Index

Abdominal distention, 4 Abdominal survey film, pancreas, 199 Acetaminophen, and dyspepsia, 6, 9 Acetylcholine, 43 N-acetylcysteine

for meconium ileus, 303 for meconium ileus equivalent, 304-305

Acid regurgitation, 2 Ackee fruit, toxins of, 111 Acute self-limiting colitis, 80 Acyclovir, hepatitis B virus, 274 Adenine arabinoside

hepatitis B virus, 272-274 toxicity of, 273-274

Adenocarcinoma, and CT imaging, 201 s-adenosylmethionine decarboxylase, 23 Alcohol, effect on intestine, 65-66 Amino acids, and decarboxylation, 46 Ammonium tetrathiomolybdate, in Wilson's

disease, 250 Anaphylactoid purpura, 84 Androgens, 340-341

and hepatic function, 350-351 in primary biliary cirrhosis, 291 production of, 340-341 testosterone, 341

Angiography, of pancreas, 195-197 Antacids, and dyspepsia, 12, 14 Antibiotics, in foods, 115-116 Antibodies, in serum sample, E. coli, 99 Anticholinergics

and dyspepsia, 13, 14 for irritable bowel syndrome, 162

Antidepressants and dyspepsia, 15, 17 for irritable bowel syndrome, 163

Antifibrotic medication, primary biliary cir­rhosis, 293

Antioxidants added to food, 117 types of, 117

Antiviral drugs acyclovir, 274 hepatitis B virus and, 272 interferons, 268-270 types of, 272

Antivitarnins, III Anxiolytics, and dyspepsia, 16 Arachidonic acid, 44 Aspartame, toxicity of, 120 Aspergillus flavus, 113-114 Aspergillus ochraceus, 114 Asthma, compared to irritable bowel syn­

drome, 149-150 Auranofin, 48 Autoimmune hepatitis, 279-280

nature of, 279 treatment of, 279-280

Autonomic nervous system, definition of, 133 Avidin, 111 Azathioprine, in primary biliary cirrhosis, 292 Azotorrhea, pancreatic insufficiency, 309

Bacillus Calmette-Guerin, vaccination, 275 Bacillus cereus, 113 Bacteria

and intestinal mucosa, 46 pathogens, disease mechanism of, 87-88

Balanitis, bacterial pathogen in, 84 Barium enema, pancreas, 195 Barium meal, pancreas, 195 Belching, 4

355

356

N-benzoyl-L-tyrosil-Lp-aminobenzoic acid test, 185

BHA,117 BHT,117 Bicarbonate secretion, test for assessment of,

186-189 Bile acids

and cholesterol gallstones, in experimental animals, 172-175

laxative effect, 48 and pancreatitis, 310

Biliary tract disease, in cystic fibrosis, 321-324

Bisacodyl, 48 Bismuth, and dyspepsia, 13, 14 Bombesin stimulation test, 189 Bone pain, in primary biliary cirrhosis, 291-

292 Botulism, 113 Bradykinin, 44 Bran, use of, 160 Breath test

for fat digestion, 184 for starch digestion, 183

Brominated oils, toxicity of, 121 Bush teas, toxins of, III

Cadaverine, 27, 110 Caerulein stimulation test, 189 Calcium-channel blockers, for irritable bowel

syndrome, 163 Campylobaeter jejuni, 46, 79 Cancer, pancreatic, differential diagnosis, 192-

194,203 Canning, in food packaging, 121 Carbohydrate intolerance, 192 Cardiovascular abnormalities, in Wilson's dis-

ease, 238-239 Cassava, toxins of, 111 Cataracts, and Wilson's disease, 237 Central nervous system, in Wilson's disease,

242 Ceruloplasmin, in Wilson's disease, 240-241,

245-246 Cheese, toxins of, 110 Chemical transmission, in central vagal path­

ways, 140-142 Chenodeoxycholic acid, and gallstone dissolu­

tion, 169-171 Chemobyl, 123 Chest pain, 2

INDEX

Chinese restaurant syndrome, 119 Chlorambucil, in primary biliary cirrhosis, 292 Cholangitis, in cystic fibrosis, 323-324 Cholecystokinin stimulation test, 189 Cholestasis

in cystic fibrosis, 323 in primary biliary cirrhosis, 291, 292 ursodeoxycholic acid, 293-294

