Encyclopedia of Gastroenterology, Three-Volume Set, Volume 1-3

ASSOCIATE EDITORS......Page 2
FOREWORD......Page 3
PREFACE......Page 5
AAA REPAIR......Page 6
Further Reading......Page 7
PHYSIOLOGY......Page 8
Further Reading......Page 9
AGING AND THE ESOPHAGUS......Page 10
AGING AND THE LIVER......Page 11
Further Reading......Page 12
ETIOLOGY......Page 13
Laboratory Tests......Page 14
ERCP......Page 15
Further Reading......Page 16
APPROACH TO THE HIV-POSITIVE PATIENT WITH A GASTROINTESTINAL COMPLAINT......Page 18
INTESTINAL DISEASE AND DIARRHEA......Page 19
HEPATOBILIARY DISEASE......Page 20
Further Reading......Page 21
APPROACH TO THE PATIENT......Page 22
Opportunistic Infections......Page 23
Neoplasms......Page 24
Further Reading......Page 25
DIAGNOSIS OF ALAGILLE SYNDROME......Page 27
Hepatic Manifestations......Page 28
Facial Features......Page 29
MORBIDITY, MORTALITY, AND OUTCOME IN ALAGILLE SYNDROME......Page 30
Further Reading......Page 31
INTRODUCTION......Page 32
Characterization of the MEOS and Its Role in Ethanol Metabolism......Page 33
Increased Xenobiotic Toxicity and Carcinogenicity; Oxidative Stress......Page 34
OXIDATION OF ETHANOL IN THE STOMACH: GENDER AND ETHNIC DIFFERENCES......Page 35
Further Reading......Page 36
Fatty Liver......Page 37
Alcoholic Hepatitis......Page 38
Cirrhosis......Page 39
Further Reading......Page 40
Screening......Page 41
Recurrent Tumor versus Radiation Fibrosis......Page 43
INFLAMMATORY BOWEL DISEASE......Page 44
Crohn's Disease......Page 45
Ulcerative Colitis......Page 46
Further Reading......Page 48
BIOLOGICAL AND MOLECULAR CHARACTERISTICS......Page 49
NOMENCLATUREÐPROTEASE INHIBITOR PHENOTYPING......Page 50
EPIDEMIOLOGY......Page 51
CLINICAL MANIFESTATIONS......Page 52
DIAGNOSIS......Page 53
POTENTIAL THERAPIES......Page 54
Further Reading......Page 55
Pathophysiology and Genetics......Page 57
Presentation and Natural History......Page 58
HETEROZYGOSITY AND OTHER ALLELES......Page 59
Further Reading......Page 60
THE ORGANISM......Page 61
PATHOGENESIS......Page 62
CLINICAL FEATURES......Page 63
TREATMENT......Page 64
Further Reading......Page 66
PHYSIOLOGY......Page 67
Further Reading......Page 68
INTRODUCTION......Page 69
DEFINITION AND DIAGNOSIS......Page 70
Primary (Immunocytic) Systemic Amyloid......Page 71
Secondary (Reactive) Systemic Amyloidosis......Page 72
CLINICAL FINDINGS......Page 73
Mouth......Page 74
Stomach......Page 75
Liver......Page 76
AA Amyloidosis......Page 77
Further Reading......Page 78
Voluntary Anorectal Inhibition Re¯ex......Page 80
Single-Loop Continence......Page 81
LONGITUDINAL MUSCLE......Page 82
LEVATOR HIATUS AND TUNNEL......Page 83
Puborectalis and the Double-Sphincter Control......Page 84
Physiologic Mechanism of Defecation......Page 85
Further Reading......Page 86
EPIDEMIOLOGY AND ETIOLOGY......Page 87
Anal Canal Cancer......Page 88
Further Reading......Page 89
EXTERNAL ANAL SPHINCTER......Page 90
RECTOANAL REFLEX......Page 91
Further Reading......Page 92
CORE SYMPTOMS OF ANOREXIA NERVOSA......Page 93
VARIANTS OF ANOREXIA NERVOSA......Page 94
RISK FACTORS, COMORBIDITIES, AND ASSOCIATED FEATURES......Page 95
COMPLICATIONS, PHYSICAL STIGMATA, AND MORBIDITY......Page 96
PATHOPHYSIOLOGY AND PSYCHOPATHOLOGY......Page 97
COURSE AND TREATMENT......Page 98
Further Reading......Page 99
SIDE EFFECTS......Page 100
Further Reading......Page 101
Secretory Diarrhea......Page 102
Opioids and Enkephalinase Inhibitors......Page 103
Berberine......Page 104
Vasoactive Intestinal Polypeptide Receptor Antagonists......Page 105
Further Reading......Page 106
SYMPTOMATOLOGY AND CLINICAL EVALUATION......Page 107
Microbes Other Than C. difficile as Causative Agents of Antibiotic-Associated Diarrhea......Page 108
CLOSTRIDIUM DIFFICILE INFECTION......Page 109
THERAPY OF ANTIBIOTIC- ASSOCIATED DIARRHEA......Page 110
Further Reading......Page 111
Regulation of Intestinal Apo AI Synthesis and Secretion......Page 112
Regulation of Intestinal Apo AIV Synthesis and Secretion......Page 113
Physiological Functions of Apo AIV......Page 114
APOLIPOPROTEIN B......Page 115
Synthesis by Enterocytes......Page 116
Further Reading......Page 117
INTRODUCTION......Page 118
PATHOPHYSIOLOGY......Page 119
DIAGNOSIS......Page 120
SPECIAL CASES......Page 122
Further Reading......Page 123
GENETIC DISORDERS OF APPETITE REGULATION......Page 124
Further Reading......Page 125
INTRODUCTION......Page 126
THE CYCLOOXYGENASE PATHWAYS: PROSTANOIDS......Page 127
Further Reading......Page 128
PATHOGENESIS......Page 129
DIAGNOSIS......Page 130
HEPATORENAL SYNDROME......Page 131
Summary......Page 132
Further Reading......Page 133
DIAGNOSIS......Page 135
Further Reading......Page 136
Clinical Criteria......Page 137
Type 2 Autoimmune Hepatitis......Page 138
Schedules......Page 139
Site-Speci®c Interventions......Page 140
Further Reading......Page 141
PERIPHERAL AUTONOMIC CONNECTIONS......Page 142
Parasympathetic Division......Page 143
ENTERIC DIVISION......Page 144
SENSORY INNERVATION......Page 145
Further Reading......Page 146
CLINICAL CONDITIONS ASSOCIATED WITH BACTERIAL OVERGROWTH......Page 147
CLINICAL FEATURES OF BACTERIAL OVERGROWTH......Page 148
DIAGNOSIS OF BACTERIAL OVERGROWTH......Page 149
MANAGEMENT OF BACTERIAL OVERGROWTH......Page 150
Further Reading......Page 151
VIBRIO CHOLERAE TOXINS......Page 153
Shigella dysenteriae TOXINS......Page 155
Bacteroides fragilis ENTEROTOXIN......Page 156
Further Reading......Page 157
INTRODUCTION......Page 158
Applications......Page 159
Esophagus......Page 160
Stomach and Duodenum......Page 162
Technique......Page 163
Applications......Page 164
Technique......Page 168
COLON AND RECTUM......Page 166
Applications......Page 167
Further Reading......Page 169
TECHNICAL SPECIFICATIONS......Page 171
Further Reading......Page 172
PATHOPHYSIOLOGY......Page 173
ENDOSCOPIC SURVEILLANCE......Page 174
Further Reading......Page 175
INTRODUCTION......Page 176
LIPID UPTAKE ACROSS THE INTESTINAL BBM......Page 177
The Unstirred Water Layer......Page 178
Intervillus Space and Villous Motility......Page 180
Acid Microclimate......Page 181
Brush Border Membrane......Page 182
Lipid-Binding Proteins......Page 183
Further Reading......Page 184
BASIC ELECTRICAL RHYTHM OF THE SMALL INTESTINE......Page 185
Further Reading......Page 186
Cutaneous Lesions......Page 187
DIAGNOSIS AND DIFFERENTIATION FROM OTHER CONDITIONS......Page 188
Further Reading......Page 189
CLINICAL SYNDROMES......Page 190
Further Reading......Page 191
CLINICAL FEATURES......Page 192
Further Reading......Page 193
Bile Composition......Page 194
INTRODUCTION......Page 195
CLASSIFICATION OF BILIARY CONSTITUENTS......Page 196
Bile Salts......Page 197
Phospholipids......Page 198
Proteins and Peptides......Page 199
Anions......Page 200
Inorganic Constituents......Page 201
Further Reading......Page 202
ETIOLOGY......Page 203
Biliary ÿ Enteric Fistulas......Page 204
Further Reading......Page 205
INTRODUCTION......Page 206
Functions of Bile Formation......Page 207
INTRAHEPATIC CHOLESTASIS......Page 208
Acknowledgments......Page 209
Further Reading......Page 210
Bile Formation......Page 211
BILE COMPOSITION......Page 212
GALLBLADDER FUNCTION......Page 213
Sinusoidal Transport......Page 214
ENTEROHEPATIC CIRCULATION......Page 215
Intestinal Absorption......Page 216
Defects in Enterohepatic Circulation Dynamics......Page 217
Further Reading......Page 218
Biliary Strictures Due to Operative Trauma......Page 220
DIAGNOSIS......Page 221
Further Reading......Page 222
COMMON BILE DUCT......Page 223
Further Reading......Page 224
INTRODUCTION......Page 225
Adenoma......Page 226
Papillomas......Page 227
Granular Cell Tumor......Page 228
Inflammatory Tumors......Page 229
Further Reading......Page 230
Further Reading......Page 231
INTRODUCTION......Page 233
Characteristics of Extrahepatic Biliary Atresia......Page 234
Diagnosis of Extrahepatic Biliary Atresia......Page 235
Extrahepatic Complications of EHBA......Page 236
Treatment of EHBA......Page 237
INTRAHEPATIC BILE DUCT PAUCITY......Page 238
INFANTILE POLYCYSTIC DISEASE/ CONGENITAL HEPATIC FIBROSIS......Page 239
Further Reading......Page 240
BILIRUBIN PRODUCTION AND ELIMINATION......Page 241
Crigler Najjar Syndrome......Page 242
Cholestasis......Page 243
Further Reading......Page 244
DIAGNOSIS......Page 245
Further Reading......Page 246
Stomach......Page 247
Further Reading......Page 248
Further Reading......Page 249
Measurement of Labeled Carbon Dioxide in Breath......Page 250
Xenolytic Labeled Carbon Dioxide Breath Tests......Page 251
Further Reading......Page 252
Occlusion of the Terminal Hepatic Venules......Page 253
CLINICAL PRESENTATION......Page 254
Interventional Radiology......Page 255
Surgical Procedures......Page 256
Further Reading......Page 257
CORE SYMPTOMS OF BULIMIA NERVOSA......Page 258
VARIANTS OF BULIMIA NERVOSA......Page 259
EPIDEMIOLOGY......Page 260
COMPLICATIONS, PHYSICAL STIGMATA, AND MORBIDITY......Page 261
NATURAL HISTORY AND TREATMENT......Page 262
Further Reading......Page 263
INTRODUCTION......Page 264
CGRP RECEPTORS......Page 265
EXPRESSION AND RELEASE OF CGRP IN THE GI TRACT......Page 266
Secretory Processes......Page 267
Mucosal Homeostasis......Page 268
SUMMARY......Page 269
Further Reading......Page 270
INTRODUCTION......Page 271
Calcium Deficiency......Page 272
Magnesium Deficiency......Page 274
Vitamin D Deficiency......Page 275
Further Reading......Page 276
CLINICAL FEATURES AND COMPLICATIONS......Page 278
Further Reading......Page 279
FUNDAMENTAL ASPECTS OF CARCINOGENESIS......Page 280
GENERAL CLASSES OF CANCER GENES......Page 281
MULTISTEP MODEL OF CANCER FORMATION......Page 282
REGULATION OF CELL GROWTH......Page 284
REGULATION OF CELL DEATH......Page 285
SIGNALING PATHWAYS AND NETWORKS IN CANCER FORMATION......Page 286
SUMMARY......Page 287
Further Reading......Page 288
GROWTH PATTERNS OF CANDIDA ALBICANS......Page 289
PREDISPOSITION AND TISSUE DAMAGE......Page 290
Further Reading......Page 291
Colonic Salvage......Page 292
Confirmatory Tests......Page 293
Approach to the Patient......Page 294
Primary Lactose Intolerance......Page 295
Sucrose Intolerance......Page 296
Miscellaneous Observations......Page 297
Further Reading......Page 298
Luminal Hydrolysis by a-Amylases......Page 299
