Stoma Care

Description

For nearly 50 years, Sleisenger & 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.

Table of Contents

1. Contributors
2. Foreword
3. The Sleisenger and Fordtran Editors
4. Preface
5. Acknowledgments
6. Abbreviation List
7. VOLUME 1
   1. Part I. Biology of the Gastrointestinal Tract
      1. Cellular Growth and Neoplasia
         1. Mechanisms of Normal Tissue Homeostasis
         2. Intestinal Tumor Development
         3. Neoplasia-Associated Genes
         4. Tumor Microenvironment
         5. Tumor Metabolism
         6. Biological Features of Tumor Metastasis
         7. Environmental Influences
         8. Molecular Medicine: Current and Future Approaches in Gastrointestinal Oncology
      2. Mucosal Immunology and Inflammation
         1. Immunoglobulins of the Mucosal Surface
         2. Physiology of Mucosal Immune Cells
         3. Functional Anatomy of the Mucosal Immune System
         4. Antigen Presentation in the Gut
         5. Effector Compartments within the Gut Immune System
      3. The Enteric Microbiota
         1. Characteristics of the Human Intestinal Microbiome
         2. Factors Affecting Intestinal Microbiome Variability and Resilience
         3. The Effect of Host–Intestinal Microbiome Interactions on Host Physiology
         4. The role of the intestinal microbiome in human disease
         5. Inflammatory Diseases
         6. Cancer
         7. Functional Gastrointestinal Disorders (see Chapter 122)
         8. The role of the Intestinal Microbiome in Modulation of Drug Response
         9. Therapeutic Modulation of the Intestinal Microbiome
         10. NonBacterial Members of the Intestinal Microbiome
         11. Future Directions
      4. Gut Sensory Transduction
         1. Hormones and Neurotransmitters
         2. Transducing Signals from the GI Lumen
         3. Nutrient Chemosensing
         4. The Transmitters
         5. Neurotransmitters
         6. Cannabinoids and other Chemical Transmitters
         7. The Importance of Hormones and Neurotransmitters
         8. Diabetes and the Gut
         9. Gastrointestinal Regulation of Appetite
   2. Part II. Nutrition in Gastroenterology
      1. Nutritional Principles and Assessment of the Gastroenterology Patient
         1. Basic Nutritional Concepts
         2. Micronutrients
         3. Starvation
         4. Malnutrition
         5. Nutritional Assessment Techniques
         6. Aggressive Nutritional Support in the Hospitalized Patient
      2. Nutritional Management
         1. Nutrition in Specific Disease States
         2. Nutritional Therapy
      3. Obesity
         1. Definitions and Epidemiology
         2. Etiology of Obesity
         3. Prognosis of Obesity
         4. Pathophysiology of Obesity
         5. Clinical Features and Diagnosis of Obesity
         6. Complications of Obesity
         7. Medical Treatment of Obesity
      4. Surgical and Endoscopic Treatment of Obesity
         1. Evaluation and Selection of Bariatric Surgery Candidates
         2. Surgical Treatments for Obesity
         3. Endoscopic Management of Bariatric Surgical Complications
         4. Endoscopic Treatments for Obesity
      5. Feeding and Eating Disorders
         1. Epidemiology
         2. Causative Factors
         3. Onset and Course
         4. Evaluation
         5. Diagnosis of Specific Disorders
         6. Other Specified Feeding or Eating Disorder and Unspecified Feeding or eating Disorder
         7. Gastrointestinal Abnormalities Associated With Eating Disorders
         8. Management of Eating Disorders in the Adult
         9. Eating Disorders and the Intestinal Microbiota
      6. Food Allergies
         1. Definitions
         2. Prevalence
         3. Pathogenesis
         4. Clinical features
         5. Diagnosis
         6. Prevention
         7. Treatment and natural history
   3. Part III. Symptoms, Signs, and Biopsychosocial Issues
      1. Acute Abdominal Pain
         1. Anatomy and Physiology
         2. Evaluation
         3. Causes
         4. Pharmacologic Management
      2. Chronic Abdominal Pain
         1. Definition and Clinical Approach
         2. Abdominal Wall Pain
         3. Centrally Mediated Abdominal Pain Syndrome
         4. Narcotic Bowel Syndrome/Opioid-induced GASTROINTESTINAL hyperalgesia
      3. Symptoms of Esophageal Disease
         1. Dysphagia
         2. Odynophagia
         3. Globus Sensation
         4. Hiccups
         5. Chest pain of Esophageal Origin
         6. Heartburn and Regurgitation
         7. Extraesophageal Symptoms of Gastroesophageal Reflux Disease
      4. Dyspepsia
         1. Definition
         2. Organic Causes
         3. PUD
         4. GERD
         5. Functional Dyspepsia
         6. Approach to Uninvestigated Dyspepsia
         7. Treatment of Functional Dyspepsia
         8. Recommendations
      5. Nausea and Vomiting
         1. Pathophysiology
         2. Clinical Characteristics
         3. Causes
         4. Evaluation
         5. Complications
         6. Treatment
      6. Diarrhea
         1. Definition
         2. Pathophysiology
         3. Clinical Classification
         4. Differential Diagnosis
         5. Evaluation
         6. Treatment
         7. Selected Diarrheal Syndromes
      7. Intestinal Gas
         1. Composition and Volume of Gastrointestinal gas
         2. Gas Metabolism and Excretion
         3. Intestinal Propulsion, Accommodation, and Tolerance to gas
         4. Clinical gas Problems
      8. Fecal Incontinence
         1. Epidemiology
         2. Pathophysiology
         3. Evaluation
         4. Treatment
      9. Constipation
         1. Definition and Presenting Symptoms
         2. Epidemiology
         3. Risk Factors
         4. Colonic Function
         5. Classification
         6. Pathophysiology
         7. Causes
