By Albert J. Bredenoord, André Smout, Jan Tack
This publication describes the motives and medical administration of practical gastrointestinal issues in a with ease comprehensible method, because of many transparent illustrations. The concrete and useful recommendation supplied should be such a lot valuable within the scientific perform of either the final practitioner and the clinical expert. sensible issues of the gastrointestinal tract, corresponding to gastroesophageal reflux ailment, practical dyspepsia, and irritable bowel syndrome, are quite common and protracted stipulations. regardless of the new e-book of many medical papers on their prognosis and remedy, a lot continues to be uncertain, and administration remains to be thought of demanding. This practice-oriented booklet might be a terrific resource of trustworthy updated counsel for all who deal with those patients.
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Additional resources for A Guide to Gastrointestinal Motility Disorders
Reflux becomes gastroesophageal reflux disease (GERD) when it causes mucosal damage or bothersome symptoms (Fig. 9). In resting state the LES is closed and together with the right crus of the diaphragm forms a tight barrier against reflux of gastric contents. We distinguish typical reflux symptoms and atypical reflux symptoms. Heartburn and regurgitation are considered typical reflux symptoms; chest pain, cough, hoarseness, and wheezing are considered atypical reflux symptoms. For atypical reflux symptoms, the relationship with reflux is often much less clear.
The swallow reflex starts when pressure sensors in the pharynx are stimulated. This activates an afferent nerve to the swallow center in brainstem. From there, motor neurons of the cranial nerves are activated that control the muscles of pharynx and upper esophagus (glossopharyngeal, vagal, and hypoglossal nerves) and the motor neurons of the vagus nerve that control the middle and distal esophagus. J. 1007/978-3-319-26938-2_4 39 4 40 The Esophagus Fig. 1 Schematic display of the anatomy of the esophagus (Published with kind permission of © Rogier Trompert Medical Art 2015) Pharynx Upper esophageal sphincter Esophageal body Lower esophageal sphincter Diaphragm Z-line Stomach A swallow can be divided into three phases, which are the oral phase, the pharyngeal phase, and the esophageal phase.
As tricyclic antidepressant intake can be associated with sleepiness, they are generally administered in the evening. Newer antidepressants (serotonin and Medications That Alter the Sensitivity of the Gastrointestinal Tract Although it seems logical to treat disorders of gastrointestinal motility with agents that alter contractility of the gastrointestinal tract, this approach is hampered by issues of efficacy and tolerance. Another approach is to decrease the sensitivity of the gastrointestinal tract, thereby suppressing signals that are generated by defective motor control or visceral hypersensitivity and thus decreasing symptom occurrence and severity.
A Guide to Gastrointestinal Motility Disorders by Albert J. Bredenoord, André Smout, Jan Tack