By Robert Logan, Adam Harris, J. J. Misiewicz, J. H. Baron
(BMJ Books) Univ. health facility, Nottingham, united kingdom. offers a concise consultant to problems of the higher gastrointestinal tract. hugely illustrated with charts, diagrams, and colour pictures. displays most modern advances in figuring out the pathophysiology and pathogenesis of this illness. For clinical scholars, nurses, and clinicians. Softcover.
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Additional info for ABC of the Upper Gastrointestinal
These may then permit identification of patients infected with “bad” bacteria so that eradication treatment can be targeted to them. Environment Gastric cancer is epidemiologically linked with diets high in salt and low in fresh fruit. Salt may change acid secretion because it suppresses parietal cells, and salty diets cause gastric atrophy. Conversely, the antioxidant vitamins in fresh fruit might protect specialised gastric cells from the reactive oxygen species released by inflammatory cells.
Causes of dyspepsia History taking is key to identifying the likely cause of dyspepsia. Gastro-oesophageal reflux disease It is important and practical to distinguish gastro-oesophageal reflux disease (GORD) from dyspepsia. Frequent heartburn is a cardinal symptom of GORD; acid reflux causes a retrosternal or epigastric burning feeling that characteristically radiates up towards the throat, is relieved transiently by antacids, and is precipitated by a meal or by lying down. Up to 60% of people with upper gastrointestinal symptoms report both heartburn and epigastric pain or discomfort.
In our view this is irrational if these patients are at sufficiently high risk to be candidates for co-treatment with acid suppressing drugs. The future A new generation of less toxic NSAIDs is probably imminent. Specific inhibitors of the inducible cyclo-oxygenase-2 enzyme (COX-2), which probably leave protective gastric prostaglandins uninhibited, are now available. Meloxicam, another recent NSAID, is well tolerated. Whether this is because it is a partially selective COX-2 inhibitor or because tested doses are low is uncertain.