This book clarifies and explains perineal anatomy and the pathophysiology of anal incontinence as well as applied pharmacology. It also institutes the new recommended classification of perineal tears, and describes anal sphincter repair techniques. The emphasis is on correct post-operative management, management of pregnancy following previous anal sphincter injury, and prevention of anal sphincter tears. The book will interest students, colorectal surgeons, physiotherapists, midwives, continence advisors, labour wards and lawyers.

Acute pancreatitis (AP) is the inflammatory process secondary to damage of the pancreatic acinar cells. AP is one of the most common diseases of the gastrointestinal tract, leading to significant emotional, physical, and financial burden for society. The diagnosis of acute pancreatitis is often established by clinical symptoms and laboratory testing. Chapter One of this book reviews the clinical characteristics of acute pancreatitis in children based on the clinically based diagnostic criteria for childhood pancreatitis, which until recently was not available. Chapter Two presents an update on the current state of walled-off pancreatic necrosis. Chapter Three provides a review of Purtscher's Retinopathy. Chapter Four examines the impact of obesity on the severity of AP. Chapter Five discusses several advances in the management of AP, from classical methods to more advances options. Chapter Six discusses management of acute biliary pancreatitis. Chapter Seven reviews radiology of AP and the complications associated with it. Chapter Eight studies the use of antibiotics in AP. The final chapter explores the therapeutic effect of Shenmai injection (SMI) on acute experimental pancreatitis and underlying mechanisms.

Chronic pancreatitis (CP), a worldwide disease, is primarily recognised as a long-standing inflammation of the pancreas that alters the organ's normal structure and functions. CP reflects the end-stage pathology of inflammation-associated diseases. It presents episodes of acute inflammation or chronic damage of pancreas with symptoms of persistent abdominal pain or malabsorption, weight loss, pain related to the intake of food containing a high percentage of fats and protein. The health conditions of diabetics have been found to deteriorate due to pancreatic damage in CP. A plethora of information has emerged in recent years in the area of pancreatitis research. The frontiers of current pancreatic research reflected its newer definitions, classifications, tools for investigations, animal models, insight into the molecular mechanisms of the initiation of the earliest pancreatic injury, the role of cytokines and inflammation; and attributes of genetic mutations in SPINK1 CFTR, CTSB, MTHFR and ACE etc. during pancreatitis. The topological variations of patients have been found to be associated to a different trend of pathogenesis and severity of the disease, which might be associated to relatively poor nutritional uptake and other environmental factors. Keeping these facts in view, we envisaged to bring out an updated overview on this subject in general and to present the experiment based information on tropical chronic pancreatitis (TCP) in the patients from northern part of India in particular.

Drug-induced mucosal damage is of immense importance in gastroenterology. It is imperative that clinicians understand how these lesions come about, what the sometimes devastating consequences are and what can be done to prevent or to treat such calamities. Drug-induced damage is bound to increase in the future as the population ages and polypharmacy becomes the rule instead of the exception. Hopes for improvement were shattered when the long term consequences of COX-2 inhibition became available. Is the COX-1/COX-2 concept truly obsolete? Several issues are discussed by European experts in the second part of the book. What the clinician should know about non acid, weakly acid or biliary reflux is discussed in depth. Novel developments of gastrointestinal neuropathies and motor disorders concentrate on IBS, pseudo-obstruction and faecal incontinence. Our surgical colleagues will certainly be interested in novel minimally invasive procedures. Finally all will learn from a critical analysis of novel diagnostic imaging modalities.

Eosinophilic esophagitis (EoE) is a chronic inflammatory condition characterized clinically by symptoms of esophageal dysfunction and histologically by dense eosinophilic infiltration. Its pathogenesis involves an immune-mediated response to environmental antigenic stimulation. The incidence and prevalence are increasing and EoE has become the most common cause of dysphagia and food impaction in adults. Its management often requires a multi-disciplinary approach as treatment includes specialized diets, anti-eosinophilic medications and esophageal dilation once fibrostensosis has developed. This book discusses the causes, symptoms and treatment options of eosinophilia.

