Clinical Gastroenterology: A Practical Problem Based Approach

Front Cover
......Page 1
Clinical gastroenterology......Page 4
Copyright
......Page 5
Dedication......Page 6
Foreword
......Page 8
Contents......Page 10
Preface......Page 12
Contributors......Page 14
History......Page 16
Pathophysiology of GORD......Page 18
Investigation of Heartburn and Acid Regurgitation......Page 19
Treatment......Page 22
Non-cardiac Chest Pain......Page 27
Key Points......Page 29
Pain on Swallowing (Odynophagia)......Page 30
Dysphagia......Page 31
Key Points......Page 41
Hiccups......Page 42
Sore Mouth......Page 46
Bad Breath......Page 48
Key Points......Page 50
Introduction......Page 52
Pathological Causes......Page 53
Generalised Abdominal Pain......Page 55
Acute Abdominal Colic......Page 61
Acute Epigastric Pain......Page 65
Acute Pancreatitis And Its Complications......Page 66
Right Upper Quadrant Pain......Page 70
Right Iliac Fossa Pain......Page 76
Left Iliac Fossa Pain......Page 78
Key Points......Page 79
Pathogenesis......Page 81
Management Guidelines......Page 82
Key Points......Page 87
Mechanisms Underlying Epigastric Pain......Page 88
Clinical Assessment......Page 89
Chronic Peptic Ulcer......Page 90
Management of Dyspepsia......Page 91
Diseases Associated With Epigastric Pain or Discomfort......Page 93
Key Points......Page 101
History......Page 103
Differential Diagnosis......Page 105
Clinical Evaluation......Page 109
Irritable Bowel Syndrome (IBS)......Page 110
Key Points......Page 113
Investigations......Page 115
Laboratory Tests......Page 117
Symptoms Associated with Intestinal Gas......Page 118
Key Points......Page 120
Physiology of Vomiting......Page 121
History......Page 122
Investigation......Page 123
Important Diseases that may cause Nausea and Vomiting......Page 125
Principles of Treatment......Page 127
Key Points......Page 128
Introduction......Page 130
Vomiting Blood......Page 131
Passing Melaena Alone......Page 137
Bright Red Blood Per Rectum......Page 138
Iron Deficiency Anaemia......Page 141
Positive Faecal Occult Blood Test......Page 142
Key Points......Page 143
Introduction......Page 145
Clinical Approach to Patients with Constipation......Page 146
Investigations......Page 147
Approach to Management......Page 150
Surgical Treatment......Page 151
Clinical Approach to Specific Types of Constipation......Page 152
Key Points......Page 154
Case
......Page 156
Examination......Page 157
Fissure-in-Ano......Page 158
Anal Sepsis......Page 160
Haemorrhoids......Page 165
Pruritus Ani......Page 169
Chronic Perianal Pain Syndromes......Page 170
Key Points......Page 171
Introduction......Page 173
Clinical Approach to Acute Diarrhoea......Page 174
Conditions Causing Food-borne Illnesses......Page 177
Travellers’ Diarrhoea......Page 179
Conditions Causing Acute Watery Diarrhoea......Page 180
Conditions Causing Acute Blood Diarrhoea......Page 182
Antibiotic-associated Diarrhoea and C. difficle Colitis......Page 186
Diarrhoea Associated with AIDS......Page 187
Key Points......Page 188
History......Page 189
Physical Examination......Page 190
Malabsorption......Page 191
Clinical Approach to the Patient with Malabsorption......Page 195
Disorders that may Cause Chronic Diarrhoea or Malabsorption......Page 198
Inflammatory Bowel Disease......Page 203
Key Points......Page 204
Introduction......Page 205
Ulcerative Colitis......Page 206
Crohn\'s Disease......Page 213
Key Points......Page 219
Definitions......Page 221
Examination......Page 222
Physiological Anorectal Assessment......Page 223
Conditions Causing Incontinence with a Normal Sphincter......Page 226
Conditions Causing Incontinence with an Abnormal Sphincter......Page 228
Key Points......Page 233
Introduction......Page 235
Pathophysiology of Anorexia and Weight Loss......Page 236
Clinical Approach to Anorexia and Weight Loss......Page 237
Management of Patients with Weight Loss......Page 241
Nutritional Support......Page 243
Diseases Associated with Weight Loss......Page 246
Key Points......Page 252
A Clinical Approach......Page 253
Identification of Food Allergens......Page 254
Food Intolerance......Page 257
Summary......Page 258
Key Points......Page 259
Introduction......Page 261
Masses within the Abdominal Wall......Page 262
Intraabdominal Masses......Page 264
Imaging......Page 270
Other Investigations......Page 276
Key Points......Page 277
Preliminary Examination of the Abdomen......Page 278
Clinical Features......Page 279
Investigations......Page 282
Diagnosis of Ascites......Page 283
Management of Ascites......Page 284
Key Points......Page 285
History......Page 286
Physical Examination......Page 287
Management of Groin Lumps......Page 291
Key Points......Page 293
Rectal or Perianal Mass......Page 294
Tumours of the Colon and Rectum......Page 296
Anal Canal Cancer......Page 305
Key Points......Page 306
Introduction......Page 308
Clinical Syndromes......Page 311
Diagnostic Tests......Page 313
Management of Suspected Obstructive Jaundice......Page 316
The Postsurgical and Critically Ill Jaundiced Patient......Page 318
The Immunocompromised Patient who is Jaundiced......Page 319
Key Points......Page 320
An Approach to the Patient with Liver Disease......Page 322
Liver Function Test Interpretation......Page 323
Tests of Liver Injury......Page 324
The Well Patient with Abnormal Liver Function Profile......Page 327
The Sick Patient with Jaundice: Acute Liver Disease......Page 330
Acute Liver Failure......Page 331
Patients Presenting with Cirrhosis and its Complications......Page 333
Complications of Portal Hypertension in the Patient with Chronic Liver Disease......Page 334
Ascites in the Cirrhotic Patient with or without Renal Impairment......Page 337
Ascites, Fever and Pain: Spontaneous Bacterial Peritonitis......Page 338
Hepatic Encephalopathy in the Cirrhotic Patient......Page 339
Liver Disease in Pregnancy......Page 340
Specific Hepatic Diseases......Page 342
Key Points......Page 359
End-stage Liver Disease......Page 361
Orthotopic Liver Transplantation......Page 368
Key Points......Page 369
Diagnosis and Management......Page 371
Biliary Incidentalomas......Page 373
Pancreatic Incidentalomas......Page 376
Hepatic Incidentalomas......Page 379
Retroperitoneal Masses......Page 386
Mesenteric Masses......Page 388
Key Points......Page 389
Medical Management......Page 390
Surgical Management......Page 391
Conclusions......Page 393
Key Points......Page 394
Introduction......Page 396
Preparing Patients for Endoscopy......Page 397
Principles of Anaesthesia for Endoscopy......Page 400
Key Points......Page 404
Index......Page 406