Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management - 2 Volume Set

Cover Sleisenger and Fordtran’s Gastrointestinal and Liver Disease Copyright Dedication Contributors Foreword The Sleisenger and Fordtran Editors Preface Acknowledgments Abbreviation List Part I: Biology of the Gastrointestinal Tract Chapter 1: Cellular Growth and Neoplasia Mechanisms of Normal Tissue Homeostasis Cellular Proliferation Apoptosis Senescence Signaling Pathways That Regulate Cellular Growth Intestinal Tumor Development Multistep Formation Clonal Expansion Cancer Stem Cells Epithelial-Mesenchymal Transition Neoplasia-Associated Genes Oncogenes Oncogenic Growth Factors and Growth Factor Receptors Signal Transduction–Related Oncogenes Nuclear Oncogenes Tumor Suppressor Genes Adenomatous Polyposis Coli Gene TP53 Gene SMAD4 Gene DNA Repair Genes Noncoding RNAs Oncogenic Signaling Pathways Tumor Microenvironment Tumor Metabolism Inflammation and Cancer Microbiome Biological Features of Tumor Metastasis Angiogenesis and Lymphangiogenesis Environmental Influences Chemical Carcinogenesis Dietary Factors Molecular Medicine: Current and Future Approaches in Gastrointestinal Oncology Next Generation Sequencing Cancer and Tumor Genomics Molecular Diagnostics Chapter 2: Mucosal Immunology and Inflammation Immunoglobulins of the Mucosal Surface Physiology of Mucosal Immune Cells Functional Anatomy of the Mucosal Immune System Peyer Patches and M Cells Intestinal Epithelial Cells Paneth cells Goblet Cells Tuft Cells Recognition of Pathogen-Associated Molecular Patterns by Pattern Recognition Receptors Antigen Presentation in the Gut Effector Compartments within the Gut Immune System Intraepithelial Lymphocytes Lamina Propria Lymphocytes and Mononuclear Cells T Cell Differentiation Innate Lymphoid Cells Dendritic Cells Macrophages Oral Tolerance Chemokine Role in Homeostasis and Inflammation Chapter 3: The Enteric Microbiota Characteristics of the Human Intestinal Microbiome Spatial Variation in the Intestinal Microbiome Temporal Changes and Resilience of the Intestinal Microbiome Factors Affecting Intestinal Microbiome Variability and Resilience Age Sex Genetics Geography and Diet Exercise Medications Other Lifestyle Factors Microbe-Microbe Signaling The Effect of Host–Intestinal Microbiome Interactions on Host Physiology Interactions Between the Intestinal Microbiome and Immune System Interactions Between the Intestinal Microbiome and Gastrointestinal Tract The Microbiome-Gut-Brain Axis The role of the intestinal microbiome in human disease Metabolic Function Inflammatory Diseases Cancer Functional Gastrointestinal Disorders The role of the Intestinal Microbiome in Modulation of Drug Response Therapeutic Modulation of the Intestinal Microbiome NonBacterial Members of the Intestinal Microbiome Future Directions Chapter 4: Gut Sensory Transduction Hormones and Neurotransmitters Defining Hormones and Neurotransmitters Modes of Transmitter Release Transducing Signals from the GI Lumen Recognizing Signals Through Cell Surface Receptors G Protein–Coupled Receptors Enzyme-Coupled Receptors Ion Channel–Coupled Receptors Nutrient Chemosensing Lipids Proteins and Amino Acids Tastants Sensing the Microbiome Other Factors Stimulating Transmitter Release The Transmitters Gut Neuropeptides Gastrin Cholecystokinin Secretin Vasoactive Intestinal Polypeptide Glucagon Glucose-Dependent Insulinotropic Polypeptide Pancreatic Polypeptide Family Substance P and the Tachykinins Somatostatin Motilin Leptin Ghrelin Neurotransmitters Acetylcholine Catecholamines Dopamine Serotonin Histamine Nitric oxide Cannabinoids and other Chemical Transmitters Cannabinoids Adenosine Cytokines The Importance of Hormones and Neurotransmitters Growth and Abnormal Growth of the Gut Growth Factor Receptors Epidermal Growth Factor Transforming Growth Factor-α Transforming Growth Factor-β Insulin-Like Growth Factors Fibroblast Growth Factor