Three distinct types of contractions perform colonic motility functions. Rhythmic phasic contractions (RPCs) cause slow net distal propulsion with extensive mixing/turning over. Infrequently occurring giant migrating contractions (GMCs) produce mass movements. Tonic contractions aid RPCs in their motor function. The spatiotemporal patterns of these contractions differ markedly. The amplitude and distance of propagation of a GMC are several-fold larger than those of an RPC. The enteric neurons and smooth muscle cells are the core regulators of all three types of contractions. The regulation of contractions by these mechanisms is modifiable by extrinsic factors: CNS, autonomic neurons, hormones, inflammatory mediators, and stress mediators. Only the GMCs produce descending inhibition, which accommodates the large bolus being propelled without increasing muscle tone. The strong compression of the colon wall generates afferent signals that are below nociceptive threshold in healthy subjects. However, these signals become nociceptive; if the amplitudes of GMCs increase, afferent nerves become hypersensitive, or descending inhibition is impaired. The GMCs also provide the force for rapid propulsion of feces and descending inhibition to relax the internal anal sphincter during defecation. The dysregulation of GMCs is a major factor in colonic motility disorders: irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and diverticular disease (DD). Frequent mass movements by GMCs cause diarrhea in diarrhea predominant IBS, IBD, and DD, while a decrease in the frequency of GMCs causes constipation. The GMCs generate the afferent signals for intermittent short-lived episodes of abdominal cramping in these disorders. Epigenetic dysregulation due to adverse events in early life is one of the major factors in generating the symptoms of IBS in adulthood.

A renowned physician shares her complete 10-day digestive tune-up for women, with important revelations about good gastrointestinal health. Many so-called cures for women’s bloating and indigestion, from juice cleanses to specialty diets, are based on junk science. For women seeking true relief from that overall feeling of discomfort in any size jeans, Dr. Robynne Chutkan has the perfect plan for feeling light, tight, and bright in ten days. Gutbliss offers: A primer on the real reasons for gastrointestinal distress, and why it’s much more common in women A look at the debilitating side effects of supposedly healthy habits—from Greek yogurt to bloat-inducing aspirin An expert analysis of symptoms that could indicate a serious underlying condition An indispensable checklist to pinpoint the exact cause of your bloating Just a few small changes in diet, lifestyle, and exercise can make a huge difference in a woman’s digestive health, but the changes have to be the right ones. Going beyond the basics of top sellers such as Wheat Belly, Dr. Chutkan’s Gutbliss empowers women to take control of their gastrointestinal wellness.

The essential dietary guide and cookbook for people with irritable bowel syndrome and other gastrointestinal disorders--with hundreds of low-fat recipes to ease the effects of IBS, lactose intolerance, Crohn's Disease, ulcerative colitis, and other digestive conditions Irritable bowel syndrome is one of our nation's most untalked-about ailments, but millions of people - mostly women - suffer from the debilitating condition, one that must be controlled primarily through diet. Contrary to what many sufferers believe, eating for IBS does not mean deprivation, never going to restaurants, boring food, or an unhealthily limited diet. It does mean cutting out such trigger foods as red meat, dairy, most fats, caffeine, alcohol, and insoluble fiber. Heather Van Vorous, who has suffered from IBS since age 9 and gradually learned how to control her IBS symptoms through dietary modifications, collects here 175 recipes she has created over 20 years. Those suffering from IBS, lactose intolerance, Crohn's Disease, ulcerative colitis, and other digestive disorders will be thrilled to discover that they can enjoy traditional homestyle cooking, international foods, rich desserts, snacks, and party foods - and don't have to cook weird or special meals for themselves while their families follow a "normal" diet. Eating for IBS will forever revolutionize the way people with IBS eat--and live.

Rifaximin is a semisynthetic rifamycin which is not absorbed from the gastrointestinal tract. It has been available in Europe and other countries for several years, and has recently been approved for treatment of traveler's diarrhea in the United States. Because of its broad spectrum of antimicrobial activity, rifaximin has been used with success in the treatment of infectious diarrhea, hepatic encephalopathy, small intestinal bacterial overgrowth, inflammatory bowel disease, and colonic diverticular disease. Potential indications include the irritable bowel syndrome and chronic constipation, Clostridium difficile infection and bowel preparation before colorectal surgery. In this publication both the present and future clinical use of rifaximin as well as the pharmacology behind it are extensively reviewed. Compiling the latest information on this remarkably active antibacterial agent, it will be an essential resource for infectiologists, gastroenterologists, and digestive surgeons alike.

