title: Improvement of Idiopathic Cardiomyopathy After Colon Clear.
abstract: BACKGROUND
  The study aimed to illustrate the effect of colon clear on idiopathic myocardial dysfunction.Helicobacter pyloricolonized the stomach since an immemorial time, as if both the stomach and the bacterium used to live together in peace harmless to each other.H. pyloricould migrate or get forced to migrate to the colon; antibiotics are seldom effective against extra-gastricH. pyloristrains. The association ofH. pyloriand some cardiovascular diseases like myocarditis and cardiomyopaty has been sufficiently mentioned in literature. The role played by the increased mucosal production of inflammatory mediators (cytokines) induced byH. pyloriamong patients with ischemic heart diseases has been also clearly illustrated. The clinical association of gastritis and carditis is controversial. Active lymphocytic myocarditis manifested by intractable ventricular tachycardia, non-specific intra-ventricular block, and myocardial dysfunction has been described in a young woman infected withH. pylori; an immune influence has been emphasized in that patient as a possible etiology behind the development of autoimmune myocarditis. It has been reported also in literature that a possible role of autoimmunity induced byH. pyloriin cardiomyopathy cannot be excluded.
  
  
  METHODS
  Three female patients with frank history ofH. pyloridyspepsia and an age range of 41 - 47 years have developed myocaditis complicated with cardiomyopathy as confirmed by echocardiography (ECG) and magnetic resonance imaging (MRI). Existence ofH. pyloriin the colon was confirmed byH. pylorifecal antigen. Colon clear was done for them.
  
  
  RESULTS
  Symptomatic improvement and clinical recovery to sinus rhythm with minimal supra-ventricular extra-systoles occurred for all patients after colon clear. Patients continued improvement to normal cardiac tracing and normal left ventricular ejection function within further 3 - 4 weeks.
  
  
  CONCLUSIONS
  Colon clear could be a simple and safe measure to improve changes in cardiac rhythm, heart rate and myocardial function developing in association withH. pyloridue to inflammatory, toxic or immune reasons.
authors.affiliation: Department of Internal Medicine, Helwan Gen Hosp, Cairo, Egypt.
authors.forename: Randa M
authors.initials: RM
authors.lastname: Nasrat
authors.affiliation: Department of Internal Medicine, Helwan Gen Hosp, Cairo, Egypt.
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Nasrat
authors.affiliation: Department of Surgery, Balghsoon Clinics, Jeddah, KSA.
authors.forename: Abdullah M
authors.initials: AM
authors.lastname: Nasrat
authors.affiliation: Department of Physiotherapy, Cardiac Surgery Academy, Cairo, Egypt.
authors.forename: Salwa A
authors.initials: SA
authors.lastname: Nasrat
keywords: Cardiomyopathy; Helicobacter pylori; Myocarditis; Senna purge