Clinical experts synthesize for the practicing physician all the important developments that have occurred recently in the diagnosis and treatment of acid-related diseases. They address the evaluation of patients suspected of harboring both peptic ulcers and ulcers from other causes, with emphasis on novel aspects of H. pylori infection. New information is also provided to assist clinicians in efficiently managing patients with dyspepsia and in the diagnosis and treatment of gastroesophageal reflux disease (GERD), including its extraesophageal manifestations and upper gastrointestinal bleeding. Authoritative and highly readable, Diseases of the Gastroesophageal Mucosa: The Acid-Related Disorders distills a wealth of cutting-edge clinical practice into one readable volume that will help every clinician manage patients with today's best diagnostic and treatment practice.

Chronic inflammatory bowel disease still represents a major gastroenterological challenge, in view of the unclear aetiology and unsatisfactory therapy. This book, the proceedings of a Falk Symposium held in L beck, Germany on 4--5 March 1994, will act as a vehicle for our current knowledge, and promote the dialogue between clinicians and those involved with the associated sciences. The book begins with international experts discussing the more recent theories concerning the aetiology and pathogenesis. Later on, the discussion turns to questions of diagnosis, and the conservative and surgical treatment of Crohn's disease and ulcerative colitis are dealt with in detail. This volume in the Falk Symposium both represents a forum of experts for discussion of the most recent findings, and provides clinical gastroenterologists with an opportunity to inform themselves of the state of the art in the field of inflammatory bowel disease.

This Trends in Inflammatory Bowel Disease Therapy Symposium was held in Vancouver, British Columbia, Canada, 27 29 August 1999. This is the seventh international symposium, sponsored by Axcan Pharma Canada Inc., since the first symposium in 1986. The Canadian Association of Gastroenterology has co-sponsored these symposia since 1990. Each symposium has been published, and reflects and updates the extensive research and education, and the understanding of the mechanisms and treatment of inflammatory bowel disease. From the beginning, Canadian and international experts have been involved, maintaining a consistently high quality, both in their presentations, during discussions, and the subsequent publication of their work. There have been major advances since the symposium held two years ago, and these are presented in this book. In keeping with modern educational practice, objectives are provided, and all presentations were subject to written independent evalu ation. All participants are asked to declare any conflicts of interest. MOCOMP and educational credits are available."

The discovery and concept that Helicobacter pylori is associated with gastric disease including gastric cancer which is one of the most common and frequently lethal forms of malignancy, heralded a new and rapidly expanding field recognizing the emergence of many new pathogens and disease syndromes in clinical medicine, as well as basic infectious disease research. There is now an extensive and widely known literature of how H. pylori is involved in a wide variety of disease syn dromes. As summarized in the introductory chapter of this volume, many major advances have been made in diagnosis, both serologic and endoscopic in time of the involvement of this organism in patients with upper GI ailments as well as its presence in those who are not clinically ill. The Introduction describes the rapid development of understanding the role of this organism in disease. The basic bacteriology of H. pylori is then described in the second chapter. Diagnostic tests for detecting H. pylori infection is then highlighted, as well as the role of such infection in gastric cancer. Current knowledge concerning risk factors and peptic ulcer pathology associated with H. pylori is then described. Newer information concerning therapy of H. pylori infection and colonization is described in a subsequent chapter as well as one concerning the effects of anti biotics on H. pylori infection. The extensive literature on natural substances with anti-H."

The gastrointestinal tract has a number of unique features. Its extensive surface is formed by a single layer of rapidly renewing cells, the intestinal epithelial cells. These cells are in contact with a number of other cell populations, including the largest part of the immune system, and with an excessive luminal antigen load, including vast numbers of bacteria. Furthermore two more organs, namely liver and pancreas, are part of the system. The rapid renewal of the epithelial layer, the interactions of different cell types, and the balance between cell proliferation and death, have been fascinating subjects of studies in recent years. Much has been learned, and cytokines have emerged as important mediators for all these interactions and homeostatic systems. This book, the proceedings of the Falk Symposium 113 on `Cytokines and Cell Homeostasis in the Gastrointestinal Tract', held in Regensburg, Germany, 16-18 September 1999, provides a forum for basic scientists and interested clinicians to exchange ideas, to discuss concepts and to plan further studies.

