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Gut Oct 2015The stomach is traditionally regarded as a hollow muscular sac that initiates the second phase of digestion. Yet this simple view ignores the fact that it is the most... (Review)
Review
The stomach is traditionally regarded as a hollow muscular sac that initiates the second phase of digestion. Yet this simple view ignores the fact that it is the most sophisticated endocrine organ with unique physiology, biochemistry, immunology and microbiology. All ingested materials, including our nutrition, have to negotiate this organ first, and as such, the stomach is arguably the most important segment within the GI tract. The unique biological function of gastric acid secretion not only initiates the digestive process but also acts as a first line of defence against food-borne microbes. Normal gastric physiology and morphology may be disrupted by Helicobacter pylori infection, the most common chronic bacterial infection in the world and the aetiological agent for most peptic ulcers and gastric cancer. In this state-of-the-art review, the most relevant new aspects of the stomach in health and disease are addressed. Topics include gastric physiology and the role of gastric dysmotility in dyspepsia and gastroparesis; the stomach in appetite control and obesity; there is an update on the immunology of the stomach and the emerging field of the gastric microbiome. H. pylori-induced gastritis and its associated diseases including peptic ulcers and gastric cancer are addressed together with advances in diagnosis. The conclusions provide a future approach to gastric diseases underpinned by the concept that a healthy stomach is the gateway to a healthy and balanced host. This philosophy should reinforce any public health efforts designed to eradicate major gastric diseases, including stomach cancer.
Topics: Gastric Mucosa; Humans; Stomach; Stomach Diseases
PubMed: 26342014
DOI: 10.1136/gutjnl-2014-307595 -
The Turkish Journal of Gastroenterology... Jun 2014Stomach endoscopic biopsies are made to determine the diagnosis of the illness, its stage, and follow-up after the treatment. It is very significant to collaborate with... (Review)
Review
Stomach endoscopic biopsies are made to determine the diagnosis of the illness, its stage, and follow-up after the treatment. It is very significant to collaborate with the clinician while evaluating endoscopic biopsies. Besides the clinical and laboratory information of the patient, the endoscopic appearance of the lesion should be known. The clinician and pathologist should use the same language and the same terminology. Although new classifications have been made to prevent the confusion of terminologies in neoplastic processes recently, most centers around the world have reported non-invasive neoplasias without giving any certain diagnosis by just commenting on it. The clinician should understand what the pathologist wants to say; pathologists should know the approach of the clinician (repetition of the biopsy, endoscopic resection, surgery). There is Helicobacter pylori (HP) in most of the stomach pathologies as the etiologic agent. No matter if the factor is HP or other etiologic agents, the tissue gives similar responses. That is why clinical-endoscopic indications should be taken into consideration, as well as histological indications, and the reports of the endoscopy should be seen. A good clinicopathologic correlation increases the accuracy of the diagnosis.
Topics: Acute Disease; Biopsy; Chronic Disease; Diagnosis, Differential; Gastritis; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Metaplasia; Stomach; Stomach Diseases; Stomach Neoplasms
PubMed: 25141310
DOI: 10.5152/tjg.2014.7906 -
Revista Espanola de Enfermedades... Nov 2023A 47-year-old man presented with a 6-day pain in the right chest. Abdominal CT showed an elliptical homogeneous mass, which was closely related to the posterior wall of...
A 47-year-old man presented with a 6-day pain in the right chest. Abdominal CT showed an elliptical homogeneous mass, which was closely related to the posterior wall of the stomach and the lesion grew from the posterior wall of the stomach to the abdominal cavity in the wedge shape. The enhanced scan showed no enhancement in the lesion. The left adrenal gland and the upper pole, pancreas and spleen were changed due to compression. Carbohydrate antigen 72-4 (CA72-4) was 45.1U/ml (0.00~5.30 U/ml). The gastroscopy results showed that there was protruded lesion in the posterior gastric wall and atrophic gastritis in the superficial stomach. Laparoscopic exploration and partial gastrectomy were performed. An 8cm × 7cm tumor was found at the posterior wall of the fundus near the cardia, with smooth serosal surface. The cystic mass was smooth surface, filled with yellow thick liquid. Microscopically, the cystic wall tissue was lined with pseudo-stratified ciliated columnar epithelium, and mucous glands were seen under the epithelium. Pathological diagnosis showed bronchogenic cysts of the gastric submucosal. At 2-month follow-up, the postoperative recovery was good.
Topics: Male; Humans; Middle Aged; Bronchogenic Cyst; Stomach Diseases; Pancreas; Spleen
PubMed: 37882202
DOI: 10.17235/reed.2023.9964/2023 -
Development (Cambridge, England) Feb 2016The stomach, an organ derived from foregut endoderm, secretes acid and enzymes and plays a key role in digestion. During development, mesenchymal-epithelial interactions... (Review)
Review
The stomach, an organ derived from foregut endoderm, secretes acid and enzymes and plays a key role in digestion. During development, mesenchymal-epithelial interactions drive stomach specification, patterning, differentiation and growth through selected signaling pathways and transcription factors. After birth, the gastric epithelium is maintained by the activity of stem cells. Developmental signals are aberrantly activated and stem cell functions are disrupted in gastric cancer and other disorders. Therefore, a better understanding of stomach development and stem cells can inform approaches to treating these conditions. This Review highlights the molecular mechanisms of stomach development and discusses recent findings regarding stomach stem cells and organoid cultures, and their roles in investigating disease mechanisms.
