It is easy to make anecdotal claims for the efficacy of new forms of treatment based on the short term results in a small number of patients. Many authors have done this for endoscopic laser therapy in the gastrointestinal tract. It is very much more difficult to carry out a comprehensive assessment of the short and long term effects of new techniques and to compare these with the results of alternative treatments for the same diseases. This book, from one of the world's leading departments of gastroenterology, describes and analyses the largest series of patients yet reported from one centre treated endoscopically with the NdYAG laser for gastrointestinal disease. The follow up extends over 8 years and the results are impressive. Some of the early claims for laser therapy have been validated, others have not, but the real value of the book is that we now have a large amount of well organised data on which to judge the merits of laser therapy. Medical laser techniques are in their infancy and the potential for future develop ment is enormous, but ideas on current applications have been consolidated and that is essential before the next concepts evolve. This book has taught us how to walk. The world is now ready to learn to run S. G. Bown, Director National Medical Laser Centre London Contents INTRODUCTION 3 Introduction and purpose of the study 5 1 General aspects of laser 6 1. 1."

In this issue of Gastrointestinal Endoscopy Clinics of North America, guest editor Dr. Catharine M. Walsh brings her considerable expertise to the topic of Pediatric Endoscopy. Since its inception in the early 1980s, pediatric endoscopy has seen dramatic innovations in both diagnostic procedures and advanced procedures that are increasingly being performed by pediatric trained endoscopists. In this issue, top experts bring you fully up to date with recent advances in this fast-changing field. Contains 14 practice-oriented topics including pediatric unsedated transnasal endoscopy; tools for improving quality in pediatric endoscopy; artificial intelligence in pediatric endoscopy; advances in endoscopy for pediatric inflammatory bowel disease; and more.  Provides in-depth clinical reviews on pediatric endoscopy, offering actionable insights for clinical practice.  Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews. 

The application of molecular techniques to gastroenterology continues to yield important advances in the development of drugs to treat gastrointestinal disorders. Important new drugs have emerged through the collaborative and complementary efforts of basic scientists, clinicians, and clinical researchers in academia and the pharmaceutical industry. The challenge has been exciting, with a few surprises along the way. Consider peptic ulcer disease as an example. The discovery of H receptors and the availability of potent and 2 selective H-receptor antagonists signaled the beginning of a new era 2 in the treatment of gastric hypersecretory states and peptic ulcers. Introduction of proton pump inhibitors offered another therapeutic option. Though H-receptor antagonists and proton pump inhibitors 2 are important and useful drugs, the discovery of the link between H. pylori infection and peptic ulcer disease has led to even more effective pharmacotherapeutic regimens. Our intent in Drug Development: Molecular Targets for GI Diseases is to bring together hands-on experts to review promising areas of gastrointestinal pharmacology. The contemporary topics covered, from a mechanistic viewpoint, are relevant to gastrointestinal inflammation and motility disorders. Authoritative opinions are offered on both future research directions and potential applications for new therapies.

Antimicrobial-associated diarrhea is often caused by Clostridium difficile; this disease can best be diagnosed by detection of fecal cytotoxin in a tissue culture assay and, when therapy is indicated, can be effectively treated with orally administered vancomycin. The cause of disease in most cases of antimicrobial-associated diarrhea that do not involve C. difficile is not known; fortunately, this form of diarrhea 1S usually mild. Antimicrobial-associated diarrhea may also rarely involve s. aureus and certain enteric pathogens. 37 QHAPTER 4 Qf. TECTlON. ISOLATION Al:iQ...IQENTlFICATlON OF CLOSTRIDIUM PIFFICILE S. P. BORRIELLO and PAULINE HONOUR Introduction 38 Detection of Co dlfflcile in stools 38 Direct methods 38 Indirect methods 39 Isolation of Co djfficjle 40 Identification of Co difflcile 44 38 DETECTION ISOLATION AND IDENTIFICATION OF CLOSTRIDIUM DIFFICILE S. P. Borriello and Pauline Honour Introduction In view of the mounting evidence generated world wide in the last few years that firmly implicates GBP. difficile as the aetiological agent in both antibiotic and non-antibiotic associated pseudomembranous colitis (Larson ~ al. , 1978, Bartlett ~ al. , 1978a, George ~ al. , 1978a), and also recent recognition of the fact that there may be a spectrum of gastrointestinal diseases associated with GBP. difficile infections (Borriello and Larson, 1981, Bolton ~ al. , 1980, Brettle ~ al. , 1982), an increasing number of laboratories are seeking to detect, isolate and identify GBP. difficile from clinical samples.

