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Lower Gastrointestinal Tract Dysfunction in Patients Receiving Long-term Hemodialysis

Lower Gastrointestinal Tract Dysfunction in Patients Receiving Long-term Hemodialysis Abstract Severe bowel dysfunction developed in 25 of 945 patients receiving long-term hemodialysis during a ten-year period. Colonic perforation occurred in 12 patients, six of whom died due to peritonitis. In seven instances, the perforation occurred spontaneously. Ten other individuals exhibited prolonged, severe adynamic ileus that progressed to colonic pseudo-obstruction in eight patients. Medical decompression (eight patients) and surgical bowel decompression (two patients) resulted in recovery in nine. Aluminum hydroxide gel, which was taken regularly by all patients, was associated with notable chronic constipation prior to the occurrence of bowel perforation or protracted adynamic ileus in 78% of these individuals. (Arch Intern Med 1982;142:303-306) References 1. Guice K, Rattazzi LC, Marchioro TL: Colon perforation in renal transplant patients. Am J Surg 1979;138:43-48.Crossref 2. Margolis DM, Etheredge EE, Garza-Garza R, et al: Ischemic bowel disease following bilateral nephrectomy or renal transplant. Surgery 1977;82:667-673. 3. Schnyder PA, Brasch RC, Salvatierra 0 Jr: Gastrointestinal complications of renal transplantation in children. Radiology 1979;130:361-366. 4. Welch JP, Schweizer RT, Bartus SA: Management of antacid impactions in hemodialysis and renal transplant patients. Am J Surg 1980;139:561-568.Crossref 5. Lipschutz DE, Easterling RE: Spontaneous perforation of the colon in chronic renal failure. Arch Intern Med 1973;132:758-759.Crossref 6. Bartolomeo RS, Calabrese PR, Taubin HL: Spontaneous perforation of the colon: A potential complication of chronic renal failure. Am J Dig Dis 1977;22:656-657.Crossref 7. Scheff RT, Zuckerman G, Harter H, et al: Diverticular disease in patients with chronic renal failure due to polycystic kidney disease. Ann Intern Med 1980;92:202-204. 8. Bischel MD, Reese T, Engel J: Spontaneous perforation of the colon in a hemodialysis patient. Am J Gastroenterol 1980;74:182-184. 9. Gierson ED, Storm FK, Shaw W, et al: Caecal rupture due to colonic ileus. Br J Surg 1975;62:383-386.Crossref 10. Carr JB, Luft FC, Hamburger RJ, et al: Intussusception in chronic renal failure. Arch Surg 1976;111:866.Crossref 11. Cryer PE, Kissane JM (eds): Clinicopathologic conference: Gastrointestinal symptoms and shock in a patient with chronic renal failure. Am J Med 1980;69:595-602.Crossref 12. Castleton KB: Idiopathic perforation of the colon. Am Surg 1962;28:329-331. 13. Bailey GL, Griffiths H, Lock JP, et al: Gastrointestinal abnormalities in uremia , in Abstracts of the Fifth Annual Meeting of the American Society of Nephrology. Washington, DC, American Society of Nephrology, 1971, p5. 14. Murphy JB: Ileus. JAMA 1896;26:15-22.Crossref 15. Ogilvie H: Large-intestine colic due to sympathetic deprivation: A new clinical syndrome. Br Med J 1948;2:671-673.Crossref 16. Stephens FO: The syndrome of intestinal pseudo-obstruction. Br Med J 1962;1:1248-1250.Crossref 17. Wanebo H, Mathewson C, Conolly B: Pseudo-obstruction of the colon. Surg Gynecol Obstet 1971;133:44-48. 18. Bardsley D: Pseudo-obstruction of the large bowel. Br J Surg 1974;61:963-969.Crossref 19. Soreide 0, Bjerkeset T, Fossdal JE: Pseudo-obstruction of the colon (Ogilvie's syndrome), a genuine clinical condition? Dis Colon Rectum 1977;20:487-491.Crossref 20. Maldonado JE, Gregg JA, Green PA, et al: Chronic idiopathic intestinal pseudo-obstruction. Am J Med 1970;49:203-212.Crossref 21. Sullivan MA, Snape WJ Jr, Matarazzo SA, et al: Gastrointestinal myoelectrical activity in idiopathic intestinal pseudo-obstruction. N Engl J Med 1977;297:233-238.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Lower Gastrointestinal Tract Dysfunction in Patients Receiving Long-term Hemodialysis

