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gastrointestinal pathophysiology

Francisca Sanchez-Jiménez, Almudena Pino-Ángeles, Rocio Rodríguez-López, María Morales, José Luis Urdiales
Human histidine decarboxylase (HDC) and dopa decarboxilase (DDC) are highly homologous enzymes responsible for the synthesis of biogenic amines (BA) like histamine, and serotonin and dopamine, respectively. The enzymes share many structural and functional analogies, while their product metabolisms also follow similar patterns that are confluent in some metabolic steps. They are involved in common physiological functions, such as neurotransmission, gastrointestinal track function, immunity, cell growth and cell differentiation...
October 18, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
I Absah, A Rishi, N J Talley, D Katzka, M Halland
BACKGROUND: Rumination syndrome is a functional gastrointestinal disorder characterized by effortless and repetitive regurgitation of recently ingested food from the stomach to the oral cavity followed by either re-swallowing or spitting. Rumination is thought to occur due to a reversal of the esophagogastric pressure gradient. This is achieved by a coordinated abdominothoracic maneuver consisting of a thoracic suction, crural diaphragm relaxation and an increase in intragastric pressure...
October 20, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Helen Louise Adams, Dharamveer Basude, Alison Kyle, Sarah Sandmann, Siba Prosad Paul
Irritable bowel syndrome (IBS) is the most common cause of non-organic recurrent abdominal pain in children. IBS is a clinical diagnosis, which is based on the Rome IV criteria for functional gastrointestinal disorders in children, as well as the patient's history. The diagnosis of IBS is established following the exclusion of organic causes of recurrent abdominal pain. Staggered investigations should be avoided because they might increase the child's and family's anxiety in the absence of an organic diagnosis...
October 12, 2016: Nursing Standard
Sanjay Bhandari, Thangam Venkatesan
Cyclic vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder that is characterized by episodic nausea and vomiting. Initially thought to only affect children, CVS in adults was often misdiagnosed with significant delays in therapy. Over the last decade, there has been a considerable increase in recognition of CVS in adults but there continues to be a lack of knowledge about management of this disorder. This paper seeks to provide best practices in the treatment of CVS and also highlight some novel therapies that have the potential in better treating this disorder in the future...
October 18, 2016: Current Treatment Options in Gastroenterology
Kenton M Sanders, Sean M Ward, Grant W Hennig
Motility patterns of the gastrointestinal tract are important for efficient processing of nutrients and waste. Peristalsis and segmentation are based on rhythmic electrical slow waves that generate the phasic contractions fundamental to gastrointestinal motility. Slow waves are generated and propagated actively by interstitial cells of Cajal (ICC), and these events conduct to smooth muscle cells to elicit excitation-contraction coupling. Extracellular electrical recording has been utilized to characterize slow-wave generation and propagation and abnormalities that might be responsible for gastrointestinal motility disorders...
October 19, 2016: Nature Reviews. Gastroenterology & Hepatology
A P van Beek, M Emous, M Laville, J Tack
BACKGROUND: Dumping syndrome, a common complication of esophageal, gastric or bariatric surgery, includes early and late dumping symptoms. Early dumping occurs within 1 h after eating, when rapid emptying of food into the small intestine triggers rapid fluid shifts into the intestinal lumen and release of gastrointestinal hormones, resulting in gastrointestinal and vasomotor symptoms. Late dumping occurs 1-3 h after carbohydrate ingestion, caused by an incretin-driven hyperinsulinemic response resulting in hypoglycemia...
October 17, 2016: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
Snehal R Patel, Shivank Madan, Omar Saeed, Mohammed Algodi, Anne Luke, Marc Gibber, Daniel J Goldstein, Ulrich P Jorde
OBJECTIVES: This study sought to determine whether the nasal mucosa can serve as a surrogate for evaluating arteriovenous malformations (AVMs) related gastrointestinal (GI) bleeding in patients supported by continuous flow left ventricular assist devices (CF LVADs). BACKGROUND: Bleeding from the mucosal surfaces of GI tract, particularly AVMs, is the most common complication of CF LVAD support. The pathophysiology of AVM formation during CF LVAD support is of critical interest yet poorly understood; in large part because of the length and accessibility of the GI tract...
