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PubMed1988

[In vivo plasmid transfer between strains of Escherichia coli in the chicken digestive system].

To study the transfer of plasmids in the gut of chickens, we introduced a conjugative plasmid pGB99, which encodes resistance to chloramphenicol (Cm), tetracycline (Tc), sulphonamide (Su) and trimethoprim (Tm), into a nalidixic acid mutant of an antibiotic sensitive avian E. coli strain (BN118). The transfer of the plasmid between the nalidixic acid resistant strain and a streptomycin resistant mutant of the same strain was studied in the gut of dixenic and gnotobiotic chickens carrying an avian microbial flora devoid of resistant E. coli. Half of the chickens received tetracycline in the drinking water. The results indicate that the plasmid transfer occurred rapidly after inoculation in the gut of the dixenic chickens, with a persistent level of 10(4) transconjugants/g in the feces of chickens without tetracycline. During the administration of tetracycline, selection of the strains harboring the R plasmid (donor strains and transconjugants) was observed. In the gut of the chickens carrying the avian flora plasmid transfer between the donor and recipient strain BN118 was only observed in the group of animals receiving tetracycline. However transfer has probably occurred between the donor strain and the commensal E. coli of the flora in animals of the two groups.

Animals↗
PubMed1996

Influence of intermittent fasting and high-fat diet on morphological changes of the digestive system and on changes of lipid metabolism in the laboratory mouse.

The simultaneous effect of intermittent starvation and a high-fat diet were investigated in mice after several weeks of experimental feeding. The animals adapted to intermittent fasting fed a high-fat diet showed a lower degree of hyperphagia than animals adapted to intermittent fasting fed a standard laboratory diet. The weight of both individual portions of the stomach was elevated in adapted animals fed both a standard laboratory diet and the high-fat diet. The weight of the small intestine was increased in adapted animals fed a high-fat diet. The length of the small intestine was not changed after 8 weeks of intermittent starvation in both adapted groups (standard laboratory diet, high-fat diet). A higher amount of body fat was found in both groups of animals adapted to intermittent fasting (standard laboratory diet, high-fat diet) but adapted animals fed a high-fat diet showed less body fat than adapted animals fed a standard laboratory diet. Lower levels of serum lipids were found in adapted animals fed a high-fat diet. These results suggest that both lipogenesis and lipid oxidation are accentuated by intermittent starvation and a high-fat diet act concomitantly.

Animals↗
PubMed1999

[Biofragmentable anastomosis ring (BAR) in surgery of the digestive system].

Twenty-six patients submitted to surgery using BAR in intestinal anastomosis have been studied. The results were compared with data of the literature concerning this device of anastomosis and about mechanical staplers and manual suture. The following data were taken into consideration: type of operation, type of anastomosis, average time of execution, complications, days of postoperative canalization and feeding, costs of three anastomosis types. Postoperative complications rate were 23% with a postoperative death rate of 7.6%. There was only one intraoperative complication during a colorectal anastomosis. The average time, to package an intestinal anastomosis using BAR, was 69.9 minutes. The average type of postoperative canalization was 3.7 days and average period in hospital was 10.3 days. The costs of manual suture, of mechanical staplers and of BAR are respectively L. 50,000, 1,340,000 and 583,000. BAR complications are similar to the other techniques; this study shows a reduction of operative time, postoperative canalization and period in hospital, with a consequent decreasing of global costs. The execution of intestinal anastomosis using BAR is easier then the other techniques, the learning time is least and the procedure is uniform. The introduction of this technique in the common operative practice together with manual suture and stapler is stressed.

Adult↗
PubMed2003

Phenotypic flexibility of structure and function of the digestive system of Japanese quail.

Organisms adjust their phenotype to fluctuating conditions of the environment and to changing internal demands. We report flexible responses of the gizzard and the small intestine of Japanese quail to a high-fibre diet. Switching from a standard diet to a high-fibre diet results in a highly significant increase in gizzard size, intestine length, mucosal surface, thickness of the intestinal muscular layer and vascularization of the mucosa. After diet switching, increased or decreased gizzard size results from changes in cell size, i.e. smooth muscle cell hypertrophy and hypotrophy, respectively. Increased cell proliferation is not the cause of increase in gizzard size. In the small intestine, however, we found elevated levels of cell proliferation after diet switching and conclude that increased capacity (upregulation) of the small intestine is based on increased rates of mitosis in the intestinal crypts. It is highly probable that elevated levels of cell proliferation in the crypts are balanced by elevated levels of cell extrusion at the tip of intestinal villi. The lipid contents of the liver were reduced, indicating that lipid stores in the liver were mobilized to fuel the flexible response of the gastrointestinal tract. During changes of organ size in response to changes in food composition, resting metabolic rate was not altered.

