Dumping Syndrome: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

DUMPING SYNDROME A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J A...

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DUMPING SYNDROME A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Dumping Syndrome: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00384-8 1. Dumping Syndrome-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on dumping syndrome. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON DUMPING SYNDROME .............................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Dumping Syndrome...................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 4 CHAPTER 2. NUTRITION AND DUMPING SYNDROME .................................................................... 29 Overview...................................................................................................................................... 29 Finding Nutrition Studies on Dumping Syndrome .................................................................... 29 Federal Resources on Nutrition ................................................................................................... 30 Additional Web Resources ........................................................................................................... 30 CHAPTER 3. ALTERNATIVE MEDICINE AND DUMPING SYNDROME .............................................. 33 Overview...................................................................................................................................... 33 National Center for Complementary and Alternative Medicine.................................................. 33 Additional Web Resources ........................................................................................................... 35 General References ....................................................................................................................... 36 CHAPTER 4. PATENTS ON DUMPING SYNDROME ........................................................................... 37 Overview...................................................................................................................................... 37 Patent Applications on Dumping Syndrome............................................................................... 37 Keeping Current .......................................................................................................................... 38 CHAPTER 5. BOOKS ON DUMPING SYNDROME............................................................................... 39 Overview...................................................................................................................................... 39 Chapters on Dumping Syndrome ................................................................................................ 39 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 47 Overview...................................................................................................................................... 47 NIH Guidelines............................................................................................................................ 47 NIH Databases............................................................................................................................. 49 Other Commercial Databases....................................................................................................... 51 APPENDIX B. PATIENT RESOURCES ................................................................................................. 53 Overview...................................................................................................................................... 53 Patient Guideline Sources............................................................................................................ 53 Finding Associations.................................................................................................................... 55 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 57 Overview...................................................................................................................................... 57 Preparation................................................................................................................................... 57 Finding a Local Medical Library.................................................................................................. 57 Medical Libraries in the U.S. and Canada ................................................................................... 57 ONLINE GLOSSARIES.................................................................................................................. 63 Online Dictionary Directories ..................................................................................................... 63 DUMPING SYNDROME DICTIONARY ................................................................................... 65 INDEX ................................................................................................................................................ 87

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with dumping syndrome is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about dumping syndrome, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to dumping syndrome, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on dumping syndrome. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to dumping syndrome, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on dumping syndrome. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON DUMPING SYNDROME Overview In this chapter, we will show you how to locate peer-reviewed references and studies on dumping syndrome.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and dumping syndrome, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “dumping syndrome” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Octreotide, a Long-Acting Somatostatin Analog, In The Management of Postoperative Dumping Syndrome: An Update Source: Digestive Diseases and Sciences. 38(2): 359-364. February 1993. Summary: Dumping syndrome, first described in 1922, is an important cause of morbidity after gastric surgery. This article provides information on dumping syndrome, focusing on the use of octreotide for management. Three sections cover the etiology, pathogenesis, and management of the disorder. The authors describe the experience to date with octreotide, a long-acting somatostatin analog, used to slow gastric emptying. A detailed table summarizes key clinical studies on octreotide. 2 tables. 51 references.

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Federally Funded Research on Dumping Syndrome The U.S. Government supports a variety of research studies relating to dumping syndrome. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to dumping syndrome. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore dumping syndrome.

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with dumping syndrome, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “dumping syndrome” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for dumping syndrome (hyperlinks lead to article summaries): •

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A case of late dumping syndrome. Author(s): Yap JC, Wang YT, Poh SC. Source: Ann Acad Med Singapore. 1994 May; 23(3): 418-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7944262

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH). 3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A clinical diagnostic index in the diagnosis of the dumping syndrome. Changes in plasma volume and blood sugar after a test meal. Author(s): Sigstad H. Source: Acta Med Scand. 1970 December; 188(6): 479-86. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5507449

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A comparative study of experimentally produced dumping syndrome after different types of gastric surgery. Author(s): Wiznitzer T, Rozin R, Menczel J, Aviram A. Source: The American Journal of Gastroenterology. 1966 February; 45(2): 91-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5904007

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A glycoside-hydrolase inhibitor in treatment of dumping syndrome. Author(s): McLoughlin JC, Buchanan KD, Alam MJ. Source: Lancet. 1979 September 22; 2(8143): 603-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=90270

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A new method for the surgical treatment of the dumping syndrome. Author(s): Lygidakis NJ. Source: Annals of the Royal College of Surgeons of England. 1981 November; 63(6): 4114. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7294684

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A new operation for the dumping syndrome and post-vagotomy diarrhea. Author(s): Herrington JL Jr, Sawyers JL. Source: Annals of Surgery. 1972 May; 175(5): 790-801. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5028491

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A new operation for the dumping syndrome associated with a small gastric pouch. A report of a case. Author(s): Gunnlaugsson GH. Source: Acta Chir Scand. 1977; 143(6): 379-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=605741

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A physiological approach to the surgical treatment of the dumping syndrome. Author(s): Stemmer EA, Guernsey JM, Heber RE, Connolly JE. Source: Jama : the Journal of the American Medical Association. 1967 March 20; 199(12): 909-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6071611

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A procedure for the management of the severe dumping syndrome. Author(s): Letts RM, Maciver DA. Source: Can Med Assoc J. 1969 June 7; 100(21): 1001. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5789549

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A study of the relationship between the rate of gastric emptying and the dumping syndrome in patients after vagotomy and drainage. Author(s): Haynes S, Thomson JP, Brown N, Keeling DH. Source: The British Journal of Surgery. 1973 April; 60(4): 307-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4700241

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Acarbose treatment of infant dumping syndrome: extensive study of glucose dynamics and long-term follow-up. Author(s): Zung A, Zadik Z. Source: J Pediatr Endocrinol Metab. 2003 July-August; 16(6): 907-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12948306

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Angina pectoris induced by dumping syndrome in idiopathic hypertrophic subaortic stenosis. Author(s): Befeler B, Ross MD, Wells DE, Castellanos A Jr, Myerburg RJ. Source: The American Journal of the Medical Sciences. 1973 July; 266(1): 67-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4146651

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Antiperistaltic jejunal segments for control of the dumping syndrome and postvagotomy diarrhoea. Author(s): Sawyers JL, Herrington J Jr. Source: The British Journal of Surgery. 1969 September; 56(9): 702. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5808413

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Antiperistaltic segments of jejunum in the treatment of the dumping syndrome. Author(s): Stemmer EA, Jones SA, Pearson SC, Connolly JE. Source: Archives of Surgery (Chicago, Ill. : 1960). 1969 April; 98(4): 396-405. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5775919

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Artificial pyloric canal. A modification of the Billroth gastrectomy for the prevention of dumping syndrome. Author(s): Chrysospathis P. Source: Bull Soc Int Chir. 1966 May-June; 25(3): 257-65. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5917119

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Assessment of the dumping syndrome: prevention and correction. Author(s): Frankel LA. Source: Int Surg. 1976 April; 61(4): 216. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1270219

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Atrial natriuretic peptide in dumping syndrome. Author(s): Tulassay Z, Tulassay T, Gupta R, Rascher W. Source: Digestion. 1993; 54(1): 44-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8513987

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Benefit of somatostatin in dumping syndrome. Author(s): Tulassay Z, Tulassay T, Tamas G Jr. Source: Surgery. 1988 January; 103(1): 130-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2892277

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Benefit of uncooked cornstarch in the management of children with dumping syndrome fed exclusively by gastrostomy. Author(s): Borovoy J, Furuta L, Nurko S. Source: The American Journal of Gastroenterology. 1998 May; 93(5): 814-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9625134

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Catecholamines in the early dumping syndrome. Author(s): Shemerdiak WP, Abramson EC, Schlesinger PK, Werner PL. Source: Clinical Chemistry. 1982 April; 28(4 Pt 1): 722-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7074854

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Characteristics of the stimulus necessary to produce the dumping syndrome. Author(s): Stemmer EA, Hegeman CO, Connolly JE. Source: The American Journal of Gastroenterology. 1970 September; 54(3): 237-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5507288

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Clinical and therapeutic applications of a new pathogenetic theory on the dumping syndrome. Author(s): Riboli EB, Mortola GP, Reboa G, Anfossi A, PANDOLFO N. Source: Int Surg. 1976 April; 61(4): 212-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1270218

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Clinical experience with isoperistaltic interposition of a jejunal segment for the incapacitating dumping syndrome. Author(s): Fenger HJ, Gudmand-Hoyer E, Kallehauge HE, Andreassen M. Source: Annals of Surgery. 1972 February; 175(2): 274-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5059610

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Clinical experiences with corrective surgery for the dumping syndrome. Author(s): Nagel CB, Farris JM. Source: American Journal of Surgery. 1968 August; 116(2): 229-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5675280

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Clinical relevance of scintigraphic measurement of gastric emptying of a solid-liquid meal in the dumping syndrome. Author(s): Jian R, Lemann M, Flourie B, Rain JJ, Rambaud JC. Source: Hepatogastroenterology. 1992 February; 39(1): 17-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1568700

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Comparison of D(+)xylose with glucose in the study of the pathophysiology of the postgastrectomy dumping syndrome. Author(s): Geokas MC, Solymar J, Beck IT. Source: Am J Dig Dis. 1967 January; 12(1): 30-41. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6017991

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Decreased activity of atrial natriuretic peptide in dumping syndrome after gastric surgery. Author(s): Tulassay Z, Tulassay T, Gupta R, Rascher W. Source: Digestive Diseases and Sciences. 1991 August; 36(8): 1177-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1830840

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Dietary habits in patients with dumping syndrome-like symptoms after proximal selective vagotomy. Author(s): Harju E. Source: Journal of Clinical Gastroenterology. 1986 October; 8(5): 525-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3782749

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Does the "dumping syndrome" occur in Jamaicans? Author(s): Thirumalai CH, Raje D. Source: The West Indian Medical Journal. 1986 March; 35(1): 46-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3716393

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Dumping syndrome after combined pyloroplasty and fundoplication. Author(s): van Kempen AA, Hoekstra JH, Willekens FG, Kneepkens CM. Source: European Journal of Pediatrics. 1992 July; 151(7): 546. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1396921

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Dumping syndrome after combined pyloroplasty and fundoplication. Author(s): Pittschieler K. Source: European Journal of Pediatrics. 1991 April; 150(6): 410-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2040349

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Dumping syndrome after Nissen fundoplication. Author(s): Veit F, Heine RG, Catto-Smith AG. Source: Journal of Paediatrics and Child Health. 1994 April; 30(2): 182-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8198856

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Dumping syndrome and diarrhoea after vagotomy. Author(s): Ihasz M, Refi M, Kiss L, Palyi A, Vaczi F, Batorfi J. Source: Acta Chir Acad Sci Hung. 1977; 18(1): 1-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=596068