September 29, 2016: JACC. Heart Failure
E Fabian, L Kramer, F Siebert, C Högenauer, R B Raggam, H Wenzl, G J Krejs
D-lactic acidosis is a rare complication that occurs mainly in patients with malabsorption due to a surgically altered gastrointestinal tract anatomy, namely in short bowel syndrome or after bariatric surgery. It is characterized by rapid development of neurological symptoms and severe metabolic acidosis, often with a high serum anion gap. Malabsorbed carbohydrates can be fermented by colonic microbiota capable of producing D-lactic acid. Routine clinical assessment of serum lactate covers only L-lactic acid; when clinical suspicion for D-lactic acidosis is high, special assays for D-lactic acid are called for...
October 10, 2016: Zeitschrift Für Gastroenterologie
Amanda Yang Shen, Aaron Stanes
BACKGROUND: Pain associated with appendiceal endometriosis can mimic other intra-abdominal pathology. The diagnosis is usually obvious during gross inspection of the appendix; however, the absence of classical macroscopic appearances may lead to missed cases in which the patient's pain is misdiagnosed and inappropriately managed. CASE: A 34-year-old woman presented with cyclical right iliac fossa pain and an elevated serum C-reactive protein of 13 mg/L (normal < 5 mg/L)...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Kohei Yamakawa, Takuya Yoshino, Kotaro Watanabe, Koichiro Kawano, Akira Kurita, Naomi Matsuzaki, Yoshiaki Yuba, Shujiro Yazumi
BACKGROUND: Cronkhite-Canada syndrome (CCS) is a rare non-inherited disorder, characterized by gastrointestinal polyposis and ectodermal changes. The pathophysiology remains unclear. Treatment with corticosteroids is considered the mainstay treatment because of its high efficacy. However, some patients have steroid-resistant CCS. The therapeutic strategy for steroid-resistant CCS is not yet established. We report two cases with steroid-resistant CCS that were effectively treated with cyclosporine (CyA)...
October 6, 2016: BMC Gastroenterology
J S Johnson, K L Martin, K G Pohler, K R Stewart
Rapidly cooling pigs after heat stress (HS) results in a pathophysiological condition, and because rapid temperature fluctuations may be associated with reduced reproductive success in sows, it lends itself to the hypothesis that these conditions may be linked. Objectives were to determine the effects of rapid cooling on thermal response and future reproductive success in pigs. Thirty-six replacement gilts (137.8±0.9kg BW) were estrus synchronized and then 14.1±0.4 d after estrus confirmation, pigs were exposed to thermoneutral conditions (TN; n=12; 19...
October 2016: Journal of Thermal Biology
Brit Long, Alex Koyfman
BACKGROUND: Sepsis is a common clinical condition, and mortality and morbidity may be severe. The current definition of sepsis involves systemic inflammatory response syndrome (SIRS) criteria, which is met by many conditions. OBJECTIVE: This review evaluates the SIRS continuum, signs and symptoms of sepsis, mimics of sepsis, and an approach to management for sepsis mimics. DISCUSSION: The current emergency medicine definition of sepsis includes SIRS, a definition that may be met by many conditions...
September 28, 2016: Journal of Emergency Medicine
Daming Sun, Jingbo Zhao, Donghua Liao, Pengmin Chen, Hans Gregersen
A number of factors influence gastrointestinal tissue structure and mechanical properties such as the physical environment and diseases like partial obstruction. Hence multi-axial biomechanical properties are important for understanding the pathophysiology of the obstructed intestine. The aim was to estimate the multi-axial biomechanical properties, in particular with focus on the shear modulus. Partial obstruction of mid-jejunum was created surgically by placement of a polyethylene ring for two weeks in seven male rats...
September 29, 2016: Annals of Biomedical Engineering
Ibrahim Hatemi, Gulen Hatemi, Aykut F Çelik
PURPOSE OF REVIEW: Gastrointestinal system can be involved in primary and secondary vasculitides. The recent data regarding the pathophysiology, clinical findings, diagnosis, management, and outcome of gastrointestinal involvement in different types of vasculitis are reviewed. RECENT FINDINGS: Diagnosis of gastrointestinal vasculitis may be difficult and relies mostly on imaging, because biopsy samples are hard to obtain and superficial mucosal biopsies have a low yield...
