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Nissen Fundoplication
A NISSEN FUNDOPLICATION, or LAPAROSCOPIC NISSEN FUNDOPLICATION when performed via laparoscopic surgery , is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia . In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia , it is the first-line procedure. The Nissen fundoplication
Nissen fundoplication
is total (360°), but partial fundoplications known as Thal (270° anterior), Belsey (270° anterior transthoracic), Dor (anterior 180–200°), Lind (300° posterior), and Toupet fundoplications (posterior 270°) are alternative procedures with somewhat different indications and outcomes. CONTENTS * 1 History * 2 Technique * 3 Mechanism of relief * 4 Complications * 5 References HISTORYDr. Rudolph Nissen (1896–1981) first performed the procedure in 1955 and published the results of two cases in a 1956 Swiss Medical Weekly
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Marlex
MARLEX is a trademarked name for crystalline polypropylene and high-density polyethylene (HDPE). These plastics were invented by J. Paul Hogan and Robert Banks , two research chemists at the Phillips Petroleum company. The material was originally interesting in the 1950s because its high melting point and tensile strength were more desirable than that of the more common form of polyethylene. For example, the medical community was eager to make use of its high melting point; objects made of Marlex could be cleaned in high temperature autoclaves without affecting their form. Marlex was used by Wham-O for their Hula Hoops in the 1950s, which helped create a market for this plastic. It is now used surgically as a reinforcing mesh in inguinal hernia repair . NOTES This article NEEDS ADDITIONAL CITATIONS FOR VERIFICATION
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Irritable Bowel Syndrome
IRRITABLE BOWEL SYNDROME (IBS) is a group of symptoms—including abdominal pain and changes in the pattern of bowel movements without any evidence of underlying damage. These symptoms occur over a long time, often years. It has been classified into four main types depending on whether diarrhea is common, constipation is common, both are common, or neither occurs very often (IBS-D, IBS-C, IBS-M, or IBS-U respectively). IBS negatively affects quality of life and may result in missed school or work. Disorders such as anxiety , major depression , and chronic fatigue syndrome are common among people with IBS. The causes of IBS are not clear. Theories include combinations of gut–brain axis problems, gut motility disorders, pain sensitivity, infections including small intestinal bacterial overgrowth , neurotransmitters, genetic factors, and food sensitivity . Onset may be triggered by an intestinal infection , or stressful life event
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Belching
BURPING (also known as BELCHING, RUCTUS, ERUPT or ERUCTATION) is the release of gas from the digestive tract (mainly esophagus and stomach ) through the mouth . CONTENTS * 1 Physiology * 2 Infants * 3 Cultural acceptance * 4 "Burped" speech * 5 In other animals * 6 References PHYSIOLOGY Burping is generally caused by swallowing air when eating or drinking and subsequently expelling it, so in this case the expelled gas is mainly a mixture of nitrogen and oxygen . Burps can also be caused by drinking carbonated beverages, such as beer , soft drinks , energy drinks , and wine in which case the expelled gas is primarily carbon dioxide from the drink itself. Common diabetes drugs metformin and Byetta can cause burping, especially at higher doses. This often resolves in a few weeks. Burping combined with other symptoms such as dyspepsia , nausea and heartburn may be a sign of an ulcer or hiatal hernia , and should be reviewed by a physician
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Dumping Syndrome
DUMPING SYNDROME occurs when food, especially sugar, moves too fast from the stomach to the duodenum —the first part of the small intestine—in the upper gastrointestinal (GI) tract . This condition is also called rapid gastric emptying. It is mostly associated with conditions following gastric or esophageal surgery, though it can also arise secondary to diabetes or to the use of certain medications; it is caused by an absent or insufficiently functioning pyloric sphincter , the valve between the stomach and the duodenum. Dumping syndrome has two forms, based on when symptoms occur. Early dumping syndrome occurs 10 to 30 minutes after a meal. It results from rapid movement of fluid into the intestine following a sudden addition of a large amount of food from the stomach. The small intestine expands rapidly due to the presence of hypertonic /hyperosmolar contents from the stomach, especially sweet foods
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Proton-pump Inhibitor
