VHJOE: Visible Human Journal of Endoscopy

Literature Review

Peter R. McNally, DO, FACP, FACG
University of Colorado School of Medicine
Center for Human Simulation
Aurora, Colorado

VHJOE Editor:

John Deutsch, MD
St. Mary's Duluth Clinic

International Editor:

Manoop S. Bhutani, MD
MD Anderson Cancer Center
Houston, TX

Editorial Board:

William R. Brugge, MD
Massachusetts General Hospital

Peter R. McNally, DO
Denver, CO

Thomas J. Savides, MD
University of California,
San Diego

C. Mel Wilcox, MD
University of Alabama, Birmingham

In this edition of VHJOE, Literature in Review, we examine two articles of clinical importance:

1. Higher Incidence of Abnormal Pap Smears in Women With Inflammatory Bowel Disease.

Kane S, Khatibi B, Reddy D.
Am J Gastroenterol. 2008;103:631-636.

Introduction

Kane, et al, demonstrated that sexually active females with IBD are at increased risk for abnormal Pap smears when compared to a like cohort without inflammatory bowel disease. Additionally, when these women are placed on immne suppressive medications their risk for abnormal Pap smear increased even further. The results of this study suggest the need close monitoring for cervical cancer among women with IBD. Furthermore, gastroenterologists should be proactive in recommendation of vaccination against HPV (Gardasil, Merck) among this high risk groups for cervical abnormalities.

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2. Probiotic Administration in Patients with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis Is Associated with Expansion of Mucosal Regulatory Cells.

Pronio A, Montesani C, Butteroni C, Vecchione S, Mumolo G, Vestri A, Vitolo D, Boirivant M.
Inflamm Bowel Dis. 2008;14:1-7.

Introduction

Pronio, et al, demonstrated that the probiotic, VSL#3, Sigma-Tau, inhibits the mucosal and systemic immune responses responsible for inflammation seen in pouchitis. The sophisticated methods of examining mucosal and systemic immunity used by Pronio, et al, serve as ideal tools to examine mechanisms of action for probiotics in other gastrointestinal disorders, such as IBD.

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