Gastrointestinal motility in clinical practice
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| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1996
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| Schriftenreihe: | Gastroenterology clinics of North America
25,1 |
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| Online-Zugang: | Inhaltsverzeichnis |
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| 245 | 1 | 0 | |a Gastrointestinal motility in clinical practice |c Michael Camilleri guest ed. |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 1996 | |
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Datensatz im Suchindex
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|---|---|
| adam_text | GASTROINTESTINAL MOTILITY IN CLINICAL PRACTICE
CONTENTS
Preface xiii
Michael Camilleri
The Epidemiology of Functional Gastrointestinal Disorders in
North America 1
G. Richard Locke III
Practicing gastroenterologists frequently see patients whose ill¬
nesses are thought to be due to alterations in gastrointestinal
function, yet the majority of people with functional gastrointesti¬
nal disorders do not seek care for their symptoms. This review
summarizes the epidemiology of these disorders with emphasis
on the most common: gastrointestinal reflux disease, noncardiac
chest pain, functional dyspepsia, irritable bowel syndrome, and
disorders of defecation.
Psychosocial Aspects of Functional Gastrointestinal Disorders 21
William E. Whitehead
The majority of patients with gastrointestinal motility disorders
have symptoms of psychological distress, and many have frank
psychiatric disorders. The role of psychological symptoms in the
pathogenesis of gastrointestinal motility disorders remains poorly
understood. It is known that psychological stress may alter gas¬
trointestinal motility and precipitate exacerbations of symptoms
in predisposed individuals and that psychological symptoms re¬
duce the tolerance of people for somatic symptoms they might
otherwise ignore or manage on their own.
GASTROENTEROLOGY CLINICS OF NORTH AMERICA
VOLUME 25 • NUMBER 1 • MARCH 1996 vii
Upper Esophageal Sphincter and Pharyngeal Function and
Oropharyngeal (Transfer) Dysphagia 35
June A. Castell and Donald O. Castell
Normal transfer of food through the pharynx during swallowing
requires coordinated activity of the muscular structures of the
tongue, pharynx, larynx, and upper esophageal sphincter. This
activity is modulated by the V, VII, IX, X, and XII cranial nerves
through the swallowing center in the medulla. Oropharyngeal
(transfer) dysphagia can be caused by a variety of neural, muscu¬
lar, or local anatomic lesions. Diagnosis is best accomplished by
barium videoradiography and solid state manometry of swal¬
lowing. A multidisciplinary therapeutic approach can be very
helpful in rehabilitation of these patients.
Esophageal Motility and Reflux Testing: State of the Art and
Clinical Role in the Twenty first Century 51
John Dent and Richard H. Holloway
Esophageal function testing has an important place in the investi¬
gation of a significant proportion of patients with esophageal
disorders. Appropriate application of these tests requires a proper
understanding of their capabilities and limitations and careful
primary assessment by other modalities. This article discusses
fluoroscopy, esophageal manometry, and esophageal pH moni¬
toring as methods of esophageal function testing.
Typical and Atypical Presentations of Gastroesophageal
Reflux Disease: The Role of Esophageal Testing in Diagnosis
and Management 75
Joel E. Richter
Gastroesophageal reflux disease (GERD) is a common disease
with many typical and atypical forms of presentation. In the
classic presentations of GERD with heartburn and regurgitation,
esophageal testing, except for endoscopy, is only required for
poorly responding patients or prior to surgical therapy. The atypi¬
cal presentations of GERD, including chest pain, asthma, and ear,
nose, and throat complaints, frequently are not associated with
heartburn or regurgitation. Esophageal testing, particularly 24
hour pH monitoring, is key to making the diagnosis and ensuring
adequate acid suppression.
Functional Dyspepsia: Insights on Mechanisms and
Management Strategies 103
Juan R. Malagelada
The instability of the clinical manifestations of functional dyspep¬
sia is notorious. This instability is manifested in two forms: tem¬
poral instability and circumstantial instability. It is probably in
the latter context that stress and other psychological factors in
Viii CONTENTS
fluence the symptoms of dyspepsia. It is conceivable that, after
all, most dyspeptic patients manage to get by thanks to the
concerted beneficial action of physician reassurance, placebo ef¬
fects, drug effects, and spontaneous improvement.
Gastric and Small Intestinal Motility in Health and Disease 113
Eamonn M. M. Quigley
This article reviews the basic physiology of foregut motility as
well as the evaluation and clinical spectrum of gastric and small
intestinal motor disorders. The limitations of symptoms as pre¬
dictors of dysmotility and the problems that surround the defini¬
tion of these disorders are emphasized. The principal clinical
syndromes considered to reflect disturbed foregut motor function
are presented. The role of motility in the pathogenesis of func¬
tional as well as the more clearly defined disorders of gastrointes¬
tinal nerve and muscle is discussed.
Colonic Motility in Health and Disease 147
Michael D. O Brien and Sidney F. Phillips
The most important and relevant symptoms of colonic dysfunc¬
tion are diarrhea, constipation, urgency, and pain. Despite the
efforts of many investigators over several decades, the motor
physiology of the human colon is still relatively obscure. In prac¬
tice, measurements of transit are the best characterized and most
widely available tests of colonic motor function. Colonic hyper
sensitivity, implying an abnormality of afferent signalling, is as¬
suming greater importance in the pathophysiology of conditions
as common as irritable bowel syndrome and inflammatory
bowel disease.
