Evaluating any patient with a complaint of abdominal pain is challenging. Abdominal pain can be benign and self-limited or a harbinger of a serious life-threatening disease (see Chapter 11 ). Chronic abdominal pain poses a particularly challenging clinical problem. Not…
Acute abdominal pain is a frequent complaint that causes patients to visit an emergency department. In 2014, 11.1 million emergency department visits in the USA were due to abdominal pain, accounting for 8% of all emergency department visits that year.…
The first recorded account of food allergy is attributed to Hippocrates, but it was not until 1921 that Prausnitz’s classic experiment initiated scientific investigation of food allergy and established the immunologic basis of allergic reactions. In his experiment, Prausnitz injected…
Acknowledgment The authors would like to thank Anne E. Becker and Sarah A. Kearney for their enormous contribution to this chapter in the 10th edition. Eating disorders (EDs) are mental disorders characterized by disturbances in body image, weight control, and/or…
Severe obesity is the leading public health crisis of the industrialized world (see Chapter 7 ). The prevalence of obesity in the USA continues to rise at an alarming rate, with two thirds of adults currently considered overweight, half of…
Definitions and Epidemiology Obesity is a chronic condition defined as an excess of body fat or adipose tissue that causes disease. Adiposity per se is difficult to measure expediently, so the use of BMI has become common as a marker…
Nutrition in Specific Disease States Nutritional assessment and directed nutritional therapy are important in the treatment of many GI diseases. Familiarity with appropriate nutritional intervention is imperative to obtain good clinical outcomes. The preceding chapter reviewed nutritional assessment, and this…
Diligent attention to patients’ nutritional needs can have a major positive impact on medical outcomes. This is particularly true in GI and liver disease because many of these conditions, in addition to altering nutrient metabolism and requirements, are prone to…
The gastrointestinal (GI) tract relies on hormones and neurotransmitters to integrate signals arising in the lumen with whole-body homeostasis. For instance, satiety in the brain is, to a great extent, induced by the presence of food in the gut. This…
Characteristics of the Human Intestinal Microbiome The intestinal microbiome is a diverse ecosystem comprising microorganisms (bacteria, archaea, fungi, and viruses including bacteriophages), their genomes (i.e., genes), and the surrounding environmental conditions. The population of microorganisms alone in a particular niche…