Sucrose Digestion......Page 300
Fructose Transport......Page 301
Further Reading......Page 302
INTRODUCTION......Page 303
PATHOGENESIS......Page 304
Small Intestinal Biopsy......Page 305
Stool Studies......Page 306
COMPLICATIONS......Page 307
Further Reading......Page 308
EPIDEMIOLOGY......Page 309
PATHOPHYSIOLOGY......Page 310
CLINICAL MANIFESTATIONS......Page 311
DIAGNOSIS......Page 312
TREATMENT......Page 313
Further Reading......Page 314
Diagnosis, Treatment, and Prevention......Page 315
Clinical Features......Page 316
Life Cycle and Biology......Page 317
Further Reading......Page 318
ETIOLOGY......Page 320
Further Reading......Page 321
CLINICAL PRESENTATION......Page 322
DIFFERENTIAL DIAGNOSIS......Page 323
DIAGNOSTIC APPROACH......Page 324
Further Reading......Page 325
ANATOMY......Page 327
Further Reading......Page 328
EPIDEMIOLOGY AND ETIOLOGY......Page 329
PRESENTATION AND DIAGNOSIS......Page 330
TREATMENT STRATEGIES......Page 331
Further Reading......Page 332
PATHOLOGY......Page 333
MANAGEMENT......Page 334
Further Reading......Page 335
Etiology/Pathophysiology......Page 336
Cholangiocarcinoma......Page 337
Other Complications......Page 338
Diagnosis......Page 339
Pathology......Page 340
Treatment of Complications of PSC......Page 341
Ischemic Cholangitis......Page 342
Infectious Cholangiopathy......Page 343
Further Reading......Page 344
INDICATIONS FOR CHOLECYSTECTOMY......Page 345
Laparoscopic Cholecystectomy......Page 346
Open Cholecystectomy......Page 347
OUTCOMES OF CHOLECYSTECTOMY......Page 348
Further Reading......Page 349
MOLECULAR FORMS......Page 350
CCK RECEPTORS......Page 351
BIOLOGICAL ACTIONS OF CCK......Page 352
Further Reading......Page 353
NATURAL HISTORY......Page 354
Differential Diagnosis of Biliary Pain......Page 355
Diagnosis......Page 356
Radiologic Imaging......Page 357
General Support......Page 358
Laboratory Tests......Page 359
MISCELLANEOUS COMPLICATIONS......Page 360
Further Reading......Page 361
PATHOGENESIS......Page 362
PREVENTION......Page 363
Further Reading......Page 364
Epidemiology......Page 365
Biochemical Changes......Page 366
Treatment......Page 367
Clinical Features......Page 368
Natural History......Page 369
VARIANT CHOLANGIOPATHIES......Page 370
Further Reading......Page 371
INTRODUCTION......Page 372
LIPID DIGESTION......Page 373
CHOLESTEROL UPTAKE BY INTESTINAL MUCOSAL CELLS......Page 375
GENETICS OF CHOLESTEROL ABSORPTION......Page 377
INHIBITORS OF CHOLESTEROL ABSORPTION......Page 378
Further Reading......Page 379
Blood Flow Regulation......Page 380
Blood Flow Regulation......Page 381
Blood Flow Regulation......Page 382
Blood Flow Regulation......Page 383
Further Reading......Page 384
Parenchymal Extinction......Page 385
Natural History of Cirrhosis......Page 386
Staging Systems......Page 388
Chronic Hepatitis......Page 389
Congestive Cirrhosis......Page 390
Further Reading......Page 391
Defective release of cobalamin from food......Page 392
Schilling Test......Page 393
Further Reading......Page 394
PREOPERATIVE PREPARATION......Page 395
Left Hemicolectomy......Page 396
Total Mesorectal Excision......Page 397
Abdominoperitoneal Excision......Page 398
LAPAROSCOPIC-ASSISTED COLORECTAL SURGERY......Page 399
Further Reading......Page 400
INTRODUCTION......Page 401
Further Reading......Page 402
PATHOPHYSIOLOGY......Page 403
DIAGNOSIS......Page 404
Further Reading......Page 405
EPIDEMIOLOGY......Page 406
Surgery......Page 407
Further Reading......Page 408
INCIDENCE, NATURAL HISTORY, AND DIAGNOSTIC EVALUATION......Page 409
SURGICAL THERAPY OF INDETERMINATE COLITIS......Page 410
Further Reading......Page 411
RADIATION-INDUCED COLITIS AND RADIATION ENTEROPATHY......Page 412
Other Drugs......Page 413
Further Reading......Page 414
Genetic Factors......Page 415
Specific infection......Page 416
Clinical Features......Page 417
Joint Disease......Page 418
Osteoporosis......Page 419
INVESTIGATION......Page 420
Radiology......Page 421
Corticosteroids......Page 422
Ciclosporin......Page 423
Explanation and Psychosocial Support......Page 424
Specific medical treatment......Page 425
Active Left-Sided or Extensive UC......Page 426
SURGICAL MANAGEMENT......Page 427
Fertility, Pregnancy, and Lactation......Page 428
Further Reading......Page 429
Anatomic Distribution......Page 430
Skin Disorder......Page 431
Carcinoma......Page 432
Radiography......Page 433
Nutritional Therapy......Page 434
5-Aminosalicylates......Page 435
Ciclosporin and Tacrolimus......Page 436
Further Reading......Page 437
INTRODUCTION......Page 439
COLON......Page 440
HISTOLOGY......Page 441
INNERVATION......Page 442
Further Reading......Page 443
INTRODUCTION......Page 444
MECHANISMS OF FLUID AND ELECTROLYTE TRANSPORT......Page 445
Absorption......Page 446
Secretion......Page 447
REGULATION OF SECRETION......Page 449
SUMMARY......Page 450
Further Reading......Page 451
INTRODUCTION......Page 452
Adaptive......Page 453
CLINICAL RELEVANCE AND FUTURE PERSPECTIVES......Page 454
Acknowledgments......Page 455
Further Reading......Page 456
Colonic Motility......Page 457
Giant Migrating Contractions......Page 458
Sensory Regulation......Page 459
Motor Neurons......Page 460
Interneurons......Page 461
Electrophysiological Regulation (Slow Waves)......Page 462
Colonic Inflammation......Page 463
Irritable Bowel Syndrome......Page 464
Further Reading......Page 465
ETIOLOGY......Page 466
DIAGNOSIS......Page 467
Further Reading......Page 468
Ischemic Colitis......Page 469
Radiation-Induced Injury......Page 470
Acute Self-Limited Colitis......Page 471
Viral Colitis......Page 472
Herpes Simplex Virus Colitis......Page 473
Amebiasis......Page 474
Enemas......Page 475
Solitary Rectal Ulcer Syndrome (Mucosal Prolapse)......Page 476
Crohn's Disease......Page 477
Ulcerative Colitis......Page 478
Idiopathic Ulcers and Isolated Cecal Ulcers......Page 479
Further Reading......Page 480
COLONOSCOPES......Page 481
THE PROCEDURE......Page 482
LOW-YIELD EXAMINATIONS......Page 483
SEDATION......Page 484
Perforation......Page 485
Postpolypectomy Coagulation Syndrome......Page 486
ANTICOAGULATION ISSUES......Page 487
Further Reading......Page 488
CLINICAL ASPECTS......Page 489
HOST FACTORS......Page 490
Personal History of Colorectal Neoplasia......Page 491
Macronutrients......Page 492
Hereditary Nonpolyposis Colorectal Cancer......Page 493
Malignant Polyps and Post-CRC Resection......Page 494
Colonoscopy......Page 495
Nonsteroidal Anti-Inflammatory Drugs......Page 496
Further Reading......Page 497
Prevalence......Page 499
THE ADENOMA-CARCINOMA SEQUENCE......Page 500
Flexible Sigmoidoscopy......Page 501
Surgery......Page 502
Further Reading......Page 503
Colorectal Cancer Screening......Page 504
Barium Enema......Page 505
Further Reading......Page 506
INDICATIONS......Page 508
COLOSTOMY FUNCTION......Page 509
Further Reading......Page 510
Ayurveda......Page 511
Mind Body Interventions......Page 512
Chelation Therapy......Page 513
Massage Therapy......Page 514
RISKS ASSOCIATED WITH CAM......Page 515
Further Reading......Page 516
Computed Tomography (CT)......Page 518
Steatosis......Page 519
Hepatocellular carcinoma......Page 520
Passive hepatic congestion......Page 521
Inflammatory Diseases......Page 522
Choledocholithiasis......Page 523
Acute pancreatitis......Page 524
Varices......Page 525
Crohn's Disease......Page 526
Neoplasms......Page 528
Appendicitis......Page 529
Infectious enterocolitides......Page 530
Neoplasms......Page 531
Further Reading......Page 534
CAUSES......Page 535
TREATMENT OF UNCOMPLICATED CONSTIPATION......Page 536
Surgical Approaches......Page 537
Further Reading......Page 538
DEFINITION......Page 539
CLINICAL PRESENTATION......Page 540
TREATMENT......Page 541
Further Reading......Page 542
Food Intolerance and Food Allergic/ Hypersensitivity Responses......Page 544
Allergic Eosinophilic Gastroenteritis......Page 545
Further Reading......Page 546
PATHOGENESIS......Page 547
Environmental Triggers......Page 548
Mucosal Immunology......Page 549
DIAGNOSIS......Page 550
PATHOLOGY......Page 551
Epithelial Protection......Page 552
Antimetabolites......Page 553
Tumor Necrosis Factor-a-Modulating Drugs......Page 555
SURGERY AND POSTOPERATIVE RECURRENCES......Page 556
Further Reading......Page 557
PATHOPHYSIOLOGY AND EPIDEMIOLOGY......Page 559
DIAGNOSIS AND EVALUATION......Page 560
Medication......Page 561
Aminosalicylates and Antibiotics......Page 562
MAINTENANCE OF REMISSION......Page 563
NUTRITIONAL THERAPY OF NONMALNOURISHED OUTPATIENTS......Page 564
Further Reading......Page 565
CLINICAL FEATURES......Page 567
SIGNIFICANCE......Page 568
Further Reading......Page 569
INTRODUCTION......Page 570
CLINICAL PICTURE......Page 571
DIAGNOSIS......Page 572
Pathology of the Pancreas......Page 573
Treatment of Pancreatic Insufficiency......Page 574
Pathogenesis of Hepatobiliary Disease......Page 575
Neonatal Cholestasis......Page 576
Diagnostic Evaluation of Liver Disease......Page 577
Medical Therapy of CF-Related Liver Disease......Page 578
INTESTINAL DISORDERS IN CYSTIC FIBROSIS......Page 579
Clinical Features of Meconium Ileus......Page 580
Clinical Features of DIOS......Page 581
Further Reading......Page 582
CYTOCHROME P450 AND DRUG INTERACTIONS......Page 583
Further Reading......Page 584
Clinical Features......Page 585
Further Reading......Page 586
NORMAL DEFECATION......Page 587
Pelvic Floor Dyssynergia......Page 588
Behavioral Approaches......Page 589
Further Reading......Page 590
SPECIFICATION OF THE ENDODERM......Page 591
FORMATION OF THE GUT TUBE......Page 592
Pancreas......Page 593
Further Reading......Page 594
DIAGNOSIS......Page 595
Type 2 Diabetes......Page 596
Nonpharmacological Therapy......Page 597
Pharmacological Therapy......Page 598
Esophagus......Page 599
Gallbladder Disease......Page 600
Further Reading......Page 601
MANAGEMENT......Page 602
Further Reading......Page 603
INTRODUCTION......Page 604
METABOLIC DERANGEMENTS......Page 605
TREATMENT......Page 606
Further Reading......Page 607
PATHOGENESIS......Page 608
CLINICAL MANIFESTATIONS AND DIAGNOSIS......Page 609
Further Reading......Page 610
PATHOPHYSIOLOGY AND DIAGNOSIS......Page 611
Large-Volume vs. Small-Volume Diarrhea......Page 612
Motility vs. Epithelial Function......Page 613
Secretory vs. Osmotic Diarrhea......Page 614
