Ahmet Tezel

Trakya University · Department of Gastroenterology

Background: Although studies are investigating the perception and beliefs about treatment and adherence to treatment in different societies related to inflammatory bowel disease, there are no studies on this subject in Turkish people with different sociocultural struc- tures. In our study, we aimed to evaluate the beliefs about treatment and its e...

Background: Patients with Crohn's disease experience major deterioration in work productivity and quality of life. We aimed to provide the long-term effects of anti-tumor necrosis factor agents on work productivity and activity impairment and quality of life in patients with Crohn's disease using the Inflammatory Bowel Disease Questionnaire and th...

The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2, has resulted in high mortality and morbidity worldwide and is still a growing problem. Inflammatory bowel disease (IBD) is a chronic inflammatory disease for which a substantial number of patients are treated with immunosuppressive medications, either occasi...

As a result of the Covid-19 pandemic, all theoretical courses and practices held face-to-face in all medical faculties in the world and in our country have been terminated, and distance education has begun to be provided with digital education opportunities. In our faculty, most of the courses in the spring semester of 2019-2020 were held asynchron...

Background and Aims: Ulcerative colitis is an idiopathic, chronic inflammatory disease with a high relapse rate. Smoking contributes to the development and progression of ulcerative colitis. We determined total rectal wall thickness in patients with ulcerative colitis who had a smoking history. Materials and Methods: We included 19 patients with ul...

Background and Aims The patients with gastro-esophageal reflux disease (GERD) have distortion of sympathetic and parasympathetic components of the autonomic nervous system. The increase in sympathetic activity results in hyperkinetic circulation with peripheral vasoconstrictor and tachycardia and also regulates blood pressure with increase of renin...

Background: Recent advances in next-generation sequencing (NGS) technology have enabled multigene testing and changed the diagnostic approach to hereditary gastrointestinal cancer/polyposis syndromes. The aim of this study was to analyze different cancer predisposition genes in hereditary/sporadic gastrointestinal cancer/polyposis. Methods: Canc...

Background and study aims: Cirrhosis is a multisystem disorder characterized by hyperdynamic circulation which can progress to multiple organ dysfunctions. Recent studies have demonstrated autonomic dysfunction and cirrhotic cardiomyopathy including diastolic dysfunction, systolic dysfunction with electrophysiologic abnormalities in patients with...

Background Management of enteropathic arthritis may be challenging due to differences in treatment response of inflammatory bowel diseases and arthritis to different therapeutic modalities, which may even cause worsening of some manifestations while improving others. Enteropathic arthritis was not addressed in the management recommendations for spo...

Abstract: Inflammatory bowel disease is a group of systemic chronic inflammatory disease that predominantly affects the gastrointestinal tract. Extraintestinal findings are frequently together in inflammatory bowel disease. Of these, metabolic bone diseases are considerably frequent. In our study, we aimed to reveal the frequency of osteoporosis an...

Background: Patients with Crohn's disease (CD) experience major deterioration in their work productivity and quality of life (QoL). Objectives of this study were to evaluate long-term effects of anti-TNF agents on work productivity and activity impairment (WPAI) in patients with CD and also to evaluate QoL using the Inflammatory Bowel Disease Quest...

Background/aims: Inflammatory bowel diseases are chronic, relapsing, inflammatory conditions. They have a genetic backround resulting in patient susceptibility. The aim of our study is to investigate the involvement of IL23R, JAK2, and STAT3 polymorphisms in inflammatory bowel diseases in a Turkish population. Materials and methods: Polymorphism...

Hepatocelluler carcinoma (HCC) is one of the most common primary tumors. Extrahepatic metastasis are seen only in 13.5-42% of the patients with HCC (1). The most common sites of metastasis are lung, lymph nodes, bone, adrenal gland and peritoneum. However, spleen metastasis is extremely rare (2-4). In this report, a case of advanced stage HCC with...

Amaç: Kronik hastalıklarda, hastaların büyük çoğunluğu hastalığın getirdiği ağrı, yorgunluk ve depresif semptomlarla birlikte sosyal yaşamlarında kısıtlılıklar, fiziksel aktivitelerini gerçekleştirmede güçlükler yaşamaktadır. Buna bağlı yaşam kalitesi etkilenmektedir. Kronik hepatitli hastalarda, hastalığının erken evrelerinde hiçbir semptom bulunm...