         8. Clinical Assessment
         9. Diagnostic Tests
         10. Treatment
      10. Gastrointestinal Bleeding
          1. Initial Assessment and Management of Acute Gastrointestinal Bleeding
          2. Upper Gastrointestinal Bleeding
          3. Lower Gastrointestinal Bleeding
          4. Obscure Overt Gastrointestinal Bleeding
          5. Obscure Occult Gastrointestinal Bleeding and Iron Deficiency Anemia
      11. Jaundice
          1. Bilirubin Metabolism and Measurement
          2. Differential Diagnosis of Hyperbilirubinemia
          3. Diagnostic Approach to Jaundice
          4. Therapeutic Approaches
      12. Biopsychosocial Issues in Gastroenterology
          1. Conceptualization of Gastrointestinal Illness
          2. Early Life
          3. Psychosocial Environment
          4. Brain-Gut Axis
          5. Symptom Experience and Behavior
          6. Clinical Applications
          7. Treatment Approach
      13. Factitious Gastrointestinal Disease
          1. Factitious Disorder, Subtle Form
          2. Related Abnormal Illness Behaviors
          3. Special Issues Related to Gastroenterology
          4. Pitfalls in the Diagnosis and Management of Abnormal Illness Behavior
   4. Part IV. Topics Involving Multiple Organs
      1. 24. Oral Diseases and Oral Manifestations of Gastrointestinal and Liver Diseases
         1. Lip Disorders
         2. Salivary Disorders
         3. Tongue Disorders
         4. Gingival Disorders
         5. ORAL Manifestations of Infections, Neoplasms, and Other Selected Disorders
         6. Gastroesophageal Reflux (GERD)
         7. Liver Disease
         8. Recurrent Aphthous Ulcers
         9. Behçet Disease
         10. Cutaneous Disorders with Oral Manifestations
         11. Amyloidosis
         12. Nutritional Deficiencies
      2. 25. Cutaneous Manifestations of Gastrointestinal and Liver Diseases
         1. Vesiculobullous Skin Diseases
         2. Lichen Planus
         3. Cutaneous Manifestations of Inflammatory Bowel Disease
         4. Vascular and Connective Tissue Disorders
         5. Cutaneous Manifestations of Gastrointestinal Malignancies
         6. Cutaneous Manifestations of Liver Disease
         7. Drug-Induced Liver Disease in Patients With Skin Disease
         8. Parasitic Diseases of the Skin and GASTROINTESTINAL TRACT
         9. Dermatitis Herpetiformis and Celiac Disease
         10. Vitamin and Mineral Deficiencies
      3. 26. Diverticula of the Pharynx, Esophagus, Stomach, and Small Intestine
         1. Zenker Diverticula
         2. Diverticula of the Esophageal Body
         3. Esophageal Intramural Pseudodiverticula
         4. Gastric Diverticula
         5. Duodenal Diverticula
         6. Jejunal Diverticula
      4. 27. Abdominal Hernias and Gastric Volvulus
         1. Diaphragmatic Hernias
         2. Gastric Volvulus
         3. Inguinal and Femoral Hernias
         4. Other Ventral Hernias
         5. Pelvic and Perineal Hernias
         6. Lumbar Hernias
         7. Internal Hernias
      5. 28. Foreign Bodies, Bezoars, and Caustic Ingestions
         1. Gastrointestinal Foreign Bodies
         2. Bezoars
         3. Caustic Ingestions
      6. 29. Abdominal Abscesses and Gastrointestinal Fistulas
         1. Abdominal Abscess
         2. Gastrointestinal Fistulas
      7. 30. Eosinophilic Disorders of the Gastrointestinal Tract
         1. Eosinophil Biology and Potential Diagnostic and Therapeutic Targets
         2. Gastrointestinal Eosinophils in Healthy States
         3. Eosinophil-Associated Gastrointestinal Disorders
         4. Resources
      8. 31. Protein-Losing Gastroenteropathy
         1. Definition and Normal Physiology
         2. Pathophysiology
         3. Clinical Features
         4. Diseases Associated with Protein-Losing Gastroenteropathy
         5. Diagnosis
         6. Treatment and Prognosis
      9. 32. Gastrointestinal Lymphomas
         1. General Principles of Lymphoma Management
         2. Gastric Lymphomas
         3. Small Intestinal Lymphomas
         4. Other Gastrointestinal Sites
         5. Immunodeficiency-Related Lymphomas
         6. Iatrogenic Lymphoproliferative Disorders
         7. HIV–Associated Non-Hodgkin Lymphoma
      10. 33. Gastrointestinal Stromal Tumors
          1. Pathology
          2. Molecular Pathogenesis
          3. Molecular Pharmacology
          4. Epidemiology
          5. Clinical Features
          6. Diagnosis
          7. Treatment
          8. Special Considerations
      11. 34. Neuroendocrine Tumors
          1. Historical Aspects
          2. Epidemiology
          3. Origin and Histochemical Features
          4. Classification
          5. Molecular Pathogenesis
          6. Multiple Endocrine Neoplasia and Other Inherited Syndromes
          7. Functional Tumors
          8. Gastrinomas
          9. Glucagonomas
          10. Vipomas
          11. Other Functional Pnets
          12. Nonfunctional Pnets
          13. Gi-Nets (Carcinoids)
          14. Carcinoid Syndrome
          15. Tumor Localization
          16. Treatment of Metastatic Disease
      12. 35. Gastrointestinal Consequences of Infection with Human Immunodeficiency Virus
          1. Odynophagia and Dysphagia
          2. Diarrhea
          3. Abdominal Pain
          4. Anorectal Disease
          5. Gastrointestinal Bleeding
          6. Hepatobiliary Disease
      13. 36. Gastrointestinal and Hepatic Complications of Solid Organ and Hematopoietic Cell Transplantation
          1. Complications of solid organ transplantation
          2. Kidney and Kidney/Pancreas Transplantation
          3. Liver Transplantation
          4. Heart, Lung, and Heart-Lung Transplantation
          5. Intestinal Transplantation
          6. Problem-Oriented Approach to Diagnosis in Solid Organ Transplantation Recipients