These proceedings of Falk Symposium 110 on `Intestinal Mucosa and its Diseases - Pathophysiology and Clinics' held at Titisee/Black Forest, Germany, 16-17 October 1998, comprehensively review salient clinical as well as scientific aspects - pending or settled - of the main intestinal diseases. In particular, chapters deal with infectious and neuroendocrine diarrhoeas, coeliac sprue, allergic enteropathy, intestinal lymphomas, colorectal carcinomas, and chronic inflammatory bowel diseases, in terms of clinical presentation as well as underlying mechanisms. This book therefore aims to bridge the gaps between basic science and clinics for the eventual treatment of patients afflicted with these diseases.

Primary care physicians and allied providers need to have a thorough understanding of the evaluation of cardiac risk and the treatment of dyslipidemias. Cholesterol is the primary target of treatment for cardiovascular risk reduction. Primary care providers must first be able to calculate cardiac risk to categorize patients into individual risk treatment groups. A large number of clinical trials and treatment guidelines and recommendations have been published since the last National Cholesterol Education Program (NCEP) Adult Treatment Panel recommendations were disseminated five years ago. This book will present an updated view of this confusing literature and recommendations and focus on an easy and practical way to approach cardiac risk reduction. A major portion of the book will present a risk reduction approach to common, difficult patient types with practical recommendations. The book will begin with a discussion of cardiovascular risk evaluation that will go beyond the NCEP risk calculator. It will incorporate decision making revolving around the metabolic syndrome, biomarkers such as inflammatory markers, and the role of non-invasive atherosclerotic imaging (Calcium score, CT angiography, carotid IMT). The second section will give an overview of lipoprotein metabolism and the development of atherosclerosis. We can then discuss the role of advanced lipid testing and the inherited lipid disorders. Section three will give an overview of treatment starting with lifestyle modification and then will cover pharmacological therapy. The fourth and most important section will present specific patient examples and a very practical approach to treatment. The patient types will be common patients that the Primary Care Physician would see and difficult problems that do not easily fit the current guidelines. The following is an outline of the chapters for the book. There are 16 chapters with each projected to be 15 - 20 pages.

Barrett's Esophagus gives an extensive overview written by the world's leading experts covering the epidemiology, gastroenterology and surgery, as well as the molecular basis of:

• the precursor lesions leading to the development of Barrett's epithelium;
• the unique characteristics of Barrett's esophagus;
• the consequences of malignant degeneration, i.e. adenocarcinoma.

All aspects in terms of diagnosis, secondary prevention, multimodality, medical and surgical treatment are elucidated.

Probiotics in Pediatric Medicine provides clinicians a tool to understand the current evidence for the role of probiotics in various pediatric disorders related to the gastrointestinal as well as the extra-intestinal tract. This book provides evidence-based up-to-date information from world experts in their fields to help clinicians make decisions regarding the use of probiotics. A list of resources, web sites, and references relevant to probiotics can be found in the appendix. Currently, the market for probiotics continues to rely heavily on health claims made by manufacturers and retailers. Clinicians have the sole responsibility to understand the various strains and preparations commercially available and to advise patients accordingly. Probiotics in Pediatric Medicine is an indispensable tool and a critical resource for health professionals that will aid in enhancing their ability to make the appropriate decisions regarding the use of probiotics.

The Sixth Edition continues the tradition of this great book by applying anatomic knowledge to state-of-the-art imaging. Chapters have been reorganized to help the reader better interpret imaging studies by clearly demonstrating what to expect and where to look for disease spread from each individual organ. Up-to-date chapters explore the dynamic concept, explain its embryologic and anatomic basis, and classify the mechanisms of disease progression. The latest imaging modalities, including CT, MRI, ultrasound, and PET, are incorporated throughout.

Endoscopic ultrasound has revolutionized the approach to lesions inside and outside the gastrointestinal tract. It has opened the door for gastroenterologists to explore organs outside of the GI lumen, such as the lymph nodes, lung, pancreas, and liver. Endoscopic Ultrasound covers all aspects of endoscopic ultrasound, from the basics to the interventional indications. Richly detailed chapters describe the utility of EUS in different parts of the body and are organized based on body site Pioneers in the field summarize new studies, and the direction of EUS in practice. Endoscopic Ultrasound provides a ready reference that will help physicians and support staff that are beginning EUS, as well as trained ultrasonographers who wish to arm themselves with a comprehensive reference and explore the future of the field.

Colorectal cancer is one of the most frequent human tumors. Despite tremendous advances in our knowledge about the pathogenesis of the disease, the prognosis remains poor for almost half of the individuals affected. This volume provides an updated and comprehensive description of the most relevant features of colorectal cancer - from molecular biology to prevention, from hereditary syndromes to new treatment modalities. It represents an invaluable source for clinicians who deal with colorectal neoplasms and for all those who wish to increase their knowledge of these malignancies.

