SEARCH · PubMed Health

Results for “GASTROINTESTINAL TRACT”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources

PubMed1996

Evaluation of undiluted N-butyl-2-cyanoacrylate in the endoscopic treatment of upper gastrointestinal tract varices.

BACKGROUND AND STUDY AIMS: Endoscopic obliteration of upper gastrointestinal tract varices using N-butyl-2-cyanoacrylate has been proposed by some authors. The aim of the present study was to evaluate prospectively the efficacy and safety of this technique, using the undiluted substance, in obtaining hemostasis of bleeding upper gastrointestinal tract varices, as well as definitive eradication of varices located in the gastric fundus and duodenum. PATIENTS AND METHODS: We carried out variceal injections of N-butyl-2-cyanoacrylate in 80 patients (51 males, 29 females, mean age 68 years, range 19-80) with upper gastrointestinal tract varices. In 24 patients, the varices were located in the esophagus, in 54 in the gastric fundus, and in the remaining two they were in the duodenum. Forty-eight patients were treated for active variceal bleeding, and the other 32 were treated electively. RESULTS: Hemostasis was achieved in 43 of the 48 patients (89.6%) treated for active variceal bleeding. Eradication was obtained in 49 of the 56 patients (87.5%) with gastric or duodenal varices. Overall complications occurred in 11 patients (10.4%). In two patients, embolization was found, and in a further two patients it was clinically suspected, but could not be proved. Ten patients (12.5%) died during the treatment period, six due to uncontrolled bleeding, two due to rebleeding, and two due to liver failure. CONCLUSIONS: Endoscopic injection of N-butyl-2-cyanoacrylate appears to be both safe and effective in the treatment of bleeding gastrointestinal tract varices. The relative value of the undiluted substance versus the diluted one should be further evaluated.

Adult↗

PubMed1985

Primary lymphoma of the gastrointestinal tract.

Forty-six instances of gastrointestinal tract lymphoma are reviewed with attention to clinical features, diagnostic studies, surgical approach and adjuvant therapy. Gastrointestinal tract lymphoma may be present at any age in individuals with pain, abdominal mass or other abdominal findings, and all ulcers and other endoscopically accessible lesions require biopsy, without regard for roentgenologic or endoscopic appearance of benignity. Resection is recommended when cure is possible; adjunctive therapy is regarded as beneficial. There is a good prognosis for those patients surviving two to three years beyond diagnosis.

Actuarial Analysis↗

PubMed1995

Prevalence of sexual abuse among patients with functional disorders of the lower gastrointestinal tract.

To evaluate the links between gastrointestinal disorders and sexual abuse, we asked 344 patients consulting in a specialized tertiary care university hospital or a gastroenterologist in private practice, if they had been sexually abused. Forty per cent of patients suffering from lower functional digestive disorder gave a history of having been victims of sexual abuse in contrast to only 10% of patients with organic diseases (P < 0.0003). The prevalence was similar in private practice and in the university hospital. Abused patients were more likely to complain of constipation (P < 0.03) and diarrhoea (P < 0.04). Anismus was more frequent in patients who had been sexually abused (P < 0.02). The prevalence of abuse was four times greater in patients with lower than with upper functional motor disorders of the gastrointestinal tract (P < 0.002). This study confirms the large prevalence of a past history of sexual abuse among patients consulting for gastrointestinal tract functional disorder, and this whatever the kind of recruitment may be. It shows the association to be much stronger in patients who have a lower rather than an upper gastrointestinal dysfunction, the major complaint of abused patients being constipation and diarrhoea.

Adolescent↗

PubMed1981

Gastric teratoma: unusual cause for bleeding of the upper gastrointestinal tract in the newborn.

Bleeding of the upper gastrointestinal tract in the full-term newborn is a relatively benign and rare occurrence. This report describes a female infant with a gastric teratoma who experienced recurrent bleeding of the upper gastrointestinal tract as a neonate and infant secondary to gastric outlet obstruction. Anteroposterior and lateral abdominal radiographs revealed a large calcified abdominal mass with the pathognomonic features of a teratoma with a mandible and teeth. Gastric teratomas have not been previously reported as an etiologic or predisposing condition of gastrointestinal hemorrhage in two large reviews concerning this topic in the newborn and infant. This patient represents the 51st case and only the second female described in the literature. The frequency and unusual features of this treatable lesion, as well as the diagnostic approach to bleeding of the upper gastrointestinal tract in the newborn, are reviewed.