          7. Complications of Hematopoietic Cell Transplantation
      14. 37. Gastrointestinal and Hepatic Manifestations of Systemic Diseases
          1. Collagen Vascular and Inflammatory Diseases (Table 37.1)
          2. Oncologic and Hematologic Diseases
          3. Endocrine Diseases
          4. Disorders of Lipid Metabolism
          5. Renal Diseases
          6. Neurologic Diseases
          7. Pulmonary Disease
          8. Critical Illness
          9. Sepsis
          10. Cardiovascular Diseases
          11. Infiltrative Diseases
      15. 38. Vascular Lesions of the Gastrointestinal Tract
          1. Primary Vascular Lesions
          2. Angiodysplasia
          3. Dieulafoy Lesion
          4. Hemangioma
          5. Congenital Arteriovenous Malformation
          6. Aneurysms
          7. Paraprosthetic-Enteric and Aortoenteric Fistulas
          8. Vascular Lesions Associated With Systemic Disorders or Manifestations
          9. Blue Rubber Bleb Nevus Syndrome
          10. Progressive Systemic Sclerosis (Scleroderma)
          11. Klippel-Trénaunay and Parkes Weber Syndromes
          12. Radiation-Induced Mucosal Injury
          13. GAVE (Watermelon Stomach) and Portal Hypertensive Gastropathy, Enteropathy, and Colopathy
          14. Anatomic Abnormalities of the Vasculature
          15. Celiac Axis Compression (Median Arcuate Ligament) Syndrome
      16. 39. Surgical Peritonitis and Other Diseases of the Peritoneum, Mesentery, Omentum, and Diaphragm
          1. Anatomy and Physiology
          2. Secondary (Surgical) Peritonitis
          3. Peritonitis of Other Causes (Box 39.2)
          4. Intra-Abdominal Adhesions
          5. Peritoneal Tumors
          6. Pelvic Lipomatosis and Peritoneal Cysts
          7. Diseases of the Mesentery and Omentum
          8. Diseases of the Diaphragm
          9. Laparoscopy in the Evaluation of Peritoneal Diseases
      17. 40. Gastrointestinal and Hepatic Disorders in the Pregnant Patient
          1. Gastrointestinal and Hepatic Function in Normal Pregnancy
          2. Drug Safety in Pregnant Patients
          3. Endoscopy During Pregnancy
          4. Imaging and Radiation Exposure During Pregnancy
          5. GI Disorders and Pregnancy
          6. Gallbladder and Pancreatic Disorders and Pregnancy
          7. Hepatic Disorders Unique to Pregnancy
          8. Other Hepatic Disorders and Pregnancy
      18. 41. Acute and Chronic Gastrointestinal Side Effects of Radiation Therapy
          1. Molecular Mechanisms of Radiation-Induced GI Damage
          2. Serial versus parallel organ function
          3. Small intestine
          4. Esophagus
          5. Stomach
          6. Colon and rectum
          7. Anus
          8. Pancreas and liver
          9. Therapeutic techniques to reduce toxicity
      19. 42. Preparation for and Complications of Gastrointestinal Endoscopy
          1. Complications of Newer Endoscopic Techniques
          2. Preparation of the Patient for Endoscopy
          3. Sedation
          4. Infections
          5. Electrosurgery
          6. Timing and Severity of Complications
          7. Egd
          8. Small Bowel Endoscopy
          9. Colonoscopy
          10. Ercp
          11. EUS
          12. Newer Endoscopic Techniques
   5. Part V. Esophagus
      1. 43. Anatomy, Histology, Embryology, and Developmental Anomalies of the Esophagus
         1. Anatomy and Histology
         2. Embryology
      2. Developmental Anomalies
      3. 44. Esophageal Neuromuscular Function and Motility Disorders
         1. Motor and Sensory Function
         2. Esophageal Motility Disorders
      4. 45. Esophageal Disorders Caused by Medications, Trauma, and Infection
         1. Medication-Induced Esophageal Injury
         2. Esophageal Injury from Nasogastric and other Nonendoscopic Tubes
         3. Esophageal Injury from Penetrating or Blunt Trauma
         4. Esophageal Tears and Hematomas
         5. Esophageal Infections in the Immunocompetent Host (BOX 45.2)
         6. Acute Esophageal Necrosis
      5. 46. Gastroesophageal Reflux Disease
         1. Epidemiology
         2. Health Care Impact
         3. Pathogenesis
         4. Clinical Features
         5. Differential Diagnosis
         6. Associated Conditions
         7. Diagnosis
         8. Clinical Course
         9. Complications
         10. Treatment of Uncomplicated Disease
         11. Treatment of Peptic Esophageal Strictures
      6. 47. Barrett Esophagus
         1. Diagnosis
         2. Epidemiology
         3. Pathogenesis
         4. Molecular Biology of Neoplasia
         5. Dysplasia
         6. Management
      7. 48. Esophageal Tumors
         1. Carcinomas
         2. Other Malignant Epithelial Tumors
         3. Benign Epithelial Tumors
         4. Malignant Nonepithelial Tumors
         5. Benign Nonepithelial Tumors
   6. Part VI. Stomach and Duodenum
      1. 49. Anatomy, Histology, and Developmental Anomalies of the Stomach and Duodenum
         1. Embryology and Anatomy Of the Stomach
         2. Vascular Supply and Drainage; Lymphatic Drainage
         3. Gastric Innervation
         4. Tissue Layers of the Stomach
         5. Microscopic Anatomy
         6. Embryology and Anatomy Of The Duodenum
         7. Vascular Supply and Drainage; Lymphatic Drainage
         8. Duodenal Innervation
         9. Microscopic Anatomy
         10. Congenital Anomalies Of The Stomach and Duodenum
      2. 50. Gastric Neuromuscular Function and Neuromuscular Disorders
         1. Electrophysiologic Basis for Normal Gastric Neuromuscular Function
         2. Regulation of Gastric Neuromuscular Activity After A Meal
         3. Gastric Sensory Activities
         4. The Stomach and the Regulation of Food Intake, Hunger, and Satiety
         5. Developmental Aspects of Gastric Neuromuscular Function
         6. Assessment of Gastric Neuromuscular Function