and Platelet-Derived Growth Factor Trefoil Factors Diabetes and the Gut Gastrointestinal Regulation of Appetite Part II: Nutrition in Gastroenterology Chapter 5: Nutritional Principles and Assessment of the Gastroenterology Patient Basic Nutritional Concepts Energy Stores Energy Metabolism Resting Energy Expenditure Energy Expenditure of Physical Activity Thermic Effect of Feeding Recommended Energy Intake in Hospitalized Patients Methods Incorporating Metabolic Stress Factors Method Without a Stress Factor Caloric Delivery and Avoidance of Hyperglycemia Proteins Nitrogen Balance Carbohydrates Lipids Essential Fatty Acids Major Minerals Micronutrients Vitamins Trace Minerals Physiologic and Pathophysiologic Factors Affecting Micronutrient Requirements Age Malabsorption and Maldigestion Starvation Malnutrition Protein-Energy Malnutrition (PEM) Primary Versus Secondary Protein-Energy Malnutrition: A Body Compartment Perspective Protein-Energy Malnutrition in Children Kwashiorkor Marasmus Nutritional Dwarfism Physiologic Impairments Caused by Protein-Energy Malnutrition System Effects Gastrointestinal Tract Cardiovascular System Immune System Respiratory System Endocrine System Other Effects Wound Healing Skin Hair Kidneys Bone Marrow Nutritional Assessment Techniques History Weight Loss Food Intake Evidence of Malabsorption Evidence of Specific Nutrient Deficiencies Influence of Disease on Nutrient Requirements Functional Status Physical Examination Hydration Status Tissue Depletion Muscle Function Specific Nutrient Deficiencies Anthropometry Functional Measures of Protein-Calorie Status Biochemical Measures of Protein-Calorie Status Serum Proteins Creatinine-Height Index Discriminant Analyses of Protein-Calorie Status Rapid Screening Tools for Assessment of Targeted Populations Subjective Global Assessment Mini-Nutritional Assessment Aggressive Nutritional Support in the Hospitalized Patient Malnourished Patients Undergoing Major Surgery Patients Hospitalized with Decompensated Alcohol-Associated Liver Disease Patients Undergoing Radiation Therapy Chapter 6: Nutritional Management Nutrition in Specific Disease States Intestinal Failure Pancreatitis Crohn Disease (CD) Liver Disease Diverticular Disease Dumping Syndrome Cancer Obesity Critical Illness Nutritional Therapy Enteral Nutrition Nasoenteric Tube Access Percutaneous Endoscopic Enteral Access Indications for Percutaneous Access Devices Cancer Stroke Dementia Percutaneous Endoscopic Gastrostomy Percutaneous Endoscopic Gastrojejunostomy Direct Percutaneous Jejunostomy Complications Enteral Feeding Enteral Formulations Complications of Enteral Feeding Parenteral Nutrition Parenteral Nutrition Formulation Administration Laboratory Testing Metabolic Complications Vascular Access Devices Central Venous Catheter Complications Special Diets Chapter 7: Obesity Definitions and Epidemiology Etiology of Obesity Dietary Factors Physical Activity Factors In-Utero and Maternal Factors Medication-Induced Weight Gain Smoking Microbiome Genetics Prognosis of Obesity Pathophysiology of Obesity Clinical Features and Diagnosis of Obesity History and Physical Examination Complications of Obesity Diabetes Lipid Derangements Cardiovascular Diseases Hypertension Kidney Disease Gallbladder Disease Liver Disease Gastroesophageal Reflux Disease (GERD) Cancer Obstructive Sleep Apnea Diseases of the Bones, Joints, Muscles, Connective Tissue, and Skin Psychosocial Dysfunction Medical Treatment of Obesity Dietary Approaches Low-Fat Diets (LFDs) Low-Carbohydrate Diets (LCDs) Meal-Replacement Diets Mediterranean Diet (MD) Intermittent Fasting Pharmacotherapy Phentermine/Topiramate Lorcaserin Bupropion/Naltrexone Liraglutide Orlistat Investigational Approaches Chapter 8: Surgical and Endoscopic Treatment of Obesity Evaluation and Selection of Bariatric Surgery Candidates Surgical Treatments for Obesity Gastric Bypass Sleeve Gastrectomy Other Operations