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Dumping syndrome and the regulation of peptide YY with verapamil. Author(s): Chandos B. Source: The American Journal of Gastroenterology. 1992 October; 87(10): 1530-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1415124

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Dumping syndrome following anterior lesser curve seromyotomy with posterior truncal vagotomy. Author(s): Barclay GR, Finlayson ND, Taylor TV. Source: The British Journal of Surgery. 1987 April; 74(4): 285. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3580803

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Dumping syndrome following Nissen fundoplication, diagnosis, and treatment. Author(s): Samuk I, Afriat R, Horne T, Bistritzer T, Barr J, Vinograd I. Source: Journal of Pediatric Gastroenterology and Nutrition. 1996 October; 23(3): 235-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8890072

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Dumping syndrome following Nissen's fundoplication: a cause for refusal to feed. Author(s): Hirsig J, Baals H, Tuchschmid P, Spitz L, Stauffer UG. Source: Journal of Pediatric Surgery. 1984 April; 19(2): 155-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6427440

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Dumping syndrome following pyloroplasty. Author(s): Bowers RF, Stockard CG Jr. Source: Archives of Surgery (Chicago, Ill. : 1960). 1966 January; 92(1): 39-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5901699

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Dumping syndrome in a young child. Author(s): de Vries TW, Doddema JW, Heijmans HS. Source: European Journal of Pediatrics. 1995 August; 154(8): 624-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7588961

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Dumping syndrome in a young Jamaican child. Author(s): McKenzie C, Boyne M, Venugopal S, Cooper E. Source: The West Indian Medical Journal. 1998 December; 47(4): 169-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10097670

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Dumping syndrome in children. Author(s): Caulfield ME, Wyllie R, Firor HV, Michener W. Source: The Journal of Pediatrics. 1987 February; 110(2): 212-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3806293

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Dumping syndrome in children. Diagnosis and effect of glucomannan on glucose tolerance and absorption. Author(s): Kneepkens CM, Fernandes J, Vonk RJ. Source: Acta Paediatr Scand. 1988 March; 77(2): 279-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2833060

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Dumping syndrome in the intra-thoracic stomach. Author(s): Sinha S, Padhy AK, Chattopadhyay TK. Source: Trop Gastroenterol. 1997 July-September; 18(3): 131-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9385862

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Dumping syndrome: a common problem following Nissen fundoplication in young children. Author(s): Bufler P, Ehringhaus C, Koletzko S. Source: Pediatric Surgery International. 2001 July; 17(5-6): 351-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11527163

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Effect of acarbose on biochemical responses and clinical symptoms in dumping syndrome. Author(s): Lyons TJ, McLoughlin JC, Shaw C, Buchanan KD. Source: Digestion. 1985; 31(2-3): 89-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3888753

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Effect of neurotensin in the dumping syndrome. Author(s): Pedersen JH, Beck H, Shokouh-Amiri M, Fischer A. Source: Scandinavian Journal of Gastroenterology. 1986 May; 21(4): 478-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3726454

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Effect of pectin on gastric emptying and gut hormone release in the dumping syndrome. Author(s): Lawaetz O, Blackburn AM, Bloom SR, Aritas Y, Ralphs DN. Source: Scandinavian Journal of Gastroenterology. 1983 May; 18(3): 327-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6369514

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Effect of tolbutamide on the dumping syndrome. Author(s): Sigstad H. Source: Scandinavian Journal of Gastroenterology. 1969; 4(3): 227-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5346670

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Efficacy of guar gum in preventing the dumping syndrome. Author(s): Harju E, Larmi TK. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1983 September-October; 7(5): 470-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6315982

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Efficacy of octreotide acetate in treatment of severe postgastrectomy dumping syndrome. Author(s): Geer RJ, Richards WO, O'Dorisio TM, Woltering EO, Williams S, Rice D, Abumrad NN. Source: Annals of Surgery. 1990 December; 212(6): 678-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2256759

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Elevation of plasma neurotensin in the dumping syndrome. Author(s): Blackburn AM, Christofides ND, Ghatei MA, Sarson DL, Ebeid FH, Ralphs DN, Bloom SR. Source: Clinical Science (London, England : 1979). 1980 October; 59(4): 237-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7428291

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Enteroanastomosis with partial gastrectomy in treatment of postcibal symptoms. Protection against dumping syndrome and diarrhea. Author(s): Dahlgren S. Source: The American Surgeon. 1966 September; 32(9): 615-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5916958

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Enteroglucagon release in the dumping syndrome. Author(s): Bloom SR, Royston CM, Thomson JP. Source: Lancet. 1972 October 14; 2(7781): 789-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4116231

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Excretion of free and conjugated 5-hydroxyindoleacetic acid during provoked dumping syndrome. Author(s): Peltola P. Source: Ann Med Exp Biol Fenn. 1968; 46(3): 505-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5734255

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Extracellular space, blood volume, and the early dumping syndrome after total gastrectomy. Author(s): Miholic J, Reilmann L, Meyer HJ, Korber H, Kotzerke J, Hecker H. Source: Gastroenterology. 1990 October; 99(4): 923-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2168330

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Gastric emptying after peptic ulcer surgery. Some pathophysiological mechanisms of the dumping syndrome. Author(s): Lawaetz O, Aritas Y, Blackburn AM, Ralphs DN. Source: Scandinavian Journal of Gastroenterology. 1982 November; 17(8): 1065-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7167737

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Gastric emptying after surgery for the dumping syndrome. Author(s): Harries AD, Dew MJ, Crawley EO, Leach KG, Salaman JR, Rhodes J. Source: Postgraduate Medical Journal. 1984 July; 60(705): 458-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6462993

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Gastroenteric anastomosis in Billroth II gastrectomy with maintenance of the physiologic diameter of the normal pylorus to prevent the dumping syndrome. Part II. Results in 1,300 cases. Author(s): Salessiotis NA. Source: American Journal of Surgery. 1975 June; 129(6): 657-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1093423

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Gastrointestinal hormone in dumping syndrome and reflux esophagitis after gastric surgery. Author(s): Yamashita Y, Toge T, Adrian TE. Source: J Smooth Muscle Res. 1997 April; 33(2): 37-48. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9403815

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Gut hormone profile and gastric emptying in the dumping syndrome. A hypothesis concerning the pathogenesis. Author(s): Lawaetz O, Blackburn AM, Bloom SR, Aritas Y, Ralphs DN. Source: Scandinavian Journal of Gastroenterology. 1983 January; 18(1): 73-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6372067

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Herrington JL Jr,+HERRINGTON JL JR: Antiperistaltic jejunal segments for control of the dumping syndrome and postvagotomy diarrhea. Author(s): Sawyers JL. Source: Surgery. 1971 February; 69(2): 263-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5539216

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Hormonal basis for the Dumping syndrome. Author(s): Davis RL, Girard DL, Eaton RP. Source: Rocky Mt Med J. 1974 February; 71(2): 94-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4811718

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Hormonal changes before and after dietary intervention in a patient with dumping syndrome. Author(s): Zador I, Youmans D, Summerford MK. Source: Acta Paediatrica (Oslo, Norway : 1992). 2000 March; 89(3): 358-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10772287

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Humoral aspects of dumping syndrome. Author(s): Blackburn AM, Bloom SR. Source: Lancet. 1981 January 10; 1(8211): 92-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6109136

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Hypoglycemia pathogenesis in children with dumping syndrome. Author(s): Rivkees SA, Crawford JD. Source: Pediatrics. 1987 December; 80(6): 937-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3317264

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Hypoglycemia unawareness in a patient with dumping syndrome: report of a case. Author(s): Bellini F, Sammicheli L, Ianni L, Pupilli C, Serio M, Mannelli M. Source: J Endocrinol Invest. 1998 July-August; 21(7): 463-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9766263

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Increased flow in the superior mesenteric artery in dumping syndrome. Author(s): Aldoori MI, Qamar MI, Read AE, Williamson RC. Source: The British Journal of Surgery. 1985 May; 72(5): 389-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3888339

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Infant dumping syndrome after gastroesophageal reflux surgery. Author(s): Meyer S, Deckelbaum RJ, Lax E, Schiller M. Source: The Journal of Pediatrics. 1981 August; 99(2): 235-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7252681

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Infant dumping syndrome: reversal of symptoms by feeding uncooked starch. Author(s): Gitzelmann R, Hirsig J. Source: European Journal of Pediatrics. 1986 December; 145(6): 504-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3816853

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Influences on the occurrence of dumping syndrome. Author(s): Kaushik SP, Ralphs DN, Hobsley M. Source: The American Journal of Gastroenterology. 1983 March; 78(3): 155-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6829534

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Insulinoma misdiagnosed as dumping syndrome after bariatric surgery. Author(s): Zagury L, Moreira RO, Guedes EP, Coutinho WF, Appolinario JC. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2004 January; 14(1): 120-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14980046

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Is the dumping syndrome a problem after standard pancreatoduodenectomy? Author(s): Trede M. Source: Hpb Surg. 1990 March; 2(1): 77-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2282333

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Isoperistaltic and antiperistaltic jejunal interposition for the dumping syndrome: a compartive study. Author(s): Cuschieri A. Source: Journal of the Royal College of Surgeons of Edinburgh. 1977 September; 22(5): 319-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=915852

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Jejunal interposition as remedial operation for severe dumping syndrome. Author(s): Mendoza CB Jr, Easley GW, Gerwig WH Jr. Source: American Journal of Surgery. 1973 March; 125(3): 318-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4690118

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Kallikrein-kinin system in postgastrectomy dumping syndrome. Author(s): Wong PY, Talamo RC, Babior BM, Raymond GG, Colman RW. Source: Annals of Internal Medicine. 1974 May; 80(5): 577-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4823809

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Long acting somatostatin analogue in dumping syndrome. Author(s): Tulassay Z, Tulassay T, Gupta R, Cierny G. Source: The British Journal of Surgery. 1989 December; 76(12): 1294-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2691013

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Long-acting analogue of somatostatin--SMS 201-995--is highly effective in the prevention of clinical symptoms related to the dumping syndrome. Author(s): Tulassay Z, Tulassay T, Gupta R, Cierny G. Source: Annals of Surgery. 1989 August; 210(2): 250-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2757427

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Long-term effect of alpha-glucosidase inhibitor on late dumping syndrome. Author(s): Hasegawa T, Yoneda M, Nakamura K, Ohnishi K, Harada H, Kyouda T, Yoshida Y, Makino I. Source: Journal of Gastroenterology and Hepatology. 1998 December; 13(12): 1201-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9918426

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Long-term results of octreotide-therapy in severe dumping syndrome. Author(s): Vecht J, Lamers CB, Masclee AA. Source: Clinical Endocrinology. 1999 November; 51(5): 619-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10594523

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Low dose acarbose without symptoms of malabsorption in the dumping syndrome. Author(s): Jenkins DJ, Barker HM, Taylor RH, Fielden H. Source: Lancet. 1982 January 9; 1(8263): 109. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6119474

