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At least 199 records · Page 11Linked to original sources
PubMed2000

Role of sucralfate in gastrointestinal diseases.

Sucralfate is a cytoprotective drug widely used in clinical practice to prevent or treat several gastrointestinal diseases such as gastro-esophageal reflux, gastritis, peptic ulcer, stress ulcer and dyspepsia. Sucralfate is a safe and well tolerated drug, as demonstrated by the quite complete lack of side effects and it is, for this reason, one of the most important therapeutic choices in the management of acid related diseases during pregnancy. Moreover, sucralfate has recently been shown to be useful in non-acid related gastrointestinal disease as well. In fact, sucralfate has also been administered topically in patients with radiation-induced mucosal procto-sigmoiditis or ulcerative colitis with surprising results. The drug is actually able to form a physical barrier between epithelium and damaging agents (-bile salts, drugs, refluxate...). Moreover, sucralfate increases the local levels of fibroblast growth factors and induces a rise in the mucosal concentration of prostaglandins which are considered important factors in mucosal healing. The aim of this paper is to describe the current and probably forthcoming uses of sucralfate in the field of gastrointestinal disorders. Moreover, we investigate the role of sucralfate as a reliable means to prevent the occurrence of reflux-like symptoms after Helicobacter pylori eradication and in the management of Helicobacter pylori negative patients affected by non-ulcer dyspepsia.

Anti-Ulcer Agents↗
PubMed2002

Acquired inhibitors to coagulation factors in patients with gastrointestinal diseases.

OBJECTIVES: To study the frequency and specificity of acquired coagulation inhibitors in inflammatory and malignant gastrointestinal diseases. METHODS: In a 10-year period, 511 patients from the island of Crete in Greece were studied, 302 with ulcerative colitis, 112 with Crohn's disease, 82 with gastrointestinal carcinoma and 15 with gastrointestinal lymphoma. Prothrombin time and activated partial thromboplastin time were measured by routine methods. When prothrombin time and/or activated partial thromboplastin time were found to be prolonged, mixture experiments with 25%, 50% and 75% pooled normal human plasma were performed. If clotting times were inadequately corrected, the presence of an acquired inhibitor against a coagulation factor was suggested. Specific coagulation factor assays were then performed with deficient plasmas. RESULTS: Fifteen patients acquired inhibitors to the following coagulation factors within the 10-year observation period: factor IX (four patients); factor X (three patients); factor XII (three patients); factor VIII (two patients); factor XI (two patients); and factor V (one patient). The activity of the above factors varied from < 1% to 10%. Five patients with ulcerative colitis, six with Crohn's disease, two with gastrointestinal lymphoma and two with gastrointestinal carcinoma developed an inhibitor. Only one patient with factor VIII inhibitor presented with severe bleeding and was treated with recombinant human activated factor VII, while the others had no complications. Remission was obtained in all patients after immunosuppressive therapy, chemotherapy or tumour resection. CONCLUSION: An increased incidence of coagulation factor inhibitors was found in patients with gastrointestinal inflammatory and malignant diseases compared to the healthy population. In addition, an increased incidence of these inhibitors was also found in the common population of Crete compared to that found in other areas.

Adolescent↗
PubMed1985

Interactions between food antigens and the immune system in the pathogenesis of gastrointestinal diseases.

This review details the evidence that interactions between food antigens and the immune system may play a role in the pathogenesis of several gastrointestinal diseases. In immediate hypersensitivity reactions to foods involving the gastrointestinal system, in milk-induced gastrointestinal disease in infants and children, and in some forms of hypereosinophilic gastroenteritis, the evidence for the participation of food antigens is extensive. Gluten-induced enteropathy and some forms of dermatitis herpetiformis are also induced by defined food proteins where the response is specific and characteristic. The role of food antigens in the pathogenesis of inflammatory bowel disease is unclear, and warrants further studies.

Animals↗
PubMed2000

Pros and cons of barium-impregnated polyethylene spheres in gastrointestinal disease.

Barium-impregnated polyethylene spheres are an alternative contrast agent for radiographic studies of the gastrointestinal tract. The spheres are a practical, efficient, and relatively inexpensive way to diagnose a number of relatively common gastrointestinal conditions. They are most useful in the diagnosis of chronic conditions. Radiographic interpretation relies on a thorough understanding of the pathophysiology of gastrointestinal disease and how various disease states influence gastrointestinal function.

Animals↗
PubMed1992

Immunopathophysiology of gastrointestinal disease in HIV infection.