Surgical Complications Nutritional Deficiencies Outcomes Endoscopic Management of Bariatric Surgical Complications Ulceration Postoperative Gastrointestinal Bleeding Stenosis Foreign Body Complications Leaks and Fistulae Pancreaticobiliary Disease Weight Regain and Dilated Gastrojejunal Anastomosis Endoscopic Treatments for Obesity Evaluation and Selection of Endoscopic Bariatric Therapy Candidates Endoscopic Bariatric Therapies Currently Performed in the USA Intragastric Balloons Aspiration Therapy Device Endoscopic Sleeve Gastroplasty Endoscopic Bariatric Therapy Complications Intragastric Balloons Aspiration Therapy Endoscopic Sleeve Gastroplasty Nutritional Deficiencies Outcomes Intragastric Balloons Aspiration Therapy Endoscopic Sleeve Gastroplasty Chapter 9: Feeding and Eating Disorders Epidemiology Causative Factors Satiety Appetite Energy Storage Onset and Course Evaluation Diagnosis of Specific Disorders Anorexia Nervosa Bulimia Nervosa Binge-Eating Disorder Other Specified Feeding or Eating Disorder and Unspecified Feeding or eating Disorder Avoidant/Restrictive Food Intake Disorder Pica Rumination Disorder Differential Diagnosis Nutritional, Medical, and Laboratory Evaluation Nutritional Evaluation Special Considerations in the Determination of Weight and Weight Status Medical Evaluation Laboratory Evaluation Gastrointestinal Abnormalities Associated With Eating Disorders Functional Gastrointestinal Disorders Esophageal Symptoms Liver Abnormalities Pancreas Complications Superior Mesenteric Artery Syndrome Gastric Motility Constipation Medications and Dietary Supplements Other Life-Threatening Gastrointestinal Complications Gastrointestinal Complications in Other Feeding and Eating Disorders Management of Eating Disorders in the Adult Psychiatric Treatment Psychotherapeutic Options Pharmacotherapy Nutritional Rehabilitation Medical Management of Gastrointestinal Symptoms Eating Disorders and the Intestinal Microbiota Chapter 10: Food Allergies Definitions Prevalence Pathogenesis Clinical features Immunoglobulin E-Mediated Disorders Pollen-Food Allergy Syndrome Gastrointestinal Allergy Mixed Immunoglobulin E- and Non–Immunoglobulin E-Mediated Disorders Eosinophilic Esophagitis Eosinophilic Gastroenteritis Allergic Eosinophilic Proctocolitis Infantile Colic Non–Immunoglobulin E-Mediated Disorders Food Protein-Induced Enterocolitis Syndrome Food Protein-Induced Enteropathy Celiac Disease Dermatitis Herpetiformis Other Gastrointestinal Disorders Diagnosis Prevention Treatment and natural history Part III: Symptoms, Signs, and Biopsychosocial Issues Chapter 11: Acute Abdominal Pain Anatomy and Physiology Visceral Pain Somatic-Parietal Pain Referred Pain Evaluation Approach to Acute Care History Chronology Location Intensity and Character Aggravating and Alleviating Factors Associated Symptoms Past Medical History Physical Examination Abdominal Examination Genital, Rectal, and Pelvic Examinations Laboratory Data Imaging Studies CT US Other Diagnostic Tests Causes Acute Appendicitis Acute Biliary Disease SBO Acute Diverticulitis Acute Pancreatitis Perforated Peptic Ulcer Acute Mesenteric Ischemia Abdominal Aortic Aneurysm Abdominal Compartment Syndrome Other Intra-abdominal Causes Extra-abdominal and Systemic Causes Special Circumstances Extremes of Age Pregnancy Immunocompromised Hosts Pharmacologic Management Chapter 12: Chronic Abdominal Pain Definition and Clinical Approach Abdominal Wall Pain Anterior Cutaneous Nerve Entrapment and Myofascial Pain Syndromes Slipping Rib Syndrome Thoracic Nerve Radiculopathy Centrally Mediated Abdominal Pain Syndrome Epidemiology Pathophysiology Ascending Visceral Pain Transmission Descending Modulation of Pain Visceral Sensitization Biochemical Role of 5-HT Role of the CNS Clinical Implications Clinical Features History Patient Behavior Physical Examination Diagnosis and Differential Diagnosis Treatment Establishing a Successful