Inflammatory bowel disease is a group of chronic inflammatory conditions affecting gastrointestinal tract. Lots of genes have been identified resulting in susceptibility to inflammatory bowel disease. Any polymorphism leading to functional modifications in tyrosine kinase-2 may precipitate excessive immune response in the intestinal mucosa. The aim...

Ataxia and tremor are rare manifestations of hepatocerebral degeneration due to portovenous shunts. Ammonia is a neurotoxin that plays a significant role in the pathogenesis of hepatic encephalopathy. A 58-year old male patient was assessed with the complaints of gait disturbance, hand tremor, and impairment of speech. His neurological examination...

Ataxia and tremor are rare manifestations of hepatocerebral degeneration due to portovenous shunts. Ammonia is a neurotoxin that plays a significant role in the pathogenesis of hepatic encephalopathy. A 58-year old male patient was assessed with the complaints of gait disturbance, hand tremor, and impairment of speech. His neurological examination...

Objective. In this study, we aimed to investigate the possible role of serum cytokines in the development of hepatic osteodystrophy. Matherial and Methods. 44 consecutive male cirrhotic patients (17 alcoholic, 20 hepatitis B, 7 hepatitis C), 15 age- and sex-matched chronic alcoholics without liver disease, and 17 age- and sex-matched healthy contro...

Inflammatory Bowel Disease (IBD) is a group of chronic and relapsing inflammatory disorders of the gastrointestinalsystem. In these cases, findings are detected in extraintestinal systems also. There is a tendency for thrombotic eventsin IBD, as in the other inflammatory processes. The pathogenesis of this thrombotic tendency is multidimensional,in...

We read with interest the article by Assche1 et al regarding the long-term outcomes of endoscopic dilatation in 133 patients with Crohn's disease exhibiting ileal, ileocolonic and anastomotic strictures, on a retrospective basis. They performed multistep dilatation utilising scope balloons starting from 15–16.5 cm and widening to 18 cm at the maxim...

Objective: Helicobacter pylori (H. pylori) is implicated in the etiology of gastric and duodenal ulcer, non-ulcer dyspepsia, atrophic gastritis, gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma (MALToma). The aim of our study is to evaluate the prevalance of H. pylori infection in patients with benign gastroduodenal diseases. M...

The outcome of Helicobacter pylori infection has been related to specific virulence-associated bacterial genotypes. The best known genotypic virulence factors of H. pylori are cytotoxin-associated gene A (cagA) and vacuolating cytotoxin gene A (vacA). The objective of this study was to assess the relationship between H. pylori cagA and vacA status...

Abdominal tuberculosis is a rare disease, with non-specific findings. Abdominal tuberculosis can mimic different pathologies. Abdominal tuberculosis could affect the entire gastrointestinal tract, peritoneum, mesentery as well as the solid organs like liver, spleen and pancreas. We present a 42-year-old woman with intra-abdominal mass of unknown or...

Inappropriate down regulation of an activated immune system is considered as the main pathogenetic mechanism in inflammatory bowel disease. Migration of circulating cells to a diseased intestine is considered as an important factor in the pathogenesis of inflammatory bowel disease. We aimed to evaluate some features of circulating immune cells in i...

To investigate whether antioxidants vitamin E and C can retard development of hepatic fibrosis in the biliary-obstructed rats. Fifty Wistar albino rats were randomly assigned to 5 groups (10 rats in each). Bile duct was ligated in 40 rats and they were treated as follows: group vitC, vitamin C 10 mg/kg sc daily; group vitE, vitamin E 15 mg/kg sc da...

It is reported that the incidence of thromboembolism is increased in ulcerative colitis (UC), and hypercoagulability persists even when patients are in remission. We evaluated the association of inflammatory response parameters with UC activity, and activation parameters of the platelets, endothelium, and the coagulation system in UC. Eighteen UC p...