Abdomen↗

PubMed1995

Mast cells in the gastrointestinal tract.

The morphology and functions of gastrointestinal mast cells (MCs) under physiological and pathological conditions were described. Special attention was paid to the MCs origin, differentiation and morphological and biochemical aspects of their degranulation. Mast cells are important component of normal architecture of the gastrointestinal tract. Many substances released from MCs during degranulation are biologically active and mediate numerous processes: blood flow regulation, epithelial and endothelial permeability, mucosal secretion, gastrointestinal tract motility, immunological events related to the antigens of various origin, angiogenesis, cancer development. Thus MC is often considered as an important agent in pathogenesis of many gastrointestinal diseases. The gastrointestinal diseases which was described in this paper are following: bacterial and parasitic infections, peptic ulcer, ulcerative colitis, Leśniowski-Crohn's disease, inflammatory polyps, intestinal graft-versus-host reaction, neoplastic tumors, mastocytosis, intestinal ischemia.

Adrenergic Fibers↗

PubMed1999

Beneficial effects of NSAIDs in the gastrointestinal tract.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin exert irritant and toxic effects upon the organs of the gastrointestinal tract. NSAID toxicity in the gastrointestinal tract is related, at least in part, to the inhibition of the cyclo-oxygenase (COX) enzyme, leading to a reduction of 'cytoprotective' prostaglandin synthesis. In this paper, examples in which NSAIDs exert beneficial effects in the gastrointestinal tract are discussed. NSAIDs, particularly aspirin, are showing promise in the chemoprevention of colorectal, and, to a lesser degree, oesophageal cancers. The clinical value of NSAIDs in the treatment of established gastrointestinal tract cancers is also worthy of further study. There is good clinical evidence showing the value of diclofenac for the treatment of biliary colic and aspirin or ibuprofen for the prevention of gallstones. NSAIDs also have therapeutic potential against other inflammatory gastrointestinal diseases in the oesophagus and possibly pancreas and liver. To a lesser degree, there is some evidence that NSAIDs may have a therapeutic potential in certain gastrointestinal motility disorders, such as aspirin in the post-irradiation syndrome. It therefore follows that in these cancerous, inflammatory and motility pathologies, prostaglandins exert deleterious effects. The paradox of prostaglandins being 'cytoprotective' and potentially damaging can be explained by considering the enzymic origin of prostaglandins. COX-1 is expressed physiologically while inducible COX-2 is expressed in pathological situations. The beneficial clinical effects of selective COX-2-inhibiting NSAIDs in the gastrointestinal tract deserve further study. This paper challenges the concept of 'cytoprotection'.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed1987

Clinical and pathophysiological aspects of somatostatin and the gastrointestinal tract.

Somatostatin is present in the gastrointestinal tract in appreciable amounts. The highest concentrations of the polypeptide are found in the stomach, the upper small intestine, and the pancreas. Within the gastrointestinal tract, somatostatin inhibits various functions, including endocrine and exocrine secretion, motility, blood flow, absorption, and growth. The polypeptide regulates these functions by endocrine, paracrine, neurocrine or luminal mechanisms. Abnormalities of endogenous somatostatin have been implicated in several gastrointestinal disorders, including the somatostatinoma syndrome, antroduodenal D-cell hyperplasia, peptic ulcer, obesity, and liver cirrhosis. Because of its potent inhibitory effects, somatostatin or somatostatin-analogues have been used as therapeutic agents in various clinical conditions, such as upper gastrointestinal haemorrhage, endocrine pancreatic tumours, gastrointestinal and pancreatic fistulas, pancreatitis, secretory diarrhoea, and dumping syndrome. The recent availability of the synthetic long-acting somatostatin-analogue SMS 201-995 (Sandostatin) has greatly facilitated the therapeutical application of somatostatin-polypeptides.

