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The Gastrointestinal System and the Elderly

  • Thomas W. Sheehy
Part of the Contemporary Geriatric Medicine book series (COGM, volume 3)

Abstract

Gastrointestinal diseases increase with age, and their clinical presentations are often confused by functional complaints and by pathophysiologic changes affecting the individual organs and the nervous system of the gastrointestinal tract. Hence, the statement that diseases of the aged are characterized by chronicity, duplicity, and multiplicity is most appropriate in regard to the gastrointestinal tract. Functional bowel distress represents the most common gastrointestinal disorder in the elderly. Indeed, over one-half of all their gastrointestinal complaints are of a functional nature. In view of the many stressful situations confronting elderly patients, such as loss of loved ones, the fears of helplessness, insolvency, ill health, and retirement, it is a marvel that more do not have functional complaints, become depressed, or overcompensate with alcohol. These, of course, make the diagnosis of organic complaints all the more difficult in the geriatric patient. In this chapter, we shall deal primarily with organic diseases afflicting the gastrointestinal tract of the elderly. To do otherwise would require the creation of a sizable textbook.

Keywords

Irritable Bowel Syndrome Acute Pancreatitis Gastric Ulcer Acute Pancreatitis Acute Cholecystitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Leeming, J. T. and Dymock, I. W., 1978, The upper gastrointestinal tract, in: Textbook of Geriatric Medicine and Gerontology, Churchill Livingstone, New York, p. 345.Google Scholar
  2. 2.
    Arey, L. B., Tremain, M. J., and Mozingo, F. L., 1935, The numerical and topographical relation of taste buds to human circumvallate papillae throughout the life span, Anat. Record 64:9–25.CrossRefGoogle Scholar
  3. 3.
    Atkinson, M. A., 1976, Disorders of oesophageal motility, Clin. Gastroenterol. 5:49–102.Google Scholar
  4. 4.
    Palmer, 1976, Disorders of the cricopharyngeus muscle: A review. Gastroenterology 71:510–519.PubMedGoogle Scholar
  5. 5.
    Piaget, F. and Fouillet, J., 1959, Le pharynx et I’oesphage senileu estude clinique, radiologique et radiocinematographique,Med. Lyon 40:951–967.PubMedGoogle Scholar
  6. 6.
    Orringer, M. D., 1980, Extended cervical esophagomyotomy for cricopharyngeal dysfunction,J. Thorac. Cardiovasc. Surg. 80:669–678.PubMedGoogle Scholar
  7. 7.
    Duranceau, C. A., Letendre, J., Clermont, R. J., L’Evesque, H. P., and Barbeau, A., 1978, Oropharyngeal dysphagia in patients with ovelopharyngeal muscular dystrophy, Can. J. Surg 21:326–329.PubMedGoogle Scholar
  8. 8.
    Loizou, L. A., Small, M., and Dalton, G. A., 1980, Cricopharyngeal myotomy in motor neuron diseases,J. Neurol. Neurosurg. Psychiatry 43:42–45.PubMedCrossRefGoogle Scholar
  9. 9.
    Henderson, R. D. and Marryatt, G., 1977, Cricopharyngeal myotomy as a method of treating cricopharyngeal dysphagia secondary to gastroesophageal reflux,J. Thorac. Cardiovasc. Surg. 74:721–725.PubMedGoogle Scholar
  10. 10.
    Zuckerbraun, L. and Bahanan, M. S., 1979, Cricopharyngeus myotomy as the only treatment for Zenker diverticulum, Ann. Otol. Rhinol. Laryngol. 88:798–803.PubMedGoogle Scholar
  11. 11.
    LeDuc, J. R. and Meban, S., 1985, Dysphagia following vagotomy. Can. J. Surg 28:537–538.PubMedGoogle Scholar
  12. 12.
    Rattan, S., 1981, Neural regulation of gastrointestinal motility, Med. Clin. North Am. 65:1129–1147.PubMedGoogle Scholar
  13. 13.
    Qualman, S. J., Haupt, H. M., Yang, P., and Hamilton, S. R., 1984, Esophageal Lewy bodies associated with ganglion cell loss in achalasia: Similarity to Parkinson’s disease. Gastroenterology 87:848–856.PubMedGoogle Scholar
  14. 14.
    Selmonosky, C. A., Byrd, R., Blood, C., and Blanc, J. S., 1981, Useful triad for diagnosing the cause of chest pain. South Med. J. 74:947–949.PubMedCrossRefGoogle Scholar
  15. 15.
    Henderson, R. D., 1980, The Esophagus: Reflux and Primary Motor Disorders, Williams & Wilkins, Baltimore, pp. 165–166.Google Scholar
  16. 16.
    Ellis, F. H., Jr., 1976, Management of oesophageal achalasia, Clin. Gastroenterol. 5:89–102.Google Scholar
  17. 17.
    Lipshutz, W. H., 1979, Understanding and managing achalasia of the esophagus, Prac. Gastroenterol. 3:21—25.Google Scholar
  18. 18.
    Bortolotti, M. and Labo, G., 1981, Clinical and manometric effects of nifedipine in patients with esophageal achalasia. Gastroenterology 80:39–44.PubMedGoogle Scholar
  19. 19.
    Soergel, K. H., Zboralske, F. F., and Amberg, J. R., 1964, Presbyesophagus esophageal motility in nonagenarians,J. Clin. Invest. 43:1742–1749.CrossRefGoogle Scholar
  20. 20.
    Hollis, J. B. and Castell, D. O., 1974, Esophageal function in elderly man, Ann. Intern. Med. 80:371–374.PubMedGoogle Scholar
  21. 21.
    Reidel, W. L. and Clouse, R. E., 1985, Variations in clinical presentation of patients with esophageal contraction abnormalities, Dig. Dis. Sci. 30:1065–1071.PubMedCrossRefGoogle Scholar
  22. 22.
    Richter, J. E., Barish, C. F., and Castell, D. O., 1986, Abnormal sensory perception in patients with esophageal chest pain. Gastroenterology 91:845–852.PubMedGoogle Scholar
  23. 23.
    Ritchie, J., 1973, Pain from distention of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut 14:125–132.PubMedCrossRefGoogle Scholar
  24. 24.
    Whitehead, W. E., Engel, B. T., and Schuster, M. D., 1982, Irritable bowel syndrome: Physiological and psychological difference between diarrhea- predominant and constipation-predominant patients, Dig. Dis. Sci. 25:404–413.CrossRefGoogle Scholar
  25. 25.
    Benjamin, S. B., Gerhardt, D. C., and Castell, D. O., 1979, High amplitude peristaltic esophageal contractions associated with chest pain and/or dysphagia, Gastroenterology 77:478–483.PubMedGoogle Scholar
  26. 26.
    Narducci, F., Bassotti, G., Gaburri, M., and Morelli, A., 1985, Transition from nutcracker esophagus to diffuse esophageal spasm. Am. J. Gastroenterol. 80(4):242–244.PubMedGoogle Scholar
  27. 27.
    Richter, J. E., Dalton, C. B., Brice, R. G., Castell, D. O., 1985, Nifedipine: A potent inhibition of contractions in the body of the human esophagus, Gastroenterology 89:549–554.PubMedGoogle Scholar
  28. 28.
    Blackwell, J. M., Ritchie, J. E., Wu, W. C., Cowan, R. J., and Castell, D. O., 1984, Esophageal radionuclide transit tests. Potential false positive results, Clin. Nucl. Med. 9:679–683.PubMedCrossRefGoogle Scholar
  29. 29.
    Dimarino, A. J., Jr., 1979, Esophageal spasm: Diagnosis and management, Pract. Gastroenterol. 3:26–31.Google Scholar
  30. 30.
    Swamy, N., 1977, Esophageal spasm: Clinical and manometric response to nitroglycerine and long acting nitrates. Gastroenterology 72:23–27.PubMedGoogle Scholar
  31. 31.
    Henderson, R. D. and Pearson, F. G., 1976, Reflux control following extended myotomy in primary disordered motor activity (diffuse spasm) of the esophagus, Ann. Thorac. Surg. 22:278–283.PubMedCrossRefGoogle Scholar
  32. 32.
    Ellis, F. H., 1964, Surgical treatment of esophageal hypermotility disturbances, JAMA 188:862–866.PubMedCrossRefGoogle Scholar
  33. 33.
    Eras, P., Goldstein, M. J., and Sherlock, P., 1972, Candida infection of gastrointestinal tract. Medicine 51:367–379.PubMedCrossRefGoogle Scholar
  34. 34.
    Asha, F. P., Lee, H. H., and Nostrant, T. T., 1986, Herpetic esophagitis: A diagnostic challenge in the immunocompromised host. Am. J. Gastroenterol. 81:246–253.Google Scholar
  35. 35.
    Fisher, R. S. and Cohen, S., 1978, Gastroesophageal reflux, Med. Clin. North Am. 62:3–20.PubMedGoogle Scholar
  36. 36.
    Dodds, W. J., Hogan, W. J., Helm, J. F., and Dent, J., 1981, Pathogenesis of reflux esophagitis. Gastroenterology 81:376–394.PubMedGoogle Scholar
  37. 37.
    Dodds, W. J., Dent, J., Hogan, W. J., Helm, J. F., Hauser, R., Patel, G. K., and Egide, M. S., 1982, Mechanisms of gastroesophageal reflux in patients with reflux esophagitis, N. Engl. J. Med. 307:1547–1552.PubMedCrossRefGoogle Scholar
  38. 38.
    Frazier, J. L. and Fendler, K. J., 1983, Current concepts in the pathogenesis and treatment of reflux esophagitis, Clin. Pharm. 2:546–557.PubMedGoogle Scholar
  39. 39.
    Castell, D. O., 1975, Lower esophageal spincter: physiological and clinical aspects, Ann. Intern. Med. 83:390–401.PubMedGoogle Scholar
  40. 40.
    Behor, J. and Sheahan, D. C., 1975, Histologic abnormalities in reflux esophagitis, Arch. Pathol. 99:387–391.Google Scholar
  41. 41.
    Dent, J., Dodds, W. J., and Friedman, R. H., 1980, Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects, J. Clin. Invest. 65:256–267.PubMedCrossRefGoogle Scholar
  42. 42.
    Welch, R. W. and Drake, S. T., 1980, Normal lower esophageal spincter pressure: A comparison of rapid vs. slow pull through techniques. Gastroenterology 78:1446–1451.PubMedGoogle Scholar
  43. 43.
    Gill, R. C., Bowes, K. L., Murphy, P. D., and Kingma, Y. J., 1986, Esophageal motor abnormalities in gastroesophageal reflux and the effects of fundoplication. Gastroenterology 91:364–369.PubMedGoogle Scholar
  44. 44.
    Goldberg, H. I., Dodds, W. J., and Gee, S., 1969, Role of acid and pepsin in acute experimental esophagitis, Gastroenterology 56:223–230.PubMedGoogle Scholar
  45. 45.
    Helm, J. F., Dodd, W. J., Pelc, L. R., Palmer, D. W., Hogan, W. J., and Teeter, B. C., 1984, Effect of esophageal emptying and saliva on clearance of acid from the esophagus, N. Engl J. Med. 310(5):284–288.PubMedCrossRefGoogle Scholar
  46. 46.
    Henderson, R. D., Mugashe, R. L., Jeejeebhoy, K. N., Szczpanski, M. M., Gullen, J., Marryatt, G., and Boxzko, A., 1973, Synergism of acid and bile salts in the production of experimental esophagitis. Can. J. Surg. 16:12–17.PubMedGoogle Scholar
  47. 47.
    Kivilaakso, E., Fromm, D., and Silen, W., 1980, Effect of bile salts and related compounds on isolated esophageal mucosa, Surgery 87:280–285.PubMedGoogle Scholar
  48. 48.
    Wesdorf, L C. E., Dekker, W., and Klinkenberg-Knol, E. C., 1983, Treatment of reflux oesophagitis with ranitidine. Gut 24:921–924.CrossRefGoogle Scholar
  49. 49.
    Koeltz, H. R., Birchler, R., Bretholz, A., et al, 1986, Healing and relapse of reflux esophagitis during treatment with ranitidine, Gastroenterology 91(5):1198–1205.Google Scholar
  50. 50.
    Dent, G., Downton, J., Heddle, R., Puckle, P. J., Toouli, J., MacKinnon, A. M., and Wyman, J. B., 1986, Effects of Omeprazole on peptic esophagitis and esophageal motility and pH, Scand.J. Gastroenterol. 20:723–727.Google Scholar
  51. 51.