Background: Oxidative stress has been associated with tissue injury in alcoholic liver disease. Although this close association is well known, whether prevention of oxidative stress retards tissue injury has not been thoroughly investigated. Objective: The aim of this study was to determine the effects of supplementation with vitamins E and C on...

Inflammatory bowel disease (IBD) is an idiopathic inflammatory disease of the gastrointestinal tract. The pathophysiology of IBD is probably the result of the complex interaction of genetic susceptibility and environmental influences. There is a well-known risk of thrombosis in patients with IBD. We present the case of a 53-year-old man with ulcera...

Patients with inflammatory bowel disease have an increased tendency for thromboembolism. In this study we aimed to determine the frequency of FV gene and Prothrombin G20210A gene mutations in a group of patients with Crohn's Disease (CD) and estimate its correlation with disease activity and clinical subtype. Forty-four CD patients and 43 healthy c...

Clinical presentationA 50 year old man was admitted to the emergency room suffering from right upper quadrant pain and vomiting for two days. He had a history of diarrhoea and 10 kg weight loss in the past two months. On arrival, physical examination revealed a distended abdomen with muscular resistance and hypotension. Laboratory data were arteria...

The American Journal of Gastroenterology is published by Nature Publishing Group (NPG) on behalf of the American College of Gastroenterology (ACG). Ranked the #1 clinical journal covering gastroenterology and hepatology*, The American Journal of Gastroenterology (AJG) provides practical and professional support for clinicians dealing with the gastr...

To determine the epidemiological features of ulcerative colitis in the Trakya region of Turkey, southeast Europe, we conducted a descriptive, cross-sectional, hospital-based study. All subjects were followed, and age, sex, place of residence, family history, educational status, tobacco consumption and use of oral contraceptives were recorded. The s...

Opening anomalies (ectopic drainage) of the common bile duct and the pancreatic ducts are rarely seen. Although recognised easily during clinical interventions on ERCP, these anomalies are stilll published as case presentations in the literature (1). Its real prevelance remains unknown. In a total of 4000 ERCPs, we determined ectopic drainage to th...

Background/aims: To investigate the typical features of gastric MALT lymphoma on endoscopic ultrasonography and to demonstrate its usefulness in the diagnosis of this disease. Methods: Five patients with gastric MALT lymphoma (three low grade, two high grade) who underwent EUS examination between October 1995 and November 1996 were included in this...

Several previous report regarding the clinical behavior and course of ulcerative colitis in the elderly were conflicting. We therefore undertook this study to determine the clinical characteristics of the disease in patients in whom the onset of symptoms and diagnosis occurred after age 60. The patients who were followed up with regular intervals a...

To aim of the present study was to determine the value of transrectal ultrasonography (TRUS) in the assessment of disease activity in ulcerative colitis patients, and in differentiating between mucosal inflammation and transmural inflammation. TRUS examinations were used to study 30 control individuals and 76 patients with inflammatory bowel diseas...

Epidemiological and clinical observation in 362 Ulcerative Colitis and 91 Crohn's disease were made in Turkiye Yuksek Ihtisas Hospital between January, 1993 and December, 1997. Besides demographic findings of the patients, cigarette consumption, oral contraceptive usage, family history, geographic distribution and ameobea frequency as an activating...

An increased tendency for thromboembolism is a well known problem of inflammatory bowel disease (IBD). Microvascular thrombosis has also been claimed as a pathogenic factor in IBD. Recently a point mutation in the gene coding factor V (FV Leiden) has been identified in various thromboembolic diseases, but the role in IBD is unknown. To determine th...

We studied HLA tissue status in 16 fully diagnosed gluten enteropathy patients. Fifty five healthy kidney donors were enlisted as controls. HLA BS, B12, DQ2 and DQ3 were significant (p<0.05) but, DR3 was far more significant (p< 0.005). This relative risk for DR3 / DR7 was 11, DR3 / DR3 was 6.6 and DR5 / DR7 was 0.89.

In this study, predictive factors affecting the succes of medical treatment in ulcerative colitis were examined. Eighty patients were admitted to hospital and surgery was perfomed on 18 cases who failed to respond to medical treatment. Clinical data and laboratory values were obtained within 24 hours of admission. Clinical disease activity, pulse r...

