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At least 631 records · Page 35Linked to original sources
PubMed1995

Role of Helicobacter pylori in gastrointestinal disease: implications for primary care of a revolution in management of dyspepsia.

The majority of patients with dyspepsia are managed in general practice. However, most of the literature on Helicobacter pylori and its association with gastrointestinal disease has originated from secondary care. This review summarizes the role of H pylori in dyspepsia from the perspective of primary care and suggests a new strategy for the management of dyspeptic patients in this setting. Recent meta-analyses and consensus statements have supported the use of eradication therapy as first-line treatment of peptic ulceration. Studies from primary care have supported the use of eradication therapy in patients who have H pylori related peptic ulcer disease and require long-term H2-antagonist medication, on both clinical benefit and cost-effectiveness grounds. Of the many regimens proposed for the eradication of H pylori, the best evidence supports a triple combination of bismuth, metronidazole and tetracycline. Regimens using proton pump inhibitors may be more acceptable to patients but lack good evidence from trials. Use of a positive serum enzyme-linked immunoabsorbent assay for H pylori antibodies as a criterion for endoscopic investigation has been shown to result in a 23% reduction in endoscopic workload. Further research should answer questions of importance to general practitioners, such as the role of eradication therapy in patients with nonulcer dyspepsia and the effectiveness of eradication of H pylori in the prevention of gastric cancer.

Dyspepsia↗
PubMed1981

[Neuro-psychiatric aspects of gastrointestinal disease (author's transl)].

On principle one has to distinguish between inflammatory (infectious) and non-inflammatory intestinal diseases. These may affect merely certain parts of the gastrointestinal tract or influence the entire digestive system. Leading symptoms of all these diseases are disturbances of intestinal motility and of secretion, both causing diarrhoea or, rarely, constipation. The clinical picture can be acute or chronic. Acute manifestations, especially with high temperatures, include various florid psychopathological phenomena of an exogenous type of reaction. Chronic diseases of the gastrointestinal system do not show the above-mentioned picture. Very rarely encephalopathy causes organic psychosyndromes. Neurological findings point to lesions of the peripheral nerves (polyneuropathy), funicular defects within the spinal cord (funicular myelitis) and, very rarely, to encephalopathy. Syndromes of polyneuritis can be seen in acute, as well as in chronic enteropathies. Spinal lesions are only found in cases with chronic gastro-intestinal disease. With the exception of funicular myelosis in genuine pernicious anaemia (here parenteral substitution with vitamin B 12 is the therapy of choice) -- all gastroenterogenous neurological signs are only minimally accounted for by disturbances of B 1 and B 12 absorption. These substances should be used only in combination with other agents combating the basic disease.

Diagnosis, Differential↗
PubMed1999

Mesenchymal tumors of the gastrointestinal tract: a paradise for acronyms (STUMP, GIST, GANT, and now GIPACT), implication of c-kit in genesis, and yet another of the many emerging roles of the interstitial cell of Cajal in the pathogenesis of gastrointestinal diseases?

This commentary addresses the nature of interstitial cells of Cajal (which can now be conveniently demonstrated by immunostaining for c-kit) and their possible role in the genesis of various motility disorders of the gastrointestinal tract. The evolution of the concept on the nature of gastrointestinal stromal tumors is discussed, with emphasis on the recent finding of a very high frequency of c-kit immunoreactivity in these tumors, suggesting that they might exhibit differentiation toward interstitial cells of Cajal. The practical immunohistochemical applications of antibodies to c-kit in diagnostic pathology are also discussed.

Adolescent↗
PubMed1989

Drug absorption in gastrointestinal disease and surgery.

It is well recognized that drug absorption from the gastrointestinal tract is influenced by gastric and intestinal motility, surface area available for absorption, and physicochemical properties of the drug. Disease and surgery have been shown to alter these factors. Consequently, drug absorption can be altered as well, and these affect drug therapy. Apparently this effect is variable, but the variability may be due in part to the complexities of performing studies in this area. For example, many patient factors as well as drug characteristics must be considered. In addition, appropriate interpretation of results requires that intravenous data be collected if changes in absorption are based on bioavailability. At this time, the alterations in drug absorption due to gastrointestinal disease and surgery are of unknown or little clinical significance; nevertheless, clinicians should be aware that the possibility of malabsorption exists and anticipate any monitoring of or alterations in therapy that may have to be made.

Celiac Disease↗