| Popis: |
Background and Aim:Non-specific terminal ileum abnormalities (INSTIA) are frequently observed on ileo-colonoscopic examinations, but their clinical significance is unclear. Moreover, there is no recommended protocol for the management of these abnormalities. Presuming infectious origin, a randomized controlled trial of empirical protocolized management with three commonly used antimicrobial agents was carried out with an aim to study its impact on patients with INSTIA. Methodology:Patients with INSTIA were randomized into two groups such as both symptomatic and empirical protocolized treatment with three commonly used antimicrobial agents [rifaximin, albendazole and tinidazole (group A)] and symptomatic treatment alone (group B). Clinical, endoscopic, and histological findings of these subjects were noted at baseline and after follow-up of 3 months. The primary outcome measure was mucosal healing on follow-up ileo-colonoscopy after 3 months.Results: A total of 60 patients with INSTIA were enrolled. The most prevalent symptoms were abdominal discomfort (61.6%), diarrhoea (41.6%), and constipation (40%). The incidence of ulcers, nodularity and erosions were 62.1%, 27.6%, 10.34% in group A and 58%, 29%, 13% in group B respectively. After a mean follow-up duration of 3.36 ± 0.27 months, both groups showed comparable resolution in clinical symptoms (92.4% vs 88.8%, p=0.954), ileo-colonoscopic findings (88.5%vs 81.5%, p=0.765), and histological characteristics (76.5%vs 70.4%, p=0.806).Conclusion: The clinical, endoscopic, and histopathological remission occurs in most patients with INSTIA. The use of empirical protocolized management with antimicrobials did not have any impact on the rate of mucosal healing in these patients. |
