groups, confirming their significance in these tissues. Gene expression levels varied distinctly across different GIT segments and between young and mature subjects. The differences between calves and adults were particularly pronounced in areas such as the forestomachs, ileum, and jejunum, indicating potential changes in peptides regulating food intake based on the developmental phase. In mature individuals, the forestomachs predominantly displayed an increase in GHRL expression, while the intestines had elevated levels of GHSR, GPR173, LEP, and NUCB2. In contrast, the forestomachs in calves showed upregulated expressions of LEP, LEPR, and NUCB2, highlighting the potential importance of peptides from these genes in bovine forestomach development.

Eosinophil Involvement Outside the Esophagus in Eosinophilic Esophagitis

Eosinophilic gastrointestinal diseases (EGIDs) are chronic, immune-mediated disorders, characterized clinically by gastrointestinal (GI) symptoms and histologically by eosinophil-predominant infiltration in ≥1 GI tract segment.1 A recent, international consensus by 91 experts proposed a new framework for EGID nomenclature to establish updated terms, designations, and conventions.2 Although this framework offers a standardized starting point for the field, debate is ongoing regarding the appropriate terminology for cases involving multiple areas, such as "non-eosinophilic esophagitis (EoE) EGID and EoE" or "non-EoE EGID with esophageal involvement (EI)." Notably, in a survey of these experts, 61% agreed with the later term "non-EoE EGID with EI," because EoE is isolated to the esophagus by current diagnostic criteria.3 However, limited molecular and pathogenic data exist to support the distinction. Furthermore, disease burden of symptoms and comorbidities generally is higher in non-EoE EGIDs than EoE.4 Presently, there is no screen to predict non-EoE EGID concomitance in EoE; therefore, decision-making to further explore other GI segment involvement is clinically challenging. We aimed to answer 2 fundamental questions in the field (Figure1A): Is there a shared or distinct pathogenesis between patients with isolated EoE and non-EoE EGIDs with EI as assessed by patient characteristics and molecular profiles? Can we predict concomitant non-EoE EGIDs when EoE exists? Herein, we report a similar molecular signature between EoE and EI and a potential predictive model to identify concomitant non-EoE EGIDs in patients with EoE.

Role of peripheral and tissue eosinophils and eosinophil cationic protein in pediatric inflammatory bowel disease.

Inflammatory bowel disease (IBD), eosinophilic gastrointestinal disease (EGID), and functional abdominal pain disorder (FAPD) present with nonspecific gastrointestinal (GI) symptoms clinically and also have some similarities in pathogeneses associated with eosinophils. Therefore, we aimed to evaluate the role of eosinophils in IBD compared to EGID and FAPD by investigating eosinophils in peripheral blood and GI tissue and eosinophil cationic protein (ECP). Pediatric patients with chronic GI symptoms who underwent endoscopic biopsies were enrolled. Complete blood cell counts, inflammatory markers, immunoglobulin E (IgE), serum ECP levels, and endoscopic and histopathologic findings were retrospectively reviewed. A total of 387 patients were included: 179 with EGID, 107 with IBDs, and 82 with FAPD. Peripheral absolute eosinophil count (AEC), total IgE, and serum ECP were significantly higher in both IBD and EGID than in FAPD (all p < 0.05). Statistically significant differences were noted among the three groups in tissue eosinophil counts in each segment of GI tract except for the esophagus (p < 0.05). Significant differences were observed in tissue eosinophil counts in the ascending, sigmoid colon, and rectum between EGID and IBD (p < 0.05). Peripheral and tissue eosinophils in the stomach and duodenum revealed positive correlation in both EGID and IBD (both p < 0.001). Elevated eosinophil-related markers, as well as increased tissue eosinophilic infiltration in the affected areas of the GI tract in both IBD and EGID compared to FAPD, suggest that eosinophils might play a common important role in the pathogeneses of both diseases.

