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Gastrointestinal and Hepatic Manifestations of Systemic Diseases

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Geriatric Gastroenterology

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Abstract

Gastrointestinal (GI) presentations are common manifestations of systemic disease. Diabetics manifest delayed gastric emptying, poorly correlated with symptoms and linked to poor glycemic control. Treatment with metoclopramide and domperidone for antiemesis may cause central nervous system side effects. Diarrhea, constipation, and small intestinal bacterial overgrowth are recognized to occur in diabetics. Amyloid deposition in the small bowel may present with diarrhea, steatorrhea, or pain. Liver disease, although common, usually has few symptoms but may present with hepatomegaly and a raised alkaline phosphatase. The GI manifestations of thyroid disease range from hypomotility in hypothyroidism to hypermotility in hyperthyroidism, and associated autoimmune gastritis. Sarcoidosis commonly involves the liver; elevated alkaline phosphatase levels are associated with disease ranging from granulomas to biliary cirrhosis. The esophagus is commonly affected in scleroderma with heartburn, dysphagia, and regurgitation. Delayed gastric emptying, small bowel dysmotility with bacterial overgrowth, colonic inertia, and weakness of the internal anal sphincter with fecal incontinence are common in scleroderma. Chronic heart disease may cause congestive hepatopathy, hypoxic hepatitis, malabsorption, and protein-losing enteropathy. Chronic kidney disease is associated with GI bleeding, hypergastrinemia, constipation, pancreatic abnormalities, and nonocclusive mesenteric ischemia.

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Authors and Affiliations

  1. Department of Medicine, Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, One Robert Wood Johnson Place, New Brunswick, NJ, 08903, USA

    Ellen C. Ebert MD

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  1. Ellen C. Ebert MD
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Correspondence to Ellen C. Ebert MD .

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Editors and Affiliations

  1. Hospital, Department of Medicine, Saint Peter’s University, 254 Easton Ave, New Brunswick, 08901, New Jersey, USA

    C. S. Pitchumoni

  2. (North Division), Department of Medicine, Montefiore Medical Center, 600 East 233rd Street, Bronx, 10466, New York, USA

    T. S. Dharmarajan

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Ebert, E.C. (2012). Gastrointestinal and Hepatic Manifestations of Systemic Diseases. In: Pitchumoni, C., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1623-5_67

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  • DOI: https://doi.org/10.1007/978-1-4419-1623-5_67

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