    Henderson, R. D. and Harryatt, G. V., 1983, Total Fundoplication gastroplasty (Nissen gastroplasty), Ann. Thorac. Surg. 39:74–79.CrossRefGoogle Scholar
  52. 52.
    Maher, J. W., Hockins, M. P., and Woodward, E. R., 1985, Reoperations for esophagitis following failed antireflux procedures, Ann. Surg. 201:723–727.PubMedCrossRefGoogle Scholar
  53. 53.
    Sheehy, T. W., 1982, Personal observations.Google Scholar
  54. 54.
    Eastwood, G. L., 1977, Does early endoscopy benefit the patient with active upper gastrointestinal bleeding?. Gastroenterology 72(5, Pt.l):737–739.PubMedGoogle Scholar
  55. 55.
    Graham, D. Y., 1980, Limited value of early endoscopy in the management of acute upper gastrointestinal bleeding. Am. J. Surg. 140(2):284–290.PubMedCrossRefGoogle Scholar
  56. 56.
    Keller, R. T. and Logan, G. M., Jr., 1976, Comparison of emergent endoscopy and upper gastrointestinal series radiography in acute upper gastrointestinal hemorrhage. Gut 17(3): 180–184.PubMedCrossRefGoogle Scholar
  57. 57.
    The National ASGE Survey on Upper Gastrointestinal Bleeding, 1981, I: Study design and baseline data, Gastrointes. Endosc. 27(2):73–79.CrossRefGoogle Scholar
  58. 58.
    Chang, F. C., Drake, J. E., and Farha, G. J., 1977, Massive upper gastrointestinal hemorrhage in the elderly. Am. J. Surg. 134(6):721–723.PubMedCrossRefGoogle Scholar
  59. 59.
    Yao, E. H. and Wang, Y., 1983, Acute upper gastrointestinal bleeding in the aged. A retrospective analysis of 100 cases, Med. J. Aust. 1:311–312.PubMedGoogle Scholar
  60. 60.
    Cutler, J. A. and Mendelhoff, A. L, 1981, Upper gastrointestinal bleeding. Nature and magnitude of the problem in the U.S., Dig. Dis. Sci. 26(1 Suppl):765–775.Google Scholar
  61. 61.
    The National ASGE Survey on Upper Gastrointestinal Bleeding, 1981, III: Endoscopy in upper Gastrointestinal bleeding, Gastrointest. Endosc. 27(2):94–102.CrossRefGoogle Scholar
  62. 62.
    Peterson, W. L., Barnett, C. C., Smith, H. J., Allen, M. H., and Corbett, D. B., 1981, Routine early endoscopy in upper-gastrointestinal tract bleeding. A randomized, controlled trial, N. Engl.J. Med. 305(16):925–929.CrossRefGoogle Scholar
  63. 63.
    Inglesias, M. D., Dourdourekas, D., Adomavicius, J., Villa, F., Shobassy, N., and Steigmann, F., 1979, Prompt endoscopic diagnosis of upper gastrointestinal hemorrhage: Its value for specific diagnosis and management, Ann. Surg. 189(1):90–95.CrossRefGoogle Scholar
  64. 64.
    Editorial, 1981, Why treat cirrhosis? Bri. Med.J. 283:338.CrossRefGoogle Scholar
  65. 65.
    Storey, D. W., Brown, S. G., Swain, C. P., Salmon, P. R., Kirkhan, J. S., and Northfield, T. C., 1981, Endoscopic prediction of recurrent bleeding in peptic ulcers, N. Engl.J. Med. 304(16):915–916.CrossRefGoogle Scholar
  66. 66.
    Silverstein, F. E., Gilbert, D. A., Tedesco, F. J., Buenger, N. K., and Pershing, J., 1981, The National ASGE survey on upper gastrointestinal bleeding. IL Clinical prognostic factors, Gastrointest. Endosc. 27(2):80–93.PubMedCrossRefGoogle Scholar
  67. 67.
    Foster, D. N., Miloszewski, K.J. A., and Losowsky, M. S., 1978, Stigmata of recent hemorrhage in diagnosis and prognosis of upper gastrointestinal bleeding, Br. Med.J. 1:1174–1177.Google Scholar
  68. 68.
    Griffiths, W. J., Neumann, D. A., and Welsh, J. D., 1979, The visible vessel as an indicator of uncontrolled or recurrent gastrointestinal hemorrhage, N. Engl J. Med. 300(25): 1411–1413.PubMedCrossRefGoogle Scholar
  69. 69.
    Mitchell, K. J., MacDougall, B. R., Silk, D. B., and William, R., 1982, A prospective reappraisal of emergency endoscopy in patients with portal hypertension, Scand. J. Gastroenterol. 17:965–968.PubMedGoogle Scholar
  70. 70.
    Hunt, P. S., Francis, J. K., Hansky, J., Hillman, H., Korman, M. G., McLeish, J., Marshall, R., and Schmidt, G., 1983, Reduction in mortality from upper gastrointestinal hemorrhage, Med. J. Aust. 26:552–555.Google Scholar
  71. 71.
    Hunt, P. S., Hansky, J., and Korman, M. G., 1979, Mortality in patients with haematemesis and melaena: A prospective study, Br. Med. J. 1:1238–1240.PubMedCrossRefGoogle Scholar
  72. 72.
    Burroughs, A. K., Jenkins, W. J., Sherlock, S., Dunk, A., Walt, R. P., Osuafor, T. O., Mackie, S., and Dick, R., 1983, Controlled trial of propranolol for prevention of recurrent variceal hemorrhage in patients with cirrhosis, N. Engl. J. Med. 309:1539–1542.PubMedCrossRefGoogle Scholar
  73. 73.
    1981, Propranolol: Its role in the management of portal hypertension. Am. J. Gastroenterol. 78:124–126.Google Scholar
  74. 74.
    LeBrec, D., Poynard, T., Hillmon, P., and Benhamou, J. P., 1981, Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis, N. Engl. J. Med. 305:1371–1374.PubMedCrossRefGoogle Scholar
  75. 75.
    Sogaard, P. L., 1981, Propranolol in portal hypertension. Lancet 1:1204.CrossRefGoogle Scholar
  76. 76.
    Conn, H. O., 1984, Emergency portal caval shunt in the management of bleeding varices, Pract. Gastroentestol. 8:17–21.Google Scholar
  77. 77.
    Kiefhaber, P., Kiefhaber, K., Huber, F., and Nath, G., 1986, Endoscopic neodymium: YAG laser coagulation in gastrointestinal hemorrhage. Endoscopy 18(2):46–51.PubMedCrossRefGoogle Scholar
  78. 78.
    O’Brien, J. D., Day, S. J., and Burnham, W. R., 1986, Controlled trial of small bipolar probe in bleeding peptic ulcers. Lancet 1:464—466.PubMedCrossRefGoogle Scholar
  79. 79.
    Terblanche, J., Bornman, P. C., Kahn, D., Jonker, M. A., Campbell, J. A., Wright, J., and Dirsch, R., 1983, Failure of repeated injection sclerotherapy to improve long-term survival after oesophageal bleeding. A five year prospective controlled clinical trial. Lancet 2:1328–1333.PubMedCrossRefGoogle Scholar
  80. 80.
    Witzel, L., Wolbergs, E., and Merki, H., 1985, Prophylactic endoscopic sclerotherapy of esophageal varices. Lancet 1:773–775.PubMedCrossRefGoogle Scholar
  81. 81.
    Terblanche, J., Bornman, P. C., Kahn, D., and Kirsch, R. E., 1986, Sclerotherapy in acute variceal bleeding: Technique and results. Endoscopy 18(Suppl 2):23–27.PubMedCrossRefGoogle Scholar
  82. 82.
    Bornman, P. C., Terblanche, J., Kahn, D., Jonker, M. A., and Kirsch, R. E., 1986, Limitations of multiple injection sclerotherapy sessions for acute variceal bleeding, Afr. Med. J. 70:34–36.Google Scholar
  83. 83.
    Spence, R. A., Anderson, J. R., and Johnston, G. W., 1985, Twenty-five years of injection sclerotherapy for bleeding varices, Br. J. Surg. 72(3): 195–198.PubMedCrossRefGoogle Scholar
  84. 84.
    Sarin, S. K., Sachdev, G., Nanda, R., Batra, S. K., and Anand, B. S., 1986, Comparison of the two time schedules for endoscopic sclerotherapy: A prospective randomized controlled study. Gut 27:710–713.PubMedCrossRefGoogle Scholar
  85. 85.
    Reilly, J. J., Jr., Schade, R. R., and Van Thiel, D. S., 1984, Esophageal function after injection sclerotherapy: Pathogenesis of esophageal stricture, Am. J. Surg. 147:85–88.PubMedCrossRefGoogle Scholar
  86. 86.
    Permutt, R. P. and Cello, J. P., 1982, Duodenal ulcer disease in the hospitalized elderly patient. Dig. Dis. Sci. 27(1): 1–6.PubMedCrossRefGoogle Scholar
  87. 87.
    Grossman, M. I., Guth, P. H., Isenberg, J. I., Passaro, E. P., Roth, B. E., Sturdevant, R. A. L., and Walsh, J. H., 1976, A new look at peptic ulcer, Ann. Intern. Med. 84(l):57–67.PubMedGoogle Scholar
  88. 88.
    Grossman, M. I. (ed.), 1981, Peptic Ulcer; Guide for the Practicing Physician, 1st ed.. Yearbook Medical Publishers, Chicago, pp. 10–11.Google Scholar
  89. 89.
    Elashoff, J. D. and Grossman, M. L, 1980, Trends in hospital admissions and death rates for peptic ulcer in the United States from 1970–1978, Gastroenterology 78(2):280–285.PubMedGoogle Scholar
  90. 90.
    Pulvertaft, C. N., 1968, Comments on the incidence and natural history of gastric and duodenal ulcer. Postgrad. Med. J. 44:597–602.PubMedCrossRefGoogle Scholar
  91. 91.
    Pulvertaft, C. N., 1972, Experiences with peptic ulcer in the elderly men in New York, Age Aging 1:24–29.CrossRefGoogle Scholar
  92. 92.
    Rotter, J. L, Sones, J. Q., Samloff, I. M., Gursky, J. M., Richardson, C. T., Walsh, J. H., and Rimoin, S. L., 1979, Duodenal-ulcer associated with elevated serum pepsinogen I: An inherited autosomal dominant disorder, N. Engl.J. Med. 300(2):63–66.PubMedCrossRefGoogle Scholar
  93. 93.
    Cowan, W. K., 1973, Genetics of duodenal and gastric ulcer, Clin. Gastroenterol. 2:539–546.Google Scholar
  94. 94.
    Rotter, J. I. and Rimoin, D. L. 1977, Peptic ulcer disease—A heterogenous group of disorders? Gastroenterology 73(3):604–607.PubMedGoogle Scholar
  95. 95.
    Grossman, M. I. (ed.), 1981, Peptic Ulcer: Guide for the Practicing Physician, Yearbook Medical Publishers, Chicago, pp. 21–23.Google Scholar
  96. 96.
    Goodwin, C. S., Armstrong, J. A., and Marshall, B. J., 1986, Campylobacter pyloridis, gastritis and peptic ulceration,J. Clin. Pathol. 39:353–365.PubMedCrossRefGoogle Scholar
  97. 97.
    Rathbone, B. J., Wyatt, J. I., and Heatley, R. V., 1986, Campylobacter pyloridis: A new factor in peptic ulcer disease? Gut 27:635–641.PubMedCrossRefGoogle Scholar
  98. 98.
    Marshall, B. J., McGechie, D. B., Rogers, P. A., and Glancy, R. J., 1985, Pyloric Campylobacter infection and gastroduodenal disease, Med. J. Aust. 142(8):439–444.PubMedGoogle Scholar
  99. 99.
    Axon, A. T. R., 1986, Campylobacter pyloridis: What role in gastritis and peptic ulcer? Br. Med.J. 293:772.CrossRefGoogle Scholar
  100. 100.
    Marshall, B. J., Armstrong, J. A., McGechie, D. B., and Glancy, R. J., 1985, Attempt to fulfill Koch’s postulates for pyloric Campylobacter, Med.J. Aust. 142(8):436–439.PubMedGoogle Scholar
  101. 101.