Watery vs. Fatty vs. Inflammatory Diarrhea......Page 615
DIAGNOSTIC APPROACH AND MANAGEMENT......Page 616
Further Reading......Page 618
EPIDEMIOLOGY......Page 619
Acute Infectious Diarrhea......Page 620
Persistent Infectious Diarrhea......Page 621
The Elderly......Page 622
TREATMENT......Page 626
Further Reading......Page 627
Diarrhea, Pediatric......Page 628
REGULATION OF INTESTINAL FLUID SECRETION AND ABSORPTION......Page 629
APPROACH TO THE CHILD WITH DIARRHEA......Page 630
INFECTIOUS DIARRHEA IN CHILDREN......Page 631
Inflammatory Diarrhea......Page 632
LABORATORY EVALUATION OF DIARRHEA......Page 633
Further Reading......Page 635
FAT AND RED MEAT......Page 637
Folic Acid......Page 638
GENE-NUTRIENT INTERACTIONS......Page 639
Further Reading......Page 640
DIETARY FIBER......Page 642
Introduction......Page 643
Case-Control Studies......Page 644
Prospective Studies......Page 645
Intervention Trials......Page 646
Biological Mechanisms......Page 647
Short-Chain Fatty Acids/Resistant Starch......Page 649
Summary......Page 650
Introduction......Page 651
Treatment......Page 652
Introduction......Page 653
Treatment......Page 654
Introduction......Page 655
Treatment......Page 656
Further Reading......Page 657
DIETARY REFERENCE INTAKE VALUES......Page 658
TOLERABLE UPPER INTAKE LEVELS OF NUTRIENTS......Page 659
TOTAL ENERGY EXPENDITURE AND ESTIMATED ENERGY REQUIREMENT......Page 666
CONCLUSION......Page 667
Further Reading......Page 668
DIGESTION AND ABSORPTION OF FAT......Page 669
DIGESTION AND ABSORPTION OF CARBOHYDRATE......Page 670
Fat-Soluble Vitamins......Page 672
ADAPTATION TO CHANGES IN NEED OR LOAD......Page 673
Further Reading......Page 674
INTRODUCTION......Page 675
PATHOPHYSIOLOGIC BASIS......Page 676
Further Reading......Page 677
DIVERTICULITIS......Page 678
DIVERTICULAR BLEEDING......Page 679
Further Reading......Page 680
DIAGNOSIS......Page 681
TREATMENT......Page 682
Further Reading......Page 683
ANATOMIC AND PHYSIOLOGIC CONSIDERATIONS......Page 684
Migrating Motor Complex......Page 685
Fed Motor Pattern......Page 686
Extrinsic Factors......Page 687
DUODENAL FEEDBACK REGULATION OF GASTRIC EMPTYING......Page 688
Further Reading......Page 689
CLINICAL PRESENTATION......Page 690
Medical Therapy......Page 691
Further Reading......Page 692
EPIDEMIOLOGY......Page 693
Aspirin and NSAIDs......Page 694
Idiopathic......Page 695
Symptoms and Signs......Page 696
Serology......Page 697
Treatment......Page 698
CONCLUSIONS......Page 699
Further Reading......Page 700
PATHOLOGY AND BIOPSY OF THE DUODENUM......Page 701
Further Reading......Page 702
IMPORTANT MICROSCOPIC CONSIDERATIONS......Page 703
Further Reading......Page 704
CLASSIFICATION......Page 705
History and Physical Examination......Page 706
SUMMARY......Page 707
Further Reading......Page 708
Gastrointestinal......Page 709
Further Reading......Page 710
INTRODUCTION......Page 711
Action Potentials and Plateau Potentials......Page 712
Recording EGGs......Page 713
Fasting......Page 714
Bradygastrias......Page 715
Nausea of Pregnancy......Page 716
Diabetic Gastroparesis......Page 717
Acknowledgment......Page 718
Further Reading......Page 719
INTRODUCTION......Page 720
Myoelctric Responses......Page 721
Pharyngoesophageal Responses......Page 722
Chemoreceptor Trigger Zone......Page 723
Further Reading......Page 724
INTRODUCTION......Page 725
Endocrine Cells......Page 726
Nerves......Page 727
LIFETIME CHANGES IN THE ENDOCRINE PANCREAS......Page 728
Replication......Page 729
Further Reading......Page 730
ANTI-GLIADIN ANTIBODIES......Page 731
Further Reading......Page 732
Endoscopic Ultrasonography......Page 733
Radial Scanning Echoendoscopes......Page 734
EUS-GUIDED FINE NEEDLE ASPIRATION......Page 735
Gastric Cancer......Page 736
Pancreatic Cancer......Page 737
Celiac Plexus Neurolysis......Page 738
Evaluation of Mediastinal Masses......Page 739
Further Reading......Page 740
Complications of Conscious Sedation......Page 741
Bleeding......Page 742
Treatment of Esophageal Malignancies......Page 743
Pancreatitis......Page 744
Perforation......Page 745
Stenting......Page 746
Bleeding......Page 747
CONCLUSION......Page 748
Further Reading......Page 749
INTRODUCTION......Page 750
INDICATIONS......Page 751
DRUG NUTRIENT INTERACTIONS......Page 752
Further Reading......Page 753
INTRODUCTION......Page 754
MYENTERIC AND SUBMUCOSAL PLEXUSES......Page 755
NEURONAL TYPES......Page 756
NEUROTRANSMISSION......Page 757
Slow Excitatory Postsynaptic Potentials......Page 758
Further Reading......Page 759
PATHOPHYSIOLOGY......Page 760
Further Reading......Page 761
HISTORY AND CHEMISTRY......Page 762
METABOLISM OF INTESTINAL PROGLUCAGON-DERIVED PEPTIDES......Page 764
Gastrointestinal Actions of Glucagon-like Peptide 1......Page 765
Effects of Glucagon-like Peptide 1 on Appetite and Food Intake......Page 766
THERAPEUTIC APPLICATIONS OF GLUCAGON-LIKE PEPTIDE 1 AND GLUCAGON-LIKE PEPTIDE 2......Page 767
Further Reading......Page 768
CLINICAL PRESENTATION......Page 769
Further Reading......Page 770
GASTROINTESTINAL TRACT EPITHELIAL BARRIER......Page 772
TIGHT JUNCTION STRUCTURE......Page 773
Signal Transduction Pathways Regulating TJ Function......Page 774
Modifications in Epithelial Paracellular Permeability by Leukocytes......Page 775
Idiopathic Inflammatory States......Page 776
SUMMARY......Page 777
Further Reading......Page 778
CELL CYCLE AND METHODS FOR STUDYING PROLIFERATION......Page 779
STOMACH......Page 780
SMALL INTESTINE......Page 781
COLON AND RECTUM......Page 782
DISEASES OF THE GASTROINTESTINAL EPITHELIUM INVOLVING ABNORMAL PROLIFERATION......Page 783
Further Reading......Page 784
EPITHELIAL RESTITUTION IN THE ESOPHAGUS......Page 785
EPITHELIAL RESTITUTION IN THE STOMACH......Page 786
Intestinal Epithelial Restitution: Role of Peptides......Page 787
CONCLUSION......Page 788
Further Reading......Page 789
Bile Reflux......Page 790
Stress......Page 791
Further Reading......Page 792
INTRODUCTION......Page 793
Pathology......Page 794
CLINICAL MANIFESTATIONS AND DIAGNOSIS......Page 795
STAGING AND SURVIVAL......Page 796
Further Reading......Page 797
INTRODUCTION......Page 799
DYSPLASIA IN BARRETT'S ESOPHAGUS......Page 800
MANAGEMENT RECOMMENDATIONS......Page 801
Further Reading......Page 802
CLINICAL PRESENTATION AND MANAGEMENT......Page 803
Further Reading......Page 804
Selection of the Optimal Antireflux Surgical Procedure......Page 805
Collis Gastroplasty......Page 806
Epiphrenic Diverticulum......Page 807
Esophageal Cancer......Page 808
Options for Reconstruction After Esophagectomy......Page 809
Ivor Lewis Esophagectomy......Page 810
The McKeown Operation and Three-Hole Esophagectomy (Abdominothoracicocervical Esophagectomy)......Page 811
Complications of Esophageal Resection for Cancer......Page 812
Further Reading......Page 813
Etiology......Page 814
Management......Page 815
Diagnosis......Page 816
Further Reading......Page 817
IMMUNOSUPPRESSION-ASSOCIATED ESOPHAGEAL ULCERS......Page 818
TUMORS......Page 819
Further Reading......Page 820
MUCOSA......Page 821
UPPER ESOPHAGEAL SPHINCTER......Page 822
CIRCULATION......Page 823
Further Reading......Page 824
DEVELOPMENTAL ANOMALIES......Page 825
Further Reading......Page 826
FUNCTIONAL MORPHOLOGY OF THE EXOCRINE PANCREAS......Page 827
Acinar Cells......Page 828
Pancreatic Duct Cells and Goblet Cells......Page 830
Further Reading......Page 831
PATHOPHYSIOLOGY AND NATURAL HISTORY......Page 833
DIET MODIFICATION......Page 834
Further Reading......Page 835
MORPHOLOGY OF EXOCYTOSIS......Page 836
MOLECULAR MECHANISM OF EXOCYTOSIS......Page 837
Further Reading......Page 838
Extracolonic Polyps......Page 839
Malignant Manifestations......Page 840
Screening......Page 841
Acknowledgments......Page 842
Further Reading......Page 843
Conditions in Which Adenomatous Polyps Develop......Page 844
Disease variants......Page 845
Colon surgery......Page 846
Diagnosis......Page 847
Genetic testing......Page 848
Conditions in Which Hamartomatous Polyps Develop......Page 849
Disease phenotype......Page 850
Genetics......Page 851
Multiple Endocrine Neoplasia Type I......Page 852
Risk of Colon Cancer in Relatives......Page 853
Genetics......Page 854
Familial Pancreatic Cancer......Page 855
Treatment......Page 856
Further Reading......Page 857
ANESTHESIA......Page 858
MODIFYING POSTOPERATIVE CARE......Page 859
Further Reading......Page 860
Gastric Lipase......Page 861
Pancreatic Phospholipase A2......Page 862
INTRALUMINAL PROCESSES......Page 863
Formation of the Chylomicron......Page 864
Movement of Chylomicrons from the Golgi to the Lymph......Page 865
TWO POOLS OF INTESTINAL TRIGLYCERIDE......Page 866
PHYSIOLOGICAL CONSEQUENCES OF LYMPHATIC/PORTAL VEIN DELIVERY......Page 867
Further Reading......Page 868
EPIDEMIOLOGY......Page 869
Pelvic Floor Muscles......Page 870
Less Commonly Employed Treatments......Page 871
Further Reading......Page 872
EXTRACELLULAR MATRIX COMPOSITION IN NORMAL LIVER AND HEPATIC SCAR......Page 873
STELLATE CELL ACTIVATION: THE CENTRAL EVENT IN HEPATIC FIBROSIS......Page 874
Histologic and Morphometric Methods......Page 875
Noninvasive Methods......Page 876
Further Reading......Page 877
Nutrition......Page 878
Factors associated with nonhealing fistulas......Page 879
Pancreatic......Page 880
Further Reading......Page 881
SOURCE OF COLONIC GAS......Page 882
Further Reading......Page 883
GENETICS......Page 884
Pregnancy......Page 885
Seizure Disorders......Page 886
Further Reading......Page 887
INTRODUCTION......Page 888
MANAGEMENT......Page 889
Chronic (or Late-Phase) IgE-Associated Allergic Reactions......Page 890
Further Reading......Page 891
FOOD ADDITIVES AND PRESERVATIVES......Page 892
FOOD INTOLERANCE IN INFLAMMATORY BOWEL DISEASE AND IRRITABLE BOWEL SYNDROME......Page 893
Further Reading......Page 894
BACTERIAL FOOD POISONING......Page 895
Bacillus cereus......Page 896
TREATMENT AND PREVENTION......Page 897
Further Reading......Page 898
INFECTIOUS CAUSES OF FOOD- AND WATER-BORNE ILLNESS......Page 899
Methylmercury......Page 900
FOOD HANDLING......Page 901
Further Reading......Page 902
CHANGING EPIDEMIOLOGY OF FOODBORNE DISEASES......Page 903
Bacterial Causes of Foodborne Illness......Page 904
Parasitic Causes of Foodborne Illness......Page 905
Bacterial Toxin-Induced Foodborne Illness......Page 906
