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PubMed1989

Nutritional support and gastrointestinal disease.

The use of nutritional support in patients with acute gastrointestinal disease requires a thorough knowledge of the pathophysiology and nutritional alterations that are caused by the disease process. Although nutritional therapy of a patient with gastrointestinal disease is not curative of the underlying disease, it does provide essential support to the patient, which improves response to, and eventual recovery from, illness. Special considerations need to be made to avoid complicating the patient's condition by inappropriate use of nutritional support solutions, which can lead to abnormal liver function.

Acute Disease↗
PubMed2005

Work related mortality from gastrointestinal diseases and alcohol among seafarers employed in British merchant shipping from 1939 to 2002.

OBJECTIVES: To investigate work related mortality from gastrointestinal diseases and from alcohol among seafarers who were employed in British merchant shipping from 1939 to 2002. METHODS: A longitudinal study, based on official mortality files from 1976-2002 and official mortality returns from 1939-1975, with a population of 7.29 million seafarer-years at risk. RESULTS: From 1939 to 2002, there were 864 deaths from gastrointestinal diseases and 72 from alcoholism. Overall mortality from gastrointestinal diseases fell from 18.4 per 100,000 in 1939-49 to 9.3 in 1970-79 and 0.3 in 1990-2002. Mortality from alcoholism, and from alcohol-related diseases such as liver cirrhosis and diseases of the pancreas, increased up to the 1960s or 1970s, but fell thereafter. From 1950 to 1972, mortality from gastrointestinal diseases was 1.8 times higher among Asian seafarers compared to British seafarers, largely because of liver disease, peritonitis and peptic ulcer. At the time of the last censuses of seamen in 1961 and 1971, compared with the general British male working aged population, morality among British seafarers was greatly increased for peritonitis and alcoholism but not for most other gastrointestinal diseases. CONCLUSIONS: Sharp reductions in mortality from gastrointestinal diseases and from alcoholism since the 1970s contrasts with increases among the general British population, and are largely because of the "flagging-out" of most British deep sea ships, and consequent reductions in long voyages, as well as reductions in alcohol consumption among seafarers at work. Largely because of the healthy worker effect, seafarers were usually only at increased risks from particularly acute diseases.

Alcoholism↗
PubMed1990

Assessment of functional gastrointestinal disease: the bowel disease questionnaire.

A need exists for a self-report questionnaire that reliably and accurately measures symptoms and that distinguishes patients with functional gastrointestinal disease from those with other conditions. We have developed such an instrument, the bowel disease questionnaire, and herein describe details of its discriminatory validity. Data from 399 subjects were analyzed. Patients with gastrointestinal symptoms were ultimately diagnosed as having functional gastrointestinal disease (82 with the irritable bowel syndrome and 33 with functional dyspepsia) or organic gastrointestinal disease (N = 101). There were 145 healthy control subjects and 38 patients with a psychiatric disease, somatoform disorder (which includes those with a diagnosis of hypochrondriasis, psychogenic pain, and somatization or conversion disorder). All subjects completed the questionnaire before undergoing an independent diagnostic assessment by experienced physicians. Functional gastrointestinal disease could be distinguished from organic disease, somatoform disorder, and health by using models derived from logistic discriminant analysis. With use of these models, the estimated probability of functional gastrointestinal disease was then calculated. Descriptive symptom scores were of less value than the scores derived from the data sets by logistic discriminant analysis. Age did not significantly affect the responses to the questionnaire items. We conclude that, in the population studied, the bowel disease questionnaire is a valid measure of symptoms of functional gastrointestinal disease, and this instrument may have clinical and research applications.

Adult↗
PubMed1984

[Diet in gastrointestinal diseases--1983 status].

In the treatment of gastrointestinal disease, no spectacular novelties have been introduced within the past few years. Dietary fibre, medium chain triglycerides (MCT) and certain formula diets have been established as standard tools in the treatment of various gastrointestinal diseases. Some progress has been noted with the introduction of longterm enteral feeding via needle catheter jejunostomies and longterm home parenteral nutrition. Study of the effects, use, practicability and cost of numerous "traditional" diets has led to a more realistic and critical prescription of diets. There is a general trend towards the prescription of diets only when their influence on the disease or on the abnormal nutritional state is superior to the effects of normal food.

Celiac Disease↗
PubMed1989

Neurologic manifestations of gastrointestinal disease.