In summary, gastrointestinal manifestations are a major complication of HIV infection. These manifestations present clinically as early, intermediate, and late-phase enteric illness due to HIV itself or the acquisition of opportunistic infections and neoplasms. HIV-induced defects in lymphocytes and mononuclear phagocytes, which circulate through and populate the gastrointestinal mucosa, and a sequence of HIV-dependent alterations in mucosal integrity represent the fundamental immunopathophysiologic basis for these clinical manifestations.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Mechanisms of disease: nicotine--a review of its actions in the context of gastrointestinal disease.

Smoking tobacco is associated with a number of gastrointestinal disorders. In some, such as Crohn's disease and peptic ulcer disease, it increases the risk of disease and has a detrimental effect on their course. In others, such as ulcerative colitis, it decreases the risk of disease and can have a favorable effect on disease course and severity. In the eighteenth and nineteenth centuries, nicotine was used as a 'panacea' for various ailments, including abdominal symptoms--it is now under investigation to elucidate its role in gastrointestinal diseases that are associated with smoking. The actions of nicotine are complex; it is likely that its effects on the central nervous system, gastrointestinal tract and immune system interact with other risk factors, such as genetic susceptibility, to influence disease outcomes. This review focuses on the mechanisms of action of nicotine that might be relevant in gastrointestinal disease.

Gastrointestinal Diseases↗
PubMed1982

Clinicopathological studies of gastrointestinal disease in macaques.

Evaluation of mortality during a two-year period at a primate colony indicated that 34% of nonexperimental deaths in macaques one year of age and older were due to gastrointestinal disease. Of deaths related to gastrointestinal disease, 12% had acute gastric dilatation, 18% had shigellosis, 12% had nontuberculous mycobacterial disease, and 58% were of undetermined cause. Histologic evaluation of the alimentary tract indicated that the large intestine was the most common site of anatomical change in monkeys that had diarrhea at the time of death. Monkeys that had a single terminal episode of diarrhea had less gastric inflammatory lesions than those that had multiple episodes of diarrhea in the last year of life.

Animals↗
PubMed1982

Clinicopathological studies of gastrointestinal disease in macaques.

Evaluation of mortality during a two-year period at a primate colony indicated that 34% of nonexperimental deaths in macaques one year of age and older were due to gastrointestinal disease. Of deaths related to gastrointestinal disease, 12% had acute gastric dilatation, 18% had shigellosis, 12% had nontuberculous mycobacterial disease, and 58% were of undetermined cause. Histologic evaluation of the alimentary tract indicated that the large intestine was the most common site of anatomical change in monkeys that had diarrhea at the time of death. Monkeys that had a single terminal episode of diarrhea had less gastric inflammatory lesions than those that had multiple episodes of diarrhea in the last year of life.

Animals↗
PubMed1985

Extra intestinal influences on exhaled breath hydrogen measurements during the investigation of gastrointestinal disease.

During the clinical investigation of patients with gastrointestinal disease by exhaled breath hydrogen measurement, the occurrence of inexplicable variations in recorded hydrogen values led to a search for extra intestinal factors which were capable of adversely influencing breath hydrogen concentration and impairing the diagnostic accuracy of the test. Serial breath samples were collected from normal subjects under a variety of conditions which might occur during routine clinical study, including, hyperventilation, exercise, cigarette smoking, and carbohydrate ingestion. Breath hydrogen concentrations were consistently reduced by hyperventilation (p less than 0.01) and exercise (p less than 0.05). Cigarette smoking, in contrast, caused a marked rise in measured breath hydrogen (p less than 0.01), as did oral carbohydrate (p less than 0.05). Prior bactericidal mouthwash abolished this carbohydrate associated rise, suggesting that the hydrogen was the result of fermentation by oropharyngeal bacteria. Because, in all instances, the changes in breath hydrogen were of sufficient magnitude to interfere with data interpretation, it is recommended that these factors are eliminated, whenever possible, from conditions of study.

Bacteria, Anaerobic↗
PubMed2006

Polyphenols and gastrointestinal diseases.

PURPOSE OF REVIEW: This article will review the role of polyphenols in gastrointestinal diseases. Ingested polyphenols are concentrated in the gastrointestinal tract and are not well absorbed into the rest of the body. Thus, the high luminal concentrations achieved support a potential for therapeutic uses in the gastrointestinal tract. Additionally, there is great interest from the general public in complementary and alternative medicine. RECENT FINDINGS: Dietary polyphenols are a major source of antioxidants consumed by humans. Polyphenols possess not only antioxidant properties but also antiviral, antibacterial, antiinflammatory and anticarcinogenic effects, as well as the ability to modulate certain signaling pathways such as nuclear factor-kappaB activation. Green tea polyphenols have been shown to have efficacy in various models of inflammatory bowel disease. Silymarin, or milk thistle, is hepatoprotective against many forms of experimental liver injury and is widely used in human liver diseases, such as hepatitis C and alcoholic cirrhosis, with an excellent safety profile (but with unclear efficacy). SUMMARY: Substantial in-vitro and animal studies support the beneficial effects of polyphenols in many gastrointestinal diseases. Well designed multicenter trials in humans, such as those called for in the 2005 National Institutes of Health Requests for Applications for Silymarin Centers, will be critical for defining the safety, appropriate dosing and therapeutic efficacy of such agents.

