scholarly journals P0932CLINICAL EVALUATION OF DISTURBANCES GASTROINTESTINAL TRACT IN PATIENT WITH CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marufjon Salokhiddinov ◽  
Faxriddin Umarov
Keyword(s):  
Chronic Kidney Disease ◽  
Duodenal Ulcer ◽  
Renal Failure ◽  
Gastrointestinal Tract ◽  
Comparison Group ◽  
Gi Tract ◽  
Erosive Gastritis ◽  
Upper Gi ◽  
Ulcerative Lesions ◽  
Upper Gastrointestinal

Abstract Background and Aims Chronic kidney disease (CKD) affects gastrointestinal function and results in numerous adaptive and maladaptive responses. Disruption of the colonic microbiome and its attendant consequences - the loss of gut barrier integrity and increased generation of uremic toxins - has become well-recognized. However, less attention has been paid to characterizing the mechanisms behind the dysfunction of the upper gastrointestinal (GI) tract, largely owing to the difficulty of studying small bowel function in vivo Method The study included 72 people, of whom 52 made up the main group (CKD group) and 20 people - the comparison group (healthy volunteers without a kidney and cardiovascular disease). The main group consisted of patients with CKD stage 3 (RCGF creatinine 30-59ml / min / m2). The criterion for the inclusion of patients in the study, in addition to reducing the eGFR (estimated glomerular filtration rate), was the presence of arterial hypertension. The renal filtration function was the preserved comparison group and was reduced in the CKD group (p <0.001), which served as a criterion for the inclusion of patients in the study. To assess the state of the gastrointestinal tract, all patients underwent an endoscopic study with an assessment of the acidity and evacuation function of the stomach Results The study showed that 75% of patients had complaints of a dry and unpleasant taste in the mouth, poor appetite, aversion to meat food, nausea. These symptoms were directly related to the level of eGFR. There was also a difference in the frequency and nature of the erosive, erosive-ulcerative, ulcerative lesions of the esophagus and formation of erosions and ulcers in patients with CKD occurred significantly more often against the background of chronic gastritis and with the severity of the inflammatory process with severe dyspeptic disorders. The frequency of erosive, erosive-ulcerative and ulcerative lesions of the mucous membrane of the upper GI tract among CKD patients was 72%, which were manifested by nausea, decreased appetite, heaviness in the stomach after eating, belching, heartburn, epigastric pain (in 50% of patients), meteorism, pain in the epigastric region during palpation. Endoscopic examination of patients with CKD noted the presence of erosive esophagitis, erosive gastritis, erosive bulb it, erosive duodenitis, mixed erosive lesions, erosive-ulcerative gastritis, gastric ulcer, ulcer of duodenal ulcer. Among them, the leading place is occupied by erosive gastritis and mixed erosive lesions, which account for 22% and 27%, respectively. Hemorrhagic erosions were more common in the stomach (41%) and 12: duodenal ulcer (47%) in patients with CKD Conclusion Erosive, erosive-ulcerative, ulcerative lesions of the upper gastrointestinal tract occur in 76% of patients with CKD. The frequency, nature, prevalence of these lesions are associated with the treatment of CKD - active (hemodialysis) and conservative, the stage of chronic renal failure. In patients with chronic renal failure, the endoscopic picture of erosive, erosive-ulcerative, ulcerative lesions of the upper GI tract is diverse.

scholarly journals Fecal Microbiota Transplantation Using Upper Gastrointestinal Tract for the Treatment of Refractory or Severe ComplicatedClostridium difficileInfection in Elderly Patients in Poor Medical Condition: The First Study in an Asian Country

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Tae-Geun Gweon ◽  
Jinsu Kim ◽  
Chul-Hyun Lim ◽  
Jae Myung Park ◽  
Dong-Gun Lee ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Fecal Microbiota Transplantation ◽  
Medical Condition ◽  
Performance Status ◽  
Fecal Microbiota ◽  
Gi Tract ◽  
Upper Gi ◽  
Low Performance ◽  
Upper Gastrointestinal ◽  
Upper Gi Tract