Salinity induced changes in the progression of water, ion and nutrient fluxes along the gastrointestinal tract of Atlantic salmon smolt (Salmo salar)

Water ingestion in fish increases with both water salinity and feeding. However, it is unclear whether, during feeding, water ingestion is intended to aid chyme liquefaction in the stomach or to maintain the osmotic homeostasis within the body of the fish. We investigated the effects of increasing water salinity (0, 10, 20, 35 ppt) on the progression of water, ion and nutrient fluxes in the gastrointestinal tract of Atlantic salmon smolt (Salmo salar) fed a commercial-like diet. Furthermore, the effect of water salinity on blood pH, plasma osmolality and ions was investigated. The experiment lasted for 8 weeks. Chyme was collected from 4 gastrointestinal tract (GIT) segments (stomach, proximal, middle and distal intestine) and analysed for dry matter, pH, osmolality, crude protein and mineral content. Water and electrolyte fluxes, kinetic of digestion and faecal digestibility were measured using yttrium oxide (Y2O3) as an inert marker. We found that between 0 and 35 ppt chyme dry matter decreased by 1.6% and 4.8% in the stomach and proximal intestine, respectively. Chyme pH was not affected by water salinity in the stomach, but it increased linearly (p < 0.001) with salinity in all intestinal segments. Chyme osmolality increased linearly (p < 0.001) with salinity in the stomach and it decreased in all intestinal segments. Water fluxes were similar among salinities in the stomach, but they increased nearly fivefold (6.2 versus 27.3 ml g−1 ingested DM) in the proximal intestine between 0 ppt and 35 ppt. An efflux of monovalent ions (Na+ and K+) increased linearly (p < 0.001) with salinity in the proximal intestine. An efflux of divalent ions (Ca2+ and Mg2+) increased curvilinearly (p < 0.001) with salinity in the middle intestine. Plasma osmolality and ion levels increased with salinity. Crude protein digestibility and protease activity decreased significantly with water salinity in the intestine. Our study highlights that when Atlantic salmon moves from freshwater to higher water salinity environments, drinking of saltwater does not interfere with hydration of feed in the stomach, but instead bypasses to the proximal intestine to aid in osmoregulatory water uptake. Therefore, we suggest that water ingestion in seawater fish is intended for osmoregulation rather than to aid digestion by liquefying chyme in the stomach.

Standardized Quantification of Mast Cells in the Gastrointestinal Tract in Adults

Current data on the normal quantity of mast cells throughout the adult gastrointestinal tract are limited in several domains. These include microanatomic localization of mast cells, standardization of staining and counting methods, and reporting of microscope field of view. To address this lack of reliable reference ranges to facilitate the study of and diagnosis of emerging mast cell-mediated diseases. We examined biopsies obtained from the esophagus, stomach, duodenum, and colon from an unselected cohort. Mean and peak mast cell density were determined on slides stained for tryptase and CD117, and were expressed per high power field (hpf) and surface area (mm2), thus deriving reference ranges (average ± 2 SDs). For the most common hpf surface area (0.238 mm2), upper limits of the derived reference ranges for average/peak mast cells were 0.15/3.67 (esophagus, tryptase), 0.70/5.98 (esophagus, CD117), 22.56/35.30 (stomach, tryptase), 31.32/53.10 (stomach, CD117), 30.28/49.77 (duodenal crypts, tryptase), 41.96/65.26 (duodenal crypts, CD117), 4.98/11.56 (duodenal villi, tryptase), 8.38/14.17 (duodenal villi, CD117), 26.58/41.08 (colon, tryptase), and 35.57/57.92 (colon, CD117). Interobserver variability was moderate to good. There was significant correlation between average and peak mast cell counts. These data help standardize mast cell reference ranges throughout the gastrointestinal tract in adults, which can be used to determine whether abnormal levels of mast cells are present in patients with suspected mast cell-mediated disease. Our data show that the commonly used cutoff of 20 mast cells per hpf irrespective of the gastrointestinal tract segment is an underestimate of an appropriate cutoff in stomach, duodenum (crypt area), and colon.

Nonsteroidal antiinflamatory drugs and risks of ulceration and other complications: some results of the problem investigation and own clinical observations

Nonsteroidal antiinflamatory drugs (NSAIDs) are widely used in clinical practice. Most widely used among them are “traditional” NSAIDs – 82,9 %, administration of selective COG-2 inhibitors was much less numerous. Starting from the primary care main attention upon using of mentioned drugs should be paid to safety, especially at chronic states, which require prolonged treatment. Safety should be in the center of attention considering influences on heart-and-vessel system and kidney. But mainly authors consider side effects on gastrointestinal tract, because of high spreading and severity. Moreover, side effects from lower segments of gastrointestinal tract demonstrate obvious trend for increasing. Some scientific results proved, that more than 40 % of injures connected with NSAIDs appeared in lower segments of gastrointestinal tract (small intestine and bowel). The article provides the results of own clinical observations of the case with multiple (eight) perforations of gastrointestinal tract upon uncontrolled self administered different NSAIDs by the multiply comorbided patient. We consider such a description demonstrative during practical classes in state and English languages at pre- and postgraduate levels.