    Kaldor, J., Tee, W., McCarthy, P., Watson, J., and Dwyer, B., 1985, Immune response to Campylobacter pyloridis in patients with peptic ulceration. Lancet 1:921.PubMedCrossRefGoogle Scholar
  102. 102.
    McNulty, C. A. M., Gearty, J. C., Crump, B., Davis, M., Donovan, I. A., Melikian, J., Lister, D. M., and Wise, R., 1986, Campylobacter pyloridis and associated gastritis: Investigator blind placebo controlled trial of bismuth subsalicylate and erythromycin ethylsuccinate, Br. Med. J. 293:645–649.CrossRefGoogle Scholar
  103. 103.
    McLean, A. J., Harrison, P. M., loannides-Demos, L. L., Byrne, A. J.,McCarthy, P., and Dudley, F. J., 1984, Microbes, peptic ulcer, and relapse rates with different drugs. Lancet 2:525–526.PubMedCrossRefGoogle Scholar
  104. 104.
    Hazell, S. L. and Lee, A., 1986, Campylobacter pyloridis, urease hydrogen ion back diffusion, and gastric ulcers. Lancet 2:15–17.PubMedCrossRefGoogle Scholar
  105. 105.
    Narayanan, M. and Steinheber, F. U., 1976, The changing face of peptic ulcers in the elderly, Med. Clin. North Am. 60(6): 1159–1172.PubMedGoogle Scholar
  106. 106.
    Steurp, K. and Mosbeck, J., 1973, Trends in mortality from peptic ulcer in Denmark, Scand. J. Gastroenterol. 8:49–53.Google Scholar
  107. 107.
    Akdamar, K., Dyck, W., and Englert, A., 1981, Cimetidine versus placebo in the treatment of benign gastric ulcer: A multicenter double blind study, Gastroenterology 80(5 Ft.2):1098.Google Scholar
  108. 108.
    McGuigan, J. E., 1981, A consideration of the adverse effects of Cimetidine, Gastroenterology 80(1):181–192.PubMedGoogle Scholar
  109. 109.
    Martin, F., Farley, A., Gagnon, M., and Bensewana, D., 1982, Comparison of the healing capacities of sucralfate and Cimetidine in the short-term treatment of duodenal ulcer: A double blind randomized trial. Gastroenterology 82(3):401–405.PubMedGoogle Scholar
  110. 110.
    Pop, P., Nikkeis, R. E., Thys, O., and Dorrestein, G. C., 1983, Comparison of sucralfate and Cimetidine in the treatment of duodenal and gastric ulcers. A multicenter study, Scand. J. Gastroenterol. 83(Suppl):43–47.Google Scholar
  111. 111.
    Miller, J. P. and Faragher, E. B., 1986, Relapse of duodenal ulcer: Does it matter which drug is used in initial treatment? Br. Med. J. 293:1117- 1118.CrossRefGoogle Scholar
  112. 112.
    Makalinao, A. V. and Zano, F. M., 1984, Ranitidine in the treatment of peptic ulcer, Clin. Ther. 6:185–192.PubMedGoogle Scholar
  113. 113.
    Shulz, T. B., Berstad, A., Rydning, A., and Frislid, K., 1984, Treatment of gatric ulcer with ranitidine, Scand. J. Gastroenterol. 19:119–121.Google Scholar
  114. 114.
    Patty, I., Benedek, S., Dejak, G., Javor, T., Kenzez, P., Morzon, F., Nagy, L., Simon, L., Tzarnor, F., and Mzozsik, G., 1983, Cytoprotective effect of vitamin A and its clinical importance in the treatment of patients with chronic gastric ulcer. Int. J. Tissue React. 5:301–307.PubMedGoogle Scholar
  115. 115.
    Ries, R. K., Gilbert, D. A., and Katon, W., 1984, Tricyclic antidepressant therapy for peptic ulcer disease. Arch. Intern. Med. 144(3):566–569.PubMedCrossRefGoogle Scholar
  116. 116.
    Huttemann, W., Rohner, H. G., duBosque, G., Rehner, M., Hebbelin, H., Martens, W., Horstkotte, W., and Dammann, H. G., 1986, Oral omeprazole, 20 mg vs. 30 mg once daily. Effect of healing rates on 115 duodenal ulcer patients, Scand. J. Gastroenterol. 21(Suppl 118):173–174.CrossRefGoogle Scholar
  117. 117.
    Smallwood, R. A., Pritchard, P. J., Rubinstein, D., Brian-Jones, D., Dudley, F. J., Louis, W. J., and Yeumans, N. J., 1986, Double blind comparison of omeprazole, 10 mg versus 30 mg for healing duodenal ulcers, Scand. J. Gastroenterol. 21(Suppl 118):17l-172.CrossRefGoogle Scholar
  118. 118.
    Walan, A., 1986, Treatment of duodenal ulcer disease: Clinical results with omeprazole, Scand. J. Gastroenterol. 21(Suppl 118):118–122.CrossRefGoogle Scholar
  119. 119.
    McArthur, K. E., Collen, M. J., Maton, P. N., Cherner, J. A., Howard, J. M., Ciarleglio, C. A., Cornelius, M. J., Jensen, R. T., and Gardner, J. D., 1986, Omeprazole—An effective drug for Zollinger-Ellison syndrome, Scand. J. Gastroenterol. 21(Suppl 118):182–183.CrossRefGoogle Scholar
  120. 120.
    Boyd, E. J., Wilson, J. A., and Wormsley, K. G., 1983, Review of ulcer treatment: role of ranitidine,J. Clin. Gastroenterol. l(Suppl):133–141.Google Scholar
  121. 121.
    Sonnenberg, A., Muller-Lissner, S. A., Votel, E., Schmid, P., Gonvers, J. J., Peter, P., Strohmeyer, G., and Blum, A. L., 1981, Predictors of duodenal ulcer healing and relapse. Gastroenterology 81(6): 1061–1067.PubMedGoogle Scholar
  122. 122.
    Patwardhan, R. V., Johnson, R. F., Sinclair, A. P., Schenker, S., and Speeg, K. v., 1981, Lack of tolerance and rapid recovery of cimetidine-inhibited chlordiazepoxide (Librium) elimination, Gastroenterology 81(3):547–551.PubMedGoogle Scholar
  123. 123.
    Klotz, U. and Reimann, I., 1980, Delayed clearance of diazepam due to Cimetidine, N. Engl. J. Med. 302(18):1012–1014.PubMedCrossRefGoogle Scholar
  124. 124.
    Patwardhan, R. V., Yarborough, G. W., and Desmond, P. V., 1980, Cimetidine spares the glucuronidation of Lorazepam and Oxazepam, Gastroenterology 79(5, Pt.l):912–916.PubMedGoogle Scholar
  125. 125.
    Roberts, R. K., Grice, J., Wood, L., Petroff, V., and McGuffie, G., 1981, Cimetidine impairs elimination of theophylline and antipyrine. Gastroenterology 81(1):19–21PubMedGoogle Scholar
  126. 126.
    Silver, B. A. and Bell, W. R., 1979, Cimetidine potentiation of the hypoprothrombinemic effect of warfm, Ann. Intern. Med. 90(3):348–349.PubMedGoogle Scholar
  127. 127.
    Solvell, L., 1986, Safety aspects of omeprazole, Scand. J. Gastroenterol. 21(Suppl 118):129–135.CrossRefGoogle Scholar
  128. 128.
    Pillay, S. P., Hardie, L R., and Burnett, W., 1981, Emergency surgery for the complication of peptic ulcer in the elderly, Aust. NZ J. Surg. 51:590- 594.CrossRefGoogle Scholar
  129. 129.
    Brooks, J. R. and Eraklis, A. J., 1964, Factors affecting the mortality from peptic ulcer. The bleeding ulcer and ulcer in the aged, N. Engl. J. Med. 271:803–809.PubMedCrossRefGoogle Scholar
  130. 130.
    Silverstein, F. E., Gilbert, D. A., Tedesco, F. J., Buenger, N. K., and Pers- ing, J., 1981, The national ASGE survey on upper gastrointestinal bleeding. IL Clinical prognostic factors, Gastrointest. Endosc. 27(2):80–93.PubMedCrossRefGoogle Scholar
  131. 131.
    Allan, R. and Dykes, P. A., 1976, A study of factors influencing mortality rates from gastrointestinal hemorrhage, Q.J. Med. 45(180):533–550.PubMedGoogle Scholar
  132. 132.
    Bornman, P. C., Theodorou, N. A., Shuttleworth, R. D., Essel, H. P., and Marks, L N., 1985, Importance of hypovolemic shock and endoscopy signs in predicting recurrent haemorrhage from peptic ulcer: A prospective study, Br. Med. J. 291:245–247.CrossRefGoogle Scholar
  133. 133.
    Eschar, J., Pavlotsky, M. M., Cohen, L., and Tabac, C., 1986, Gastrointestinal endoscopy in octagenarians,J. Clin. Gastroenterol. 8:520–524.CrossRefGoogle Scholar
  134. 134.
    Swain, C. P., Blown, S. G., Storey, D. W., Kirkham, J. S., Northfield, T. C., and Salmon, P. R., 1981, Controlled trial of argon laser photo-coagulation in bleeding peptic ulcers. Lancet 2:1313–1316.PubMedCrossRefGoogle Scholar
  135. 135.
    Luk, G. D., Bynum, T. E., and Hendrix, T. R., 1979, Gastric aspiration of localization of gastrointestinal hemorrhage,JAMA 241(6):576–578.PubMedCrossRefGoogle Scholar
  136. 136.
    Bernuau, J., Nouel, O., Belghiti, J., and Rueff, B., 1981, Severe upper gastrointestinal bleeding. Part III: Guidelines for treatment, Clin. Gastroenterol. 10(l):38–59.PubMedGoogle Scholar
  137. 137.
    Kayasseh, L., Gyr, K., Keller, U., Stalder, G. A., and Wall, M., 1980, Somatostatin and Cimetidine in peptic ulcer hemorrhage: A randomized controlled trial, Lancet 1:844–848.PubMedCrossRefGoogle Scholar
  138. 138.
    Collins, R. and Langman, M., 1985, Treatment with histamine H2-antagonists in acute upper gastrointestinal hemorrhage: Implications of randomized trials, N. Engl J. Med. 313(11):660–666.PubMedCrossRefGoogle Scholar
  139. 139.
    Protell, R. L., Silverstein, F. E., Gilbert, D. A., and Feld, A. D., 1981, Severe upper gastrointestinal bleeding. Part I: Causes, pathogenesis and methods of diagnosis, Clin. Gastroenterol 10(1): 17–26.PubMedGoogle Scholar
  140. 140.
    Walt, R., Katschinski, B., Logan, R., Ashley, J., and Langman, M., 1986, Rising frequency of ulcer perforation in elderly people in United Kingdom, Lancet 1:489–492.PubMedCrossRefGoogle Scholar
  141. 141.
    Mattingly, S. S. and Griffen, W. O., Jr., 1980, Factors influencing morbidity and mortality in perforated duodenal ulcer. Am. Surg. 46(2):61–66.PubMedGoogle Scholar
  142. 142.
    Coleman, J. A. and Denham, M. J., 1980, Perforation of peptic ulceration in the elderly, Age Ageing 9(4):257–261.PubMedCrossRefGoogle Scholar
  143. 143.
    Sommerville, K., Faulkner, G., and Langhan, M., 1986, Nonsteroidal antiinflammatory drugs and bleeding peptic ulcer. Lancet 1:462–464.CrossRefGoogle Scholar
  144. 144.
    Sirinek, K. R., Levine, B. A., Schwesinger, W. J., and Aust, J. B., 1981, Simple closure of perforated peptic ulcer: Still an effective treatment for patients with delay in treatment. Arch. Surg. 116:591–596.PubMedCrossRefGoogle Scholar
  145. 145.
    Kirkpatrick, J. R. and Bouwman, D. L., 1980, A logical solution to the perforated ulcer controversy, Surg. Gynecol Obstet. 150(5):683–686.PubMedGoogle Scholar
  146. 146.
    Nussbaum, M. S. and Schusterman, M. A., 1985, Management of giant duodenal ulcer, Am. J. Surg. 149(3):357–361.PubMedCrossRefGoogle Scholar
  147. 147.
    Lumsden, K., Maclarnon, J. C., and Dawson, J., 1970, Giant duodenal ulcer. Gut 11:592–599.PubMedCrossRefGoogle Scholar
  148. 148.
