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At least 775 records · Page 43Linked to original sources
PubMed1994

Uptake of antigens: role in gastrointestinal disease.

The intestine is exposed to a wide variety of macromolecules. Because macromolecules are antigenic, mechanisms have evolved in the gastrointestinal tract to regulate their absorption. Macromolecular uptake can be beneficial in delivering essential factors for growth and in sampling the antigenic milieu of the gastrointestinal tract. Specific transport mechanisms exist to execute this physiological absorption. However, inappropriate and uncontrolled antigen transport may occur in disease states, or as a prelude to disease states in the gastrointestinal tract. Such transport may result in immune responses that are harmful. In this review we examine both physiological transport of macromolecules through epithelia and through M cells. We also discuss uncontrolled transport and its relation to disease states. We conclude by examining the interrelationship between antigen transport and an altered immune system in the establishment of gastrointestinal disease.

Animals↗
PubMed1981

Nutritional support in gastrointestinal disease.

Nutritional support is capable of spontaneously healing many gastrointestinal fistulas, particularly if the fistula arises from bowel that is not involved with inflammatory bowel disease or a malignant growth. The choice of either enteral or parenteral nutrition can be used in the treatment of any fistula, the use of enteral nutrition should be more selective. It is recommended that enteral therapy for an upper gastrointestinal fistula be carried out by distal infusion of the diet by either tube or operative jejunostomy. Infusion of the diet distal to the site of the fistula should not increase drainage of the fistula. If drainage does increase in response to enteral feeding, then enteral therapy should be discontinued, and parenteral therapy should be started. Similarly, a fistula of the ileum or colon may also be treated with enteral therapy into the proximal bowel as long as sufficient length of normal bowel exists to absorb the diet proximal to the fistula.

Colitis, Ulcerative↗
PubMed1973

Duodenoscopy in the diagnosis of upper gastrointestinal disease.

Duodenoscopy was undertaken in 143 patients with upper gastrointestinal tract symptoms. There were no complications of the procedure. The duodenum was successfully entered in 98% of attempts, and in 90% of patients the examination was judged to be technically successful. When compared with radiological assessment, the findings at duodenoscopy significantly altered diagnosis and management in 21% of patients. The endoscopic appearance of the non-ulcerated duodenal mucosa could not be consistently correlated with changes found in biopsy tissue obtained under direct vision. Duodenoscopy is a valuable adjunct in the clinical assessment of upper gastrointestinal tract symptoms suspected to be due to pathological changes in the duodenum.

Biopsy↗
PubMedDate not supplied

The effect of nutritional status on morbidity after elective surgery for benign gastrointestinal disease.

The effect of nutritional status on the morbidity and mortality of major gastrointestinal surgery for benign disease was studied in 32 patients. Malnutrition was defined as a serum albumin less than 3.5 g/dl and a recent weight loss greater than 10%, in addition to any two of the following: weight for height, midarm circumference or triceps skin-fold thickness less than 10th percentile. The morbidity and mortality in the 17 malnourished patients was 59% and 29%, respectively, compared with 20% and 7% in 15 well-nourished patients matched for age and operative procedure (p less than 0.05). After operation, the mean duration of inadequate oral nutritional intake period (IONIP, defined as a caloric intake greater than 60% requirement) was 11.9 days +/- 2.9 (SEM) in well-nourished patients compared with 30.5 days +/- 3.7 in the malnourished group. The longer IONIP in malnourished patients was a consequence of the higher morbidity in this group, thus warranting the consideration of supportive (postoperative) parenteral nutrition in malnourished patients who undergo major gastrointestinal surgery for benign disease.

Adolescent↗
PubMed1978

[Ultrasonic diagnosis in infiltrative gastrointestinal diseases (author's transl)].

The cockade phenomenon in the ultrasound picture is a sign of an infiltration of the gastrointestinal wall caused by tumour or inflammation. In 27 out of 40 patients with known infiltrations of the wall the cockade phenomenon could be demonstrated. In 16 out of 21 patients in whom this ultrasound phenomenon had primarily led to a suspected wall infiltration further diagnostic investigations proved organic wall thickening. Even if the cockade phenomenon is thus neither a specific nor a sensitive sign of gastrointestinal wall infiltrations the observation of this phenomenon is particularly important in patients in whom wall infiltrations of the gastrointestinal tract are not suspected.

Colonic Neoplasms↗
PubMed2003

Genotyping and phenotyping of beta2-toxigenic Clostridium perfringens fecal isolates associated with gastrointestinal diseases in piglets.