Diversity and functional prediction of fungal communities in different segments of mongolian horse gastrointestinal tracts

BackgroundAnaerobic fungi are effective fibre-degrading microorganisms in the digestive tract of horses. However, our understanding of their diversity and community structure is limited, especially in different parts of the gastrointestinal tract.ResultsFor the first time, high-throughput sequencing technology was used to analyse and predict fungal microbial diversity in different parts of the gastrointestinal tract of Mongolian horses. The results revealed that the richness and diversity of fungi in the hindgut of Mongolian horses were much higher than those in the foregut. The foregut was dominated by Basidiomycota and Ascomycota, whereas the hindgut was dominated by Neocallimastigomycota and Basidiomycota. At the genus level, the relative abundance of many pathogenic fungi (Cryptococcus, Cladosporium, Alternaria, and Sarocladium) in the foregut was significantly higher than that in the posterior gut, indicating that Mongolian horses have strong disease resistance. The prediction of fungal function also showed significant differences in the fungal flora between the foregut and the hindgut. The fungi in Mongolian horses’ foreguts were mainly pathologically nutritive and contained many animal and plant pathogens, particularly in the small intestine (jejunum and ileum). This indicates that the foregut may be the most important immune site in the digestive system of Mongolian horses, which explains the high disease resistance of Mongolian horses. The number of unassigned functional groups in the posterior gut was significantly higher than that in the anterior gut, indicating that the functions of fungal groups in the posterior gut have not been fully explored, and further studies are required in the future.ConclusionsAnalysis of high-throughput sequencing results revealed that the fungal composition varied greatly among different gastrointestinal tract segments in Mongolian horses, whose hindgut contains many anaerobic fungi involved in plant cellulose degradation. This provides important basic data for studying fungal diversity in the digestive system of healthy horses, which can be used for the health assessment of horses and provides clues for further research on the disease resistance and digestive capacity of horses, as well as a reference for the early diagnosis of intestinal diseases and innovative treatment methods.

Understanding Discordance between In Vitro Dissolution, Local Gut and Systemic Bioequivalence of Budesonide in Healthy and Crohn's Disease Patients through PBPK Modeling.

The most common method for establishing bioequivalence (BE) is to demonstrate similarity of concentration-time profiles in the systemic circulation, as a surrogate to the site of action. However, similarity of profiles from two formulations in the systemic circulation does not imply similarity in the gastrointestinal tract (GIT) nor local BE. We have explored the concordance of BE conclusions for a set of hypothetical formulations based on budesonide concentration profiles in various segments of gut vs. those in systemic circulation using virtual trials powered by physiologically based pharmacokinetic (PBPK) models. The impact of Crohn's disease on the BE conclusions was explored by changing physiological and biological GIT attributes. Substantial 'discordance' between local and systemic outcomes of VBE was observed. Upper GIT segments were much more sensitive to formulation changes than systemic circulation, where the latter led to false conclusions for BE. The ileum and colon showed a lower frequency of discordance. In the case of Crohn's disease, a product-specific similarity factor might be needed for products such as Entocort® EC to ensure local BE. Our results are specific to budesonide, but we demonstrate potential discordances between the local gut vs. systemic BE for the first time.

Effect of dietary macronutrient composition and buffering capacity on chyme characteristics and digestion kinetics in the gastrointestinal tract of freshwater rainbow trout (Oncorhynchus mykiss)

