Portal hypertension is the abnormal pathophysiologic state that develops in liver cirrhosis and certain other disorders with characteristic clinical and hemodynamic features. There has been great progress in our under standing and management of portal hypertension, particularly in the diagnostic and therapeutic approaches. The so-called Banti's syndrome, a disorder whose existence had long been questioned, is now a well-defined portal hypertensive disease. The recently introduced Doppler ftowmetry is currently yielding new information on portal hemodynamics. Endoscopic sclerotherapy and beta-blockers have come to be widely used in the man agement and prevention of variceal bleeding. In spite of all these advances, a number of unsolved questions remain, such as whether sclerotherapy, pharmacotherapy or surgery is warranted for prevention of bleeding, which is more effective as an elective treatment, the surgical or endoscopic approach, and whether surgical portacaval shunt should be totally replaced by selective shunt operations. These new developments and problems are clearly and comprehensively described and discussed by the foremost authorities in 44 chapters, which are divided into five sections: 1) Patho physiology, 2) Hemodynamic Investigations, 3) Imaging Investigations, 4) Clinical and Pathological Features, and 5) Esophageal and Gastrointestinal Bleeding. The primary goal of this monograph, to provide a framework of patho physiology of portal hypertension with authoritative descriptions of the clinical and laboratory manifestations of various portal hypertensive dis orders, has clearly been achieved by these excellent contributions.

Constipation: A Practical Approach to Diagnosis and Treatment serves as an unmet resource for physicians and other health care providers, including trainees and students, who see patients with constipation. The text reviews pathophysiologic mechanisms and details evaluation and management strategies. The volume also enables the reader to identify epidemiologic factors and quality of life parameters for patients with constipation, discuss differences in pathophysiologic mechanisms for different etiologies of constipation, recognize primary causes of constipation, and assess special considerations related to the symptom of constipation including presentations in the elderly, in pregnant women, in patients with systemic diseases, and patients with a history of abuse. Written by thought leaders and recognized experts in gastrointestinal motility and medical education, Constipation: A Practical Approach to Diagnosis and Treatment is of great value and utility for gastroenterologists, primary care physicians, gynecologists, nurse practitioners, physician's assistants, as well as fellows and residents.

Often, information in review books can raise as many questions as it answers. This interferes with the study process, because the learner must either look up additional information or skip ahead without truly comprehending what he or she has read. As an alternative, Pediatric Gastroenterology and Nutrition: A Practically Painless Review presents bite-size chunks of information that can be read and processed rapidly, helping learners to stay active while studying and to pick up new information the first time they read it. This book's question and answer format allows for self-testing or study with a partner or a group. The format also facilitates dipping into the book during a few minutes of downtime at the hospital or office. Pediatric Gastroenterology and Nutrition: A Practically Painless Review is a quick and easy way to master these tricky topics and is suitable for those studying for the pediatric board exam, practicing physicians brushing up their skills and any busy clinician who wants to learn more about these topics while on the go.

This book is written to assist those who have responsibility for the nutritional and gastrointestinal care of children with neurodisability. The emphasis throughout is on the importance of multidisciplinary care. It is concerned with the problems surrounding the nutritional management of children with neurological impairment who have difficulty swallowing and feeding. Written from a multidisciplinary perspective by a group of authors with considerable clinical and research experience in this area, it covers: ?The epidemiology of feeding disorders in children with cerebral palsy ?Nutritional assessment?Evaluation of oral-motor function?Dietetic management?Nursing issues in the nutritional care of the disabled child?Tube feeding?Gastrointestinal problems and their investigatio

From one of the world's leading medical institutions, this volume brings the reader up to date on recent developments in a specialty that presents a variety of challenges to those concerned with the treatment of disorders of the digestive and hepatobiliary systems. Organised on a broadly anatomical basis, the volume is divided into four sections covering the upper and lower GI tract, endoscopy, and the liver. Medical and surgical problems, paediatric disease, new therapeutic agents, techniques and procedures - in addition to advances in genetics and cell biology that are likely to have an impact on clinical practice - are all discussed.

Anus: Treatment and Pathology is the perfect guide for the diagnosis and management of patients with anal canal and pelvic floor disorders. Using annotated diagrams matched to cross- sectional radiology with ultrasound and MRI, this book will not only give the reader a thorough understanding of normal anal canal and pelvic floor anatomy, but will also take the reader through the common benign and malignant conditions which affect the anal canal and pelvis describing in detail their pathophysiology, investigation and management. Anus: Treatment and Pathology is aimed at practicing general surgeons, colorectal surgeons and surgical trainees, which can be used either as a practical reference guide for day to day colorectal surgical practice or for in depth text based learning.