The neurologic manifestations of gastrointestinal disease are generally thought to be uncommon, although an increasing number of previously unidentified associations are being established. These neurologic disorders may result from nutritional or non-nutritional causes. In the absence of clear malnutrition, it is likely that many of these disorders are underdiagnosed. As an example, Wernicke's encephalopathy is found at autopsy in as many as 2 per cent of brains, a very high percentage, given the rare recognition during life. The likely underdiagnosis of nutritional neurologic disorders is unfortunate because many are treatable and, more importantly, are preventable if malabsorption is suspected and appropriate supplementation initiated. For the neurologist, familiarity with the occasional association between neurologic abnormalities and specific gastrointestinal disorders is important, as is familiarity with the neurologic characteristics of disorders, such as Whipple's disease, that may present as isolated neurologic syndromes without gastrointestinal symptoms or signs. Renewed interest in selective deficiency states has resulted in identification of causative factors in several neurologic syndromes of previously presumed degenerative etiology. Recognition of the potential neurologic consequences of prolonged deficiency states also is important for the internist, because many of the syndromes are poorly reversible once symptomatic. The benefits of prevention invariably exceed those of treatment.

Central Nervous System Diseases↗
PubMed1979

Mortality and autopsy rate for gastrointestinal diseases in Finland in 1955--1973.

Gastrointestinal diseases accounted for about 10% of all natural deaths in Finland in 1955--1973. Total mortality for these diseases decreased slightly amongst young and middle-aged people in 1955--1973. This was mainly because mortality for ulcerative diseases of the stomach and the small intestine decreased continuously in practically all are groups, and also because the death rates of men and women from malignant neoplasms of the stomach decreased slightly but linearly at all ages. The autopsy rates increased highly significantly in all major categories of deaths between 1963 and 1973. In 1973 the autopsy rate for diseases of the digestive system (the ninth ICD main group) was 67%. This rate exceeded highly significantly the mean autopsy rate recorded for all (38%) and all natural deaths (33%). The autopsy rate for gastrointestinal malignancies was 26%, which in turn was highly significantly lower than the average rate for all and all natural deaths. The highest single autopsy rates in 1973 were recorded for ulcer of the duodenum (87%), diseases of the pancreas (78%), cholelithiasis (77%), and chronic enteritis and ulcerative colitis (76%). The present results suggest that the mortality statistics of Finland are obviously more reliable for the gastrointestinal diseases as a cause of death than in most other major categories of diseases.

Adolescent↗
PubMed2003

[Alcohol-induced gastrointestinal diseases].

UNLABELLED: Alcohol induced gastrointestinal diseases are common and significant, and may lead to early death. The annual death caused by alcoholic liver disease and pancreatitis in Hungary is up to 8000. Metabolites, mainly acetaldehyde and free radicals are responsible for the injury. Although the alcohol itself is not carcinogenic, some maligancies are more common among alcoholics. AIM AND METHODS: In this review the hepatic and extrahepatic metabolism of alcohol, the epidemiology, pathomechanism, clinical signs of the alcohol induced organ damages and the treatment options are summarized. RESULTS: Type IV alcoholdehydrogenase in the stomach has a role in the first pass metabolism. The liver is the main place of the metabolism. If the amount of alcohol exceeds the metabolising capacity, the toxic substances cause lipidperoxidation, membrane and organ injury. Alcohol metabolism is different in the pancreas, the activity of fatty acid ethanol ester synthase activity is more pronounced. In alcoholics the leukoplakia, oropharingeal carcinoma, oesophagitis, Mallory-Weiss syndrome, liver cirrhosis related oesophageal variceal bleeding, chronic gastritis, liver diseases, pancreatitis, bowel motility disorders, malabsorption and colorectal carcinoma are more frequent. The fatty liver remains reversible for a long. Following steatohepatitis, fibrosis, cirrhosis and liver carcinoma may develop. Despite growing knowledge of the role of endotoxins, cytokines, nutritional, immunological and genetic factors, it is still unknown why the given disease will develop in a patient, and there is no parameter for determining the point of irreversibility of the alterations. The possibilities for medical treatment are limited, since some patients do not cooperate properly, and on the other hand, the drugs and measurements can control only a part of the whole process (antioxidants, anti-inflammatory drugs, monoclonal anti-cytokine antibodies), and are appropriate only for the treatment of complications as ascites, portal hypertension, oesophageal varices, portosystemic encephalopathy, malabsortion, infections, vitamin deficiency. CONCLUSIONS: Therefore the prevention and abstinence are very important. The task of the general practitioner and the role of the cooperation among the patient, the physician, the family and the community are very important.