Animals↗
PubMed1987

Comparison of CA-50, a new tumour marker, with carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) in patients with gastrointestinal diseases.

Serum levels were determined in 434 patients with benign and malignant gastrointestinal diseases and compared with the serum concentrations of carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP). The highest proportion of elevated CA-50 levels (greater than 17 U ml-1) was found in patients with pancreatic cancer (73%). High levels were mainly associated with advanced cancer, but also half of the patients with a resectable pancreatic tumour had an increased CA-50 concentration. The CA-50 level was elevated in 37-58% of patients with colorectal, gastric, hepatocellular and biliary tract cancers. In all gastrointestinal cancers, CA-50 gave additional information compared with CEA and AFP, except in hepatocellular carcinoma where AFP was the best marker.

Antigens, Neoplasm↗
PubMed1999

[Gastrointestinal disease with elevated plasma homocysteine level].

Elevated plasma homocystein (tHcy) is a marker for functional deficiency of folate and/or cobalamin. Malabsorption of these vitamins occurs in various gastroenterologic diseases. A frequent mutation (C677T) in the gene coding for the enzyme methyltetrahydrofolate reductase (MTHFR) is often associated with elevated values of tHcy. We have investigated 24 patients with tHcy > 40 mumol/l for gastrointestinal disease that can contribute to such elevation. Of these, 19 were homozygous for mutated MTHFR, four were heterozygous and one was normal. We found two cases of probable celiac disease, one case of Crohn's disease and one case of ulcerative colitis. These four were homozygous for the C667T mutation. Furthermore, we found eight persons who were anacidic; four homozygous, three heterozygous and one normal. All had gastritis histologically, six had serum gastrin > 50 pmol/l, and four were already on treatment with cobalamin injections. Helicobacter pylori-infection was found in nine out of 22 persons. Gastrointestinal disease occurs frequently in patients with tHcy > 40 mumol/l, but with the exception of conditions resulting in serious deficiency of cobalamin, these diseases alone do not seem sufficient to cause such high levels. We suggest that a reasonable approach to patients with homocystein values above 40 mumol/l is to exclude cobalamin deficiency, and that further investigations should be based upon thorough anamnesis and symptoms.

Biomarkers↗
PubMed2003

Prevalence of Tropheryma whipplei DNA in patients with various gastrointestinal diseases and in healthy controls.

BACKGROUND: Little is known about the epidemiology of Tropheryma whipplei and its prevalence in people without clinical signs of Whipple's disease. PATIENTS AND METHODS: We screened 239 patients with various gastrointestinal diseases for T. whipplei DNA and compared them with 215 healthy controls in order to check whether T. whipplei might be a risk factor for common gastrointestinal problems or diseases. We detected the 16S rDNA of T. whipplei in salivary and stool samples using a specific seminested PCR. RESULTS: The prevalence of T. whipplei DNA in patients and in controls was 4.2% (95% CI 2.0-7.6% ) and 7.0% (95% CI 4.0-11.3%), respectively. None of the different gastrointestinal diseases was associated with a higher rate of PCR-positive tests, except for the group of patients with reflux syndrome. Five out of 43 patients with reflux were found to be positive, with all five being positive in the salivary sample. This is in contrast to our findings in carriers without reflux with mainly positive stool samples (p < 0.01). CONCLUSION: We conclude that the asymptomatic carrier state of T. whipplei indeed exists and that it is much more frequent than the rare Whipple's disease. The higher prevalence of T. whipplei DNA in the saliva of patients with reflux syndrome suggests that the stomach might be the habitat of the organism.

Actinomycetales↗
PubMedDate not supplied

Common laboratory and diagnostic testing in patients with gastrointestinal disease.

Evaluating patients with gastrointestinal (GI) illness involves the use of many different diagnostic modalities, including laboratory studies, diagnostic imaging, and endoscopy. Rapid advances in all three areas have provided clinicians with a wide array of testing at their fingertips. The frequent challenge in evaluating a patient is deciding which testing will lead to a diagnosis in the most direct and efficient manner. This article reviews many of the tests that are considered in the evaluation of individuals with complaints referable to the GI tract.

Angiography↗
PubMed2005

Why do complications of gastrointestinal disease and procedures come as serial rather than singular events?

