Abstract:
:Primary prevention of colonic adenomas and cancer through dietary interventions or chemoprevention has great appeal. This article discusses primary prevention goals and promising nutritional or chemopreventive strategies. There is substantial observational evidence that diets high in total calories and fat and or low in fruits and vegetables or total fiber as well as low levels of physical activity are related to the risk of colonic neoplasia. Similar observational data indicate that diets high in specific nutrients such as antioxidant vitamins or calcium may be protective. The article describes some of the newer chemopreventive agents and reviews the data linking diet and lifestyle to colorectal cancer risk, focusing on interventions that have also been studied in prospective clinical trials. Finally the evidence supporting the role of non-steroidal anti-inflammatory drugs for the chemoprevention of CRC is reviewed and the status of several other promising newer agents that are entering human trials is summarized.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Gatof D,Ahnen Ddoi
10.1016/s0889-8553(02)00011-0subject
Has Abstractpub_date
2002-06-01 00:00:00pages
587-623, xiissue
2eissn
0889-8553issn
1558-1942pii
S0889-8553(02)00011-0journal_volume
31pub_type
杂志文章,评审abstract::Esophageal high-resolution manometry (HRM) improves the management of patients with nonobstructive dysphagia. It has increased the diagnostic yield for detecting achalasia and defined three clinically relevant achalasia subtypes. Esophagogastric junction (EGJ) outflow obstruction, defined as an impaired EGJ relaxation...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2011.09.006
更新日期:2011-12-01 00:00:00
abstract::This article examines the transitions in pharmacological therapy for obesity. It reviews the current options approved by the Food and Drug Administration and several drugs approved for other indications that can be used to treat obesity as well. Because weight regulation is complex and redundant systems protect agains...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2010.01.001
更新日期:2010-03-01 00:00:00
abstract::Numerous extraintestinal diseases have been associated with IBD. The role of the gastrointestinal tract in host response to the foreign antigens present in the gut makes the enteric immune system highly susceptible to any external perturbation to the system. Dysregulation of the enteric immune response results in path...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(01)00019-x
更新日期:2002-03-01 00:00:00
abstract::Understanding of hemorrhoidal pathology and treatment has come a long way. The theory of a sliding anal canal lining and the knowledge that hemorrhoidal cushions are a normal part of the anal anatomy should encourage symptom control rather than radical removal of tissue. Techniques that fix the cushions back in positi...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70173-4
更新日期:2001-03-01 00:00:00
abstract::Several hepatobiliary diseases appear to be mediated by the host immune response. They can be subdivided into those in which the immune reaction is against an infectious agent such as hepatitis viruses, those in which the immune reaction appears to be against an autoantigen expressed on hepatobiliary cells, and those ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::The effort to improve outcomes in esophageal cancer has included attempts at improving staging and patient selection. 2-Deoxy-2-[(18)F]fluoro-Dglucose positron emission tomography (FDG-PET) has been extensively studied in this context and has been widely accepted as a staging tool. Its role in restaging or assessing t...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2009.01.007
更新日期:2009-03-01 00:00:00
abstract::The development of colorectal neoplasia originates from normal colonic mucosa, progresses to the adenomatous polyp, and later may evolve into carcinoma. This procession of histologic change can be defined by a series of successive waves of clonal expansion that contain certain genetic alterations. These genetic altera...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70272-7
更新日期:1996-12-01 00:00:00
abstract::Topical therapy with amino salicylate enemas is the treatment of choice for proctitis, proctosigmoiditis, and left-sided ulcerative colitis. Adjunctive sulfasalazine therapy is often required. Relapse rates of 80 per cent can be expected within 3 months of discontinuing therapy. ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-03-01 00:00:00
abstract::New high-resolution colonoscopes and filter technologies are allowing us to visualize more lesions and better characterize lesions within the gastrointestinal tract. In light of recent findings that flat and serrated lesions are more likely to contain invasive cancer and that even small lesions (5-10 mm) may contain a...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2010.08.022
更新日期:2010-12-01 00:00:00
abstract::Pediatric patients with inflammatory bowel disease (IBD) stand to benefit from quality improvement (QI) due to the chronic nature of the disease, frequent interaction with the health care system, and exposure to high-risk treatments. The use of QI in health care has led to significant improvements in quality and relia...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2018.07.013
更新日期:2018-12-01 00:00:00
abstract::Barrett's esophagus, currently defined as endoscopically apparent columnar metaplasia of the esophagus with histologic documentation of goblet cells, is the precursor to esophageal adenocarcinoma. However, not all patients with this disorder require intensive surveillance. Pathologic diagnosis and grading of dysplasia...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2007.08.004
更新日期:2007-12-01 00:00:00
abstract::Successful treatment of unresectable and metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs) requires the thoughtful choice of systemic therapy as a component of a multidisciplinary therapeutic approach. The role of somatostatin analogues is established in symptom relief, but the efficacy of interferon ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2010.08.013
更新日期:2010-09-01 00:00:00
abstract::Esophageal adenocarcinoma (EAC) has increased dramatically in the past 3 decades, making its precursor lesion Barrett's esophagus (BE) an important clinical problem. Effective interventions are available, but overall outcomes remain unchanged. Most of the BE population remains undiagnosed; most EACs are diagnosed late...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2015.02.008
更新日期:2015-06-01 00:00:00