Animals↗
PubMed2005

Storage and absorption in the digestive system of carnivorous and herbivorous prickleback fishes (Teleostei: Stichaeidae): ontogenetic, dietary, and phylogenetic effects.

The effects of ontogeny, diet, and phylogeny on glycogen storage levels and esterase and alkaline phosphatase activities in four related prickleback fishes were determined in situ using quantitative histochemistry. Of these species, Cebidichthys violaceus and Xiphister mucosus shift from carnivory to herbivory at approximately 45 mm standard length (SL), whereas Xiphister atropurpureus and Anoplarchus purpurescens remain carnivores. Comparisons between small (30-40 mm SL) and larger (60-75 mm SL) wild-caught juveniles showed that glycogen storage levels and alkaline phosphatase activity were unchanged with ontogeny. Comparisons between the larger wild-caught juveniles and juveniles of the same size that had been raised on a high-protein animal diet revealed that glycogen storage level and alkaline phosphatase activity increased in all species in response to this diet. Esterase activity also increased in response to the high-protein animal diet in all four species but increased with ontogeny only in C. violaceus, X. mucosus, and X. atropurpureus, in the xiphisterine clade, and not in A. purpurescens, in the adjacent alectriine clade. Xiphister mucosus and X. atropurpureus showed indistinguishable responses in esterase activity to ontogeny and diet despite their divergent natural diets. Overall, glycogen storage level and alkaline phosphatase activity responded primarily to diet, whereas esterase activity was also influenced by ontogeny and phylogeny and differed between intestinal regions among the species.

Age Factors↗
PubMedDate not supplied

[Management of digestive system carcinoid tumors and carcinoid syndrome].

INTRODUCTION: Carcinoid tumors are rare, most of the publications are case reports and the clinical series are uncommon. The quality of life and survival time of these patients depend on the adequate control of tumor growth and good palliation of their symptoms. AIMS: The purpose of this study is to inform epidemiological data and forms of management for these tumors and the Carcinoid Syndrome at the National Institute of Cancerology (INCan) at Mexico City in the last 15 years. METHODS: A retrospective review of the clinical records of patients diagnosed and treated at the INCan with carcinoid tumors from 1982 to 1997 was performed. RESULTS: The most common origin place was the gastrointestinal tract (GI), and the majority involved the right colon and the appendix. The longest survivors were patients with tumors originated in the appendix, tumors smaller than 2 cm or localized. At the time of diagnosis 47% of patients had metastatic disease that was also a poor prognostic factor. The experience in our hospital seem to support the use of interferon alone or in combination with octreotide or debulking surgery for the palliation of carcinoid syndrome. CONCLUSIONS: Carcinoid tumors are rare, and have a slow growth and less aggressive biological nature than noncarcinoid tumors. Treatment should be focused on trying to cure the small or localized lesions or to find the best palliative method for those symptomatic advanced lesions.

Adult↗
PubMed1994

[Use of Diprivan for digestive system endoscopy].

After evaluation of the patient's clinical condition and appropriate premedication is seems reasonable to suggest for: 1. Endoscopic procedures involving the gastro-intestinal tract: slow, titrated induction, using 0.5 to 1 mg.kg-1 of propofol, until the required level of sedation has been achieved; this may or not be preceded by the injection of a low dose of midazolam (0.02 to 0.03 mg.kg-1) or of alfentanil (5 micrograms.kg-1); maintenance is achieved by bolus injections of 20 mg (up to 0.5 mg.kg-1); maintenance of spontaneous ventilation, with oxygen administration is the rule; SpO2 is monitored routinely; anaesthesia has to be performed according to the recommendations of the French Society of Anaesthesia and Intensive Care (SFAR) and the anaesthetist must be prepared to manage any incident during the endoscopy and the recovery period. 2. Procedures involving the biliary tract and the oesophagus, which require deeper anaesthesia: induction should again be titrated using a very slow infusion, with doses ranging from 0.9 to 2.2 mg.kg-1); the maintenance requires a continuous infusion, doses ranging from 4 to 6 mg.kg-1.h-1 when propofol is administered alone and from 4 to 12 mg.kg-1.h-1 when combined with an opioid; continuous oxygenation is necessary using a nasal airway; the need for intubation depends on the type of procedure and the status of the patient; the same monitoring devices and similar safety measures are required during and after procedure as for any anaesthetic or sedation, especially when it is performed in day-case patients or outside the operating theatre.