Topics: Animals; Body Patterning; Endoderm; Humans; Signal Transduction; Stem Cells; Stomach; Stomach Diseases
PubMed: 26884394
DOI: 10.1242/dev.124891 -
The Oncologist Dec 2015Although the majority of gastric carcinomas are sporadic, approximately 10% show familial aggregation, and a hereditary cause is determined in 1%-3% cases. Of these,... (Review)
Review
Although the majority of gastric carcinomas are sporadic, approximately 10% show familial aggregation, and a hereditary cause is determined in 1%-3% cases. Of these, hereditary diffuse gastric cancer is the most recognized predisposition syndrome. Although rare, the less commonly known syndromes also confer a markedly increased risk for development of gastric cancer. Identification and characterization of these syndromes require a multidisciplinary effort involving oncologists, surgeons, genetic counselors, biologists, and pathologists. This article reviews the molecular genetics, clinical and pathologic features, surveillance guidelines, and preventive measures of common and less common hereditary gastric cancer predisposition syndromes.
Topics: Adenocarcinoma; Genetic Predisposition to Disease; Humans; Neoplastic Syndromes, Hereditary; Polyps; Stomach Diseases; Stomach Neoplasms
PubMed: 26424758
DOI: 10.1634/theoncologist.2015-0205 -
Chirurgia (Bucharest, Romania : 1990) 2020Post-gastrectomy complications have been the associated sequelae after curative gastrectomy for long time. They include a conundrum of symptoms ranging from serious... (Review)
Review
Post-gastrectomy complications have been the associated sequelae after curative gastrectomy for long time. They include a conundrum of symptoms ranging from serious metabolic alterations to disorders attributed to mechanical and neural factors after reconstruction of the digestive continuity. Though, with the advancement in the surgical expertise and techniques and shift towards medical and endoscopic management for benign gastro-duodenal ulcer disease, there has been a decline in the incidence of these complications; they continue to raise "red flags" after major oncologic gastric resections. Identification of these symptoms and protocol based management of the same is of utmost importance in the surgical armamentarium of trainees and practicing physicians and surgeons.
Topics: Gastrectomy; Humans; Postgastrectomy Syndromes; Stomach Diseases; Stomach Neoplasms; Treatment Outcome
PubMed: 32876015
DOI: 10.21614/chirurgia.115.4.423 -
Gut Feb 1982A prospective search for gastro-oesophageal candidiasis was made by histological examination of all the biopsies taken from 465 patients endoscoped consecutively during...
A prospective search for gastro-oesophageal candidiasis was made by histological examination of all the biopsies taken from 465 patients endoscoped consecutively during a 12 month period. The criterion for diagnosis was the demonstration of infiltration of tissue or ulcer slough by yeasts and hyphae. Nineteen cases of candidiasis were found giving an overall incidence of 4%. There were 12 cases with oesophageal candidiasis, two with both oesophageal and gastric candidiasis, and five with gastric candidiasis. In none of the patients was candidiasis suspected before endoscopy. Symptoms referable to the candidiasis were uncommon and radiology was not helpful in diagnosis. There was associated local pathology (particularly peptic ulceration and carcinoma of the stomach or oesophagus) in all except two patients, which suggests that the candidiasis is usually secondary to mucosal damage. In the series, candidiasis was present in 27% of patients with oesophageal cancer, 20% of patients with gastric cancer, 16% of patients with benign gastric ulcers, and 15% of patients with oesophagitis.
Topics: Aged; Candidiasis; Esophageal Diseases; Female; Humans; Male; Middle Aged; Prospective Studies; Stomach Diseases
PubMed: 7068036
DOI: 10.1136/gut.23.2.137 -
Clinics in Liver Disease May 2014Portal hypertensive gastropathy (PHG) and colopathy (PHC) are considered complications of portal hypertension. Both entities are clinically relevant because they may... (Review)
Review
Portal hypertensive gastropathy (PHG) and colopathy (PHC) are considered complications of portal hypertension. Both entities are clinically relevant because they may cause insidious blood loss or even acute massive gastrointestinal hemorrhage. Endoscopic evaluation is necessary for the diagnosis of PHG and PHC. The existence of different endoscopic criteria for PHG and PHC makes consensus difficult and results in a broad range of reported prevalence. Therapy targeted at reduction of portal pressure and mucosal blood flow has been used to treat acute bleeding; nonselective β-blockers are the most frequently used agents. Further studies are needed to clarify the natural history, pathogenesis, and treatment of PHG and PHC.