         7. Neuromuscular Disorders of the Stomach
         8. Diagnosis of Gastric Neuromuscular Disorders
         9. Treatment
      3. 51. Gastric Secretion
         1. Functional Anatomy
         2. Paracrine, Hormonal, Neural, and Intracellular Regulation of Gastric Acid Secretion
         3. Measurement of Gastric Acid Secretion
         4. Diseases Associated with Increased Gastric Acid Secretion
         5. Pepsinogen Secretion
         6. Gastric Lipase Secretion
         7. Intrinsic Factor Secretion
         8. Bicarbonate Secretion
         9. Mucus Secretion
         10. Gastric Cancer Biomarkers in Gastric Juice
      4. 52. Gastritis and Gastropathy
         1. Definitions
         2. Acute Gastritis
         3. Chronic Gastritis
         4. Carditis
         5. Other Infectious Gastritides
         6. Granulomatous Gastritides
         7. Distinctive Gastritides
         8. Gastritis in Inflammatory Bowel Disease
         9. Gastritis Cystica Profunda
         10. Allergic Gastritis (see also Chapter 10)
         11. Reactive Gastropathies
         12. Hyperplastic Gastropathies, Including Ménétrier’s Disease
         13. Portal Hypertensive Gastropathy
         14. Differential Diagnosis
         15. Treatment
      5. 53. Peptic Ulcer Disease
         1. Epidemiology
         2. Etiology and Pathogenesis
         3. Clinical Features and Diagnosis
         4. Medical Therapy of Active Peptic Ulcer Disease
         5. Refractory Ulcers
         6. Prevention of Ulcer Disease
         7. Complications and Their Treatment
         8. Stress ulcers
      6. 54. Adenocarcinoma of the Stomach and Other Gastric Tumors
         1. Epidemiology
         2. Etiology and Pathogenesis
         3. Tumor Genetics
         4. Premalignant Conditions
         5. Screening and Surveillance
         6. Prevention
         7. Clinical Features
         8. Diagnosis
         9. Classification and Staging
         10. Prognosis and Treatment
         11. Miscellaneous Gastric Tumors
   7. Part VII. Pancreas
      1. 55. Anatomy, Histology, Embryology, and Developmental Anomalies of the Pancreas
         1. History of the Pancreas
         2. Anatomy
         3. Histology and Ultrastructure
         4. Development of the Pancreas
         5. Developmental Anomalies
      2. 56. Pancreatic Secretion
         1. Functional Anatomy
         2. Composition of Exocrine Secretions
         3. Functions of the Major Digestive Enzymes
         4. Digestive Enzyme Synthesis and Transport
         5. Cellular Regulation of Enzyme Secretion
         6. Organ Physiology
         7. Pancreatic Secretory Function Tests
      3. 57. Genetic Disorders of the Pancreas and Pancreatic Disorders in Childhood
         1. Background
         2. Definitions and Terminology
         3. Genes that Modify Inflammation, Progression to Chronic Pancreatitis and Modifier Phenotypes
         4. Integration of Genetics And Patient Management
         5. Pancreatitis in Children
         6. Clinical Management of Mendelian Disorders of the Pancreas
         7. Rare Genetic Syndromes With Pancreatic Pathology
         8. Familial Metabolic Syndromes Associated With Recurrent Acute and Chronic Pancreatitis
      4. 58. Acute Pancreatitis
         1. Incidence and Burden of Disease
         2. Definitions
         3. Course of the Disease
         4. Pathogenesis and Pathophysiology
         5. Predisposing Conditions
         6. Clinical Features
         7. Differential Diagnosis
         8. Laboratory Diagnosis
         9. Diagnostic Imaging
         10. Distinguishing Alcoholic From Gallstone Pancreatitis
         11. Predictors of Disease Severity
         12. Treatment (Fig. 58.5)
      5. 59. Chronic Pancreatitis
         1. Epidemiology
         2. Pathology
         3. Pathophysiology
         4. Etiology
         5. Clinical features
         6. Physical examination
         7. Diagnosis
         8. Diagnostic strategy
         9. Treatment
         10. Complications
      6. 60. Pancreatic Cancer, Cystic Pancreatic Neoplasms, and Other Nonendocrine Pancreatic Tumors
         1. Pancreatic cancer
         2. Cystic Tumors of the Pancreas
         3. Other Pancreatic Tumors
      7. 61. Endoscopic Treatment of Pancreatic Disease
         1. Acute Pancreatitis
         2. Local Complications of Acute Pancreatitis (Also see Chapter 58)
         3. Chronic Pancreatitis (See Also Chapter 59)
         4. Pancreatic Duct Leaks
         5. Pancreatic Cancer (See Also Chapter 60)
         6. Pancreatic Cysts
   8. Part VIII. Biliary Tract
      1. 62. Anatomy, Histology, Embryology, Developmental Anomalies, and Pediatric Disorders of the Biliary Tract
         1. Embryology of the Liver and Biliary Tract
         2. Anatomy and Histology
         3. Developmental Anomalies
         4. Approach to Disorders of the Biliary Tract in Infants and Children
         5. Pediatric Disorders of the Bile Ducts
         6. Pediatric Disorders of the Gallbladder
      2. 63. Biliary Tract Motor Function and Dysfunction
         1. Anatomy and Physiology
         2. Functional Gallbladder Disorder
         3. Sphincter of Oddi Dysfunction
         4. Failure of Response to Biliary Sphincterotomy
         5. Sphincter of Oddi Dysfunction in Pancreatitis
      3. 64. Bile Secretion and the Enterohepatic Circulation
         1. Bile Acid Synthesis and Metabolism
         2. The Enterohepatic Circulation
         3. Hepatic Bile Acid Transport and Bile Secretion
         4. Intestinal and Renal Bile Acid Transport
         5. Disorders of the Enterohepatic Circulation
         6. Bile Acid–Based Therapy
         7. Bile Acid Sequestrants and Transport Inhibitors
      4. 65. Gallstone Disease
         1. Types of Gallstones
         2. Epidemiology
         3. Composition and Abnormalities of Bile
         4. Pathophysiology