Patient-Physician Relationship Instituting a Treatment Plan Pharmacotherapy Mental Health Referral and Psychological Treatments Narcotic Bowel Syndrome/Opioid-Induced Gastrointestinal Hyperalgesia Chapter 13: Symptoms of Esophageal Disease Dysphagia Pathophysiology Differential Diagnosis and Approach Oropharyngeal Dysphagia Esophageal Dysphagia Odynophagia Globus Sensation Pathophysiology Approach Hiccups Chest pain of Esophageal Origin Pathophysiology Approach Heartburn and Regurgitation Pathophysiology Approach Extraesophageal Symptoms of Gastroesophageal Reflux Disease Chapter 14: Dyspepsia Definition Organic Causes Intolerance to Food or Drugs PUD GERD Gastric and Esophageal Cancer Biliary and Pancreatic Tract Disorders Other GI or Systemic Disorders Functional Dyspepsia Dyspepsia Symptom Complex Pattern and Heterogeneity Subgroups Overlap with Heartburn and IBS Epidemiology Pathophysiology Delayed Gastric Emptying Impaired Gastric Accommodation to a Meal Hypersensitivity to Gastric Distension Low-Grade Mucosal Inflammation in the Duodenum Altered Duodenal Sensitivity to Lipids or Acid Other Mechanisms Pathogenic Factors Genetic Predisposition Infection Hp Infection Postinfection Functional Dyspepsia Psychosocial Factors Approach to Uninvestigated Dyspepsia History and Physical Examination Laboratory Testing Initial Management Strategies Prompt Endoscopy and Directed Treatment Test and Treat for Hp Infection Empirical Antisecretory Drug Therapy Recommendations Additional Investigations Treatment of Functional Dyspepsia General Measures Pharmacologic Treatment Acid-Suppressive Drugs Eradication of Hp Infection Prokinetic Agents Agents that Enhance Gastric Accommodation Centrally Acting Neuromodulators Other Pharmacotherapeutic Approaches Psychological Interventions Recommendations Chapter 15: Nausea and Vomiting Pathophysiology Clinical Characteristics Causes Acute Vomiting Gastric Outlet Obstruction Acute Intestinal Obstruction Intestinal Infarction Infectious and Inflammatory Causes Extraintestinal Causes Medications and Toxins Metabolic Causes Neurologic Causes Postoperative Nausea and Vomiting Chronic or Relapsing Vomiting Partial Intestinal Obstruction GI Motility Disorders Neurologic Disorders Nausea and Vomiting During Pregnancy Hyperemesis Gravidarum Functional Vomiting Cyclic Vomiting Syndrome and Cannabinoid Hyperemesis Syndrome Cyclic Vomiting Syndrome Cannabinoid Hyperemesis Syndrome Superior Mesenteric Artery Syndrome Rumination Syndrome Evaluation Acute Vomiting Imaging Additional Tests Chronic Vomiting Esophageal Manometry Measurement of Gastric Emptying Cutaneous Electrogastrography Antroduodenal Manometry Autonomic Function Tests Histopathologic Studies Complications Emetic Injuries to the Esophagus and Stomach Spasm of the Glottis and Aspiration Pneumonia Fluid, Electrolyte, and Metabolic Alterations Nutritional Deficiencies Treatment Correction of Metabolic Complications Pharmacologic Treatment Central Antiemetic Agents Dopamine D2 Receptor Antagonists Benzimidazole Derivatives Phenothiazines and Butyrophenones Antihistamines and Antimuscarinic Agents Serotonin Antagonists Glucocorticoids Cannabinoids Neurokinin-1 Receptor Antagonists Adjuvant Agents and Therapies Gastric Prokinetic Agents Serotonin 5-HT4 Receptor Agonists Motilin Receptor Agonists Gastric Electrical Stimulation Acknowledgment Chapter 16: Diarrhea Definition Pathophysiology Osmotic Diarrhea Secretory Diarrhea Complex Diarrhea Clinical Classification Acute Versus Chronic Diarrhea Large-Volume Versus Small-Volume Diarrhea Osmotic Versus Secretory Diarrhea Watery Versus Fatty Versus Inflammatory Diarrhea Epidemiologic Features Differential Diagnosis Evaluation History Physical Examination Acute Diarrhea Chronic Diarrhea Chronic Secretory Diarrhea Chronic Osmotic Diarrhea Chronic Inflammatory Diarrhea Chronic Fatty Diarrhea Treatment Acute Diarrhea Chronic Diarrhea Selected Diarrheal Syndromes