Although Clostridium perfringens is recognized as an important cause of clostridial enteric diseases, only limited knowledge exists concerning the association of particular C. perfringens toxinotypes (type A to E) with gastrointestinal (GI) diseases in domestic animals. Some C. perfringens isolates also produce the newly discovered beta2-toxin (CPB2). Recent epidemiological studies suggested that C. perfringens isolates carrying the gene encoding CPB2 (cpb2) are strongly associated with clostridial GI diseases in domestic animals, including necrotic enteritis in piglets and typhlocolitis in horses. These putative relationships, obtained by PCR genotyping, were tested in the present study by further genotyping and phenotyping of 29 cpb2-positive C. perfringens isolates from pigs with GI disease (pig GI disease isolates). PCR and restriction fragment length polymorphism analysis reconfirmed the presence of cpb2 gene sequences in all the disease isolates included in the study. Furthermore, genotyping by pulsed-field gel electrophoresis analyses showed that the pig GI disease isolates included in this study all carry a plasmid cpb2 gene, yet no clonal relationships were detected between the cpb2-positive pig GI disease isolates surveyed. Finally, CPB2-specific Western blotting demonstrated CPB2 expression by all of the cpb2-positive isolates surveyed. The CPB2 proteins made by five of these pig GI disease isolates were shown to have the same deduced amino acid sequences as the biologically active CPB2 protein made by the original type C isolate, CWC245. Collectively, our present results support a significant association between CPB2-positive C. perfringens isolates and diarrhea in piglets.

Animals↗
PubMed2005

[MRI in gastrointestinal diseases].

Magnetic resonance imaging (MRI) has been called the most important development in medical diagnosis since the discovery of the X-ray more than 100 years ago. The effectiveness of MRI has been expanded to a variety of gastrointestinal disorders. The gastroenterologist's attention is currently focused on biliopancreatic and bowel diseases. Magnetic resonance cholangiopancreatography (MRCP) has become a competitive replacement for diagnostic endoscopic retrograde cholangiopancreatography (ERCP) in a variety of hepatobiliary and pancreatic diseases. MR enteroscopy has the potential to become the preferred method for evaluating the entire small bowel, while on the other hand virtual colonoscopy is far from being promoted as a tool for general screening purposes in suspected colon diseases. In summary, whether or not the survival of endoscopy is under debate, MRI could mark a historic turning point in gastroenterology. So, MRI hardware might interdisciplinarily be used by, e. g., radiologists and gastroenterologists.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1984

Gastrointestinal disease associated with meningococcemia.

Despite the multiple organ involvement seen in meningococcal disease, there is little in the literature to support gastrointestinal symptoms as the predominant finding. In the past year four patients with meningococcemia and meningitis presented with gastrointestinal symptoms. In three cases the gastrointestinal findings were of such severity that the diagnosis of meningococcemia was obscured.

Adolescent↗
PubMed2002

Diet and gastrointestinal disease.

Dietary manipulation can be an important part of therapy for several common gastrointestinal disorders. In Crohn disease, the provision of adequate protein and calories may not only improve symptoms but may be associated with acceleration of growth. In celiac disease, the dietary restriction of gluten is curative of the intestinal inflammation. In chronic nonspecific diarrhea and functional constipation, the provision of appropriate amounts of fiber and fluids may ameliorate symptoms. A thorough understanding of the role of diet is essential to the management of these disorders.

Age Factors↗
PubMed1978

Carcinoembryonic antigen (CEA) levels in benign gastrointestinal disease states.

Elevated circulating CEA levels occur in patients with benign gastrointestinal and hepatic disorders. These are usually less than 10 ng/ml. Of clinical importance is the influence of liver disease on the interpretation of CEA. At least 50% of patients with severe benign hepatic disease have elevated CEA levels, most often active alcoholic cirrhosis, and also chronic active and viral hepatitis, and cryptogenic and biliary cirrhosis. Patients with benign extrahepatic biliary obstruction may have increased plasma CEA, the highest in patients with co-existent cholangitis and especially liver abscess. The liver appears to be essential for the metabolism and/or excretion of CEA. Hence, liver work-up is needed to assess any patient with an elevated CEA. A damaged liver may further augment elevated CEA levels due to cancer. The increased circulating CEA observed in some patients with active ulcerative colitis tends to correlate with severity and extent of disease and usually returns to normal with remission. CEA levels also may be mildly elevated in patients with pancreatitis and in adults with colonic polyps. Smoking may contribute to the increased CEA levels seen in patients with alcoholic liver disease and pancreatitis. Therefore, in interpreting mildy elevated circulating CEA levels in patients with GI tract diseases, one must consider benign as well as malignant etiologies.

Animals↗
PubMed1988

Naproxen: antirheumatic efficacy and safety in patients with pre-existing gastrointestinal disease.

Nonsteroidal antiinflammatory drugs (NSAIDs) effectively reduce pain and inflammation of rheumatoid arthritis (RA). To further refine the appropriate uses of NSAID therapy, NSAIDs have been evaluated for possible gastrotoxicity, particularly in patients who have pre-existing gastrointestinal (GI) disease. In the present study, 58 such RA patients (36 women, 22 men) treated long-term with naproxen were monitored for periods up to 2.5 years to determine if any gastrotoxicity were induced by naproxen. We found an extremely low incidence of fecal occult blood, patient complaints of GI discomfort, complications documented by GI studies, and patient discontinuance of naproxen therapy because of complaints. Studies reported in the medical literature support our observations that naproxen can be well tolerated and is effective as long-term RA treatment when patients who have clinically significant pre-existing GI disease are managed with conventional treatments and appropriate monitoring.

Arthritis, Rheumatoid↗