Infection by Helicobacter pylori has for many years been one of the medical conditions most studied not only in the gastroenterological context. This is because, in recent years, H. pylori has also been involved in a number of extra-intestinal diseases. In this book, we have tried to involve the biggest international experts on the subject. Some authors have tried to provide a complete view of the most common and widely used diagnostic methods, both invasive and non-invasive, also explaining the unusual techniques and the most innovative complementary methods not yet used in clinical practice. Other international experts have tried to describe the latest findings on pathogenesis and the various clinical manifestations of infection by H. pylori in the various systems. One chapter is reserved for H. pylori infection in childhood, an important period especially in transmission of the infection, explaining the various international guidelines for correct diagnosis and treatment. The authors have also provided the latest evidence regarding the various methods of eradication therapy, with a critical analysis of the reasons that compel some researchers to believe that eradication at all costs is not always correct and useful for humans. The book also deals with the current and latest knowledge regarding the progress and the difficulties in the development of a vaccine against H. pylori infection, the implementation of which could solve the problem of the difficulty in the eradication linked mainly to the onset of antibiotic-resistance.

Barrett's oesophagus refers to an abnormal change or metaplasia in the cells of the lower portion of the oesophagus. When the normal squamous epithelium lining of the oesophagus is replaced by goblet cells, Barrett's oesophagus is diagnosed. The medical significance of Barrett's oesophagus is its strong association with oesophageal adenocarcinoma, a particularly lethal cancer. In this book, the authors discuss the risk factors, diagnosis and management of Barrett's oesophagus. Topics include chemoprevention strategies including aspirin and non-steriodal inflammatory agents in treating Barrett's oesophagus; an endoscopic ablative technique used in the management of Barrett's oesophagus and early oesophageal cancer; a histopathological analysis of protease activated receptor-2 (PAR-2) and cyclooxygenase-2 (COX-2) immunoexpression in oesophageal glandular metaplasia; and the impact of inflammation-metaplasia-adenocarcinoma sequence and inflammatory microenvironment in oesophageal carcinogenesis using surgical rat models.

Short bowel syndrome (SBS) is defined as intestinal failure following a loss of intestinal length which causes marked maldigestion and malabsorption of dietary nutrients and induces major faecal issues, loss of energy, nitrogen, and fat. Intestinal failure and SBS continue to be important clinical problems due to their high mortality and morbidity rates, as well as their devastating socio-economic effects. Although intestinal transplantation has emerged as a feasible alternative in the treatment of children with SBS in the last two decades, intestinal adaptation remains the only chance for survival in a subset of these patients. Intestinal adaptation is defined as a process of progressive recovery from intestinal failure following bowel resection. In this book, the aetiology of SBS, its pathophysiology, and the cellular and molecular mechanisms of intestinal adaptation are reviewed. The most common complications of SBS, including intestinal failure associated liver disease and sepsis, are outlined with strategies to reduce them. The potential role of tissue engineering for SBS that go beyond the "simple" generation of the tubular small intestine is discussed. Such knowledge will likely provide the basis for further advances in the treatment of patients with short bowel syndrome and suggest new therapeutic strategies to maintain gut integrity, eliminate the dependence on total parenteral nutrition, and avoid the need for intestinal transplantation.

Proceeding of the 10th International Symposium. Coeliac disease is again in front of the stage. After the advent of intestinal biopsy in clinical practice in the early sixties and during the following years, coeliac disease gained its status of a disease exemplary of the immune reaction of the gut mucosa to food antigens. During the following 10-15 years coeliac disease vanished behind progresses in mucosal immunology, and in the molecular biology of HLA molecules. The last years have seen the transformation of coeliac disease, from a rare and serious malabsorption syndrome into a polymorphic condition, the "coeliac iceberg" the immersed part of which now raises important public health issues. Regular International Symposium witness the development of our knowledge concerning coeliac disease. The last International Symposium on coeliac disease took place in Paris, at the Pasteur Institute in June 2-5, 2002. Its aim was to equally underline the major progresses made during the recent years in epidemiology, the genetics, the pathophysiology of the intestinal lesions and in the serological methods of diagnosis, the new clinical aspects of the disease and the more accurate evaluation of the risk of cancer, lesser than previously estimated. We hope that these proceeding will fulfil the expectations of all those, scientists as well as clinicians, paediatricians or adult gastroenterologists, who wish to update their knowledge on coeliac disease, this old but still stimulating lady of gastroenterology.