Anesthesia, Intravenous↗
PubMed2000

[Resident physician training in the digestive system. The point of view of the residents].

AIM: To evaluate various aspects of current training of Spanish residents in gastroenterology. METHOD: An anonymous postal questionnaire was sent to fourth-year resident physicians in Spanish hospitals with accredited gastroenterology residency programs. RESULTS: Forty residents in the fourth year (53% offered positions), four from the second year and one from the first year (20 men, 25 women) answered the survey. Mean age was 29.7 years (26-42 years). Fifty-one percent of the departments did not have ultrasonography facilities apart from those in the radiology department. Endoscopic retrograde cholangiopancreatography (ERCP) was available in all the departments but in 55% of these, residents did not receive training in this technique. Forty-one percent of residents did not know the objectives of the various training periods. Eighty-four percent evaluated the pressure of clinical work as "intense" or "very intense" with 67% reporting that it disturbed their training "seriously" or "very seriously" and 71% that it disturbed their personal lives. Supervision in ultrasonography, endoscopy and clinical work were mainly evaluated as "good" or "very good". Supervision was rated lower in outpatient departments and while on duty. Forty-two percent of residents rated the supervision of the personal tutor as "average". Seventy-six percent were "fairly" or "very interested" in the introduction of "areas of specific training". CONCLUSIONS: The quality of residents' training in general and of gastroenterology training in particular is high. There are, however, several aspects which could be improved.

Adult↗
PubMed1993

[Transport of nitrates and nitrites into the milk of dairy cows through the digestive system].

Increased nitrate concentrations in milk are not only dangerous to human health as the milk is the material for production of baby and infant food, but they cause also many problems in technological milk processing. The study was aimed at the transfer of nitrates and nitrites into milk of dairy cows following nitrate loading. An experiment included 6 dairy cows of the Slovakian Spotted breed at the Experimental Veterinary Centre at Zemplínska Teplica. Prior to start of the experiment samples of feedstuffs and feed water, milk were taken and examined for the presence of nitrates and nitrites. KNO3 in water solution was applied to selected dairy cows in two-week intervals in single peroral doses of 150; 75; 37.5; 18.75 and 9.5 g two hours before evening milking. Nitrate and nitrite residue contents were studied in individual milk samples obtained from manual milking 2, 14, 26, 38 and 50 hours after application of appropriate KNO3 amount. Following the peroral application of KNO3 to dairy cows, a marked increase in nitrate content in milk appeared in dependence on applied KNO3 (Tab. I). Average value of residual nitrate in milk two hours after administration of 150 g of KNO3 was 34.60 mg of NO3-/l. Increased levels of residual nitrate in milk were found also 38 hours after KNO3 application. Nitrate content in milk after 50 hours was almost identical with that that was determined in milk of experimental cows from morning milking on the day of administration of 150 g of KNO3, considered as the control samples. The values of residual nitrate exceeded 0.05 mg neither in single sample of NaNO2/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1982

Detection and localization of alkaline and acid phosphatases in the digestive system of the adult Catla catla (Hamilton), an Indian freshwater major carp by histochemical methods.

The localization and distribution of alkaline phosphatase (ALPase) and acid phosphatase (ACPase) in the various regions of the alimentary canal viz., buccopharynx, oesophagus, intestine, rectum and hepatopancreas of adult Catla catla have been studied by employing various histochemical techniques. ALPase activity was recorded in the various regions of the alimentary canal in the present study although its intensity of localization and distribution varies greatly. The highest ALPase activity was detected in the columnar epithelial cells of the intestine including their brush border, sub-mucosal layer as well as in the basement membrane while intense activity of the same was observed in the epithelial cells (stratified and columnar) of the buccopharynx and oesophagus, hepatic and pancreatic acinar cells. The intense localization of ALPase was also found in the nuclei of the epithelial cells (stratified and columnar), sub-mucosal connective tissue nuclei, hepatic cell nuclei, and sub-mucosal polysaccharide granules of the intestine. The moderate ALPase activity was detected in the neuroepithelial cells of the taste buds in the buccopharynx, cytoplasm of the epithelial cells (stratified and columnar) and muscularis layers. The blood vessels of the intestine and rectum also furnished moderate ALPase activity. The weak ALPase activity was noticed in the brush border of the rectum and also in the basement membrane. Intense ACPase activity was recorded in the striated border of the intestinal villi, while moderate activity of the same was detected in the nuclei of the stratified and columnar epithelial cells of the various regions of the alimentary canal as well as in the hepatic and pancreatic acinar cells. Very weak ACPase activity was localized in the cytoplasm of the stratified epithelial cells of the buccopharynx and oesophagus.