IBS and Functional Diarrhea Food-Induced Diarrhea Microscopic Colitis Postsurgical Diarrhea Gastric Surgery Bowel Resection Ileostomy Bile Acid–Induced Diarrhea Diarrhea in Hospitalized Patients Factitious Diarrhea Idiopathic Secretory Diarrhea Diarrhea of Obscure Origin Chapter 17: Intestinal Gas Composition and Volume of Gastrointestinal gas Gas Metabolism and Excretion Diffusion of Gas Between the Intestinal Lumen and Blood Mouth to Stomach Small Intestine Colon Colonic Endoluminal Microenvironment and Gas Metabolism Plasticity of Microbiota and Gas Metabolism Odoriferous Gases Anal Evacuation Intestinal Propulsion, Accommodation, and Tolerance to Gas Clinical Gas Problems Repetitive Eructation Pathophysiology Treatment Flatulence Pathophysiology Treatment Impaired Gas Evacuation Abdominal Bloating and Distention Pathophysiology Treatment Nonpharmacologic Therapies Pharmacologic Therapies Pneumatosis Cystoides Intestinalis Chapter 18: Fecal Incontinence Epidemiology Pathophysiology Functional Anatomy and Physiology of the Anorectum Pathogenic Mechanisms Abnormal Anorectal and Pelvic Floor Structures Anal Sphincter Muscles Puborectalis Muscle Nervous System Rectum Abnormal Anorectal and Pelvic Floor Function Impaired Anorectal Sensation Dyssynergic Defecation and Incomplete Stool Evacuation Descending Perineum Syndrome Altered Stool Characteristics Miscellaneous Mechanisms Evaluation History Physical Examination Diagnostic Testing Anorectal Manometry Rectal Sensory Testing Imaging the Anal Canal Anal Endosonography MRI Defecography Balloon Expulsion Test Neurophysiologic Testing Clinical Utility of Tests for Fecal Incontinence Treatment Supportive Measures Specific Therapies Pharmacologic Therapy Biofeedback Plugs, Sphincter Bulking Agents, and Electrical Stimulation Surgery Other Procedures Colostomy Sacral Nerve Stimulation Percutaneous Tibial Nerve Stimulation Novel Therapies Specific Subgroups of Patients Patients with Spinal Cord Injury Patients with Fecal Seepage Older Persons Children Acknowledgment Chapter 19: Constipation Definition and Presenting Symptoms Epidemiology Prevalence Incidence Public Health Perspective Risk Factors Gender Age Ethnicity and Nationality Socioeconomic Status and Education Level Diet and Physical Activity Medication Use Colonic Function Luminal Contents Absorption of Water and Sodium Diameter and Length Motor Function Innervation and the Interstitial Cells of Cajal Defecatory Function Size and Consistency of Stool Classification Pathophysiology Normal-Transit Constipation Slow-Transit Constipation Defecatory Disorders Causes Disorders of the Anorectum and Pelvic Floor Rectocele Descending Perineum Syndrome Diminished Rectal Sensation Rectal Prolapse and Solitary Rectal Ulcer Syndrome Systemic Disorders Hypothyroidism Diabetes Mellitus Hypercalcemia Nervous System Disease Loss of Conscious Control Parkinson Disease Multiple Sclerosis Spinal Cord Lesions Lesions Above the Sacral Segments Lesions of the Sacral Cord, Conus Medullaris, Cauda Equina, and Nervi Erigentes (S2 to S4) Structural Disorders of the Colon, Rectum, and Anus Obstruction Disorders of Smooth Muscle Myopathy Affecting Colonic Muscle Hereditary Internal Anal Sphincter Myopathy Systemic Sclerosis Muscular Dystrophies Disorders of Enteric Nerves Congenital Aganglionosis or Hypoganglionosis Congenital Hyperganglionosis (Intestinal Neuronal Dysplasia) Acquired Neuropathies Neuropathies of Unknown Cause Medications Psychological Disorders Depression Eating Disorders Denied Bowel Movements Fecal Impaction Clinical Assessment History Physical Examination Diagnostic Tests Tests for Systemic Disease Tests for Structural Disease Physiologic Measurements Colonic Transit Time Radiopaque Markers Wireless Motility Capsule Colonic Transit Scintigraphy Tests to Assess the Physiology of Defecation Defecography Balloon Expulsion Test Anorectal Manometry EMG of Striated Muscle Activity