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Measurement of superior mesenteric artery flow by means of Doppler ultrasound in early dumping syndrome. Author(s): Vecht J, van Oostayen JA, Lamers CB, Masclee AA. Source: The American Journal of Gastroenterology. 1998 December; 93(12): 2380-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9860396

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Mechanism of the post-gastrectomy dumping syndrome. Author(s): Machella TE. Source: Gastroenterology. 1968 April; 54(4): Suppl: 721-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5653781

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Mechanisms by which octreotide ameliorates symptoms in the dumping syndrome. Author(s): Hasler WL, Soudah HC, Owyang C. Source: The Journal of Pharmacology and Experimental Therapeutics. 1996 June; 277(3): 1359-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8667198

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Neurotensin and substance P and dumping syndrome. Author(s): Ito S, Iwasaki Y, Momotsu T, Takai K, Shibata A, Matsubara Y, Muto T. Source: The Tohoku Journal of Experimental Medicine. 1981 September; 135(1): 11-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6172887

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Neurotensin and the dumping syndrome. Author(s): Delle Fave G, Bruzzone R, Annibale B, Severi C, De Toma G. Source: Lancet. 1981 May 30; 1(8231): 1209. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6112548

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Neurotensin, vasoactive intestinal peptide, and Roux-en-Y gastrojejunostomy. Their role in the dumping syndrome. Author(s): Sirinek KR, O'Dorisio TM, Howe B, McFee AS. Source: Archives of Surgery (Chicago, Ill. : 1960). 1985 May; 120(5): 605-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3985800

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Noninvasive vascular assessment of dumping syndrome. Usefulness in therapeutic decisions. Author(s): Creaghe SB, Saik RP, Pearl J, Peskin GW. Source: The Journal of Surgical Research. 1977 April; 22(4): 328-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=850396

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Nutritional management of dumping syndrome associated with antireflux surgery. Author(s): Khoshoo V, Roberts PL, Loe WA, Golladay ES, Pencharz PB. Source: Journal of Pediatric Surgery. 1994 November; 29(11): 1452-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7844719

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Nutritional manipulation in the management of dumping syndrome. Author(s): Khoshoo V, Reifen RM, Gold BD, Sherman PM, Pencharz PB. Source: Archives of Disease in Childhood. 1991 December; 66(12): 1447-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1776896

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Nutritional studies in patients with dumping syndrome. I. Subjects with postcibal symptoms. Author(s): Hanngren A, Hedenstedt S, Reizenstein P. Source: Am J Dig Dis. 1967 January; 12(1): 71-80. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6017995

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Nutritional studies in the dumping syndrome. 3. Retention of orally administered calcium in patients after gastrectomy. Author(s): Sjoberg HE, Reizenstein P. Source: Am J Dig Dis. 1967 November; 12(11): 1156-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6057058

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Nutritional studies in the dumping syndrome. II. Effects of secondary jejunal transposition. Author(s): Hanngren A, Hedenstedt S, Reizenstein P. Source: Am J Dig Dis. 1967 November; 12(11): 1149-55. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6057057

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Octreotide acetate induces fasting small bowel motility in patients with dumping syndrome. Author(s): Richards WO, Geer R, O'Dorisio TM, Robarts T, Parish KL, Rice D, Woltering G, Abumrad NN. Source: The Journal of Surgical Research. 1990 December; 49(6): 483-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2263084

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Octreotide in the treatment of the dumping syndrome. Author(s): Primrose JN. Source: Digestion. 1990; 45 Suppl 1: 49-58; Discussion 58-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2335268

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Octreotide, a long-acting somatostatin analog, in the management of postoperative dumping syndrome. An update. Author(s): Lamers CB, Bijlstra AM, Harris AG. Source: Digestive Diseases and Sciences. 1993 February; 38(2): 359-64. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8425449

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On the dumping syndrome as one of the postcibal syndromes after gastric resection. Author(s): Takayama T, Nozaki S. Source: Int Surg. 1966 August; 46(2): 190-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5947660

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On the role of some factors in the origin of the so-called dumping syndrome. Author(s): Baev B, Gatsinski P, Dimitrov D. Source: Nauchni Tr Vissh Med Inst Sofiia. 1968; 47(2): 57-67. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4240147

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Pathophysiological studies of the effect of isoperistaltic jejunal interposition in the treatment of the incapacitating dumping syndrome. Author(s): Fenger HJ, Kallehauge HE, Gudmand-Hoyer E. Source: Scandinavian Journal of Gastroenterology. 1972; 7(3): 283-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5034536

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Plasma enteroglucagon and plasma-volume changes after oral hypertonic glucose-their relationship to the dumping syndrome. Author(s): Thomson JP, Bloom SR, Haynes S, Ogawa O. Source: The British Journal of Surgery. 1973 April; 60(4): 308. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4700242

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Plasma enteroglucagon levels in the dumping syndrome. Author(s): Bloom SR, Royston CM, Thomson JP. Source: Clin Sci. 1972 December; 43(6): 18P. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4646269

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Plasma neurotensin release and gastric emptying in the dumping syndrome. Author(s): Blackburn AM, Lawaetz O, Bloom SR. Source: Life Sciences. 1983 February 21; 32(8): 833-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6827914

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Plasma peptide YY (PYY) in dumping syndrome. Author(s): Adrian TE, Long RG, Fuessl HS, Bloom SR. Source: Digestive Diseases and Sciences. 1985 December; 30(12): 1145-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2866074

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Postprandial GLP-1, norepinephrine, and reactive hypoglycemia in dumping syndrome. Author(s): Gebhard B, Holst JJ, Biegelmayer C, Miholic J. Source: Digestive Diseases and Sciences. 2001 September; 46(9): 1915-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11575444

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Principles of diet therapy for postgastrectomy Dumping syndrome. Author(s): Unser HL. Source: Major Probl Clin Surg. 1976; 20: 159-62. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=957780

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Proceedings: Characterization of glucagon responses to different meals in the dumping syndrome. Author(s): O'Connor FA, Buchanan KD, Trimble ER, Hayes JR, Kennedy TL. Source: Gut. 1974 April; 15(4): 348. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4834592

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Proximal jejunal reversal procedure without interposition for management of dumping syndrome. Author(s): Chang TH, Myers HC. Source: The American Surgeon. 1975 October; 41(10): 632-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1163905

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Radioisotope evidence of varying transit of solid food in gastrectomized patients with and without dumping syndrome. Author(s): Palermo F, Boccaletto F, Magalini M, Chiara G, Tommaseo T, Dapporto L. Source: Nuklearmedizin. 1988 October; 27(5): 195-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3194231

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Reactive hypoglycaemia due to late dumping syndrome: successful treatment with acarbose. Author(s): Imhof A, Schneemann M, Schaffner A, Brandle M. Source: Swiss Medical Weekly : Official Journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology. 2001 February 10; 131(5-6): 81-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11383230

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Recent concepts in the dumping syndrome. Author(s): Drapanas T. Source: J Miss State Med Assoc. 1969 November; 10(11): 493-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5352794

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Relationship between changes in digit blood flow and the dumping syndrome. Author(s): Strandness DE Jr, Bell JW. Source: Annals of Surgery. 1967 November; 166(5): 773-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6057086

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Release of vasoactive intestinal peptide in the dumping syndrome. Author(s): Sagor GR, Bryant MG, Ghatei MA, Kirk RM, Bloom SR. Source: British Medical Journal (Clinical Research Ed.). 1981 February 14; 282(6263): 50710. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6780101

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Remedial operation for dumping syndrome and-or postvagotomy diarrhea. Author(s): Sawyers JL, Herrington JL Jr. Source: Southern Medical Journal. 1971 May; 64(5): 589-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5573078

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Results following remedial operation for severe dumping syndrome. Author(s): Gerwig WH Jr, Easley GW, Mendoza CB Jr. Source: Archives of Surgery (Chicago, Ill. : 1960). 1967 October; 95(4): 631-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5006636

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Role of 5-hydroxytryptamine in the dumping syndrome after gastrectomy: histochemical study. Author(s): Tobe T, Kimura C, Fujiwara M. Source: Annals of Surgery. 1967 March; 165(3): 382-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6019312

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Serotonin and the dumping syndrome. Author(s): Reichle FA, Brigham MP, Rosemond GP. Source: Jama : the Journal of the American Medical Association. 1967 March 20; 199(12): 914-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6071559

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Serotonin and the dumping syndrome: a reappraisal. Author(s): Jesseph JE. Source: Surgery. 1968 March; 63(3): 536-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5644683

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Serotonin metabolism in the dumping syndrome: studies on human portal vein. Author(s): Reichle FA, Brigham MP, Reichle RM, Rosemond GP. Source: Surg Forum. 1969; 20: 343-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5383082

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Simultaneous measurement of intestinal blood flow and plasma levels of vasoactive substances in a case of early dumping syndrome. Case report. Author(s): Naito Y, Tamai S, Shichino T, Shindo K, Matsui T, Singu K, Fukata J, Mori K. Source: The European Journal of Surgery = Acta Chirurgica. 1991 March; 157(3): 231-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1678639

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Small bowel injury as a factor in the dumping syndrome. Author(s): Butt K, Kottmeier PK, Adamsons J, Fitzgerald J, Brandwein G, McNally EF, Dennis C. Source: Surgery. 1967 October; 62(4): 572-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6051106

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Somatostatin analogue SMS 201-995 (octreotide) as a possible solution to the dumping syndrome after gastrectomy or vagotomy. Author(s): Primrose JN, Johnston D. Source: The British Journal of Surgery. 1989 February; 76(2): 140-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2702445

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Somatostatin and the dumping syndrome. Author(s): Reasbeck PG, Van Rij AM. Source: British Medical Journal (Clinical Research Ed.). 1985 April 13; 290(6475): 1147. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2859076

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Somatostatin and the dumping syndrome. Author(s): Long RG, Adrian TE, Bloom SR. Source: British Medical Journal (Clinical Research Ed.). 1985 March 23; 290(6472): 886-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2858244

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Studies in dumping syndrome. V. Tuberculosis in gastrectomized patients. Author(s): Hanngren A, Reizenstein P. Source: Am J Dig Dis. 1969 October; 14(10): 700-10. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4980916

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Studies in the dumping syndrome. IV. Effect of calcium therapy on calcium metabolism and osteopenia in gastrectomized patients. Author(s): Arman E, Reizenstein P. Source: Am J Dig Dis. 1969 March; 14(3): 153-62. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5773912

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Studies in the dumping syndrome. VI. Calcium deficiency after partial gastrectomy. Author(s): Arman E, Nilsson LH, Reizenstein P. Source: Am J Dig Dis. 1970 May; 15(5): 455-62. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5439472