    Eisenberg, R. L., Margulis, A. R., and Moss, A. A., 1978, Giant duodenal ulcers, Gastrointest. Radiol 2(4):347–353.PubMedGoogle Scholar
  149. 149.
    Klamer, T. W. and Mahr, M. M., 1978, Giant duodenal ulcer: A dangerous variant of a common illness, Am. J. Surg. 135(6):760–762.PubMedCrossRefGoogle Scholar
  150. 150.
    Oshita, Y., Okazki, Y., Takemoto, T., and Kawai, K., 1986, What are the signs of recent hemorrhage and what do they mean? Criteria for massive bleeding, Endoscopy 18(Suppl 2): 11–14.PubMedCrossRefGoogle Scholar
  151. 151.
    Dronfield, M. W., Atkinson, M., and Langman, M. J. S., 1979, Effect of different operation policies on mortality from bleeding peptic ulcer, Lancet 1:1126–1128.PubMedCrossRefGoogle Scholar
  152. 152.
    Himal, H. S., Perrault, C., and Mzabi, R., 1978, Upper gastrointestinal hemorrhage: Aggressive management decreases mortality. Surgery 84(4):448–454.PubMedGoogle Scholar
  153. 153.
    Rossi, R. L., Braasch, J. W., Cady, B., and Sedgwick, C. E., 1981, Parietal cell vagotomy for intractable and obstructing duodenal ulcer. Am. J. Surg. 141(4):482–486.PubMedCrossRefGoogle Scholar
  154. 154.
    Pemberton, J. H. and Van Heerden, J. A., 1980, Vagotomy and pyloroplasty in the treatment of duodenal ulceration: Long-term results, Mayo Clin. Proc. 55(1): 14–18.PubMedGoogle Scholar
  155. 155.
    Rossi, R. L., Dial, P. F., Georgi, P., Braasch, J. W., and Shea, J. H., 1986, A five to ten year follow-up study of parietal cell vagotomy, Surg. Gynecol. Obstet. 162:301–306.PubMedGoogle Scholar
  156. 156.
    Madden, G. J., Britten-Jones, R., Hetzel, D. J., Clifton, P. M., Kiroff, G. K., and Jamieson, G. G., 1984, Symptomatic and asymptomatic ulcer recurrence following highly selective vagotomy, Surg. Gastroenterol. 3:29—33.Google Scholar
  157. 157.
    Adkins, R. B., Jr., DeLozier, J. B., III, Scott, H. M., Jr., and Sawyer, J. L., 1985, The management of gastric ulcers: A current review, Ann. Surg. 201(6):741–751PubMedCrossRefGoogle Scholar
  158. 158.
    Bader, J. R., 1985, The surgical treatment of peptic ulcer disease: A physician’s view. Dig. Dis. Sci. 30(Suppl ll):525–545.Google Scholar
  159. 159.
    Chatterfer, D., 1976, Idiopathic chronic gastritis, Surg. Gynecol. Obstet. 143:986–1000.Google Scholar
  160. 160.
    Siurala, M., 1974, Atrophic gastritis; a possible pre-cancerus condition, Neoplasma 21:253.PubMedGoogle Scholar
  161. 161.
    Salmeron, M., Desplaces, N., La verenge. A., and Hodart, R., 1986, Campylobacter-like organisms and acute purulent gastritis, Lancet 2:975–976.PubMedCrossRefGoogle Scholar
  162. 162.
    Palmer, E. D., 1981, Idiopathic gastritis, Am. Fam. Physician 23(6):167–17l.PubMedGoogle Scholar
  163. 163.
    Strickland, R. G., Fisher, J. M., Lewin, K., and Taylor, K. B., 1973, The response to prednisolone in atrophic gastritis; a possible effect on non- intrinsic factor-mediated vitamin B 12 absorption, Gut 14:13–19.PubMedCrossRefGoogle Scholar
  164. 164.
    Clearfield, H., 1981, Drug therapy of ascites. Am. Fam. Physician 23(1):204- 205.PubMedGoogle Scholar
  165. 165.
    Hoyumpa, A. M., Jr., Desmond, P. V., Avant, G. R., Roberts, R. K., and Schenker, S., 1979, Hepatic encephalopathy (clinical conference), Gastroenterology 76(1): 184–195.PubMedGoogle Scholar
  166. 166.
    Webber, F. L., 1981, Therapy of portal systemic encephalopathy: the practical and promising (editorial). Gastroenterology 81:174–177.Google Scholar
  167. 167.
    Tygstrup, N. and Ranek, L., 1981, Fulminant hepatic failure, Clin. Gastroenterol. 10(1): 191–208.PubMedGoogle Scholar
  168. 168.
    Kaplan, M. M., 1980, Liver dysfunction secondary to congestive heart failure, Pract. Cardiol. 6:39–47.Google Scholar
  169. 169.
    Gonzales, C., Cochrane, A. M. G., Eddleston, A. L. W. F., and Williams, R., 1979, Mechanisms responsible for antibody-dependent, cell-mediated cytotoxicity to isolated hepatocytes in chronic active hepatitis. Gut 20(5):385–388.PubMedCrossRefGoogle Scholar
  170. 170.
    Wands, J. R., Perrotto, J. L., and Albert, F., 1975, Cell-mediated immunity in acute and chronic hepatitis, J. Clin. Invest. 55(5):921–929.PubMedCrossRefGoogle Scholar
  171. 171.
    Jacobson, I. M. and Dienstag, J. L. 1984, The delta hepatitis agent: “Viral hepatitis, type B,” Gastroenterology 86:1614–1617.PubMedGoogle Scholar
  172. 172.
    Knodell, R. G., Conrad, M. F., and Ishak, K. G., 1977, Development of chronic liver disease after acute non-A, non-B post-transfusion hepatitis. Gastroenterology 72(5 Pt.l):902–909.PubMedGoogle Scholar
  173. 173.
    Koretz, R. L., Stone, O., and Gitnick, G. L., 1980, The long-term course of non-A, non-B post-transfusion hepatitis. Gastroenterology 79(5):893–898.PubMedGoogle Scholar
  174. 174.
    Dienstag, J. L. and Alter, H. J., 1986, Non-A-non-B hepatitis: Evolving epidemiologic and clinical perspectives, Semin. Liver Dis. 6:67–81.PubMedCrossRefGoogle Scholar
  175. 175.
    Lam, K. C., Lai, C. L., Trepo, C., and Wu, P. C., 1981, Deleterious effect of prednisolone in HBsAg-positive chronic active hepatitis, N. Engl. J. Med. 304(7):380–386.PubMedCrossRefGoogle Scholar
  176. 176.
    Sherlock, S. and Thomas, H. C., 1985, Treatment of chronic hepatitis due to hepatitis B virus. Lancet 2:1343–1346.PubMedCrossRefGoogle Scholar
  177. 177.
    Perrillo, R. P., Regenstein, F. G., Bodicky, C. J., Campbell, C. R., Saunders, G. E., and Sunwoo, Y. C., 1985, Comparative efficacy of adenine ara- binoside-5-monophosphate and prednisone withdrawal followed by adenine arabinoside-5-monophosphate in the treatment of chronic active hepatitis B, Gastroenterology 88(3):780–786.PubMedGoogle Scholar
  178. 178.
    Vokosuka, O., Omata, M., Imazeki, F., et al., 1985, Combination of short- term prednisolone and adenine arabinoside in the treatment of chronic hepatitis B. A controlled study. Gastroenterology 89:246–251.Google Scholar
  179. 179.
    Heaton, K. W., 1973, The epidemiology of gallstones and suggested aetiology, Clin. Gastroenterol. 2:67–83.PubMedGoogle Scholar
  180. 180.
    Bateson, M. C., 1984, Gallbladder disease and cholecystectomy rate are independently variable. Lancet 2:621–624.PubMedCrossRefGoogle Scholar
  181. 181.
    Glenn, F., 1981, Surgical management of acute cholecystitis in patients 65 years of age and older, Ann. Surg. 193:56–59.PubMedCrossRefGoogle Scholar
  182. 182.
    Bouchier, I. A. D., 1969, Postmortem study of frequency of gallstones in patients with cirrhosis of the liver. Gut 10:705–710.PubMedCrossRefGoogle Scholar
  183. 183.
    Pattinson, N. R. and Chapman, B. A., 1986, Distribution of biliary cholesterol between mixed micelles and non-micelles in relation to fasting and feeding in humans. Gastroenterology 91:697–701.PubMedGoogle Scholar
  184. 184.
    Heaton, K. W. and Read, A. G., 1969, Gallstones in patients with disorders of terinal ileum and disturbed bile salt metabolism, Br. Med. J. 111:494- 496.CrossRefGoogle Scholar
  185. 185.
    Bouchier, I. A. D., 1973, The biochemistry of gallstone formation, Clin. Gastroenterol. 2:49–66.PubMedGoogle Scholar
  186. 186.
    Ahlber, J., Angelin, B., and Einarsson, L., 1981, Hepatic 3-hydroxy 3- methylglutaryl coenzyme A reductase activity and biliary lipid composition in man; relation to cholesterol gallstone disease and effects of cholic acid and chenodeoxycholic acid treatment,J. Lipid Res. 22:410–422.Google Scholar
  187. 187.
    Mok, H. Y. I., Von Bergmann, K., and Grundy, S. M., 1980, Kinetics of enteropathic circulation during fasting: Biliary lipid secretion and gallbladder storage. Gastroenterology 78:1023–1033.PubMedGoogle Scholar
  188. 188.
    Misra, P. S. and Bank, S., 1982, Gallbladder disease: Guide to diagnosis, Hosp. Med. 18:109–138.Google Scholar
  189. 189.
    Thistle, J. L., Cleary, P. A., Lachin, J. M., Tyor, M. P., and Hersh, T., 1984, The Steering Committee: 1984: The natural history of cholelithiasis: The National Cooperative Gallstone Study, Ann. Intern. Med. 101:171–175.PubMedGoogle Scholar
  190. 190.
    Croker, J. R., 1985, Biliary tract disease in the elderly, Clin. Gastroenterol. 14:773–809.PubMedGoogle Scholar
  191. 191.
    Bateson, M. C., 1986, Gallstone disease: Present and future. Lancet 2:1265–1267.PubMedCrossRefGoogle Scholar
  192. 192.
    Leuschner, U., 1986, Endoscopic therapy of biliary calculi, Clin. Gastroenterol. 15:333–358.PubMedGoogle Scholar
  193. 193.
    Schoenfield, L. J. and Lachin, J. M., 1981, The Steering Committee and the National Cooperative Gallstone Study Group, chenodiul (chendeox- ycholic acid) for dissolution of gallstones, the National Cooperative Gallstone Study, a controlled trial of efficacy and safety, Ann. Intern. Med. 95:257–282.PubMedGoogle Scholar
  194. 194.
    Bateson, M. C., 1982, Dissolving gallstones, Br. Med. J. 284:1–3.CrossRefGoogle Scholar
  195. 195.
    Freilich, H. S., Malet, P. E., Schwartz, J. S., and Soloway, R. D., 1986, Chemical and morphologic characteristics of cholesterol gallstones that failed to dissolve on Chenodiol. The national cooperative gallstone study. Gastroenterology 91:713–718.PubMedGoogle Scholar
  196. 196.
    From, H., 1984, Gallstone dissolution and the cholesterol-lipoprotein axis. Propitious effects of ursodeoxycholic acid, Gastroenterology 87:229–233.Google Scholar
  197. 197.
    Toulet, J., Rousselet, J., Viteau, J. M., etal., 1984, Dissolutions incompletes des calculs. Calcifications cholecystectomies, apres treatment de la lithiase vesiculaire par I’acide chenodesoxycholequie, Gastroenterol. Clin. Biol. 7:969–974.Google Scholar
  198. 198.
    Allen, M. J., Borody, T. J., Bugliosi, T. F., May, G. R., LaRusso, N. F., and Thistle, J. L., 1985, Rapid dissolution of gallstones by methyl tert-butyl ether. Preliminary observations, N. Engl. J. Med. 312(4):217–220.PubMedCrossRefGoogle Scholar
  199. 199.
    DiPadova, C., DiPadova, F., Montorsi, W., and Tritapepe, R., 1986, Methyl tert-butyl ether fails to dissolve retained radioluscent common bile duct stones. Gastroenterology 91:1296–1300.Google Scholar
  200. 200.