Anorectal and Pelvic Floor Function:
Relevance to Continence, Incontinence, and Constipation 163
Peter M. Sagar and John H. Pemberton
Anorectal tests need to be tailored to the presentation of the
individual patient. Clearly the tests are most useful when they
identify anatomic or physiologic abnormalities for which there
are successful treatments. For the incontinent patient, anal ma
nometry is the most useful test. Sphincter injuries should be
repaired, whereas neurogenic incontinence is best treated initially
with biofeedback. Three tests are most useful for the constipated
patient: (l)colonic transit time, (2)degree of pelvic floor descent
on straining, and (3)balloon expulsion. Colonic inertia responds
to total colectomy and pelvic floor dysfunction to biofeedback.
Meanwhile, patients with irritable bowel syndrome require rere
ferral to their physicians.
CONTENTS ix
Histopathology of the Enteric Neuropathies:
From Silver Staining to Immunohistochemistry 183
Chandar Singaram and Ashok SenGupta
The gut is abundantly supplied with neurons, extrinsic and intrin¬
sic nerve fibers. Knowledge regarding the structure of the enteric
nervous system derives principally from the classic silver staining
methods. Because silver stains do not provide information on
the molecular constituents of neurons, these data only facilitate
classification and may have diagnostic significance. Studies using
histochemistry and immunohistochemistry are now completing
the morphologic picture and laying the groundwork for the for¬
mulation of therapeutic strategies based upon demonstrable
chemical defects in enteric disease.
Gastrointestinal Motility in Neonatal and Pediatric Practice 203
Carlo Di Lorenzo and Paul E. Hyman
Caring for children with gastrointestinal motility disorders re¬
quires an understanding of age related changes in gastrointestinal
function and in the clinical expression of disease. Successful eval¬
uation of the child with a gastrointestinal motility disorder neces¬
sitates an approach that takes into account not only the child s
symptoms, but also the stage of development. This article reviews
the ontogeny of gastrointestinal motility; the techniques available
for the study of gastrointestinal motility in children; and the
presentation, pathophysiology, and treatment of pediatric func¬
tional bowel diseases. Differences in children compared with
adults in performing and analyzing motility testing and in evalu¬
ating motility disorders are emphasized.
Therapeutic Strategies for Motility Disorders:
Medications, Nutrition, Biofeedback, and Hypnotherapy 225
Gianrico Farrugia, Michael Camilleri, and
William E. Whitehead
Gastrointestinal motility is regulated by a complex balance of
inhibitory and excitatory neuronal, humoral, and mechanical fac¬
tors. The goal in the management of motility disorders is to
maintain adequate nutrition while decreasing symptoms. This
can be accomplished by medications and support of nutrition and
biofeedback; the application of these therapeutic strategies to
patients with gut motility disorders is reviewed.
Gastrointestinal Sensation: Mechanisms and Relation to
Functional Gastrointestinal Disorders 247
Michael Camilleri, Stuart B. Saslow, and Adil E. Bharucha
This article reviews the basic anatomy and physiology of visceral
afferent function and its application to a clearer understanding of
visceral pain and symptoms in patients with functional gastroin
X CONTENTS
testinal disorders. Recent investigations have focused on the po¬
tential role of visceral tone, different afferent (A delta and C)
fibers, dorsal column neurons, and supraspinal modulation in the
elicitation of visceral perception of noxious and nonnoxious stim¬
uli arising in the gut. Greater understanding of these pathomech
anisms and their pharmacologic manipulation offers an opportu¬
nity for future therapeutic strategies for these disorders.
Index 259
Subscription Information Inside back cover
CONTENTS xi
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| series | Gastroenterology clinics of North America |
| series2 | Gastroenterology clinics of North America |
| spellingShingle | Gastrointestinal motility in clinical practice Gastroenterology clinics of North America Beweeglijkheid gtt Lever gtt Maagdarmziekten gtt Motilité gastrointestinale Spijsvertering gtt Gastrointestinal Motility Gastrointestinal system Motility Gastrointestinale Motilitätsstörung (DE-588)4129007-0 gnd Pathophysiologie (DE-588)4044898-8 gnd Darmperistaltik (DE-588)4148803-9 gnd |
| subject_GND | (DE-588)4129007-0 (DE-588)4044898-8 (DE-588)4148803-9 (DE-588)4143413-4 |
| title | Gastrointestinal motility in clinical practice |
| title_auth | Gastrointestinal motility in clinical practice |
| title_exact_search | Gastrointestinal motility in clinical practice |
| title_full | Gastrointestinal motility in clinical practice Michael Camilleri guest ed. |
| title_fullStr | Gastrointestinal motility in clinical practice Michael Camilleri guest ed. |
| title_full_unstemmed | Gastrointestinal motility in clinical practice Michael Camilleri guest ed. |
| title_short | Gastrointestinal motility in clinical practice |
| title_sort | gastrointestinal motility in clinical practice |
| topic | Beweeglijkheid gtt Lever gtt Maagdarmziekten gtt Motilité gastrointestinale Spijsvertering gtt Gastrointestinal Motility Gastrointestinal system Motility Gastrointestinale Motilitätsstörung (DE-588)4129007-0 gnd Pathophysiologie (DE-588)4044898-8 gnd Darmperistaltik (DE-588)4148803-9 gnd |
| topic_facet | Beweeglijkheid Lever Maagdarmziekten Motilité gastrointestinale Spijsvertering Gastrointestinal Motility Gastrointestinal system Motility Gastrointestinale Motilitätsstörung Pathophysiologie Darmperistaltik Aufsatzsammlung |
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