For more than 50 years, Sleisenger & Fordtran’s Gastrointestinal and Liver Disease has been the definitive reference for gastroenterology and hepatology physicians, students and trainees, and the broader multi-disciplinary GI care team. Now guided by a new generation of leaders in the field, this two-volume masterwork brings together the knowledge and expertise of hundreds of global experts who keep you up to date with all aspects of GI and liver disease—everything from basic science to new techniques and technologies. A consistent organization, more than 1,100 full-color illustrations, and clinically practicable algorithms ensure quick access to updated and current information on the diagnosis, treatment, and management of gastrointestinal and liver diseases. The 12th edition welcomes a new senior editorial team of Drs. Raymond T. Chung, David T. Rubin, and C. Mel Wilcox, and features many improvements and additions.
1. Introduction - p. 244 2. Definition - p. 244 3. Evaluation - p. 250 4. Physical Examination - p. 252 5. Differential Diagnosis - p. 252 6. Diagnostic Approach - p. 254 7. Management - p. 262 8. 18. Intestinal Gas - p. 264 9. 19. Fecal Incontinence - p. 273 10. Epidemiology - p. 273 11. Pathophysiology - p. 273 12. Evaluation - p. 277 13. Treatment - p. 283 14. 20. Constipation - p. 292 15. Definition and Presenting Symptoms - p. 292 16. Epidemiology - p. 293 17. Risk Factors - p. 293 18. Colonic Function - p. 295 19. Classification - p. 297 20. Pathophysiology - p. 297 21. Causes - p. 298 22. Clinical Assessment - p. 303 23. Diagnostic Tests - p. 304 24. Defecography - p. 306 25. Treatment - p. 307 26. 21. Gastrointestinal Bleeding - p. 319 27. Initial Assessment and Management of Acute Gastrointestinal Bleeding - p. 319 28. Upper Gastrointestinal Bleeding - p. 326 29. Lower Gastrointestinal Bleeding - p. 342 30. Risk Factors and Risk Stratification - p. 343 31. Mortality - p. 343 32. Diagnostic and Therapeutic Approach - p. 344 33. Causes and Management - p. 345 34. Obscure Overt Gastrointestinal Bleeding - p. 350 35. Causes - p. 351 36. Diagnostic Tests - p. 353 37. Obscure Occult Gastrointestinal Bleeding and Iron Deficiency Anemia - p. 355 38. 22. Jaundice - p. 357 39. 23. Factitious Gastrointestinal Diseases - p. 369 40. Part IV. Processes Involving Multiple Organs - p. P4 41. 24. Oral Diseases and Oral Manifestations of Gastrointestinal and Liver Diseases - p. 378 42. 25. Cutaneous Manifestations of Gastrointestinal and Liver Diseases - p. 388 43. 26. Diverticula of the Pharynx, Esophagus, Stomach, and Small Intestine - p. 401 44. 27. Abdominal Hernias and Gastric Volvulus - p. 410 45. Diaphragmatic Hernias - p. 410 46. Gastric Volvulus - p. 416 47. Inguinal and Femoral Hernias - p. 418 48. Other Ventral Hernias - p. 421 49. Incisional Hernias - p. 421 50. Pelvic and Perineal Hernias - p. 424 51. Lumbar Hernias - p. 424 52. Internal Hernias - p. 425 53. 28. Foreign Bodies, Bezoars, and Caustic Ingestions - p. 429 54. 29. Abdominal Abscesses and Gastrointestinal Fistulas - p. 442 55. 30. Eosinophilic Disorders of the Gastrointestinal Tract - p. 455 56. 31. Protein-Losing Gastroenteropathy - p. 462 57. 32. Gastrointestinal and Hepatic Manifestations of Coronavirus Infection - p. 469 58. 33. Gastrointestinal Consequences of Infection With Human Immunodeficiency Virus - p. 477 59. 