Further Reading......Page 908
Foreign Bodies......Page 910
Outcome......Page 911
Food......Page 912
Further Reading......Page 913
ETIOLOGY......Page 914
CLINICAL MANIFESTATIONS......Page 915
Other Organ Systems......Page 916
Management of Other Speci®c Complications......Page 917
Further Reading......Page 918
INTRODUCTION......Page 919
TREATMENT......Page 920
Promotility Agents......Page 921
Alternative Medicine......Page 922
Further Reading......Page 923
CANDIDAL OROPHARYNGO- ESOPHAGITIS AND NONESOPHAGEAL GUT SITES......Page 924
EMERGING AND UNUSUAL FUNGAL INFECTIONS......Page 926
Further Reading......Page 927
CLINICAL PRESENTATION......Page 928
NEWBORN SCREENING......Page 930
Neurological Abnormalities......Page 931
Further Reading......Page 932
PATHOGENESIS......Page 933
Further Reading......Page 934
Acalculous Cholecystitis......Page 935
Gallstones......Page 936
Complications of Cholelithiasis......Page 937
Further Reading......Page 938
Bile Acids......Page 939
CHOLESTEROL SUPERSATURATION......Page 940
NUCLEATION OF CHOLESTEROL CRYSTALS......Page 941
MIXED CHOLESTEROL STONES, PIGMENT STONES, AND THE ROLE OF BACTERIA......Page 943
BILIARY SLUDGE......Page 944
Further Reading......Page 945
STOMACH ANATOMY AND FUNCTION......Page 947
BENIGN AND CANCEROUS STOMACH TUMORS......Page 948
GASTRECTOMY......Page 949
Further Reading......Page 950
INTRODUCTION......Page 952
General Organization of the Stomach and Regional Variations......Page 953
Endocrine/Paracrine Cells Involved in the Regulation of HCl Secretion......Page 954
Somatostatin-Storing D Cells in Oxyntic and Antral Glands......Page 955
Extrinsic Innervation and CNS Control......Page 956
Cephalic Phase......Page 957
Gastric Phase......Page 958
Regulation of HCl Secretion at the Level of the Parietal Cell......Page 959
Regulation of Histamine Release from ECL Cells......Page 960
Synthesis and Release of Gastrin from G Cells and Gastrin Functions......Page 961
Further Reading......Page 962
Helicobacter pylori......Page 964
Further Reading......Page 965
Solids......Page 966
Small Intestinal Feedback......Page 967
Carbon Breath Tests......Page 968
ETIOLOGY AND SEQUELAE OF DISORDERED GASTRIC EMPTYING......Page 969
History and Physical Examination......Page 970
Surgery......Page 971
Further Reading......Page 972
PHYSIOLOGY......Page 973
STRUCTURE AND ION TRANSPORT......Page 974
Further Reading......Page 975
BACTERIA......Page 976
FUNGI......Page 978
PARASITES......Page 979
Further Reading......Page 980
PATTERNS OF FASTING AND POSTPRANDIAL GASTRIC MOTILITY......Page 981
Extrinsic Innervation of the Stomach......Page 983
Assessment of Gastric Wall Motion......Page 984
Measurement of Antropyloroduodenal Phasic Contractions......Page 985
Further Reading......Page 986
ETIOLOGY......Page 988
TREATMENT......Page 989
Further Reading......Page 990
PATHOLOGY......Page 991
CLINICAL MANIFESTATIONS-DIAGNOSIS......Page 993
MANAGEMENT-TREATMENT......Page 994
Further Reading......Page 995
CONTROL OF THE ACCOMMODATION REFLEX......Page 996
CONCLUSIONS......Page 998
Further Reading......Page 999
OBESITY AND ITS TREATMENT......Page 1000
GASTRIC STAPLING AND GASTRIC BYPASS......Page 1001
Further Reading......Page 1002
Operative Procedures......Page 1003
Complications of Operative Management......Page 1004
Preoperative Evaluation and Indications for Operation......Page 1005
Operative Procedures......Page 1006
Further Reading......Page 1007
Nonsteroidal Antiinflammatory Drugs......Page 1008
Helicobacter pylori......Page 1009
Elderly Population......Page 1010
Acid Suppressive Agents......Page 1011
Antiulcer Therapy......Page 1012
Further Reading......Page 1013
ETIOLOGY AND PATHOGENESIS......Page 1014
Further Reading......Page 1015
GASTRIN DURING DEVELOPMENT......Page 1016
GASTRIN RECEPTOR AND SIGNALING......Page 1017
GASTRIN PROCESSING AND PHYSIOLOGICAL RELEVANCE OF OTHER PROGASTRIN-PROCESSING PRODUCTS......Page 1018
Overview......Page 1019
Helicobacter pylori, Ulcers, and Gastrin......Page 1020
Cancer......Page 1021
Further Reading......Page 1022
GASTRIN-RELATED PEPTIDE RECEPTORS, PHARMACOLOGY, AND THEIR CELL TRANSDUCTION MECHANISMS......Page 1023
PHYSIOLOGICAL/PHARMACOLOGICAL ROLES OF GASTRIN-RELATED PEPTIDE......Page 1025
GASTRIN-RELATED PEPTIDE IN PATHOLOGIC CONDITIONS......Page 1027
Further Reading......Page 1028
Secretion of Gastrin......Page 1030
Cell of Origin......Page 1031
Secretion of Other Products......Page 1032
Confirming the Diagnosis of Zollinger-Ellison Syndrome......Page 1033
Management of Gastric Acid Hypersecretion......Page 1034
Metastatic Gastrinoma......Page 1035
Further Reading......Page 1036
ASSOCIATIONS WITH OTHER DISEASES......Page 1037
Further Reading......Page 1038
MICROBIOLOGY......Page 1039
ROLE OF H. PYLORI INFECTION IN CHILDREN WITH ULCERS AND GASTRITIS......Page 1040
IMMUNE RESPONSES TO H. PYLORI INFECTION ARE NOT PROTECTIVE......Page 1041
DIAGNOSTIC METHODS......Page 1043
VACCINES FOR THE PREVENTION OF H. PYLORI INFECTION......Page 1044
Further Reading......Page 1045
Gastro-colic Reflex......Page 1047
NEURONAL MECHANISMS......Page 1048
Further Reading......Page 1049
INTRODUCTION......Page 1051
Norovirus......Page 1052
Sapovirus......Page 1053
TREATMENT AND PREVENTION......Page 1054
Further Reading......Page 1055
TYPES OF GASTROENTEROSTOMIES......Page 1056
Further Reading......Page 1057
SYMPTOMS......Page 1058
COMPLICATIONS......Page 1059
DIAGNOSTIC TESTING......Page 1060
MEDICAL THERAPY......Page 1061
SURGICAL MANAGEMENT......Page 1063
Further Reading......Page 1065
EPIDEMIOLOGY......Page 1066
Esophageal pH Monitoring......Page 1067
Conservative Therapy......Page 1068
APPROACH TO GASTROESOPHAGEAL REFLUX DISEASE SYMPTOMS IN CHILDREN......Page 1069
Feeding and Swallowing Dif®culties......Page 1070
Asthma......Page 1071
Esophageal Duplications......Page 1072
Further Reading......Page 1073
Laminins, Nidogen, and Type IV Collagen......Page 1074
Fibronectin and Tenascin......Page 1075
DERIVATION OF THE MATRIX......Page 1076
MATRIX REGULATION OF RESTITUTION AND MUCOSAL HEALING......Page 1077
Further Reading......Page 1078
ESOPHAGUS......Page 1079
SMALL INTESTINE......Page 1082
Further Reading......Page 1083
MEDICAL INDICATIONS FOR GASTROSTOMY......Page 1084
Further Reading......Page 1085
INTRODUCTION......Page 1086
RECOGNIZING SIGNS OF A HEREDITARY CANCER SYNDROME......Page 1087
LIMITATIONS TO GENETIC TESTING TECHNOLOGY......Page 1088
Further Reading......Page 1089
EPIDEMIOLOGY, DISEASE, AND TREATMENT......Page 1090
Further Reading......Page 1091
Morphology......Page 1092
Electrophysiological Properties and Neuroglial Interactions......Page 1093
Further Reading......Page 1094
LOCALIZATION AND DEVELOPMENT......Page 1096
GIP RECEPTOR......Page 1098
GIP as Incretin......Page 1099
REGULATION OF EXPRESSION......Page 1100
CONTRIBUTION TO DISEASES......Page 1101
Further Reading......Page 1102
INTRODUCTION......Page 1103
Clinical Features......Page 1104
GLYCOGEN STORAGE DISEASE TYPE III......Page 1105
Epidemiology......Page 1106
Further Reading......Page 1107
Gut Mucosal Integrity......Page 1109
Epidermal Growth Factor......Page 1110
Transforming Growth Factor-......Page 1111
Hepatocyte Growth Factor......Page 1112
Trefoil Peptides......Page 1113
General Considerations......Page 1114
Inflammatory Bowel Disease and Necrotizing Enterocolitis......Page 1115
Further Reading......Page 1116
ENDOCRINOLOGY......Page 1117
Children......Page 1118
GH THERAPY......Page 1119
Other Uses......Page 1120
Further Reading......Page 1121
INTRODUCTION......Page 1122
UROGUANYLIN, GUANYLIN, AND COLON CANCER......Page 1123
Further Reading......Page 1124
INTRODUCTION......Page 1125
MECHANISM OF ACTION......Page 1126
EFFICACY......Page 1127
Prophylaxis of Stress-Related Gastric Hemorrhage......Page 1128
Interference with Drug Absorption......Page 1129
Further Reading......Page 1130
EXTRAORAL PATHOLOGIC HALITOSIS......Page 1132
Further Reading......Page 1133
PEUTZ - JEGHERS SYNDROME......Page 1134
BANNAYAN - RILEY - RUVALCABA SYNDROME......Page 1135
Further Reading......Page 1136
ANATOMY AND PHYSIOLOGY......Page 1138
Further Reading......Page 1139
BACTERIAL VIRULENCE FACTORS......Page 1140
TRANSMISSION......Page 1141
Peptic Ulcer Disease......Page 1142
Urea Breath Testing......Page 1143
Antibody Testing......Page 1144
Treatment Regimens......Page 1145
Further Reading......Page 1146
NEMATODES......Page 1148
TREMATODES......Page 1149
CESTODES......Page 1152
Further Reading......Page 1153
ETIOLOGY AND PATHOGENESIS......Page 1154
CLINICAL PRESENTATION......Page 1155
TREATMENT......Page 1156
Further Reading......Page 1157
Signs Related to the Extent of Blood Loss......Page 1158
Upper Gastrointestinal Tract Hemorrhage......Page 1159
Further Reading......Page 1160
CLINICAL PRESENTATION AND DIAGNOSIS......Page 1161
OPERATIVE MANAGEMENT......Page 1162
Further Reading......Page 1163
Gastrointestinal......Page 1164
Further Reading......Page 1165
HISTOPATHOLOGY......Page 1166
Further Reading......Page 1167
Hepatic Stellate Cells......Page 1168
Nitric Oxide......Page 1169
Neurohumoral Regulation......Page 1170
Hepatic Artery and Autoregulation......Page 1171
Hepatic Circulation in Response to Endotoxin......Page 1172
Further Reading......Page 1173
CLASSIFICATION......Page 1174
Episode of Hepatic Encephalopathy......Page 1175
Neuropsychological Tests......Page 1176
Improvement of Extraintestinal Elimination of Ammonia......Page 1177
Further Reading......Page 1178
CAUSES OF HEPATIC GRANULOMAS......Page 1179
Further Reading......Page 1180
VIROLOGY......Page 1181
DIAGNOSIS......Page 1182
CLINICAL MANIFESTATIONS......Page 1183
Further Reading......Page 1184
HISTORY OF DISCOVERY......Page 1186
DIAGNOSIS......Page 1187
HBeAg- Chronic Hepatitis B......Page 1188
EVOLUTION OF HBV......Page 1189
Vaccines for the Future......Page 1191
Drug-Resistant HBV and Combination Chemotherapy......Page 1192
Further Reading......Page 1193
Routes of Transmission and Epidemiology......Page 1194
Clinical Course and Serology......Page 1195
Treatment of Acute Infection......Page 1196
Demographic Factors Associated with Higher and Lower Chronicity Rates......Page 1197
Features of Efficacious Immune Responses......Page 1198
Liver Damage......Page 1199