Duodenum↗

PubMed2006

Role of Toll-like receptors in health and diseases of gastrointestinal tract.

The human gastrointestinal (GI) tract is colonized by non-pathogenic commensal microflora and frequently exposed to many pathogenic organisms. For the maintenance of GI homeostasis, the host must discriminate between pathogenic and non-pathogenic organisms and initiate effective and appropriate immune and inflammatory responses. Mammalian toll-like receptors (TLRs) are members of the pattern-recognition receptor (PRR) family that plays a central role in the initiation of innate cellular immune responses and the subsequent adaptive immune responses to microbial pathogens. Recent studies have shown that gastrointestinal epithelial cells express almost all TLR subtypes characterized to date and that the expression and activation of TLRs in the GI tract are tightly and coordinately regulated. This review summarizes the current understanding of the crucial dual roles of TLRs in the development of host innate and adaptive immune responses to GI infections and the maintenance of the immune tolerance to commensal bacteria through down-regulation of surface expression of TLRs in intestinal epithelial cells.

Animals↗

PubMed1997

MR imaging of the gastrointestinal tract with i.v., gadolinium and diluted barium oral contrast media compared with unenhanced MR imaging and CT.

OBJECTIVE: To determine an optimal MR imaging technique and pulse sequence for evaluating mural and serosal disease of the gastrointestinal tract, we administered 2% oral barium sulfate and obtained fat-suppressed gadolinium-enhanced breath-hold fast multiplanar spoiled gradient-recalled (FMPSPGR) MR images. We then compared these images with spin-echo T1-weighted and T2-weighted fast spin-echo MR images and with CT images. SUBJECTS AND METHODS: Thirty-one patients with suspected diseases of the gastrointestinal tract were imaged with spin-echo T1-weighted, fast spin-echo T2-weighted, and fat-saturated gadolinium-enhanced FMPSPGR MR imaging. Before undergoing MR imaging, all patients received 1350 ml of 2% barium sulfate oral contrast media. For CT scans, patients received 120 ml of iodinated i.v. contrast material and 2% barium sulfate oral contrast material. CT and MR images were retrospectively and independently reviewed by two radiologists for ability to see normal bowel wall, for the presence of abnormal gastrointestinal tract mural thickening or enhancement, and for overall gastrointestinal tract visualization. Findings were correlated with surgical findings, endoscopy, and barium studies. RESULTS: Ten patients had benign disease, 16 had malignant gastrointestinal tract disease, and five had no gastrointestinal tract abnormalities. In 94% of patients, the gadolinium- and barium-enhanced FMPSPGR MR images were superior to CT and spin-echo MR sequences for depicting the wall of the normal bowel (p < .001). For the two observers, the FMPSPGR MR images with i.v. and oral contrast material were seen as revealing 94% and 95% of bowel segments with malignant or inflammatory mural thickening or serosal tumor. In comparison, CT revealed 64% and 72% (p < .01 and p < .0001, respectively), fast spin-echo T2-weighted MR images revealed 21% and 28% (p < .0001), and T1-weighted MR images revealed 17% and 18% (p < .0001). The gadolinium- and barium-enhanced MR images were preferred for overall gastrointestinal tract visualization in 65% of patients compared with 1% for CT scans (p < .001). In 32% of patients, the enhanced MR images were equivalent to CT images. CONCLUSION: MR evaluation of the gastrointestinal tract requires bowel distention with oral contrast material as well as motion reduction techniques, including glucagon and rapid gradient-echo pulses that allow breath-hold imaging. Fat-suppressed gadolinium-enhanced FMPSPGR MR imaging with diluted barium oral contrast media is effective for imaging benign and malignant mural and serosal abnormalities of the gastrointestinal tract.

Administration, Oral↗

PubMed2001

Long-acting octreotide is effective in controlling rebleeding angiodysplasia of the gastrointestinal tract.