Alcohol Drinking↗
PubMed2003

Gastric dysrhythmia in infants with gastrointestinal diseases measured by epigastric impedance.

BACKGROUND: Gastrointestinal symptoms have been reported in association with myoelectrical dysrhythmia, where different types of gastric electrical activity have been described. These types of gastric myoelectrical activity and dysrhythmia can be measured by electrogastrography using cutaneous electrodes. Epigastric impedance is a non-invasive method used to study gastric emptying time and gastric phasic activity. At present no study of gastric dysrhythmia, measured with epigastric impedance, has been presented, and the purpose of the present study was to investigate gastric rhythms by means of impedance gastrography in control infants, compared to infants with different gastrointestinal diseases, before and after treatment of their disease. METHOD: 21 patients (age 0-2 months) and 40 healthy infants (age 0-2 months) were investigated. The patients suffered from partial or total intestinal obstruction, necrotizing enterocolitis or pyloric stenosis.All infants were fasting and studied during periods of at least one hour. The patients were examined in the acute state and after treatment when possible. RESULTS: A pathologic result was found in 90% of the patients. A persistent phasic activity pattern was found in 19 of the 21 patients, high frequency phasic activity in 11 of the 21 patients. Short-term phasic activity was only found in 13 out of 40 of the normal infants (32.5%). CONCLUSION: Using epigastric impedance we found that infants with partial or total intestinal obstruction had gastric phasic activity, which was not found in the control infants. The origin of the gastric phasic activity patterns is unknown, but they may be related to electrical control activity.

Electric Impedance↗
PubMed1996

The cutaneous manifestations of gastrointestinal disease.

Specific cutaneous manifestations are found to be associated with gastrointestinal disease. A careful examination of the skin, therefore, may uncover clues to underlying diseases of the gastrointestinal tract, pancreas, and liver. This article explores the alimentary cutaneous relationship.

Adenomatous Polyposis Coli↗
PubMed1978

Streptococcus bovis bacteremia and underlying gastrointestinal disease.

Twenty-six adults with Streptococcus bovis endocarditis and ten with bacteremia alone were studied to determine possible portals of entry. Of 36 patients (17 with endocarditis, eight with bacteremia alone), 25 had gastrointestinal lesions or manipulation. In 22, the gastrointestinal tract appeared to be the source of S bovis bacteremia. Four patients had either carcinoma of the colon (two) or potentially malignant villous adenomas (two) when first seen because of S bovis bacteremia. None of these, nor two other patients with benign colonic polyps, had bowel-related symptoms or signs prior to admission. Since S bovis is a normal intestinal tract inhabitant, bacteremia may frequently be associated with bowel lesions. Streptococcus bovis bacteremia may provide an early clue to the presence of serious and clinically unexpected gastrointestinal disease. Gastrointestinal tract evaluation should be part of S bovis bacteremia patient management, with or without endocarditis.

Adult↗
PubMed1992

Gastrointestinal disease in the immunocompromised host.

Gastrointestinal disease in two groups of immunocompromised patients, namely the AIDS patient and the post-bone marrow transplant patient, are discussed. Disease entities include opportunistic infections, Kaposi's sarcoma, lymphoma and other B cell proliferative disorders, cancer following transplantation, typhlitis, and pseudomembranous colitis.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Interventional nutrition for gastrointestinal disease.

Nutritional intervention plays a key role in the successful management of gastrointestinal disease. This article focuses on several novel areas of nutritional intervention that are becoming increasingly important in gastrointestinal disease, including short-chain fatty acids, omega-3 polyunsaturated fatty acids and glutamine. Short-chain fatty acids are the principal end-products of bacterial fermentation of dietary fibers and have profound effects on normal intestinal cell metabolism and proliferation. Short-chain fatty acids have the potential to improve overall intestinal health, stimulate intestinal healing, and decrease intestinal inflammation. Omega-3 fatty acids, from dietary sources or supplements, may also be useful in decreasing intestinal inflammation and in preventing intestinal cancer. Finally, glutamine also may play an important role in the nutritional management of gastrointestinal disease.

Animals↗
PubMed1987

Hematologic manifestations of gastrointestinal disease.

A diverse number of hematologic abnormalities may occur in association with gastrointestinal disease. For example, deficiencies of iron, folate, and vitamin B12 often accompany and may be the first clue to diseases such as colon cancer, celiac sprue, and chronic gastritis, respectively. A compilation of the hematologic disorders associated with diseases of the gastrointestinal tract, liver, and pancreas is provided.

Esophageal Diseases↗