IBS, which affects almost one in six Americans, is characterized by abdominal pain, bloating, gas, and diarrhea or constipation. Today more than ever before, physicians are able to diagnose this complex disorder, understand and explain its origins, and develop a treatment plan that effectively meets the individual needs of a patient. Drawing on his many years of experience treating people who have symptoms of IBS, Dr. Brian E. Lacy explains normal digestion, the causes of IBS, how IBS is diagnosed, and what to expect with treatment. He also explores special topics such as IBS in children and psychological, hypnotherapeutic, and psychiatric therapies. Important new information in the second edition includes: the roles of fiber, gluten, lactose, and fructose in the development and treatment of IBS; the use of probiotics and antibiotics to treat IBS; similarities and differences between IBS and inflammatory bowel disease (IBD); the relationship between small intestine bacterial overgrowth and IBS; how to make the most of your visits to a gastroenterologist; and lifestyle modifications that can improve symptoms of IBS. Making Sense of IBS is an essential resource for anyone who has symptoms or a diagnosis of IBS as well as for health professionals who treat people with this complex disorder.

Ever since the invention of the fiberoptic endoscope in 1888, gastrointestinal endoscopy has grown increasingly popular in day-to-day patient management. Most recently, a variety of therapeutic procedures are also being performed through the endoscope. With increasing technological advances, new endo scopic procedures will be appearing on the horizon. It, therefore, becomes extremely relevant for the gastrointestinal nurse or assistant to be familiar with various endoscopic procedures. Gastrointestinal Endoscopy and Related Procedures will be a useful and practical guide in the making of a qualified gastrointestinal assistant. This book is notable for its elegant style, illustrations, detailed account of procedures, and especially the instructions on patient care. Discussions on physical preparation of gastrointestinal procedures, helpful hints and instrument care add to the value of this book. The psychological impact on the patient undergoing endo scopic procedures and the nurse's role in alleviating 'the fear of the unknown' also is properly covered in the text. It is refreshing to see a nursing perspective in the writing of this text. Throughout the whole book, one can feel a warm and humane approach towards patients with gastrointestinal disease. All these and more are, of course, a result of Sister Morag Ravenscroft's vast experience along with the guidance of Dr Charles Swan. It is a textbook worth reading and relishing. Marcia Pfeifer R.N."

GI Emergencies: A Quick Reference Guide contains practical information regarding the diagnosis and management of common gastrointestinal emergencies. Each chapter is written by a fellow or resident with an experienced clinician. This offers the perspective of a trainee, who has many basic questions about how to handle a given situation, combined with the experience of a seasoned practitioner who can guide the work-up and treatment of each clinical case. The result is a reference that provides the clinical acumen of a trained gastroenterologist in an easy-to-use format for physicians to approach GI emergencies efficiently and thoroughly. The dual-perspectives blend perfectly together to create a practical, evidence-based read for the learning physician. In GI Emergencies: A Quick Reference Guide, Dr. Robert C. Lowe and Dr. Francis A. Farraye, along with 20 contributors, help physicians deal with problems as they occur in a "real-time" format. Some Topics Include: * Evaluation and management of acute liver failure * Caustic ingestions, foreign bodies, and food impaction * Nonvariceal upper GI hemorrhage * Acute pancreatitis * Complications of endoscopy The case-based format is less formal than that of a typical textbook, making it enjoyable without losing the educational value and evidence-based recommendations needed to provide excellent patient care. With succinct key teaching points, GI Emergencies: A Quick Reference Guide assists physicians who are training interns, residents, and medical students in training, making it an all-around reference for those in the gastroenterology field.

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."

Master the evaluation and treatment of swallowing disorders! Dysphagia: Clinical Management in Adults and Children, 3rd Edition provides the information you need to diagnose and manage dysphagia in patients of all ages. Emphasizing evidence-based practice, this complete resource covers topics from esophageal disorders to respiratory and iatrogenic disorders. This edition adds a new Aging and Dysphagia chapter and is updated with the latest research and advances in dysphagia management. Written by speech-language pathology educators Michael E. Groher and Michael A. Crary, this guide helps you develop clinical reasoning skills and learn today's best practices in dysphagia management. Learning features include chapter outlines, learning objectives, and bullet-point summaries in each chapter, helping you focus on and master key content. Emphasis on evidence-based practice prepares you to make and then properly support your diagnostic and treatment decisions. Case histories promote critical thinking in realistic clinical situations. Critical thinking questions help you assess your knowledge and reinforce understanding of the material. Video clips on the Evolve companion website depict a range of swallowing disorders. NEW! Aging and Dysphagia chapter examines the increasing evidence that older persons living at home may be at risk for dysphagia without any overt underlying disease. UPDATED! Treatment for Adults chapter is thoroughly revised. NEW! Clinical Pearls highlight key information that you need to know to prepare for the clinical setting. UPDATED content and references throughout reflect the latest research in the field.