Rectal Sensitivity and Sensation Testing Treatment General Measures Reassurance Lifestyle Changes Psychological Support Fluid Intake Dietary Changes and Fiber Supplementation Low-FODMAP Diet Specific Therapeutic Agents Methylcellulose Ispaghula (Psyllium) Calcium Polycarbophil Guar Gum Flaxseed Mixed Soluble and Insoluble Fiber Other Laxatives Osmotic Laxatives Poorly Absorbed Ions Poorly Absorbed Sugars Lactulose Sorbitol and Mannitol Polyethylene Glycol Stimulant Laxatives Anthraquinones Castor Oil Diphenylmethane Derivatives Stool Softeners and Emollients Docusate Sodium Mineral Oils Enemas and Suppositories Phosphate Enemas Saline, Tap Water, and Soapsuds Enemas Stimulant Suppositories and Enemas Prosecretory Laxatives Chloride Channel Activator Guanylate Cyclase C Agonists Linaclotide Plecanatide Serotonergic Laxatives Tegaserod Prucalopride Other Agents Cholinergic Agents Botulinum Toxin Future Agents Chenodeoxycholate Elobixibat Relamorelin Velusetrag Other Forms of Therapy Defecation Training Anorectal Biofeedback Complementary and Alternative Medical Therapies Sacral Nerve Stimulation Surgery Colectomy Selection of Patients Type of Operation Construction of a Stoma Operations for Defecatory Disorders Chapter 20: Gastrointestinal Bleeding Initial Assessment and Management of Acute Gastrointestinal Bleeding History Physical Examination Laboratory Studies Clinical Determination of the Bleeding Site Hospitalization Resuscitation Initial Medical Therapy Endoscopy Endoscopic Hemostasis Imaging Surgery Upper Gastrointestinal Bleeding Epidemiology Risk Factors and Risk Stratification Upper Endoscopic Technique Peptic Ulcer Pathogenesis Histopathology Endoscopic Risk Stratification Doppler Endoscopic Probe Endoscopic Hemostasis Active Bleeding and Nonbleeding Visible Vessels Adherent Clots Clean-Based Ulcers Techniques for Endoscopic Hemostasis Active Arterial Bleeding Nonbleeding Visible Vessel Adherent Clot Oozing of Blood From an Ulcer Without Other Stigmata Flat Spots Clean-Based Ulcers Newer Endoscopic Techniques Hemospray Over-the-Scope Hemoclip Testing for Hp Infection Pharmacologic Therapy Acid Suppression Medication Somatostatin and Octreotide Second-Look Endoscopy Rebleeding After Endoscopic Treatment Angiography, Surgery, and Over-the-Scope Hemoclips Immediate Postendoscopic Management High-Risk Endoscopic Stigmata Intermediate-Risk Stigmata Low-Risk Endoscopic Stigmata Prevention of Recurrent Ulcer Bleeding Hp Infection Aspirin, Other NSAIDs, and Antiplatelet Drugs Repeat Endoscopy to Confirm Gastric Ulcer Healing Other Nonvariceal Causes Esophagitis Ulcer Hemorrhage in Hospitalized Patients Dieulafoy Lesion Mallory-Weiss Tears Cameron Lesions UGI Malignancy GAVE Portal Hypertensive Gastropathy Hemobilia Hemosuccus Pancreaticus Postsphincterotomy Bleeding Aortoenteric Fistula Varices Medical Management of Acute Variceal Bleeding Balloon Tamponade Endoscopic Sclerotherapy Endoscopic Band Ligation TIPS Portosystemic Shunt Surgery Lower Gastrointestinal Bleeding Risk Factors and Risk Stratification Mortality Diagnostic and Therapeutic Approach Anoscopy Flexible Sigmoidoscopy Radionuclide Imaging Angiography CT and CT Colonography Colonoscopy Barium Enema Role of Surgery Causes and Management Diverticulosis Endoscopic Stigmata Endoscopic Hemostasis Angiography and Surgery Colitis Postpolypectomy Bleeding Colon Neoplasia Radiation Proctitis Colonic Angioectasia Internal Hemorrhoids Anal Fissures Rectal Varices Rectal Dieulafoy Lesions Rectal Ulcers Obscure Overt Gastrointestinal Bleeding Causes Angioectasia HHT Blue Rubber Bleb Nevus Syndrome Meckel Diverticulum NSAID–Induced Small Intestinal Erosions and Ulcers Small Intestinal Neoplasms Small Intestinal Diverticula Dieulafoy Lesion of the Small Intestine Diagnostic Tests Imaging Endoscopy Push Enteroscopy Intraoperative Endoscopy and Surgical Exploration Capsule Endoscopy Deep Enteroscopy of the Jejunum and Ileum