Topics: Acute Disease; Chronic Disease; Colonic Diseases; Endoscopy, Gastrointestinal; Gastrointestinal Hemorrhage; Humans; Hypertension, Portal; Primary Prevention; Secondary Prevention; Stomach Diseases
PubMed: 24679502
DOI: 10.1016/j.cld.2014.01.008 -
World Journal of Gastroenterology Jul 2023Using rat stomach perforation as a prototypic direct lesion applied in cytoprotection research, we focused on the first demonstration of the severe occlusion/...
BACKGROUND
Using rat stomach perforation as a prototypic direct lesion applied in cytoprotection research, we focused on the first demonstration of the severe occlusion/ occlusion-like syndrome induced by stomach perforation. The revealed stomach-induced occlusion/occlusion-like syndrome corresponds to the previously described occlusion/occlusion-like syndromes in rats suffering multicausal pathology and shared severe vascular and multiorgan failure. This general point was particularly reviewed. As in all the described occlusion/occlusion-like syndromes with permanent occlusion of major vessels, peripheral and central, and other similar noxious procedures that severely affect endothelium function, the stable gastric pentadecapeptide BPC 157 was resolving therapy.
AIM
To reveal the stomach perforation-induced general occlusion/occlusion-like syndrome and BPC 157 therapy effect.
METHODS
The procedure included deeply anesthetized rats, complete calvariectomy, laparotomy at 15 min thereafter, and stomach perforation to rapidly induce vascular and multiorgan failure occlusion/occlusion-like syndrome. At 5 min post-perforation time, rats received therapy [BPC 157 (10 µg or 10 ng/kg) or saline (5 mL/kg, 1 mL/rat) (controls)] into the perforated defect in the stomach). Sacrifice was at 15 min or 60 min post-perforation time. Assessment (gross and microscopy; volume) included: Brain swelling, peripheral vessels (azygos vein, superior mesenteric vein, portal vein, inferior caval vein) and heart, other organs lesions ( stomach, defect closing or widening); superior sagittal sinus, and peripherally the portal vein, inferior caval vein, and abdominal aorta blood pressures and clots; electrocardiograms; and bleeding time from the perforation(s).
RESULTS
BPC 157 beneficial effects accord with those noted before in the healing of the perforated defect (raised vessel presentation; less bleeding, defect contraction) and occlusion/occlusion-like syndromes counteraction. BPC 157 therapy (into the perforated defect), induced immediate shrinking and contraction of the whole stomach (unlike considerable enlargement by saline application). Accordingly, BPC 157 therapy induced direct blood delivery the azygos vein, and attenuated/eliminated the intracranial (superior sagittal sinus), portal and caval hypertension, and aortal hypotension. Thrombosis, peripherally (inferior caval vein, portal vein, abdominal aorta) and centrally (superior sagittal sinus) BPC 157 therapy markedly reduced/annihilated. Severe lesions in the brain (swelling, hemorrhage), heart (congestion and arrhythmias), lung (hemorrhage and congestion), and marked congestion in the liver, kidney, and gastrointestinal tract were markedly reduced.
CONCLUSION
We revealed stomach perforation as a severe occlusion/occlusion-like syndrome, peripherally and centrally, and rapid counteraction by BPC 157 therapy. Thereby, further BPC 157 therapy may be warranted.
Topics: Rats; Animals; Rats, Wistar; Syndrome; Stomach Diseases; Peptide Fragments; Hemorrhage; Anti-Ulcer Agents
PubMed: 37545637
DOI: 10.3748/wjg.v29.i27.4289 -
Clinics in Liver Disease Nov 2019Complications of portal hypertension include portal hypertensive gastropathy and colopathy. These disorders may cause chronic or acute gastrointestinal bleeding. The... (Review)
Review
Complications of portal hypertension include portal hypertensive gastropathy and colopathy. These disorders may cause chronic or acute gastrointestinal bleeding. The diagnosis is made endoscopically; therefore, there is great variability in their assessment. Portal hypertensive gastropathy can range from a mosaic-like pattern resembling snakeskin mucosa to frankly bleeding petechial lesions. Portal hypertensive colopathy has been less well-described and is variably characterized (erythema, vascular lesions, petechiae). Treatment is challenging and results are inconsistent. Currently, available evidence does not support the use of beta-blockers for primary prevention. Further investigation of the pathogenesis, natural history, and treatment of these disorders is needed.
Topics: Adrenergic beta-Antagonists; Anemia, Iron-Deficiency; Argon Plasma Coagulation; Colonic Diseases; Colonoscopy; Endoscopy, Digestive System; Gastrointestinal Hemorrhage; Humans; Hypertension, Portal; Ligation; Liver Cirrhosis; Portasystemic Shunt, Transjugular Intrahepatic; Sclerotherapy; Stomach Diseases
PubMed: 31563216
DOI: 10.1016/j.cld.2019.07.002