Acknowledgments This work was supported by National Institutes of Health grant CA190710 and Welch Endowed Chair in Biochemistry, Grant No. BI-0028, at Texas Tech University Health Sciences Center. Digestion and absorption of dietary nutrients constitute the primary physiologic function of…
The GI tract processes 8 to 9 L of fluid daily that is derived from oral intake and endogenous exocrine secretions. Intestinal fluid absorption functions with 98% efficiency, allowing only 100 to 200 mL to be excreted each day. The…
Each day, 1200 to 1500 mL of ileal effluent enter the colon, 200 to 400 mL of which are excreted as stool. The colon mixes its contents to facilitate transmural exchange of water, electrolytes, and short-chain fatty acids and, in…
Efficient absorption of nutrients and maintenance of orderly aboral movement of chyme and indigestible residues are the most important goals of small intestinal motor and sensory function. Small intestinal motility is also critically important in preventing SIBO (see Chapter 105…
Anatomy Macroscopic Features Small Intestine The small intestine is a specialized tubular structure within the abdominal cavity in continuity with the stomach proximally and the colon distally. The small bowel increases in length from about 250 cm in the term…
Although specific treatments for certain chronic liver diseases may favorably alter their natural history by diminishing, halting, or permitting regression of hepatic fibrosis, once major complications of cirrhosis such as ascites or hepatic encephalopathy develop, treatment options are limited and…
Hepatic mass lesions include tumors, tumor-like lesions, abscesses, cysts, hematomas, and confluent granulomas. Hepatic tumors may originate in the liver—from hepatocytes, bile duct epithelium, or mesenchymal tissue—or spread to the liver from primary tumors in remote or adjacent organs. In…
ALF is characterized by a sudden insult to the liver with catastrophic consequences, usually in the absence of preexisting liver disease. Coagulopathy and encephalopathy are the twin cardinal features that reflect the severity of liver injury, and both are required…
Chronic liver disease and ALF disrupt normal homeostasis and cause systemic manifestations that may dominate the clinical features of liver disease. Most of these extrahepatic syndromes are reversible with LT. Hepatic Encephalopathy The term hepatic encephalopathy (HE) encompasses a wide…
Ascites is defined as the abnormal accumulation of fluid in the peritoneal cavity. In Western countries, cirrhosis is the most common cause of ascites, representing over 80% of cases. In the remaining cases, ascites may be caused by other conditions…