ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Endoscopic ultrasound (EUS), a relatively new addition to the endoscopist’s diagnostic armamentarium, provides detailed images of the gut wall layers and surrounding organs. Endosonography is highly accurate in the staging of gastrointestinal neoplasms and may provide information that is invaluable in treatment planning, such as evidence of unresectability. EUS also has particular utility in the evaluation of submucosal lesions of the gastrointstinal tract and the preoperative localization of pancreatic endocrine tumors. Currently, in the United States, Olympus and Pentax manufacture two different endosonography systems, each with unique advantages and disadvantages. Recently, EUS-directed biopsy has enhanced the diagnostic potential of the procedure. With the recent approvel of CPT codes and reimbursement values, interest in the procedure is likely to expand. Adequate training in EUS is essential for the successful performance of the procedure; a period of proctored training with an experienced endosonographer is recommended.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A consensus meeting was held in Stockholm on Oct,9,f1993 after consultations with the Swedish Association of Gastroenterology and Gastrointestinal Endoscopy. The meeting was attended by 35 physicians with a special interst in Helicobacter5 pylori–associated diseases representing the folloing medical disciplines: gastroenterology,surgery, internal medicine, histopathology, microbiology immunology, infectious dieseases, clinical physiology, and cancer epidemiology. The aims of the meeting were to define and recommend methods of diagnosis, indications for anti–H. pylori therapy, alternatives for treatment regimens, principles of follow-up observation, and suitable measures of quality control. The Participants agreed to recommend anti–H. pyloritherapy only for the treatment of H. pylori–associated gastric and duodenal ulcer disease. A combination of amoxicillin, 1,000 mg b.i.d., plus omeprazole, 20 mg b.i.d.,for 2 weeks was considered the first‐ treatment. Second– options are not specified, but amoxicillin plus a higher-dose omeprazole, clarithromycin plus omeprazole, or various triple regimens were discussed.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We describe our clinical experience in the evaluation of gastrointestinal symptoms in patients with Parkinson’s disease. Dysphagia, heartburn, medication-related nausea, and constipation were the predominant symptoms. Although all of the patients localized their dysphagia to the oropharynx and although oropharyngeal dysfunction was common, evaluation revealed significant dysfunction in either the esophageal body or lower esophageal sphincter in many—gastroesophageal reflux-related disease being especially common. Studies of anorectal sphincter and pelvic floor function in those patients with constipation demonstrated a high incidence of abnormal external anal sphincter dysfunction. We conclude, first, that dysphagia in patients with Parkinson’s disease should not be assumed to result solely from oropharyngeal dysfunction but deserves detailed evaluation and, second, that constipation in Parkinson’s disease is commonly consequent on anorectal sphincter and pelvic floor dysfunction.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Ninety patients with endoscopically proven duodenal ulcer were followed for 1 year. All patients were initially treated with an H2-receptor antagonist. Those with more than two relapses within 1 year received triple therapy consisting of colloidal bismuth subcitrate, amoxicillin, and metronidazole. Results showed that 27 patients were symptom-free after one full course of H2antagonist, 47 had one or two clinical recurrences, and 16 patients had more than two recurrences. Twelve of the latter group wereHelicobacter pyloripositive and were treated with triple therapy. We conclude that only a minority of duodenal ulcer patients needs to be treated with triple therapy; most of them can be treated with antisecretory agents

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We studied the relationship between Helicobacter pylori (H. pylori) infection and gastric acid secretion, along with fasting serum gastrin levels, in 55 asymptomatic healthy volunteers under 30 years old (29 H. pyloripositive, 26 H. pylori-negative). Mean scores of antral gastritis were significantly higher in H. pylori-positive subjects than in H. pylori-negative subjects. There was no significant difference in both basal and maximal acid output between H. pylori-positive and H. pylori-negative subjects. Fasting serum gastrin levels were significantly higher in H. pylori-positive subjects than in H. pylorinegative subjects. Sex did not significantly affect gastritis scores, gastric acid secretion, or fasting serum gastrin levels, although maximal acid output was slightly higher in H. pylori-negative men than in H. pylori-positive men. Our results suggest that H. pylori infection has no direct effect on gastric acid secretion in young healthy subjects, although it induces hypergastrinemia.