Digestive Diseases and Sciences

, Volume 46, Issue 12, pp 2555–2566 | Cite as

REVIEW: Small Bowel Review: Diseases of the Small Intestine

  • A.B.R. Thomson
  • M. Keelan
  • A. Thiesen
  • M.T. Clandinin
  • M. Ropeleski
  • G.E. Wild
Article

Abstract

In the past year there have been many advances in the area of small bowel physiology and pathology and therapy. In preparation for this review, over 1500 papers were assessed. The focus is on presenting clinically useful information for the practicing gastroenterologist. Selected important clinical learning points include the following: (1) glutamine may restore the AIDs-associated increased intestinal permeability to normal; (2) substance P is a major mediator of diarrhea caused by Costridium difficile toxin A, acting by binding to a G-protein-coupled receptor, and represents a possible 2therapeutic target; (3) the serological diagnosis of celiac disease has been greatly enhanced with the use of anti-endomysial antibody testing, and the recent antitransglutaminase; (4) a quarter of patients with celiac disease may have secondary pancreatic insufficiency and require enzyme replacement therapy; (5) in the patient with unexplained elevation in the serum transaminase concentration, consider celiac disease as an obscure possibility; (6) bosentan and endothelin receptor agonist may prove to be useful in reducing gut ischemia in patients with septic shock; and (7) the administration of recombinant human fibroblast growth factor-2 may prove to be useful to prevent radiation damage to the gastrointestinal tract.

small bowel small intestine intestinal permeability diarrhea celiac disease diarrhea septic shock radiation damage 

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Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • A.B.R. Thomson
    • 1
  • M. Keelan
    • 1
  • A. Thiesen
    • 1
  • M.T. Clandinin
    • 1
  • M. Ropeleski
    • 2
  • G.E. Wild
    • 2
  1. 1.Cell and Molecular Biology Collaborative Network in Gastrointestinal Physiology, Nutrition and Metabolism Research Group, Division of Gastroenterology, Department of MedicineUniversity of AlbertaEdmontonCanada
  2. 2.Division of Gastroenterology and Department of Anatomy and Cell BiologyMcGill UniversityMontrealCanada

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