Cholesterol gallstones, 167-176 bile acid, altered proportions in experimental

animals, 172-175 and chenodeoxycholic acid, 169-171 compared to pigment gallstones, 168 diet for dissolution of, 168-171

Cholestyramine, in primary biliary cirrhosis, 291

Chronic hepatitis definition of, 263 etiologies of

autoimmune hepatitis, 279 hepatitis B virus, 265-276 hepatitis C virus, 277-279 hepatitis delta virus, 276-277 viral hepatitis, 265

pathology, 263-264 chronic active hepatitis, 264 chronic lobular hepatitis, 264 chronic persistent hepatitis, 264

Circulation. See Intestinal microcirculation Cirrhosis, 60

in Wilson's disease, 231, 232, 240 See also Primary biliary cirrhosis

Cisapride, and dyspepsia, 15, 16 Clonidine, 48 Clostridium absonum, 172 Clostridium botulinum, 113, 118 Clostridium diffieile, 46-47, 79 Clostridium limosum, 172 Coffee, roasting, mutagen formation, 118 Colchicine, in primary biliary cirrhosis, 293 Colitis

acute self-limiting type, 80 hemorrhagic colitis

bacterial pathogen in, 82-83 gastrointestinal aspects of, 84-85 spastic colitis, 152 symptoms of, 82

Computerized axial tomography dynamic scanning method, 201-202 of pancreas, 201-202 and Wilson's disease, 247-248

INDEX

Constipation, and intestinal absorption, 39, 40 Cooking, and food toxicants, 122 Copper

dietary, and intestinal absorption, 224-225 hematogenous transport of, 225-226 hepatic copper metabolism, 227 hepatic overload, non-Wilsonian liver dis-

ease, 244 tissue distribution, 224 total body copper, 224 See also Wilson's disease

Corticosteroids in primary biliary cirrhosis, 292 withdrawal in hepatitis patients, 275, 276,

280 Cow's milk, toxicants in, 123 Crohn's disease, vascularity in, 64 Cycad seeds, toxins of, III Cyclamates, toxicity of, 120 Cyclosporin A

in autoimmune hepatitis, 280 in primary biliary cirrhosis, 292-293

Cystadenomas, and CT imaging, 201 Cystic fibrosis

adult patients, 300 biochemical findings in small intestinal

mucosa, 311-312 future view, 325 gastrointestinal disease in, 300-314

differential diagnosis of abdominal pain, 302 gastro-esophageal reflux, 305-306 intussusception and volvulus, 305 meconium ileus, 302-303 meconium ileus equivalent, 304-305 pancreatitis, 308 pathology related to pancreas, 307-308 peptic ulcer disease, 306-307 rectal prolapse, 304

genetic factors, 299-300, 324, 325 hepatobiliary disease in

gallbladder disease, 321-324 liver disease, 318-320

incidence of, 300 malabsorption syndrome, 308-312

pancreatic enzyme therapy, 312-314 malnutrition in, 314-318 nature of, 299, 324-325 survival time, 300

Cystic neoplasms, and CT imaging, 201 Cytomegalovirus, 265 Cytotoxicity assay, E. coli, 98-99

Descyclovir, 274 Diabetes mellitus

cystic fibrosis, 308 effects on intestine, 63-64

Diamine oxidase, 61, 75 Diamines,46 Diarrhea

definition of, 35, 37

357

enteric pathogens, virulence properties, 87-88

and intestinal absorption, 39, 40 medications for, 161-162 watery diarrhea syndrome, 44

Diet and dissolution of cholesterol gallstones,

168-171 and dyspepsia, 12 fiber and irritable bowel syndrome, 151 in Wilson's disease, 248