BACKGROUND: Management of bleeding angiodysplasia of the gastrointestinal tract is often a major clinical problem. Lesions are frequently multiple, not detectable or missed during conventional endoscopy and patients are sometimes at high risk for complications because of advanced age and serious concomitant disorders. AIMS: To determine the efficacy of a new formulation of somatostatin analogue (octreotide long-acting) in management of recurrent bleeding angiodysplasia in patients resistant to endoscopic treatment and not suitable for surgery. PATIENTS AND METHODS: Three patients with recurrent bleeding angiodysplasia of gastrointestinal tract were treated with long-acting octreotide administered intramuscularly 20 mg monthly to each individual. The number of admissions for acute bleeding, hospital stay and number of blood units transfused before and after treatment (followup: 15-17 months) were regularly monitored. RESULTS: In each patient, a relevant decrease in number of hospital admissions, duration of hospital stay, number of administered blood units was seen and mean haemoglobin values significantly increased in all of them after introducing long-acting octreotide therapy. CONCLUSIONS: This is the first report on use of long-acting octreotide in bleeding angiodysplasia of gastrointestinal tract. Data suggest that long-acting octreotide is a safe drug and is successful in controlling recurrent gastrointestinal bleeding due to angiodysplasia in elderly patients not eligible for surgical or endoscopic therapy.

Aged↗

PubMed1992

Metastatic tumors to the upper gastrointestinal tract: endoscopic experience.

Metastatic tumors to the upper gastrointestinal tract were identified by esophagogastroduodenoscopy in 14 patients. Malignant melanoma, breast cancer, and lung cancer were the most common primary cancers in four, three, and three patients, respectively. Osteogenic sarcoma, renal cell carcinoma, Meckel cell carcinoma of the skin, and germ-cell tumor were the primary cancer in the remaining four. The esophagus was involved in three patients, the stomach in 13, duodenum in four, and papilla of Vater in one. Upper gastrointestinal bleeding and anemia were the most common presenting features. There was correlation between symptoms and endoscopic findings in all patients. Involvement of gastrointestinal tract at endoscopy was the initial and only evidence of metastases in all patients without evidence of metastases elsewhere, as evidenced by other diagnostic tests in any of these patients. Endoscopic biopsies and/or brush cytology provided histologic diagnosis in all 14 patients. The endoscopic and nonendoscopic literature regarding metastases to the upper gastrointestinal tract is reviewed.

Adenocarcinoma↗

PubMed1997

[Detection of human herpesvirus 8 (HHV 8) in Kaposi sarcomas of the gastrointestinal tract].

Involvement of Kaposi's sarcoma in the gastrointestinal tract is common in AIDS patients. The disease is, however, usually asymptomatic and, due to the tumor growth primarily in the submucosa, biopsy diagnosis is possible in under 25%. The recently described human herpes virus 8 (HHV8) is closely associated with all forms of Kaposi's sarcoma. Detection of HHV8 in the tissue samples may therefore improve the diagnosis of gastrointestinal Kaposi's sarcoma. In the present study we analyze autopsy samples of tumor and non-tumor tissue from the gastrointestinal tract in patients with and without Kaposi's sarcoma for the presence of HHV8 DNA using a nested polymerase chain reaction (PCR) assay. HHV8 DNA was present in all 15 tissues with Kaposi's sarcoma. In contrast, HHV8 DNA was present only in 3 (18.8%) of 16 gastrointestinal tissues of patients with Kaposi's sarcoma but without histologically detectable tumor. No HHV8 DNA was present in 15 tissue samples of AIDS patients without Kaposi's sarcoma. Our data show that detection of HHV8 DNA using a nested PCR assay is a highly sensitive and specific diagnostic test for Kaposi's sarcoma in autopsy tissue samples from the gastrointestinal tract. It should therefore be possible to use detection of HHV8 DNA in biopsy material as an assay for the diagnosis of Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗

PubMed1977

[Disorders of the blood circulation in the gastrointestinal tract].