This is a personal account of the British contribution to gastroenterology over the last 200 years. It covers the common diseases of the oesophagus and stomach, followed by coeliac disease, inflammatory bowel disease and functional gastrointestinal disease. The final section discusses the British impact on endoscopy. Each disease is followed from its earliest description and is based on monographs and journal articles. The aim of the book is to explain why and how physicians and surgeons have managed to achieve so much during this time and with this in mind the author has interviewed over 100 people who have actually made this history. Whenever possible anecdotes and personal recollections are included. The illustrations are by the author. It includes: section one the oesophagus; section two the stomach and duodenum; section three the small intestine coeliac disease; section four inflammatory bowel disease; Section five functional bowel disease; and, section six gastrointestinal endoscopy.

Gluten is a complex structural protein, constituted by a particular composition of amino acids present in wheat. In this book, the authors address the sources, composition and health effects of gluten. Topics include immunoassays for measuring coeliac harmful protein and peptides in gluten-free foods; gluten-related disorders; gluten formation and health effects; meat analogue produced with soy protein isolate and vital gluten by thermoplastic extrusion; the potential of gliadin for biomaterial applications; gluten ataxia in Europe and the United States; new therapeutic options for celiac disease; and a review of gluten-free food products for celiac consumers.

John Libbey Eurotext continues to publish the proceedings of the gastroenterology seminars taught by leading European specialists and organised by the European Association for Gastroenterology and Endoscopy (EAGE). The aim of the book is to describe major clinical and therapeutic progress observed during 2002: gastrooesophageal reflux disease, inflammatory bowel disease, irritable bowel syndrome, colon cancer, liver cancer.

Swallowing difficulties or dysphagia, can occur with numerous conditions, some of which are permanent, some reversible, and some progressive. The underlying etiology can be neurological, muscular, or mechanical/obstructive. The authors of this book present topical research in the study of the risk factors, diagnosis and treatment of dysphagia. Topics discussed include the etiology and prognosis associated with dysphagia; prevention of radiation-induced dysphagia; dysphagia in the myopathies; swallow screening as an essential component of acute stroke management and the perioperative risk factors for dysphagia. (Imprint: Nova Biomedical)

This portable handbook provides daily guidance on one of the most prevalent conditions in medicine, gastroesophageal reflux disease and related acid-reflux conditions. Gastroenterologists in training and in practice will use the variety of pedagogic features -- such as case histories, potential pitfall boxes, key points, management algorithms, and useful weblinks -- in each chapter to find quick answers to immediate questions.

In this book, the authors present current research in the study of the symptoms, treatment and prevention of gastrointestinal disorders. Topics discussed include short bowel syndrome; gastrointestinal disorders in pregnant women; dual topology of the gastric proton pump; epithelial barrier function in inflammatory bowel disease; treatment of laryngopharyngeal symptoms related to gastroesophageal reflux disease by proton pump inhibitors; Crohn's disease and the therapeutic perspectives of gastrointestinal melatonin.

A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the oesophageal opening in the diaphragm. This book presents topical research in the study of the types, symptoms and treatment of hernias. Topics discussed include minimally invasive repair of inguinal hernia in children; surgical approach to parastomal hernia and risk factors for incisional hernia after severe secondary peritonitis.

Acute appendicitis is caused by inflammation of the vermiform appendix and usually causes pain in the right lower abdominal quadrant, referred rebound tenderness, overlying muscle spasm and cutaneous hyperesthesia. This disease is common and occurs with an annual incidence of 0.25% in the normal population, and there is a lifetime risk for acute appendicitis of 7-9%. This book presents research data from across the globe in the study of appendicitis, its symptoms, diagnosis and treatments. Included herein are topics such as appendicitis during pregnancy; antibiotic therapy alone in the management of acute appendicitis; diagnostic strategies and immunology in acute appendicitis; and utilisation of the Alvarado score to perform CT for acute appendicitis.