The aim of this study was to investigate the impact of dietary macronutrient composition and buffering capacity (BC) on chyme characteristics and digestion kinetics in freshwater rainbow trout (Oncorhynchus mykiss). Dietary macronutrient composition was altered by changing the protein-to-energy ratio (P:E) while keeping the fat-to-starch ratio constant. Dietary BC was increased by supplementation of CaCO3. The experiment lasted for 6 weeks. Fish were fed four diets having high and low P:E ratio and high and low CaCO3 level. This experiment was planned according to a 2x2x2 factorial design. The three factors were dietary P:E ratio, BC and time sampling after feeding (3 and 7 h). Chyme was collected from four gastrointestinal tract (GIT) segments (stomach, proximal, middle and distal intestine) and analysed for dry matter (DM), pH, osmolality, crude protein (CP) and mineral content. Relative water fluxes (RWF), electrolyte fluxes, kinetic of digestion and faecal digestibility (ADCs) were measured using yttrium oxide (Y2O3) as an inert marker. All chyme characteristics (including water fluxes) were not influenced by the interaction effect between dietary factors and sampling time (p > 0.05). Both dietary treatments did not affect chyme DM in the stomach. Low P:E diet increased (p < 0.001) chyme DM in all the intestinal segments. Dietary CaCO3 only affected (p < 0.05) chyme DM in the distal intestine. Low P:E diet decreased (p < 0.001) chyme pH in all GIT segments compared to the high P:E diet. Low CaCO3 diet decreased chyme pH in the proximal and middle intestine (p < 0.05) compared to the high CaCO3 diet. RWF were affected only by the dietary P:E ratio in the stomach and in the proximal intestine. Fish fed the high P:E diet had a lower water influx in the stomach and a higher water influx in the proximal intestine than fish fed the low P:E diet. Dietary P:E ratio affected electrolyte fluxes in the GIT, while no effect of CaCO3 was detected. Both dietary factors had a minimal or no effect on the kinetic of digestion in the different GIT segments, while a significant effect was present in all ADCs. Our findings suggest that dietary macronutrient composition, rather than buffering capacity, is the primary factor responsible for changes in chyme characteristics, water and ion fluxes in the GIT of freshwater rainbow trout. Furthermore, changes in dietary macronutrient composition and buffering capacity significantly affect faecal digestibility but are not reflected in digestion kinetics.

GSPE Pre-Treatment Exerts Long-Lasting Preventive Effects against Aging-Induced Changes in the Colonic Enterohormone Profile of Female Rats.

The impact that healthy aging can have on society has raised great interest in understanding aging mechanisms. However, the effects this biological process may have on the gastrointestinal tract (GIT) have not yet been fully described. Results in relation to changes observed in the enteroendocrine system along the GIT are controversial. Grape seed proanthocyanidin extracts (GSPE) have been shown to protect against several pathologies associated with aging. Based on previous results, we hypothesized that a GSPE pre-treatment could prevent the aging processes that affect the enteroendocrine system. To test this hypothesis, we treated 21-month-old female rats with GSPE for 10 days. Eleven weeks after the treatment, we analyzed the effects of GSPE by comparing these aged animals with young animals. Aging induced a greater endocrine response to stimulation in the upper GIT segments (cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1)), a decrease in the mRNA abundance of GLP-1, peptide YY (PYY) and chromogranin A (ChgA) in the colon, and an increase in colonic butyrate. GSPE-treated rats were protected against a decrease in enterohormone expression in the colon. This effect is not directly related to the abundance of microbiome or short-chain fatty acids (SCFA) at this location. GSPE may therefore be effective in preventing a decrease in the colonic abundance of enterohormone expression induced by aging.

Comparative analysis of two nonlethal methods for the study of the gut bacterial communities in wild lizards.

Fecal samples or cloacal swabs are preferred over lethal dissections to study vertebrate gut microbiota for ethical reasons, but it remains unclear which nonlethal methods provide more accurate information about gut microbiota. We compared the bacterial communities of three gastrointestinal tract (GIT) segments, that is, stomach, small intestine (midgut), and rectum (hindgut) with the bacterial communities of the cloaca and feces in the mesquite lizard Sceloporus grammicus. The hindgut had the highest taxonomic and functional alpha diversity, followed by midgut and feces, whereas the stomach and cloaca showed the lowest diversities. The taxonomic assemblages of the GIT segments at the phylum level were strongly correlated with those retrieved from feces and cloacal swabs (rs > 0.84 in all cases). The turnover ratio of Amplicon Sequence Variants (ASVs) between midgut and hindgut and the feces was lower than the ratio between these segments and the cloaca. More than half of the core-ASVs in the midgut (24 of 32) and hindgut (58 of 97) were also found in feces, while less than 5 were found in the cloaca. At the ASVs level, however, the structure of the bacterial communities of the midgut and hindgut were similar to those detected in feces and cloaca. Our findings suggest that fecal samples and cloacal swabs of spiny lizards provide a good approximation of the taxonomic assemblages and beta diversity of midgut and hindgut microbiota, while feces better represent the bacterial communities of the intestinal segments at a single nucleotide variation level than cloacal swabs.

Evaluation of the normal gastrointestinal tract in cats using dual-phase computed tomography.