Acid Phosphatase↗
PubMed1997

Induction of apoptosis in neuroendocrine tumors of the digestive system during treatment with somatostatin analogs.

The extent of apoptosis identified by in situ DNA nick end labelling (TUNEL) on tissue samples obtained from patients with neuroendocrine tumors was correlated with the clinical outcome in patients treated with high-dose somatostatin analog (lanreotide 12 mg/day), n = 8, or other biotherapy including interferon-alpha (IFN-alpha), n = 4, low-dose somatostatin analog (octreotide or lanreotide), n = 3, or a combination of both, n = 1. Biopsies were obtained before the start of treatment and/or after 6 months and 12 months. After 6 months of treatment, 5 patients receiving high-dose somatostatin analog showed a biochemical response (decrease in different neuroendocrine tumor markers) and 4 of these showed an increase in apoptotic index (AI: percentage of apoptotic cells) by 1.94 +/- 1.71%. At 12 months, AI was also increased in patients with a biochemical response (4.22 +/- 3.93%). However, none showed a decrease in tumor size on computerized tomography (CT) and none of the patients treated with low-dose somatostatin analog or IFN-alpha showed any significant increase in AI during treatment. In an experimental model, nude mice were xenografted with the neuroendocrine cell line (BON-1). From the 2nd day of tumor implantation, they received treatment with either placebo, high-dose octreotide, IFN-alpha, or a combination of both, for 28 days. In mice receiving treatment with high-dose octreotide (300 microg/kg, t.i.d) there was a threefold increase in apoptotic cells as compared to the placebo group (p = 0.0084), while the combination group had few cells with ultra-structural changes indicating apoptosis and the IFN-alpha treated group showed no significant changes. However, tumor growth inhibition was more pronounced in the combination group (p = 0.0011). This probably denotes that tumor growth inhibition could be achieved more efficiently by blocking the cell cycle than by inducing apoptosis. We concluded that treatment with high-dose somatostatin analogs may induce apoptosis in neuroendocrine tumors, while this is not found during treatment with low-dose somatostatin analogs or IFN-alpha. We also found that an increase in AI during high-dose somatostatin analog treatment was correlated with the biochemical response, but not with the tumor size as detected by CT in patients or with the tumor mass in the experimental model.

Aged↗
PubMed1986

The use of epidemiology, scientific data, and regulatory authority to determine risk factors in cancers of some organs of the digestive system. 6. Pancreatic cancer.

The etiology of pancreatic cancer remains elusive. It predominates in males and in certain ethnic populations (i.e., Polynesians and blacks). Primarily a disease of aging, it is rare in individuals under 40. Genetics is believed to play a very small part if any. While diabetics have higher than expected incidence and mortality rates, several recent studies have indicated that in most cases the diabetes is an early sign of pancreatic cancer rather than a predisposing condition. Other conditions have been infrequently reported in association with pancreatic cancer. None of them have shown a definitive associative pattern and are believed to represent coincidental occurrences. Migrant studies of Japanese immigrants implicate some type of environmental etiology, since pancreatic cancer rates increase dramatically within one to two generations. Studies on atom bomb survivors have demonstrated no link between a single intense dose of radiation and subsequent development of this disease. Workers exposed to low-level radiation have shown an increase in pancreatic cancer, but this result may reflect methodologic problems. Many chemicals have been shown to cause pancreatic cancer in animals, and chemists exhibit higher pancreatic cancer rates than expected. However, the human cases have not been traced to any specific chemical. Many other occupations besides chemistry have shown increased pancreatic cancer rates, but the common factor in these occupations is not obvious. Studies analyzing the relationship of alcohol consumption to pancreatic cancer yield conflicting results. This may be explained if the observed effects are due to a confounder, such as cigarette smoking; to an ingredient other than alcohol contained in alcoholic beverages, such as nitrosamines; or to the immunosuppressive effects of chronic excessive alcohol consumption. Smoking is the risk factor showing the most definitive and consistent results. There is little doubt that it plays an etiologic role, and it probably accounts for the higher incidence of the disease in males. Most other research does not support MacMahon's reported association between coffee drinking and pancreatic cancer. Recent studies have indicated a generally increased fluid intake in pancreatic cancer patients due to a disease-induced disturbance in glucose tolerance function. Such increased fluid intake would tend to manifest itself in the most popular beverage of the country (i.e., coffee in the United States and tea in the United Kingdom). Animal studies have indicated a link between pancreatic cancer and high fat and/or high protein diets as well as raw soybean consumption.(ABSTRACT TRUNCATED AT 400 WORDS)

Alcohol Drinking↗
PubMed1983

Calcium metabolism in broiler breeder hens. 2. The influence of the time of feeding on calcium status of the digestive system and eggshell quality in broiler breeders.