Celiac Disease is an authoritative text intended to educate healthcare practitioners, gastroenterologists, physicians and nutritionists about the diverse manifestations, complications and management of gluten-sensitive enteropathy. The seventeen-chapter text provides the latest research on pathophysiology, including animal models, immunopathogenesis, genetics and the intestinal microflora. The book also features chapters on diagnosis, monitoring, complications and nutritional management, including therapies on the horizon. The text concludes with appendices that provide educational tools for symptom monitoring and dietary guidance. Written by specialists in their respective fields, Celiac Disease is a comprehensive resource that provides the healthcare practitioner an evidence-based practical guide to pathogenesis and therapy of celiac disease.

A rigorous and groundbreaking study. Martine Derzelle is the first researcher to approach hypochondria as a relational pathology. Martine Derzelle is the first researcher to approach hypochondria as a relational pathology.

The author tackles a subject that has puzzled care professionals for decades: hypochondria. Martine Derzelle confronts all specialists (psychotherapists, psychiatrists, doctors, psychosomaticians) with the paradox of this pathology and the theoretical void on which the approach to those patients who express a suffering of various kinds has stood for more than a century.

In the first part, the author highlights the lack of theoretical elaboration on hypochondria in the existent literature; in the second part, on the basis of clinical examples, she analyzes the nature of the disease, and then offers a completely innovative theoretical elaboration. Finally, in the third part, she proposes a new and specific approach to treating this pathology at both the theoretical and clinical levels within the framework of psychoanalysis and implementing key concepts from relational psychosomatics.

Diseases of the Liver in Children: Evaluation and Management provides a comprehensive, state-of-the art review of pediatric liver disease, with a practical approach useful for the primary care provider or general gastroenterologist. With an emphasis on tables and images, this book serves as a reference for understanding basic hepatic processes and the significance of laboratory findings. It also discusses the state of the art of diagnosis and treatment of diseases that affect the pediatric liver. The text captures the key elements of treatment and monitoring important for the primary care provider partnering in the care of these patients with pediatric hepatologists. The current state of transplantation and other surgical approaches are also discussed. The importance of aggressive bowel rehabilitation in the prevention of end-stage total parenteral nutrition-induced liver disease is also covered. Written by experts in their fields and including the most up to date clinical information, Diseases of the Liver in Children: Evaluation and Management serves as a very useful resource for physicians.

Single Incision Laparoscopic and Transanal Colorectal Surgery provide a comprehensive and state-of-the art review of single incision laparoscopic and transanal colorectal surgery. The text concentrates on surgical techniques and tricks in single incision laparoscopic and transanal surgery with detailed descriptions of the techniques, as well as indications and limitations of the procedures. The newly available evidence on these procedures is emphasized and all procedures are richly illustrated with diagrams and photos. Written by experts in their fields, Single Incision Laparoscopic and Transanal Colorectal Surgery is valuable resource for general surgeons, colon and rectal surgeons, laparoscopic GI surgeons, surgical residents and fellows in training interested in these two rapidly developing fields in colorectal surgery.

'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

As we approach the end of this millennium, enteric diseases remain impor tant public health problems. In many parts of the world, sanitary measures have advanced little over the last century, although some of the governments in those areas are striving to improve facilities for sanitation and to educate their people in proper handling of food, water, sewage, and other modes of transmission of pathogenic microbes. Even in highly developed countries, outbreaks of diarrheal diseases occur today. Globally, the annual morbidity from enteric infections is estimated at several billion and deaths at several million per year. In this volume, descriptions of some of these diseases, of immunity that results from them, of clinical studies that promote under standing of individual and community immunity, of molecular factors of pathogenesis, and/or of advances in vaccine development have been pro vided by leading researchers. At present, the application of molecular methods is enhancing the identification of protective antigens of many microorganisms. In addition, new methods for design and delivery of vac cines are being devised. Perhaps then more effective tools for reducing at least some of these diseases will be available within the next decade. Lois J. Paradise Herman Friedman Mauro Bendinelli vii Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv LOIS J. PARADISE 1. Indigenous Microorganisms as a Host Defense 1 KENNETH H. WILSON 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2. Composition of Intestinal Biota. . . . . . . . . . . . . . . . . . . . . . . . 2 3. Molecular Approaches to Determine Composition of the Biota . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4. Role of the Host in Determining the Composition of the Biota . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dysphagia: Diagnosis and Treatment of Esophageal Motility Disorders provides a interdisciplinary overview of the diagnosis and management of dysphagia and other esophageal symptoms. All aspects of dysphagia are covered, with detailed consideration of both physiology and evaluation methods. Hot topics include coverage on the pharmacological causes of dysphagia, the physiology of normal swallowing, ambulatory pH monitoring as well as recurrent dysphagia after treatments. The content is grounded in evidence-based medicine that is the result of clinical outcome research, both prospective and randomized, making this the perfect reference for clinical researchers and a go-to for general surgeons, foreguts surgeons, thoracic surgeons and gastroenterologists.