Diagnostic Tests for HCV: Detection of Antibodies and HCV RNA......Page 1200
HCV RNA and Proteins......Page 1201
Which Liver Cells Support HCV Replication during Chronic Infection?......Page 1203
Further Reading......Page 1204
INTRODUCTION......Page 1206
NATURAL HISTORY......Page 1207
DIAGNOSTIC AND CLINICAL FEATURES......Page 1208
Further Reading......Page 1209
EPIDEMIOLOGY......Page 1210
Further Reading......Page 1211
Hepatocellular Carcinoma (HCC)......Page 1212
RISK FACTORS......Page 1213
Laboratory Features......Page 1214
SCREENING AND SURVEILLANCE......Page 1215
Ablative Therapy......Page 1216
CONCLUSION......Page 1217
Further Reading......Page 1218
Hepatocytes......Page 1219
PRINCIPLES OF CELL ISOLATION AND CULTURE......Page 1220
MANIPULATION OF CELLS FOR IN VITRO AND OTHER APPLICATIONS......Page 1221
MECHANISMS IN CELL THERAPY......Page 1222
Further Reading......Page 1223
PATHOPHYSIOLOGY......Page 1224
DIFFERENTIAL DIAGNOSIS......Page 1225
CONCLUSION......Page 1226
Further Reading......Page 1227
Hepatotoxicity, Drug-Induced......Page 1228
EPIDEMIOLOGICAL ASPECTS......Page 1229
FACTORS MODULATING HEPATOTOXICITY......Page 1230
Physiological Factors......Page 1231
Genetic Factors Contributing to Drug Hepatotoxicity......Page 1232
Acute Hepatocellular Hepatitis......Page 1233
Acute cholestatic hepatitis......Page 1234
Chronological Criteria......Page 1235
Causality Assessment by Scoring Systems......Page 1236
Performance of Causality Assessment......Page 1237
Further Reading......Page 1238
FORMS OF HEPATOTOXIN-INDUCED LIVER INJURY......Page 1240
ROLE OF KUPFFER CELLS AND CYTOKINES IN TOXIN-INDUCED LIVER INJURY......Page 1241
Further Reading......Page 1242
ALDOLASES......Page 1243
Signs and Symptoms......Page 1244
Treatment......Page 1245
Further Reading......Page 1246
CLINICAL FEATURES......Page 1247
Serum Iron Studies......Page 1248
Hepatic Iron......Page 1249
PATHOPHYSIOLOGY......Page 1250
Therapeutic Phlebotomy......Page 1251
ROLE OF LIVER BIOPSY......Page 1252
Further Reading......Page 1253
ANATOMY......Page 1254
SURGERY......Page 1255
Further Reading......Page 1256
Type I......Page 1257
Type II......Page 1258
DIAGNOSIS AND MANAGEMENT......Page 1259
Nissen Fundoplication......Page 1260
Further Reading......Page 1261
INTRODUCTION......Page 1262
TREATMENT......Page 1263
Further Reading......Page 1264
INTRODUCTION......Page 1265
HEREDITARY FACTORS......Page 1266
PATHOPHYSIOLOGY......Page 1267
Further Reading......Page 1268
SOURCE OF GASTRIC HISTAMINE......Page 1269
STRUCTURE OF HISTAMINE-2 RECEPTOR ANTAGONISTS......Page 1270
Further Reading......Page 1271
Further Reading......Page 1273
Metabolism of Apolipoprotein B-100-Containing Lipoproteins......Page 1274
Metabolism of Apolipoprotein A-Containing Lipoproteins......Page 1275
Apolipoprotein A-Containing Lipoproteins......Page 1276
TREATMENT OF HYPERLIPIDEMIA......Page 1277
Statins......Page 1278
Fibrates......Page 1279
Cholesterol Absorption Inhibitors......Page 1280
Further Reading......Page 1281
GASTROINTESTINAL SYMPTOMS AND SIGNS......Page 1282
Multiple Endocrine Neoplasia Syndromes......Page 1283
Further Reading......Page 1284
Malabsorption......Page 1285
Drug Toxicity......Page 1286
Further Reading......Page 1287
Anorectal Function......Page 1288
Further Reading......Page 1289
ACTIVATING THE ILEAL BRAKE AND JEJUNAL BRAKE AS TREATMENT......Page 1290
Further Reading......Page 1291
PREOPERATIVE PREPARATIONS......Page 1292
Mucosectomy and Cuff Formation......Page 1293
Other Pouches......Page 1294
CONTRAINDICATIONS TO POUCH FORMATION......Page 1295
Further Reading......Page 1296
Selective IgA Deficiency......Page 1297
Primary Antibody Deficiencies......Page 1298
Further Reading......Page 1300
FUNCTIONS OF INTESTINAL IgA......Page 1302
Further Reading......Page 1303
INTRODUCTION......Page 1304
Rectourethral Fistula......Page 1305
Anorectal Agenesis without Fistula......Page 1306
ASSOCIATED ANOMALIES......Page 1307
PRESENTATION AND DIAGNOSIS......Page 1308
Surgical Considerations......Page 1309
POSTOPERATIVE MANAGEMENT......Page 1310
Further Reading......Page 1311
ICCs ARE DISRUPTED IN PATIENTS WITH GI MOTILITY DISORDERS......Page 1312
SLOW-WAVE PACEMAKING MECHANISM IN ICCS......Page 1313
ICCS ARE POSSIBLE PRECURSORS TO STROMAL AND OMENTAL TUMORS......Page 1314
Further Reading......Page 1315
Diagnosis......Page 1316
Type IIIa......Page 1317
Treatment......Page 1318
Further Reading......Page 1319
Strangulated Bowel Obstruction......Page 1320
Plain Films of the Abdomen......Page 1321
Second-Look Exploration......Page 1322
Further Reading......Page 1323
Intestinal Ischemia......Page 1324
Mesenteric Arterial Thrombosis......Page 1325
Mesenteric Venous Thrombosis......Page 1326
Further Reading......Page 1327
NEUROPATHIC FORM......Page 1328
Further Reading......Page 1329
OCCURRENCE AND DISTRIBUTION......Page 1330
CELLULAR UPTAKE AND METABOLISM OF IF-CBL......Page 1331
Further Reading......Page 1332
Physical Exam......Page 1333
Computed Tomography Scan Diagnosis......Page 1334
Air Enema Reduction......Page 1335
ADULT INTUSSUSCEPTION......Page 1336
Further Reading......Page 1337
LUMENAL IRON METABOLISM......Page 1338
ENTEROCYTE IRON UPTAKE, PROCESSING, AND RELEASE......Page 1339
REGULATION......Page 1340
Further Reading......Page 1341
PATHOPHYSIOLOGY......Page 1342
Central Nervous System Modulation......Page 1343
Altered Bowel Habits......Page 1344
Initial Evaluation......Page 1345
Severity of Symptoms......Page 1346
Role of Fiber in IBS......Page 1347
The Pain-Predominant IBS Patient......Page 1348
SUMMARY......Page 1349
Further Reading......Page 1350
DIAGNOSIS......Page 1351
Further Reading......Page 1352
CLINICAL DISEASE......Page 1353
THERAPY......Page 1355
MECHANISM OF ACTION OF INTRAVENOUS IMMUNOGLOBULIN......Page 1356
Further Reading......Page 1357
MANAGEMENT......Page 1358
Further Reading......Page 1359
TECHNIQUE OF LAPAROSCOPY......Page 1360
PHYSIOLOGY OF LAPAROSCOPY......Page 1361
COMPLICATIONS OF LAPAROSCOPY......Page 1362
Suspected Acute Appendicitis or Gynecologic Abdominal Disease......Page 1363
Staging of Malignancy......Page 1364
Inguinal Hernia Repair......Page 1365
Small Intestinal Surgery......Page 1366
SUMMARY......Page 1367
Further Reading......Page 1368
MORPHOGENESIS......Page 1369
HIRSCHSPRUNG'S DISEASE......Page 1370
Further Reading......Page 1371
Osmotic Laxatives......Page 1372
Secretagogues and Agents with Direct Effects on Epithelium, Nerves, or Smooth Muscle......Page 1373
Use in Toxic Ingestions......Page 1374
Further Reading......Page 1375
Lipoproteins......Page 1376
Complex Lipid Synthesis......Page 1377
INTESTINAL LIPOPROTEIN SECRETION......Page 1378
HEPATIC LIPOPROTEIN SECRETION......Page 1380
Further Reading......Page 1381
PATHOGENESIS......Page 1382
DIAGNOSIS......Page 1383
Further Reading......Page 1384
TYPES OF LIVER BIOPSY......Page 1385
LIVER BIOPSY SPECIMEN PREPARATION IN THE LABORATORY......Page 1386
PRINCIPLES FOR LIVER BIOPSY INTERPRETATION......Page 1387
Primary Sclerosing Cholangitis......Page 1389
Further Reading......Page 1390
Simple Cysts......Page 1392
Cystadenomas......Page 1393
Cavernous Hemangiomas......Page 1394
Cystadenocarcinoma......Page 1395
CHOLEDOCHAL CYSTS AND CAROLI'S DISEASE......Page 1396
Echinococcal/Hyatid Cysts......Page 1397
Further Reading......Page 1399
INTRODUCTION......Page 1400
INCIDENCE......Page 1401
Clinical Features and Diagnosis......Page 1402
Management......Page 1403
Further Reading......Page 1404
INTRODUCTION......Page 1406
PRESENTATION AND DIFFERENTIAL DIAGNOSIS......Page 1407
THERAPY......Page 1409
OUTCOME......Page 1411
Further Reading......Page 1412
WARM (NORMOTHERMIC) ISCHEMIA......Page 1413
Ischemia in the Diseased Liver......Page 1414
COLD ISCHEMIA......Page 1415
Further Reading......Page 1416
INDICATIONS AND CONTRAINDICATIONS......Page 1418
Transplantation for Alcoholic Liver Disease......Page 1419
Transplants from Living Donors......Page 1420
Side Effects of Immunosuppression......Page 1421
Hepatitis B......Page 1422
Further Reading......Page 1423
LIVER DEVELOPMENT......Page 1424
VASCULAR ANATOMY......Page 1425
LYMPHATIC SYSTEM......Page 1426
Hepatocytes......Page 1427
Kupffer Cells......Page 1428
Further Reading......Page 1429
Embryology and Gene Regulation......Page 1430
Developmental Anomalies......Page 1431
CONCLUSION......Page 1432
Further Reading......Page 1433
INITIAL EVALUATION......Page 1434
Urgent Colonoscopy......Page 1435
Red Cell Scanning......Page 1436
Diverticular Hemorrhage......Page 1437
Colonic Angiomas......Page 1438
Internal Hemorrhoids......Page 1439
Further Reading......Page 1440
ETIOLOGY AND PATHOGENESIS......Page 1441
Other......Page 1442
DIAGNOSIS......Page 1443
Further Reading......Page 1444
ANATOMICAL CONSIDERATIONS......Page 1445
Lymphatic Transport of Proteins......Page 1446
Primary Intestinal Lymphangiectasia......Page 1447
Further Reading......Page 1448
NATURAL KILLER CELLS......Page 1449
B LYMPHOCYTES......Page 1450
T Lymphocytes Recognize Antigen in the Context of MHC......Page 1451
Lymphocyte Location in the Gastrointestinal Tract......Page 1452
Fecal Immunoglobulin Production......Page 1453
Further Reading......Page 1454
Treatment......Page 1455
ENTEROPATHY-ASSOCIATED T-CELL LYMPHOMA......Page 1456
Further Reading......Page 1457
CLINICAL MANIFESTATIONS......Page 1458
THE GENETIC BASIS OF LYNCH SYNDROME......Page 1459
MANAGEMENT OF LYNCH SYNDROME......Page 1460
Further Reading......Page 1462
Fatty Infiltration......Page 1463
Cirrhosis......Page 1464
Focal Nodular Hyperplasia......Page 1466
Hepatocellular Carcinoma......Page 1467
Cholelithiasis and Choledocholithiasis......Page 1468
Primary Biliary Cirrhosis......Page 1469
Normal Pancreas......Page 1470
Pancreas Divisum......Page 1471
Pancreatic Cystic Tumors......Page 1472
Pancreatic Islet Cell Tumor......Page 1473
Further Reading......Page 1474
THE CAUSE OF DIARRHEA IN STEATORRHEA......Page 1475
Other Malabsorbed Nutrients in Celiac Sprue......Page 1476
Pathophysiology of Stasis Syndrome......Page 1477
Treatment......Page 1478
Treatment......Page 1479
Symptoms, Diagnosis, and Treatment......Page 1480
Further Reading......Page 1481
Clinical Presentation......Page 1482
Further Reading......Page 1483
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Further Reading......Page 1492