Diarrhoea is a clinical symptom characterised by an increase in the volume, wateriness, or frequency of bowel movements. Acute diarrhoea is a common cause of death in developing countries and the second most common cause of infant deaths world-wide. The loss of fluids through diarrhoea can cause severe dehydration which is one cause of death in diarrhoea sufferers. The causes of diarrhoea can be infectious or non-infectious. Infectious causes are due to bacteria, viruses, or parasites. This book presents research on diarrheal viruses; cholera in Africa; the pathogenesis of Clostridium-difficile associated diarrhea; faecal organic anions in calf diarrhoea and the pathophysiology of irritable bowel syndrome with diarrhoea.

This book covers all aspects of this important and common disorder. Topics covered in the 18 chapters include historical background, basic anatomy and physiology, etiology and pathogenesis, presentation, diagnostic methods, conservative and office procedures, surgical treatment and complications of haemorrhoids, offering a comprehensive critical analysis of advantages and disadvantages of the recognised treatment options, covering both recent advances and traditional treatments in the field. It provides authoritative in-depth presentations of all perspectives and latest techniques available, their advantages and disadvantages. The book includes a wealth of full-colour clinical images to support the visual aspects of haemorrhoidal disease.

Why do certain easily preventable diseases persist in the modern world? Renate Lellep Fernandez sheds light on this paradox by investigating the high incidence of iodine deficiency disease (IDD) among mountain villagers in northern Spain. Just as the mystery of non-prevention leads the author far beyond the confines of a single place, so are the experiences of these villagers rich in lessons for biocultural anthropology and public health in many contexts. The symptoms of iodine deficiency include not only the disfiguring goiters associated with the disease but also a catalog of more serious and even fatal complications. The burden of caring for victims of IDD has taxed the resources of this Spanish village beyond reason. Yet even though its people were-and are-eager for good health and quick to take advantage of modern medical treatment, which has long been available, until very recently they failed to learn that iodized salt prevents the disease. A Simple Matter of Salt unveils the social and political obstacles that have impeded the successful dissemination of preventive knowledge. Here are valuable implications for the prevention of other endemic diseases on a global scale. This title is part of UC Press's Voices Revived program, which commemorates University of California Press's mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1990.

An ulcer is the result of an imbalance between aggressive and defensive factors. The pathology of ulcer is complex and may involve overproduction of acid or pepsin, inadequate mucosal defence, reflux of bile and pancreatic juice into stomach. Peptic ulcer is a classical example of the biopsychosocial model of disease and like most diseases, it has a multifactorial origin. Furthermore, peptic ulcer disease (PUD) is one of the common disorders affecting the digestive system. The lifetime risk of ulcer is 5-10% in developed countries. This book examines the psychosocial risk factors for developing peptic ulcers. It is shown that PUD occurs more frequently among individuals with anxiety and depressive disorders. The use of a fibrinogen- and thrombin-coated collagen patch for a perforated peptic ulcer is researched as a method to reduce morbidity and mortality rates. Through the application of such a device, previously used in hepatic surgery, a new and simple modification to the standard technique may improve the seal of the traditional repair, has no complications and makes the overall operation faster. In addition to peptic ulcers, the aetiology, diagnosis and treatment of gastric and skin ulcers are explored in this book, including the four most common etiologies that account for the large majority of skin ulcers in the elderly, the prevention and treatment of pressure ulcers and the results of research done on opical opioid therapy in treating pain from ulcers.

Diarrhoea is a clinical symptom characterised by an increase in the volume, wateriness, or frequency of bowel movements. Diarrhoea can be osmotic, secretory, malabsorptive, exudative, due to abnormal intestinal motility, or due to bacterial overgrowth. In osmotic diarrhoea, for example, the gut mucosa fails to absorb intestinal contents into the blood stream resulting in accumulation of these substances in intestinal lumen. Subsequently, excessive amount of water remains in stool leading to diarrhoea. This book presents research on various types of diarrhoea, as well as their causes and the available treatments.