Partly inspired by means of the st...

Partly inspired by means of the stomach viruses going around this time of year, and partly inspired by dint of the amount of work forward our desks, we've decided to denominate this our heartburn issue. Here in these pages you'll find a tour d'horizon of gastrointestinal question s ranging from nausea, vomiting, and intestinal parasites to gastric cancer.

Nausea and vomiting may be caused on a number of medical question at issues and treatment ideally consists of correcting the underlying cause. A variety of antiemetic agents are available, and treatment choice hangs on the pathophysiology of nausea and vomiting. In the "Clinical Pharmacology" article forward page 1169, authors Zachary A. Flake, MD Fort Collins (Colo) Family Medicine Residency Program, Robert D Scalley, Pharm.D., University of Wyoming (Laramie), and Austin G Bailey, MD Fort Collins Family Medicine Residency Program, review the suitable selection of antiemetics. The neurotransmitters histamine, acetylcholine, serotonin, and dopamine commonly are implicated in nausea and vomiting and are the targets of greatest in number therapeutic modalities. For a list of the primary classes of antiemetics, as well as specific agents in each class, behold Table 1 of the article, forward page 1171. The authors also provide a patient information handout in succession causes and treatment of nausea and vomiting (see page 1176)

The "Practical Therapeutics" article upon page 1161 reviews common intestinal parasites in the United States. Corry Jeb Kucik, LT MC USN, Gary L Martin, LCDR MC USN, and britzska V. Sortor, LCDR, MC, USN, Naval Hospital Jacksonville (Fla.), discuss diseases caused from Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica. E vermicularis, or pinworm, is the in the greatest degree prevalent nematode in the United States. Diagnosis of pinworm infestation can be made with the "cellophane tape test" Giardia, which causes nausea, vomiting, diarrhea, malabsorption and weight los can be discovered through stool ova and parasite studies. A. duodenale and N americanus are hookworms that cause vital fluid loss, anemia, pica and wasting. Diagnosis is confirmed by the agency of demonstrating eggs in the fece E histolytica can cause intestinal ulcerations, ensanguined diarrhea, weight loss, fever, gastrointestinal obstruction, and peritonitis. Amebas also can cause liver abscesses. Diagnostic studies include stool and serologic assays, barium studies, and liver imaging.

In an article forward gastric cancer on page 1133 authors John C Layke, conclude University of Illinois Metropolitan assign places to Hospitals, Chicago, and Peter P Lopez MD University of Miami indoctrinate of Medicine, point out that although gastric cancer has decreased in common occurrence over the past half hundred it caused over 12,000 deaths last year and take the part ofs a leading cause of cancer-related deaths in developing countries. The incidence of distal stomach cancers has declined, while reported cases of proximal gastric carcinoma, including tumors at the gastroesophageal junction, have increased. Early diagnosis of gastric cancer is still difficult because greatest in number patients are asymptomatic in the early stages. Weight los and abdominal pain are late signs of disease progression. Risk factors include chronic atrophic gastritis, Helicobacter pylori infection, smoking, heavy alcohol use, and dietary factors. A patient information handout onward stomach cancer is provided forward page 1145.

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group