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340150103019
Publisher site
See Article on Publisher Site

Abstract

Abstract Severe bowel dysfunction developed in 25 of 945 patients receiving long-term hemodialysis during a ten-year period. Colonic perforation occurred in 12 patients, six of whom died due to peritonitis. In seven instances, the perforation occurred spontaneously. Ten other individuals exhibited prolonged, severe adynamic ileus that progressed to colonic pseudo-obstruction in eight patients. Medical decompression (eight patients) and surgical bowel decompression (two patients) resulted in recovery in nine. Aluminum hydroxide gel, which was taken regularly by all patients, was associated with notable chronic constipation prior to the occurrence of bowel perforation or protracted adynamic ileus in 78% of these individuals. (Arch Intern Med 1982;142:303-306) References 1. Guice K, Rattazzi LC, Marchioro TL: Colon perforation in renal transplant patients. Am J Surg 1979;138:43-48.Crossref 2. Margolis DM, Etheredge EE, Garza-Garza R, et al: Ischemic bowel disease following bilateral nephrectomy or renal transplant. Surgery 1977;82:667-673. 3. Schnyder PA, Brasch RC, Salvatierra 0 Jr: Gastrointestinal complications of renal transplantation in children. Radiology 1979;130:361-366. 4. Welch JP, Schweizer RT, Bartus SA: Management of antacid impactions in hemodialysis and renal transplant patients. Am J Surg 1980;139:561-568.Crossref 5. Lipschutz DE, Easterling RE: Spontaneous perforation of the colon in chronic renal failure. Arch Intern Med 1973;132:758-759.Crossref 6. Bartolomeo RS, Calabrese PR, Taubin HL: Spontaneous perforation of the colon: A potential complication of chronic renal failure. Am J Dig Dis 1977;22:656-657.Crossref 7. Scheff RT, Zuckerman G, Harter H, et al: Diverticular disease in patients with chronic renal failure due to polycystic kidney disease. Ann Intern Med 1980;92:202-204. 8. Bischel MD, Reese T, Engel J: Spontaneous perforation of the colon in a hemodialysis patient. Am J Gastroenterol 1980;74:182-184. 9. Gierson ED, Storm FK, Shaw W, et al: Caecal rupture due to colonic ileus. Br J Surg 1975;62:383-386.Crossref 10. Carr JB, Luft FC, Hamburger RJ, et al: Intussusception in chronic renal failure. Arch Surg 1976;111:866.Crossref 11. Cryer PE, Kissane JM (eds): Clinicopathologic conference: Gastrointestinal symptoms and shock in a patient with chronic renal failure. Am J Med 1980;69:595-602.Crossref 12. Castleton KB: Idiopathic perforation of the colon. Am Surg 1962;28:329-331. 13. Bailey GL, Griffiths H, Lock JP, et al: Gastrointestinal abnormalities in uremia , in Abstracts of the Fifth Annual Meeting of the American Society of Nephrology. Washington, DC, American Society of Nephrology, 1971, p5. 14. Murphy JB: Ileus. JAMA 1896;26:15-22.Crossref 15. Ogilvie H: Large-intestine colic due to sympathetic deprivation: A new clinical syndrome. Br Med J 1948;2:671-673.Crossref 16. Stephens FO: The syndrome of intestinal pseudo-obstruction. Br Med J 1962;1:1248-1250.Crossref 17. Wanebo H, Mathewson C, Conolly B: Pseudo-obstruction of the colon. Surg Gynecol Obstet 1971;133:44-48. 18. Bardsley D: Pseudo-obstruction of the large bowel. Br J Surg 1974;61:963-969.Crossref 19. Soreide 0, Bjerkeset T, Fossdal JE: Pseudo-obstruction of the colon (Ogilvie's syndrome), a genuine clinical condition? Dis Colon Rectum 1977;20:487-491.Crossref 20. Maldonado JE, Gregg JA, Green PA, et al: Chronic idiopathic intestinal pseudo-obstruction. Am J Med 1970;49:203-212.Crossref 21. Sullivan MA, Snape WJ Jr, Matarazzo SA, et al: Gastrointestinal myoelectrical activity in idiopathic intestinal pseudo-obstruction. N Engl J Med 1977;297:233-238.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1982

References