Protein Malnutrition......Page 1486
Physiologic Response to Injury and Critical Illness......Page 1487
Cytokines and Their Role in Injury......Page 1488
Clinical History and Physical Examination......Page 1489
FUNCTIONAL TESTS FOR MALNUTRITION......Page 1490
NUTRITIONAL SUPPORT......Page 1491
INTRODUCTION......Page 1494
EMBRYOLOGY AND DEVELOPMENTAL PATHOLOGY......Page 1495
PRESENTATION AND DIAGNOSIS......Page 1497
TREATMENT......Page 1498
OUTCOME AND FUTURE DIRECTION......Page 1499
Further Reading......Page 1500
Outcome Measures......Page 1501
Indications and Clinical Value......Page 1502
Indications......Page 1503
Further Reading......Page 1504
ETIOLOGY AND PATHOGENESIS......Page 1505
Further Reading......Page 1506
HISTORY OF THE MAST CELL......Page 1508
Histochemical Characteristics......Page 1509
Immunological Activation......Page 1510
Biogenic Amines......Page 1511
Lipid-Derived Mediators......Page 1512
Differential Release of Mediators......Page 1513
CONCLUSION......Page 1514
Further Reading......Page 1515
Gastric Abnormalities......Page 1516
Pathogenesis of Diarrhea......Page 1517
Further Reading......Page 1518
Bowel Obstruction......Page 1519
Asymptomatic Diverticula......Page 1520
Further Reading......Page 1521
Diagnosis......Page 1522
OTHER NEUROMUSCULAR DISEASES THAT AFFECT THE INTESTINE......Page 1523
Evaluation and Treatment......Page 1524
Further Reading......Page 1525
CLINICAL......Page 1526
Further Reading......Page 1527
IDENTIFICATION TECHNIQUES......Page 1528
ESTABLISHING A STABLE MICROFLORA......Page 1529
BENEFICIAL MICROFLORA......Page 1530
Further Reading......Page 1531
INTRODUCTION......Page 1532
A MEAL STOPS THE MIGRATING MOTOR COMPLEX......Page 1533
Further Reading......Page 1534
BACKGROUND......Page 1535
LAPAROSCOPIC CHOLECYSTECTOMY......Page 1536
LAPAROSCOPIC ANTIREFLUX SURGERY......Page 1537
MINIMALLY INVASIVE GASTRIC SURGERY......Page 1538
MINIMALLY INVASIVE SURGERY FOR STAGING OF MALIGNANCY......Page 1539
SUMMARY......Page 1540
Further Reading......Page 1541
STRUCTURE AND LOCALIZATION......Page 1542
STRUCTURE-ACTIVITY AND RECEPTOR......Page 1543
PHYSIOLOGICAL ROLE......Page 1544
CONTRIBUTION TO CLINICAL MEDICINE......Page 1545
Further Reading......Page 1546
PEYER'S PATCHES AND M CELLS......Page 1547
MUCOSAL B LYMPHOCYTES......Page 1548
SUMMARY......Page 1549
Further Reading......Page 1550
Technical Aspects......Page 1551
Tumors of the Esophagus......Page 1552
Chronic Gastritis......Page 1553
Duodenitis......Page 1554
Normal Colonic/Rectal Mucosa......Page 1555
Ulcerative Colitis and Crohn's Disease......Page 1556
Other Inflammatory Disorders of the Colon and Rectum......Page 1557
Further Reading......Page 1558
MEN 2......Page 1559
Zollinger-Ellison (Gastrinoma) Syndrome......Page 1560
Insulinoma......Page 1561
TUMOR LOCALIZATION......Page 1562
Further Reading......Page 1563
Treatment......Page 1564
Further Reading......Page 1565
MYCOBACTERIUM TUBERCULOSIS......Page 1566
Further Reading......Page 1567
THE ROLE OF NAUSEA IN THE SURVIVAL OF THE ORGANISM......Page 1568
PHYSIOLOGICAL CHANGES THAT ACCOMPANY THE DEVELOPMENT OF NAUSEA......Page 1569
Further Reading......Page 1570
Enteral Feeding......Page 1571
CLINICAL FEATURES......Page 1572
TREATMENT......Page 1573
Further Reading......Page 1574
Hookworms: Necator americanus and Ancylostoma spp.......Page 1576
Strongyloidiasis......Page 1578
Further Reading......Page 1579
EXTRAHEPATIC NEONATAL CHOLESTASIS......Page 1580
Etiology of Biliary Atresia......Page 1582
Etiology of AGS......Page 1583
Progressive Familial Intrahepatic Cholestasis......Page 1585
Diagnosis, prognosis, and management of PFIC-3......Page 1586
3b-Hydroxy-C27 -steroid dehydrogenase/isomerase deficiency......Page 1587
Hereditary Tyrosinemia Type 1......Page 1589
Further Reading......Page 1590
OTHER CLINICAL ASSOCIATIONS......Page 1591
IRON METABOLISM AND THE PHYSIOLOGIC BASIS OF DISEASE......Page 1592
LIVER HISTOLOGY......Page 1593
Further Reading......Page 1595
INTRODUCTION......Page 1597
PHYSIOLOGICAL JAUNDICE......Page 1598
Increased Bilirubin Production......Page 1599
Assessment of Hemolysis......Page 1600
TREATMENT OF HYPERBILIRUBINEMIA......Page 1601
Intravenous Immune Globulin......Page 1602
Further Reading......Page 1603
Excessive Gastric Aspiration......Page 1604
Further Reading......Page 1605
EPIDEMIOLOGY......Page 1607
ASSOCIATED ANOMALIES......Page 1608
TREATMENT......Page 1609
Further Reading......Page 1610
Further Reading......Page 1611
GENE AND PRECURSOR STRUCTURE......Page 1612
Neurotensin Receptor Type 1......Page 1613
Gastrointestinal Secretions......Page 1614
PATHOLOGY......Page 1615
Further Reading......Page 1616
NITRIC OXIDE SYNTHASE-2......Page 1617
Further Reading......Page 1618
MECHANISM OF ACTION......Page 1619
Rheumatoid Arthritis......Page 1620
Further Reading......Page 1621
RISK FACTORS......Page 1622
LIVER HISTOLOGY......Page 1623
NATURAL HISTORY......Page 1624
Further Reading......Page 1625
Other......Page 1626
SEPSIS RELATING TO SURGICAL PROCEDURES......Page 1627
Pneumonia......Page 1628
Further Reading......Page 1629
Cyclooxygenase-Independent Toxicity (Topical Damage)......Page 1630
ADVERSE GI EFFECTS OF NSAIDS......Page 1631
Phospholipid NSAIDs......Page 1632
Further Reading......Page 1633
Gastric Emptying......Page 1634
Other Studies......Page 1635
Chronic Cholecystitis......Page 1636
Labeled Leukocytes......Page 1637
Other Agents......Page 1638
Further Reading......Page 1639
INTRODUCTION......Page 1641
Nonspecific......Page 1642
Amino Acids......Page 1643
Calcium......Page 1644
Further Reading......Page 1645
Successful Aging......Page 1647
CAVEATS IN ASSESSING NUTRITIONAL STATUS IN THE ELDERLY......Page 1648
Undernutrition in the Elderly......Page 1649
Further Reading......Page 1650
INTRODUCTION......Page 1652
Serum Albumin......Page 1653
Isotope Dilution......Page 1654
Computerized Axial Tomography and Magnetic Resonance Imaging......Page 1655
History......Page 1656
Evaluation for Specific Nutrient Deficiencies......Page 1657
GERIATRIC NUTRITIONAL ASSESSMENT......Page 1658
Further Reading......Page 1659
Calories......Page 1660
EXERCISE......Page 1661
MEDICATIONS......Page 1662
BENEFITS OF INTENTIONAL WEIGHT LOSS......Page 1663
Further Reading......Page 1664
INTRODUCTION......Page 1665
The Physical Examination......Page 1666
Differential Diagnosis......Page 1667
Evaluation......Page 1668
Types of Fecal Occult Blood Tests......Page 1669
Differential Diagnosis and Approach to Evaluation......Page 1671
Iron Deficiency Anemia......Page 1672
Differential Diagnosis and Approach to Evaluation......Page 1673
CONCLUSIONS......Page 1674
Further Reading......Page 1675
Antacids......Page 1676
ANTIDIARRHEAL AGENTS......Page 1678
Adsorbent Drugs......Page 1679
Osmotically Active Agents (Saline Laxatives)......Page 1680
ANTIEMETIC DRUGS......Page 1681
SUMMARY AND CONCLUSIONS......Page 1682
Further Reading......Page 1683
ANATOMICAL RELATIONSHIPS......Page 1684
PANCREATIC DEVELOPMENT AND THE DUCT SYSTEM......Page 1685
VASCULATURE AND LYMPHATICS......Page 1686
NERVOUS INNERVATION......Page 1687
Further Reading......Page 1688
EMBRYONIC ANATOMY......Page 1689
MOLECULAR INFLUENCES......Page 1690
DEVELOPMENTAL ABNORMALITIES......Page 1691
Further Reading......Page 1692
Protein Deficiency......Page 1693
Further Reading......Page 1694
PANCREAS DIVISUM......Page 1695
Further Reading......Page 1697
PATTERNS OF BICARBONATE SECRETION......Page 1698
MECHANISM OF DUCTAL BICARBONATE SECRETION......Page 1699
Further Reading......Page 1700
EPIDEMIOLOGY......Page 1701
PATHOLOGY......Page 1702
DIAGNOSIS AND STAGING......Page 1703
SURGICAL TREATMENT......Page 1705
PALLIATION OF UNRESECTABLE PANCREATIC ADENOCARCINOMA......Page 1706
FUTURE STRATEGIES......Page 1707
Further Reading......Page 1708
SYNTHESIS AND PACKAGING OF DIGESTIVE ENZYMES......Page 1709
Further Reading......Page 1710
Pancreas Divisum......Page 1711
Shwachman-Diamond Syndrome......Page 1712
Jeune Syndrome......Page 1713
Hereditary Pancreatitis......Page 1714
ACUTE PANCREATITIS......Page 1715
CHRONIC PANCREATITIS......Page 1717
Further Reading......Page 1718
Pancreatic Ductal Adenocarcinoma......Page 1719
PATHOLOGY AND MOLECULAR BIOLOGY......Page 1720
CLINICAL PRESENTATION......Page 1721
Computed Tomography Scanning......Page 1722
Magnetic Resonance Imaging......Page 1723
Endoscopic Ultrasound......Page 1724
Laparoscopy......Page 1725
Surgery......Page 1726
CONCLUSION......Page 1727
Further Reading......Page 1728
INTRODUCTION......Page 1729
The Central Nervous System Controls Pancreatic Secretion through the Autonomic Nervous System......Page 1731
Cholecystokinin......Page 1732
Inhibitory Hormones......Page 1733
Transmembrane Signaling......Page 1734
Zymogen Granule Exocytosis......Page 1735
Further Reading......Page 1736
TUBELESS TESTS......Page 1737
Further Reading......Page 1738
Peptide Structure......Page 1739
Pancreatic Polypeptide Biological Actions......Page 1740
Mechanisms of Peptide YY Release......Page 1741
Peptide YY Biological Actions......Page 1742
NPY Gene Expression and Receptors......Page 1743
Further Reading......Page 1744
PRESENTATION AND DIAGNOSIS......Page 1745
Further Reading......Page 1746
INDICATIONS AND CONTRAINDICATIONS......Page 1747
RECIPIENT OPERATION......Page 1748
STATUS OF ISLET TRANSPLANTATION......Page 1749
Further Reading......Page 1750
PHYSIOLOGY......Page 1751
Further Reading......Page 1752
Cystic Tumors of the Pancreas......Page 1753
Serous Cystadenoma......Page 1754
Intraductal Papillary Mucinous Tumor......Page 1755
Further Reading......Page 1756
ETIOLOGY......Page 1758
PATHOPHYSIOLOGY......Page 1759
Blood Tests......Page 1760
Initial Treatment......Page 1761
Late Treatment of Complications......Page 1762
Further Reading......Page 1763
DEMOGRAPHIC FINDINGS......Page 1764
Pancreatic Duct Obstruction......Page 1765
Idiopathic Chronic Pancreatitis......Page 1766
DIAGNOSIS......Page 1767
Endoscopic Retrograde Cholangiopancreatography......Page 1768
Indirect Tests of Pancreatic Function......Page 1769
Steatorrhea......Page 1770
Endoscopic Therapy......Page 1771
Pancreatic Pseudocyst......Page 1772
Further Reading......Page 1773
Secretagogue-Induced Pancreatitis......Page 1774
INVASIVE MODELS OF PANCREATITIS......Page 1775