The prevention of colorectal cancer is a subject of increasing medical importance, and there have been a number of promising recent developments. This book examines in detail important aspects of the current status and future prospects for chemoprevention of colorectal tumors. Research into the mechanisms that lead from early colorectal adenoma to colorectal cancer is discussed. The role and modes of action of available drugs such as celecoxib and sulindac are described, and recent data from aspirin trials are analyzed. In addition, the possible impact of nutritional agents with anti-inflammatory properties is considered, and strategies applicable in those with a high level of genetic risk are evaluated. An important feature of the book is its holistic perspective, making it relevant for gastroenterologists, internists, general practitioners, oncologists, colorectal and gastroenterological surgeons, and public health practitioners.

Magnetic resonance cholangiopancreatography (MRCP) is a novel non-invasive technique for diagnosis of pancreatic-biliary disease. The purpose of this book is to highlight the advantages, limitations and indications of MRCP. Specific examples have been selected to showcase the utility of this technique in a large variety of clinical conditions. Each example is purposefully used to stress important technical features, to give practical advice, or to discuss the role of MRCP in specific clinical situations. Important features of the book are the high quality of the illustrations, the reduction of the text to relevant and practically useful issues, and the simple and logic organisation of the case material. The book should show: the optimal technique in MRCP, the pitfalls and limitations.

Anorectal and Colorectal Diseases was frst published overall efect is a comprehensive and authoritativ-e ac in 1989 under the editorship of Marc-Claude Martico unt of the whole feld of colorectal practice. T - e lay and Jean-Claude Givel. Its success has now resulted in out is attractive, making the text easy to digest, and the a third edition, which has an expanded chapter list to il lustrations are well chosen and helpful. Te bibliog - ra take into account the many developments that ha- ve o pchy of each chapter is in itself an impressive feature of curred in coloproctology during the last 2 y0 ears. Te the book; there are, for example, over 200 references in editors have chosen an international group of autho Crh sa pter 34, Management of Malignant Tumours . who are authorities in their feld. Tey have themselves Anorectal and Colorectal Diseases will be of immense contributed extensively to a work that comprises 49 va lue to hospital-based specialists in the felds of -diges chapters dealing with all aspects of colorectal diseas t e i. v e surgery and gastroenterology. It should also appeal Te book is divided into four sections. Sec t I io co nn- to specialist nurses and undergraduates. Te book will tains 18 chapters on topics that include basic anatomy s, e rve both as a reference source of major importance physiology, clinical methodology and investigations. a nd as a guide to clinical practice."

As in previous years, the editors have selected topics which are rapidly developing and for which there is a need to communicate new information. For Roma 99 they have chosen nine topics, each subject to a pair of presentations, the first on new disease mechanisms and the second on recent development in clinical management.

Squamous cell carcinoma of the esophagus has a lower incidence than other gastrointestinal tract cancer; however, there are many difficult issued related to the choice of appropriate therapy for these patients. In recent years, the use of multimodal treatment has greatly improved the prognosis of patients affected by this disease but several aspects of the oncological and surgical management are still controversial. This book aims to give a homogeneous approach to esophageal cancer treatment, based on the author's lifetime experience in conjunction with exhaustive review of recent literature. In each chapter surgeons and oncologists will find appropriate tools for correct management of the diagnosis and therapy of this difficult disease. The book analyzes all the aspects of staging and treatment, such as modern diagnostic and staging techniques (MRI or PET-CT), endoscopic treatment of early cancer, new minimally invasive and open surgical techniques, and combined treatment. In addition, there are chapters dedicated to the postoperative course of these patients, as well as their quality of life, with indications for the correct follow-up and treatment of relapses.

This book contains the proceedings of Falk Symposium 167 entitled 'Liver under Constant Attack - From Fat to Viruses', which was held in Mainz, Germany, on 20-21 September 2008. It merges up-to-date viral liver immunology with relevant topics in clinical practice. Sections cover viral hepatitis, immunosuppressive approaches in liver patients, malignant liver diseases, inflammatory liver diseases and complications of liver cirrhosis. Interdisciplinary discussion of new concepts in the treatment of liver diseases makes this book valuable for scientists and clinicians alike.

This book is the proceedings of the Falk Workshop on 'Strategies of Cancer Prevention in Gastroenterology', held in Mainz, Germany, on 17 September 2008. The meeting was a unique opportunity to assemble so many of the world's best experts to discuss the state of the art and future developments and challenges in cancer prevention in gastroenterology. Barrett's, gastric and colorectal cancer were the main topics, with cancer in inflammatory bowel disease as a particular subject. The overall impression of the meeting was the experience that in many countries of the world the strategies are similar with, of course, focus on different ways to reach the same goal of reducing incidence and cancer mortality. It was extremely stimulating to exchange new ideas and new concepts and to see what progress in public awareness has been made in different countries. Cancer prevention is and will continue to remain a major political as well as a genuinely medical task, to work for more convenient and useful programs and to carry the burden of broad acceptance. This workshop was another milestone on the long road towards this difficult goal. All those working in this important field will find in this book detailed information and instruction for their clinical and/or scientific activities.