Get rid of GERD for good Is your heartburn making you dread meal times? No matter how delicious a feast is before you, the prospect of that burning pain, nausea, and even vomiting can be enough to make you turn away. Heartburn is a symptom of Gastroesophageal Reflux Disease, commonly called acid reflux, and the pain is caused by stomach acid damaging the tissue in your esophagus. It's more than a minor annoyance GERD is a precursor to esophageal cancer, and it affects over 50 million Americans. There are medications to treat GERD, but what most sufferers don't realize is that a few simple lifestyle changes can help your medication work better or get you off medications completely. Acid Reflux Diet & Cookbook for Dummies is your roadmap to ending GERD for good. In it, you'll find lifestyle and diet modifications that prevent symptoms from occurring in the first place, as well as explanations about the mechanism of the condition and how and why these modifications help. The book contains over 70 practical recipes, plus tips on navigating grocery stores, restaurant menus, and the holiday season. You'll gain valuable insight on the small, easy changes that can make a big difference, and get answers to questions like: * Is your posture and sleep position working against you? * Can chewing gum really help or hurt? * What supplements may work just as well, or better than, prescriptions? * How does eating more often help prevent symptoms? Whether you've tried every treatment available and still haven't found relief, or are hoping to avoid prescription medication completely, Acid Reflux Diet & Cookbook for Dummies is a clear, comprehensive guide to getting rid of GERD.

Howard C. Thomas In normal subjects the regulatory apparatus of the immune system permits responses to foreign antigens but suppresses those directed to "self' components. Autoimmune disease occurs as a failure ofthis system either as a result of a primary defect in the regulatory apparatus (primary autoimmunization) or because of a change in the antigenicity of the tissues (secondary autoimmunization). Autoaggressive reactions are characterised by the presence of autoantibodies. When these are directed to membrane displayed antigens (Fig. 1) they are probably of importance in the lysis of hepatocytes. Those directed to cytoplasmic antigens may be useful diagnostically but are of unknown pathogenic significance. When no extrinsic aetiological factor can be identified, the process is assumed to be the result of a failure ofthe regulatory system, allowing the spontaneous expansion of a clone of autoreactive lymphocytes. The defect may be generalised or specific to certain groups of self-antigens and thus the autoimmune disease may be either multi- or unisystemic. The recent development of techniques to enumerate and measure the functional activity of the suppressor lymphocytes which control the effector limbs of the immune system has enabled investigators to test whether the various purported autoimmune diseases do have as their basis a generalised defect in immunoregu lation. Assessment of antigen-specific immunoregulatory function is, however, not yet readily available. liver Membrane I Antigen (LIM) I Liver I HLA, A, B, C, Sensitisation to Specific -;::!IIIL. .

Jeder fA1/4nfte Deutsche leidet unter Reizdarmbeschwerden. Vielleicht auch Sie? Dieses Buch verspricht Linderung bei Durchfall oder Verstopfungen, BlAhungen und Schmerzen. Der Internist und ErnAhrungsmediziner Dr. Matthias Robert beschreibt, was sich hinter dem Reizdarmsyndrom verbirgt, welche so gar nicht reizenden Symptome es mit sich bringt und welche Untersuchungen Ihr Arzt bei Ihnen durchfA1/4hrt, um die Diagnose stellen und andere Erkrankungen ausschlieA en zu kAnnen. Er erklArt, wie das komplexe Organ Darm funktioniert, wie eng Bauch und Hirn verbunden sind und warum deshalb Psyche und Stress eine so groA e Rolle beim Reizdarmsyndrom spielen. Vor allem aber setzt er sich mit den verschiedenen MAglichkeiten der Therapie auseinander und stellt eine ganze Reihe von MAglichkeiten vor, wie Sie Ihre Beschwerden lindern kAnnen: ErnAhrungsumstellung und Entspannung, Medikamente und alternative Heilmethoden. Damit endlich Ruhe in Ihrem Bauch einkehrt.