Difluormethylornithine, 24, 26, 30 5-5 dimethyl-2, 4-oxazolidinedione test, 189 Dinoflagellates, 112 DNA probes, E. coli, 98-99 Domoic acid, 112 Dopamine, 43 Dopaminergic receptor blockers, and dyspep­

sia, 15, 16 Drug effects

and dyspepsia, 6, II gastrointestinal side effects, 48

Duodenitis chronic, and dyspepsia, 5 erosive, 5 nonerosi ve, 5

Dyes, foods, toxicity of, 120-121 Dynamic scanning method, computerized axial

tomography, 201-202 Dynorphin, 43 Dyspepsia, non-ulcer

antidepressants, 17 management principles, 17 surgery, 17

causality chronic duodenitis, 5 chronic gastritis, 5 drugs, 6, 9 environmental, 6, 9 gastric acid secretion, 9 Giardia lamblia, 11 life-event stress, 11 personality factors, 9, 11

358

Dyspepsia, non-ulcer (cont.) causality (cont.)

upper gastrointestinal-tract motility, 6 visceral afferent dysfunction, 6

definition of, 1-2 differential diagnosis, non-ulcer, 2-4 disorders related to, 3 idiopathic dyspepsia, 4 management of

antacids, 12 anticholinergic drugs, 13 anxiolytics, 16 bismuth, 13 cisapride, 16 dietary therapy, 12 dopaminergic receptor blockers, 16 H2-receptor blockers, 12-13 management principles, ll-12 pirenzepine, 13 sucralfate, 13, 16

other names for, 2 prevalence of, 1 symptoms of, 2

Edema, intestinal, microvascularity in, 65 Endocrine pancreatic function, assessment of,

191-192 Endocrinologic abnormalities, in Wilson's dis­

ease, 239 Endoscopic retrograde cholangiopancreatogra-

phy, pancreas, 203-205 Endoscopic Ultrasonography, of pancreas, 210 Entamoeba histolytica, 47 Enteric nervous system, nature of, 42-43 Enterocytes

luminal and contraluminal influences, 42 See also Intestinal lining

Enteroendocrine messengers and enterocyte function, 43-44 types of, 44

Enterosorption, 39 Enterotoxins, pathogens related to, 46-47 Environmental factors, and dyspepsia, 6 Epidermal growth factors, 76 Epigastric distress syndrome, 2 Epithelial organization, six-pack model of, 38,

39 Epstein-Barr virus, 265 Erucic acid, II 0 Escherichia coli, 46, 47

disease-causing mechanisms, 81

INDEX

Escherichia coli (cont.) as enteric pathogens, 80-81 enteropathogenic E. coli, use of term, 81 routes of transmission, 86 vero-cytotoxin producing. See Vero-

cytotoxin producing Escherichia coli Escherichia hermanni, 95 Esophagogastroduodenoscopy, 2 Estrogens, 342

estradiol, 342 and hepatic function, 351-352 production of, 342

Ethanol, effect on intestine, 65-66 Eukaryotes, 26 Exsorption, 39

Fat digestion, breath test for, 184 Fecal chymotrypsin test, 190 Fiber

bran, use of, 160 increasing, and irritable bowel syndrome,

160 and irritable bowel syndrome, 151 psyllium, 160

Fish, toxins of, lll-112, 116 Flavor enhancers, toxic effects, ll9 Rora, toxigenic potential, 46 Food, refined, 169 Food allergy, and dyspepsia, 6 Food poisoning, use of term, 113 Food toxicants

accidental contamination, examples of, 124 antibiotics added to foods, 115-ll6 antioxidants, 117 brominated oils, 121 categories of, 108 coffee roasting, 118 and cooking, 122 in cow's milk, 123 elimination of toxins, 110 environmental toxins, 115 flavor enhancers, 119 food dyes, 120-121 food poisoning, use of term, 113 food preservation agents, 116 in human milk, 122-123 leaching of toxicants from utensils, 122 in marine species, 111-ll2, ll6 mycotoxins, ll3-ll4 naturally occurring, II 0-ll2 nitrosamines, ll8-ll9

INDEX

Food toxicll!1ts (cont.) and packaging of food, 121-122 pesticide residues in foods, 114-115 physiological considerations, 108-100 preventing enteric infection, 99 smoked foods, 1l7-118 and storage of food, 112-113 sweeteners, artificial, 119-120

Foscamet, 272 Free-radicals, 75

and edema, 65 scavengers, 75

Functional dyspepsia, 2 Fusarium, 114

Galanin,43 Gallbladder disease, cystic fibrosis, 321-324 Gallstones

cholesterol. See Cholesterol gallstones and dyspepsia, 4

Gangliosides, 47 Gastric acid secretion, and dyspepsia, 9 Gastrin, and mucosal growth, 29 Gastritis, chronic, and dyspepsia, 5 Gastroesophageal reflux

cystic fibrosis, 305-306 and dyspepsia, 2

Gastrografin enemas, for meconium ileus, 303 Gastrointestinal abnormalities, in Wilson's dis­

ease, 234 Gastrointestinal motility, and vagal sensory

nerve, 134 Gastrointestinal secretion, and vagal sensory

nerve, 134 Gastrointestinal-tract motility disorders, and

dyspepsia, 6 Genetic factors

cystic fibrosis, 299-300, 324, 325 Wilson's disease, 227-229

Giardia entamoeba, 46 Giardia lamblia, and dyspepsia, 11 Glucose intolerance, in cystic fibrosis, 308 Glucosinolates, III Goitrogens, III

H2-receptor blockers, and dyspepsia, 12-13, 14

Heartburn, and dyspepsia, 2 Helicobacter pylori, 5, 13, 17 Helminths, 46

359

Hematologic manifestations, in Wilson's dis­ease, 236

Hemolytic uremic syndrome, bacterial patho­gen in, 83-84

Hemorrhagic colitis bacterial pathogen in, 82-83 colonic findings in, 85 gastrointestinal aspects of, 84-85 symptoms of, 82 VTEC associated, 84-86

Hemorrhagic cystitis, bacterial pathogen in, 84 Henoch-Schonlein purpura, 84 Hepatic copper concentration, in Wilson's dis­

ease, 244-245 Hepatitis

post-transfusion hepatitis, 277 See also Chronic hepatitis; specific types of

hepatitis Hepatitis B virus, 265-276

natural history, 266-268 treatment of, 268-276

acyclovir, 274 adenine arabinoside, 272-274 antiviral drugs, 272 immunomodulation, 274-276 interferons, 268-270 interleukin-2, 270-272 liver transplantation, 276 suramin, 274

virology, 266 Hepatitis C virus, 277-279

nature of, 277-278 treatment of, 278-279

Hepatitis delta virus, 276-277 geographic areas for outbreak, 277 nature of, 276-277 treatment of, 277

Hepatolenticular degeneration. See Wilson's disease

Herpes virus and acyclovir, 274 herpes simplex virus, 265

Histamine, 45, 46, 110 histamine toxicity, 112 and ischemic injury, 61

Homeostasis, and vagal sensory nerve, 134 Hormonal regulation, of polyamine synthesis,

28-32 Hormone stimulation tests, pancreatic, 189-

190 5-HT,44

360

Human milk, toxicants in, 122-123 Hydrocarbons

in foods, 115 hydrocarbon continuum, 109

Hydroxylamines, 46 Hypaque, for meconium ileus, 303 Hypoceruloplasminemia, in Wilson's disease,

242 Hypoxia, 61

Imaging methods pancreas. See Pancreatic disease, imaging

methods and Wilson's disease, 247-248

Immunomodulation hepatitis B virus, 274-276 hyperimmune response in, 275

Immunoreactive trypsinogen, in acute pan­creatitis, 191

Immunosuppressive therapies, primary biliary cirrhosis, 292-293

Inflammatory bowel disease, 44 drug treatment, 46 vascular hypothesis of, 65

Inflammatory factors, and irritable bowel syn­drome, 152-153

Inflammatory mediators and enterocyte function, 44-45 types of, 44-45

Ingestive behavior, and vagal sensory nerve, 134

Insorption, 39 Interferons

administration of, 270 classification of, 268 for hepatitis B virus, 268-270 hepatitis C virus, 278 hepatitis delta virus, 277 properties of, 269-270

Interleukin-2, hepatitis B virus, 270, 272 Intestinal function, villus-crypt model, 40-42 Intestinal ischemia, effects on intestine, 60-63 Intestinal lining

contraluminal factors enteroendocrine messengers, 43-44 inflammatory mediators, 44-45 neurotransmitters, 42-43

enterocytes, luminal and contraluminal influ­ences, 42

enterosorption, 39

Intestinal lining (cont.)

exsorption, 39 function of, 35 insorption, 39 luminal factors

drug effects, 48 intestinal microflora, 45-46 pathogenic organisms, 46

INDEX

transport, organizational pattern, 38-40 Intestinal microcirculation

anatomical aspects, 54 pathophysiology of

diabetes mellitus, 63-64 ethanol injury, 65-66 inflammatory bowel disease, 64-65 intestinal ischemia, 60-63 neonatal necrotizing enterocolitis, 63 portal hypertension, 60 radiation injury, 66-67

physiological aspects, 54-57 splanchnic blood flow, 53-54 transcapillary fluid exchange, 57-59

Intestinal obstruction and mucosal growth, 25 polyamines in adaptive response to, 25-26

Intussusception and volvulus, cystic fibrosis, 305

Irritable bowel syndrome altered gut function in, 146-147 compared to asthma, 149-150 and dyspepsia, 3-4 factors in pathogenesis of, 150-151 and fiber deficiency, 151 and inflammatory factors, 152-153 management, 159-164

diagnosis, 159-160 drugs in, 161-163 follow-up visit, 161 increasing fiber, 160 placebo use in, 161 and unsatisfied patient, 163-164

motor hyperresponsiveness in, 147-148 organ hyperresponsiveness in, 148-149 and pain tolerance, 146 patient profile in, 157 prevalence of, 157 psychogenic factors, 146, 157, 160 and stress, 151-152 symptoms of, 4, 158

Isothiocyanates, 111

INDEX

Kainic acid, 112 Kallidin, 44 Kayser-Fleischer rings, in Wilson's disease,

233,235,236-237,242,244,281 Kidney, in Wilson's disease, 237-238 Kinins, 44

Lactose, 110 Laxatives

bile acids as, 48 and prostaglandins, 48

Leaching, of metals into foods, 122 Lead poisoning, and utensils, 122 Liver

copper overload, non-Wilsonian liver dis-ease, 244

elimination of toxins, 110 liver disease in cystic fibrosis, 318-320 and sex hormones, 344-352

development of lesions, 350-351 hepatic regeneration studies, 351-352 pregnancy and hepatic function, 345-350 sexual dimorphism of hepatic function,

344-345 in Wilson's disease, 236, 281-282

Liver transplantation and hepatitis, 279 and hepatitis B virus, 276 primary biliary cirrhosis, 296-297 Wilson's disease, 251-252

Loperamide, 48 for irritable bowel syndrome, 161-162

Lupoid hepatitis. See Autoimmune hepatitis Lymphatics, and portal hypertension, 60

Magnetic resonance imaging of pancreas, 202-203 and Wilson's disease, 247

Malabsorption syndrome cystic fibrosis, 308-312 cystic fibrosis, pancreatic enzyme therapy,

312-314 Malnutrition, in cystic fibrosis, 314-318 Meconium ileus

cystic fibrosis, 302-303, 319 manifestations of, 302-303 nonsurgical treatment of, 303 surgical treatment of, 303

Meconium ileus equivalent cystic fibrosis, 304-305 medical treatment of, 304-305

Medications for irritable bowel syndrome, 161-163 for Wilson's disease, 248-251

Metals, in marine life, 116

361

Methotrexate, in primary biliary cirrhosis, 293 Methylprednisolone, and radiation injury, 75-