Blood flow disturbances in the gastrointestinal tract can lead to serious illness. They can be acute or chronic, their cause may be arterial or venous occlusion or hypotonia. Lesions of the gastrointestinal tract caused by ischemia depend on localisation, acuteness and degree of the blood flow disturbance. They may reach from focal and segmental ischemic lesions to extensive necroses of the entire intestinal tubes. The most serious ischemic disease is the embolic and thrombotic occlusion of the arteria mesenterica superior due to previous arterosclerotic damage. Infarction of a large part of the intestines and peritonitis can be the consequence. These patients' only chance of survival is early diagnosis--as a rule exclusively via angiography--and immediate surgery. Chronic occlusion of the arteria mesenterica superior leads to angina abdominalis which mainly occurs after food intake and can last for hours. The reason may also be a general arteriosclerosis. Men are affected more frequently and at a younger age than women. As a consequence of lowered intestinal blood flow these patients suffer from malabsorption and heavy weight loss. Conservative therapy is not effective. These patients, too, will have to be treated surgically after previous angiography. Vascular disease with decreased blood flow as its consequence can be found in a number of inflammatory diseases, in malign hypertensian, in collagen disease and in other more rare diseases as pseudoxanthoma elasticum or Ehlers-Danlos-syndrome. In the case of ischemic colitis arterial and more rarely venous occlusions cause decreased blood flow in the big bowel. A frequent consequence is colitis in the left colon which is characterized by acuteness, pain in the left side of the abdomen and by heavy rectal bleeding. Diagnosis is established by means of endoscopy, barium enema and angiography. Primarily therapy of ischemic colitis is of the conservative type. In severe cases with gangrene and peritonitis the colon has to be resected.

Acute Disease↗

PubMed1999

Percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) for decompression in the upper gastrointestinal tract. Initial experience with palliative treatment of gastrointestinal obstruction in terminally ill patients with advanced carcinomas.

BACKGROUND: Signs of gastrointestinal obstruction, with intractable vomiting and an inability to take oral food, are common symptoms in terminally ill cancer patients with advanced primary tumors or peritoneal carcinomatosis. The application of percutaneous endoscopic gastrostomy or jejunostomy (PEG/PEJ) instead of the usual nasoenteral tube is a simple method of achieving permanent decompression in the upper gastrointestinal tract. The goals of this study, in addition to establishing indications and outcome, were to identify specific aspects of tube placement and to determine the incidence of complications. METHOD: Over a period of 3 years, a total of 24 consecutive patients (mean age, 64 years; range, 37-83 years) underwent either a PEG (17/71%) or a PEJ (seven/29%). RESULTS: In all patients, PEG/PEJ obviated the need for the nasoenteral tube. A total of 22 patients (92%) were enabled to take liquids orally, and 20 (83%) were discharged to home care. With the exception of a single spontaneous dislodgement of the PEG tube, no major complications were observed. CONCLUSION: We believe that PEG/PEJ represents an effective, minimally invasive, and cost-effective method for gastrointestinal decompression in patients with advanced incurable cancer.

Abdominal Neoplasms↗

PubMed2007

[Symptoms involving the gastrointestinal tract].

Symptoms involving the gastrointestinal tract are very common in patients who require palliative treatment. They can be caused by the patient's underlying (malignant) disease or by the treatment of this disease. Nausea and vomiting as well as constipation are of the utmost importance in this context due both to their frequency as well as their complex consequences. A careful evaluation of the patient's history combined with a few diagnostic procedures will help to provide a treatment which is orientated on pathophysiology.

Gastrointestinal Diseases↗

PubMed1985

Late ultrastructural effects of heavy ions and gamma irradiation in the gastrointestinal tract of the mouse.

The irradiated gastrointestinal tract of LAF1 mice was examined one year following a single dose (1000 rad) of either 12C heavy ions or 60Co gamma rays. Qualitative ultrastructural analysis of the gastrointestinal tract of mice exposed to heavy ions or gamma irradiation did not show any discernible differences. In the stomach of irradiated mice, parietal cells contained numerous lysosomes; the gastric chief cells occasionally contained myelin figures. The epithelial cells of the small intestine, especially jejunum and ileum, showed several changes: (1) increased vacuolation was seen both inter- and intra-cellularly, (2) epithelial cell projections penetrated the basal lamina and were in contact with underlying mesenchymal cells, (3) occasional Paneth cells contained intracellular vacuoles consisting of fibrillar and granular material. In the large intestine occasional signs of degeneration were observed. Qualitative analysis of stromal elements of the gut in irradiated mice indicated the presence of damage to capillary endothelial cells, smooth muscle cells and some nerve processes. The amount of basement membrane (BM) around capillaries and small vessels was increased; the same phenomenon was observed to affect the nerve processes, but with less severity. Quantitative analysis of the basement membrane thickness around capillaries in irradiated vs. control mice showed significant differences. Basement membrane thickness around capillaries in the gastric mucosa and duodenum did not differ significantly in any of the treatment groups. In jejunum, the gamma treated animals exhibited significantly higher BM thickness when compared to unirradiated controls. In ileum, only 12C-heavy ion treated animals showed thicker BM when compared to their respective controls. In colon, both 12C- and 60Co-treated animals showed increased BM thickness when compared to controls.