Overall Approach Obscure Occult Gastrointestinal Bleeding and Iron Deficiency Anemia Fecal Occult Blood Iron Deficiency Anemia Chapter 21: Jaundice Bilirubin Metabolism and Measurement Metabolism Measurement Differential Diagnosis of Hyperbilirubinemia Disorders of Bilirubin Metabolism Isolated Unconjugated Hyperbilirubinemia Increased Bilirubin Production Decreased Bilirubin Uptake by Hepatocytes Decreased Hepatocellular Bilirubin Conjugation Isolated Conjugated or Mixed Hyperbilirubinemia Liver Disease Acute or Subacute Hepatocellular Injury Chronic Hepatocellular Disease Hepatic Disorders with Prominent Cholestasis Infiltrative Diseases Disorders Involving Cholangiocyte Injury Cholestasis with Minimal Histologic Abnormalities Atypical Presentations of Cholestasis Jaundice in Pregnancy Jaundice in the Critically Ill Patient Bile Duct Obstruction Choledocholithiasis Bile Duct Diseases Extrinsic Compression Diagnostic Approach to Jaundice History and Physical Examination Initial Laboratory Studies Overall Approach Imaging Studies Abdominal US CT MRCP ERCP Percutaneous Transhepatic Cholangiography EUS Nuclear Imaging Studies Suggested Strategies for Imaging Other Studies Serologic Testing Liver Biopsy Therapeutic Approaches Obstructive Jaundice Nonobstructive Jaundice Chapter 22: Biopsychosocial Issues in Gastroenterology Conceptualization of Gastrointestinal Illness Biomedical Model Biopsychosocial Model Early Life Learning Developmental Aspects Physiologic Conditioning Culture, Family, and Society Psychosocial Environment Life Stress and Abuse Psychological Factors Personality Psychiatric Diagnosis Psychological Distress Coping and Social Support Brain-Gut Axis Stress and GI Function Definition of Stress Effects of Stress on GI Function Role of Neurotransmitters Hypothalamic-Pituitary-Adrenal Axis Regulation of Visceral Pain Amplification of Visceral Signals Transmission to the CNS Central Amplification Stress-Mediated Effects Spinal Cord Activation of Glia Structural Changes Descending Modulation Cytokines and the Brain Symptom Experience and Behavior Clinical Applications History Taking Evaluating the Data Diagnostic Decision Making Treatment Approach Establishing a Therapeutic Relationship Eliciting, Evaluating, and Communicating the Role of Psychosocial Factors Providing Reassurance Recognizing the Patient’s Adaptations to Chronic Illness Reinforcing Healthy Behaviors Psychopharmacologic Treatment Tricyclic Antidepressants Selective Serotonin Reuptake Inhibitors Serotonin and Norepinephrine Reuptake Inhibitors Tetracyclic Agents Anti-Anxiety Agents Atypical Antipsychotic Agents Opioids Augmentation Treatment Prevention of Relapse Pharmacogenomic Testing Behavioral Treatments Clinician-Related Issues Chapter 23: Factitious Gastrointestinal Disease Factitious Disorder, Subtle Form Etiology and Motives Risk of Iatrogenic Disease Diagnosis and Detection Management Ethical Issues Related to Privacy and Confidentiality Legal Issues Related Abnormal Illness Behaviors Somatic Symptom Disorder Malingering Factitious Behavior in Patients With Bulimia Special Issues Related to Gastroenterology Surreptitious Laxative Ingestion Factitious Diarrhea Concealed Vomiting Factitious Anemia and Factitious GI Blood Loss Factitious Cancer Lessons From Case Reports Pitfalls in the Diagnosis and Management of Abnormal Illness Behavior Acknowledgment Part IV: Topics Involving Multiple Organs Chapter 24: Oral Diseases and Oral Manifestations of Gastrointestinal and Liver Diseases Lip Disorders Cheilitis Lip Neoplasms Salivary Disorders Xerostomia Sjögren Syndrome Tongue Disorders Glossitis, Glossodynia, and Oral Dysesthesia Hypogeusia and Dysgeusia Geographic Tongue Fissured Tongue Black Hairy Tongue Strawberry Tongue Atrophic Tongue Hypertrophic Tongue Leukoplakia Herpetic Geometric Glossitis Gingival Disorders Gingival Enlargement Gingivostomatitis Acute Necrotizing Ulcerative Gingivitis Lead