Background and Aims. Fecal microbiota transplantation (FMT) is a highly effective treatment option for refractoryClostridium difficileinfection (CDI). FMT may be challenging in patients with a low performance status, because of their poor medical condition. The aims of this study were to describe our experience treating patients in poor medical condition with refractory or severe complicated CDI using FMT via the upper GI tract route.Methods. This study was a retrospective review of seven elderly patients with refractory or severe complicated CDI and a poor medical condition who were treated with FMT through the upper GI tract route from May 2012 through August 2013. The outcomes studied included the cure rate of CDI and adverse events.Results. Of these seven patients who received FMT via the upper GI tract route, all patients were cured. During the 11-month follow-up period, CDI recurrence was observed in two patients; rescue FMT was performed in these patients, which led to a full cure. Vomiting was observed in two patients.Conclusions. FMT via the upper gastrointestinal tract route may be effective for the treatment of refractory or severe complicated CDI in patients with a low performance status. Physicians should be aware of adverse events, especially vomiting.

scholarly journals Study of Upper Gastrointestinal Tract Endoscopic findings in Portal Hypertension

1970 ◽  
Vol 52 (190) ◽  
Author(s):  
Lochan Karki ◽  
Manen Prasad Gorkhaly ◽  
Buddha Bahadur Karki
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Tract ◽  
Esophageal Varices ◽  
Endoscopic Finding ◽  
Upper Gastrointestinal Tract ◽  
Erosive Gastritis ◽  
Hypertensive Patients ◽  
Endoscopic Findings ◽  
Upper Gi ◽  
Upper Gastrointestinal

Introduction: The gut mucosa in portal hypertension is the seat of microcirculatory changes that compromise its integrity and increase its susceptibility to damage. The mucosal changes in portal hypertension may require pharmacological, directed endoscopic or portal decompressive therapy. The objective of the study is to find out various upper gastrointestinal tract endoscopic findings in patients of portal hypertension.Methods: A prospective, cross-sectional, observational study of sixty patients of portal hypertension was conducted from June to October 2009. The esophagus, stomach and upper duodenum was visualized for any changes, especially by taking the tip of the instrument close to the mucosa.Results: Out of total, 60, 47 (78.3%) cases were cirrhotic and 13 (21.7%) cases were non-cirrhotic portal hypertension. The most frequent upper GI endoscopic finding was esophageal varices 56 (98.3%) followed by gastropathy 49 (81.6%), gastric hyperemia 19 (31.6%), duodenal hyperemia and erosive gastritis 16 (26.6% in each) and gastric varices 12 (20%). Esophageal varices were equally prevalent among cirrhotic and non cirrhotic portal hypertensive patients, 46 out of 47 (97.9%) and 13 out of 13 (100%) respectively. Gastropathy was more prevalent in cirrhotic patients with 87.2% vs. 75% in NCPF followed by 40% in EHO. However, duodenal ulcers were seen only in EHO 12.5%. Erosive gastritis was more prevalent in EHO (75%) followed by NCPF (60%), however, it was less frequent in cirrhotic portal hypertension (14.8%).Conclusions: The most common upper GI endoscopic finding in portal hypertensive patients were found to be esophageal varices followed by gastropathy, peptic ulcer disease (gastric and duodenal hyperemia, chronic gastritis, erosive gastritis, gastric ulcer and duodenal ulcer)._______________________________________________________________________________________Keywords: gastrointestinal tract; portal hypertension; varices.

scholarly journals Ageing-related bacterial features in different segments of the mice gastrointestinal tract

2019 ◽  
Author(s):  
Qi Zhou ◽  
Liang Sun ◽  
Linfang Li ◽  
Huan Gong ◽  
Ying Zhang ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
The Elderly ◽  
Microbial Interactions ◽  
Gi Tract ◽  
Gastrointestinal Microbiota ◽  
Upper Gi ◽  
Β Diversity ◽  
Metagenome Sequencing ◽  
Upper Gastrointestinal ◽  
Upper Gi Tract