Duct Ligation/Obstruction Models......Page 1776
Further Reading......Page 1777
CAUSES......Page 1778
Further Reading......Page 1779
ACUTE PANCREATITIS......Page 1780
HEREDITARY PANCREATITIS......Page 1781
Further Reading......Page 1782
TYPES OF ANTI-NEURONAL ANTIBODIES IN PARANEOPLASTIC SYNDROME......Page 1783
Further Reading......Page 1784
INTRODUCTION......Page 1785
PROTOZOA......Page 1789
HELMINTHS......Page 1791
Further Reading......Page 1793
DORSAL VAGAL COMPLEX......Page 1794
Further Reading......Page 1795
BACKGROUND......Page 1796
Protein......Page 1797
The Central Venous Catheter......Page 1798
Catheter Care and Catheter Sepsis......Page 1799
Metabolic Complications......Page 1801
HOME PARENTERAL NUTRITION......Page 1802
THE FUTURE......Page 1803
Further Reading......Page 1804
LOCATION AND STRUCTURE OF THE PARIETAL CELL......Page 1805
MORPHOLOGICAL CHANGES AND ION TRANSPORT ACTIVITIES ASSOCIATED WITH HYDROCHLORIC ACID SECRETION......Page 1806
SIGNALING PATHWAYS INVOLVED IN THE REGULATION OF HYDROCHLORIC ACID SECRETION......Page 1807
Further Reading......Page 1809
PATHOPHYSIOLOGY......Page 1810
Further Reading......Page 1811
MEASUREMENT OF PEPTIC ACTIVITY......Page 1812
Further Reading......Page 1813
PROCEDURES......Page 1814
Further Reading......Page 1815
INDICATIONS AND CONTRAINDICATIONS......Page 1816
PERCUTANEOUS ENDOSCOPIC JEJUNOSTOMY......Page 1817
Further Reading......Page 1818
INDICATIONS FOR PTC......Page 1819
Biliary Obstruction......Page 1820
Bile Duct Leak......Page 1823
Further Reading......Page 1824
PERFORATED ESOPHAGUS......Page 1825
PERFORATED DUODENAL ULCER......Page 1826
PERFORATED DIVERTICULITIS......Page 1827
Further Reading......Page 1828
PERISTALTIC REFLEX......Page 1829
Further Reading......Page 1830
Secondary Peritonitis......Page 1831
PSEUDOMYXOMA PERITONEI......Page 1832
Further Reading......Page 1833
EMBRYOLOGY AND DEVELOPMENT......Page 1834
ANATOMY AND PHYSIOLOGY......Page 1835
Further Reading......Page 1836
PATHOGENESIS AND DIAGNOSIS......Page 1837
Further Reading......Page 1838
PEPTIC ULCER AND GASTROESOPHAGEAL REFLUX DISEASE THERAPY......Page 1839
PROKINETIC AGENTS......Page 1840
TREATMENT OF DIARRHEA......Page 1841
THERAPIES FOR IRRITABLE BOWEL SYNDROME......Page 1842
Further Reading......Page 1843
NEURAL MECHANISM......Page 1845
Further Reading......Page 1846
EVALUATION......Page 1847
Further Reading......Page 1848
Picture Archiving and Communication Systems (PACS)......Page 1849
GENERAL PRINCIPLES......Page 1850
Input......Page 1852
Output......Page 1853
General......Page 1854
Gastrointestinal Fluoroscopy......Page 1855
Cross-Sectional......Page 1856
Further Reading......Page 1857
Discovery and Gene Structure......Page 1858
Cloning, Pharmacology, and Signaling......Page 1859
Endocrine Organs......Page 1860
Immune System......Page 1861
Further Reading......Page 1862
PATHOGENESIS......Page 1864
PATHOLOGY......Page 1865
Adults......Page 1866
Pediatrics......Page 1867
Further Reading......Page 1868
A Brief History of Polyamine Discovery......Page 1869
How Is ODC Regulated?......Page 1870
Synthetic Inhibitors of Polyamines......Page 1871
Cell Growth......Page 1872
Cell Migration......Page 1873
Cancer......Page 1874
SUMMARY......Page 1875
Further Reading......Page 1876
DIAGNOSIS......Page 1877
Further Reading......Page 1878
INTRODUCTION......Page 1879
BIOCHEMICAL ABNORMALITIES IN PORPHYRIAS......Page 1880
HEPATIC PORPHYRIAS......Page 1881
Further Reading......Page 1882
Measurement of Portal Hemodynamics......Page 1883
Selection of Patients for Primary Prophylaxis......Page 1884
Endoscopic Therapy......Page 1885
Vasopressin and its analogues......Page 1886
Balloon Tamponade......Page 1887
Summary......Page 1888
Liver Transplant......Page 1889
Further Reading......Page 1890
CLINICAL PRESENTATION......Page 1891
Further Reading......Page 1892
MIXING MOVEMENTS......Page 1893
Further Reading......Page 1894
PATHOPHYSIOLOGY......Page 1895
Further Reading......Page 1896
Further Reading......Page 1897
INTRODUCTION......Page 1899
CLINICAL PRESENTATION......Page 1900
TREATMENT......Page 1902
Further Reading......Page 1903
INFLAMMATORY BOWEL DISEASE......Page 1905
GASTROESOPHAGEAL REFLUX DISEASE......Page 1906
Further Reading......Page 1907
THERAPEUTIC APPLICATIONS......Page 1908
Further Reading......Page 1909
SYMPTOMATOLOGY AND CLINICAL EVALUATION......Page 1910
Infectious Proctitis......Page 1911
Ulcerative Proctitis......Page 1912
Collagen Vascular Disease......Page 1913
Hematologic Diseases......Page 1914
Further Reading......Page 1915
HYDROLYSIS OF PROTEINS AND DETERMINANTS OF THEIR DIGESTABILITY......Page 1916
TRANSPORT OF FREE AMINO ACIDS ACROSS THE EPITHELIUM......Page 1917
Further Reading......Page 1919
CLASSIFICATION......Page 1920
ETIOLOGY OF PROTEIN-CALORIE DEFICIENCY......Page 1921
Physical Examination......Page 1922
Serum Cholesterol......Page 1923
Further Reading......Page 1924
Protein Maldigestion and Malabsorption......Page 1925
Mucosal Damage Associated with In¯ammation, Erosions, or Ulcers......Page 1926
Primary Lymphangiectasia......Page 1927
Further Reading......Page 1928
DEMONSTRATION OF PROTEIN-LOSING ENTEROPATHY......Page 1929
NONINFECTIOUS INFLAMMATORY DISORDERS THAT CAUSE PROTEIN-LOSING ENTEROPATHY......Page 1930
LYMPHATIC OBSTRUCTION......Page 1931
Further Reading......Page 1932
IRREVERSIBLE COVALENT BINDING INHIBITORS......Page 1933
K+-COMPETITIVE INHIBITORS......Page 1934
Further Reading......Page 1935
The Endogenous Opioid System......Page 1937
Further Reading......Page 1938
PSYCHIATRIC DISORDERS IN STRUCTURAL AND FUNCTIONAL GASTROINTESTINAL DISEASE......Page 1939
Psychiatric Illness in Structural Gastrointestinal Diseases......Page 1940
Psychiatric Illness in Functional Gastrointestinal Diseases......Page 1941
CAUSAL DIRECTIONALITIES IN COMORBIDITY OF GASTROINTESTINAL AND PSYCHIATRIC DISORDERS......Page 1943
CONCLUSIONS AND SUMMARY......Page 1944
Further Reading......Page 1945
BIOPSYCHOSOCIAL MODEL OF IRRITABLE BOWEL SYNDROME......Page 1946
Anxiety and Depression......Page 1947
Cognitive-Behavioral Therapy......Page 1948
Dynamic/Interpersonal Therapy......Page 1949
Further Reading......Page 1950
COMPLICATIONS......Page 1951
Further Reading......Page 1952
INTRODUCTION......Page 1953
ETIOLOGY/PATHOPHYSIOLOGY......Page 1954
DIAGNOSIS......Page 1955
OPERATIVE MANAGEMENT......Page 1956
OUTCOMES AND COMPLICATIONS......Page 1957
Further Reading......Page 1958
COMPLICATIONS......Page 1959
Further Reading......Page 1960
FUNCTION......Page 1961
Further Reading......Page 1962
Percutaneous Gastrostomy......Page 1963
Percutaneous Cholecystostomy......Page 1964
Transjugular Intrahepatic Portosystemic Shunt......Page 1965
Further Reading......Page 1966
Solitary Rectal Ulcer Syndrome......Page 1967
Rectal Prolapse......Page 1968
Stercoral Ulcer......Page 1969
Further Reading......Page 1970
CONTROVERSIES IN DEFINING RECTAL ANATOMY......Page 1971
Further Reading......Page 1972
DIAGNOSIS OF FUNCTIONAL ABDOMINAL PAIN......Page 1973
Abdominal Pain Associated with Symptoms of Upper Abdominal Distress......Page 1974
Abdominal Pain Associated with Symptoms of Altered Bowel Pattern......Page 1975
Isolated Paroxysmal Recurrent Abdominal Pain......Page 1976
Explanation of Suspected Pathophysiology and Natural History......Page 1977
Dietary Modification......Page 1978
Psychological Support......Page 1979
Further Reading......Page 1980
EPIDEMIOLOGY......Page 1981
Further Reading......Page 1982
TREATMENT OF THE ROUX STASIS SYNDROME......Page 1983
Further Reading......Page 1984
DIAGNOSIS......Page 1985
Further Reading......Page 1986
HUMAN SALIVARY GLANDS......Page 1987
Serous Cells......Page 1988
Mucous Cells......Page 1989
Connective Tissue, Vessels, and Nerves......Page 1990
Further Reading......Page 1991
General Concepts of Central and Autonomic Control......Page 1992
Myoepithelial Cells......Page 1993
Calcium Signaling......Page 1994
Muscarinic Cholinergic Stimulation of Fluid Secretion......Page 1995
Molecular Identity of Ion and Water Transport Pathways......Page 1996
Pathways for the Sorting and Release of Secretory Proteins......Page 1997
Further Reading......Page 1998
MICROBIOLOGY......Page 2000
EPIDEMIOLOGY......Page 2001
PATHOGENESIS......Page 2002
Further Reading......Page 2003
SATIETY AND APPETITE AS REGULATORS OF FOOD INTAKE......Page 2004
Cholecystokinin......Page 2005
Nutrient-Related Signals......Page 2006
Melanocortins......Page 2007
SATIETY IN DISEASE......Page 2008
Further Reading......Page 2009
RECEPTOR BIOLOGY......Page 2010
FUNCTIONS......Page 2012
Further Reading......Page 2013
INTRODUCTION......Page 2015
Vagal Afferents......Page 2016
ADEQUATE STIMULUS AND SIGNAL TRANSDUCTION......Page 2017
STIMULUS RESPONSE FUNCTION......Page 2018
Chemotransduction......Page 2019
Promiscuous Chemosensitivity......Page 2020
Further Reading......Page 2021
SYNTHESIS AND METABOLISM......Page 2022
PHARMACOLOGICAL REGULATION......Page 2023
NAUSEA AND VOMITING......Page 2024
Clinical Manifestations......Page 2025
SUMMARY......Page 2026
Further Reading......Page 2027
INTRODUCTION......Page 2028
Giardiasis......Page 2029
Syphilis......Page 2030
Herpes Simplex Virus......Page 2031
Hepatitis B......Page 2032
Further Reading......Page 2033
Immune Response......Page 2034
Preventive......Page 2035
Further Reading......Page 2036
ANATOMIC AND PHYSIOLOGIC FACTORS......Page 2037
Length, Location, and Health of Remnant Bowel......Page 2038
Long-Term Management......Page 2039
Catheter-Related Complications......Page 2040
Other Problems......Page 2041
INTESTINAL REHABILITATION......Page 2042
Further Reading......Page 2043
INTRODUCTION......Page 2044
INTESTINAL PHYSIOLOGY......Page 2045
Enteral Nutrition......Page 2046
Complications......Page 2047
SURGICAL THERAPY AND TRANSPLANTATION......Page 2048
Further Reading......Page 2049
PATIENT PREPARATION......Page 2051
SETTING UP......Page 2052
SIGMOIDOSCOPIC TECHNIQUE......Page 2053
Workup of Minor Rectal Bleeding in Patients Less Than 40 Years of Age......Page 2056
Colonic Symptoms without Bleeding......Page 2057
Chemically Induced Colitis......Page 2058
Recent Myocardial Infarction......Page 2059
Further Reading......Page 2060
ETIOLOGY......Page 2061
Prognosis......Page 2062
Further Reading......Page 2063