Gastroenterologists require detailed knowledge regarding the anatomy of the GI system in order to understand the disturbances caused by diseases they diagnose and treat. Gastrointestinal Anatomy and Physiology will bring together the world s leading names to present a comprehensive overview of the anatomical and physiological features of the gastrointestinal tract. Full colour and with excellent anatomical and clinical figures throughout, it will provide succinct, authoritative and didactic anatomic and physiologic information on all the key areas, including GI motility, hepatic structure, GI hormones, gastric secretion and absorption of nutrients. GI trainees will enjoy the self-assessment MCQs, written to the level they will encounter during their Board exams, and the seasoned gastroenterologist will value it as a handy reference book and refresher for re-certification exams

Dieses Buch ist nach der "Ulcus-Therapie" und den "Postoperativen Syndromen" der dritte Folgeband der Reihe "Interdisziplinare Gastro- enterologie". Die Reflux-Therapie erschien uns als interdisziplinares Thema besonders geeignet. Mehr noch als bei der Ulcus-Therapie ist die Grenzlinie zwischen konservativer und operativer Therapie verwaschen. Wahrend bei der Ulcuskrankheit zumindestens gewisse Vorstellungen uber die Definition des Krankheitsbildes und die Haufigkeit der Er- krankungen bestehen, besteht hieruber - auch heute noch - bei der Refluxkrankheit Unklarheit. Viele Arzte arbeiten nicht mit dem Begriff "Refluxkrankheit" , sondern sehen des Problem einzig im Zusammenhang mit der Hiatushernie. Andere fuhren Refluxbeschwerden automatisch auf eine "Gastritis" zuruck. Dementsprechend herrschen auch uber die therapeutischen Moglichkeiten Unklarheiten. Wahrend die einen auto- matisch beim Vorliegen einer Hiatushernie eine chirurgische Therapie anstreben, beginnen die anderen beim Vorliegen von "Hyperaziditats- beschwerden" nicht einmal mit einer Diagnostik, sondern begnugen sich mit halbherzigen palliativen Massnahmen. Es schien uns deshalb angezeigt, eine Gruppe von Sachkennern dieser Materie zusammenzurufen, eine Bestandsaufnahme vorzunehmen und therapeutische Richtlinien zu erarbeiten. Solche Bemuhungen sind bedeutungsvoll, da die Refluxkrankheit bei ahnlicher Symptomatologie im einen Fall eine harmlose, fast zu vernachlassigende Storung dar- stellt, im anderen Fall aber zu einer bedrohlichen Erkrankung fort- schreiten und im schlimmsten Fall sogar der Schrittmacher eines malignen Tumors sein kann.

The acute abdomen often perplexes the expert as well as the young physician. There are few areas in medicine in which Hippocrates' aphorism-the art is long, life is short, decision difficult, and delay perilous-is more applicable than here. Too often the harried physician fails to listen to the patient who is trying desperately to suggest the diagnosis. The significance of various types and location of pain often are neglected by the doctor. Physical findings are influenced by experience; the presence or absence of tenderness or a mass may be answered in entirely different ways by various observers. Because solid facts frequently are lacking, attempts to resolve diagnostic dilemmas by computer analysis or by algorithms are not likely to be successful. Fortunately, in the great majority of cases, unusual and difficult diagnostic procedures are not necessary for the identification of the acute abdomen and of the major disease. Astute clinical judgment must be based primarily upon careful attention to the pa tient's words and detailed observation."

Gastroenterologic endoscopy has made important progress in the past decade. New techniques and ideas have given it new life. The end of this evolution is not yet in sight. FuIly flexible fiberoptic instruments have eliminated all blank areas from the map of the gastrointestinal tract. Retro- grade visualization of the pancreatic and biliary system has been achieved in conjunction with radiologic methods. Operative endoscopy has de- veloped beyond the removal of foreign bodies, to a stage where laparotomy can be avoided in a number of situations. Hemostasis by laser coagulation and crushing of concrements by ultrasound and electric energy have reached the threshold of clinical applicability. With all these spectacular develop- ments, however, it is important to maintain a firm grasp of the fundamentals of endoscopy. This is the basis of day-to-day success and includes knowl- edge of the proper indications, the ability to manage complications, famil- iarity with the technical properties of the instruments, their skillful handling, and experience in organizing an endoscopy section. Endoscopists, particu- larly members of the Erlangen group, have undertaken the task of charting these fundamentals and of compiling them into a working manual for those already practicing endoscopy or intending to do so. They have been sup- ported in this effort by colleagues from other parts of the Federal Republic of Germany and from Italy.