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Studies on gastrointestinal hormone and jejunal interdigestive migrating motor complex in patients with or without early dumping syndrome after total gastrectomy with Roux-en-Y reconstruction for early gastric cancer. Author(s): Tomita R, Fujisaki S, Tanjoh K, Fukuzawa M. Source: American Journal of Surgery. 2003 April; 185(4): 354-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12657389

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Studies on the dumping syndrome. Author(s): Hochman R, Brennom W, Kottmeier PK, Adamsons R, Dennis C. Source: Bull Soc Int Chir. 1970 January-February; 29(1): 15-20. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5510183

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Studies on the pathogenesis of the early dumping syndrome induced by intraduodenal instillation of hypertonic glucose. Author(s): Snook JA, Wells AD, Prytherch DR, Evans DH, Bloom SR, Colin-Jones DG. Source: Gut. 1989 December; 30(12): 1716-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2693232

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Studies on the relationship between the qualities of substitute stomachs and the occurrence of the dumping syndrome after total gastrectomy. Author(s): Toshimitsu M. Source: Nippon Geka Hokan. 1975 July 1; 44(4): 281-312. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1238064

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Superiority of antiperistaltic jejunal segments in management of severe dumping syndrome. Author(s): Sawyers JL, Herrington JL Jr. Source: Annals of Surgery. 1973 September; 178(3): 311-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4729755

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Surgery for dumping syndrome: a new surgical approach to an old problem. (Part I of two parts). Author(s): Lygidakis NJ. Source: Med Chir Dig. 1982; 11(1): 37-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7087571

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Surgical treatment of the dumping syndrome after gastroduodenal resection. Author(s): Benedini E, Bertuccio F, Mossini A, Viotto A. Source: Int Surg. 1980 September-October; 65(5): 419-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7451061

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Surgical treatment of the dumping syndrome: new method. Author(s): Cuschieri A. Source: Annals of the Royal College of Surgeons of England. 1982 March; 64(2): 134-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7065601

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Surgical treatment of the postgastrectomy dumping syndrome. Author(s): Miranda R, Steffes B, O'Leary JP, Woodward ER. Source: American Journal of Surgery. 1980 January; 139(1): 40-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7350845

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Sympathoadrenal activation and the dumping syndrome after gastric surgery. Author(s): Mehagnoul-Schipper DJ, Lenders JW, Willemsen JJ, Hopman WP. Source: Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society. 2000 October; 10(5): 301-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11198486

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The anatomy of "the dumping syndrome". Author(s): Fitzgerald P. Source: Ir J Med Sci. 1968 October; 7(10): 471-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5760486

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The dumping syndrome after pancreatoduodenectomy. Author(s): Linehan IP, Russell RC, Hobsley M. Source: Surg Gynecol Obstet. 1988 August; 167(2): 114-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3400028

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The dumping syndrome and its treatment. A review and presentation of cases. Author(s): Buchwald H. Source: American Journal of Surgery. 1968 July; 116(1): 81-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5652363

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The dumping syndrome and the hydrogen ion concentration of the gastric contents. Author(s): Thomson JP, Russell RC, Hobsley M, Le Quesne LP. Source: Gut. 1974 March; 15(3): 200-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4841276

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The dumping syndrome. Author(s): Ralphs DN. Source: Br J Clin Pract. 1981 September; 35(9): 291-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7326182

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The dumping syndrome. Author(s): Frankel LA. Source: Archives of Surgery (Chicago, Ill. : 1960). 1971 May; 102(5): 536. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5580349

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The dumping syndrome. Author(s): Berk JL. Source: Archives of Surgery (Chicago, Ill. : 1960). 1971 January; 102(1): 88-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5538776

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The dumping syndrome. Current insights into pathophysiology, diagnosis and treatment. Author(s): Vecht J, Masclee AA, Lamers CB. Source: Scandinavian Journal of Gastroenterology. Supplement. 1997; 223: 21-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9200302

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The early dumping syndrome and propranolol. Author(s): Niv Y. Source: Annals of Internal Medicine. 1988 June; 108(6): 910-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3369789

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The early postprandial dumping syndrome: clinical manifestations and pathogenesis. Author(s): Woodward ER. Source: Major Probl Clin Surg. 1976; 20: 1-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=957773

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The early postprandial dumping syndrome: prevention and treatment. Author(s): Woodward ER, Bushkin FL. Source: Major Probl Clin Surg. 1976; 20: 14-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=957778

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The effect of somatostatin in dumping syndrome after gastric surgery. Author(s): Tulassay Z, Tulassay T, Gupta R, Tamas G. Source: Acta Gastroenterol Belg. 1993 March-April; 56(2): 219-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8103615

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The hospital "dumping syndrome": causes and treatment. Author(s): Wilder JF, Karasu B, Kligler D. Source: The American Journal of Psychiatry. 1972 May; 128(11): 1446-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5020198

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The incidence of the dumping syndrome following gastrojejunostomy with Roux-eny anastomosis. Author(s): Cade RJ, Kilby JO. Source: Postgraduate Medical Journal. 1982 December; 58(686): 760-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7170285

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The late postprandial dumping syndrome. Author(s): Woodward ER, Neustein CL. Source: Major Probl Clin Surg. 1976; 20: 28-33. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=957781

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The long-term fate of patients with dumping syndrome. Author(s): Chaimoff C, Dintsman M, Tiqva P. Source: Archives of Surgery (Chicago, Ill. : 1960). 1972 October; 105(4): 554-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5071159

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The mechanism of the dumping syndrome. Author(s): Silver D, McGregor FH Jr, Porter JM, Anlyan WG. Source: The Surgical Clinics of North America. 1966 April; 46(2): 425-39. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5324141

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The place of octreotide in the medical management of the dumping syndrome. Author(s): Scarpignato C. Source: Digestion. 1996; 57 Suppl 1: 114-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8813487

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The relationship between some physiological and psychological parameters in individuals with postgastrectomy dumping syndrome. Author(s): Borgstrom SG, Bulow KB, Nyman GE. Source: Journal of Psychosomatic Research. 1972 October; 16(6): 459-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4666663

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The relationship between the rate of gastric emptying and the dumping syndrome. Author(s): Ralphs DN, Thomson JP, Haynes S, Lawson-Smith C, Hobsley M, Le Quesne LP. Source: The British Journal of Surgery. 1978 September; 65(9): 637-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=698537

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The role of humoral factors in the dumping syndrome: experimentally induced dumping before and after portal systemic shunt. Author(s): Geokas MC, Beck IT. Source: Can Med Assoc J. 1966 June 4; 94(23): 1210-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5939554

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The successful application of jejunal interposition for severe dumping syndrome: report of a case. Author(s): Ishikawa M, Morioka E, Wada D, Komi N. Source: Surgery Today. 1994; 24(10): 911-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7894190

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Therapeutic value of octreotide for patients with severe dumping syndrome--a review of randomised controlled trials. Author(s): Li-Ling J, Irving M. Source: Postgraduate Medical Journal. 2001 July; 77(909): 441-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11423592

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Treatment of congenital microgastria and dumping syndrome. Author(s): Anderson KD, Guzzetta PC. Source: Journal of Pediatric Surgery. 1983 December; 18(6): 747-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6663400

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Treatment of dumping syndrome by interposition of an antiperistaltic segment of small intestine. Author(s): Rigas AM. Source: Int Surg. 1975 March; 60(3): 156-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1123267

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Treatment of the dumping syndrome with the somatostatin analogue SMS 201-995. Author(s): Hopman WP, Wolberink RG, Lamers CB, Van Tongeren JH. Source: Annals of Surgery. 1988 February; 207(2): 155-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2893592

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Use of a provocation test for objective assessment of dumping syndrome in patients undergoing surgery for duodenal ulcer. Author(s): Kaushik SP, Ralphs DN, Hobsley M, Le Quesne LP. Source: The American Journal of Gastroenterology. 1980 September; 74(3): 251-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7468560

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Use of hypertonic-barium mixtures in the diagnosis of the dumping syndrome. Author(s): Seymour EQ. Source: The American Surgeon. 1976 August; 42(8): 547-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=942115

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Utilization of small bowel segments as a gastric reservoir for control of the dumping syndrome. Author(s): Herrington JL Jr. Source: American Journal of Surgery. 1966 January; 111(1): 89-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5901439

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Vascular hypertonicity. A mechanism for vasodilatation in the dumping syndrome. Author(s): Lucas CE, Read RC. Source: Surgery. 1966 August; 60(2): 395-401. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5915471

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Vasoactive substances in early dumping syndrome: effects of dumping provocation with and without octreotide. Author(s): Vecht J, Gielkens HA, Frolich M, Lamers CB, Masclee AA. Source: European Journal of Clinical Investigation. 1997 August; 27(8): 680-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9279532

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CHAPTER 2. NUTRITION AND DUMPING SYNDROME Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and dumping syndrome.

Finding Nutrition Studies on Dumping Syndrome The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “dumping syndrome” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “dumping syndrome” (or a synonym): •

Trial of pectin-enriched muffins in patients with severe dumping syndrome after gastric resection. Observations on symptoms and gastric emptying pattern. Author(s): Department of Medicine, University of Copenhagen, Denmark. Source: Andersen, J R Holtug, K Uhrenholt, A Acta-Chir-Scand. 1989; 155(1): 39-41 00015482

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

Nutrition

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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The following is a specific Web list relating to dumping syndrome; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Food and Diet Hypoglycemia Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND DUMPING SYNDROME Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to dumping syndrome. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to dumping syndrome and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “dumping syndrome” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to dumping syndrome: •

A protein dietary supplement for the severe dumping syndrome. Author(s): Alexander HC. Source: Surg Gynecol Obstet. 1975 December; 141(6): 863-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1237939

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Advances in gastrointestinal electrical stimulation. Author(s): Lin Z, Chen JD. Source: Critical Reviews in Biomedical Engineering. 2002; 30(4-6): 419-57. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12739756

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Device for induction electrostimulation of a gastrointestinal anastamosis after gastric resection.

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Author(s): Pisarevskii AA, Golland VS, Chechulin YuS, Belousov AS, Sokolov YuN, Kuznetsov VA, Ivanchenko YuB, Ovchinnikov VI, Bredikhina NA, Shniger EV. Source: Biomed Eng (Ny). 1974 September; 7(6): 374-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4844300 •

Diet therapy in gastrointestinal disease: a commentary. Author(s): Arvanitakis C. Source: Journal of the American Dietetic Association. 1979 October; 75(4): 449-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=479489

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Effect of dietary fiber on complications of gastric surgery: prevention of postprandial hypoglycemia by pectin. Author(s): Jenkins DJ, Gassull MA, Leeds AR, Metz G, Dilawari JB, Slavin B, Blendis LM. Source: Gastroenterology. 1977 August; 73(2): 215-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=873118

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Emotional responses to peptic ulcer management. Author(s): Ely NE, Johnson MH. Source: The American Journal of Psychiatry. 1966 June; 122(12): 1362-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4379667

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Long-term results of surgical treatment for dumping after partial gastrectomy. Author(s): Eldh J, Kewenter J, Kock NG, Olson P. Source: The British Journal of Surgery. 1974 February; 61(2): 90-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4816249

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Pectin and gastric emptying in the dumping syndrome. Author(s): Leeds AR, Ralphs DN, Boulos P, Ebied F, Metz G, Dilawari JB, Elliott A, Jenkins DJ. Source: The Proceedings of the Nutrition Society. 1978 May; 37(1): 23A. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=662848

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Pectin in the dumping syndrome: reduction of symptoms and plasma volume changes. Author(s): Leeds AR, Ralphs DN, Ebied F, Metz G, Dilawari JB. Source: Lancet. 1981 May 16; 1(8229): 1075-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6112448

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Postprandial hypoglycemia after Nissen fundoplication for reflux esophagitis. Author(s): Zaloga GP, Chernow B.

