This book is a review of the basic tests available in gastroenterology. Emphasis is placed on these techniques of which the authors have personal experiece. The philosophy has been to evaluate investigations for their current clinical usefulness in the management of patients. A critical analysis has been made to describe those older tests which have proved their worth alongside the newer procedures which have been introduced. Just as some recent additions have rapidly gained importance, some familiar tests have lost significance because of medical progress. Testing for Helicobacter pylori has more use than acid secretory studies in the age when antibiotics have displaced the surgeon in the management of chronic peptic ulcer disease. The book is designed for trainees and clinicians without special expertise in gastroenterology, as well as being a shelf manual for the gastroenterologist and the staff of gastroenterology investigation units. Special thanks are due to the nurses on the Bishop Auckland Gastroenterology Unit, and to Amanda Gallagher who typed the manuscript. Malcolm C. Bateson Ian A.D. Bouchier 1996 Xl CHAPTER 1 H elicobacter pylori INTRODUCTION The discovery of the presence of this organism in many human stomachs and its association with disease has revolutionized our approach to peptic ulcer. Detection of H. pylori infection of the gastric mucosa and proof of its absence after eradication therapy have become pivotal in patient management. EPIDEMIOLOGY H. pylori infection is strongly associated with age and inversely with wealth.

Autorentext

Malcolm Bateson is a medical graduate of Birmingham University. After hospital posts in London and Cambridge he went to Dundee, first as a Research Fellow then as a Lecturer in Medicine.
He has been a Consultant Physician and Specialist in Gastroenterology in County Durham since 1981. He is actively associated with research in bile acids and Helicobacter pylori. Ian Bouchier is a medical graduate of Capetown University. In the course of a distinguished medical career he was Reader in Medicine at the Royal Free Hospital and Professor of Medicine at Ninewells Hospital, Dundee.
He is currently Professor of Medicine in Edinburgh. He is a world expert in gastroenterology. He is a prolific author and editor, and has produced several standard medical reference textbooks.

Klappentext

This volume is an up-to-date review of the basic tests in gastroenterology. It provides a critical analysis of recently developed tests and a thorough appraisal of well-established methods. The text of this edition has been completely revised and re-organised. The selection of tests, their performance and the interpretation of results is presented in a logical and readily accessible format. Most of the chapters deal with the separate organ systems. Copious references to further reading are provided throughout the text, which is enhanced by clear illustrations. Topics covered include: Helicobacter pylori; upper digestive endoscopy; intubation; oesophagus; stomach; duodenum; small and large bowel; absorption; gastrointestinal bleeding; stool examination; pancreas; liver biochemistry, biopsy and radiology; gallbladder and bile ducts; pancreas; laparoscopy and the peritoneum.

Inhalt

1. Helicobacter pylori.- Epidemiology.- Diagnostic tests.- 2. Upper digestive endoscopy.- Instruments.- Procedures.- Indications.- Endosonography.- ERCP.- Prophylaxis of SABE.- Safety staff and patients.- Cleaning and sterilization.- 3. Intubation.- Method.- Tubes.- Complications.- 4. Oesophagus.- Acid perfusion test.- Oesophagoscopy.- Histology.- Radiology.- Manometry.- Reflux studies.- Isotope swallow.- 5. Stomach.- Gastric emptying.- Gastric acid secretion.- Gastric cytology.- Gastric biopsy.- Radiology.- 6. Small intestine.- Intestinal biopsy.- Radiology.- Radioisotope studies.- Enteroscopy.- Protein loss.- Intestinal bacteria.- Intestinal motility.- Crohn's disease.- Metabolic disorders.- Immunology.- 7. Absorption.- Fats and related substances.- Monosaccharides.- Disaccharides.- Haematinics.- Rare disorders of intestinal absorption.- 8. Colon and rectum.- Rectal examination.- Proctoscopy.- Proctosigmoidoscopy.- Rectal biopsy.- Radiology.- Colonoscopy.- Manometry.- Immunology.- 9. Gastrointestinal bleeding.- Occult blood tests.- 99mTechnetium colloid test.- Radio-labelled erythrocytes.- Pertechnetate.- Other tests:.- Gastrointestinal bleeding in liver disease.- 10. Stool examination.- Macroscopic appearance.- Protozoa and helminths.- Bacteria.- Viruses.- 11. Pancreas.- Strucural tests.- Function tests.- Other blood tests.- Stool examination.- Sweat electrolytes.- Gene probes.- Gut endocrinology and endocrine tumours.- Pancreatic cancer markers.- 12. Liver biochemistry.- Liver function tests.- Alcoholic liver disease.- Immunology.- Viral liver disease.- Kinetic tests.- Electroencephalography.- Gilbert's syndrome.- Haemochromatosis.- Wilson's disease.- Hydatid disease.- Acute intermittent porphyria.- 13. Liver biopsy.- Percutaneous liver biopsy.-Liver aspiration.- 14. Liver imaging and manometry.- Ultrasonography.- Isotope scanning.- Radiology.- Diagnosis of cholestasis.- Portal manometry and splenoportography.- Manometry.- 15. Gallbladder and bile ducts.- Imaging.- Biliary physiology.- Bacteriology.- 16. Ascites and the peritoneum.- Paracentesis.- Peritoneal biopsy.- Laparoscopy.- Laparotomy.- Appendix 1. Antibiotic Prophylaxis in Gastrointestinal Endoscopy (BSG Guidelines).- Appendix 2. BSG Dyspepsia Management Guidelines.- Appendix 3. Chronic Diarrhoea.- Further reading.- Procedures.- Interpretation.- Reference textbooks.