    Thistle, J. L., Carlson, G. L., and Hofmann, A. F., 1980, Monooctanoin, a dissolution agent for retained cholesterol bile duct stones: Physical properties and clinical application. Gastroenterology 78:1016–1022.PubMedGoogle Scholar
  201. 201.
    Mitzel, L., Wiederholt, J., and Wolbergs, F., 1981, Dissolution of retained duct stones by perfusion with monooctanoin via a teflon catheter introduced endoscopically, Gastrointest. Endosc. 27:63–65.CrossRefGoogle Scholar
  202. 202.
    Palmer, K. R. and Hofmann, A. F., 1984, Mono-octanoin therapy: A combined experience in 343 cases of retained biliary calculi. Gut 25:A1172.CrossRefGoogle Scholar
  203. 203.
    Abate, M. A. and Moore, T. L., 1985, Monooctanoin use for gallstone dissolution, Drug Intell. Clin. Pharm. 19:708–713.PubMedGoogle Scholar
  204. 204.
    Gadacz, T. R., 1985, Ultrasonic fragmentation of gallstones in vitro. Surgery 97(5):511–513.PubMedGoogle Scholar
  205. 205.
    Shimada, J., Inamatsu, T., and Yamashiro, M., 1977, Anaerobic bacteria in biliary disease in elderly patients, J. Infect. Dis. 135:850–854.PubMedCrossRefGoogle Scholar
  206. 206.
    Munster, A. M., Goodwin, M. N., and Pruitt, B. A., 1971, Acalculous cholecystitis in burned patients, Am. J. Surg. 122:591–593.PubMedCrossRefGoogle Scholar
  207. 207.
    Morrow, D. J., Thomason, J., and Wilson, S. E., 1978, Acute cholecystitis in the elderly: A surgical emergency. Arch. Surg. 113:1149–1152.PubMedCrossRefGoogle Scholar
  208. 208.
    Cobden, L, Venables, C. W., Lendrum, R., and James, O. F. W., 1984, Gallstones presenting as mental and physical disability in the elderly. Lancet 1:1062–1063.PubMedCrossRefGoogle Scholar
  209. 209.
    Prian, G. W., Norton, L. W., and Fule, J., Jr., 1977, Clinical indications and accuracy of gray scale ultrasonography in the patient with suspected biliary tract disease, Am. J. Surg. 134:705–711.PubMedCrossRefGoogle Scholar
  210. 210.
    Thornell, F., Jansson, R., and Svanik, J., 1982, Indomethacin intravenously: a new way for effective relief of biliary pain: A double blind study in man, Surgery 90:468–472.Google Scholar
  211. 211.
    Salleh, H. B. M. and Balasegaram, M., 1974, Treatment of acute cholecystitis by routine urgent operation, Br. J. Surg. 61:705–708.PubMedCrossRefGoogle Scholar
  212. 212.
    MacDonald, J. A., 1974, Early cholecystectomy for acute cholecystitis, Can. Med. Assoc.; 111:796–799.Google Scholar
  213. 213.
    Geokas, M. C., Von Lancker, J. L., and Kadell, B. M., 1972, Acute pancreatitis, Ann. Intern. Med. 76:105–117.PubMedGoogle Scholar
  214. 214.
    Ranson, J. H., 1982, Etiological and prognostic factors in human acute pancreatitis: A review. Am. J. Gastroenterol 77(9):633–638.PubMedGoogle Scholar
  215. 215.
    Corfield, A. P., Cooper, M. J., and Williamson, R. C., 1985, Acute pancreatitis: A lethal disease of increasing incidence. Gut 26(7):724–729.PubMedCrossRefGoogle Scholar
  216. 216.
    Seligson, V. 1982, Diagnostic criteria, classification and clinical coarse in pancreatitis. Acta Chir. Scand. 512(Suppl):l-54.Google Scholar
  217. 217.
    Sarles, H., 1970, Pancreatitis, in: Symposium of Marseille (H. Sarles, ed.). Karger, Basel.Google Scholar
  218. 218.
    Durbel, J. P. and Sarles, H., 1978, Multi-center survey on the etiology of pancreatic disease: Relationship between the relative risk of developing chronic pancreatitis and alcohol, protein and lipid consumption, Digestion 18:337–350.CrossRefGoogle Scholar
  219. 219.
    Sarles, H. and Laugler, R., 1981, Alcoholic pancreatitis, Clin. Gastroenterol. 10:401–415.PubMedGoogle Scholar
  220. 220.
    Renner, I. G., Rinderkneght, H., and Douglas, A. P., 1978, Profiles of pure pancreatic secretionin patients with acute pancreatitis: The possible role of proteolytic enzymes in pathogenesis. Gastroenterology 75:1090–1098.PubMedGoogle Scholar
  221. 221.
    Guy, O., Robles-Diaz, G., Adrich, Z., Sahel, J., and Sarles, H., 1983, Protein content of precipitates present in pancreatic juice of alcoholic subjects and patients with chronic calcifying pancreatitis. Gastroenterology 84:102–107.PubMedGoogle Scholar
  222. 222.
    Acosta, J. M. and Ledesma, C. L., 1974, Gallstone migration as a cause of acute pancreatitis, N. Engl. J. Med. 290:484.PubMedCrossRefGoogle Scholar
  223. 223.
    Acosta, J. M., Ross, R., and Galli, O. M. R., 1978, Early surgery for acute gallstone pancreatitis: Evaluation of a septemic approach. Surgery 83:367–370.PubMedGoogle Scholar
  224. 224.
    Bradley, E. L., Hall, J. R., Lutz, J., Hammer, L., and Latouf, D., 1983, Hemodynamic consequences of acute pancreatitis, Ann. Surg. 198:130–133.PubMedCrossRefGoogle Scholar
  225. 225.
    Fita, R. H., 1889, Acute pmcreatitis, Boston Med. Surg. J. 120:181, 205, 229.Google Scholar
  226. 226.
    Durr, G. H. K., 1979, Acute pancreatitis, in: The Exocrine Pancreas (H. T. Howat and H. Sarles, eds.), Saunders, Philadelphia, pp. 352–401.Google Scholar
  227. 227.
    Multigner, L., Zigarella, C., Sahel, J., and Sarles, H., 1981, Lactoferrin and albumin in human pancreatic juice: A valuable test for diagnosis of pancreatic disease, Dig. Dis. Sci. 25:173–178.CrossRefGoogle Scholar
  228. 228.
    Blamey, S. L., Osborne, D. H., Gilmour, W. H., O’Neill, J., Carter, D. G., and Imrie, G. W., 1983, The early identification of patients with gallstone associated pancreatitis using clinical and biochemical factors only, Ann. Surg. 198:574–578.PubMedCrossRefGoogle Scholar
  229. 229.
    Coppa, G. F., Lefleur, R., and Ransom, J. H., 1981, The role of chibaneedle cholangiography in the diagnosis of possible acute pancreatitis with cholelithiasis, Ann. Surg. 193:393–398.PubMedCrossRefGoogle Scholar
  230. 230.
    Anderson, J. R., Spence, R. A., Laird, J. D., Ferguson, W. R., and Kennedy, T. L., 1983, Initial experience with indium III autologous imaging in patients with acute pancreatitis, Br. Med. J. 287:637–638.CrossRefGoogle Scholar
  231. 231.
    Gauthier, A., Escoffer, J. M., Camatte, R., and Sarles, H., 1981, Severe acute pancreatitis, Clin. Gastroenterol. 10:209–224.PubMedGoogle Scholar
  232. 232.
    Ranson, J. H. C., Rifkind, K. M., Roses, D. F., Fink, S. D., Ene, K., and Spencer, F. C., 1974, Prognostic signs and the role of operative management in acute pancreatitis, Surg. Gynecol. Obstet. 139:69–87.PubMedGoogle Scholar
  233. 233.
    Lange, P. and Pedersen, I., 1983, Initial treatment of acute pancreatitig, Surg. Gynecol. Obstet. 157:332–334.PubMedGoogle Scholar
  234. 234.
    Lankisch, P. G., 1984, Acute chronic pancreatitis: An update on management, Drugs 28:554–564.PubMedCrossRefGoogle Scholar
  235. 235.
    Wall, A. J. P., 1965, Peritoneal dialysis in the treatment of severe acute pancreatitis, Med. J. Aust. 2:281–284.PubMedGoogle Scholar
  236. 236.
    Balldin, G. and Ohlsson, K., 1979, Demonstration of pancreatic protease- antiprotease complexes in the peritoneal fluid of patients with acute pancreatitis, Surgery 85:451–456.PubMedGoogle Scholar
  237. 237.
    Mayer, D. A., McMahon, M. J., Corfield, A. P., Cooper, M. J., Williamson, R. C. N., Dickson, A. P., Shearer, M. G., and Imrie, C. W., 1985, Controlled clinical trial of peritoneal lavage for the treatment of severe acute pancreatitis, N. Engl J. Med. 312:399–404.PubMedCrossRefGoogle Scholar
  238. 238.
    Martin, J. K., VanHeerden, J. A., and Bess, M. A., 1984, Surgical management of acute pancreatitis. Mayo Clin. Proc. 59:259–267.PubMedGoogle Scholar
  239. 239.
    Aldridge, M. C., Ornstein, M., Glazer, G., and Dudley, H. A. F., 1985, Pancreatic resection for severe acute pancreatitis, B.J. Surg. 72:796–800.CrossRefGoogle Scholar
  240. 240.
    Warshaw, A. L., Imbembo, A. L., and Civetta, J. M., 1974, Surgical intervention in acute necrotizing pancreatitis, Am. J. Surg. 127:484–491.PubMedCrossRefGoogle Scholar
  241. 241.
    Frey, C. F., 1981, Gallstone pancreatitis, Surg. Clin. North Am. 61:923–938.PubMedGoogle Scholar
  242. 242.
    Ranson, J. H. C., 1979, The timing of biliary surgery in acute pancreatitis, Ann. Surg. 189:654–663.PubMedCrossRefGoogle Scholar
  243. 243.
    Linas, D. A. and Adson, M. D., 1983, Gallstone pancreatitis. Int. Surg. 68:153–156.Google Scholar
  244. 244.
    Heij, H. A., Veen, H. F., Egging, W. F., and Oberjop, H., 1985, Timing of surgery for acute biliary pancreatitis, Am. J. Surg. 149(3):371–374.PubMedCrossRefGoogle Scholar
  245. 245.
    Laugier, R. and Sarles, H., 1985, The pancreas, Clin. Gastroenterol. 14:749–756.PubMedGoogle Scholar
  246. 246.
    Semel, L., Schreiber, D., and Bromm, D., 1983, Gallstone pancreatitis: Support for a flexible approach. Arch. Surg. 118:901–904.PubMedCrossRefGoogle Scholar
  247. 247.
    Rosseland, A. R. and Solhaug, J. H., 1984, Early or delayed endoscopic papillotomy (EPT) in gallstone pancreatitis, Ann. Surg. 199:165–167.PubMedCrossRefGoogle Scholar
  248. 248.
    Frey, C. F., Lindinauer, S. M., and Miller, T. A., 1979, Pancreatic abscess, Surg. Gynecol. Obstet. 149:722–726.PubMedGoogle Scholar
  249. 249.
    Frey, C. F., 1978, Pancreatic pseudocysts: Operative strategy, Ann. Surg. 188:652–662.PubMedCrossRefGoogle Scholar
  250. 250.
    Robertson, G. M., Jr., Moore, E. W., and Switz, D. M., 1976, Inadequate parathyroid response in acute pancreatitis, N. Engl. J. Med. 294:512–516.PubMedCrossRefGoogle Scholar
  251. 251.
    McWilliams, H. and Gross, R., 1974, Pancreatitis and the lungs, Ann. Surg. 40:448–452.Google Scholar
  252. 252.
    Agha, F. P., 1984, Spontaneous resolution of acute pancreatic pseudocysts, Surg. Gynecol. Obstet. 158:22–26.PubMedGoogle Scholar
  253. 253.
    Rosenberg, I. K., Kahn, J. A., and Walt, A. J., 1969, Surgical experience with pancreatic pseudocysts. Am. J. Surg. 117:11–17.PubMedCrossRefGoogle Scholar
  254. 254.
    Cameron, J. L., 1978, Chronic pancreatitic ascites and pancreatic pleural effusions. Gastroenterology 74:134–140.PubMedGoogle Scholar
  255. 255.