76 Microflora, and enterocyte function, 45-46 Milk, toxicants in, 122-123 Mold, mycotoxins, 114-115 Monoamine oxidase, 110 Monoamines, 46 Monoclonal antibodies

diagnosis of pancreatic cancer, 194 sources for, 194

Monosodium glutamate, toxicity of, 119 Motilin,44 Movement disorders, in Wilson's disease, 235 Mucosal growth

and intestinal obstruction, 25 and polyamines, 24, 26-28

Musculoskeletal manifestations, in Wilson's disease, 239

Mushrooms, toxins of, 111 Mycotoxins, 113-114

foods with, 114-115

Neonatal necrotizing enterocolitis, effects on intestine, 63

Nervous dyspepsia, 2 Neurological manifestations, in Wilson's dis­

ease, 234-235 Neurophysiological study, of vagal reflexes,

139-140 Neurotensin, 44 Neurotransmitters

and enterocyte function, 42-43 types of, 43

Nitrosamines, added to food, 118-119 Nitroso,46 Nociception, and vagal sensory nerve, 134 Norepinephrine, 43 Norwalk virus, 46 Nucleus of the solitary tract, and vagal sensory

fibers, 135-137 Nutmeg, toxins of, 111

Ophthalmologic manifestations, in Wilson's disease, 236-237

Organochlorine, 114

362

Ornithine decarboxylase, 23, 24, 25, 27 Osteoarthritis, and Wilson's disease, 239 Oxazolidines, III

Pain and pancreatic disease, 4 tolerance, and irritable bowel syndrome, 146

Pancreatic cancer differential diagnosis of, 192-194, 203,

207, 209-210 histological diagnosis of, 210-211 indirect signs in imaging, 205, 207

Pancreatic disease chemical!biochemical! anatomical changes

related to, 180 clinical approach to diagnosis, 211-213 conditions related to, 179 and cystic fibrosis

pancreatitis, 308 pathology and pancreatic function, 307-

308 differential diagnosis, 192-194, 203 histopaLltologic diagnosis of, methods, 210-

211 imaging methods

abdominal survey film, 199 angiography, 195-197 barium enema, 195 barium meal, 195 and chronic pancreatitis, 205 computerized axial tomography, 201-202 endoscopic retrograde cholangio-

pancreatography, 203-205 endoscopic ultrasonography, 210 magnetic resonance imaging, 202-203 and pancreatic tumors, 205-210 percutaneous transhepatic cholangiogra-

phy, 197-199 Ultrasonography, 199-200

laboratory tests N-benzoyl-L-tyrosil-Lp-aminobenzoic acid

test, 185 breath test for fat digestion, 184 breath test for starch digestion, 183 cholecystokinin/ caerulein/bombesin stim-

ulation tests, 189 of digestive capacity of pancreas, 181-

186 of endocrine pancreatic function, 191-192 fecal chymotrypsin test, 190

Pancreatic disease (cont.) laboratory tests (cont.)

INDEX

hormone stimulation tests, 189-190 macroscopic/microscopic stool examina-

tion, 183 of malabsorption, 186 of pancreatic function tests, 180 of pancreatic secretion, 186-191 pancreolauryl test, 184-185 radioactive-isotope-labeled triolein and

fatty acid absorption tests, 184 secretin stimulation test, 186-189 of serum levels of pancreatic enzymes,

191 of serum levels of substances in synthetic

activity of pancreas, 191 seventy-two hour fecal fat balance study,

183 for vitamin B12 malabsorption, 185-186

and malabsorption syndrome, 308-312 and pain, 4 and Wilson's disease, 234

Pancreatic enzyme therapy, for malabsorption syndrome in cystic fibrosis, 312-314

Pancreatic polypeptide, 191 Pancreolauryl test, 184-185 Paralytic shellfish poisoning, 112 Pathogenic organisms

and enterocyte function, 46 prevention of infection from, 99 virulence properties of,87 -88 See also specific organisms

D-penicillamine in primary biliary cirrhosis, 293 in Wilson's disease, 234, 238, 240, 243,

248-250, 281-282 Penicillum spp., 114 Peppermint oil, for irritable bowel syndrome,

