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gastroenterocolitis

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(găs″trō-ĕn″tĕr-ō-kŏl-ī′tĭs) [″ + ″ + kolon, colon, + itis, inflammation] Inflammation of the stomach, small intestine, and colon.

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gastroenterology

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(găs″trō-ĕn″tĕr-ŏl′ă-jē) [″ + ″ + ″] The branch of medical science concerned with the study of the anatomy, physiology, and diseases of the digestive organs and their treatment. The digestive organs include the stomach, intestines, and related structures, e.g., esophagus, liver, gallbladder, and pancreas.

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gastroenterostomy

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(găs″trō-ĕn-tĕr-ŏs′tō-mē) [″ + enteron, intestine, + stoma, mouth] Surgical anastomosis between the stomach and small bowel. This operation may be employed for a variety of malignant and benign gastroduodenal diseases.

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gastroepiploic

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(gas″trō-ep″i-plō′ĭk) [gastro- + epiploic] Pert. to the stomach and greater omentum. SYN: gastro-omental.

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gastroesophageal

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(gas″trō-ĕ-sof″ă-jē′ăl) [gastro- + esophageal,] Pert. to the stomach and esophagus.

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gastroesophageal reflux disease

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ABBR: GERD. A common condition in which acid from the stomach (gastric and/or duodenal) flows back into the esophagus, causing discomfort and, in some instances, damage to the esophageal lining.

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INCIDENCE: GERD is thought to affect nearly half of all adults at least once a month.

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CAUSES: GERD occurs when the lower esophageal sphincter (LES) fails to keep gastric acid out of the esophagus. Predisposing factors include use of any agent that reduces LES pressure, hiatal hernia with incompetent sphincter, any condition that raises intra-abdominal pressure, a history of nasogastric intubation lasting more than 4 days, or pyloric surgery.

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SYMPTOMS AND SIGNS: Common symptoms include heartburn, indigestion, and noncardiac chest pain (which may mimic angina pectoris by radiating to the neck, jaw, and/or arms). Patients occasionally experience asthma, cough, hoarseness, difficulty in swallowing, or nocturnal regurgitation. Patients are taught to avoid factors that decrease LES, cause esophageal irritation, or increase intra-abdominal pressure.

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DIAGNOSIS: Although GERD is usually diagnosed based on the patient's description of its usual symptoms, tests that visualize reflux include barium esophagography (barium swallow), esophageal endoscopy, and esophageal manometry and pH monitoring.

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TREATMENT: Many patients benefit from antacids (taken 1 hr before or 3 hr after meals and at bedtime) or over-the-counter histamine-2-receptor antagonists, e.g., ranitidine. Patients who do not respond to these therapies are usually treated with proton pump inhibitors to reduce gastric acidity. Surgical treatments to strengthen the LES include Nissen fundoplication, and the construction of sphincter devices to encircle and bolster the LES.

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PATIENT CARE: Patients should avoid eating meals late in the evening or for several hours before lying down. Elevating the head of the bed 6 to 8 in (15 to 20 cm) on blocks may help in some cases. All affected patients should avoid food and beverages that worsen reflux, ...

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