    Sankaran, S. and Walt, A. J., 1976, Pancreatic ascites: recognition and management, Arch. Surg. 111:430–434.PubMedCrossRefGoogle Scholar
  256. 256.
    Malt, R. A., 1986, The perforated appendix: Editorial, N. Engl J. Med. 315:1546–1547.PubMedCrossRefGoogle Scholar
  257. 257.
    Pieper, R., Forsell, P., and Kager, L., 1986, Perforating appendicitis: A nine-year survey of treatment and results, Acta Chir. Scand. 530(Suppl):51–57.Google Scholar
  258. 258.
    Gaffney, P. R.. 1984, Wound infections in appendicitis: Effective prophylaxis, World J. Surg. 8 (3):287–292.PubMedCrossRefGoogle Scholar
  259. 259.
    Mayo, W. J., 1930, Diverticular of the sigmoid, Ann. Surg. 92:739–743.PubMedCrossRefGoogle Scholar
  260. 260.
    Connell, A. M., 1977, Pathogenesis of diverticular disease of the colon. Adv. Intern. Med. 22:377–395.PubMedGoogle Scholar
  261. 261.
    Eastwood, M. A., Smith, A. N., Brydon, W. G., and Pritchard, J., 1978, Colonic function in patients with diverticular disease. Lancet 1:1181–1182.PubMedCrossRefGoogle Scholar
  262. 262.
    Kyle, J. and Davidson, A. I., 1975, The changing pattern of hospital admissions for diverticular disease of the colon, Br. J. Surg. 62:537–541.PubMedCrossRefGoogle Scholar
  263. 263.
    Whiteway, J. and Morson, B. C., 1985, Pathology of the ageing—Diverticular disease, Clin. Gastroenterol. 14:829–846.PubMedGoogle Scholar
  264. 264.
    Painter, N. S. and Burkitt, D. P., 1975, Diverticular disease of the colon, Clin. Gastroenterol. 4:3–21.PubMedGoogle Scholar
  265. 265.
    Ornstein, M. H., Littlewood, E. R., and Baird, I. M., 1981, Are fiber supplements really necessary in diverticular disease of the colon? A controlled clinical trial, Br. Med. J. 282:1353–1356.CrossRefGoogle Scholar
  266. 266.
    Taylor, R. H., 1984, Bran yesterday-bran tomorrow, Br. Med. J. 289:69–70.CrossRefGoogle Scholar
  267. 267.
    Barling, S., 1926, The peridiverticular state and diverticulosis, Br. Med. J. 1:322–323.Google Scholar
  268. 268.
    Weinreich, J. and Andersen, D., 1976, Intraluminal pressure in the sigmoid colon, I: Methods and results in normal subjects, Scand. J. Gastroenterol. 11:557–580.Google Scholar
  269. 269.
    Painter, N. S., 1985, The cause of diverticular disease of the colon, its symptoms and its complications. Review and hypothesis, J.R. Coll. Surg. Edinburgh 30(2): 118–122.Google Scholar
  270. 270.
    Hodgson, J. A. B., 1973, Transverse taeniomyotomy for diverticular disease, Dis. Colon Rectum 16(4):283–289.PubMedCrossRefGoogle Scholar
  271. 271.
    Almy, T. P. and Howell, D. A., 1980, Diverticular disease of the colon, N. Engl. J. Med. 302:324–331.PubMedCrossRefGoogle Scholar
  272. 272.
    Parks, T. G., 1975, Natural history of diverticular disease of the colon, Clin. Gastroenterol. 4:53–69.PubMedGoogle Scholar
  273. 273.
    Fleischner, F. G., 1966, The question of barium enema as a cause of perforation in diverticulitis, Gastroenterology 51:290–292.Google Scholar
  274. 274.
    Burakoff, R., 1981, An updated look at diverticular disease, Geriatrics 36:83–91.PubMedGoogle Scholar
  275. 275.
    Suits, G. S. and Knoepp, L. F., 1985, A community experience with entero- vesical fistulas. Am. Surg. 51(9):523–528.PubMedGoogle Scholar
  276. 276.
    Boley, S. J., DiBiase, A., Brandt, L. J., and Sammartano, R. J., 1979, Lower intestinal bleeding in the elderly, Am. J. Surg. 137:57–64.PubMedCrossRefGoogle Scholar
  277. 277.
    Hackford, A. W., Schoetz, D. J., Jr., Coller, J. A., and Veidenheimer, M. C., 1985, Surgical management of complicated diverticulitis: The Lahey Clinic experience, 1967 to 1982, Dis. Colon Rectum 28(5):317–321.PubMedCrossRefGoogle Scholar
  278. 278.
    Morson, B. C., 1976, Genesis or colorectal cancer, Clin. Gastroenterol. 5:505–525.PubMedGoogle Scholar
  279. 279.
    Grinnell, R. S. and Lane, N., 1958, Benign and malignant adenomatous polyps and papillary adenomas of the colon and rectum. An analysis of 1856 tumors in 1335 patients, Surg Gynecol. Obstet. 106:519–538.Google Scholar
  280. 280.
    Morson, B. G. and Bussey, H. J., 1985, Magnitude for risk for cancer in patients with colorectal adenomas, Br. J. Surg. 72(Suppl):S23–25.PubMedCrossRefGoogle Scholar
  281. 281.
    Schutte, A. G., 1973, Familial diffuse polyposis of the colon and rectum: Supplementary report on three pedigrees, Dis. Colon Rectum 16:517–523.PubMedCrossRefGoogle Scholar
  282. 282.
    Smith, W. G. and Kern, B. B., 1973, The nature of the mutation space in familial multiple polyposis: Papillary carcinoma of the thyroid, brain tumors, and familial multiple polyposis, Dis. Colon Rectum 16:264–271.PubMedCrossRefGoogle Scholar
  283. 283.
    Wolff, W. L and Shinya, H., 1973, Polypetomy via the fiberoptic colo- noscope: Removal of neoplasms beyond reach of the sigmoidoscope, N. Engl. J. Med. 288:329–332.PubMedCrossRefGoogle Scholar
  284. 284.
    Cheng, H., Bjerknes, M., Amar, J., and Gardiner, G., 1986, Crypt production in normal and diseased human colonic epithelium, Anat. Record 216:44–48.CrossRefGoogle Scholar
  285. 285.
    Muto, T., Bussey, H. J. R., and Morson, B. C., 1975, The evolution of cancer of the colon and rectum. Cancer 36:2251–2270.PubMedCrossRefGoogle Scholar
  286. 286.
    Oohara, T., Ogino, A., and Tohma, H., 1981, Histogenesis of microscopic adenoma and hyperplastic (metaplastic) gland in non-polyposis coli, Dis. Colon Rectum 24:375–384.PubMedCrossRefGoogle Scholar
  287. 287.
    Whitehead, R., 1975, Rectal polyps and their relationship to cancer, Clin. Gastroenterol. 4:545–561.PubMedGoogle Scholar
  288. 288.
    Chobanian, J., Cattau, E. L., VanNess, M., Powers, B. J., Winters, C., and Johnson, R. B., 1985, News report, Hosp. Pract. 20:147.Google Scholar
  289. 289.
    Fenoglio, C. M., Kaye, G. L, and Lane, N., 1973, Distribution of human colonic lymphatics in normal, hyperplastic and adenomatous tissue. Its relationship to metastasis from small carcinomas or pedunculated adenomas, with two case reports, Gastroenterology 64:51–66.PubMedGoogle Scholar
  290. 290.
    Williams, C. B., 1985, Polyp follow-up: How—who for and how often, Br. J. Surg 72:S25–26.PubMedCrossRefGoogle Scholar
  291. 291.
    Waye, J. D. and Braunfeld, S., 1982, Surveillance intervals after colonoscopic polypectomy, Endoscopy 14:79–81.PubMedCrossRefGoogle Scholar
  292. 292.
    Vellar, I. D. and Doyle, J. C., 1977, Acute mesenteric ischemia, Aust NZ J. Surg. 47:54–61.CrossRefGoogle Scholar
  293. 293.
    Ottinger, L. W., 1978, The surgical management of acute occlusion of the superior mesenteric artery, Ann. Surg. 188:721–731.PubMedCrossRefGoogle Scholar
  294. 294.
    Cooke, M. and Sande, M. D., 1983, Diagnosis and outcome of bowel infarction on an acute medical service. Am. J. Med. 75:984–991.PubMedCrossRefGoogle Scholar
  295. 295.
    McGregor, D. H., Pierce, G. E., Thomas, J. H., and Tiezer, K. L., 1980, Obstructive lesions of distal mesenteric arteries. A light and electron microscopic study, Arch. Pathol. Lab. Med. 104:79–83.PubMedGoogle Scholar
  296. 296.
    Ottinger, L. W. and Austen, W. G., 1967, A study of 135 patients with mesenteric infarction, Surg. Gynecol. Obstet. 124:251–261.PubMedGoogle Scholar
  297. 297.
    O’Donnel, J. A. and Hobson, R. W., 1980, Operative confirmation of Doppler ultrasound in evaluation of intestinal ischemia, Surgery 87:109–112.Google Scholar
  298. 298.
    Renton, C. J. C., 1972, Non-occlusive intestinal infarction, Clin. Gastroenterol. 1:655–674.Google Scholar
  299. 299.
    Saegesser, F., 1980, The acute abdomen: Part I; Differential diagnosis, Clin. Gastroenterol. 10:123–176.Google Scholar
  300. 300.
    MacCannell, K. L., 1986, Comparison of an intravenous selective mesenteric vasodilator with intra-arterial papaverine in experimental nonoc-clusive mesenteric ischemia. Gastroenterology 41:79–83.Google Scholar
  301. 301.
    Knot, E. A., TenCate, J. W., Beuin, T., Iburg, A. H., and Tytgat, G. N., 1985, Antithrombin III metabolism in two colitis patients with acquired antithrombin III deficiency. Gastroenterology 89:421–425.PubMedGoogle Scholar
  302. 302.
    Fiddian-Green, R. G., Amelin, P. M., Herrmann, J. B., Arous, E., Cutler, B. S., Schiedler, M., Wheeler, H. B., and Baker, S., 1986, Prediction of the development of sigmoidischemia on the day of aortic operations: Indirect measurements of intramural pH in the colon, Arch. Surg. 121:654–660.PubMedCrossRefGoogle Scholar
  303. 303.
    lida, M., Matsui, T., Fuchigami, T., Twashita, A., Yao, T., and Fusishima, M., 1986, Ischemic colitis: Serial changes in double contrast barium enema examination. Radiology 152:337–341.Google Scholar
  304. 304.
    Scowcroft, C. W., Sahawski, R. A., and Kozarek, R. A., 1981, Colonoscopy in ischemic colonoscopy, Gastrointest. Endosc. 27:156–161.PubMedCrossRefGoogle Scholar
  305. 305.
    Drossman, D. A., Sandler, R. S., McKee, D. C., and Lowitz, A. J., 1982, Bowel patterns among subjects not seeking health care. Gastroenterology 83:529–534.PubMedGoogle Scholar
  306. 306.
    Leonard-Jones, J. E., 1985, Pathophysiology of constipation, Br. J. Surg. 72:S7–8.CrossRefGoogle Scholar
  307. 307.
    Connell, A. M., Hilton, C., Irving, G., Leonard-Jones, G. E., and Misiewicz, I. J., 1965, Variations of bowel habit in two population samples, Br. Med. J. 5470(2): 1095–1099.CrossRefGoogle Scholar
  308. 308.
    Brocklehurst, J. C., 1985, Colonic disease in the elderly, Clin. Gastroenterol. 14:725–747.PubMedGoogle Scholar
  309. 309.
    Ritchie, J. A., 1986, Colonic motor activity at rest and after food and carbachol, Gut 9:502–511.CrossRefGoogle Scholar
  310. 310.
    Brocklehurst, J. C. and Kahn, Y., 1969, A study of fecal stasis in old age and the use of “dorbanex” in its prevention, Gerontol. Clin. (Basel) 11:293–300.CrossRefGoogle Scholar
  311. 311.
    Marzio, L., LanFranchi, G. A., Bazzocchi, G., and Cuccurullo, F., 1985, Anorectal motility and rectal sensitivity in chronic idiopathic constipation: Effect of high fiber diet, J. Clin. Gastroenterol 7:391–399.PubMedCrossRefGoogle Scholar
  312. 312.