September 28, 2016: Current Opinion in Rheumatology
Yasmin da Silva Chaves, Afrânio Côgo Destefani
Introduction: The dumping syndrome is frequent in bariatric surgery. It is probably the most common syndrome following partial or complete gastrectomy. Its prevalence in partial gastrectomy can reach up to 50%, thus it can be a significant complication arising from some types of bariatric surgeries. Objective: Critical analysis on dumping syndrome, its pathophysiology, diagnosis and treatment. Methods: A literature review was performed using the key words: 'dumping syndrome', 'bariatric surgery' and 'rapid dumping syndrome'...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Edoardo Savarino, Andrea Ottonello, Salvatore Tolone, Ottavia Bartolo, Myong Ki Baeg, Farhood Farjah, Shiko Kuribayashi, Katerina P Shetler, Christian Lottrup, Ellen Stein
The 21st century offers new advances in diagnostic procedures and protocols in the management of esophageal diseases. This review highlights the most recent advances in esophageal diagnostic technologies, including clinical applications of novel endoscopic devices, such as ultrathin endoscopy and confocal laser endomicroscopy for diagnosis and management of Barrett's esophagus; novel parameters and protocols in high-resolution esophageal manometry for the identification and better classification of motility abnormalities; innovative connections between esophageal motility disorder diagnosis and detection of gastroesophageal reflux disease (GERD); impedance-pH testing for detecting the various GERD phenotypes; performance of distensibility testing for better pathophysiological knowledge of the esophagus and other gastrointestinal abnormalities; and a modern view of positron emission tomography scanning in metastatic disease detection in the era of accountability as a model for examining other new technologies...
September 28, 2016: Annals of the New York Academy of Sciences
Julie G In, Jennifer Foulke-Abel, Mary K Estes, Nicholas C Zachos, Olga Kovbasnjuk, Mark Donowitz
The development of indefinitely propagating human 'mini-guts' has led to a rapid advance in gastrointestinal research related to transport physiology, developmental biology, pharmacology, and pathophysiology. These mini-guts, also called enteroids or colonoids, are derived from LGR5(+) intestinal stem cells isolated from the small intestine or colon. Addition of WNT3A and other growth factors promotes stemness and results in viable, physiologically functional human intestinal or colonic cultures that develop a crypt-villus axis and can be differentiated into all intestinal epithelial cell types...
September 28, 2016: Nature Reviews. Gastroenterology & Hepatology
Maria M Buckley, Rebecca O'Brien, Michelle Devlin, Aisling A Creed, Mark G Rae, Niall P Hyland, Eamonn M M Quigley, Declan P McKernan, Dervla O'Malley
In addition to its role in regulating energy homeostasis, the adipokine, leptin modifies gastrointestinal (GI) function. Indeed, leptin-resistant obese humans and leptin-deficient obese mice exhibit altered GI motility. In the functional GI disorder, irritable bowel syndrome (IBS), circulating leptin levels are reported to differ from healthy controls. Additionally, IBS patients display altered cytokine profiles, including elevated circulating levels of the pro-inflammatory cytokine, interleukin (IL)-6, which bears structural homology and similarities in intracellular signalling to leptin...
September 27, 2016: Experimental Physiology
Hui-Yi Feng, Yang-Chao Chen
The role of bile acids in colorectal cancer has been well documented, but their role in pancreatic cancer remains unclear. In this review, we examined the risk factors of pancreatic cancer. We found that bile acids are associated with most of these factors. Alcohol intake, smoking, and a high-fat diet all lead to high secretion of bile acids, and bile acid metabolic dysfunction is a causal factor of gallstones. An increase in secretion of bile acids, in addition to a long common channel, may result in bile acid reflux into the pancreatic duct and to the epithelial cells or acinar cells, from which pancreatic adenocarcinoma is derived...
September 7, 2016: World Journal of Gastroenterology: WJG
A Venara, M Neunlist, K Slim, J Barbieux, P A Colas, A Hamy, G Meurette
Postoperative ileus (POI) is a major focus of concern for surgeons because it increases duration of hospitalization, cost of care, and postoperative morbidity. The definition of POI is relatively consensual albeit with a variable definition of interval to resolution ranging from 2 to 7 days for different authors. This variation, however, leads to non-reproducibility of studies and difficulties in interpreting the results. Certain risk factors for POI, such as male gender, advanced age and major blood loss, have been repeatedly described in the literature...
September 22, 2016: Journal of Visceral Surgery
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