Animals↗

PubMedDate not supplied

Prospective evaluation of a clinical guideline recommending hospital length of stay in upper gastrointestinal tract hemorrhage.

CONTEXT: Upper gastrointestinal tract hemorrhage (UGIH) is a common and potentially life-threatening disorder. Resource utilization can vary without adverse effect on patient outcome. Clinical practice guidelines are a potential solution to reduce variation in practice while improving patient outcomes. OBJECTIVE: To validate prospectively the safety, acceptability, and impact of a clinical practice guideline defining the medically appropriate length of stay (LOS) for patients hospitalized with UGIH. DESIGN: Prospective, controlled time-series study with an alternate-month design. Outcome surveyors and patients were blinded to study group allocation. GUIDELINE: A retrospectively validated scoring system using 4 independent variables: hemodynamics, time from bleeding, comorbidity, and esophagogastroduodenoscopy (EGD) findings to predict risk of adverse events. The quantitative risk for the low-risk subset was 0.6% (95% confidence interval [CI], 0.0%-2.0%) for subsequent complications and 0% (95% CI, 0.0%-0.9%) for life-threatening complications from this retrospective evaluation. SETTING: A 1000-bed, not-for-profit, university-affiliated teaching hospital. PATIENTS: Consecutive adult patients hospitalized for acute UGIH. INTERVENTION: Concurrent feedback of guideline recommendation (same-day hospital discharge) to physicians caring for patients at low risk for complication. No risk information was provided during control months. RESULTS: Seventy percent (209/299) of UGIH patients achieved low-risk status according to the guideline and were therefore potentially suitable for early discharge from the hospital. Providing real-time quantitative risk information (intervention group only) was associated with an increase in guideline compliance from 30% to 70% (P<.001) and a decrease in mean (SD) LOS from 4.6 (3.5) days to 2.9 (1.3) days (mean reduction of 1.7 days per patient; P<.001). No differences in complications, patient health status, or patient satisfaction were found when measured 1 month after discharge. An independent variable predicting decreased hospital LOS for low-risk UGIH patients was early EGD. CONCLUSIONS: Implementation of the clinical practice guideline safely reduced hospital LOS for selected low-risk patients with acute UGIH. Further prospective validation in other settings is warranted.

Adult↗

PubMed1984

Assessment of mouse strain on bacterial translocation from the gastrointestinal tract.

The translocation of indigenous bacteria from the gastrointestinal tract to the mesenteric lymphnodes was compared in ten strains of mice. Indigenous Escherichia coli were cultured from the mesenteric lymphnodes of only two of the six mouse strains examined. Thus, spontaneous translocation of indigenous enteric bacteria across the intestinal barrier did not occur to any significant extent in any of the mouse strains examined. Since bacterial overgrowth in the gastrointestinal tract promotes bacterial translocation, bacterial translocation was tested in ten mouse strains including B10 series after antibiotic-decontaminated and subsequent colonization with streptomycin-resistant E. coli C25. E. coli C25 populated the ceca of the mice at levels of 10(8) to 10(9) per gram and translocated to 90-100% of the mesenteric lymphnodes with mean of 10(1.13) to 10(1.86) per mesenteric lymphnode. However, there were no significant differences between mouse strains as to the translocation incidence or the numbers of viable E. coli C25 per mesenteric lymphnode. Thus, genetic differences between mouse strains did not influence bacterial translocation from the gastrointestinal tract to the mesenteric lymphnodes.

Animals↗