    Barnes, P. R., Hawley, P. R., Preston, D. M., and Lennard-Jones, J. E., 1985, Experience of posterior division of the puborectalis muscle in the management of chronic constipation, Br. J. Surg. 72:475—477.PubMedCrossRefGoogle Scholar
  313. 313.
    Nivatvongs, S. and Hooks, V. H., 1983, Chronic constipation: Important aspects of workup and management. Postgrad. Med. 74:313–323.PubMedGoogle Scholar
  314. 314.
    Brocklehurst, J. C., 1980, Disorders of the lower bowel and in old age, Geriatrics 35:47–54.PubMedGoogle Scholar
  315. 315.
    Sandman, P. I., Adolfson, R., Hallmans, G., Nygren, C., Nystron, I. and Winblad, B., 1983, Treatment of constipation with high bran bread in long term care of severely demented elderly patients, J. Am. Geriatr. Soc. 31:283–293.Google Scholar
  316. 316.
    Fisher, M., Adkins, W., Hall, L., Seaman, P., Hsi, S., and Marlett, J., 1985, The effects of dietary fibre in a liquid diet on bowel function of mentally retarded individuals, J. Mental Defic. Res. 29:373–381.Google Scholar
  317. 317.
    Preston, D. M. and Lennard-Jones, J. C., 1985, Pelvic motility and response to intraluminal biscodyl in slow transit constipation. Dig. Dis. Sci. 30(4):289–294.PubMedCrossRefGoogle Scholar
  318. 318.
    Badiali, D., Marchessiano, A., Pallone, F., Paoluzi, P., Bausano, G., lan- noni, C., Materia, E., Anzini, F., and Corazziari, E., 1985, Melanosis of the rectum in patients with chronic constipation, Dis. Colon Rectum, 28:241–245.PubMedCrossRefGoogle Scholar
  319. 319.
    Smith, R. G., Currie, J. E. J., and Walls, A. D. F., 1978, Whole gut irrigation: a new treatment for constipation, Br. Med. J. 6134 (2):396–397.CrossRefGoogle Scholar
  320. 320.
    Duecher, F. and Nothiger, F., 1980, Stercoraceous perforation of the colon, Wien. Med. Wochenschr. 130:40–41.Google Scholar
  321. 321.
    Nelson, R. P. and Brugh, R., 1980, Bilateral ureteral obstruction secondary to massive fecal impaction, Urology 16:403–406.PubMedCrossRefGoogle Scholar
  322. 322.
    Lerman, B. B., Levin, M. L., and Patterson, R., 1979, Hepatic encephalopathy precipitated by fecal impaction. Arch. Intern. Med. 139:707–708.PubMedCrossRefGoogle Scholar
  323. 323.
    Gefalu, G. A., McKnight, G. T., and Pike, J. I., 1981, Treating impaction: a practical approach to an unpleasant problem. Geriatrics 36:143–146.Google Scholar
  324. 324.
    Tobin, G. W. and Brocklehurst, J. G., 1986, Fecal incontinence in Residential homes for the elderly: Prevalence, aetiology and management. Age Ageing 15:41–46.PubMedCrossRefGoogle Scholar
  325. 325.
    Schiller, L. R., 1986, Faecal incontinence, Clin. Gastroenterol. 15:687–704.PubMedGoogle Scholar
  326. 326.
    Meunier, P. and Mollard, P., 1977, Control of the internal anal sphincter (manometric study with human subjects). Pflügers Arch. 370:233–239.PubMedCrossRefGoogle Scholar
  327. 327.
    Beersiek, F., Parks, A. G., Swash, M., 1979, Pathogenesis of anorectal incontinence: A histiometric of the anal sphincter musculature, J. Neurol. Sci. 42:111–127.PubMedCrossRefGoogle Scholar
  328. 328.
    Bartolo, D. C. C., Jarratt, J. A., and Read, N. W., 1983, The cutaneo-anal reflex: A useful index of neuropathy? Br. J. Surg. 70:660–663.PubMedCrossRefGoogle Scholar
  329. 329.
    Read, M., Read, N. W., Barber, D. C., and Duthie, H. L., 1982, Effects of loperamide on anal sphincter function in patients complaining of chronic diarrhea with fecal incontinence and urgency. Dig. Dis. Sci. 27:807–814.PubMedCrossRefGoogle Scholar
  330. 330.
    O’Rourke, D. A. and Egerton, W. M., 1985, A puborectal sling in the management of anal incontinence and rectal prolapse, Aust. NZ J. Surg. 55:493–495.CrossRefGoogle Scholar
  331. 331.
    Sheehy, T. W., 1976, Diarrhea, J. Med. Assoc. St. Ala. 46(3):26–31.Google Scholar
  332. 332.
    Fortran, J. S., 1967, Speculations on the pathogenesis of diarrhea, Fed. Proc. 26:1404–1414.Google Scholar
  333. 333.
    Pentland, B. and Pennington, C. R., 1980, Acute diarrhea in the elderly, Age Ageing 9:90–92.PubMedCrossRefGoogle Scholar
  334. 334.
    Woodhouse, K. W., 1985, Drugs and the aging gut, liver, pancreas, Clin. Gastroenterol. 14:863–881.PubMedGoogle Scholar
  335. 335.
    Smith, I. M., 1977, Infections in the elderly. Continuing Education Fam. Phys. 7:18–29.Google Scholar
  336. 336.
    Jewkes, J., Larson, H. E., Price, A. D., Sanderson, P. J., and Davis, H. A., 1981, Aetiology of acute diarrhea in adults. Gut 22:388–392.PubMedCrossRefGoogle Scholar
  337. 337.
    George, W. L., Nakata, M. M., Thompson, J., and White, M. L., 1985, Aeromonas related diarrhea in adults. Arch. Intern. Med. 145:2207–2211.PubMedCrossRefGoogle Scholar
  338. 338.
    McEvoy, A., Dutton, J., and James, O. F. W., 1983, Bacterial contamination of the small intestine is an important cause of of occult malabsorption in the elderly, Br. Med. J. 287:789–799.CrossRefGoogle Scholar
  339. 339.
    Phillips, S. F., 1972, Diarrhea: A current view of the pathophysiology, Gastroenterology 63:495–518.PubMedGoogle Scholar
  340. 340.
    Phillips, S. F., 1975, Diarrhea-Pathogenesis and diagnostic techniques, Postgrad. Med. 57:65–71.PubMedGoogle Scholar
  341. 341.
    Krejs, G. J., 1986, Diarrhea, Clin. Gastroenterol 15:477–744.Google Scholar
  342. 342.
    Gorbach, S. L., 1972, The toxigenic diarrheas, Hosp. Pract. 8:103–110.Google Scholar
  343. 343.
    Lai, C. Y., 1980, The chemistry and biology of cholera toxin, CRC Grit. Rev. Biochem. 9:171–206.CrossRefGoogle Scholar
  344. 344.
    Moriarity, K. J. and Turnberg, L. A., 1986, Bacterial toxins and diarrhea, Clin. Gastroenterol. 15:529–543.Google Scholar
  345. 345.
    Cantey, J. R., 1985, Infectious diarrhea: Pathogenesis and risk factors. Am. J. Med. 78:65–75.PubMedCrossRefGoogle Scholar
  346. 346.
    Sciarretta, G., Vicini, G., Fagioli, G., Verri, A., Ginerva, A., and Malagutti, P., 1986, Use of Selena-25 homocholytaurine to detect bile acid malabsorption in patients with ileal dysfunction diarrhea, Gastroenterology 91:1–9.PubMedGoogle Scholar
  347. 347.
    Murray, B. E., 1986, Resistance of Shigella, Salmonella, and other selected enteric pathogens to antimicrobial agents. Rev. Infect. Dis. 8 (Suppl 2):S172–181.PubMedCrossRefGoogle Scholar
  348. 348.
    Ericsson, G. D., Dupont, H. L., and Johnson, P. G., 1986, Nonantibiotic therapy for travellers’ diarrhea. Rev. Infect. Dis. 8:S202–206.PubMedCrossRefGoogle Scholar
  349. 349.
    Roth, J. L. A., 1976, Gastrointestinal gas, in: Gastroenterology, 3rd Ed., Vol. 4, (H. L. Bockus, ed.), Saunders Philadelphia, pp. 652–655.Google Scholar
  350. 350.
    Levitt, H. M., 1983, Gastrointestinal gas and abdominal symptoms. Part I, Pract. Gastroenterol. 7:6–12.Google Scholar
  351. 351.
    Levitt, H. M., 1983, Gastrointestinal gas and abdominal symptoms, Part II, Pract. Gastroenterol. 8:6–18.Google Scholar
  352. 352.
    Steggerda, F. R., 1968, Gastrointestinal gas following food consumption, Ann. NY Acad. Sci. 150:57–66.PubMedCrossRefGoogle Scholar
  353. 353.
    Raskin, J., 1983, Intestinal gas. Geriatrics 38:77–84.PubMedGoogle Scholar
  354. 354.
    Kerlin, P. and Phillips, S., 1983, Differential transit of liquids and solids residue through the human ileum. Am. J. Physiol. 245:638–643.Google Scholar
  355. 355.
    Urban, E., 1984, Beans, gas and science. Gastroenterology 86:994–995.Google Scholar
  356. 356.
    Drossman, D. A., Powell, D. W., and Sessions, J T., Jr., 1977, The irritable bowel syndrome, Gastroenterology 73:811–822.PubMedGoogle Scholar
  357. 357.
    Hislop, I. G., 1971, Psychological significance of the irritable colon syndrome, Gut 12:452–457.PubMedCrossRefGoogle Scholar
  358. 358.
    Lydiard, R. B., Laraia, M. T., Howell, E. F., and Ballenger, J. C., 1986, Can panic disorder present as an irritable bowel syndrome? J. Clin. Psychiatry 47:470–473.PubMedGoogle Scholar
  359. 359.
    Young, S. J., Alpers, D. H., Northland, C. C., and Woodruf, R. A., Jr., 1976, Psychiatric illness and the irritable bowel syndrome. Practical implications for the primary physician, Gastroenterology 70:162–166.PubMedGoogle Scholar
  360. 360.
    Thompson, W. S. and Heaton, K. W., 1980, Functional bowel disorders in apparently healthy people. Gastroenterology 79:283–288.PubMedGoogle Scholar
  361. 361.
    Almy, G. P. and Tulin, M., 1947, Alterations in man under stress. Experimental production of changes simulating the “irritable colon,” Gastroenterology 8:616–626.PubMedGoogle Scholar
  362. 362.
    Haddad, H. and Devroede-Bertrand, G., 1981, Large bowel motility disorders, Med. Clin. North Am. 65:1377–1396.PubMedGoogle Scholar
  363. 363.
    Almy, T. P., 1980, The irritable bowel syndrome: Back to square 1? Dig. Dis. Sci. 25:401–403.PubMedCrossRefGoogle Scholar
  364. 364.
    Horowitz, L. and Farrar, J. T., 1962, Intraluminal small intestinal pressure in normal patients and in patients with functional gastrointestinal disorders, Gastroenterology 42:455–464.PubMedGoogle Scholar
  365. 365.
    Lasser, R. B., Bond, J. H., and Levitt, M. D., 1975, The role of intestinal gas in functional abdominal pain, N. Engl. J. Med. 293:524–526.PubMedCrossRefGoogle Scholar
  366. 366.
    Gann, P. A., Read, N. W., Brown, G., Hobson, N., and Holdsworth, G. D., 1983, Irritable bowel syndrome: relationship of disorders in the transit of a single solid meal to symptom patterns. Gut 24:405–411.CrossRefGoogle Scholar
  367. 367.
    Ghristensen, L. A., Fallingborg, J., Nielsen, S. T., Thommesen, P., Jensen, P. F., 1986, Abnormal duodenal loop in patients with irritable bowel syndrome, Scand. J. Gastroenterol. 21:6–8.CrossRefGoogle Scholar
  368. 368.
    Alun-Jones, V., Shorthouse, M., McLaoughlan, P., etal, 1982, Food Intolerance: A major factor in the pathogenesis of irritable bowel syndrome. Lancet 2:1115–1117.Google Scholar
  369. 369.
    Kruis, W., Weinzierl, M., Schussler, P., and Holl, J., 1986, Comparison of the therapeutic effect of wheat bran, mebeverine and placebo in patients with irritable bowel syndrome, Digestion 34:196–201.PubMedCrossRefGoogle Scholar
  370. 370.
