By Albert J. Bredenoord, André Smout, Jan Tack

​This e-book describes the factors and medical administration of practical gastrointestinal problems in a with ease comprehensible approach, by means of many transparent illustrations. The concrete and functional suggestion supplied may be such a lot useful within the medical perform of either the final practitioner and the clinical professional. sensible problems of the gastrointestinal tract, akin to gastroesophageal reflux disorder, practical dyspepsia, and irritable bowel syndrome, are quite common and protracted stipulations. regardless of the hot book of many medical papers on their prognosis and therapy, a lot continues to be uncertain, and administration remains to be thought of not easy. This practice-oriented e-book might be a great resource of trustworthy up to date counsel for all who deal with those patients.

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Sample text

In case of gastroesophageal reflux disease and in a subset of functional dyspepsia patients, they generate symptom relief, and they are effective at healing esophageal lesions in reflux esophagitis (Fig. 2). For symptoms occurring less frequently, histamine-2 blockers (such as ranitidine, famotidine, or cimetidine) can be used, which are less potent but have a more rapid onset of action. 2 Stool Softeners In case of constipation, a number of therapeutic agents act to soften consistency and increase volume of stool, based on two modes of action.

Esophageal motility disorders are classified into primary and secondary motility disorders. Secondary motility disorders are caused by another disease, for example, scleroderma that affects the esophageal muscles. In case of esophageal dysphagia, the first step is to exclude an organic cause using endoscopy. Biopsies are always taken to exclude the presence of allergic or eosinophilic esophagitis, even when the esophagus has a normal endoscopic appearance. When endoscopy did not reveal any abnormalities and biopsies are normal, further testing for motility disorders will be performed.

Botulinum 44 4 The Esophagus Fig. 4 Barium swallow radiograph in a patient with achalasia. The esophageal lumen is distended, while at the level of the transition from the esophagus to the stomach, there is hardly any contrast visible (bird’s beak) Surgical treatment consists of a laparoscopic cleavage of the LES, myotomy according Heller. Usually this procedure is combined with a fundoplication according to Dor to reduce any reflux after the myotomy. Reflux symptoms may occur after all successful treatments for achalasia, as the sphincter pressure will be reduced and there is no peristalsis in the esophagus to clear refluxed gastric contents.

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