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Ten to 25% of healthy persons have bloating at some time or other. It is very common in those with the irritable bowel syndrome, constipation, or anorexia nervosa. Although the cause of functional bloating remains unknown, old explanations such as a low diaphragm, exaggerated lumbar lordosis, and psychiatric problems have been disproved. New suggestions on its etiology include recent weight gain, weak abdominal muscles, and retained fluid in loops of small intestine. No treatment is of proven benefit, but treatment by weight loss, exercise, and prokinetics should be studied.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Forty-seven patients (ages 17-74 years, 33 women) who had irritable bowel syndrome and who attended a gastroenterology clinic had their whole-gut transit time (WGTT) assessed by an abdominal radiograph after ingesting 20 radioopaque markers on 4 consecutive days. Immediately afterward, the patients completed a questionnaire that asked about their stool form on the Bristol Scale, their bowel frequency, and whether they thought they had been experiencing diarrhea or constipation during the previous 5 days. WGTT varied from 7 to 96 h. Stool form correlated significantly with WGTT (r=- 0.57, p < 0.001), whereas stool frequency did not (r=0.31, NS). The regression equation relating WGTT to stool form was WGTT (h) = 75 - 10 (stool form). WGTT, stool form, and frequency were significantly different in patients reporting constipation compared with those who reported diarrhea, diarrhea and constipation, or neither, but in the last three groups these parameters were not significantly different from each other. Patients’ recollection of stool form is a reasonable guide to their transit time and can be used in the office to identify pseudodiarrhea and true constipation.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Twenty consecutive patients with first-time presentation of suspected inflammatory bowel disease underwent both endoscopy with biopsy and magnetic resonance imaging (MRI) within a 3-day period; the relative abilities of endoscopy and MRI to distinguish ulcerative colitis (UC) from Crohn’s disease (CD) and to determine the severity of the disease process were compared. In 18 of 20 patients, a diagnosis of UC or CD could be made on histological specimens. MRI correctly diagnosed 17 of these 18 patients using Tl-weighted fat-suppressed spin echo and gadolinium enhancement. Endoscopy correctly diagnosed 15 patients. Overall, MRI was not significantly better (p>0.05) than endoscopy in distinguishing UC from CD. MRI correctly graded the severity of inflammatory changes in 13 of 20 patients, and endoscopy did so in 11 of 20. MRI and endoscopy findings were within one grade of histology findings in seven patients each. No significant difference (p>0.05) was found between MRI and endoscopy in the ability to estimate the severity of the disease (as determined from biopsies). Bowel wall thickness measured on MR images demonstrated good correlation with percentage of contrast enhancement: r=0.61; p=0.003. In sum, magnetic resonance imaging was shown to be comparable with endoscopy in differentiating UC from CD and in gauging the severity of disease. Transmural assessment, sagittal imaging, and the lack of invasiveness were attractive features of MRI. resonance.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Congenital chloride diarrhea (CCD) is a common metabolic disorder in Saudi children with an incidence of 1 in 5,500. The present retrospective study from Saudi Arabia, over 7.5 years, presents the clinical, biochemical, and treatment details in 10 children with CCD. The perinatal characteristics of maternal polyhydramnios, prematurity, abdominal distention, and diarrhea were seen in 100% and hyperbilirubinemia in 90% of patients. Hypokalemic hypochloremic metabolic alkalosis was a feature in 50% of the children and acidosis in both neonates. Fecal chloride greater than 100 mmol/L in 100% and fecal chloride greater than the sum of fecal sodium and potassium were found in 55% of patients. The mean age at the time of diagnosis was 10 months and the mean duration of follow-up for the group was 38 months (range 2-89 months). Eight of the nine patients treated with continuous oral electrolyte solution demonstrated “catchup” physical growth. Mental subnormality, growth retardation, and renal impairment were seen in one patient who failed to comply with the treatment. Cerebral palsy in another child was due to neonatal intraventricular hemorrhage.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID