Download A Guide to Gastrointestinal Motility Disorders by Albert J. Bredenoord, André Smout, Jan Tack PDF
By Albert J. Bredenoord, André Smout, Jan Tack
This e-book describes the motives and scientific administration of useful gastrointestinal issues in a simply comprehensible approach, via many transparent illustrations. The concrete and functional suggestion supplied could be such a lot necessary within the medical perform of either the overall practitioner and the scientific professional. practical issues of the gastrointestinal tract, corresponding to gastroesophageal reflux ailment, useful dyspepsia, and irritable bowel syndrome, are quite common and persistent stipulations. regardless of the hot e-book of many clinical papers on their analysis and therapy, a lot continues to be uncertain, and administration remains to be thought of not easy. This practice-oriented booklet might be a fantastic resource of trustworthy up to date counsel for all who deal with those patients.
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Extra resources for A Guide to Gastrointestinal Motility Disorders
Sample text
The bolus has entered the esophagus and the esophageal swallow phase has been initiated. After the bolus has passed the UES, the sphincter will close. The peristaltic wave initiated by the swallow (primary peristalsis) moves further in distal direction with a propagating velocity of 3–5 cm/s. The peristaltic wave will have traversed the esophagus in about 10 s. Peristalsis ensures that passage of food is also possible in supine position; gravity thus only plays a minor role. If the esophagus is dilated in the absence of a swallowing, for example, during inflation of air during endoscopy, peristalsis will be triggered.
The UES relaxes and the pharyngeal constrictors contract so the bolus is moved in distal direction. 4. A peristaltic wave starts above the pharynx and moves in distal direction. This will push the bolus through the relaxed UES. The bolus has entered the esophagus and the esophageal swallow phase has been initiated. After the bolus has passed the UES, the sphincter will close. The peristaltic wave initiated by the swallow (primary peristalsis) moves further in distal direction with a propagating velocity of 3–5 cm/s.
This makes it possible to measure gastric emptying by measuring the concentration of 13CO2 repeatedly after ingestion of the isotope-labeled meal. The mathematical calculations required for this are rather complex. Often 13C-octanoic acid is used to label the meal, because octanoic acid is not broken down in the stomach, absorbed in the proximal small bowel, and then metabolized. Gastric emptying is the rate-limiting step in this process of labeled CO2 formation. The rate of gastric emptying as measured with the 13C breath test correlates well with the rate measured with the gold standard technique, scintigraphy.