PROTON-PUMP INHIBITORS (PPIS) are a group of drugs whose main action is a pronounced and long-lasting reduction of gastric acid production. Within the class of medications, there is no clear evidence that one agent works better than another. They are the most potent inhibitors of acid secretion available. This group of drugs followed and largely superseded another group of medications with similar effects, but a different mode of action, called H2-receptor antagonists . PPIs are among the most widely sold drugs in the world, and the first one, omeprazole , is on the WHO Model List of Essential Medicines
WHO Model List of Essential Medicines
. The cost between different agents varies significantly
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Pyloroplasty
PYLOROPLASTY is a surgery performed to widen the opening at the lower part of the stomach, also known as the pylorus. When the pylorus thickens, it becomes difficult for food to pass through. The surgery is performed to widen the band of muscle known as the pyloric sphincter , a ring of smooth, muscular fibers that surrounds the pylorus and helps to regulate digestion and prevent reflux (see illustration). The widening of the pyloric sphincter enables the contents of the stomach to pass into the first part of the small intestine known as the duodenum . CONTENTS * 1 Applications * 2 Demographics * 3 Description and Procedure * 4 Risks * 5 Alternatives * 6 References APPLICATIONS Pyloroplasty
Pyloroplasty
can be performed on a narrowed or thickened pylorus, but also on a normal pylorus. Pyloroplasty
Pyloroplasty
is used to treat those who have complications causing a blockage of the pylorus, commonly peptic ulcers
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Gastric Acid
GASTRIC ACID, GASTRIC JUICE or STOMACH ACID, is a digestive fluid formed in the stomach and is composed of hydrochloric acid (HCl), potassium chloride (KCl) and sodium chloride (NaCl). The acid plays a key role in digestion of proteins , by activating digestive enzymes , and making ingested proteins unravel so that digestive enzymes break down the long chains of amino acids . Gastric acid
Gastric acid
is produced by cells in the lining of the stomach, which are coupled in feedback systems to increase acid production when needed. Other cells in the stomach produce bicarbonate , a base, to buffer the fluid, ensuring that it does not become too acidic. These cells also produce mucus , which forms a viscous physical barrier to prevent gastric acid from damaging the stomach
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Esophageal Dilatation
ESOPHAGEAL DILATATION is a therapeutic endoscopic procedure that enlarges the lumen of the esophagus . CONTENTS * 1 Indications * 2 Types of dilators * 3 Complications * 4 References INDICATIONSIt can be used to treat a number of medical conditions that result in narrowing of the esophageal lumen, or decrease motility in the distal esophagus. These include the following: * Peptic stricture * Schatzki rings * Achalasia
Achalasia
* Scleroderma
Scleroderma
esophagus * Rarely esophageal cancer TYPES OF DILATORSThere are three major classes of dilators: * MERCURY-WEIGHTED BOUGIES are blindly inserted bougies placed into the esophagus by the treating physician . They are passed in sequentially increasing sizes to dilate the obstructed area
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Alcohol Poisoning
ALCOHOL INTOXICATION (also known as DRUNKENNESS among other names) is a physiological condition that may result in psychological alterations of consciousness . Drunkenness is induced by the ingestion or consumption of alcohol in a living body. Alcohol intoxication
Alcohol intoxication
is the result of alcohol entering the bloodstream faster than it can be metabolized by the body. Metabolism results in breaking down the ethanol into non-intoxicating byproducts. Some effects of alcohol intoxication (such as euphoria and lowered social inhibitions ) are central to alcohol's desirability as a beverage and its history as one of the world's most widespread recreational drugs . Despite this widespread use and alcohol's legality in most countries, many medical sources tend to describe any level of alcohol intoxication as a form of poisoning due to ethanol's damaging effects on the body in large doses
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Human Gastrointestinal Tract
GASTROINTESTINAL is an adjective meaning of or pertaining to the stomach and INTESTINES. A tract is a collection of related anatomic structures or a series of connected body organs. The GASTROINTESTINAL TRACT (DIGESTIVE TRACT, GI TRACT, GIT, GUT, or ALIMENTARY CANAL) is an organ system within humans and other animals which takes in food, digests it to extract and absorb energy and nutrients, and expels the remaining waste as feces and urine . The mouth , oesophagus , stomach, and intestines are part of the human alimentary canal. All bilaterians have a gastrointestinal tract, also called a gut or an alimentary canal. This is a tube that transfers food to the organs of digestion . In large bilaterians, the gastrointestinal tract generally also has an exit, the anus , by which the animal disposes of feces (solid wastes). Some small bilaterians have no anus and dispose of solid wastes by other means (for example, through the mouth)