Experiments were conducted to determine the influence of time of dietary calcium intake on eggshell quality in broiler breeder hens. In Experiment 1, 60 hens were randomly divided among three treatment groups. The control group received 155 g feed (3.1% calcium) per day at 0800 hr whereas the morning- (a.m.) and evening-fed (p.m.) treatments received a .42% calcium diet (155 g/bird) and were intubated with 4.2 g calcium at 0800 or 1600 hr, respectively. Egg weight, shell weight, and specific gravity were determined at 3-day intervals for 15 days. In Experiment 2, 150 breeder hens were randomly divided among two treatment groups. They were fed 122 g per hen during a 2.5-hr feeding time at 0700 to 0930 or 1530 to 1800 hr. Eggs were collected for egg weight, shell weight, and specific gravity determinations. At the end of the 5th week, 10 hens from each treatment group were sacrificed at various times throughout a 24-hr period and the contents of each segment of the GI tract and feces were analyzed for moisture, dry matter, and calcium. In Experiment 3, two commercial broiler-breeder houses with 5,000 hens each were used. They were fed 132 g/hen per day at 0530 hr daily with water provided ad lib. The feeding time of one house was moved forward by 2 or 2.5 hr per day until the feeding time was 1600 hr. Eggs were collected for 2 weeks following pretreatment data and values determined for specific gravity. Eggs were also candled at 7 days incubation to determine embryonic mortality and fertility. Hens intubated at 0800 hr with their daily supply of calcium did not maintain shell quality equivalent to controls (Experiment 1). However, hens intubated at 1600 hr had no difficulty maintaining shell quality. Hens fed at 1530 hr had significantly better shell quality during all weeks tested compared to hens fed at 0700 hr (Experiment 2). The p.m.-fed hens had 66.9% more calcium available at 1800 hr (2.07 vs. 1.24 g) compared to a.m.-fed hens. Hens fed at 1600 hr in the commercial houses (Experiment 3) had significantly better eggshell quality (specific gravity) than hens fed at 0530 hr. There was no significant difference in percent embryonic mortality or percent fertility when eggs were candled after 7 days of incubation. It was concluded that p.m.-fed hens had significantly more calcium available during the stages of eggshell calcification. The result was significantly better eggshell quality.

Animals↗
PubMed2005

Assessing potential bioavailability of raspberry anthocyanins using an in vitro digestion system.

The bioavailability of anthocyanins from raspberry extracts was assessed using an in vitro digestion procedure that mimics the physiochemical and biochemical changes that occur in the upper gastrointestinal tract (GIT). Effectively all of the total phenol content of the raspberry extract survived gastric digestion and partitioned between the IN sample, which represents the serum available material, and the OUT sample, which represents the material that remains in the GIT and passes through to the colon. All of the anthocyanins also survived gastric digestion, but only approximately 5% entered the IN sample and approximately 70% of total anthocyanins were recovered in the IN and OUT samples. Codigestion of the raspberry extract with commonly combined foodstuffs such as bread, breakfast cereal, ice cream, and cooked minced beef gave a different pattern. The total phenol content of the IN samples was slightly reduced by codigestion with ice cream or breakfast cereal but unaffected by codigestion with bread or minced beef. In most cases, the phenol contents of the postgastric and OUT samples were reduced as compared with the expected values. However, the anthocyanin content of the IN samples was unaffected or increased by coincubation with the foodstuffs. This suggests that polyphenols transiently bind to food matrices during digestion, which protects the more labile anthocyanins from degradation, and they are free to diffuse into the IN sample. The anthocyanin composition of the bioavailability samples was monitored by liquid chromatography-mass spectrometry. All eight anthocyanins previously identified in raspberry were detected in the extract and the postgastric samples at similar yields. All eight anthocyanins could be discerned in the IN and OUT samples, but some such as cyanidin-3-O-glucoside were greatly reduced and others such as pelargonidin-3-O-glucoside were apparently increased in abundance. These differences in stability and their importance for the bioavailability of anthocyanins are discussed.

