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Duodenal ulceration Incidence There have been marked changes in the demography of patients presenting with duodenal ulceration in the West. In part, this may relate to the widespread use of gastric antisecretory agents and H. pylori eradication therapy in pa...

Duodenum The duodenum is lined by a mucus-secreting columnar epithe lium. In addition, Brunner’s glands lie beneath the mucosa and are similar to the pyloric glands in the pyloric part of the stom ach. Endocrine cells in the duodenum produce cholecystokinin a...

Endocrine cells The stomach has numerous endocrine cells that are critical to its function. In the gastric antrum, the mucosa contains G cells, which produce gastrin. Throughout the body of the stomach, enterochroma ffi n-like (ECL) cells are abundant and produ...

Erosive gastritis This is caused by agents that disturb the gastric mucosal barrier; NSAIDs and alcohol are common causes. The NSAID-induced gastric lesion is associated with inhibition of cyclo-oxygenase type 1 (COX-1) receptor enzyme, reducing production of...

FURTHER READING Al-Batran S-E, Homann N, Schmalenberg H et al . Perioperative che - motherapy with docetaxel, oxaliplatin, and fluorouracil/leucovorin (FLOT) versus epirubicin, cisplatin, and fluorouracil or capecit - abine (ECF/ECX) for resectable gastric or ga...

Flexible endoscopy Flexible endoscopy is more sensitive than conventional radiology in the assessment of the majority of gastroduodenal conditions, particularly peptic ulceration, gastritis and duodenitis. In upper gastrointestinal bleeding, endoscopy is far...

Foreign bodies in the stomach A variety of ingested foreign bodies reach the stomach, and very often these can be seen on a plain radiograph. If possible, they should be removed endoscopically but, if not, most can be left to pass normally . Even objects su...

GASTRIC CANCER Carcinoma of the stomach is a major cause of mortality world - wide. Its prognosis tends to be poor, with cure rates little better than 5–10%, although better results are obtained in Japan, where the disease is common. Gastric cancer is actually...

GASTRIC OUTLET OBSTRUCTION The two common causes of gastric outlet obstruction are gastric cancer (see Gastric cancer ) and pyloric stenosis secondary to peptic ulceration. With the decreasing incidence of peptic ulceration gastric outlet obstruction should ...

GASTRITIS The great variety of names and classification systems used in gastritis is confusing. Thankfully , the understanding of gastritis has increased markedly following elucidation of the role of gastritis should be classified according to the underlying a...

GASTROINTESTINAL STROMAL TUMOURS Gastrointestinal stromal tumours (GISTs) may arise in any part of the gastrointestinal tract but 50% will be found in the stomach. Previously named leiomyoma and leiomyosarcoma, the term GIST is now used, recognising the disti...

Gastric acid secretion Secretion of gastric acid and pepsin tends to run in parallel, although the understanding of the mechanisms of gastric acid secretion is considerably greater than that of pepsin. Numerous factors are involved to some degree in the prod...

Gastric emptying studies These are useful in the study of gastric dysmotility problems, particularly those that follow gastric surgery . The principle is that a radioisotope-labelled liquid and solid meal is ingested by the patient and emptying of the stomach...

Gastric erosions Erosive gastritis has a variety of causes, especially NSAIDs. Fortunately , most such bleeding settles spontaneously , but it can be a major problem to treat. In general terms, although there is a di ff use erosive gastritis, there is one (or ...

Gastric mucus and the gastric mucosal barrier The gastric mucous layer is essential to the integrity of the gastric mucosa. It is a viscid layer of mucopolysaccharides produced by the mucus-producing cells of the stomach and the pyloric glands. Gastric mucu...

Gastric ulcers Incidence As with duodenal ulceration, H. pylori and NSAIDs are the important aetiological factors. Gastric ulceration is also asso ciated with smoking. Gastric ulceration is much less common than duodenal ulceration. The gender incidence is equ...

Gastroduodenal motor activity The motility of the gastrointestinal tract is modulated by its intrinsic nervous system. Critical in this process is the migrat - - ing motor complex (MMC). In the fasting state, and after food has cleared, there is a period of ...

HAEMATEMESIS AND MELAENA Upper gastrointestinal haemorrhage remains a major medi - cal problem with an incidence of over 100/100 000 per year in Western practice. The incidence increases with age. Haemorrhage is strongly associated with NSAID use. Despite imp...