Gastrointestinal Oncology is an expanding field with important medical, scientific, socio-political and ethical challenges. In the last few years, the discipline has undergone changes in our knowledge of tumour biology, diagnosis and treatment. The rate of progress in some gastrointestinal malignancies as oesophageal adenocarcinoma or malignancies of the rectum is dramatic, in other malignancies as pancreatic carcinoma or not. It is generally accepted that the management of these tumours deserves a multidisciplinary approach. Our current understanding of the management of these tumours is the specific focus of this two-day interdisciplinary Postgraduate Course.

Molecular Genetics of Colorectal Neoplasia A Primer for the Clinician provides the latest information on the genetics of colorectal cancer within a context of basic genetics, describing the subject in understandable language and making it clinically relevant. In this way, clinicians can become familiar with genetic terms and techniques related to colorectal neoplasia, providing a background upon which to build an appreciation of future advances and an ability to include them in the practicalities of patient care. This edition is intended for the healthcare provider or industry concerned with colorectal neoplasia: including general and colorectal surgeons, pathologists, oncologists, gastroenterologists, internal medicine and family practice physicians, nurses, geneticists, counsellors, registry co-ordinators, epidemiologists, and statisticians.

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.

Recent clinical trials of adjuvant therapy for gastric cancer in Japan have shown improved survival benefits, but the results have been considered controversial and have been viewed with some skepticism in the West. Until now, the efforts of Japanese surgical oncologists in multimodality therapy have not been fully understood because they have not been adequately reported in English. This volume now presents the experience and expertise of Japanese surgeons who utilize preoperative or intraoperative chemotherapy, or a combination of systemic and regional chemotherapy. Their collected work provides valuable insight in the Japanese perspective and success in treating gastric cancer. Included in the appendix is an extensive tabular analysis of the gastric cancer database at the Cancer Institute Hospital of Tokyo. Probably the largest such database in the world from a single institution, the analyses present the state of the art in treatment of gastric cancer.

A distinguished panel of world authorities reviews the current state of today's understanding, diagnosis, and treatment of pancreatic cancer. Their cutting-edge reviews discuss both medical and surgical modalities and include numerous insights into the basic molecular processes underlying the disease. Among the key topics covered are the prospects for early diagnosis using molecular techniques, the latest diagnostic and therapeutic methods, the role of laparoscopy (diagnostic and therapeutic), and nonsurgical treatment. The reviewers also address the future possibilities for clinical advances, quality of life concerns, and the value of the Japanese "extended Whipple resection." Pancreatic Cancer will become the new standard reference for all clinicians who diagnose and treat this disease, as well as for basic scientists needing a summary of the many recent advances.
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Gastrointestinal motility has evolved from an esoteric laboratory tool into a sophisti cated diagnostic technique that is now widely used clinically to guide in management of complex gastrointestinal problems. Today, it is the most rapidly growing subspecialty within gastroenterology. Previously, many of the gastrointestinal motility problems were either ignored or attributed to a disturbance of "psyche." But with the growing knowledge and understanding of how a dysfunction of the gastrointestinal muscle and nerves can cause disease, we are at the threshold of a revolution in our approach to the diagnosis and treatment of gastrointestinal motility disorders. The purpose of this book is to serve as a useful, up-to-date reference manual and guide for the diagnostic and therapeutic approach towards common adult and pediatric gastrointestinal motility problems. In order to enhance the understanding of these disor ders, a problem-oriented approach has been chosen, and wherever possible the authors have provided clinical case scenarios to illustrate their message. The emphasis has been on how to diagnose and treat motility disorders rather than to provide an encyclopedic infor mation. The reference list at the end of each chapter should enable the enthusiast to seek further information. Some of the material presented in this book has been derived from the proceedings of the annual University ofIowa College of Medicine GI Motility Symposia."

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.

A concise, practical guide to the diagnosis and treatment of liver disease. Authoritative and practical, this important new book not only spells out the advantages and limitations of the latest diagnostic tests, but also provides numerous algorithms for evaluating patients and treating the liver problems commonly encountered by primary care physicians. Here, too, the reader will find described the nuances of serological tests for the detection of viral infections and how best to use invasive and noninvasive radiological tests in specific circumstances. Common complications are fully discussed and detailed practical information is given on how to recognize the patient's immediate problems and deal with them effectively. This book's numerous diagrams, clinical "pearls", and cost comparisons will clarify the often complex and bewildering array of conditions associated with liver disease and make it a definitive and indispensable guide for primary care physicians, medical students, and residents.

Gout: Basic Science and Clinical Practice is a thoroughly researched comprehensive text which covers all important aspects of gout, including its genetics, pathophysiology, diagnosis, and management. Gout is probably the most common rheumatic disease after osteoarthritis and is becoming more common with the prevalence of the metabolic syndrome in the US, and in many other countries. Only about 10% of patients with gout are treated by rheumatologists and this often leads to inadequate diagnosis and treatment in general medical practice. Written by an expert in the field this book is valuable reference for rheumatologists and others in the medical profession who are interested in understanding and managing this important disease.