A stoma is the result of an operation to remove disease such as cancer, Crohn's disease or diverticulitis - or from a bowel obstruction or injury to the digestive or urinary system. It is an artificial opening that allows faeces or urine either from the intestine or from the urinary tract to pass. There are three main types of stoma related to the digestive and urinary system - these are: colostomy, ileostomy and urostomy (Coloplast.co.uk). This book is a guide to stoma surgery and care for GI surgeons, from basic information to the latest advances in the field. Beginning with an overview of the digestive system, the next chapters explain the physiology and different types of stoma, including both permanent and temporary. The following chapters cover stoma surgery, post-surgical maintenance and possible complications. Other topics include sustenance with stoma, stoma care for different patient groups such as children or those with disabilities, the role of the stoma nurse and more. The book concludes with a section of frequently asked questions with detailed answers. Key points Comprehensive guide to stoma surgery and care for GI surgeons Covers permanent and temporary stoma and possible complications Includes FAQs with detailed answers Features clinical photographs, diagrams and tables to assist learning

For at least three centuries, Holland has been at the centre of research on intestinal malabsorption. In the 17th and 18th centuries, early descriptions of coeliac disease and tropical sprue were published by physicians trained in Holland, and it was in 1950 that Dicke published his painstaking and vital observations that coeliac disease in children was caused by the inges tion of wheat flour. Subsequent careful work with van de Kamer and Weijers showed that the harmful agent was gluten. Since these discoveries were made, research in intestinal malabsorption, particularly in the adult, has continued in several centres in Holland. At Nijmegen, for example, dr. Cluysenaer, dr. van Tongeren and their as sociates have been involved in long-term studies of patients with intestinal disease for the past fifteen years. In this book they describe their experience of the investigation and treatment of fifty patients with the adult form of coeliac disease. Their monograph gives an account of the history, definition and incidence of the disorder, and then goes on to undertake a critical review of the pathogenesis of the coeliac lesion. Before embarking on the different patterns of malabsorption seen in adult coeliac disease, the authors describe the normal small intestine, its morphology and function."

VI J. R. VON RONNEN PREFACE This atlas is a selection of the roentgenograms of patients who visited the Radiology Department at the University Hospital in Leiden between 1970 and 1974. The heads of this department are Prof. J. R. von Ronnen and Prof. A. E. van Voorthuisen. In this atlas, the most frequently occurring radiological abnormalities of the small intestine are illustrated as clearly as possible - without the shadows caused by flocculation or segmentation of the contrast fluid. The author hopes it will be a positive contribution towards the attainment of the highest possible diagnostic score. It should be remembered that the key to good diagnostics is not only a perfect examination technique, but also the knowledge and character of the physician. If these factors are optimal, then the best possible series of roentgenograms will be obtained, at least as far as technique is concerned. All patients were examined by the enteroclysis technique. With this method of examination of the small intestine, the contrast fluid is administered via an infusion directly into the duodenum instead of orally. The infusion method has added a new dimension to the radiological examination of the small intestine. This method has turned out to be especially suitable for the comparative evaluation of motility, and also for the study of disturbed motility.