         5. Genetics
         6. Pigment Stones
         7. Natural History
         8. Diagnosis
         9. Clinical Disorders
         10. Uncommon Complications
      5. 66. Treatment of Gallstone Disease
         1. Medical Treatment
         2. Surgical Treatment
         3. Choice of Treatment
         4. Indications for Treatment
         5. Choledocholithiasis
         6. Bile Duct Injury and Stricture
         7. Postcholecystectomy Syndrome
         8. Gallstones, Cholecystectomy, and Cancer
      6. 67. Acalculous Biliary Pain, Acute Acalculous Cholecystitis, Cholesterolosis, Adenomyomatosis, and Gallbladder Polyps
         1. Acalculous Biliary Pain
         2. Acute Acalculous Cholecystitis
         3. Cholesterolosis
         4. Adenomyomatosis
         5. Gallbladder Polyps
      7. 68. Primary and Secondary Sclerosing Cholangitis
         1. Primary Sclerosing Cholangitis
         2. Secondary Sclerosing Cholangitis
      8. 69. Tumors of the Bile Ducts, Gallbladder, and Ampulla
         1. Cholangiocarcinoma
         2. Gallbladder Carcinoma
         3. Ampullary Carcinoma
         4. Other Tumors of the Biliary Tract
      9. 70. Endoscopic and Radiologic Treatment of Biliary Disease
         1. Imaging of the Biliary Tract
         2. ERCP
         3. Endoscopic Treatment
         4. Percutaneous Transhepatic Cholangiography
         5. Percutaneous Cholecystostomy Tube Placement
         6. Combined Percutaneous and Endoscopic Approaches
8. VOLUME 2
   1. Part IX. Liver
      1. 71. Embryology, Anatomy, Histology, and Developmental Anomalies of the Liver
         1. Embryology
         2. Anatomy
         3. Histology
         4. Developmental Anomalies
      2. 72. Liver Physiology and Energy Metabolism
         1. Liver Cell Types and Organization
         2. Integration of the Functions of the Different Cell Types
         3. Regeneration and Apoptosis of Liver Cells
         4. Protein Synthesis and Degradation in the Liver
         5. Hepatic Nutrient Metabolism
      3. 73. Liver Chemistry and Function Tests
         1. Bilirubin (See Chapter 21)
         2. Aminotransferases
         3. Alkaline phosphatase
         4. Tests of Hepatic Synthetic Function
         5. Tests to Detect Hepatic Fibrosis
         6. Quantitative Liver Function Tests
         7. Bile Acids
         8. Specific Applications of Liver Biochemical Testing
      4. 74. Overview of Cirrhosis
         1. Pathogenesis
         2. Diagnosis
         3. Natural History
         4. Prognosis
         5. Treatment
         6. Acute-on-Chronic Liver Failure
      5. 75. Hemochromatosis
         1. Causes Of Iron Overload
         2. Pathophysiology
         3. Clinical Features
         4. Diagnosis
         5. Treatment
         6. Prognosis
         7. Family Screening
      6. 76. Wilson Disease
         1. Copper Metabolism
         2. Molecular Pathogenesis
         3. Pathology
         4. Clinical Features
         5. Diagnosis
         6. Treatment
         7. Prognosis
      7. 77. Other Inherited Metabolic Disorders of the Liver
         1. Clinical Features of Metabolic Liver Disease
         2. α1-Antitrypsin Deficiency
         3. Glycogen Storage Diseases
         4. Congenital Disorders of Glycosylation
         5. Porphyrias
         6. Tyrosinemia
         7. Urea Cycle Defects
         8. Bile Acid Synthesis and Transport Defects
         9. Cystic Fibrosis
         10. Mitochondrial Liver Diseases
      8. 78. Hepatitis A
         1. Virology
         2. Epidemiology
         3. Pathogenesis
         4. Clinical Features
         5. Diagnosis
         6. Prevention and Treatment
      9. 79. Hepatitis B
         1. Epidemiology
         2. Virology
         3. Pathogenesis
         4. Natural History
         5. Clinical and Pathologic Features
         6. Diagnosis
         7. Treatment
         8. Prevention
      10. 80. Hepatitis C
          1. Virology
          2. Epidemiology
          3. Pathogenesis
          4. Clinical features
          5. Diagnosis
          6. Liver Biopsy and Noninvasive Assessment of Fibrosis
          7. Natural History
          8. Treatment
      11. 81. Hepatitis D
          1. Epidemiology
          2. Virology
          3. Pathogenesis
          4. Diagnosis
          5. HDV RNA
          6. Clinical Features
          7. Natural History
          8. Treatment
          9. Prevention
      12. 82. Hepatitis E
          1. Virology
          2. Epidemiology
          3. Pathogenesis
          4. Clinical features
          5. Diagnosis
          6. Treatment
          7. Prevention
      13. 83. Hepatitis Caused by Other Viruses
          1. Discovery of Novel Hepatitis Viruses
          2. Gbv-C/human Pegivirus
          3. Tt Virus Infection
          4. Sanban, Yonban, AND Sen virus and Tt Virus–Like Minivirus Infections
          5. The Search for Other Non–A-E Viral Hepatitis Infections
          6. Systemic Viral Infections That May Involve the Liver
      14. 84. Bacterial, Parasitic, and Fungal Infections of the Liver, Including Liver Abscesses
          1. Bacterial Infections Involving or Affecting the Liver
          2. Parasites (TABLES 84.1 AND 84.2)
          3. Fungi
          4. Liver Abscess
      15. 85. Vascular Diseases of the Liver
          1. Budd-Chiari Syndrome
          2. Extrahepatic portal vein obstruction
          3. Portal vein thrombosis in patients with cirrhosis
          4. Idiopathic noncirrhotic portal hypertension
          5. Sinusoidal obstruction syndrome (hepatic veno-occlusive disease)
          6. Congenital portosystemic shunts
          7. Ischemic hepatitis
          8. Congestive hepatopathy
          9. Ischemic cholangiopathy
          10. Idiopathic sinusoidal dilatation and peliosis hepatis
          11. Hepatic artery aneurysm and Hepatic Infarction