Alternative Medicine 35

Source: Gastroenterology. 1983 April; 84(4): 840-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6825995 •

Pruritus as a manifestation of the dumping syndrome. Author(s): Harries AD, Tredree R, Heatley RV, Rhodes J, Holt PJ. Source: The British Journal of Dermatology. 1982 December; 107(6): 707-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7171489

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The measurement of bidirectional sodium fluxes across the intestinal wall in man using whole gut perfusion. Author(s): Love AH, Rohde JE, Abrams ME, Veall N. Source: Clin Sci. 1973 March; 44(3): 267-78. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4632621

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The sphincter control mechanism in the dumping syndrome. Author(s): FRANKEL LA. Source: J Int Coll Surg. 1964 February; 41: 127-33. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14126251

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Treatment of postgastrectomy dumping syndrome by hypnotic suggestion; preliminary report. Author(s): LEONARD AS, PAPERMASTER AA, WANGENSTEEN OH. Source: J Am Med Assoc. 1957 December 14; 165(15): 1957-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13480849

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Trial of pectin-enriched muffins in patients with severe dumping syndrome after gastric resection. Observations on symptoms and gastric emptying pattern. Author(s): Andersen JR, Holtug K, Uhrenholt A. Source: Acta Chir Scand. 1989; 155(1): 39-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2929202

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•

AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

•

drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

•

Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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•

Google: http://directory.google.com/Top/Health/Alternative/

•

Healthnotes: http://www.healthnotes.com/

•

MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

•

Open Directory Project: http://dmoz.org/Health/Alternative/

•

HealthGate: http://www.tnp.com/

•

WebMDHealth: http://my.webmd.com/drugs_and_herbs

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to dumping syndrome; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Herbs and Supplements Glucomannan Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. PATENTS ON DUMPING SYNDROME Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “dumping syndrome” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on dumping syndrome, we have not necessarily excluded nonmedical patents in this bibliography.

Patent Applications on Dumping Syndrome As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to dumping syndrome:

5Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm. 6 This has been a common practice outside the United States prior to December 2000.

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Effects of glucagon-like peptide-1 (7-36) on antro-pyloro-duodenal motility Inventor(s): Goeke, Burkhard; (Gauting, DE), Schirra, Joerg; (Kirchhain, DE) Correspondence: Beth A. Burrous; Foley & Lardner; Washington Harbour; 3000 K Street, N.W., Suite 500; Washington; DC; 20007; US Patent Application Number: 20020098195 Date filed: March 14, 2001 Abstract: The present invention provides an effective method for inhibiting antroduodenal motility in healthy subjects and patients suffering from various disorders, without the side effects associated with other pharmaceutical compositions. GLP-1 slows antro-duodenal motility and may be used for the treatment or prevention of gastrointestinal disorders such as diarrhea, postoperative dumping syndrome and irritable bowel syndrome, and also premedication in endoscopic procedures. Excerpt(s): The present invention relates to inhibiting antro-duodenal motility with GLP-1 and methods to alleviate discomfort during endoscopy and to alleviate symptoms of gastrointestinal disorders. Glucagon has been widely used to cause a variable reduction in gastroduodenal motility. The effect of glucagon appears to be dose-dependent with a minimally effective dose being 0.5 mg. Glucagon, however, does not facilitate colonoscopic evaluation (Norfleet, Gastrointest. Endosc., 24, 164-5, 1978), and at doses as high as 2 mg glucagon does not reduce contractions in the antrum (Gregerson et al., Scand. J. Gastroenterol. 23 (Supp 152), 42-47 (1988)). Furthermore, glucagon is contraindicated in persons with diabetes (Paul & Freyschmidt, ROFO Rortschr. Geb. Rontgenstr. Nuklearmed., 125, 31-7 (1996)), is expensive and its efficacy has been questioned. Side effects associated with the use of glucagon include nausea and vomiting. The effects are dose-dependent and can appear at a dose of 1 mg (Larsen et al., Scand. J. Gastroenterol. 21, 634-640, 1986; Gregersen et al., supra, Diamant Handbook Experimental Pharm, Lefevre ed., Vol. 66/2, 611-643, 1983). As dosages required to sufficiently reduce motility frequently exceed 1 mg, side effects from glucagon use are common. Such side effects render the patient extremely uncomfortable and often cause the endoscopic procedure to be interrupted or aborted. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with dumping syndrome, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “dumping syndrome” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on dumping syndrome. You can also use this procedure to view pending patent applications concerning dumping syndrome. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON DUMPING SYNDROME Overview This chapter provides bibliographic book references relating to dumping syndrome. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on dumping syndrome include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Chapters on Dumping Syndrome In order to find chapters that specifically relate to dumping syndrome, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and dumping syndrome using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “dumping syndrome” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on dumping syndrome: •

Carbohydrate-Modified Diets Source: in Cataldo, C.B., DeBruyne, L.K., and Whitney, E.N. Nutrition and Diet Therapy: Principles and Practice. 4th ed. St. Paul, MN: West Publishing Company. 1995. p. 565594. Contact: Available from West Publishing. 620 Opperman Drive, P.O. Box 64779, St. Paul, MN 55164. (800) 340-9378 or (612) 687-7000. PRICE: $58.25. ISBN: 0314044485. Summary: Diet planners use two types of carbohydrate-modified diets: one type prescribes the amount of carbohydrate whereas the other eliminates a specific type of carbohydrate. This chapter, from a text on nutrition and diet therapy, first describes diabetes mellitus, a disorder that benefits from a carbohydrate-controlled diet. Next, the chapter covers hypoglycemia and the dumping syndrome, disorders that benefit from diets that control both the amount and type of carbohydrate. Finally, the authors examine lactose intolerance, a disorder in which one type of carbohydrate, specifically

40

Dumping Syndrome

lactose, must be restricted. The section on diabetes covers the treatment of insulindependent diabetes (IDDM), notably the use of insulin, diet and activity, coordinating therapy, and special concerns for children and teens with IDDM; the treatment of noninsulin-dependent diabetes (NIDDM), including the roles of dietary and drug therapies; and diabetes in pregnancy and later life. The chapter concludes with a case study depicting a child with IDDM. •

Gastric Surgery Source: in American Dietetic Association. Manual of Clinical Dietetics, Sixth Edition. Chicago, IL: American Dietetic Association. 2000. p.395-400. Contact: Available from American Dietetic Association. 216 West Jackson Boulevard, Chicago, IL 60606. (800) 877-1600 or (312) 899-0040. Fax (312) 899-4899. PRICE: $59.95 for members, $70.00 for nonmembers. ISBN: 0880911875. Summary: Medical nutrition therapy (MNT) is used for patients who have undergone gastric (stomach) surgery to provide adequate energy and nutrients to support tissue healing following surgery, and to minimize reflux (return of stomach contents to the esophagus or mouth), early satiety, dumping syndrome, or weight loss. This chapter on gastric surgery is from a comprehensive manual of clinical dietetics designed to help dietitians, physicians, and nurses deliver quality nutrition care. The chapter includes the purpose of nutrition care, the indications for use, a description of the diet, meal planning approaches, a definition of the disease or condition, and a discussion section. The guidelines are designed for individuals who undergo a surgical procedure involving bypass or excision of the pyloric sphincter, resulting in an inability to regular normal emptying of the stomach. Surgical procedures include vagotomy, pyloroplasty, hemigastrectomy involving Billroth I and II anastomosis, total gastrectomy, esophagogastrectomy, Whipple's procedure, gastroenterostomy, gastrojejunostomy, and Roux-en-y esophagojejunostomy. In general, the diet follow gastric surgery limits beverages and liquids at meals and the intake of simple carbohydrates, is high in protein and moderate in fat, and avoids foods that are known to increase intestinal peristalsis, such as caffeine. 1 figure. 1 table. 4 references.

•

Surgery for Peptic Ulcer Disease and Postgastrectomy Syndromes Source: in Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 1441-1454. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-6423. Fax: (301) 223-2400. Website: www.lww.com. PRICE: $289.00. ISBN: 781728614. Summary: The surgical treatment of peptic ulcer is most frequently required when complications of previously unappreciated ulcers occur. This chapter on surgery for peptic ulcer disease (PUD) and postgastrectomy syndromes is from a lengthy, twovolume textbook that integrates the various demands of science, technology, expanding information, good judgment, and common sense into the diagnosis and management of gastrointestinal patients. The chapter covers elective surgery for PUD, surgery for duodenal ulcer, surgery for gastric ulcer, surgical treatment of peptic ulcer complications (hemorrhage, perforation, obstruction), and complications of the surgery for peptic ulcer, including recurrent ulcer, dumping syndrome, postvagotomy diarrhea, alkaline reflux gastritis, delayed gastric emptying, and gastric cancer. 13 figures. 3 tables. 132 references.

Books

•

41

Disorders of Gastric Emptying Source: in Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 1292-1320. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-6423. Fax: (301) 223-2400. Website: www.lww.com. PRICE: $289.00. ISBN: 781728614. Summary: This chapter on disorders of gastric emptying is from a lengthy, two-volume textbook that integrates the various demands of science, technology, expanding information, good judgment, and common sense into the diagnosis and management of gastrointestinal patients. Gastric motility disorders include delayed gastric emptying (gastroparesis), rapid gastric emptying (as seen in dumping syndrome), and disorders with motor and sensory abnormalities (e.g., functional dyspepsia). Each disorder can present with a spectrum of symptoms that may be mild, leading to empiric treatment, or severe and incapacitating. Evaluation may guide treatments that target the underlying pathophysiology. Management of these patients requires an understanding of the pathophysiology, clinical tests, and new treatment options. 3 figures. 6 tables. 312 references.