163 Peptic ulcer disease, cystic fibrosis, 306-307 Peptides, types of, 43 Percutaneous transhepatic cholangiography,

pancreas, 197-199 Peritonitis, in Wilson's disease, 234 Personality factors, and dyspepsia, 9, II Pesticides

residues in foods, 114-115 types of, 114

Phenobarbitone, in primary biliary cirrhosis, 291

INDEX

Phenolphthalein, 48 Phototherapy, in primary biliary cirrhosis,

291 Phytanic acid, 110 Pirenzepine, and dyspepsia, 13, 14 Placebo, in irritable bowel syndrome, 161 Plastics, in food packaging, 121 Polarized cells, transport across, 37-38 Polyamines

in adaptive response to intestinal obstruc-tion, 25-26

biosynthetic pathway, 24 and mucosal growth, 24, 26-28 regulation of, 23-24 sources in gut, 32 synthesis, hormonal regulation of, 28-32 types of, 23

Polychlorinated biphenyls, in foods, 121 Polynuclear aromatic hydrocarbon residues,

and smoked foods, 117-118 Portal hypertension

effects on intestine, 60 types of, 60

Pregnancy, and hepatic function, 345-350 Primary biliary cirrhosis

antifibrotic medication, 293 asymptomatic patients, 290-291 bone pain in, 291-292 formula for determining survival time, 290-

291 immunosuppressive therapies, 292-293 liver transplantation, 296-297 mean survival time, 290 palliative therapies, for symptoms, 291-292 primary outcome measures in therapeutic tri-

als, 290-291 pruritis in, 291 ursodeoxycholic acid, 293-294

Progesterone, 339-340 and hepatic function, 350 metabolism of, 340 secretory factors, 340

Prokaryotes, 26 Prostaglandins, 44, 45

and laxatives, 48 Protozoa, and intestinal mucosa, 46 Pruritis, in primary biliary cirrhosis, 291 Pseudo-ulcer syndrome, 2 Psychiatric manifestations, in Wilson's disease,

235-236

Psychogenic factors in dyspepsia, 9, 11 irritable bowel syndrome, 146, 157, 160

Psyllium, 160 Puffer fish, toxins of, 112 Putrescine, 26-27, 30, 110 Pyrrolizidine alkaloids, 111

Radiation biological effect on cells, 71, 72 cellular respons~, 72-73 diagnosis of radiation injury, 74-75 effects on intestine, 66-67 factors in radiation injury, 72 intestinal response to, 73 management of radiation injury, 75-76 prevention of injury, 75 radiosensitivity, areas of, 71-72

363

surgical intervention of radiation injury, 76 syndromes of radiation injury, 73-74

Radioactive-isotope-Iabeled triolein and fatty acid absorption tests, 184

Rectal prolapse cystic fibrosis, 304 management of, 304

Red tide, 112 Ricinoleic acid, 48 Rifampin, in primary biliary cirrhosis, 291 Rotavirus, 46

Saccharin, toxicity of, 119 Salmonella, 46 Scombroid, 112 Secretin, 44 Secretin stimulation test, 186-189 Senna anthraquinones, 48 Sex hormones

androgens, 340-341 chemical structure of, 337-339 estrogens, 342 mechanisms of action, 342-344 progesterone, 339-340 See also Liver, and sex hormones

Shellfish, toxins of, 111-112, 116 Shiga-like toxin, use of term, 89-90 Shigella, 46, 47, 89 Smoked foods, toxins of, 117-118 Somatostatin, 43 Sorbitol-negative colonies, E. coli, 95, 98 Spastic colitis, 152

364

Spennidine/spennine Nl-acetyltransferase, 23, 27,30

Sphincter of Oddi, disorders of, 4 Splanchnic blood flow, 53-54 Stabilizers, food, toxicity of, 121 Staphylococcal intoxication, 113 Staphylococcus aureus, 47 Starch digestion, breath test for, 183 Starling force equation, 57, 59, 66 Steatorrhea, pancreatic insufficiency, 308-310 Stool examination, and pancreatic disease, 183 Stress

and dyspepsia, 11 and irritable bowel syndrome, 151-152

Substance P, 43, 45 Sucralfate, and dyspepsia, 13, 15, 16 Sulphapyridine, 46 Sulphasalazine, 46 Suramin, hepatitis B virus, 274 Surgery, and dyspepsia, 17 Sweeteners, artificial, toxicity of, l19-120 Symmetrical cells, transport across, 37-38