          12. Hereditary hemorrhagic telangiectasia
          13. Diabetic hepatosclerosis
      16. 86. Alcohol-Associated Liver Disease
          1. Epidemiology
          2. Spectrum of Disease
          3. Pathogenesis
          4. Diagnosis of Alcohol Abuse
          5. Diagnosis of Alcohol-Associated Liver Disease
          6. Cofactors that may Influence Progression of Alcohol-Associated Liver Disease
          7. Prognosis
          8. Treatment
      17. 87. Nonalcoholic Fatty Liver Disease
          1. Epidemiology
          2. Definitions and Associations
          3. Pathogenesis
          4. Clinical Features and Diagnosis
          5. Focal Fatty Liver
          6. Natural History
          7. Clinical Associations
          8. Treatment
          9. Lifestyle Modification
          10. Bariatric Surgery
          11. Pharmacotherapy
          12. LT
      18. 88. Liver Disease Caused by Drugs
          1. Hepatic Drug Metabolism
          2. Liver Disease Caused by Drugs
          3. Dose-Dependent Hepatotoxicity
          4. Drug-Induced Acute Hepatitis
          5. Drug-Induced Granulomatous Hepatitis
          6. Drug-Induced Chronic Hepatitis
          7. Drug-Induced Acute Cholestasis
          8. Drug-Induced Chronic Cholestasis
          9. Drug-Induced Steatohepatitis and Hepatic Fibrosis
          10. Drug-Induced Vascular Toxicity
          11. Liver Tumors
      19. 89. Liver Disease Caused by Anesthetics, Chemicals, Toxins, and Herbal and Dietary Supplements
          1. Anesthetic Agents
          2. Chemicals
          3. Metals
          4. Drugs of Abuse
          5. Botanical and Environmental Hepatotoxins
          6. Vitamins
          7. Herbal, Dietary, Weight-Loss, and Body-Building Supplements
      20. 90. Autoimmune Hepatitis
          1. Epidemiology
          2. Pathophysiology
          3. Clinical Features
          4. Diagnosis and Classification
          5. Treatment
          6. LT
          7. Prognosis
      21. 91. Primary Biliary Cholangitis
          1. Epidemiology
          2. Pathogenesis
          3. Clinical Features
          4. Diagnosis
          5. Natural History
          6. Antimitochondrial Antibody-Negative Primary Biliary Cholangitis
          7. Treatment
          8. Management of Complications of Chronic Cholestasis
          9. Liver Transplantation
      22. 92. Portal Hypertension and Variceal Bleeding
          1. Normal Portal Circulation
          2. Hemodynamic Principles of Portal Hypertension
          3. Measurement of Portal Pressure
          4. Detection of Varices
          5. Causes of Portal Hypertension
          6. Clinical Assessment
          7. Treatment
          8. TIPS
          9. Management of Specific Causes of Portal Hypertension-Related Bleeding
      23. 93. Ascites and Spontaneous Bacterial Peritonitis
          1. Pathogenesis of Ascites in Cirrhosis
          2. Diagnosis
          3. Differential Diagnosis of Ascites
          4. Prognosis
          5. Complications of Ascites
          6. Management of Ascites in Cirrhosis
          7. Spontaneous Bacterial Peritonitis
      24. 94. Hepatic Encephalopathy, Hepatorenal Syndrome, Hepatopulmonary Syndrome, and Other Systemic Complications of Liver Disease
          1. Hepatic Encephalopathy
          2. Hepatorenal Syndrome
          3. Hepatopulmonary Syndrome and Portopulmonary Hypertension
          4. Cirrhotic Cardiomyopathy
          5. Endocrine Dysfunction
          6. Bone Disease
          7. Coagulation Disorders
      25. 95. Acute Liver Failure
          1. Definition
          2. Etiology and Epidemiology
          3. Diagnosis
          4. Clinical Features
          5. Approach to Management
          6. Prognosis
          7. Liver Transplantation
          8. Treatment of Complications
          9. Extracorporeal Liver Support
      26. 96. Hepatic Tumors and Cysts
          1. Malignant Tumors
          2. Benign Tumors
          3. Tumor-Like Hepatic Lesions
          4. Hepatic Cysts
          5. Approach to the Patient with AN Hepatic Mass
      27. 97. Liver Transplantation
          1. Indications
          2. Listing Criteria and Policies of the United Network for Organ Sharing
          3. Contraindications
          4. Transplant Evaluation and Listing
          5. Disease-Specific Indications
          6. Surgical Aspects
          7. Immunosuppression
          8. Postoperative Course
          9. Long-Term Management
   2. Part X. Small and Large Intestine
      1. 98. Anatomy, Histology, Embryology, and Developmental Anomalies of the Small and Large Intestine
         1. Anatomy
         2. Embryology
         3. Abnormalities in Normal Embryologic Development
      2. 99. Small Intestinal Motor and Sensory Function and Dysfunction
         1. Anatomy
         2. Normal Small Intestinal Motor and Sensory Function
         3. Integrated Control of Motility
         4. Abnormal Motor and Sensory Function
         5. Measurement of Small Intestinal Motility
         6. Normal in Vivo small Intestinal Motility Patterns
         7. Clinical Approach
         8. Approach to Patients with Possible Small Intestinal Motor Dysfunction
      3. 100. Colonic Motor and Sensory Function and Dysfunction
         1. Methods To Record Colonic Motility
         2. Anatomy and Basic Control Mechanisms of the Colon and Anorectum
         3. Innervation of the Colon
         4. Anorectal Anatomy and Innervation
         5. Relationships Between Cellular Events, Pressure, and Flow
         6. Colonic and Anorectal Motor Patterns
         7. Regulation of Colonic Filling and Transit
         8. Defecation
         9. Modulators of Colonic Motility
         10. Disorders Of Colonic Motility
      4. 101. Intestinal Electrolyte Absorption and Secretion
         1. Intestinal Architecture and Transport
         2. Basic Epithelial Cell Model