Because of the increasing burden of hepatitis C and fatty liver disease, there is an explosion in the prevalence of chronic liver failure and hence its complications. The onset of Hepatic Encephalopathy (HE) in these patients has a significant impact on the quality of life, morbidity and mortality. Unfortunately, the approach observed by most clinicians to this complex disorder is minimalistic. Hepatic Encephalopathy provides a comprehensive review on pathophysiology and clinically important aspects in HE. Topics in basic physiology, nitrogen metabolism, new insights into pathogenesis and brain edema are covered in great detail. The authors have made a special effort by simplifying the complex aspects of pathogenesis and diagnosis so that it can be easily understood and applied clinically. This volume also focuses on recent developments regarding diagnoses of subtle forms of HE, also known as minimal or covert HE as well as on new treatments. Hepatic Encephalopathy will be of great value to gastroenterologists, hepatologists, pathologists, medical residents, fellows, internists, and general practitioners who treat patients with hepatic encephalopathy.

Probiotic microorganisms have a long history of use, and their health benefits for hosts are well documented. This Microbiology Monographs volume provides an overview of the current knowledge and applications of probiotics. Reviews cover the biology and probiotic potential of the thoroughly studied prokaryotic genera Lactobacillus and Bifidobacterium, several eukaryotic microorganisms, probiotic strain characterization, and the analytical methods (such as FISH, microarray, and high throughput sequencing) required for their study. Further chapters describe the positive effects of probiotics on malabsorption disorders such as diarrhea and lactose intolerance, and document the clinical evidence of benefits in treating allergies and lung emphysema, and in dermatological applications. Also addresses are topics such as genetically engineered strains, new carriers for probiotics, protection techniques, challenges of health claims, safety aspects, and future market trends.

In recent years there have been a number of significant developments of natural products for the treatment of rheumatic diseases, pain and gastro-intestinal ulcers and inflammation. The volume covers some of these novel developments of natural products which are of current and future interest as therapies for the above-mentioned conditions. Most available volumes cover a wide range of biological and technicological aspects of natural products and their discovery, some involving synthesis and properties of chemical compounds. The difference in this volume is that the natural products have a focus on their therapeutic effects on pain, arthritic and gastrointestinal diseases. Some of the natural products covered are either at the experimental stage of development while others are well-established clinically-used products. Each has its own unique place in therapy.

The endoscopic use of lasers in the treatment of gastrointestinal d seases began within the last decade and has evolved rapidly. Work is now being done at more than 150 centers in Europe, the United States, Japan and the rest of the world. To date no publi cation has defined the state of the art. This text attempts to fill that void. To disseminate information about therapeutic laser endoscopy, an increasing number of short courses have been sponsored in the United States wherein the attendee hears didactic lectures, views video tapes, and in addition, has the opportunity to have a "hands-on" experience with endoscopic laser therapy in the animal labs. This book is an expansion of the material presented in one such course sponsored by The Cook County Hospital in Chicago, Illinois, in October, 1982. The course was organized by Peter Bright-Asare, M. D., Chairman of Gastroenterology at the time of the course and chaired by Dr. Bright-Asare and myself. Some of the lectures from the course have been broadened and formalized. Other chapters were invited and added. Also included are group discussions about issues that are either controversial or undefined. Attempts were made to secure consensus opinion from experienced investigators in areas where no hard scientific experimental or clinical data exists. The contributors have a wide range of interest and expertise. Dr."

Autoimmune (IgG4-related) Pancreatitis and Cholangitis reviews the breadth of clinical, imaging, histological, laboratory, and imaging features associated with IgG4-associated systemic disease, especially AIP and IAC. Written by experts in their fields, each chapter includes an overview of existing data as well as the most up-to-date scientific information and emerging data. The book also addresses areas of uncertainty and controversy, briefly highlighting clinical and research needs relative to the respective topic. Comprehensive and easy to use, Autoimmune (IgG4-related) Pancreatitis and Cholangitis is a valuable resource for physicians who deal with or are interested in these complex disease processes, including gastroenterologists, hepatologists, and surgeons.

This volume presents the most recent developments in diagnosis and treatment of patients with gastroesophageal reflux disease (GERD) and those who continue to be refractory to conventional GERD therapies. The book delineates the role of newly developed endoscopic therapies in GERD and outlines the best candidates for surgical fundoplication. Topics as the risks associated with GERD, lifestyle modification in GERD and the role of H2RA and proton pump inhibitor therapy in treating reflux disease are also explored. Written by authorities in the field, Diagnosis and Treatment of Gastroesophageal Reflux Disease is a concise yet comprehensive resource that is useful for primary care providers, gastroenterologists, pulmonologists, surgeons and ENT specialists.