BACKGROUND: It often appears as if complications arising from gastrointestinal disease and interventional procedures come in 'series' and 'cluster' in individual patients. AIM: The aim of this study was to analyse the clustering of complications in terms of stochastic modelling and Markov chains. METHODS: A patient with gastrointestinal disease is simulated to move along either a 'bad track' associated with multiple consecutive complications or a 'good track' free of complications, the transitions within each track and between the two tracks being governed by probability values. RESULTS: Because the occurrence of a single complication increases the risk of further complications, subjects who encounter their first complication are more likely to experience a second, third or even more complications, before they leave the 'bad track' and their personal chain of cascading complications becomes discontinued. The model of a Markov chain explains why the overall number of complications in the total population of patients with digestive disease remains low even if individual patients are expected to encounter more than a single complication. CONCLUSIONS: Published complication rates for gastrointestinal procedures underestimate the true risk to the patient, because they do not consider the added vulnerability to cascading complications after the first event.

Cluster Analysis↗
PubMed1987

Serum elastase 1 in inflammatory pancreatic and gastrointestinal diseases and in renal insufficiency. A comparison with other serum pancreatic enzymes.

Serum elastase 1 has been evaluated in 115 patients with pancreatic and nonpancreatic gastrointestinal diseases and in 36 healthy controls. Increased serum elastase 1 values were found in all 27 patients with acute pancreatitis. If the diagnostic cutoff was established as the 2-fold increase above the upper normal range, sensitivity of elastase 1 (100%) was superior to pancreatic lipase (90%), immunoreactive trypsin (87%) and pancreatic amylase (78%). Specificity was 96% for elastase 1 at this cutoff. No distinction was possible between edematous and necrotizing acute pancreatitis on the basis of peak serum elastase 1 concentrations. Among 32 patients with chronic pancreatitis increased serum elastase 1 values were found in 22% and decreased values in 16% of patients, showing a striking parallelism to serum values of pancreatic lipase and immunoreactive trypsin. Specificity, established in controls and 49 patients with different gastrointestinal diseases, was 77% for elastase 1, 76% for immunoreactive trypsin, 83% for pancreatic lipase and 91% for pancreatic amylase. In addition, we investigated 21 patients with severe chronic renal diseases. In patients with renal insufficiency elastase was increased in 33%, comparable to the frequency of increased amylase and pancreatic amylase serum levels, whereas immunoreactive trypsin was increased in 95%. Immunoreactive trypsin showed a significant correlation to creatinin serum concentration, whereas the other enzymes did not.

Acute Disease↗
PubMed1993

[The role of free radical scavengers in gastrointestinal diseases].

Be it ever so complex the natural antioxidant scavenger system of the organism, the protection provided by it seems to be inappropriate in certain diseases of the gastrointestinal mucus membrane, such as chronic inflammation, immune- and malignant diseases of the bowel. Despite the wide range of therapeutic attempts, the treatment of these diseases has not yet been solved, and the anti-inflammatory-, immunomodulatory-, cytostatic drugs currently used, have several side effects. Therefore, the so called natural- and synthetic antioxidants have been more widely employed for additional and adjuvant treatment. It also has become clear that the direct free radical scavenging effect and/or the membrane protection play an important role in the action mechanism of several old-established drugs. The recent report lists those natural and synthetic antioxidants which have been successfully employed in the clinical treatment of bowel diseases. Among the natural antioxidants, a protective effect of vitamins A, C and E have been demonstrated in the treatment of gastroduodenal ulcer and gastric cancer. Among the synthetic antioxidants, 5-amino-salicylic acid was the most effective drug in the treatment of chronic inflammations of the bowel. With getting the more precise knowledge about details of free radical reactions and with clearing up their role in pathological processes, it is possible to develop new and effective synthetic antioxidants, and widely employ them therapeutically.

Aminosalicylic Acids↗
PubMed1991

Special diagnostic and therapeutic considerations in elderly patients with upper gastrointestinal disease.

Special diagnostic and therapeutic considerations apply to older patients with upper gastrointestinal disease. Age-related anatomical and physiologic changes occur in the major organ systems, affecting functions as diverse as swallowing and hepatic and renal clearance of therapeutic drugs. Because of these factors, and because older patients are more likely to be receiving multiple drugs for concomitant illness, they are more prone to drug-drug interactions and to medication-induced injury of the esophagus and stomach. In addition, several gastrointestinal disorders, notably gastroesophageal reflux and peptic ulcer disease, are commonly seen in the elderly. This report reviews those age-related system changes that affect the gastrointestinal tract, and also reviews the esophageal and gastric disorders that are common and/or particularly problematic in the elderly. Diagnostic techniques to evaluate gastrointestinal disease in older patients and approaches to therapy for this population are described as well.

Aged↗