         3. Segmental Heterogeneity of Transport
         4. Movement Across the Intestinal Epithelium
         5. Tight and Leaky Epithelia
         6. Transepithelial Transport
         7. Transcellular Transport
         8. Water Movement
         9. Channels, Carriers, and Pumps
         10. Ion Transporters
         11. Extracellular Regulation: Microbial, Autocrine, Luminal, Paracrine, Immunologic, Neural, and Endocrine Systems (Malpines)
         12. Systemic Effects
         13. Osmotic Effects
         14. Specific Regulatory Factors
         15. Intracellular Mediators
         16. Epithelial Regulation in Context
      5. 102. Digestion and Absorption of Carbohydrate, Protein, and Fat
         1. An Overview of the Digestive Process
         2. Nutrient Transporters
         3. Carbohydrates
         4. Fat
      6. 103. Digestion and Absorption of Micronutrients
         1. Water-soluble vitamins
         2. Fat-Soluble Vitamins
         3. Minerals and Trace Elements
      7. 104. Maldigestion and Malabsorption
         1. Etiology and Pathophysiology
         2. Fats
         3. Proteins and Amino Acids
         4. Carbohydrates
         5. Vitamins
         6. Minerals
         7. Mechanisms that Compensate for Malabsorption
         8. Clinical Features and Evaluation
         9. Malabsorption in Specific Situations and Disease States
         10. General Approach to Management
      8. 105. Small Intestinal Bacterial Overgrowth
         1. Definition
         2. Pathogenesis
         3. Causes
         4. Clinical Features
         5. Diagnosis
         6. Treatment
      9. 106. Short Bowel Syndrome
         1. Etiology
         2. Incidence and Prevalence
         3. Pathophysiology
         4. Intestinal Adaptation to Resection
         5. Medical Management
         6. Home Parenteral Nutrition
         7. Complications
         8. Surgical Management
         9. Pharmacologic Enhancement of Bowel Adaptation
         10. Survival and Quality of Life
      10. 107. Celiac Disease
          1. Definitions
          2. History of Celiac Disease
          3. Epidemiology
          4. Pathology
          5. Pathogenesis
          6. Clinical Features
          7. Diagnosis
          8. Differential Diagnosis
          9. Treatment
          10. Nonresponsive Celiac Disease
          11. Refractory Celiac Disease
          12. Celiac Disease and Malignancy
          13. Prognosis
          14. Future Therapies
      11. 108. Tropical Diarrhea and Malabsorption
          1. Infectious Diarrhea In The Tropics
          2. Tropical Sprue
          3. Other Diseases that May Cause Malabsorption in the Tropics
          4. Approach To The Patient With Suspected Malabsorption
      12. 109. Whipple Disease
          1. History
          2. Epidemiology
          3. Microbiology and Genomics
          4. Pathogenesis and Immunology
          5. Clinical Features
          6. Pathology
          7. Diagnosis
          8. Differential Diagnosis
          9. Treatment and Prognosis
      13. 110. Infectious Enteritis and Proctocolitis
          1. Susceptibility to Intestinal Infection
          2. General Principles of Infectious Enteritis and Proctocolitis
          3. Enterotoxigenic Pathogens
          4. Invasive Pathogens
          5. Sexually Transmitted Infectious Proctitis
          6. Viral Pathogens
          7. Travelers’ Diarrhea
          8. Tuberculosis of the Intestinal Tract
          9. Overview of Treatment
      14. 111. Food Poisoning
          1. Approach to the Patient
          2. Bacterial Food Poisoning
          3. Fish Poisoning
          4. Shellfish-Poisoning Syndromes
          5. Mercury Poisoning
      15. 112. Antibiotic-Associated Diarrhea and Clostridioides difficile Infection
          1. Antibiotic-Associated Diarrhea
          2. Pseudomembranous Enterocolitis
      16. 113. Intestinal Protozoa
          1. Entamoeba histolytica
          2. Other Amebae That Infect the Human Intestine
          3. Giardia intestinalis
          4. Dientamoeba fragilis
          5. Blastocystis hominis
          6. Cryptosporidium Species
          7. Cyclospora cayetanensis
          8. Cytoisospora belli (Previously Isospora belli)
          9. Microsporidia
          10. Trypanosoma cruzi (Chagas Disease or American Trypanosomiasis)
      17. 114. Intestinal Worms
          1. Nematodes
          2. Cestodes
          3. Trematodes
      18. 115. Epidemiology, Pathogenesis, and Diagnosis of Inflammatory Bowel Diseases
          1. Epidemiology
          2. Etiology and Pathogenesis
          3. Pathologic Features
          4. Clinical Features
          5. Differential Diagnosis of IBD
          6. Establishing the Diagnosis in IBD
          7. Measuring Disease Activity in IBD
      19. 116. Management of Inflammatory Bowel Diseases
          1. Medical Therapy
          2. Surgical Therapy
          3. Management of Inflammatory Bowel Disease –Related Complications
          4. Management of Inflammatory Bowel Disease in Special Situations
      20. 117. Ileostomies, Colostomies, Pouches, and Anastomoses
          1. Configuration of An Ileostomy
          2. Configuration of A Colostomy
          3. Continent Ileostomy (Kock Pouch)
          4. Anastomotic Dehiscence and The Ghost Ileostomy
          5. Ileal Pouch-Anal Anastomosis
          6. Pathophysiologic Consequences of Proctocolectomy
          7. Ostomy Complications and Management
          8. Complications of Ileal Pouch-Anal Anastomosis
          9. Abdominal Colectomy and Ileorectal Anastomosis
          10. Colostomy in the Management of Ulcerative Colitis
          11. Risk-Benefit Analysis
      21. 118. Intestinal Ischemia
          1. Anatomy of the Splanchnic Circulation
          2. Pathophysiology and Pathology
          3. Acute Mesenteric Ischemia