In cats, although ultrasonography remains the preferred modality to evaluate the gastrointestinal tract, computed tomographic (CT) examination of the abdomen is commonly performed. However, a normal description of the gastrointestinal tract is lacking. This study describes the conspicuity and contrast enhancement pattern of the normal gastrointestinal tract in cats using dual-phase CT. Pre- and dual-phase postcontrast (early scan at 30 seconds and late scan mean at 84seconds) abdominal CT exams of 39 cats without history, clinical signs or diagnosis of gastrointestinal disease were reviewed. The gastrointestinal tract was examined for conspicuity and enhancement pattern using commercially available viewing software (Osirix, v.6.5.2), and diameters of 16 gastrointestinal segments were recorded and compared with published radiographic and ultrasonographic reference values. Of the 624 gastrointestinal segments, 530 (84.9%) were identified on precontrast studies and 545 (87.3%) segments on postcontrast studies. Of the gastrointestinal wall segments, 257 (41.2%) were identified on precontrast studies and 314 (50.3%) on postcontrast studies. Gastrointestinal segment diameters correlated well with published normal values, whereas wall thickness measurements usually were smaller compared with sonographic normal values. Early mucosal surface enhancement was frequently seen in the gastric cardia and fundus and ileocolic junction, and a mainly transmural wall enhancement in other gastrointestinal segments. Dual-phase CT allows for the identification of gastrointestinal tract segments and walls in cats. Contrast enhancement improves conspicuity and demonstrates wall layering in the cardia, fundus and ileocolic junction.

Endometriosis : A Rare Etiology for Small Bowel Obstruction

Endometriosis affecting gastrointestinal tract has been reported in 3-37% of menstruating women. It is seen in the recto-sigmoid, caecum, small bowel and the appendix in decreasing frequency. Involvement of the ileum by endometriosis is quite rare ,1-7% cases have been documented..Endometriosis of ileal segment of gastrointestinal tract leading to intestinal obstruction ranges from 7% to 23%.We report a 40 year. old female who presented with complete intestinal obstruction ten days with history of recurrent subacute intestinal obstruction for one year. She was previously treated with empirical Antitubercular drug to which she did not respond. Now histology of the resected specimen showed endometriosis in muscular propria and submucosa , leading to fibrosis and stricture formation.

Saignement duodénal dû à une métastase d’un cancer pulmonaire contrôlé par radiothérapie : cas clinique et revue de la littérature

Gastrointestinal (GI) metastases in lung cancer rarely occur. We report here the case of a 43-year-old male active smoker who was admitted to our hospital for cough, abdominal pain and melena. Initial investigations revealed poorly differentiated adenocarcinoma of the superior-right lobe of the lung: positive for thyroid transcription factor-1 and negative for protein p40 and for antigen CD56, with peritoneal, adrenal and cerebral metastasis, as well as anemia requiring major transfusion support. Over 50% of cells were positive for PDL-1, and ALK gene rearrangement was detected. GI endoscopy showed a large ulcerated nodular lesion of the genu superius with active intermittent bleeding, as well as an undifferentiated carcinoma with positivity for CK AE1/AE3 and TTF-1, and negativity for CD117, corresponding to metastatic invasion originating from lung carcinoma. Palliative immunotherapy with pembrolizumab was proposed, followed by targeted therapy with brigatinib. Gastrointestinal bleeding was controlled with a single 8Gy dose of haemostatic radiotherapy. GI metastases are rare in lung cancer and present nonspecific symptoms and signs but no characteristic endoscopic features. GI bleeding is a common revelatory complication. Pathological and immunohistological findings are critical to diagnosis. Local treatment is usually guided by the occurrence of complications. In addition to surgery and systemic therapies, palliative radiotherapy may contribute to bleeding control. However, it must be used cautiously, given a present-day lack of evidence and the pronounced radiosensitivity of certain gastrointestinal tract segments.

The Gut Microbiome Influences the Gene Expression Profile of Neuroendocrine and Enteroendocrine Systems