abstract::The goal of nutritional support in acute pancreatitis is to reduce inflammation, prevent nutritional depletion, correct a negative nitrogen balance, and improve outcomes. Enteral nutrition (EN) in severe acute pancreatitis (SAP) should be preferred to parenteral nutrition. It maintains the integrity of the gut barrier...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2017.10.002
更新日期:2018-03-01 00:00:00
abstract::The intestine contains major subdivisions of the nervous and immune systems. The lymphoid compartments of the intestine contain functionally distinguishable populations of immunologic cells and are innervated differently. The lamina propria has an extensive network of nerves using the neuropeptides SOM, SP, and VIP. S...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00
abstract::Striking geographical differences occur in the clinical presentation of hepatocellular carcinoma in high and low incidence areas. This tumor is also associated with a number of paraneoplastic phenomena that may antedate the clinical appearance. ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1987-12-01 00:00:00
abstract::Surveillance for hepatocellular carcinoma (HCC) has become routine despite a lack of evidence of efficacy. Suitable candidates for surveillance include patients with cirrhosis and some subsets of noncirrhotic chronic hepatitis B carriers. The best surveillance testis ultrasonography at 6- to 12-month intervals. Serolo...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2004.04.012
更新日期:2004-09-01 00:00:00
abstract::The modern management of patients with upper gastrointestinal bleeding includes, in selected patients, the performance of timely multimodal endoscopic hemostasis followed by profound acid suppression. This article discusses the available data on the use of antisecretory regimens in the management of patients with blee...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2010.08.002
更新日期:2010-09-01 00:00:00
abstract::Irritable bowel syndrome (IBS) is a common disorder that has been shown to aggregate in families and to affect multiple generations, but not in a manner consistent with a major Mendelian effect. Relatives of an individual with IBS are 2 to 3 times as likely to have IBS, with both genders being affected. To date, more ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2010.12.011
更新日期:2011-03-01 00:00:00
abstract::Endoscopic approaches have revolutionized the palliation of advanced pancreatic cancer. The ideal management consists of a multidisciplinary approach involving surgeons, endoscopists, radiologists, and oncologists. Concurrent advances in the fields of interventional radiology and laparoscopic surgical oncology should ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2007.04.001
更新日期:2007-06-01 00:00:00
abstract::Preeclampsia has traditionally been viewed as one of several forms of hypertension complicating pregnancy. More recently, the multisystem nature of this unique gestational disorder has been emphasized. Pathophysiologic events, including abnormal placentation and heightened vascular reactivity, may occur weeks or month...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1992-12-01 00:00:00
abstract::Achalasia is a rare motility disorder of the esophagus characterized by the absence of peristalsis and defective relaxation of the lower esophageal sphincter. Patients present at all ages with dysphagia and regurgitation as main symptoms. The diagnosis is suggested by barium swallow and endoscopy and confirmed by mano...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2012.11.009
更新日期:2013-03-01 00:00:00
abstract::This brief review summarizes the physiology and pharmacology of eicosanoids and describes how they have been tested for possible application in liver disease and transplantation. The objective is to trace the stepwise application from the laboratory to the bedside. Although many questions remain to be answered, the ob...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70254-5
更新日期:1996-06-01 00:00:00
abstract::Ulcerative colitis and Crohn's disease both may occur in the elderly. In many populations, a second peak in the incidence of inflammatory bowel disease occurs near age 70. Clinical manifestations of inflammatory bowel disease in the elderly are generally similar to those seen in younger patients, although there is a t...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-06-01 00:00:00
abstract::CD and UC represent a spectrum of chronic IBD that present in protean ways and are accompanied by a variety of systemic sequelae. Sulfasalazine and the newer 5-aminosalicylates are important in the management of mild-to-moderate disease, whereas corticosteroids remain the primary therapy for most patients with moderat...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70058-3
更新日期:1999-06-01 00:00:00
abstract::Capsule endoscopy is a relatively new technology available in the investigation of IBD. Its place in the algorithm of evaluating IBD is being refined. Capsule endoscopy has the ability to visualize the entire SB with very few complications. It is a sensitive test for the diagnosis of mucosal changes, but should be vie...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2012.01.005
更新日期:2012-06-01 00:00:00
abstract::Evidence indicates that the gut microbiota and/or interactions between the microbiota and the host immune system are involved in the pathogenesis of inflammatory bowel disease (IBD). Strategies that target the microbiota have emerged as potential therapies and, of these, probiotics have gained the greatest attention. ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2017.08.003
更新日期:2017-12-01 00:00:00
abstract::Because functional bowel disorders have no reliable markers, they must be defined by their symptoms. The various constellations of symptoms (syndromes) may have different mechanisms, differential diagnoses, and treatments. Therefore, precise classification is important on clinical and scientific grounds. Functional bo...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-06-01 00:00:00
abstract::Ulcerative colitis and Crohn disease are chronic inflammatory diseases with typical onset in early adulthood. These diseases, therefore, can affect a woman throughout the many stages of her life, including menstruation, sexuality, pregnancy, and menopause. Unique health issues face women during these stages and can af...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2016.02.007
更新日期:2016-06-01 00:00:00
abstract::Radiation therapy (RT) has been used to treat cancers for more than a century. Recent randomized trials have helped clarify the treatment recommendations in the use of RT for colorectal cancers. This article reviews these trials to illustrate key concepts, places these trials in perspective, and provides direction for...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2007.12.010
更新日期:2008-03-01 00:00:00