Abstract:
GOALS:A clinical problem is posed by patients with symptoms suggestive of gluten sensitivity (diarrhea, weight loss, unresponsive iron-deficiency anemia, etc.); however, small intestinal biopsies reveal only minor abnormalities, such as lymphocytosis with or without crypt hyperplasia (Marsh I-II). Our aim was to assess the benefit of a gluten-free diet (GFD) in patients with these small bowel mucosal abnormalities. STUDY:We studied 35 patients (11 men, 24 women; mean age, 28 years; range, 22-51 years) referred to us for gastrointestinal symptoms or unexplained or unresponsive diseases. Because celiac disease was suspected to be the underlying pathology, small intestinal biopsies were taken. These revealed only minor abnormalities: 11 patients showed Marsh I type lesions, whereas 24 patients demonstrated Marsh II type lesions. Although the histologic lesions were inconsistent for celiac disease and a suspicion of a borderline celiac disease persisted, all patients were motivated to adhere to GFD. RESULTS Only 23 patients adhered to our advice and followed a GFD; follow-up biopsies were taken after 8 to 12 months. In the Marsh I lesion group (seven patients), five patients showed mucosal normalization to Marsh 0 and two showed persistence of Marsh I lesions. In the Marsh II lesion group (16 patients), 9 patients revealed mucosal normalization, 5 improved to a Marsh I lesion, and 3 revealed persistence of Marsh II lesions. A dramatic clinical improvement in symptoms was noted in all patients who were on a GFD, with symptoms virtually disappearing in all patients. Seven patients who refused GFD were reevaluated 8 to 12 months later. Symptoms and histologic lesions were unchanged in six, all of whom refused again to adhere to a GFD. One of the seven with Marsh I lesions had a worsening of symptoms and of histologic lesions (from Marsh I to Marsh IIIa); so, this last patient adhered to a GFD. CONCLUSIONS:Symptoms disappeared after GFD in patients suspected to have celiac disease but with slight histologic lesions. Although Marsh I-II lesions cannot be classified as celiac lesions (ESPGAN criteria), the patients' symptoms at presentation and the clear improvement of symptoms when on GFD, with or without improvement of histologic lesions, supports the assumption that these patients are sensitive to gluten and may justify treatment with a GFD.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Tursi A,Brandimarte Gdoi
10.1097/00004836-200301000-00006subject
Has Abstractpub_date
2003-01-01 00:00:00pages
13-7issue
1eissn
0192-0790issn
1539-2031journal_volume
36pub_type
杂志文章abstract::We report a 50-year-old woman with alpha 1 antitrypsin deficiency (PiSZ phenotype) who developed clinical features of malabsorption after vagotomy and pyloroplasty. The intestinal biopsy demonstrated total villous atrophy with hypertrophy of the crypts. After gluten withdrawal, digestive function and the appearance of...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198610000-00014
更新日期:1986-10-01 00:00:00
abstract:GOALS:We aimed to quantify pharyngeal exposure to gastric contents in patients diagnosed with reflux-related hoarseness and healthy controls using new diagnostic techniques. BACKGROUND:Hoarseness with typical signs on laryngoscopy is commonly thought to be caused by esophagopharyngeal reflux. New methods are proposed ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000011
更新日期:2014-04-01 00:00:00
abstract::Physicians sometimes forget nongastrointestinal causes of abdominal pain. Yet, abdominal pain was the major complaint of three patients with ureteropelvic junction obstruction (UPJ). Definitive diagnosis can be made either by a "hydration" intravenous pyelogram or by an intravenous pyelogram during an attack. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-197912000-00011
更新日期:1979-12-01 00:00:00
abstract::Two preparations of acetylsalicylic acid (ASA) were tested for their effects on gastroduodenal mucosa in a randomized crossover double-blind study that involved 12 healthy volunteers. Medication M (Monobeltin) consisted of 1,050 mg ASA provided with an enteric coat and medication C (Colfarit) consisted of 1,000 mg of ...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-198806000-00008
更新日期:1988-06-01 00:00:00
abstract::5-Fluorouracil (5-FU), in association with leucovorin (LV), is the most used chemotherapy agent in the treatment of colorectal cancer. Response rate, as well as side-effect incidence, increases with the dose intensity of regimens that are used. The most common dose-limiting toxicity for 5-FU/LV modulation is diarrhea....
