Gastrointestinal tract diseases/disorders

Mastocytosis is a disorder characterized by increased numbers of mast cells in the skin, bone marrow, gastrointestinal tract, Uver, spleen, and lymph nodes [9,10]. The prevalence is unknown the incidence has been roughly estimated to be 3-7 new patients per million per year [9]. Most cases are sporadic with only a limited number (50-100) of cases with mastocytosis reported to pass from generation to generation [11], Mastocytosis presents at any age, although most cases occur during the first 2 years of life (childhood-onset) or after puberty (adult-onset) [9]. Mastocytosis in childhood often is self-limited and involves only the skin, whereas the course in patients with adult-onset disease is normally chronic and includes systemic involvement. 

Irritable bowel syndrome (IBS) is a disorder of the gastrointestinal tract that interferes with the normal functions of the colon. At various points in the past, IBS has been referred to as mucous colitis, spastic colon, irritable colon, or nervous stomach. IBS is generally described as afunctional disorder rather than a disease per se. A functional disorder involves symptoms that cannot be attributed to a specific injury, infection, or other physical problem. A functional disorder occurs because of altered physiologic processes rather than structural or biochemical defects and may be subject to nervous system influence. IBS is associated with frequent fluctuation in symptoms, loss of productivity, and decreased quality of life. Although IBS has been referred to as functional bowel disease, true functional bowel disease may be more indicative of widespread gastrointestinal involvement including (but not limited to) the colon. 

Anticoagulant drugs include heparin and warfarin (Coumadin ) —agents used to prevent deep vein thrombosis. They are also used to prevent formation of emboli due to atrial fibrillation, valvular heart disease, and other cardiac disorders. Heparin, which is not absorbed by the gastrointestinal tract, is available only by injection its effect is immediate. 

Pathophysiologically, constipation generally results from disordered colonic transit or anorectal function as a result of a primary motility disturbance, certain drugs, or in association with a large number of systemic diseases that affect the gastrointestinal tract. Constipation from any cause may be exacerbated by chronic illnesses that lead to physical or mental impairment and result in inactivity or physical immobility. Additional contributing factors may include a lack of fiber in the diet, generalized muscle weakness, and possibly stress and anxiety. 

Bromocriptine is a D2 agonist its structure is shown in Table 16-4. This drug has been widely used to treat Parkinson s disease and has also been used to treat certain endocrinologic disorders, especially hyperprolactinemia (see Chapter 37 Hypothalamic Pituitary Hormones), but in lower doses than for parkinsonism. Bromocriptine is absorbed to a variable extent from the gastrointestinal tract peak plasma levels are reached within 1-2 hours after an oral dose. It is excreted in the bile and feces. The usual daily dose of bromocriptine in the treatment of parkinsonism is between 7.5 and 30 mg, depending on response and tolerance. In order to minimize adverse effects, the dose is built up slowly over 2 or 3 months from a starting level of 1.25 mg twice daily after meals the daily dose is then increased by 2.5 mg every 2 weeks depending on the response or the development of adverse reactions. 

Ulcerative colitis is an inflammatory disease of the lower gastrointestinal tract, which results in episodes of diarrhoea. There may also be extraintestinal symptoms, including anaemia, arthritis, dermatological problems and eye disorders. 

There are several other metabolic disorders, but because they are not very common, not much is known about them. For example, a disease known as amyloidosis results when enough amyloid protein builds up in one or more organs to cause the organ(s) to malfunction. The heart, kidneys, nervous system and gastrointestinal tract are most often affected. Amyloid (pronounced am -i-loyd) is an abnormal protein that may be deposited in any of the body s tissues or organs. This abnormal protein comes from cells in the bone marrow, so amyloidosis is known as a bone marrow disease. The bone marrow makes protective antibodies that protect against infection and disease. After they have served their function, these antibodies are broken down and recycled by... 

Inflammatory bowel disease (ulcerative colitis and Crohn s disease) is a general term for a group of chronic inflammatory disorders of unknown cause involving the gastrointestinal tract. Despite many attempts to confirm an infectious agent as the cause of disease, no bacterial. 

Inflammatory bowel disease is divided into two major gastrointestinal disorders ulcerative colitis (UC) and Crohn s disease. Both diseases are chronic and tend to be characterized by periods of exacerbations and remissions. Major differences between UC and Crohn s disease are differentiated by anatomic location and distribution. UC occurs in the colon and rectum, whereas Crohn s disease can occur throughout the gastrointestinal tract. UC tends to be continuous, diffuse, and mucosal Crohn s appears segmental, focal, and transmural. Fissures, strictures, abdominal masses, and pain are commonly associated with Crohn s. Classical symptoms of UC include chronic diarrhea with tenesmus, rectal bleeding, and abdominal pain. 

Menkes disease is an X-linked inherited disorder in which dietary copper is absorbed from the gastrointestinal tract but cannot be transported to the vascular space because of the genetic absence of an intracellular ATPase. Hence, copper... 

Cystinuria is a disorder of renal and gastrointestinal tract amino acid transport that also affects lysine, ornithine, and arginine. The four amino acids share a common transport mechanism (discussed above). Clinically, it presents as urinary stone disease because of the insolubility of cystine. In cystinosis, cystine crystals are deposited in tissues because of a transport defect in ATP-dependent cystine efflux from lysosomes (discussed above). 

Inflammatory diseases of the gastrointestinal tract discharge mucus, serum proteins, and blood into the gut. Sometimes bowel movements consist only of mucus, exudate, and blood. Exudative diarrhea probably affects other absorptive, secretory, or motility functions to account for the large stool volume associated with this disorder. 

Crohn disease. An ongoing disorder that causes inflammation of the digestive tract, also referred to as the gastrointestinal tract. Crohn disease can affect any area of the gastrointestinal tract, from... 

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