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.

The author was motivated to write this important book because currently there is no systematically-written document on the ZIKV disease, which could serve at this crucial moment as a textbook for medical students, physicians, nurses, and other healthcare providers as well as a reference book for basic researchers, professors, and the general public. The original concept of ZIKV-Charnolopathy due to compromised mitochondrial bioenergetics in highly vulnerable (neural progenitor cells, spermatocytes, oocytes etc.) cells and its amelioration by physiological and/or pharmacological interventions is based on years of research experience. This book describes unique organ and disease-specific Charnoly body (CB) inhibitors, charnolophagy inducers, CB sequestration inhibitors, and chanolophagosome stabilisers as promising charnolopharmacotherapeutics. They are meant to aid in the prevention and treatment of the ZIKV-linked diversified spectrum of neurodevelopmental anomalies (embryopathies) in newborn infants and Guillain Barre Syndrome (GBS) in adults. Clinical management of ZIKV-induced GBS employing IV immunoglobulin and plasmapheresis (plasma exchange) is also described.

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.

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.

Inflammatory Bowel Diseases: A Clinician s Guide provides practical guidance for the diagnosis and management of those suspected or known to have one of the forms of these complex diseases. It is perfect both for gastroenterology trainees learning to care for these patients and the experienced physician as a concise and practical resource for day to day use. Written by the experts, Inflammatory Bowel Diseases: A Clinician s Guide is an essential tool for all gastroenterologists managing patients with inflammatory bowel disease.

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.

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.

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.

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)

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.

Packed with Board-focused hints, case studies and an online Board-standard MCQ test offering CME credits, this fantastic book covers every gastroenterology disease and symptom you re likely to encounter and is the perfect tool to prepare for Board exams and certification.

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.