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Irritable bowel syndrome. 肠易激综合症。

The Gastroenterologist Pub Date : 2020-07-24 DOI: 10.1146/ANNUREV.MED.52.1.319

Y. Ringel, A. Sperber, D. Drossman

{"title":"Irritable bowel syndrome.","authors":"Y. Ringel, A. Sperber, D. Drossman","doi":"10.1146/ANNUREV.MED.52.1.319","DOIUrl":"https://doi.org/10.1146/ANNUREV.MED.52.1.319","url":null,"abstract":"Irritable bowel syndrome (IBS) is a common medical disorder that is associated with significant disability and health care costs. A practical approach to diagnosis and management of patients afflicted by this disorder has previously been hampered due to incomplete understanding of its pathophysiology, lack of diagnostic precision, and absence of specific treatments. Over the last decade, epidemiological, physiological, and psychosocial data have emerged to improve our understanding of this disorder and its treatment. IBS is currently believed to result from dysregulation of intestinal motor, sensory, and central nervous system function. Symptoms are due to both disturbances in intestinal motility and enhanced visceral sensitivity. Psychosocial factors, although not part of IBS per se, have an important role in modulating the illness experience and its clinical outcome. Use of multinational symptom-based \"Rome\" criteria has increased diagnostic specificity and has helped to minimize studies done to exclude other disease. Finally, treatment involves an integrated pharmacological and behavioral approach that is determined by the severity of the illness and its physiological and psychosocial determinants.","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"275 1","pages":"315-26"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76513978","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}

引用次数: 80

Clostridium Difficile Disease 艰难梭菌病

The Gastroenterologist Pub Date : 2007-10-25 DOI: 10.1002/9780470987025.CH18

L. Mcfarland, C. Surawicz

引用次数: 13

Common pediatric esophageal disorders. 常见的小儿食道疾病。

The Gastroenterologist Pub Date : 1998-06-01

J F del Rosario, S R Orenstein

引用次数: 0

Pathophysiology and treatment of hepatorenal syndrome. 肝肾综合征的病理生理及治疗。

The Gastroenterologist Pub Date : 1998-06-01

F Wong, L Blendis

{"title":"Pathophysiology and treatment of hepatorenal syndrome.","authors":"F Wong, L Blendis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hepatorenal syndrome is a progressive oliguric renal failure complicating the course of advanced cirrhosis and ascites. Significant hemodynamic changes occur in these patients consisting of marked systemic arterial vasodilatation and renal vasoconstriction. Traditionally, the systemic arterial vasodilatation with the consequent underfilling of the effective arterial blood volume has been held responsible for the pathogenesis of the renal vasoconstriction. Recent data showing a dissociation between the extent of arterial underfilling and the development of renal dysfunction in these patients have lead to the proposal of a hepatorenal interaction directly causing the renal vasoconstriction, with arterial underfilling secondarily contributing further to the renal vasoconstriction. Diagnosis of hepatorenal syndrome remains one of exclusion. Treatment is largely ineffective except for liver transplantation, which unfortunately is not available to all patients because of their short survival. Prognosis is very poor once it has developed. Therefore, physicians should be alert to avoid precipitating factors in these patients. Recent development of new therapies such as the use of a transjugular intrahepatic portosystemic shunt or systemic vasoconstrictors appear promising, but their efficacy should be evaluated in prospective randomized controlled trials.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"6 2","pages":"122-35"},"PeriodicalIF":0.0,"publicationDate":"1998-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20578179","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}

引用次数: 0

Update on obesity treatment. 肥胖症治疗的最新进展。

The Gastroenterologist Pub Date : 1998-06-01

D C Schaefer, L J Cheskin

引用次数: 0

Pseudomyxoma peritonei. 腹膜假性粘液瘤。

The Gastroenterologist Pub Date : 1998-06-01

H Pan, C McGary, K A LaVorgna, S Nair, J Andrews, M H Floch

引用次数: 0

The technical aspects of biofeedback therapy for defecation disorders. 排便障碍生物反馈疗法的技术方面。

The Gastroenterologist Pub Date : 1998-06-01

S S Rao

{"title":"The technical aspects of biofeedback therapy for defecation disorders.","authors":"S S Rao","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neuromuscular conditioning using biofeedback techniques is a useful method of treatment for patients with refractory defecation disorders such as fecal incontinence or constipation with obstructive defecation. This article provides current perspectives regarding the principles and techniques of performing biofeedback therapy. In patients with incontinence, the goals are to improve the strength of the anal sphincter, improve sensory perception, and improve coordination between the rectum and anal sphincter. In patients with obstructive defecation, the goals are to relax the anal sphincter, improve rectoanal coordination, and improve sensory perception. Neuromuscular conditioning is an instrument-based learning technique. Over the years, several devices and methods have become available for performing this training, but no single method is either superior or universally popular. The three modalities that are commonly used for neuromuscular conditioning are visual, verbal, and audio feedback. Ideally, the training program should be customized for each patient based on the underlying dysfunction(s). After biofeedback therapy, symptomatic improvement has been reported in 70 to 80% of patients with either incontinence or obstructive defecation. Recent studies also demonstrated objective improvement in anorectal function. In the future, it is likely that simpler and user-friendly, solid-state computerized systems may facilitate a wider use of this treatment.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"6 2","pages":"96-103"},"PeriodicalIF":0.0,"publicationDate":"1998-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20578177","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}

引用次数: 0

Tests of the liver: use and misuse. 肝脏检查:使用和误用。

The Gastroenterologist Pub Date : 1998-03-01

J Aranda-Michel, K E Sherman

引用次数: 0

Clostridium difficile disease: diagnosis and treatment. 艰难梭菌病:诊断与治疗。

The Gastroenterologist Pub Date : 1998-03-01

C M Surawicz

引用次数: 0

Helicobacter pylori and gastric cancer: what is the real risk? 幽门螺杆菌与胃癌:真正的风险是什么?

The Gastroenterologist Pub Date : 1998-03-01

M Crespi, F Citarda

{"title":"Helicobacter pylori and gastric cancer: what is the real risk?","authors":"M Crespi, F Citarda","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Some epidemiological data point to an association between infection from Helicobacter pylori (Hp) and gastric cancer, although several unresolved issues still cast doubts on the real weight of this association. These issues are as follows: the male-to-female ratio of gastric cancer ranges from 4:1 to 1.5:1 in all studies, whereas the prevalence of Hp infection is the same in both sexes; the prevalence of Hp infection is as high as 90% in several developing countries where the frequency of gastric cancer is very low; the acquisition of the infection at a young age, considered very important with regard to the risk for cancer, varies from 4.2% to 83% in several countries in which the mortality for stomach cancer is approximately 10 in 100,000; and the incidence of cancer in patients with a duodenal ulcer is half that of the general population, but Hp infects up to 100% of these patients. In the sequence of events that leads to gastric cancer, Hp appears to play a role only in the very initial steps, as a causative agent of chronic inflammation. The further events that cause gastric atrophy, intestinal metaplasia, dysplasia, and cancer are multifactorial, involving environmental agents and the host response. It is therefore inappropriate to consider Hp a direct carcinogen for humans. This also applies to specific strains of the bacterium such as the cagA gene. In fact, Hp infection is widespread in humans, and only a small minority will ever be affected by peptic ulcer and cancer.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"6 1","pages":"16-20"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20453667","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}

引用次数: 0

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