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Article Transcutaneous posterior tibial nerve stimulation for fecal incontinence in inflammatory bowel disease patients: a therapeutic option? 2009
Vitton V, Damon H, Roman S, Nancey S, Flourié B, Mion F. · Hospices Civils de Lyon, Digestive Physiology, Hôpital Edouard Herriot, Lyon, France. · Inflamm Bowel Dis. · Pubmed #18972550 No free full text.
Abstract: BACKGROUND: Fecal incontinence associated with inflammatory bowel disease (IBD) may be particularly difficult to treat. Two recent studies showed that transcutaneous posterior tibial nerve stimulation may improve fecal continence. In this pilot study, we tested the usefulness of this noninvasive technique to treat fecal incontinence in IBD. METHODS: Twelve patients with IBD (7 Crohn's disease, 2 undetermined colitis, 3 ulcerative colitis) were treated by applying transcutaneous posterior tibial nerve electrical stimulation daily for 3 months. A clinical evaluation was performed at the end of treatment, with Wexner's score and Harvey-Bradshaw index and analog scales to assess symptoms and quality of life. RESULTS: At 3 months, 5 patients (41.6%) reported a significant symptomatic and quality of life improvement, although only 1 reported a significant modification in the Wexner score. CONCLUSION: These preliminary results are encouraging, although further studies are necessary. Posterior tibial nerve electrical stimulation may represent a new therapeutic option to treat the difficult problem of fecal incontinence in patients with IBD.
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Article Is scintigraphic double-track appearance a sign of severe acute episodes of ulcerative colitis? free! 2004
Morelec I, Nancey S, Roman S, Rocca P, Potier P, François Y, Pellet O, Vignal J, Bonmartin A, Descos L, Flourié B. · Service de Médecine Nucléaire, Centre Hospitalier Lyon-Sud, Pierre-Bénite. · Gastroenterol Clin Biol. · Pubmed #15094670 links to free full text
Abstract: AIM: In comparison to endoscopy, clinical and biological criteria are less predictive of severity in attacks of ulcerative colitis (UC). Our aim was to assess the value of the double-track scintigraphic appearance in the assessment of the severity of acute UC by comparing it to endoscopic criteria. PATIENTS AND METHODS: We reviewed medical records of 52 patients hospitalized for an acute attack of UC, who had undergone within 48 hours of presentation both a technetium 99m hexamethyl propylene amine oxime (99mTc-HMPAO) granulocyte scintigraphy and endoscopic examination (colonoscopy: n=20; rectosigmoidoscopy: n=32). RESULTS: Taking into account the colonic segments examined together with both methods in the same patient or results obtained with colonoscopies, there was an excellent agreement between the double-track scintigraphic appearance and endoscopic criteria of severity. CONCLUSION: In patients with previously diagnosed UC, 99mTc-HMPAO granulocyte scintigraphy when available may replace endoscopic examination to assess the severity of attacks.
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