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PubMed1981

[Endotoxins and the pathogenesis of gastrointestinal diseases (author's transl)].

Endotoxins are constituents of the capsules of intestinal gram-negative Flora. Under pathological conditions with limited clarification function of the liver RES (alcoholic hepatitis, severe virus hepatitis, cholestasis, cirrhosis of the liver) they do reach the systemic circulation. If the colon is primarily diseased (ulcerative colitis, Crohn's disease) or secondarily damaged (edema of the colonic wall in acute pancreatitis) they pass through the wall into the peritoneal cavity and from there into the systemic circulation (endotoxemia). Attention to the endotoxemias can explain a number of systemic complications which often determine the clinical course of the diseases named. A basis is also created for seeking an effective form of therapy.

Acute Disease↗
PubMed1978

[Enteric hyperoxaluria. I. Intestinal oxalate absorption in gastrointestinal diseases (author's transl)].

Oxalate-urolithiasis and hyperoxalaria have been reported to be a frequent complication in patients with small bowel disease, especially in patients with ileal resection due to Crohn's disease. Hyperabsorption of oxalate seems to be the main patholgenetic factor for "enteric" hyperoxalaria. Intestinal absorption and urinary excretion of oxalate was measured in patients with various gastrointestinal diseases after oral or rectal administration of 14C-oxalate. Kinetic data suggest that 14C-oxalate is absorbed in the small, the large bowel and the rectum as well. Oxalate absorption was decreased in patients with a colectomy and in active ulcerative colitis, but increased in patients with ileal resection, chronic liver disease, and steatorrhea due to chronic pancratitis or sprue. There existed a positive correlation between 14C-oxalate absorption and the amount of fecal fat excretion. The data suggest that hyperoxaluria and hyperabsorption of oxalate are not a specific finding in patients with bile acid malabsorption, but may occur too, in steatorrhea without alteration of bile acid metabolism.

Celiac Disease↗
PubMed1994

Role of endoscopic ultrasonography in diagnosis, staging, and outcome of gastrointestinal diseases.

Using endoscopic ultrasound imaging, highly accurate gastrointestinal tumor characterization and staging is now possible without surgery. Precise endosonographic preoperative staging allows use of the TNM pathological staging system to stratify treatment for esophageal, gastric, rectal, and pancreatobiliary tumors. Endoscopic ultrasonography often establishes a diagnosis in malignant and, in certain patients, benign disease; accurately evaluates anastomoses for recurrent tumor; and characterizes submucosal masses. When histology is required, endoscopic ultrasonography has a critical role in defining an abnormal area for deep submucosal biopsy from the gastrointestinal lumen. Endoscopic ultrasonography is unsurpassed in determining resectability of gastrointestinal neoplasms. It can be used to monitor treatment of downstaged tumors prior to attempted resection. Using endoscopic ultrasonography for earlier diagnosis and precise staging will significantly improve the clinical outcome of patients with gastrointestinal disease as significant advances both in surgical techniques and in combined chemotherapy and radiotherapy continue to be made and applied selectively.

Digestive System Diseases↗
PubMed2002

Experimental analysis of eosinophil-associated gastrointestinal diseases.

Eosinophil infiltration into the gastrointestinal tract occurs in a wide range of diseases. However, the underlying cellular and molecular mechanisms involved in eosinophil migration and the role of eosinophils in disease pathogenesis are largely unknown. Recent studies using experimental models of eosinophil-associated gastrointestinal allergy have revealed differential roles for IL-5 and eotaxin in the modulation of eosinophil accumulation into various regions of the gastrointestinal tract. Furthermore, such studies have revealed a possible role for eosinophils in the pathogenesis of gastrointestinal disorders. The present review describes the clinical manifestations of various eosinophil-associated gastrointestinal disorders and the current understanding of the role of IL-5 and eotaxin in the allergic inflammatory response, and the participation of the eosinophilic granulocyte in the expression of disease.

Animals↗
PubMedDate not supplied

The diagnostic value of scoring models for organic and non-organic gastrointestinal disease, including the irritable-bowel syndrome.

