Gastrointestinal intraluminal pH in normal subjects and those with colorectal adenoma or carcinoma

Article Abstract:

It has been proposed that the pH (acidity) of the gastrointestinal tract may play an important role in the development of colorectal cancer. Specifically, high pH (high alkalinity) in the stomach and intestines may promote bacterial degradation of bile acids (digestive substances secreted by the liver) and cholesterol into carcinogens. The protective effect of fiber against colorectal cancer, according to this hypothesis, results from the fermentation of fiber into fatty acids, which causes acidification of the gastrointestinal tract. If low acidity in the stomach and intestines promotes the development of colorectal cancer, patients with this disease should have lower levels of acidity than subjects without cancer. To test this hypothesis, gastrointestinal pH was measured in 30 patients with colorectal cancer and in 37 patients with benign colorectal adenomas, as well as in 66 normal patients without evidence of gastrointestinal dysfunction. Patients swallowed a pH-sensitive radiotransmitter, and acidity was measured as the transmitter traversed the gastrointestinal tract. There were no differences in the pH of any of the segments of the small or large intestine in either the colorectal cancer patients or colorectal adenoma patients compared with the healthy volunteers. These results indicate that either gastrointestinal acidity is unrelated to the development of colorectal cancer, or that the relationship is more complicated than previously supposed, and depends upon type of food ingested or some other physiological characteristics of the patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Measurement, Causes of, Hydrogen-ion concentration, pH measurement, Gastric acid

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Prognosis in familial non-polyposis colorectal cancer

Article Abstract:

There is extensive interest in improving methods for predicting survival rates in populations of patients suffering from different types of colorectal cancer. It has been reported that there may be different survival rates for patients with hereditary tumors; the so-called cancer family syndrome (the occurrence of similar cancers in numerous first-degree relatives) may be predictive of prolonged survival compared with patients suffering from sporadic (non-familial) tumors. To determine whether the prognosis differed for patients with familial colorectal cancer compared with non-familial, a study was done in which the records of 205 patients under the age of 55 with confirmed colorectal cancer were evaluated. The family histories and causes of death were verified for virtually all the first-degree relatives of these patients. The strength of the influence of family history was assessed using a derived score that took into account death from colorectal cancer within a given family and compared this with the average population mortality. Using this index, family history was not predictive of survival rate either in a univariate analysis or in a multivariate analysis in which age, sex, stage and site of cancer, and duration of symptoms were controlled. Hence, family history does not appear to be an important predictor of survival among patients with colorectal cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Genetic aspects, Cancer, Cancer genetics

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Epidemiological study of asymptomatic inflammatory bowel disease: the identification of cases during a screening programme for colorectal cancer

Article Abstract:

A colorectal cancer screening program gave researchers an opportunity to study the occurrence of inflammatory bowel disease in the population at large. A group of people without symptoms of colorectal cancer were offered blood tests in a screening study for the disease. Almost 18,000 people completed the tests and 481 individuals with positive tests underwent full investigation of the colon. Previously undiagnosed inflammatory bowel disease (ulcerative colitis, or inflammation of the mucous of the colon) was detected in 8 people. Five cases had total ulcerative colitis. One patient had proctitis, the inflammation of the rectal mucosa. Two patients had Crohn's disease, a chronic inflammatory bowel disease. Two other patients with ulcerative colitis were identified; their disease had not been monitored for 25 and 45 years respectively. Current studies of the epidemiology of these conditions may underestimate the occurrence of colorectal cancer by 27 to 38 percent.

Diagnosis, Ulcerative colitis, Colorectal diseases, Intestinal diseases, Crohn's disease, Proctitis

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