Abstract Background: Ageing is associated with alternations of gastrointestinal (GI) microbiota according to metagenome sequencing. However, the most commonly used sequencing samples were from feces, therefore it remains unknown how the upper gastrointestinal microbiota changes with age and to what extent the fecal can represent the gastrointestinal microbiota. To investigate associations between the microbiota of whole GI tract and ageing, we compared microbial diversity and composition of six GI segments in different phenotypes with a mouse model. Results: Microbial α and β diversity were significantly different between the upper and lower GI tract. The jejunum and ileum samples had significantly lower phylogenetic diversity than large intestinal and stomach did (P < 0.01). About 22.9% core OTUs (n=80) were shared by the whole GI tract, and fecal represented significantly higher microbiota with content from large intestine than content form upper GI tract (82.7% vs. 65.2%, P <0.001). Sutterella, Aggregatibacter, Lactococcus, Lactobacillus and Streptococus were significantly enriched in the upper GI tract, while 14 anaerobes such as Ruminococcus were significantly enriched in the lower GI tract (P < 0.05). The elderly mice had the significant microbial dissimilarity (both in α and β-diversity) with the young- and middle-aged ones. These differences were dependent on GI segments; especially in the lower GI tract, more obvious variations were found. However, the age-associated change was smaller when it compared with the high-fat diet treated mice. Conclusion: The GI microbiota was gradually changed with age and the changes were affected by GI segments. The microbial interactions with host motivate future studies exploring the specified GI microbiota interventions of disease. Keywords: Healthy ageing, Gut microbiota, 16S rRNA sequencing, Gastrointestinal tract, mice

scholarly journals Spatial and Temporal Analysis of the Stomach and Small-Intestinal Microbiota in Fasted Healthy Humans

mSphere ◽  
2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Anna M. Seekatz ◽  
Matthew K. Schnizlein ◽  
Mark J. Koenigsknecht ◽  
Jason R. Baker ◽  
William L. Hasler ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Upper Gastrointestinal Tract ◽  
Rrna Gene ◽  
Gi Tract ◽  
Microbial Composition ◽  
Content Type ◽  
Healthy Humans ◽  
Health And Disease ◽  
Upper Gastrointestinal ◽  
Over Time

ABSTRACTAlthough the microbiota in the proximal gastrointestinal (GI) tract have been implicated in health and disease, much about these microbes remains understudied compared to those in the distal GI tract. This study characterized the microbiota across multiple proximal GI sites over time in healthy individuals. As part of a study of the pharmacokinetics of oral mesalamine administration, healthy, fasted volunteers (n = 8; 10 observation periods total) were orally intubated with a four-lumen catheter with multiple aspiration ports. Samples were taken from stomach, duodenal, and multiple jejunal sites, sampling hourly (≤7 h) to measure mesalamine (administered att = 0), pH, and 16S rRNA gene-based composition. We observed a predominance ofFirmicutesacross proximal GI sites, with significant variation compared to stool. The microbiota was more similar within individuals over time than between subjects, with the fecal microbiota being unique from that of the small intestine. The stomach and duodenal microbiota displayed highest intraindividual variability compared to jejunal sites, which were more stable across time. We observed significant correlations in the duodenal microbial composition with changes in pH; linear mixed models identified positive correlations with multipleStreptococcusoperational taxonomic units (OTUs) and negative correlations with multiplePrevotellaandPasteurellaceaeOTUs. Few OTUs correlated with mesalamine concentration. The stomach and duodenal microbiota exhibited greater compositional dynamics than the jejunum. Short-term fluctuations in the duodenal microbiota were correlated with pH. Given the unique characteristics and dynamics of the proximal GI tract microbiota, it is important to consider these local environments in health and disease states.IMPORTANCEThe gut microbiota are linked to a variety of gastrointestinal diseases, including inflammatory bowel disease. Despite this importance, microbiota dynamics in the upper gastrointestinal tract are understudied. Our article seeks to understand what factors impact microbiota dynamics in the healthy human upper gut. We found that the upper gastrointestinal tract contains consistently prevalent bacterial OTUs that dominate the overall community. Microbiota variability is highest in the stomach and duodenum and correlates with pH.