Scoring models based on history and physical examination have been developed to discriminate patients with non-organic gastrointestinal disease from those who have organic disease. The application of these models may lead to more efficient diagnosis and prevent somatization. Although the models have high diagnostic accuracy in the population in which they have been developed, their value in other populations has not been established. In this study previously developed models were tested in validation populations defined by the original selection criteria from the studies in which the models were developed and in unselected general practice and outpatient populations. The diagnostic performance of the models are expressed in terms of odds ratio and sensitivity and specificity for the classification of patients as having organic and non-organic disease. The diagnostic performance of all the models were rather low in the validation populations. Relatively few elements of the models had independent diagnostic value. In addition, the correlation between the scoring models, expressed in Cohen's kappa, was extremely low. The diagnostic values of the scoring models were not reproduced in comparable and unselected populations. Therefore, it is concluded that the diagnostic value of such a model has little external validity.

Adolescent↗
PubMed2001

The role of H pylori in gastrointestinal disease. A guide to identification and eradication.

Helicobacter pylori, which is responsible for the most common infection worldwide, has been implicated in several gastrointestinal diseases, such as peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma. In this article, Dr Knigge discusses the unique adaptation of H pylori to the acidic gastric environment and describes diagnostic tests to identify the organism, treatment recommendations, and tools to confirm eradication of infection.

Gastrointestinal Diseases↗
PubMed1997

Quantitative systemic and local evaluation of the antiviral effect of ganciclovir and foscarnet induction treatment on human cytomegalovirus gastrointestinal disease of patients with AIDS. Italian Foscarnet GID Study Group.

In a group of 29 AIDS patients with biopsy-proven human cytomegalovirus (HCMV) gastrointestinal disease (GID), HCMV GID was shown to correlate mostly with systemic HCMV infection. The antiviral induction treatment (IT) with either ganciclovir (GCV) or foscarnet (PFA) caused a significant reduction in the level of HCMV antigenemia, viremia and leukoDNAemia, and a complete virus clearance or a sharp drop of viral load in the blood of 13/13 patients and in the gastrointestinal (GI) mucosa of 12/13 (92%) patients in the GCV arm, and in the blood of 13/14 (93%) patients and in the GI mucosa of 10/12 (83%) patients in the PFA arm of the study, respectively. Similarly, the clinical response was good in 13/15 (87%) patients in the GCV arm and in 13/14 (93%) patients in the PFA arm. In addition, the finding that 2/6 patients positive for HCMV isolated from both GI mucosa and blood prior to IT were still positive in the GI tract after IT, suggested that IT could be prolonged to clear the virus from GI tract. In conclusion, both GCV and PFA showed a remarkable systemic and local antiviral effect in the treatment of HCMV GID in AIDS patients.

AIDS-Related Opportunistic Infections↗
PubMed2002

Gastrointestinal diseases and halitosis: association of gastric Helicobacter pylori infection.

The relationship between gastrointestinal conditions and halitosis is discussed. Few reports have suggested that gastrointestinal diseases may cause halitosis. H. pylori infection, which causes gastric ulcers, is considered as a possible cause for halitosis. Intensity of malodour of mouth air was found to be higher in H. pylori-positive patients than in negative patients. The levels of hydrogen sulphide and dimethyl sulphide in mouth air were also significantly higher in the positive patients than in the negative patients (P<0.05). When odour strength in exhaled breath was compared between the two groups, no significant difference was found. Hence, H. pylori infection might not cause a systemic condition producing breath odour. Although there were no significant differences in periodontal parameters or tongue coating between the positive and negative groups, H. pylori may be a frequent contributor to the production of malodour even though its role had not been suspected before. Further study would be necessary to clarify the reason for the increase of volatile sulphur compounds (VSCs) level in H. pylori infection.

Adult↗
PubMed1988

Exploratory celiotomy for gastrointestinal disease in neonatal foals: a review of 20 cases.

The medical records of 20 neonatal foals in which exploratory celiotomies were performed for gastrointestinal disease were reviewed. In all 20 foals, persistent pain and/or progressive abdominal distension were the primary clinical findings influencing the decision to operate. However, ancilliary laboratory data were important to the proper medical management of these foals during anaesthesia and following surgery. Surgical diagnoses of the 20 foals included ileus (nine foals; 45 per cent), small colon obstruction (five foals; 25 per cent), large colon displacement (three foals; 15 per cent), small intestinal displacement (two foals; 10 per cent), and perforated gastric ulcer (one foal; 5 per cent). Seventeen foals were recovered from anaesthesia, 13 of these were discharged from the hospital, seven were alive six months or more following discharge. Sepsis was the cause of death in six of the 10 foals that died following recovery.

Animals↗