Anthocyanins↗
PubMed1986

[Heterotopic segmental autotransplantation of the pancreas with digestive system anastomosis in the dog].

Segmental autotransplantation of pancreas in the heterotopic position, with digestive anastomosis protected by an epiploplasty was performed in a series of 22 dogs. Twenty dogs survived the operation and nine were followed up for 4 weeks: the histologic and morphologic qualities of the graft were very favorable from both endocrine and exocrine points of view. This morphohistologic quality can be related to the digestive anastomosis performed, which failed to provoke any specific complications to a large extent. This study should be completed by improvement in the vascularization of the graft by a splenic arteriovenous fistula and a concomitant study of the endocrine function of the transplanted pancreas in dogs with experimentally-induced diabetes.

Animals↗
PubMed2002

Effects of aerobic and anaerobic digestion systems on pathogen and pathogen indicator reduction in municipal sludge.

In this study, the effectiveness of anaerobic treatment systems in reducing pathogenic density levels was evaluated under the US EPA municipal sludge rule (40 CFR Part 503 Rule). Wastewater and sludge samples were analyzed for both pathogens and pathogenic indicator organisms from six different existing wastewater treatment systems. The results indicate that Class B sludge requirements under the US 503 Rule are reasonable and can be achievable by the existing treatment systems while Class A sludge requirements under the same rule may not be easily achieved by the existing treatment systems. The effects of volatile solids loading rates on anaerobic digester performance were investigated. Under anaerobic digestion conditions, it appears that the log reductions in fecal coliform and fecal streptococcus appeared to be dependent on VSS loading rates. On the other hand, Salmonella sp. density reductions did not appear to be dependent on VSS loading rates.

Bacteria, Aerobic↗
PubMed1996

[Diseases of the digestive system and a system for patient classification: diagnostic-related groups (DRG)].

In the last years different classification systems for hospitalized patients have been developed in the United States, that allow to evaluate different aspects of any Hospital: The quality, the efficacy and the efficiency. The classification of "The Diagnosis Related Groups" (DRG) relates the hospitalized patients with the expenses that they generate, and it is the most used in Europe. In the version DRG-All Patient, all the diagnoses and procedures of the hospitalized patients, using the International Classification of Diseases, are divided in to 25 Major Diagnostic Categories (MDC) where each one excludes all the others. We describe the behavior with respect to the age, sex and stay of all the GDR integrated in the CDM 6 and 7: diseases and disorders of the digestive tract, and diseases and disorders of the hepatobiliary system and the pancreas. The study has been carried out with a national data base of two millions of cases seen from 214 acute-care Hospitals. The MDC number 6 is the most frequent, with an important number of patients in the pediatric age; it is more frequent in males; the average stay is 8.59 days and 19 GDR (36.5%) have a variation coefficient greater than one. The other MDC, number 7 is less frequent, the majority of the patients are between 60-80 years of age, the average stay is 12.2 days with a coefficient of variation greater than one in 4 GDR (17.4%). Clinical Services should know the characteristics and behavior of their patients, as well as the comparison with the national data bases. This may allow a control of the quality and the costs by using a common "language" with the managers.

Diagnosis-Related Groups↗
PubMed1993

[Stress and the digestive system].

Functional disorders mainly occur in young, anxious hyperactive, sometimes obsessional patients and involve all parts of digestive tract: feeling of obstruction the upper oesophagus or dysphagia; aerophagia related to a slow gastric emptying or gastric fullness relieved by eructation; biliary vomiting and pain in right abdominal upper quadrant which might correspond to a form of migraine without headache; irritable bowel, characterized by abdominal discomfort and constipation. Obviously, the diagnosis of functional disorders required elimination of an organic disease by appropriate endoscopic investigations. Psychosomatic disorders mainly comprise gastroduodenal ulcers and inflammatory bowel diseases. Although psychologic profiles have been associated with gastro-duodenal ulcer, these are not necessary for the development of the disease. The role of emotional factors has decreased since very efficient anti-secretory drugs are available. Inflammatory bowel diseases, in particular ulcerative colitis is frequently associated to behaviour disorders. The patient is usually a young woman brought up by an overprotective family. It is generally recognized that attacks of ulcerative colitis may be triggered by emotional factors. Thus, Stress may interact with digestive tract. In some cases, as in patients with irritable bowel or distal ulcerative colitis, psychotherapy such as Schultz's Autogenous Training, improves the patient's condition.

Arousal↗