•

Nutrition in Gastrointestinal Disease: An Overview Source: in Kirby, D.F. and Dudrick, S.J., eds. Practical Handbook of Nutrition in Clinical Practice. Boca Raton, FL: CRC Press. 1994. p. 49-63. Contact: Available from CRC Press. 2000 Corporate Boulevard NW., Boca Raton, FL 33431. (800) 272-7737 or (561) 994-0555. Fax (800) 374-3401. E-mail: [email protected]. Website: http://www.crcpress.com. PRICE: $89.95. ISBN: 0849378478. Summary: This chapter, from a clinical nutrition textbook, provides an overview of nutrition in gastrointestinal disease. The authors review the normal mechanisms of digestion and absorption, with emphasis on nutritional abnormalities. The implications of acute GI tract failure are discussed. Specific diseases involving the GI system are also addressed, with emphasis on the role of nutritional support as both primary and adjunctive therapy. Diseases include short bowel syndrome, inflammatory bowel disease, acute and chronic pancreatitis, liver disease, diverticular disease, peptic ulcer disease, dumping syndrome, irritable bowel syndrome, and fistulas. Recommendations for the use of nutritional intervention and therapy are offered as indicated. 68 references. (AA-M).

•

Rapid Gastric Emptying Source: in Snape, W.J., ed. Consultations in Gastroenterology. Philadelphia, PA: W.B. Saunders Company. 1996. p. 259-263. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. PRICE: $125.00. ISBN: 0721646700. Summary: This chapter, from a gastroenterology yearbook, covers rapid gastric emptying. Rapid gastric emptying has been demonstrated in a myriad of medical conditions, and has been a well-recognized problem following gastric surgery. After a section outlining postgastrectomy dumping, the authors consider other causes of rapid gastric emptying and the interplay of gastric emptying and other diseases, including duodenal ulcer disease, gastric ulcers, achalasia, obesity, pancreatic insufficiency,

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bulimia, portal hypertension, diabetes mellitus, dumping syndrome in children, severe head trauma, thyroid disease, and Zollinger-Ellison syndrome. Treatment of symptomatic rapid gastric emptying remains less than satisfactory. Diet is important. Small, frequent meals without accompanying liquids, and decreased simple carbohydrate ingestion are the basics of therapy directed at diminishing dumping symptoms. Patients with dumping syndrome frequently find that lying down after eating helps with reducing their symptomatology, possibly by reducing gravitational forces that may facilitate gastric emptying. Other treatment options include the use of high-viscosity meals, pectin, alteration of gastrointestinal peptides, medications, and surgery. 46 references. (AA-M). •

Diagnosis and Management of Gastric Emptying Disorders Source: in Cameron, J.L., et al., eds. Advances in Surgery. Vol 27. St. Louis, MO: MosbyYear Book, Inc. 1994. p. 233-255. Contact: Available from Mosby Year-Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 426-4545. Fax (800) 535-9935. E-mail: [email protected]. PRICE: Contact directly for current price. ISBN: 815114923. ISSN: 00653411. Summary: This chapter, from a textbook on surgery, describes the relevant physiology and pathophysiology of gastric emptying. In addition, the authors discuss the diagnosis and management of gastric emptying disorders. Gastric emptying, the final common pathway for gastric secretory and motor events, is the net result of coordinated contraction and relaxation of the stomach, pylorus, and duodenum. Functional changes in the gastroduodenal musculature may result from primary neuromuscular disorders or systemic metabolic diseases, while surgical denervation, bypass, and resection results in structural and mechanical changes in the gastroduodenum. Gastric emptying disorders covered include dumping syndrome and delayed gastric emptying. Dumping symptoms may occur in up to 50 percent of postgastrectomy patients, but most patients are treated satisfactorily by dietary manipulation or, in the rare incapacitated patient, by the long-acting somatostatin analogue octreotide. Reconstructive gastric surgery may rarely be indicated to slow gastric emptying and alleviate the dumping syndrome. Pharmacologic therapy of delayed gastric emptying has seen the introduction of several new and promising prokinetic agents, including bethanechol, metoclopramide, cisapride, domperidone, motilin, and erythromycin. In addition, surgical intervention for mechanical causes of gastric outlet obstruction is readily justified. 4 figures. 1 table. 106 references. (AA-M).

•

Postgastrectomy Diet Source: in American Dietetic Association. Manual of Clinical Dietetics. Chicago, IL: American Dietetic Association. 1996. p. 411-417.PD. Contact: Available from American Dietetic Association. 216 West Jackson Boulevard, Chicago, IL 60606. (800) 877-1600 or (312) 899-0040. Fax (312) 899-4899. PRICE: $59.95 for members, $70.00 for nonmembers. ISBN: 0880911530. Summary: This section describing a postgastrectomy diet is from a manual that serves as a nutrition care guide for dietetics professionals, physicians, nurses, and other health professionals. The manual integrates current knowledge of nutrition, medical science, and food to set forth recommendations for healthy individuals and those for whom medical nutrition therapy (MNT) is indicated. The postgastrectomy diet is designed to provide adequate calories and nutrients to support tissue healing and to prevent weight

Books

43

loss and dumping syndrome after gastric surgery. A postgastrectomy diet is used for persons who undergo a surgical procedure involving bypass or excision of the pylori sphincter, resulting in the body's inability to regularly empty the stomach. The text outlines the purpose, use, modifications, and adequacy of the diet. The section also notes the related physiology, discussing dumping syndrome, lactose intolerance, hypoglycemia, steatorrhea, and vitamin and mineral deficiencies. A brief sample menu is included. 2 tables. 11 references. (AA-M). •

Gastrointestinal Disorders Source: in Lysen, L.K. Quick Reference to Clinical Dietetics. Gaithersburg, MD: Aspen Publishers, Inc. 1997. p. 43-57. Contact: Available from Aspen Publishers, Inc. Fulfillment, 7201 McKinney Circle, Frederick, MD 21704. (800) 234-1660 or (800) 638-8437. PRICE: $35.00. ISBN: 0834206293. Summary: This section on gastrointestinal disorders is from a reference book on clinical dietetics and is part of a chapter on the use of nutrition management for specific medical conditions. Gastrointestinal (GI) disorders often result in maldigestion and malabsorption of nutrients and present as diarrhea. Diarrhea can have severe nutritional consequences through loss of essential nutrients such as water, minerals, vitamins, electrolytes, and micronutrients. Severe diarrhea can disrupt nutrient absorption to such an extent that malnutrition can occur. GI disorders can be both the cause and result of life threatening conditions. Disruption of the normal processes of nutrient digestion and absorption causes malnutrition, which may lead to serious clinical complications. After a brief review of the anatomy of the GI tract, the author discusses digestion, absorption, secretion, motility, adaptation, the immunologic barrier of the GI tract (the mucosa), nutritional implications in the assessment of the GI tract, factors that may affect the ability to deliver appropriate nutritional support, and specific disorders. These include swallowing difficulties (dysphagia); reflux esophagitis or gastroesophageal reflux disease (GERD); achalasia (motility disorder of the esophagus); esophageal perforation, obstruction, and varices; peptic ulcer disease; gastritis; vomiting; hiatal hernia; gastric outlet obstruction; GI bleeding; dumping syndrome; bezoar formation; absorption disorders; obstruction of the small intestine; lactase deficiency; inflammatory bowel disease; and short bowel syndrome. 7 tables. 10 references.

45

APPENDICES

47

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute7: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

7

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:9 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

8

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 9 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway10 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “dumping syndrome” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 1950 18 484 0 4166 6618

HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.14 Simply search by “dumping syndrome” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

10

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

11

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists15 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.16 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.17 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

15 Adapted 16

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 17 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

53

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on dumping syndrome can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to dumping syndrome. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to dumping syndrome. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “dumping syndrome”:

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Digestive Diseases http://www.nlm.nih.gov/medlineplus/digestivediseases.html Fibromyalgia http://www.nlm.nih.gov/medlineplus/fibromyalgia.html Irritable Bowel Syndrome http://www.nlm.nih.gov/medlineplus/irritablebowelsyndrome.html Kidney Diseases http://www.nlm.nih.gov/medlineplus/kidneydiseases.html Rheumatoid Arthritis http://www.nlm.nih.gov/medlineplus/rheumatoidarthritis.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on dumping syndrome. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Dumping Syndrome Source: in Kerestes-Smith, J.; Chua, G.; Sullivan, K. Guidelines for Nutritional Care. Ann Arbor, MI: Food and Nutrition Services, University of Michigan Medical Center. 1995. Chapter 41, p. 41.1-41.3. Contact: Available from Guidelines for Nutritional Care. Food and Nutrition Services, 2C227-0056, University of Michigan Hospitals, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0056. (313) 936-5199. Fax (313) 936-5195. PRICE: $79.00 including shipping and handling (as of 1996). ISBN: 0964799405. Summary: This chapter on dietary recommendations for individuals with dumping syndrome is from a manual that outlines the impact of nutrition on promoting health and preventing and treating disease. Included are sections detailing indications for use, contraindications, a description of the diet including a brief physiological and/or biochemical rationale, guidelines for nutritional management, nutrient adequacy, ordering procedures, and references for both health care providers and the layperson. 7 references.

•

Dietary Guidelines For Post-Gastrectomy Dumping Syndrome Source: Rochester, MN: Mayo Clinic, Patient and Health Education Center. 1990. 2 p.

Patient Resources

55

Contact: Available from Mayo Clinic, Patient and Health Education Center. 200 First Street, SW, Rochester MN 55905. (507) 284-2511. PRICE: $0.80 plus shipping and handling (for health care professionals only). Order Number MC 833. Summary: This patient education brochure offers dietary suggestions for managing post-gastrectomy dumping syndrome. Symptoms of this syndrome may include diarrhea, nausea, vomiting, abdominal fullness, and gas. Topics include the importance of eating well-balanced, regularly scheduled meals; the role of sugars, protein-rich foods, dairy products, and fat-containing foods; fluid intake; and monitoring weight gain or loss. A sample menu for a suggested daily intake is provided. The brochure concludes with blank spaces for the listing of health care providers and phone numbers. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to dumping syndrome. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to dumping syndrome. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with dumping syndrome.

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The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about dumping syndrome. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “dumping syndrome” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “dumping syndrome”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “dumping syndrome” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “dumping syndrome” (or a synonym) into the search box, and click “Submit Query.”