Poisoning Oral Manifestations of Infections, Neoplasms, and Other Selected Disorders Candidiasis Herpesvirus Infections Human Papillomavirus Infection Kaposi Sarcoma Other HIV-Related Conditions Squamous Cell Carcinoma Inflammatory Bowel Disease Gastroesophageal Reflux (GERD) Liver Disease Recurrent Aphthous Ulcers Behçet Disease Cutaneous Disorders with Oral Manifestations Amyloidosis Nutritional Deficiencies Chapter 25: Cutaneous Manifestations of Gastrointestinal and Liver Diseases Vesiculobullous Skin Diseases Pemphigoid Pemphigus Epidermolysis Bullosa Erythema Multiforme Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Spectrum Lichen Planus Cutaneous Manifestations of Inflammatory Bowel Disease Vascular and Connective Tissue Disorders Cutaneous Manifestations of Gastrointestinal Malignancies Polyposis Syndromes Internal Malignancy and Related Disorders Cutaneous Metastases Cutaneous Manifestations of Liver Disease Drug-Induced Liver Disease in Patients With Skin Disease Parasitic Diseases of the Skin and Gastrointestinal Tract Dermatitis Herpetiformis and Celiac Disease Vitamin and Mineral Deficiencies Chapter 26: Diverticula of the Pharynx, Esophagus, Stomach, and Small Intestine Zenker Diverticula Epidemiology, Etiology, and Pathophysiology Clinical Features and Diagnosis Complications Treatment and Prognosis Diverticula of the Esophageal Body Epidemiology, Etiology, and Pathophysiology Clinical Features and Diagnosis Complications Treatment and Prognosis Esophageal Intramural Pseudodiverticula Epidemiology, Etiology, and Pathophysiology Clinical Features and Diagnosis Complications Treatment and Prognosis Gastric Diverticula Epidemiology, Etiology, and Pathophysiology Clinical Features and Diagnosis Complications Treatment and Prognosis Duodenal Diverticula Extraluminal Diverticula Epidemiology, Etiology, and Pathophysiology Clinical Features and Diagnosis Complications Treatment and Prognosis Intraluminal Diverticula Epidemiology, Etiology, and Pathogenesis Clinical Features and Diagnosis Complications Treatment and Prognosis Jejunal Diverticula Epidemiology, Etiology, and Pathophysiology Treatment and Prognosis Chapter 27: Abdominal Hernias and Gastric Volvulus Diaphragmatic Hernias Hiatal and Paraesophageal Hernias Etiology and Pathophysiology Epidemiology Clinical Features, Diagnosis, and Complications Treatment and Prognosis Congenital Diaphragmatic Hernias Etiology and Pathophysiology Epidemiology Cl "For nearly 50 years Sleisenger and Fordtran's Gastrointestinal and Liver Disease has been the go-to reference for gastroenterology and hepatology residents, fellows, physicians, and the entire GI caregiving team. Now in a fully revised 11th Edition, this two-volume masterwork brings together the knowledge and expertise of hundreds of global experts who keep you up to date with the newest techniques, technologies, and treatments for every clinical challenge you face in gastroenterology and hepatology. A logical organization, more than 1,100 full-color illustrations, and easy-to-use algorithms ensure that you'll quickly and easily find the information you need. Key features include : features new and expanded discussions of chronic hepatitis B and C, Helicobacter pylori infection, colorectal cancer prevention through screening and surveillance, biologic agents and novel small molecules to treat and prevent recurrences of inflammatory bowel disease (IBD), gastrointestinal immune and autoimmune diseases, and more ; offers reliable coverage of key topics such as Barrett esophagus, gut microbiome, enteric microbiota and probiotics, fecal microbiota transplantation, and hepatic, pancreatic, and small bowel transplantation ; provides more quick-reference algorithms that summarize clinical decision making and practical approaches to patient management ; employs a consistent, templated, format throughout for quick retrieval of information."--adaptació de la contracoberta