    Gann, P. A., Rear, N. W., and Holdsworth, G. D., 1984, What is the benefit of coarse wheat bran in patients with irritable bowel syndrome, Gut 25:168–173.CrossRefGoogle Scholar
  371. 371.
    Krivis, W., Thieme, C. H., Weinzierl, M., Schusser, P., Holl, J., and Paulus, W. L., 1984, A diagnostic score for the irritable bowel syndrome: Its value in the exclusion of organic disease. Gastroenterology 87:1–7.Google Scholar
  372. 372.
    Kyosola, K, 1985, Positive criteria for the irritable bowel syndrome. Gastroenterology 89:235–236.PubMedGoogle Scholar
  373. 373.
    Whitehead, W. E., 1980, Irritable bowel syndrome: Physiological and psychological differences between diarrhea-predominant and constipation- predominant patients. Dig. Dis. Sci. 25:404–413.PubMedCrossRefGoogle Scholar
  374. 374.
    Boley, S. J., Brandt, L. J., and Frank, M. S., 1981, Severe lower intestinal bleeding: Diagnosis and treatment, Clin. Gastroenterol. 10:65–91.PubMedGoogle Scholar
  375. 375.
    Boley, S. J., DiBiase, A., Brandt, L. J., and Sammartano, R. J., 1979, Lower intestinal bleeding in the elderly. Am. J. Surg. 137:57–64.PubMedCrossRefGoogle Scholar
  376. 376.
    Welch, C. E., Athanasoulis, C. A., and Galdabini, J. J., 1978, Hemorrhage from the large bowel with special reference to angiodysplasia and diverticular disease. World J. Surg. 2:73–83.PubMedCrossRefGoogle Scholar
  377. 377.
    Athanasoulis, C. A., Galdabini, J. J., Waltman, A. C., Novelline, R. A., Greenfield, A. J., and Ezpeleta, M. I., 1977–1978, Angiodysplasia of the colon: a cause of rectal bleeding, Cardiovasc. Radiol. 1:3–13.CrossRefGoogle Scholar
  378. 378.
    Boley, S. J., Sammartano, R. J., Adams, A., DiBiase, A., Kleinhaus, S., and Sprayregen, S., 1977, On the nature of etiology of vascular ectasias of the colon. Degenerative lesions of aging. Gastroenterology 72:650–660.PubMedGoogle Scholar
  379. 379.
    Alvi, A., Dann, R. W., Baum, S., and Biery, D. N., 1977, Scintigraphic detection of acute gastrointestinal bleeding. Radiology 124:753–756.Google Scholar
  380. 380.
    Nausbaum, M. and Baum, S., 1963, Radiographic demonstration of unknown sites of gastrointestinal bleeding, Surg. Forum 14:374–375.Google Scholar
  381. 381.
    American Cancer Society: Cancer Facts &: Figures, 1980, American Cancer Society, New York, p. 9.Google Scholar
  382. 382.
    Miller, C., 1962, Carcinoma of the thoracic oesophagus and cardia. A review of 405 cases, Br. J. Surg. 49:507–522.PubMedCrossRefGoogle Scholar
  383. 383.
    Haskell, C. M., 1980, Cancer Treatment, Saunders, Philadelphia, pp. 233–246.Google Scholar
  384. 384.
    Adelstein, D. J., Forman, W. B., and Beavers, B., 1984, Esophageal carcinoma: A six year review of the Cleveland Veterans Administration Hospital experience, Cancer 54:918–923.PubMedCrossRefGoogle Scholar
  385. 385.
    Lowe, W. C., 1972. Survival with carcinoma of the esophagus, Ann. Intern. Med. 77:915–918.PubMedGoogle Scholar
  386. 386.
    Boyce, H. W. and Palmer, E. D., 1975, Techniques of Clinical Gastroenterology, Charles C Thomas, Springfield, IL, pp. 230–231.Google Scholar
  387. 387.
    Horton, J. and Hill, G. J., 1977, Clinical Oncology, Saunders, Philadelphia, pp. 247–250.Google Scholar
  388. 388.
    Ming, S. C., 1977, Gastric carcinoma: A pathological classification. Cancer 39:2475–2485.PubMedCrossRefGoogle Scholar
  389. 389.
    Riberio, M. M., Sarmento, J. A., Simoes, M. A. S., and Bostos, J., 1981, Prognostic significance of Lauren 8c Ming classifications and other pathological parameters in gastric carcinoma. Cancer 47:780–784.CrossRefGoogle Scholar
  390. 390.
    Kobayashi, S., Yoshii, Y., and Kzsugai, T., 1977, Biopsy and cytology in the diagnosis of early gatric cancer: 10-year experience with direct vision techniques at a Japanese institution, Endoscopy 8:53–58.PubMedCrossRefGoogle Scholar
  391. 391.
    Goldsmith, H. S. and Gnosh, B. L., 1970, Carcinoma of the stomach, Am. J. Surg. 120:317–319.PubMedGoogle Scholar
  392. 392.
    Hoerr, S. O., 1981, Long term results in patients who survive five or more years after gastric resection for primary carcinoma, Surg. Gynecol. Obstet. 153:820–822.PubMedGoogle Scholar
  393. 393.
    Moertel, C., 1974, Cancer of the gastrointestinal tract: Chemotherapy, JAMA 228:1290–1291.PubMedCrossRefGoogle Scholar
  394. 394.
    Vernick, L. J. and Kuller, L. H., 1981, Cholecystectomy and right-sided colon cancer: An epidemiological study, Lancet 2:381–383.PubMedCrossRefGoogle Scholar
  395. 395.
    Linos, D., Bearo, C. M., O’Fallon, W. M., Dockerty, M. B., Beart, R. W., and Kurland, L. T., 1981, Cholecystectomy and carcinoma of the colon. Lancet 2:379–381.PubMedCrossRefGoogle Scholar
  396. 396.
    Rundgren, A. and Mellstrom, D., 1983, Cholecystectomy and colon cancer in the elderly. Age Ageing 12:44–49.PubMedCrossRefGoogle Scholar
  397. 397.
    Werner, D., DeHerr, K., and Mitschke, H., 1977, Cholecystectomy and carcinoma of the colon, Z. Krebsforsch. 88:223–230.CrossRefGoogle Scholar
  398. 398.
    Haines, A., Metz, G., Dilawari, J., Blendis, L., and Wiggins, H., 1977, Breath methane in patients with cancer of the large bowel. Lancet 2:481–483.PubMedCrossRefGoogle Scholar
  399. 399.
    Pique, J. M., Pallares, M., Cuso, E., Vilar-Bonet, J., and Gassull, M. A., 1984, Methane production and colon cancer. Gastroenterology 87:601–605.PubMedGoogle Scholar
  400. 400.
    Perman, J. A., 1984, Methane and colorectal cancer. Gastroenterology 87:778–730.Google Scholar
  401. 401.
    Edwards, R. T. M., Bransom, C. J., Crosby, D. L., and Pathy, M. S., 1983, Colorectal carcinoma in the elderly: Geriatric and surgical practice compared, Age Ageing 12:256–262.PubMedCrossRefGoogle Scholar
  402. 402.
    Vellacott, K. D. and Hardcastle, J. D., 1981, An evaluation of flexible sigmoidoscopy, Br. Med. J. 283:1583–1586.CrossRefGoogle Scholar
  403. 403.
    Koehler, P. R., Feldberg, M. A. M., and Van Waes, P. F. G. M., 1984, Preoperative staging of rectal cancer with computerized tomogaphy: Accuracy, efficacy and effect on patient management. Cancer 54:512–516.PubMedCrossRefGoogle Scholar
  404. 404.
    Diehl, A. K., 1981, Screening for colorectal cancer, J. Fam. Pract. 12:625–632.PubMedGoogle Scholar
  405. 405.
    Cohen, H., Willis, L, and Wallack, M., 1986, Surgical experience of colon resection in the extreme elderly. Am. Surg. 52:214–217.PubMedGoogle Scholar
  406. 406.
    Silverberg, E. and Holleb, A. L., 1975, Major trends in cancer: 25 year survey. Cancer 25:2–8.Google Scholar
  407. 407.
    Eisenberg, B., Decosse, J. J., Harford, F., and Michel, E. K.J., 1982, Carcinoma of the colon and rectum: The natural history reviewed in 1204 patients. Cancer 49:1131–1134.PubMedCrossRefGoogle Scholar
  408. 408.
    Fielding, L. P., Phillips, R. K. S., Fry, J. S., and Hittinger, R., 1986, Prediction of outcome after curative resection for large bowel cancer. Lancet 2:904–907.PubMedCrossRefGoogle Scholar
  409. 409.
    Gingold, B. S., 1981, Local treatment (electrocoagulation) for carcinoma of the rectum in the elderly, J. Am. Geriatr. Soc. 29:10–13.PubMedGoogle Scholar
  410. 410.
    Engstrom, P. F., Maclntyre, J. M., Douglass, J. O., Jr., Muggia, F., and Mittleman, A., 1982, Combination chemotherapy of advanced colorectal cancer utilizing 5-flurouracil, semustine, Vincristine, and Hydroxyurea, Cancer 49:1555–1560.PubMedCrossRefGoogle Scholar
  411. 411.
    Hall, T. J., Blackstone, M. O., Cooper, M. J., Hughes, R. G., and Moossa, A. R., 1978, Prospective evaluation of endoscopic retrograde cholangiopancreatography in the diagnosis of periampullary cancer, Ann. Surg. 187:313–317.PubMedCrossRefGoogle Scholar
  412. 412.
    Haaga, J. R., Alfidi, R. J., Havrilla, T. R., Tubbs, R., Gonzalez, L., Meaney, T. F., and Corsi, M. A., 1977, Definitive role of CT scanning of the pancreas. The second year’s experience. Radiology 124:723–730.PubMedGoogle Scholar
  413. 413.
    Fitzgerald, P. J., Fortner, J. G., Watson, R. C., Schwartz, M. K., Sherlock, P., Benua, R. S., Cubilla, A. L., Schottenfeld, D., Miller, D., Sinawer, S. J., Lightdale, C. J., Leidner, S. D., Nisselbaum, J. S., Mendendez-Botet, C. J., and Poleski, M. H., 1978, The value of diagnostic aids in detecting pancreas cancer. Cancer 41:868–879.PubMedCrossRefGoogle Scholar
  414. 414.
    McBride, C. M., 1976, Primary carcinoma of the liver. Surgery 80:322–327.PubMedGoogle Scholar
  415. 415.
    Tan, A. Y., Law, C. H., and Lee, Y. S., 1977, Hepatitis B antigen in the liver cells in cirrhosis and hepatocellular carcinoma. Pathology 9:57–64.PubMedCrossRefGoogle Scholar
  416. 416.
    Knowles, D. M., II, Casarella, W. J., Johnson, P. M., and Wolff, M., 1978, Clinical, radiologic and pathologic characterization of benign hepatic neoplasms, Medicine 57:223–237.PubMedCrossRefGoogle Scholar
  417. 417.
    Bedikian, A. Y., Valdivieso, M., and Bodney, G. P., 1980, Systemic chemotherapy for advanced gastrointestinal cancer. South. Med. J. 73:1046–1052.PubMedCrossRefGoogle Scholar
  418. 418.
    Rankin, S. W. and Brown, P. E., 1930, Diverticulitis of the colon, Surg. Gynecol Obstet. 50:836–847.Google Scholar
  419. 419.
    Oschner, H. C. and Bargen, G. A., 1935, Diverticulitis of the large intestine: An evaluation of historical and personal observations, Ann. Int. Med. 9:282–296.Google Scholar
  420. 420.
    Willard, J. H. and Buckus, H., 1936, Clinical and therapeutic states of cases of colonic office practise. Am. J. Dig. Dis. Nutr. 3:580–585.CrossRefGoogle Scholar
  421. 421.
    Allen, A. W., 1953, Surgery of diverticulosis of the colon. Am. J. Surg. 86:545–548.PubMedCrossRefGoogle Scholar
  422. 422.
    Smith, C. and Christensen, W. R., 1939, The incidence of colonic diverticulosis, Am. J. Roentgenol. 82:996–997.Google Scholar

Copyright information

© Plenum Publishing Corporation 1988

Authors and Affiliations

  • Thomas W. Sheehy
    • 1
  1. 1.Birmingham Veterans Administration Medical CenterUniversity of Alabama in Birmingham, School of MedicineBirminghamUSA

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