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200103000-00010
更新日期:2001-03-01 00:00:00
abstract::The intensity of diagnostic workup of patients with human immunodeficiency virus (HIV)-related chronic diarrhea is controversial. In the ideal setting in which an enteric pathogen is detected with minimal evaluation (stool tests) and in which specific treatment clears the diarrhea, eradicates the pathogen, and improve...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199304000-00018
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Guidelines for chronic hepatitis C virus (HCV) management have recommended that a liver biopsy be repeated at 3-year intervals for HIV/HCV-coinfected patients and 5-year intervals for those with HCV monoinfection to assess fibrosis progression. However, it is unclear if patients are willing to repeat this pr...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318266fe70
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:The clinical effect of probiotics on irritable bowel syndrome (IBS) is still controversial. AIMS:We aimed to evaluate the effects of a probiotic mixture on IBS symptoms and the composition of fecal microbiota in patients with diarrhea-dominant IBS (D-IBS). METHODS:Fifty patients with D-IBS were randomized ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,随机对照试验
doi:10.1097/MCG.0b013e31823712b1
更新日期:2012-03-01 00:00:00
abstract::Eosinophilic esophagitis is a recently described disease characterized by the presence of upper gastrointestinal tract symptoms in association with a dense esophageal eosinophilic infiltrate. The awareness and interest of physicians and researchers in this disease has been increasing as reflected by the number of publ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e318211f95b
更新日期:2011-09-01 00:00:00
abstract::Identical twins presented as sexagenarians with heartburn, regurgitation, and dysphagia; each had a Barrett esophagus remarkably similar to the other. This instance suggests a hereditary influence upon the development of mucosal dysplasia in some patients with this condition. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198306000-00011
更新日期:1983-06-01 00:00:00
abstract::We reviewed 195 colonoscopies to determine whether procedure efficiency differed with the use of an intermediate-length (135 cm) colonoscope compared with a long (165 cm) colonoscope. The cecum was intubated with the 135-cm scope in 92.6% of procedures and with the 165-cm colonoscope in 96.8% of procedures (chi 2 meth...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199507000-00008
更新日期:1995-07-01 00:00:00
abstract:GOALS:We intended to identify the factors associated with missed appointments at a gastroenterology (GI) clinic in an academic setting. BACKGROUND:Missed clinic appointments reduce clinic efficiency, waste resources, and increase costs. Limited data exist on subspecialty clinic attendance. STUDY:We performed a case-c...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000706
更新日期:2017-05-01 00:00:00
abstract::Antacids, cimetidine, carbenoxolone, colloidal bismuth, and prostaglandins promote healing of gastric and duodenal ulcer at a rate nearly twice that of healing during placebo administration. These short-term, 4-12 week healing rates are nearly the same for each agent, with a 65 to 85% range. Drugs that appear to produ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::Lactobacillus species are part of normal gastrointestinal flora and are an uncommon cause of bacteremia. Lactobacillus casei subsp. rhamnosus was repeatedly isolated in the blood cultures of a 43-year-old woman with ulcerative colitis. Lactobacillus spp. could be considered a potential opportunistic pathogen whenever ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200109000-00019
更新日期:2001-09-01 00:00:00
abstract:GOALS:Follicular lymphoma (FL) is a common nodal lymphoma. Primary gastrointestinal follicular lymphoma (GIFL) is rare and most commonly occurs in the elder women with indolent clinical course, mainly in the duodenum and terminal ileum. We conducted this study to characterize GIFL in Taiwan. STUDY:A total of 13 cases ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3180f62b12
更新日期:2008-10-01 00:00:00
abstract::The authors report a rare case of hepatocellular carcinoma (HCC) that developed 6 years after a sustained and complete response to interferon (IFN) therapy for chronic hepatitis C. A 61-year-old Japanese man presented with a mass in the liver that was diagnosed as HCC. Six years earlier he was treated with IFN-alpha a...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199909000-00024
更新日期:1999-09-01 00:00:00
abstract::We recently treated a patient with adult-onset Still's disease who developed macrophage activation syndrome (MAS) secondary to disseminated histoplasmosis while being treated with adalimumab. The gastroenterology service was consulted early, before diagnosis, as the patient presented with elevated liver enzymes and di...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e3181f6015f
更新日期:2011-03-01 00:00:00
