{"title":"Emotional sequelae of chronic inflammatory bowel disease in children and adolescents.","authors":"T Bruce","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It is clear that further study needs to be made of the link between emotional disorder and chronic inflammatory bowel disease in children. It is commonly accepted that such a link exists in ulcerative colitis and although there is at present no proof in either direction it seems highly probable that such a relationship is also present in Crohn's disease. We have seen that the families of children with Crohn's disease appear to find it much more than ordinarily difficult to accept such a relationship, but an objective study is projected to explore the presence of psychiatric illness in our patients and their families. Such a study will be extremely time consuming, requiring the services of a part-time research worker, and the exigencies of clinical service have so far prevented its being set in motion. We feel that our experience in St Bartholomew's Hospital during the past seven years has very clearly demonstrated the value of close liaison between the Child Psychiatry Unit and the Paediatric Inflammatory Bowel Disease Clinic, and the much greater efficacy of such a liaison as against referrals made to a separate Psychiatric Unit. It should be emphasized, however, that a liaison of this sort is time consuming, and in our experience has involved child psychiatrists, social workers, child psychotherapists and behaviour therapists. Thus the provision of such a service is expensive both in time and money. Where a new Paediatric Inflammatory Bowel Disease Clinic is being projected there must be very careful forward planning, looking particularly at financial implications if a psychiatric liaison team is to be included.</p>","PeriodicalId":75717,"journal":{"name":"Clinics in gastroenterology","volume":"15 1","pages":"89-104"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15068979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bacterial Diarrhoea","authors":"Michael Gracey","doi":"10.1016/S0300-5089(21)00669-6","DOIUrl":"https://doi.org/10.1016/S0300-5089(21)00669-6","url":null,"abstract":"<div><p>Bacterial infections are important causes of diarrhoea in infants and children, particularly in developing countries and in other settings where standards of personal and community hygiene are low.</p><p>Knowledge of bacterial diarrhoeas has been significantly expanded in recent years by the finding that many episodes of acute diarrhoea are due to infections with bacteria which produce enterotoxins that interfere with intestinal fluid and electrolyte transport (the ‘enterotoxigenic’ diarrhoeas). Several ‘newer’ bacterial agents have also been identified which would not have been detected in earlier studies of the epidemiology of infective diarrhoeas; these include <em>Aeromonas, Campylobacter, Clostridium difficile</em> and <em>Yersinia.</em> Another important advance has been new knowledge about mechanisms by which bacteria cause diarrhoea; this has led to the widespread successful application of oral rehydration therapy in treatment of acute watery diarrhoeas.</p></div>","PeriodicalId":75717,"journal":{"name":"Clinics in gastroenterology","volume":"15 1","pages":"Pages 21-37"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136603494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chronic undernutrition/growth retardation in cystic fibrosis.","authors":"V L Soutter, P Kristidis, M A Gruca, K J Gaskin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There is now sufficient evidence to prove that the maintenance of a high energy normally balanced diet prevents malnutrition/growth retardation and may well enhance prognosis in patients with CF. Most patients are able to tolerate the normal to high fat content without undue problems with steatorrhoea and with the recent advent of more effective enzyme replacement therapy, this should be even less of a problem. Conversely, there is an equally large bulk of evidence to indicate that the maintenance of a low fat diet, while controlling symptoms from steatorrhoea in some patients, is energy depriving and produces growth failure. In children or teenagers who are presently growth retarded, installation of a high energy intake may improve growth in some, but not in others. Further investigation of the latter patients is required to evaluate their persistent anorexia and advantages and disadvantages of nutritional supplementation by invasive techniques. Certainly growth and wellbeing can be vastly improved. However, such studies may well have to be multicentered to obtain sufficient patients to control for the many variables involved, in order to demonstrate the effects on pulmonary function.</p>","PeriodicalId":75717,"journal":{"name":"Clinics in gastroenterology","volume":"15 1","pages":"137-55"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14215197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intestinal Motility and its Disorders","authors":"P.J. Milla","doi":"10.1016/S0300-5089(21)00675-1","DOIUrl":"https://doi.org/10.1016/S0300-5089(21)00675-1","url":null,"abstract":"","PeriodicalId":75717,"journal":{"name":"Clinics in gastroenterology","volume":"15 1","pages":"Pages 121-136"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136456428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antigen Handling by the Small Intestine","authors":"W. Allan Walker","doi":"10.1016/S0300-5089(21)00668-4","DOIUrl":"https://doi.org/10.1016/S0300-5089(21)00668-4","url":null,"abstract":"","PeriodicalId":75717,"journal":{"name":"Clinics in gastroenterology","volume":"15 1","pages":"Pages 1-20"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136603492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Viral Diarrhoea","authors":"G.P. Davidson","doi":"10.1016/S0300-5089(21)00670-2","DOIUrl":"https://doi.org/10.1016/S0300-5089(21)00670-2","url":null,"abstract":"<div><p>It is apparent from this review that great progress has been made over the past 10 years in defining the aetiology of viral diarrhoea. Rotavirus is a major cause of gastroenteritis in children, particularly during the winter months. However, if bacteriological and virological data are pooled, our current aetiological knowledge reveals that a pathogen is not detected in 20 to 30% of cases in most perennial investigations.</p><p>Now that human rotavirus has been cultured, complete characterization may be possible. However, practical methods for cultivating many of the other possible viral pathogens are needed before they can be characterized completely. Meanwhile, electron microscopy, although time-consuming, cumbersome and expensive, is the only method for detecting many of the other potential viral pathogens. We have much still to learn about the epidemiology of these agents, particularly in the developing countries, their importance in causing chronic diarrhoea, how they are transmitted, and the immune responses to infection. The development of a potential rotavirus vaccine is exciting and creates the possibility of control for this devastating disease.</p></div>","PeriodicalId":75717,"journal":{"name":"Clinics in gastroenterology","volume":"15 1","pages":"Pages 39-53"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136603493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}