'I deeply respect and honour the work of Ann Louise Gittleman, whom I consider as a teacher, as well as what she has done to bring intelligence to the world of nutrition.' Dr Mark Hyman Eat your way to a faster metabolism, easier weight loss and better health - from New York Times bestselling author and health pioneer Ann Louise Gittleman. One reason many diets fail is that they don't correct the shutdown of key fat-burning tissues in the body: brown fat, muscle and the microbiome. Each of these prefers a specific type of food for optimal function and this expert book tells you exactly how to fuel them. Radical Metabolism will shake up your long-held beliefs and assumptions about what is healthy, especially when it comes to diet. However, this isn't just about weight loss - this is about putting the brakes on ageing, gaining the tools necessary to dodge age-related illness and staying energised for life. The book is divided into three sections: The first section lays out the scientific basis for the Radical Metabolism plan so that you can understand the rationale behind the programme. Discover the five radical rules for rescuing your metabolism, the forgotten but powerful role bile plays in the body's slimming systems and the hero ingredients that are key to lasting weight loss. The second section is the eating diet plan. It starts off with the 4-Day Radical Intensive Cleanse, a simple juicing-and-souping detox plan designed to give your liver and gallbladder a rest before the main programme. The 21-Day Radical Reboot will teach you how to reawaken and retrain your metabolism to build a lasting and lean body. The third section expands the menu with a collection of 49 recipes (anglicised for UK readers) and provides a maintenance plan and additional guidance for staying on track for life. An easy-to-follow programme with the nutritional and scientific research to back it up, this book offers simple strategies that produce radical results. REAP THE BENEFITS OF A RADICAL METABOLISM: - Lasting weight loss - Greater energy - Balanced mood - Healthier skin - Protection against health problems, such as type II diabetes and gallbladder issues

Challenges in Inflammatory Bowel Disease (IBD), is a book for gastroenterologists and surgeons, and for trainees who know the tried and tested information, but now want to know about the areas of controversy in this fast-moving area. Suitable for gastroenterologists, surgeons, and trainees who know the tried and tested information, but now want to know about the areas of controversy in this fast-moving area, this title focuses on modern issues, and covers various aspects. From a review of the first edition: "The editors and publishers have succeeded admirably in at least three respects... Firstly, they have assembled an all-star cast of contributors ... Secondly, they have constructed this monograph ingeniously. Each chapter title is phrased as a question, which is then examined critically with scores of references that are pertinent and up to date. As a third defining feature of this ambitious volume, the editors have demanded and received from their authors highly critical analyses of "the most recently available evidence." The authors analyse and interpret the evidence in ways that allow each chapter to reach reasonably well founded conclusions.

Our knowledge of the diseases of the small intestine has increased greatly since the second world war. The advances made in the auxiliary sciences, in particular biochemistry and histology, are mainly responsible and have led to their increased importance in this field. It is unfortunate that although radiology also contributed new understanding, it has not been able to match the progress of the other sciences. In spite of the advancements made in, for instance, vascular examination, radiology has experienced a relative decrease in its importance to the differential diagnosis of the diseases of the small intestine. The main reason for this is that radiology can only offer an extremely modest contribution to the differentiation between the many diseases with the malabsorption syndrome. In a number of cases, radiological differential diagnosis is in principle not possible because there are only histological and biochemical abnormalities of the mucous membrane of the small intestine without macroscopic abnormalities. There remain however many diseases with malabsorption for which a morphological examination can be highly valuable. This applies for: 1. diseases with gross anatomical abnormalities: anastomoses, fistulae, blind loops; strictures, adhesions; diverticula. 2. diseases with local, usually rather gross mucosal abnormalities: leukemia, Hodgkin's disease, lymphosarcoma; intra-mural bleeding; local edema due to venous congestion (e. g. thrombosis) or lymphatic obstruction (irradiation treatment). 3. diseases with more general mucosal abnormalities: edema due to: lymphangiectasis, allergic reactions, protein-losing enteropathy; amyloidosis, Whipple's disease, scleroderma.

Dirk Haller und Gabriele Hörmannsperger geben einen Überblick über die zentrale Rolle des Darms und seiner Bewohner für die Gesundheit und vermitteln zusätzlich einen ersten Eindruck von den komplexen und dynamischen Interaktionen zwischen D+armbakterien und Wirt. Denn Forschungsergebnisse der letzten Jahre weisen darauf hin, dass die lange unbeachteten Darmbakterien (intestinale Mikrobiota) eine unerwartet zentrale Rolle für die Aufrechterhaltung der Gesundheit einnehmen. Die Forschung beschäftigt sich aktuell intensiv damit, die Grundlagen für ein funktionierendes und gesundheitsförderndes mikrobielles Ökosystem zu identifizieren. Dieses Wissen kann zukünftig für die Entwicklung gezielter Maßnahmen zur Prävention und Therapie Mikrobiota-assoziierter Erkrankungen eingesetzt werden.