While reflux disease, achalasia, esophageal spasm, gastroparesis and IBS include some of the most common disorders in all disease categories, our understanding of their pathophysiology remains elusive. The field of clinical gastrointestinal motility has for decades relied on the measurement of intraluminal pressures to deduce intestinal movements that define these difficult and enigmatic disorders of gut function. Although computers have greatly facilitated the analysis of data obtained from intraluminal pressure recordings, the sensors and catheters used to measure intraluminal pressures have changed little over the last 20 years. In the last 3 years, a new technologic breakthrough has taken place in the evaluation of gastrointestinal motor function. It is called high-resolution manometry. Rather than the old 4 to 8 channel conventional systems used to measure intraluminal pressure, high-resolution catheters employ 36 closely spaced, solid state pressure transducers. This technology enhances the resolution of gut motor activity incredibly. By using color to depict pressure, high-resolution color contours are beautiful images that give a detailed spatial and temporal picture of gastrointestinal motor function that was previously impossible. By recognizing motor patterns, diagnoses can be made that are very difficult, if not impossible, to appreciate with the old technology. High-resolution manometry is a dramatic technical leap in a long time stagnant field.

Since the previous M.D. Anderson Solid Tumor Oncology Series publication on pancreatic cancer, there have been major advances in our understanding of molecular events which underlie pancreatic cancer development, both in the sporadic and inherited forms. This book provides information on the recent progress and improvements. It brings to the forefront the most current advances that have been made in understanding pancreatic cancer development and successfully treating this disease.

Taking the problem-based approach, this text helps clinicians improve their diagnostic and therapeutic skills in a focused and practical manner. The cases included demonstrate the diversity of clinical practice in the specialty worldwide, and are divided into five major sections: Upper GI, Pancreato-Biliary, Liver, Small and Large Bowel, and Miscellaneous.

Significant scientific progress has been made in recent years in the aetiopathogenesis of chronic inflammatory bowel diseases (IBD), that has changed or will change in the future the diagnostic and therapeutic approach in these diseases. The relevance of classical conventional IBD therapies has been critically re-evaluated under criteria of evidence-based medicine approaches. On the other hand, new therapeutic options have emerged. These include modern immunomodulators, biologics, probiotics, worm eggs and extracorporeal therapies. The clinical relevance of these new modalities is often difficult to assess for physicians who do not work frequently with IBD patients.

Biopsy Interpretation of the Gastrointestinal Tract Mucosa is your definitive bench reference for the diagnosis of these challenging specimens. One of the best-selling titles in the Biopsy Interpretation Series, its practical, richly illustrative coverage encompasses the most common mucosal biopsies from the esophagus, stomach, small intestine, large intestine, and anus, helping you to evaluate the full range of samples and recognize their distinguishing features. This volume focuses on neoplastic entities; Volume One, also available, is your complete source on non-neoplastic gastrointestinal lesions. Key Features Successfully navigate both common and unusual issues that arise in the day-to-day interpretation of gastrointestinal biopsies. Entities covered in this volume include: Barrett esophagus, mesenchymal neoplasms such as GIST, schwannoma, and benign fibroblastic polyp, hereditary cancer syndromes, and many more. Enhance your interpretation skills with valuable pearls and pitfalls at the beginning of each chapter. Compare your samples to hundreds of full-color illustrations that capture the characteristic appearance of most mucosal biopsies of the gastrointestinal tract. Access additional illustrations plus 50 multiple-choice review questions in the companion VitalSource eBook! Your book purchase includes a complimentary download of the enhanced eBook for iOS, Android, PC & Mac. Take advantage of these practical features that will improve your eBook experience: The ability to download the eBook on multiple devices at one time - providing a seamless reading experience online or offline Powerful search tools and smart navigation cross-links that allow you to search within this book, or across your entire library of VitalSource eBooks Multiple viewing options that enable you to scale images and text to any size without losing page clarity as well as responsive design The ability to highlight text and add notes with one click

Advanced Imaging of the Abdomen is invaluable to the practising radiologist, and the more senior radiology resident and fellow, who is looking for a background reference source when discussing a suggested imaging approach with the referring physician.

The book includes extensive lists, tables, line drawings and illustrations - ultrasonography, computed tomography, magnetic resonance images, scintigraphy. It bridges the interface between the referring clinician and radiologist when faced with a patient suspected of having a complex or more unusual abdominal condition.