Testosterone, 341 Tetrodotoxin, 112 Thiaminase, 111 Thrombotic thrombocytopenic purpura, bacteri­

al pathogen in, 84 Thumbprinting of bowel, 84 Total parenteral nutrition, and radiation injury,

75-76 Tranquilizers, for irritable bowel syndrome,

163 Transport

intestinal lining, organizational pattern, 38-40

and symmetrical and polarized cells, 37-38 villus-crypt model, 40-42

Trientine, in Wilson's disease, 250, 282 Tryptamine, 46 Tumor markers, differential diagnosis, pancre­

atic disease, 192-194 Tyramine, 46, II 0

Ulcerative colitis, vascularity in, 64 Ultrasonography, pancreas, 199-200 Urinary copper excretion, laboratory tests,

243-244 Ursodeoxycholic acid, primary biliary cir­

rhosis, 293-294

Vaccination Bacillus Calmette-Guerin, 275 and hepatitis B virus, 268

Vagal reflexes afferent pathways, 133 anatomical factors, 131-133

INDEX

central connections to efferent fibers, 135, 137

central projections to nucleus of the solitary tract, 137, 139

chemical transmission in central pathways, 140-142

gastrointestinal functions influenced by, 130 hierarchy of nervous control of gut motility,

132 neurophysiology of, 139-140 research activity related to, 129-131 roles of, 134 sensory modalities, 133-134

Vegetables, toxins of, 110-l11 Vero-cytotoxin producing Escherichia coli,

80-100 clinical diseases related to, 82-84 diagnosis of, 95-99 hemorrhagic colitis, gastrointestinal aspects

of,84-85 intestinal adherence by, 92-95 invasive properties of, 88-89 isolation of, 82 transmission of, 86 treatment of VTEC illness, 99-100 vero cytotoxin

biological properties, 89-91 role in human disease, 91-92 structure/mechanism of action/genetics

of,91 Vibrio cholera, 46, 47, 88 Villus-crypt model, intestinal function, 40-42 VIP, 43, 44 Viral hepatitis, 265 Viruses

herpes virus, 265, 274 and intestinal mucosa, 46

Visceral afferent dysfunction, and dyspepsia, 6

Vitamins antivitamins, 111 deficiencies in cystic fibrosis, 316-317 in primary biliary cirrhosis, 291-292 toxic effects, 107, 110

INDEX

Vitamins (cont.) vitamin B12 malabsorption, test for, 185-

186 water soluble A, D, E, 291-292

Wilson's disease cardiovascular abnormalities in, 238-239 clinical features of, 231-232, 281 diagnostic screening for, 246-247 discovery of, 223 endocrinologic abnormalities in, 239 gastrointestinal manifestations of, 234 genetic factors in, 227-229 hematologic manifestations of, 236 hepatic manifestations of, 232-234, 239-

241 laboratory tests

of cerebrospinal fluid copper concentra­tion, 246

of hepatic copper concentration, 244-245 of incorporation of radiocopper into

ceruloplasmin, 245-246 of serum ceruloplasmin, 240-241 of serum copper, 243 of urinary copper excretion, 243-244

musculoskeletal involvement in, 239

Wilson's disease (cont.) natural history of, 230-231 neurological manifestations of, 234-235 neuropathology of, 242

365

ophthalmologic manifestations of, 236-237 pathogenesis of, 229-230 psychiatric manifestations of, 235-236 radiologic features of, 247-248 renal abnormalities of, 237-238 treatment of

dietary management, 248 drug therapy, 248-251 liver transplantation, 251-252 long-term management, 252-253

Xanthine oxidase, 61, 63 Xenobiotics, metabolism of, 109-110 X-ray negative dyspepsia, 2

Yersinia enterocolitica, 46, 79

Zidovudine, 272 Zinc deficiency, in cystic fibrosis, 316-317 Zinc therapy, in Wilson's disease, 250-251,

282