PATHOGENESIS......Page 2065
Skin......Page 2067
DIAGNOSIS......Page 2068
Systemic Manifestations......Page 2069
Further Reading......Page 2070
INDICATIONS......Page 2071
TYPES OF TRANSPLANTS......Page 2072
Multivisceral Transplantation......Page 2073
Immunosuppression......Page 2074
Rejection......Page 2075
RESULTS......Page 2076
Further Reading......Page 2077
INTERDIGESTIVE MOTILITY PATTERN......Page 2078
Further Reading......Page 2079
INTRODUCTION......Page 2080
THE INTESTINAL EPITHELIUM......Page 2081
ABSORPTION OF WATER-SOLUBLE MOLECULES......Page 2082
SECRETION......Page 2083
Genetic Defects in Cl- Secretion......Page 2084
Further Reading......Page 2085
Small Intestine, Anatomy......Page 2086
MUSCULARIS EXTERNA......Page 2087
Architecture......Page 2088
Crypt epithelium......Page 2089
PEYER'S PATCHES......Page 2090
Further Reading......Page 2091
PATHOGENESIS......Page 2092
DIAGNOSIS......Page 2093
Primary Small Bowel Lymphomas......Page 2094
Further Reading......Page 2095
EMBRYOLOGY OF THE SMALL INTESTINE......Page 2097
Regional Differentiation in the Small Bowel......Page 2098
Crypt - Villus Axis Morphogenesis......Page 2099
Crypt Stem Cells and Epithelial Cell Differentiation......Page 2100
Further Reading......Page 2101
PEPTIC ULCER DISEASE......Page 2102
GASTROINTESTINAL CANCERS......Page 2103
Further Reading......Page 2104
CLINICAL FEATURES......Page 2105
INVESTIGATIONS......Page 2106
Conservative Treatment......Page 2107
Operative Treatment......Page 2108
SUMMARY......Page 2109
Further Reading......Page 2110
Somatostatin-14 and -28......Page 2111
Intraluminal Stimuli Influence Gastric Somatostatin Release......Page 2112
SOMATOSTATIN RECEPTORS......Page 2113
The SSTR2 Is the Receptor Subtype Predominant in the Stomach......Page 2114
Somatostatin Is the Main Inhibitor of Gastric Acid Secretion......Page 2115
Somatostatin Inhibits Pancreatic Amylase Release through SSTR5 Receptors......Page 2116
Further Reading......Page 2117
DEFINITIONS......Page 2119
ANATOMY, PHYSIOLOGY, AND PATHOPHYSIOLOGY......Page 2120
Clinical Evaluation......Page 2121
Quantitative Hepatobiliary Scintigraphy......Page 2122
Sphincter of Oddi Manometry......Page 2123
Medical Therapy......Page 2124
Endoscopic Therapy......Page 2125
SOD IN RECURRENT PANCREATITIS......Page 2126
SOD IN PATIENTS WITH INTACT GALLBLADDER......Page 2127
SUMMARY......Page 2128
Further Reading......Page 2129
DIVISION OF THE LATERAL INTERNAL ANAL SPHINCTER......Page 2130
Further Reading......Page 2131
ENTERIC NERVOUS CONTROL......Page 2132
Further Reading......Page 2133
INJURY TO THE SPLEEN......Page 2134
MECHANICAL HYPERSPLENISM......Page 2135
Further Reading......Page 2136
Biliary Obstruction Secondary to Stone Disease......Page 2137
STENTING OF THE COLON......Page 2138
Further Reading......Page 2139
ADENOMAS OF THE STOMACH......Page 2140
Clinical Manifestations......Page 2141
Staging......Page 2142
Treatment......Page 2143
Further Reading......Page 2144
Location and Anatomic Divisions......Page 2146
General Appearance......Page 2147
Body and Fundus......Page 2148
Serosa......Page 2149
Further Reading......Page 2150
DISEASE AND ILLNESS......Page 2151
THE MIND/BRAIN GUT CONNECTION......Page 2152
FUNCTIONAL MEDICAL SYMPTOMS AND SYNDROMES......Page 2153
Further Reading......Page 2154
Natural History......Page 2155
Sucralfate......Page 2156
Further Reading......Page 2157
Submucosal Tumors of the Gastrointestinal Tract......Page 2158
Lipoma......Page 2159
Carcinoid Tumor......Page 2160
Stromal Cell Tumor......Page 2161
Extrinsic Compression......Page 2162
Further Reading......Page 2163
INTRODUCTION......Page 2165
GASTROINTESTINAL MOTILITY......Page 2166
GASTROINTESTINAL SECRETION......Page 2167
INTESTINAL INFLAMMATION......Page 2168
CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING......Page 2169
Further Reading......Page 2170
NEUROLOGIC PATHWAYS......Page 2171
Preparatory and Oral Phases......Page 2172
Esophageal Phase......Page 2173
Further Reading......Page 2174
INTRODUCTION......Page 2176
Further Reading......Page 2177
PERIPHERAL ORGANIZATION OF THE TASTE SYSTEM......Page 2178
TASTE RECEPTORS, SIGNAL TRANSDUCTION, AND GUSTATORY PROCESSING......Page 2179
Sour Taste......Page 2180
Signal Transduction and Processing......Page 2181
OLFACTORY RECEPTORS AND SIGNAL TRANSDUCTION......Page 2182
THE VOMERONASAL ORGAN......Page 2183
Further Reading......Page 2184
REGULATION OF TH1 AND TH2 RESPONSES......Page 2185
Allergic Responses and Responses to Parasitic Infection......Page 2187
Intestinal Graft-versus-Host Disease......Page 2188
Further Reading......Page 2189
ETIOLOGY......Page 2190
DIAGNOSTIC PROCEDURES......Page 2191
Further Reading......Page 2192
Cellular Transport and Regulation......Page 2193
Genetic Conditions and Cu Metabolism......Page 2194
Cellular and Systemic Regulation of Zn......Page 2195
Cellular and Systemic Regulation of Mn......Page 2196
Cellular and Systemic Regulation of Se......Page 2197
Further Reading......Page 2198
INTRACELLULAR SIGNALING BY TRANSFORMING GROWTH FACTOR-b......Page 2199
A ROLE FOR TRANSFORMING GROWTH FACTOR-b IN GASTROINTESTINAL CANCER......Page 2200
Further Reading......Page 2201
BACKGROUND......Page 2202
ACUTE REJECTION......Page 2203
CELL PRODUCTS......Page 2204
CHRONIC REJECTION......Page 2206
Further Reading......Page 2207
SCOPE OF THE PROBLEM......Page 2208
Shock......Page 2209
Head Injuries......Page 2210
Further Reading......Page 2211
INCIDENCE......Page 2212
Immunoprophylaxis......Page 2213
Further Reading......Page 2214
BLOOD TREMATODES (SCHISTOSOMES)......Page 2215
INTESTINAL TREMATODES (FASCIOLOPSIS BUSKI, HETEROPHYES HETEROPHYES, AND METAGONIMUS YOKOGAWAI)......Page 2216
Further Reading......Page 2217
PATHOGENESIS OF INFECTION......Page 2219
Further Reading......Page 2220
INTRODUCTION......Page 2222
Nutritional......Page 2223
Micronutrient Deficiencies......Page 2224
Morphological Alterations......Page 2225
Further Reading......Page 2226
SYNTHESIS AND ACTIVATION OF TRYPSIN......Page 2227
Further Reading......Page 2228
Tumor Necrosis Factor-a (TNF-a)......Page 2229
Regulation of TNF-a Messenger RNA Stability......Page 2230
TNF-a IN HUMAN DISEASE......Page 2231
Further Reading......Page 2232
EPIDEMIOLOGY AND GENETICS......Page 2233
PATHOPHYSIOLOGY......Page 2234
Dietary Restriction and Liver Transplantation......Page 2235
Further Reading......Page 2236
GASTROINTESTINAL TRACT......Page 2237
THE LIVER......Page 2238
FOCAL LESIONS......Page 2241
BILIARY TREE......Page 2244
PANCREAS......Page 2246
NEW METHODS......Page 2248
CONCLUSIONS......Page 2249
Further Reading......Page 2250
APPROACH TO THE PATIENT......Page 2251
RISK ASSESSMENT......Page 2253
ENDOSCOPIC HEMOSTASIS......Page 2254
Endoscopic Hemostatic Methods......Page 2255
Angiographic Therapy......Page 2256
Curing the Ulcer Disease......Page 2257
SUMMARY......Page 2258
Further Reading......Page 2259
TYPES OF UPPER GASTROINTESTINAL ENDOSCOPES......Page 2260
Indications for Upper Gastrointestinal Endoscopy......Page 2261
Examination of the Esophagus......Page 2262
Examination of the Duodenum......Page 2263
The Technique of Therapeutic Upper Endoscopy......Page 2264
Achalasia......Page 2265
Further Reading......Page 2266
MOTOR INNERVATION......Page 2267
SENSORY INNERVATION......Page 2268
BEHAVIORAL CONSIDERATIONS AND SENSATION......Page 2269
Further Reading......Page 2270
Variceal Bleeding......Page 2271
PREDICTION OF VARICEAL HEMORRHAGE......Page 2272
Pharmacologic Therapy......Page 2273
MANAGEMENT OF ACUTE VARICEAL HEMORRHAGE......Page 2275
Somatostatin, Octreotide, and Vapreotide......Page 2276
Surgical Therapy......Page 2277
Pharmacologic Therapy......Page 2278
Surgical Therapy......Page 2279
COST-COMPARISON OF AVAILABLE THERAPIES......Page 2280
Further Reading......Page 2281
Pathology......Page 2282
Diagnosis......Page 2283
Pathology......Page 2284
Clinical Presentation......Page 2285
Clinical Presentation......Page 2286
Further Reading......Page 2287
Epidemiology and Pathogenesis......Page 2288
Treatment......Page 2289
KAPOSIFORM HEMANGIOENDOTHELIOMAS......Page 2290
Venous Malformations......Page 2291
Complex Combined Vascular Malformations......Page 2293
Further Reading......Page 2294
ETIOLOGY AND PATHOGENESIS......Page 2295
Neurologic......Page 2297
THERAPY AND PROGNOSIS......Page 2298
Further Reading......Page 2299
Vasoactive Intestinal Peptide (VIP)......Page 2300
VPAC1......Page 2301
Distribution......Page 2302
Stimulation of Secretion......Page 2303
Effects on Cellular Growth and Differentiation......Page 2304
VIP Scanning......Page 2305
Further Reading......Page 2306
CLINICAL FEATURES......Page 2307
Further Reading......Page 2308
CT TECHNIQUE......Page 2309
ADVANTAGES OF CT COLONOGRAPHY......Page 2310
Further Reading......Page 2311
Plant Sources......Page 2313
Extraintestinal Metabolism......Page 2314
Further Reading......Page 2315
Intrinsic Factor......Page 2316
Intestinal Parietal Transport......Page 2317
Intracellular Metabolism......Page 2318
Bacterial Overgrowth......Page 2319
TREATMENT OF VITAMIN B12 DEFICIENCY......Page 2320
Further Reading......Page 2321
METABOLISM......Page 2322
DEFICIENCY......Page 2323
Further Reading......Page 2324
Treatment......Page 2325
COLONIC VOLVULUS......Page 2326
Treatment and Outcome......Page 2327
Further Reading......Page 2328
Intestinal Thiamine Absorption......Page 2329
Regulation of Intestinal Riboflavin Uptake......Page 2330
Metabolic Role and Deficiency......Page 2331
Molecular Identity of Ascorbic Acid Transport System(s)......Page 2332
Regulation of Intestinal Biotin Uptake......Page 2333
Molecular Identity of the Intestinal Folate Transport System......Page 2334
Further Reading......Page 2335
Congenital Esophageal Webs......Page 2336
ANTRAL WEBS......Page 2337
Further Reading......Page 2338
ETIOLOGY, CLINICAL FEATURES, AND DIAGNOSIS......Page 2339
Further Reading......Page 2340
DIAGNOSIS......Page 2341
TREATMENT......Page 2343
PROGNOSIS......Page 2344
Further Reading......Page 2345
EXOGENOUS AND SYSTEMIC SOURCES OF SALIVARY PATHOLOGY......Page 2346
Further Reading......Page 2347
EPIDEMIOLOGY......Page 2348
Further Reading......Page 2349
DIAGNOSIS......Page 2350
TREATMENT......Page 2351
Further Reading......Page 2352
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