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Salivary Gland
The SALIVARY GLANDS in mammals are exocrine glands , glands with ducts , that produce saliva , which is composed of several components including amylase , a digestive enzyme that breaks down starch into maltose and glucose . In humans and some other mammals the secretion is alpha-amylase , also known as ptyalin. CONTENTS* 1 Structure * 1.1 Parotid glands * 1.2 Submandibular glands * 1.3 Sublingual glands * 1.4 Minor salivary glands * 1.5 Von Ebner\'s glands * 1.6 Nerve
Nerve
supply * 1.7 Microanatomy * 1.7.1 Acini * 1.7.2 Ducts * 1.8 Gene and protein expression * 2 Development * 2.1 Aging * 3 Function * 4 Clinical significance * 5 Other animals * 6 See also * 7 References * 8 External links STRUCTURE Salivary glands: #1 is Parotid gland , #2 is Submandibular gland , #3 is Sublingual gland
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PubMed Central
PUBMED CENTRAL (PMC) is a free digital repository that archives publicly accessible full-text scholarly articles that have been published within the biomedical and life sciences journal literature. As one of the major research databases within the suite of resources that have been developed by the National Center for Biotechnology Information (NCBI), PubMed
PubMed
Central is much more than just a document repository. Submissions into PMC undergo an indexing and formatting procedure which results in enhanced metadata, medical ontology , and unique identifiers which all enrich the XML
XML
structured data for each article on deposit. Content within PMC can easily be interlinked to many other NCBI databases and accessed via Entrez
Entrez
search and retrieval systems, further enhancing the public's ability to freely discover, read and build upon this portfolio of biomedical knowledge
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PubMed Identifier
PUBMED is a free search engine accessing primarily the MEDLINE database of references and abstracts on life sciences and biomedical topics. The United States National Library of Medicine (NLM) at the National Institutes of Health
National Institutes of Health
maintains the database as part of the Entrez
Entrez
system of information retrieval . From 1971 to 1997, MEDLINE online access to the MEDLARS Online computerized database primarily had been through institutional facilities, such as university libraries . PubMed, first released in January 1996, ushered in the era of private, free, home- and office-based MEDLINE searching. The PubMed
PubMed
system was offered free to the public in June 1997, when MEDLINE searches via the Web were demonstrated, in a ceremony, by Vice President Al Gore
Al Gore

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Food Poisoning
FOODBORNE ILLNESS (also FOODBORNE DISEASE and colloquially referred to as FOOD POISONING) is any illness resulting from the food spoilage of contaminated food , pathogenic bacteria , viruses , or parasites that contaminate food, as well as toxins such as poisonous mushrooms and various species of beans that have not been boiled for at least 10 minutes. Symptoms vary depending on the cause, and are described below in this article. A few broad generalizations can be made, e.g.: The incubation period ranges from hours to days, depending on the cause and on how much was consumed. The incubation period tends to cause sufferers to not associate the symptoms with the item consumed, and so to cause sufferers to attribute the symptoms to gastroenteritis for example. Symptoms often include vomiting, fever, and aches, and may include diarrhea
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Digital Object Identifier
In computing, a DIGITAL OBJECT IDENTIFIER or DOI is a persistent identifier or handle used to uniquely identify objects, standardized by the International Organization for Standardization
International Organization for Standardization
( ISO
ISO
). An implementation of the Handle System , DOIs are in wide use mainly to identify academic, professional, and government information, such as journal articles, research reports and data sets, and official publications though they also have been used to identify other types of information resources, such as commercial videos. A DOI aims to be "resolvable", usually to some form of access to the information object to which the DOI refers. This is achieved by binding the DOI to metadata about the object, such as a URL , indicating where the object can be found
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