          4. Outcomes
          5. Mesenteric Venous Thrombosis
          6. Focal Segmental Ischemia of the Small Intestine
          7. Colonic Ischemia
          8. Chronic Mesenteric Ischemia (Intestinal Angina)
          9. Vasculitis and Angiopathy of the Splanchnic Circulation
      22. 119. Intestinal Ulcerations
          1. Causes
          2. Congenital Diseases
          3. Coagulopathic Diseases
          4. Inflammatory Diseases of Blood Vessels (Vasculitis)
          5. Infectious Diseases
          6. Neoplastic Diseases
          7. Iatrogenic Injury and Pharmacologic Agents
          8. Identifying Small Bowel Ulcers
      23. 120. Appendicitis
          1. Historical Perspective
          2. Epidemiology
          3. Anatomy and Embryology
          4. Pathology
          5. Pathogenesis
          6. Clinical Features
          7. Diagnosis
          8. Complications
          9. Treatment
          10. Outcomes
          11. Special Topics
      24. 121. Diverticular Disease of the Colon
          1. Epidemiology
          2. Pathology
          3. Pathogenesis
          4. Asymptomatic Diverticulosis
          5. Symptomatic Uncomplicated Diverticular Disease
          6. Diverticulitis
          7. Segmental Colitis Associated with Diverticulosis
          8. Diverticular Hemorrhage
      25. 122. Irritable Bowel Syndrome
          1. Definitions
          2. Clinical Features
          3. Epidemiology
          4. Risk Factors
          5. Pathophysiology
          6. Diagnosis
          7. Treatment
          8. Prognosis
      26. 123. Intestinal Obstruction
          1. Acute Small Bowel Obstruction
          2. Chronic Small Bowel Obstruction
          3. Large Bowel Obstruction
      27. 124. Ileus and Pseudo-Obstruction Syndromes
          1. Ileus
          2. Acute Colonic Pseudo-Obstruction
          3. Chronic Intestinal Pseudo-Obstruction
          4. Megacolon and Megarectum
      28. 125. Tumors of the Small Intestine
          1. Descriptive Epidemiology
          2. Biology and Biochemical Changes
          3. Risk Factors and Associated Conditions
          4. Clinical Features
          5. Adenocarcinoma
          6. Other Primary Tumors of the Small Intestine
          7. Mesenchymal Tumors
          8. Lymphomas (see Chapter 32)
          9. Secondary Tumors
      29. 126. Colonic Polyps and Polyposis Syndromes
          1. Conventional Adenomas
          2. Pathology
          3. Sessile Serrasted Adenomas and Hyperplastic Polyps
          4. Non-Neoplastic Polyps and Polypoid Lesions
          5. Gastrointestinal Polyposis Syndromes
      30. 127. Colorectal Cancer
          1. Epidemiology
          2. Etiology
          3. Biology
          4. Familial colorectal cancer
          5. Predisposing factors
          6. Pathology
          7. Natural history and staging
          8. Prognosis
          9. Clinical features
          10. Diagnosis and screening
          11. Treatment
          12. Other malignant colonic tumors
      31. 128. Other Diseases of the Colon
          1. Cathartic colon and the effect of laxatives on the colon
          2. Chemical colitis
          3. Colitis cystica profunda and Superficialis
          4. Colon ulcers
          5. Diversion colitis
          6. Endometriosis
          7. Malakoplakia
          8. Microscopic Colitis(lymphocytic and collagenous)
          9. Neutropenic enterocolitis (typhlitis)
          10. Pneumatosis Coli (pneumatosis cystoides intestinalis)
      32. 129. Anal Diseases
          1. Anatomy
          2. Examination of the Anus and Rectum
          3. Hemorrhoids
          4. Anal Fissure
          5. Abscesses and Fistulas
          6. Anal Malignancies
          7. Anal Warts
          8. Pruritus Ani
          9. Anal Stenosis
          10. Unexplained Anal Pain
          11. Hidradenitis Suppurativa
          12. Pilonidal Disease
   3. Part XI. Additional Treatments for Patients with Gastrointestinal and Liver Disease
      1. 130. Probiotics
         1. Definition and Implications
         2. Clinical Evidence OF Effect
         3. Conclusions
      2. 131. Complementary, Alternative, and Integrative Medicine
         1. Definition and Epidemiology
         2. Types of Therapies
         3. Demography of Complementary and Alternative Medicine Users
         4. Rationale for use
         5. Gastrointestinal Disorders Amenable to Complementary and Alternative Therapies
         6. Medical Marijuana
         7. Safety and Regulation of Complementary and Alternative Medicine Therapies
      3. 132. Palliative Care Medicine in Patients with Advanced Gastrointestinal and Hepatic Disease
         1. What is palliative medicine?
         2. Hospice versus Palliative Care
         3. Exploring goals of care
         4. Prognostication
         5. Key prognostic variables and tools in Gastrointestinal and Liver Disease15-19
         6. Common Themes in palliating gastrointestinal and hepatic diseases
         7. Index

Author Biography

Mark Feldman

Affiliations and Expertise
William O. Tschumy Jr., MD, Chair of Internal Medicine, Director, Internal Medicine Residency Program, Texas Health Presbyterian Hospital Dallas; Clinical Professor of Internal Medicine, University of Texas Southwestern Medical School, Dallas, Texas

Lawrence Friedman

Affiliations and Expertise
Professor of Medicine, Harvard Medical School; Professor of Medicine, Tufts University School of Medicine, Boston, Massachusetts; The Anton R. Fried, MD, Chair, Department of Medicine, Newton-Wellesley Hospital, Newton, Massachusetts; Assistant Chief of Medicine, Massachusetts General Hospital, Boston, Massachusetts

Lawrence Brandt

Affiliations and Expertise
Professor of Medicine and Surgery, Albert Einstein College of Medicine, Emeritus Chief, Division of Gastroenterology, Montefiore Medical Center, Bronx, New York