Objective/Hypothesis: The gut microbiome influences metabolism, but the underlying mechanisms are not completely understood. We hypothesized that the gut microbiome modulates metabolism by regulating the expression of key neuroendocrine and enteroendocrine genes such as neuropeptide Y (Npy) which is a potent brain orexigenic peptide and G-protein-coupled receptor-17 (Gpr17) which decreases incretin secretion in the gut.&#x0D; Approach: The gene expression profiles in mouse hypothalamus and gastrointestinal tract segments (duodenum, jejunum, ileum, and colon) were compared from germ-free (GF) mice (n=9 females, n=9 males) and conventional mice (n=9 females, n=9 males). Gene transcription was determined through total RNA yield extracted from the various tissues using qRT-qPCR. The data was analyzed using two-way ANOVA and unpaired t-test.&#x0D; Results: We found that RNA yield in brain and gut tissues differed in a sex and microbiome dependent manner. The medial basal hypothalamus of the female germ-free mice had lower RNA yield compared with conventional female mice (p=0.0082). In the intestine, the RNA concentrations of the germ-free mice showed a decrease from the proximal to distal gut, however, an opposite trend was observed in the conventional mice with an overall increase of concentration from the proximal to distal gut. This trend may reflect the high concentration of the microbiota in the distal gut. Regarding gene expression of the neuroendocrine and enteroendocrine systems, Npy had lower expression in the medial basal hypothalamus (MBH) of conventional males (p=0.004), Gpr17 showed moderate duodenal expression in conventional mice (p=0.029), and Gpr17 showed increased duodenal expression in germ-free females (p=0.044).&#x0D; Summary/Conclusions: With enriched microbiota in the ileum and colon, our results indicate that gut microbiota increase host gene transcription in the distal gut segments. Future studies will aim at investigating the mechanistic link between the microbiome and regulation of gene expression in neuroendocrine and enteroendocrine tissues.

Oregano extract fed to pre-weaned dairy calves. Part 1: Effects on intake, digestibility, body weight, and rumen and intestinal bacteria microbiota

Essential oils have become attractive candidates for use in the livestock industry, yet their mode of action over microbial populations of animals remains largely unknown. To gain further insight, this study investigated the bacterial population in segments of gastrointestinal tract and performance of pre-weaned dairy calves supplemented with a commercial Oregano extract containing essential oils. Ten Holstein calves weighing 37.1 kg ± 3.6 kg were fed 6 L/day of milk replacer, and had free access to water and calf starter ad libitum from the first day, and to hay ad libitum from the third week of the start of the study period. The calves were randomly assigned to two treatments: CON - without additive; and OR - 60 mg/kg body weight per day with oregano extract. Weaning occurred on the 53rd day of the experimental period and on the 54th day, all calves were euthanized, and their rumen, jejunum, cecum and colon contents were sampled to determinate bacterial population. The OR supplementation increased starter concentrate intake, but did not affect feed conversion, average daily gain (ADG), total VFA acetate, butyrate, and propionate ruminal concentrations, as well as C2 to C3 ratio. Apparent digestibility tended to increase in OR for DM, OM, NFCcp and CP. The alpha diversity analysis (Shannon index) indicated a higher diversity of rumen and jejunum bacterial population in OR calves. Oregano extract affected positively and negative the abundance of both positive and gram-negative bacteria in the gastrointestinal tract. Moreover, OR decreased potentially pathogenic genera such Streptococcus, Escherichia and Clostridium, albeit it also decreased the population of the potentially beneficial Bifidubacterium in the jejunum and cecum. Oregano extract supplemented to pre-weaned dairy calves modulates bacteria microbiota and may contribute to reduce pathogenic bacteria in the gastrointestinal tract.

Gastro-Intestinal Microbiota in Equines and Its Role in Health and Disease: The Black Box Opens.

Horses are large non-ruminant herbivores and rely on microbial fermentation for energy, with more than half of their maintenance energy requirement coming from microbial fermentation occurring in their enlarged caecum and colon. To achieve that, the gastro-intestinal tract (GIT) of horses harbors a broad range of various microorganisms, differing in each GIT segment, which are essential for efficient utilization of feed, especially to use nutrients that are not or little degraded by endogenous enzymes. In addition, like in other animal species, the GIT microbiota is in permanent interplay with the host's cells and is involved in a lot of functions among which inflammation, immune homeostasis, and energy metabolism. As for other animals and humans, the horse gut microbiome is sensitive to diet, especially consumption of starch, fiber, and fat. Age, breeds, stress during competitions, transportation, and exercise may also impact the microbiome. Because of its size and its complexity, the equine GIT microbiota is prone to perturbations caused by external or internal stressors that may result in digestive diseases like gastric ulcer, diarrhea, colic, or colitis, and that are thought to be linked with systemic diseases like laminitis, equine metabolic syndrome or obesity. Thus, in this review we aim at understanding the common core microbiome -in terms of structure and function- in each segment of the GIT, as well as identifying potential microbial biomarkers of health or disease which are crucial to anticipate putative perturbations, optimize global practices and develop adapted nutritional strategies and personalized nutrition.