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15.10.3 Coeliac disease 2884 section 15  Gastroenterological disorders 2884 15.10.3  Coeliac disease Peter D. Mooney and David S. Sanders ESSENTIALS Coeliac disease is a common disorder of the small intestine in which storage proteins in dietary wheat, rye, an...

15.10.4 Gastrointestinal lymphomas 2892 section 15  Gastroenterological disorders 2892 15.10.4  Gastrointestinal lymphomas Kikkeri N. Naresh ESSENTIALS Primary gastrointestinal lymphoma is the most common extranodal lymphoma and is almost exclusively of non-​H...

15.10.5 Disaccharidase deficiency 2902 section 15  Gastroenterological disorders 2902 FURTHER READING Cellier C, et  al. (2000). Refractory sprue, coeliac disease, and enteropathy-​associated T-​cell lymphoma. Lancet, 356, 203–​8. De Leeuw RJ, et al. (2007). W...

15.10.6 Whipple’s disease 2909 15.10.6  Whipple’s disease 2909 Swallow DM (2003). Genetics of lactase persistence and lactose in­ tolerance. Annual Reviews in Genetics, 37, 197–​219. Swallow DM (2006). DNA test for hypolactasia premature. Gut, 55, 131. Tori AJ...

15.10.7 Effects of massive bowel resection 2911 15.10.7  Effects of massive bowel resection 2911 T. whipplei DNA is detectable in various body fluids and tissues. Sampling should be performed depending on the clinical manifest­ ations: small-​bowel biopsies fo...

15.10.8 Malabsorption syndromes in the tropics 2916 section 15  Gastroenterological disorders 2916 intestine) and result from multiple factors, particularly stasis in the biliary tract due to low levels of gut hormones such as cholecysto­ kinin. d-​lactic acid...

15.11 Crohn’s disease 2925 15.11 Crohn’s disease Miles Parkes and Tim Raine ESSENTIALS Crohn’s disease is a common form of chronic inflammatory bowel disease. Typically involving one or more of the terminal ileum, colon, and perineum, it causes patchy transmur...

15.12 Ulcerative colitis 2937 ESSENTIALS Ulcerative colitis is a chronic relapsing and remitting disease in which chronic inflammation affects the rectum and extends proximally to a variable extent. The precise aetiology remains unknown but involves an interpl...

15.13 Irritable bowel syndrome 2951 ESSENTIALS Symptoms suggestive of disturbed lower gastrointestinal func- tion without adequate explanation are very common in adults in the Western world, up to 15% of whom experience such symp- toms at any one time, althoug...

15.14 Colonic diverticular disease 2960 ESSENTIALS Colonic diverticula are herniations of mucosa through the bowel musculature. They are seen most often in the sigmoid and descending colon, with a prevalence of up to 65% in people over the age of 80 in Europea...

15.15 Congenital abnormalities of the gastrointestinal tract 2967 ESSENTIALS Congenital abnormalities of the gastrointestinal tract can be divided into macroscopic anatomical abnormalities and single gene high- penetrance functional defects that present either...

15.16 Cancers of the gastrointestinal tract 2977 ESSENTIALS Cancers of the gastrointestinal tract are one of the most rewarding interfaces in translational medicine, leading to greater understanding of the genetic mechanisms leading to cancer and the developme...

15.17 Vascular disorders of the gastrointestinal tract 2997 ESSENTIALS A wide range of vascular disorders and vasculitides may affect the gastrointestinal tract. Most are quite uncommon, but presentations are often dramatic with intestinal bleeding or gangrene...

15.18 Gastrointestinal infections 3008 ESSENTIALS Gastrointestinal infections, especially diarrhoea and vomiting, are responsible for substantial morbidity, mortality, and socioeconomic penalties worldwide. In poor countries, the greatest burden of dis- ease i...

15.19 Miscellaneous disorders of the bowel 3025 ESSENTIALS A wide range of miscellaneous disorders can affect the bowel. Those discussed in this chapter include cystic disorders, protein-​losing enteropathy, vascular disorders of the intestine, intestinal pseu...

15.2 Symptoms of gastrointestinal disease 2727 ESSENTIALS The skilful analysis of symptoms indicating disorders of the digestive system is an integral part of the practice of internal medicine. Many patients with abdominal symptoms do not have easily defined o...

15.20 Structure and function of the liver, biliary tract, and pancreas 3032 ESSENTIALS Liver and biliary tract The liver, sited in the right upper quadrant of the abdomen, com- prises eight segments, each of which is a complete functional unit with a single po...

15.21 Pathobiology of chronic liver disease 3043 Wajahat Z. Mehal ESSENTIALS Chronic liver disease is responsible for most of the clinical burden of liver disease. Chronic liver injury can occur via a variety of mech- anisms, including sterile inflammation and...