57

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.18

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

18

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)19: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

19

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

59

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

61

•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

63

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

65

DUMPING SYNDROME DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 5-hydroxyindoleacetic acid: 5HIAA. A break-down product of serotonin that is excreted in the urine. Serotonin is a hormone found in high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abscess: A localized, circumscribed collection of pus. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean

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intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic,

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or surgical procedure to prevent infectious complications. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrial: Pertaining to an atrium. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Bethanechol: A slowly hydrolyzed muscarinic agonist with no nicotinic effects. Bethanechol is generally used to increase smooth muscle tone, as in the GI tract following abdominal surgery or in urinary retention in the absence of obstruction. It may cause hypotension, cardiac rate changes, and bronchial spasms. [NIH] Bezoar: A ball of food, mucus, vegetable fiber, hair, or other material that cannot be digested in the stomach. Bezoars can cause blockage, ulcers, and bleeding. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH]

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Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchial Spasm: Spasmodic contraction of the smooth muscle of the bronchi. [NIH] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH]

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Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinoid: A type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors are usually benign. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Colitis: Inflammation of the colon. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with

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lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Constipation: Infrequent or difficult evacuation of feces. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH]

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Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Dietary Fiber: The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. [NIH] Dietetics: The study and regulation of the diet. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Domperidone: A specific blocker of dopamine receptors. It speeds gastrointestinal peristalsis, causes prolactin release, and is used as antiemetic and tool in the study of dopaminergic mechanisms. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenum: The first part of the small intestine. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU]

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Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Empiric: Empirical; depending upon experience or observation alone, without using scientific method or theory. [EU] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Enteroglucagon: Glucagon-like polypeptide secreted in the intestinal tract. It does not share a common receptor site with pancreatic glucagon. The peptide has glycogenolytic activity. [NIH]

Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzymes: Biological molecules that possess catalytic activity. They may occur naturally or be synthetically created. Enzymes are usually proteins, however catalytic RNA and catalytic DNA molecules have also been identified. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erythrocyte Volume: Volume of circulating erythrocytes. It is usually measured by radioisotope dilution technique. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a

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peripheral sense organ. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Extracellular: Outside a cell or cells. [EU] Faecal: Pertaining to or of the nature of feces. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrectomy: An operation to remove all or part of the stomach. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Outlet Obstruction: The hindering of output from the stomach to the small intestine. The source varies: peptic ulcer, foreign bodies, aging, neoplasms, etc. [NIH] Gastric Resection: An operation to remove part or all of the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU] Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] Gastroenterostomy: Surgical construction of a channel between the stomach and intestines. [NIH]

Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the

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esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastroparesis: Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying. [NIH] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glycoside: Any compound that contains a carbohydrate molecule (sugar), particularly any such natural product in plants, convertible, by hydrolytic cleavage, into sugar and a nonsugar component (aglycone), and named specifically for the sugar contained, as glucoside (glucose), pentoside (pentose), fructoside (fructose) etc. [EU] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH]

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Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache, accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileum: The lower end of the small intestine. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease.

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[NIH]

Ingestion: Taking into the body by mouth [NIH] Instillation: . [EU] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet.

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[NIH]

MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Micronutrients: Essential dietary elements or organic compounds that are required in only small quantities for normal physiologic processes to occur. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Motilin: A 22-amino acid polypeptide (molecular weight 2700) isolated from the duodenum. At low pH it inhibits gastric motor activity, whereas at high pH it has a stimulating effect. [NIH]

Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuromuscular: Pertaining to muscles and nerves. [EU]

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Neurotensin: A biologically active tridecapeptide isolated from the hypothalamus. It has been shown to induce hypotension in the rat, to stimulate contraction of guinea pig ileum and rat uterus, and to cause relaxation of rat duodenum. There is also evidence that it acts as both a peripheral and a central nervous system neurotransmitter. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Octreotide: A potent, long-acting somatostatin octapeptide analog which has a wide range of physiological actions. It inhibits growth hormone secretion, is effective in the treatment of hormone-secreting tumors from various organs, and has beneficial effects in the management of many pathological states including diabetes mellitus, orthostatic hypertension, hyperinsulinism, hypergastrinemia, and small bowel fistula. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Insufficiency: Absence of or reduced pancreatic exocrine secretion into the duodenum and resultant poor digestion of lipids, vitamins, nitrogen, and carbohydrates. [NIH]

Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU]

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Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Piloerection: Involuntary erection or bristling of hairs. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma Volume: Volume of plasma in the circulation. It is usually measured by indicator dilution techniques. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH]

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Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Portal Hypertension: High blood pressure in the portal vein. This vein carries blood into the liver. Portal hypertension is caused by a blood clot. This is a common complication of cirrhosis. [NIH] Portal System: A system of vessels in which blood, after passing through one capillary bed, is conveyed through a second set of capillaries before it returns to the systemic circulation. It pertains especially to the hepatic portal system. [NIH] Portal Vein: A short thick vein formed by union of the superior mesenteric vein and the splenic vein. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postgastrectomy Syndrome: A condition that occurs after an operation to remove the stomach (gastrectomy). [NIH] Postoperative: After surgery. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the

Dictionary 81

nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pyloric Sphincter: The muscle between the stomach and the small intestine. [NIH] Pyloroplasty: An operation to widen the opening between the stomach and the small intestine. This allows stomach contents to pass more freely from the stomach. [NIH] Pylorus: The opening in a vertebrate from the stomach into the intestine. [EU] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiratory System: The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock.

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[NIH]

Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [NIH] Shunt: A surgically created diversion of fluid (e.g., blood or cerebrospinal fluid) from one area of the body to another area of the body. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Splenic Vein: Vein formed by the union (at the hilus of the spleen) of several small veins from the stomach, pancreas, spleen and mesentery. [NIH] Steatorrhea: A condition in which the body cannot absorb fat. Causes a buildup of fat in the stool and loose, greasy, and foul bowel movements. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH]

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Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Systemic: Affecting the entire body. [NIH] Thoracic: Having to do with the chest. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH]

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Truncal: The bilateral dissection of the abdominal branches of the vagus nerve. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagotomy: The interruption or removal of any part of the vagus (10th cranial) nerve. Vagotomy may be performed for research or for therapeutic purposes. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Varices: Stretched veins such as those that form in the esophagus from cirrhosis. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoactive: Exerting an effect upon the calibre of blood vessels. [EU] Vasoactive Intestinal Peptide: A highly basic, single-chain polypeptide isolated from the intestinal mucosa. It has a wide range of biological actions affecting the cardiovascular, gastrointestinal, and respiratory systems. It is also found in several parts of the central and peripheral nervous systems and is a neurotransmitter. [NIH] Vasodilatation: A state of increased calibre of the blood vessels. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH]

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87

INDEX 5 5-hydroxyindoleacetic acid, 12, 65 A Abdomen, 65, 68, 76, 82, 84 Abdominal, 55, 65, 67, 71, 76, 77, 78, 84 Abdominal Pain, 65, 76 Abscess, 65 Adaptation, 43, 65 Adenosine, 65, 68, 79 Adjunctive Therapy, 41, 65 Adjustment, 65 Adrenal Medulla, 65, 72, 78 Adrenergic, 65, 66, 71, 72, 80, 83 Adverse Effect, 65, 82 Affinity, 65, 66, 82 Agonist, 66, 67, 71 Alertness, 66, 68 Algorithms, 66, 68 Alimentary, 66, 71 Alkaline, 40, 66, 67, 68 Alternative medicine, 66 Amino Acids, 66, 72, 79, 80, 83, 84 Ampulla, 66, 72 Anaesthesia, 66, 75 Analog, 3, 17, 66, 78 Anastomosis, 12, 25, 40, 66 Angina, 6, 66, 80 Angina Pectoris, 66, 80 Antagonism, 66, 68 Anti-Anxiety Agents, 66, 80 Antibacterial, 66, 82 Antibiotic, 66, 72, 80, 82 Antibiotic Prophylaxis, 66, 80 Antibody, 65, 67, 69, 75 Antiemetic, 67, 71, 77 Antigen, 65, 67, 70, 75 Anxiety, 66, 67, 80 Artery, 13, 15, 67, 68 Asymptomatic, 67, 78 Atrial, 7, 8, 67 Atrium, 67 Autodigestion, 67, 78 B Bacteria, 66, 67, 72, 73, 77, 82 Bacterial Physiology, 65, 67 Bacteriostatic, 67, 72 Barium, 27, 67 Base, 67, 76, 84

Bethanechol, 42, 67 Bezoar, 43, 67 Bilateral, 67, 84 Bile, 67, 68, 73, 75, 76 Bile Acids, 67, 68, 73 Biliary, 68, 78 Biliary Tract, 68, 78 Biochemical, 10, 54, 68, 81 Biotechnology, 4, 49, 68 Bloating, 68, 74, 76 Blood Coagulation, 68 Blood pressure, 68, 75, 80, 82 Blood vessel, 68, 69, 77, 79, 82, 84 Blood Volume, 12, 68 Body Fluids, 68, 71, 73, 78, 82 Bowel, 17, 21, 27, 68, 71, 75, 76, 78, 82 Bronchial, 67, 68 Bronchial Spasm, 67, 68 Bulimia, 42, 68 Bypass, 40, 42, 43, 68 C Caffeine, 40, 68 Calcium, 17, 21, 68, 69, 84 Capillary, 69, 80 Carbohydrate, 39, 42, 69, 74 Carcinoid, 65, 69 Cardiac, 67, 68, 69, 72 Cardioselective, 69, 80 Cardiovascular, 69, 81, 84 Caudal, 69, 75, 80 Cell, 66, 67, 68, 69, 70, 71, 73, 76, 78, 79, 81, 83 Central Nervous System, 68, 69, 74, 78, 81 Cerebrospinal, 69, 82 Cerebrospinal fluid, 69, 82 Chronic, 41, 69, 72, 78, 84 Cirrhosis, 69, 80, 84 Clinical trial, 4, 49, 69, 81 Cloning, 68, 69 Colitis, 69, 75, 76 Colon, 69, 75, 76 Complement, 69, 70 Complementary and alternative medicine, 33, 36, 70 Complementary medicine, 33, 70 Computational Biology, 49, 70 Confusion, 70, 75, 84 Conjugated, 12, 70

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Dumping Syndrome

Constipation, 70, 76 Contraindications, ii, 54, 70 Convulsions, 70, 75 Cranial, 70, 74, 79, 84 Cyclic, 68, 70 D Dairy Products, 55, 70 Deuterium, 70, 75 Diabetes Mellitus, 39, 42, 70, 74, 78 Diagnostic procedure, 37, 71 Diaphragm, 71, 75 Diarrhea, 5, 11, 13, 20, 38, 40, 43, 55, 71, 76 Diarrhoea, 6, 9, 71 Dietary Fiber, 34, 71 Dietetics, 40, 42, 43, 71 Digestion, 7, 10, 17, 25, 41, 43, 66, 67, 68, 71, 74, 76, 78, 82 Digestive system, 71, 73 Digestive tract, 71, 82 Dilution, 71, 72, 79 Direct, iii, 71, 81 Dissection, 71, 84 Distal, 71, 73, 81 Diuresis, 68, 71 Domperidone, 42, 71 Dopamine, 71, 77, 78 Dorsal, 71, 80 Dose-dependent, 38, 71 Duct, 66, 71, 73, 82 Duodenal Ulcer, 26, 40, 41, 71 Duodenum, 42, 67, 71, 72, 73, 76, 77, 78, 79, 82 Dyspepsia, 41, 71 Dysphagia, 43, 71 E Efficacy, 11, 38, 72 Elective, 40, 72 Electrolyte, 72, 73, 78, 80, 82, 84 Embryo, 72, 75 Empiric, 41, 72 Endoscope, 72 Endoscopic, 38, 72 Endoscopy, 38, 72 Enteroglucagon, 11, 18, 72 Environmental Health, 48, 50, 72 Enzymatic, 68, 70, 72 Enzymes, 71, 72, 78 Epinephrine, 65, 71, 72, 78 Erythrocyte Volume, 68, 72 Erythromycin, 42, 72 Esophageal, 43, 72, 74 Esophagitis, 12, 34, 43, 72, 74