Irritable Bowel Syndrome is an extremely common disorder that is diagnosed in 50% of cases by people who have consulted a gastroenterologist. Symptoms vary from constipation to diarrhea, stomach pains, colic, headaches, and backache. Conventional treatment such as drugs and high-fiber diets make it worse. Shirley Trickett offers non-drug treatments for self help, including dietary changes, therapeutic massage, homeopathy, colonic irrigation, aromatherapy, and reflexology. Key to this new edition are the following new sections: - Aloe Vera, l-glutamine, and glucosamine supplements. - How to bring down your cortisol levels to manage anxiety and blood sugar problems. - How to minimize severe weight loss by bringing down allergic reactions, and thereby. - Enabling sufferers to widen their diet.

This book aims to familiarize readers with the most common acute surgery topics encountered in clinical practice and is unique in its use of infographics. It will be used in clinical rotations in surgery as a supplement to the knowledge gained, and will also provide instructors with a complementary tool, offering a wide-ranging guide to general aspects of acute surgery, with some hints on gynecologic and urologic emergencies. The book is intended to provide medical students and junior residents in medicine or surgery with a comprehensive and up-to-date overview of the most relevant operative techniques.

This third edition text provides a completely revised and updated new version of this unique, modern, practical text that covers the strategic evaluation, specific approaches, and detailed management techniques utilized by expert colorectal surgeons caring for patients with complex problems–whether they result from underlying colorectal disease or from complications arising from previous surgical therapy. The format follows that of both a “how to” manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. By making use of evidence-based recommendations, each chapter includes not only background information and diagnostic/therapeutic guidelines, but also provides a narrative by the author on his/her operative technical details and perioperative “tips and tricks” that they utilize in the management of these complex surgical challenges. Distinctive to this book, is the reliance on experts in the field including past presidents of the ASCRS, as well as multiple other national and internationally recognized surgeons, to lend their personal insight into situations where data may be more sparse, but individual and collective experience is paramount to making sound decisions and thereby optimizing patient outcomes. The text includes chapters on the assessment of risk and methods utilized to minimize perioperative complications. In addition, it incorporates sections covering the medical and surgical therapies for abdominal, pelvic and anorectal disease. Moreover, the technical challenges of managing complications resulting from the original or subsequent operations is addressed. The underlying focus throughout the text is on providing pragmatic and understandable solutions that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems. However, it also goes beyond the technical aspects of colorectal surgery and includes special sections highlighting the essence of a surgeon; covering aspects involving the medical-legal, ethical, and economic challenges confronting surgeons. Throughout the text, each author provides an ongoing narrative of his/her individual surgical techniques along with illustrations and diagrams to “personally” take the reader through the crucial steps of the procedure, and key points of patient care inherent to that topic. Additionally, where appropriate, links to online videos give the reader an up-front look into technical aspects of colorectal surgery.

This book conjoins the latest advances on the use of endoscopy to diagnose, monitor, and treat patients with inflammatory bowel disease. Chapters include the historical use of rigid sigmoidoscopy, non-interventional imaging procedures, and the correlation of pathology and endoscopic visualization. This is the first book to include individual chapters in gastroenterology, colorectal surgery, and IBD texts, the preeminent role of endoscopic imaging in the management of chronic ulcerative colitis, and Crohn's disease. It also includes chapters on capsule endoscopy and balloon and overtube-assisted enteroscopy to define the presence and activity of Crohn's enteritis and additional chapters defining the use of random biopsies versus chromoendoscopy, and computer enhanced imaging to define possible dysplasia development. The book also includes access to online videos, making it the ultimate verbal and visual tool for all medical professionals interested in the advances in the field over the last several decades. Endoscopy in Inflammatory Bowel Disease is a concise text that is of great value to practicing endoscopists, gastroenterologists, general or colorectal surgeons, physicians in training, and all medical professionals caring for patients with inflammatory bowel disease.

Irritable Bowel Syndrome (IBS) is a condition that is often misunderstood and misdiagnosed. Despite common perceptions, only 50% of cases are related to diet and the causes of the other 50% of cases are rarely examined and sufferers are unable to find suitable treatment. In this groundbreaking new book, Professor John Hunter reveals how you can solve the causes of your IBS. Using his carefully-constructed questionnaire, find out the reasons for your symptoms then turn to the appropriate chapter to learn how to treat them. Irritable Bowel Solutions also answers all the other questions that might be causing concern, such as: -What if I don't fit any of the types described? -What do probiotics really do and are they helpful? -Will my disease always affect me or can I manage it effectively?