abstract::In this paper, I have focused on the issue of the clinical gastroenterologist who refuses to evaluate and endoscope the patient with AIDS. The discussion centers around the legal and ethical properties of such a decision, and the legal doctrine of abandonment. Finally, I have reviewed recent recommendations regarding ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1984-06-01 00:00:00
abstract::The clinicopathologic features of 221 patients with intestinal-type (IT) gastric cancer were compared retrospectively with those of 290 diffuse type (DT). Intestinal type was characterized by an older mean age (65.0 +/- 10.8 years vs. 56.2 +/- 13 years), a higher male-female ratio (2.56 vs. 1.06), predominance of bloo...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199712000-00019
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND/GOALS:Many patients with a history of injection drug use (IDU) are excluded from hepatitis C virus (HCV) treatment. This prospective multicenter study aimed to determine the impact of IDU history on HCV treatment candidacy and outcomes. STUDY:Between 1999 and 2001, 4318 HCV-infected patients seen at 24 VA M...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,多中心研究
doi:10.1097/01.mcg.0000212644.82853.51
更新日期:2007-02-01 00:00:00
abstract::Twenty consecutive patients with unresectable, locally advanced pancreatic cancer were treated with split courses of radiotherapy (RT) and simultaneous multidrug chemotherapy consisting of 5 fluorouracil, continuous infusion, streptozotocin, and cisplatin. A separate, retrospective study identified a group of 28 conte...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:10.1097/00004836-199304000-00006
更新日期:1993-04-01 00:00:00
abstract::Microbial signals stimulate development and maintenance of the neonatal immune system. The process begins in utero, with limited exposure to microbes in the intrauterine environment, as well as maternal immune signals priming the developing immune system. After birth and initial colonization, the immune system must be...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0000000000000355
更新日期:2015-11-01 00:00:00
abstract::Severely ill patients with ulcerative colitis are usually treated with parenteral corticoids. Those with signs of systemic toxicity usually receive antibiotics as well. However, the role of antibiotics in patients without high fever, profound leukocytosis, peritoneal signs or megacolon is not clear. Since 1985, seven ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199307000-00005
更新日期:1993-07-01 00:00:00
abstract::Sclerosing cholangitis may be a cause of refractory pain in patients infected with the human immunodeficiency virus. We performed celiac plexus block in three such patients with sever pain from sclerosing cholangitis and a poor response to conventional analgesia. The pain had been centered in the epigastrium and/or up...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199607000-00013
更新日期:1996-07-01 00:00:00
abstract::In this study we investigated the relationship between chronic gastric ulcers and the appearance of connexin 32 or connexin 43. Samples were taken endoscopically and the appearance of connexin 32 or connexin 43 was assessed by Western blotting using anticonnexin 32 or anticonnexin 43 antibodies. Normal gastric mucosa ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND AND AIM:Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. The objective of this study was to describe the recent trend of health care resource utilization and short-term mortality of Medicare beneficiaries with NAFLD. METHODS:This study utilized data from a ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000071
更新日期:2015-03-01 00:00:00
abstract:GOALS:Our objective was to determine whether high serologic IgA tissue transglutaminase antibodies (TTGA) are exclusively associated with celiac disease (CD). BACKGROUND:IgA TTGA are found in the serum of most individuals with CD. This serologic marker is used to screen individuals with suspected CD for duodenal biops...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,多中心研究
doi:10.1097/MCG.0b013e31802e70b1
更新日期:2008-03-01 00:00:00
abstract::Adhesive tape wound around the shaft of an upper GI endoscope serves as a simple method to dilate upper GI strictures under endoscopic control. This technique avoids the need for guidewires and fluoroscopy. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198506000-00005
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:The current prevalence of primary antibiotic resistance of H. pylori is not known in Korea. This study was done to evaluate the prevalence of primary antibiotic resistance of H. pylori, and to evaluate the effect of point mutations of 23S rRNA on the rate of eradication of H. pylori. METHODS:H. pylori were ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181d04592
更新日期:2010-09-01 00:00:00
abstract::A 37-year-old woman developed multiple liver abscesses caused by Campylobacter jejuni, as a consequence of unrecognized and inadequately treated Campylobacter enteritis. The diagnosis was established by isolation of Campylobacter jejuni from blood and pus obtained from one of the liver abscesses during laparoscopy. Th...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199506000-00011
更新日期:1995-06-01 00:00:00