Esophagus, 40, 43, 71, 72, 73, 74, 76, 79, 81, 82, 84 Evacuation, 70, 72, 73 Evoke, 72, 82 Exocrine, 73, 78 Extracellular, 12, 73, 82 F Faecal, 71, 73 Family Planning, 49, 73 Fat, 40, 55, 73, 76, 82 Fistula, 73, 78 Flatus, 73 Fluid Therapy, 73, 78 Fold, 73, 77 Fructose, 73, 74 G Gallbladder, 65, 68, 71, 73 Gas, 55, 73, 75, 76, 78, 81 Gastrectomy, 6, 11, 12, 15, 17, 20, 21, 22, 34, 40, 54, 55, 73, 80 Gastric, 3, 5, 6, 8, 11, 12, 17, 18, 22, 23, 24, 25, 27, 30, 33, 34, 35, 40, 41, 42, 43, 67, 73, 74, 77, 78, 79 Gastric Emptying, 3, 6, 8, 11, 12, 18, 25, 30, 34, 35, 40, 41, 42, 73, 74 Gastric Juices, 73, 78 Gastric Outlet Obstruction, 42, 43, 73 Gastric Resection, 17, 30, 33, 35, 73 Gastrin, 73, 75 Gastritis, 40, 43, 73 Gastroduodenal, 22, 38, 42, 73 Gastroenterology, 5, 7, 8, 9, 10, 11, 12, 14, 15, 18, 24, 26, 34, 35, 40, 41, 73 Gastroenterostomy, 40, 73 Gastroesophageal Reflux, 13, 43, 73 Gastroesophageal Reflux Disease, 43, 73 Gastrointestinal, 12, 22, 33, 34, 38, 40, 41, 42, 43, 69, 71, 72, 74, 81, 83, 84 Gastroparesis, 41, 74 Gastrostomy, 7, 74 Gene, 68, 74 Gland, 65, 74, 75, 78, 81, 82, 83 Glucose, 6, 8, 10, 18, 22, 70, 74, 75, 76 Glucose Intolerance, 70, 74 Glucose tolerance, 10, 74 Glucose Tolerance Test, 74 Glycoside, 5, 74 Goats, 70, 74 Governing Board, 74, 80 H Headache, 68, 74, 75 Heartburn, 74, 75

89

Hemorrhage, 40, 74 Hepatic, 74, 80 Hiatal Hernia, 43, 75 Hormone, 11, 12, 22, 65, 72, 73, 75, 76, 78, 80, 83 Humoral, 13, 26, 75 Humour, 75 Hydrogen, 23, 67, 69, 70, 75, 77, 81 Hypertension, 74, 75, 78, 80, 84 Hyperthyroidism, 75, 80 Hypnotic, 35, 75 Hypoglycaemia, 19, 75 Hypoglycemia, 13, 18, 31, 34, 39, 43, 75 Hypotension, 67, 70, 75, 78 Hypothalamus, 75, 78 Hypothermia, 75 I Idiopathic, 6, 75 Ileum, 75, 76, 78 Immunologic, 43, 75 Incompetence, 73, 75 Induction, 33, 75, 80 Inflammation, 69, 72, 73, 75, 78, 79, 84 Inflammatory bowel disease, 41, 43, 75 Ingestion, 42, 74, 76, 79 Instillation, 22, 76 Insulin, 40, 74, 76 Insulin-dependent diabetes mellitus, 76 Internal Medicine, 14, 19, 24, 73, 76 Intestinal, 20, 35, 40, 72, 74, 76, 84 Intestinal Mucosa, 76, 84 Intestine, 68, 76, 79, 81 Intracellular, 68, 76, 80 Ions, 67, 72, 75, 76 Irritable Bowel Syndrome, 38, 41, 54, 76 J Jejunum, 6, 76 K Kb, 48, 76 L Large Intestine, 71, 76, 81, 82 Lesion, 76, 84 Lipid, 76 Liver, 41, 65, 67, 68, 69, 71, 73, 74, 76, 80 Localized, 65, 76, 79, 84 Lower Esophageal Sphincter, 73, 74, 76 M Malabsorption, 15, 43, 76, 82 Malabsorption syndrome, 76, 82 Malnutrition, 43, 76 MEDLINE, 49, 77 Membrane, 70, 77, 79

Menopause, 77, 80 Mesenteric, 13, 15, 77, 80 Mesentery, 77, 82 Metoclopramide, 42, 77 Microbiology, 65, 77 Micronutrients, 43, 77 Modification, 6, 77 Molecular, 49, 51, 68, 70, 77, 80 Molecule, 67, 70, 74, 77, 81 Motilin, 42, 77 Motility, 17, 38, 41, 43, 77, 81 Motion Sickness, 77 Motor Activity, 70, 77 Mucosa, 43, 77, 80 Mucus, 67, 77 Musculature, 42, 77 Myocardial infarction, 77, 80 N Nausea, 38, 55, 67, 74, 77, 84 Neoplasms, 73, 77 Neural, 75, 77 Neuromuscular, 42, 77, 84 Neurotensin, 10, 11, 16, 18, 78 Neurotransmitter, 65, 71, 78, 83, 84 Nitrogen, 78 Norepinephrine, 18, 65, 71, 78 Nutritional Support, 41, 43, 74, 78 O Octreotide, 3, 11, 15, 16, 17, 21, 25, 26, 27, 42, 78 Orthostatic, 78 P Pancreas, 65, 71, 73, 76, 78, 82 Pancreatic, 41, 72, 73, 78 Pancreatic Insufficiency, 41, 78 Pancreatic Juice, 73, 78 Pancreatitis, 41, 78 Pathophysiology, 8, 24, 41, 42, 78 Patient Education, 54, 55, 58, 60, 63, 78 Pepsin, 78 Peptic, 12, 34, 40, 41, 43, 73, 78, 79 Peptic Ulcer, 12, 34, 40, 41, 43, 73, 79 Peptide, 7, 8, 9, 18, 38, 72, 79, 80 Perforation, 40, 43, 79 Perfusion, 35, 79 Peripheral Nervous System, 78, 79, 83, 84 Peristalsis, 40, 71, 79 Pharmacologic, 42, 79, 83, 84 Pharynx, 73, 79, 84 Phospholipids, 73, 79 Phosphorus, 68, 79 Physiologic, 12, 66, 77, 79, 81

90

Dumping Syndrome

Physiology, 42, 43, 73, 79 Piloerection, 75, 79 Plants, 74, 78, 79 Plasma, 5, 11, 18, 20, 34, 68, 74, 79 Plasma Volume, 5, 34, 68, 79 Pneumonia, 70, 79 Poisoning, 77, 79 Polypeptide, 72, 77, 80, 84 Portal Hypertension, 42, 80 Portal System, 26, 80 Portal Vein, 20, 80 Posterior, 9, 71, 78, 80 Postgastrectomy Syndrome, 40, 80 Postoperative, 3, 17, 38, 80 Postprandial, 18, 24, 25, 34, 80 Potassium, 80 Practice Guidelines, 50, 80 Premedication, 38, 80 Projection, 78, 80 Prolactin, 71, 80 Propranolol, 24, 80 Protein S, 68, 72, 80 Proteins, 66, 67, 69, 72, 77, 78, 79, 80 Protons, 75, 80 Proximal, 8, 19, 71, 81 Public Policy, 49, 81 Pyloric Sphincter, 40, 81 Pyloroplasty, 8, 9, 40, 81 Pylorus, 12, 42, 81 R Radioactive, 75, 81 Randomized, 72, 81 Receptor, 65, 67, 71, 72, 81 Rectum, 69, 71, 73, 75, 76, 81 Refer, 1, 69, 81 Reflux, 12, 34, 40, 43, 73, 74, 81 Refraction, 81, 82 Regimen, 72, 81 Regurgitation, 73, 74, 81 Resection, 22, 42, 81, 82 Respiratory System, 81, 84 Retinoids, 81, 84 S Screening, 69, 81 Secretion, 43, 75, 76, 77, 78, 81 Secretory, 42, 81 Serotonin, 20, 65, 78, 81 Shock, 81, 83 Short Bowel Syndrome, 41, 43, 82 Shunt, 26, 82 Side effect, 38, 65, 82, 83 Small intestine, 26, 43, 71, 73, 75, 76, 81, 82

Smooth muscle, 67, 68, 82, 83 Sodium, 35, 82, 83 Somatic, 75, 79, 82, 84 Spastic, 76, 82 Specialist, 56, 82 Spectrum, 41, 82 Sphincter, 35, 43, 82 Splenic Vein, 80, 82 Steatorrhea, 43, 82 Stenosis, 6, 82 Stimulant, 68, 82 Stimulus, 7, 82 Stomach, 10, 40, 42, 43, 65, 67, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82 Stool, 69, 76, 82 Stress, 76, 77, 82 Stricture, 82 Substance P, 72, 81, 83 Sweat, 75, 83 Sympathomimetic, 71, 72, 78, 83 Symptomatic, 42, 66, 78, 83 Symptomatology, 42, 83 Systemic, 42, 68, 72, 80, 83 T Thoracic, 10, 71, 83, 84 Thyroid, 42, 75, 83 Tissue, 40, 42, 67, 69, 76, 77, 78, 79, 81, 82, 83 Tolerance, 74, 83 Tone, 67, 83 Tooth Preparation, 65, 83 Toxic, iv, 83 Toxicology, 50, 83 Trachea, 79, 83 Transfection, 68, 83 Translation, 72, 83 Translocation, 72, 83 Transmitter, 71, 78, 83 Trauma, 42, 72, 74, 78, 83 Truncal, 9, 84 Tunica, 77, 84 U Ulcer, 40, 71, 84 Ulceration, 79, 84 Uraemia, 78, 84 Urinary, 67, 84 Urinary Retention, 67, 84 Urine, 65, 71, 84 Uterus, 78, 84 V Vagotomy, 5, 6, 8, 9, 21, 40, 84 Vagus Nerve, 84

91

Varices, 43, 84 Vascular, 16, 27, 84 Vasculitis, 78, 84 Vasoactive, 16, 19, 20, 27, 84 Vasoactive Intestinal Peptide, 16, 19, 84 Vasodilatation, 27, 84 Vein, 80, 82, 84

Verapamil, 9, 84 Veterinary Medicine, 49, 84 Viscosity, 42, 84 Vitamin A, 43, 84 W Windpipe, 79, 83, 84

92

Dumping Syndrome

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