Upper Gastrointestinal Langerhans Cell Histiocytosis: A Report of 2 Adult Cases and a Literature Review

2020 ◽  
pp. 106689692096456
Author(s):  
Yui Matsuoka ◽  
Yoshiki Iemura ◽  
Masakazu Fujimoto ◽  
Shinsuke Shibuya ◽  
Atsushi Yamada ◽  
...  
Keyword(s):  
Langerhans Cell Histiocytosis ◽  
Mononuclear Cells ◽  
Malignant Neoplasm ◽  
Langerhans Cell ◽  
Braf V600e ◽  
Gi Tract ◽  
Upper Gi ◽  
Upper Gastrointestinal ◽  
Upper Gi Tract

Langerhans cell histiocytosis (LCH) with primary involvement of the upper gastrointestinal (GI) tract is rare. We report 2 adult cases of localized LCH in the upper-GI tract, including the second reported adult case of esophageal LCH and review 11 previously reported cases. Case 1 involved the esophagus of a 61-year-old man; histiocytosis was detected when endoscopy was performed for an examination of epigastric pain. Case 2 involved the stomach of a 56-year-old woman wherein the lesion was detected during a follow-up endoscopy after Helicobacter pylori infection. Both biopsy specimens exhibited diffuse proliferation of mononuclear cells with nuclear convolution and a background of eosinophilic infiltrate. The cells were immunohistochemically positive for CD1a and langerin, and BRAF V600E mutation was detected in Case 2. Follow-up endoscopy for both cases revealed that the lesions disappeared without any treatment. It is important to avoid misdiagnosing LCH of the upper-GI tract as a malignant neoplasm.

scholarly journals Endoscopic study of upper gastrointestinal mucosal lesion in chronic renal failure

2017 ◽  
Vol 5 (4) ◽  
pp. 1316
Author(s):  
Manoj Gupta ◽  
Atul Shende
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Mucosal Lesion ◽  
Ulcer Disease ◽  
Upper Gi ◽  
Gastrointestinal Lesions ◽  
Duration Of Disease ◽  
Upper Gastrointestinal

Background: Chronic renal failure is a syndrome complex results from progressive and irreversible destruction of nephrons regardless of cause. This diagnosis implies that GFR is known to have been reduced for atleast 3 to 6 months. To study the clinical manifestations and assess the type and prevalence of upper gastrointestinal lesions and to correlate the clinical and biochemical parameters with upper GI mucosal lesion in chronic renal failure patients.Methods: Fifty CRF patients from nephrology and Medicine OPD, admitted in the department of Medicine, M.Y. Hospital, Indore, during January 2002 to April 2003 were studied. A detailed History, clinical examination, Urine Examination, renal Function test, U.S.G. was done and then upper GI Endoscopy was performed.Results: Thirty-six males and fourteen females (n=50) were studied. Most common age group was 41-50 years; commonest GI symptom was Anorexia (100%) and Nausea was present in (94%) of patients and GI bleed was seen in (8%). The common upper GI lesion were gastritis (28%), Oesophagitis (16%) and Duodenitis (12%). No patients had Gastric or Duodenal Ulcers. Majority of patients had creatinine clearance between 5-10 ml /min and most of the patients had duration of disease between 11-20 months.Conclusions: Gastrointestinal symptoms are very frequent in CRF patients. There is a high incidence of inflammatory charges of gastrointestinal mucosa in patients of CRF and chronic uremic patients are not at high risk of developing ulcer disease. There is no correlation of these gastrointestinal symptoms and inflammatory changes with age, sex, severity and duration of disease.

scholarly journals The Way to Man's Heart Is through the Stomach

2019 ◽  
Author(s):  
Rebecca Grossman ◽  
Rohin Francis
Keyword(s):  
Cardiovascular System ◽  
Significant Proportion ◽  
Organ System ◽  
Differential Diagnoses ◽  
Gi Tract ◽  
Iatrogenic Injuries ◽  
Upper Gi ◽  
System A ◽  
Organ Systems ◽  
Upper Gastrointestinal