Gastrointestinal diseases present a considerable problem in human medicine in terms of both morbidity and mortality. The aim of this book is to cover the different immunological disorders of the gut with special reference to immunopathological and protective mechanisms. It will be of general interest to clinicians, scientists and students concerned with the gastrointestinal tract. Topics covered include: the current status of research into toxin-secreting pathogens, Campylobacter, Giardia and HIV; the immunological features of idiopathic inflammatory gut diseases such as Crohn's disease and intractable diarrhoea; the genesis of the flat mucosa; the iatrogenic diseases of the gut such as graft-versus-host disease and small bowel allografts; the immune mechanisms and lesions in the gut of patients with parasitic nematode infections (very important in the tropics). Basic background on the immune apparatus in the intestine is also discussed, as are the effects of inflammation on intestinal permeability.

In offering this book to what we hope will be interested readers, we have several aspirations. We have aspired to present to students and clinicians a rather narrow view of epidemiology concentrating on the causal factors and setting of the more usual gastroenterological problems and giving greater space to conditions of importance for which major knowledge of causation andcourse is available. Part of the rationale is thebelief that modern medicine lays excessive emphasis on therapy with increasingly expensive, and in many cases, dangerous drugs and too little emphasis on the causes and avoidance of disease. We are of the view that traditional views handed st down through generations of clinicians need scrutiny worthy of 21 century medicine whose currency includes topics like nanomoles, megabytes and logistic regression. We hope that clinicians will see that there is often a practical application to the findings of epidemiological exploration and that what passes for canonical knowledge is so often unsubstantiated myth and are fully aware of the reluctance of organized medicine to reject old paradigms in favor of the new, matched by an often uncritical enthusiasm for new therapies. Our researches have increased our belief in the major role of social factors especially diet, both in quantity and quality in many disorders and that clinicians have a responsibility to provide appropriate advice to policy makers as well as patients.

Endoscopy has revolutionized clinical gastroenterology. In 1961 Basil Hirschowitz published the first flexible endoscopic examination of the stomach and duodenal bulb. We moved from flexible fiberendoscopes to current video-endoscopic equip ment. Current video-endoscopes incorporate a black and white or color 'chip' at the tip of the instrument which transforms the visual image into electronic signals. The size of the pincet is constantly getting smaller, heading for 5 /Lm, further increasing the resolution. The signals are reassembled into high-quality color images in a video monitor. Endoscopes are now used to examine the entire gastrointestinal tract from esophagus to rectum, including the biliary and pancreatic ductal system. Targeted endoscopic biopsy offers rapid and precise diagnosis. Endoscopic ultrasonography is of unsurpassed accuracy in staging gastrointestinal tumors, in assessing pancreatic and biliary disease, and disorders of the rectum and anal canal. Moreover, targeted cytological sampling is possible of abnormalities of the intestinal wall or peri intestinal lymph node. Yet despite these glamorous achievements changes are to be expected in the overall emphasis of diagnostic endoscopy. Magnetic resonance cholangiopancreatography may very well compete for a substantial fraction of diagnostic ERCP. Virtual colonoscopy or computed tomographic colography may well compete with (and take over?) screening/surveillance colonoscopy."

Ulcerative colitis and Crohn's disease remain a great therapeutic challenge to the medical community. In recent years knowledge about the pathogenesis of these diseases has progressed rapidly but the cause of the diseases remains completely unknown. It has become clear that dysregulation of the mucosal immune system is the basis for the chronic evolution of the diseases in a genetically susceptible population. Exciting new therapeutic approaches have been attempted in the last couple of years and cytokine and anti-cytokine treatments in particular seem very promising, especially in intractable disease. The format of the Falk Symposium 106 on Advances in Inflammatory Bowel Diseases', held in Brussels, Belgium, June 18-20, 1998, was somewhat innovative as each session attempted to link the new insights into pathogenetic mechanisms with new therapeutic approaches, resulting in optimal information transfer. The classic therapeutic schemes were updated with a special focus on step-wise build-up of therapy.