This study was designed to explore the relationship between Helicobacter pylori (H.pylori) infection and demographic, dietary and symptomatologic factors. Ninety-eight patients applied to our gastroenterology outpatient clinic for dyspeptic complaints were included in the study. Following a questionnaire, esophagogastroduodenoscopy with antral biop...

Anti-neutrophil cytoplasmic antibodies (ANCA) were found positive in 29 of 46 (63%) ulcerative colitis (UC) patients and in 3 of 13 (13%) Crohn's Disease (CD) patients whereas non of the controls were found ANCA positive. The differences were statistical positive in both groups when compared with control group (p<0.0001). Among 29 ANCA positive UC...

In inflammatory bowel disease (IBD), there is a risk of decreased bone mineral dansity due to lack of calcium intake, vitamin D malabsorbtion, inactivity amenorrhea and corticosteroid therapy. In this study, osteopenia prevelance and the risk factors in IBD was examined. 52 cases, 40 with ulcerative colitis and 12 with Crohn's disease (mean age, 36...

Seasonal variation in the onset and relapse of ulcerative colitis have been studied with conflicting results. In this study; records of 124 patients with ulcerative colitis were evaluated. These patients were regularly observed by Inflammatory Bowel Disease Unit and no etiologic agent responsible for the relapses was established. 124 patients were...

The interobserver variation among two experienced endoscopists in the assessment endoscopic activity index was investigated in 48 patients with ulcerative colitis. Results were analyzed with kappa statistics. According to kappa values, agreement on the endoscopic assessment of vascular pattern, granularity and mucosa were good to fair (Kappa values...

In this study, 17 patients with endoscopically and histologically proven solitary rectal ulcer syndrome and 14 patients with diagnosis of hemorrhoids as control have been evaluated with transrectal ultrasound. Mean rectal wall thickness was measured 1.6 mm, muscularis propria was 2.3 mm, submucosa was 1.6 mm, muscularis mucosa was 0.9 mm and mucosa...

Autonomic neuropathy (AN) was evaluated in 11 patients with Crohn's disease (CD), 48 patients with ulcerative colitis (UC) and 20 healthy subjects (mean age 35 years, range 17-19 years) by non invasive cardiac autonomic reflex tests. Mean age of CD patients was 30 (range 22-55) and mean age of UC patients was 35 (range 19-68). Relation of presence...

Upper gastrointestinal endoscopy as a safe method can be performed even in outpatients. In this paper, we aimed to discuss the diagnosis and treatment modalities in esophageal perforations observed after upper gastrointestinal endoscopies in three patients in the light of literature. In Turkiye Yuksek Ihtisas Hospital, 7000 upper gastrointestinal e...

Chronic viral hepatitis frequently associated with autoimmune markers. In our medical center we aimed to detect the prevalance of autoimmune serological markers such as ANA, AMA, SMA and LKM in chronic viral hepatitis and estimate, whether there is a striking difference between etiological groups and autoimmune hepatitis. We assessed 140 patients w...

There are reports of treatment of biliary cutaneous fistulae by endoscopically placed nasobiliary drains. We report our fistulae treatment results from this method. We treated 11 patients with bronchobiliary fistulas (BBFs) endoscopically during the last 6 years. In most cases, the BBF's were the result of Hydatid cyst operations. Six patients had...

In order to assess the role of transabdominal ultrasonography in ulcerative colitis, 57 patients with ulcerative colitis (26 active, 31 inactive) were examined by transabdominal ultrasonsography and compared with colonoscopy. Thirty of the patients were female and 27 were male. The average age was 39 years (range: 16-68). The average duration was 4...

The main reason of fatal prognosis in carcinoma of the pancreas is the recognition of the disease in advanced stages. Determination of the population at risk and careful evaluation of the findings in this group may help the diagnosis to be made earlier. In our study, some of the demographic features, symptoms and the findings of 117 subjects with c...

The role of Helicobacter pylori (Hp) in the etiopathogenesis for gastric and duodenal pathologies is unquestionably accepted. Although various therapy protocols have been formed to cure Hp infection, relapse is widely seen. In this study, we tried a new regimen consisting of a macrolide group antibiotic, clarithromycin, and the proton pump inhibito...