AbstractOrgan systems do not exist in a vacuum. However, in an era of increasingly specialized medicine, the focus is often on the organ system alone. Many symptoms are associated with differential diagnoses from upper gastrointestinal (GI) and cardiovascular medical and surgical specialties. Furthermore, a large number of rare but deadly conditions cross paths between the upper GI tract and cardiovascular system; a significant proportion of these are iatrogenic injuries from a parallel specialty. These include unusual fistulae, herniae, and embolisms that transcend specialties. This review highlights these conditions and the shared anatomy and embryology of the two organ systems.

scholarly journals Gastric cytoprotection as a basis for defense and restoration of gastrointestinal mucosa in erosive-ulcerative lesions of different etiologies

2020 ◽  
pp. 7-18
Author(s):  
Konstantin V. Ivashkin ◽  
Eldos A. Izatullaev ◽  
Vasilisa R. Korneeva
Keyword(s):  
Protective Effect ◽  
Mechanism Of Action ◽  
Gi Tract ◽  
Gastrointestinal Mucosa ◽  
Upper Gi ◽  
Gastroduodenal Mucosa ◽  
Gastric Cytoprotection ◽  
Vitamin U ◽  
Ulcerative Lesions ◽  
Present Possibility

Aim: to analyze the mechanism of action and effectiveness of gastrointestinal (GI) tract mucosa defense within the scope of latest treatment scheme using the example of MMSC (Vitamin U) and to present possibility of its use in erosive-ulcerative lesions of different etiologies.General findings:Conclusion: Medications, that exert protective effect on gastroduodenal mucosa, MMSC (vitamin U), particularly, could be used for the purpose of main treatment schemes fortification and remission maintaining in erosive-ulcera- tive damage of upper GI tract.

scholarly journals Upper Gastrointestinal Endoscopy in Lumbini Medical College and Teaching Hospital

2013 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
Bishal Khattri Chhetri ◽  
M S Paudel ◽  
Nabin Pokharel ◽  
Shadev Prasad Dhungana ◽  
Anuj Paudel ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Gastrointestinal Tract ◽  
Teaching Hospital ◽  
Esophageal Varices ◽  
Gastrointestinal Endoscopy ◽  
Common Finding ◽  
Upper Gastrointestinal Endoscopy ◽  
Ulcer Disease ◽  
Medical College ◽  
Upper Gastrointestinal

  Introduction: Upper gastrointestinal (UGI) endoscopy includes visualization of the oropharynx, esophagus, stomach, and proximal duodenum, with real time assessment and interpretation of the findings encountered. An upper endoscopy is indicated in the diagnostic evaluation of signs and symptoms of a wide variety of gastrointestinal disorders. Besides there are some therapeutic implication of the endoscopy. This study was conducted to study the spectrum of diseases found during the upper gastrointestinal endoscopy in patient presenting in Lumbini Medical College and Teaching Hospital (LMCTH).   Methods: This was a retrospective observational study carried out in LMCTH. The endoscopic record book of the patients who underwent UGI endoscopy for various reasons from February 2011 to 2013 was analysed. The risk factor of smoking and alcohol was also included and analysed in the study.   Results: All together 550 upper GI endoscopy was performed in the two years. There were 290 males (52.72%) and females were 260 (47.38%). The mean age was 45.7 years (SD=17.9). Most of the patient belonged to the age group 41 to 80 years (71%). Among total patients, 209 (38%) of them were found to be macroscopically normal. Of those who had positive endoscopic findings; 165 (48.4%) had gastritis and 36 (10.6%) had duodenal ulcer, esophageal varices was in 30 (8.8%), gastric carcinoma in nine (2.6%) of cases. Cigarette smoking was significantly associated with the presence of peptic ulcer disease (p=0.01) and malignancy of gastrointestinal tract (p=0.03). Alcohol intake was non-significantly related to peptic ulceration (p=0.07) and malignancy of gastrointestinal tract (p=0.09).   Conclusion: Upper gastrointestinal endoscopy is a safe and useful procedure for investigating patients with gastrointestinal complains. Gastritis was the most common finding among the patients who had abnormal endoscopy followed by duodenal ulcer and esophageal varices.

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