34. Gastrointestinal and Hepatic Complications of Solid Organ and Hematopoietic Cell Transplantation - p. 489 60. Complications of Solid Organ Transplantation - p. 489 61. Kidney and Kidney/Pancreas Transplantation - p. 491 62. Liver Transplantation - p. 492 63. Heart, Lung, and Heart-Lung Transplantation - p. 493 64. Intestinal Transplantation - p. 494 65. Problem-Oriented Approach to Diagnosis in Solid Organ Transplantation Recipients - p. 494 66. Complications of Hematopoietic Cell Transplantation - p. 496 67. 35. Gastrointestinal and Hepatic Manifestations of Systemic Diseases - p. 511 68. Collagen Vascular and Inflammatory Diseases - p. 511 69. Oncologic and Hematologic Diseases - p. 520 70. Endocrine Diseases - p. 527 71. Disorders of Lipid Metabolism - p. 530 72. Renal Diseases - p. 531 73. Neurologic Diseases - p. 532 74. Pulmonary Disease - p. 534 75. Critical Illness - p. 534 76. Sepsis - p. 535 77. Cardiovascular Diseases - p. 535 78. Infiltrative Diseases - p. 536 79. Primary Immunodeficiency Diseases - p. 541 80. 36. Vascular Lesions of the Gastrointestinal Tract - p. 543 81. 37. Surgical Peritonitis and Other Diseases of the Peritoneum, Mesentery, Omentum, and Diaphragm - p. 563 82. 38. Gastrointestinal and Hepatic Disorders in the Pregnant Patient - p. 577 83. Gastrointestinal and Hepatic Function in Normal Pregnancy - p. 577 84. Drug Safety in Pregnant Patients - p. 578 85. Endoscopy During Pregnancy - p. 578 86. Imaging and Radiation Exposure During Pregnancy - p. 578 87. GI Disorders and Pregnancy - p. 579 88. Gallbladder and Pancreatic Disorders and Pregnancy - p. 582 89. Hepatic Disorders Unique to Pregnancy - p. 582 90. Other Hepatic Disorders and Pregnancy - p. 587 91. 39. Acute and Chronic Gastrointestinal Side Effects of Radiation Therapy - p. 591 92. 40. Preparation for and Complications of GI Endoscopy - p. 605 93. Part V. Neoplasia Involving Multiple Organs - p. P5 94. 41. Gastrointestinal Lymphomas∗ - p. 615 95. 42. Gastrointestinal Stromal Tumors - p. 632 96. Pathology - p. 632 97. Molecular Pathogenesis - p. 634 98. Molecular Pharmacology - p. 636 99. Epidemiology - p. 636 100. Clinical Features - p. 636 101. Diagnosis - p. 638 102. Treatment - p. 640 103. Special Considerations - p. 646 104. 43. Neuroendocrine Tumors - p. 647 105. Historical Aspects - p. 647 106. Epidemiology - p. 647 107. Origin and Histochemical Features - p. 648 108. Classification - p. 649 109. Molecular Pathogenesis - p. 650 110. Multiple Endocrine Neoplasia and Other Inherited Syndromes - p. 650 111. Functional Tumors - p. 651 112. Gastrinomas - p. 654 113. Glucagonomas - p. 657 114. VIPomas - p. 659 115. Other Functional pNETs - p. 660 116. Nonfunctional pNETs - p. 660 117. GI-NETs (Carcinoids) - p. 660 118. Carcinoid Syndrome - p. 666 119. Tumor Localization - p. 668 120. Treatment of Metastatic Disease - p. 669 121. 44. Enterocolitis and Hepatitis Induced by Cancer Immunotherapy - p. 673 122. Part VI. Esophagus - p. P6 123. 45. Anatomy, Histology, Embryology, and Developmental Anomalies of the Esophagus - p. 681 124. 46. Esophageal Neuromuscular Function and Motility Disorders - p. 694 125. 47. Esophageal Disorders Caused by Medications, Trauma, and Infection - p. 720 126. 48. Gastroesophageal Reflux Disease - p. 729 127. Epidemiology - p. 729 128. Health care Impact - p. 731 129. Clinical Features - p. 737 130. Differential Diagnosis - p. 738 131. Associated Conditions - p. 738 132. Diagnosis - p. 739 133. Clinical Course - p. 743 134. Complications - p. 743 135. Treatment of Uncomplicated Disease - p. 744 136. Treatment of Peptic Esophageal Strictures - p. 750 137. 49. Barrett Esophagus - p. 751 138. 50. Esophageal Tumors - p. 761 139. Conflicts of Interest and Acknowledgement - p. 761 140. Carcinomas - p. 761 141. Other Malignant Epithelial Tumors - p. 778 142. Benign Epithelial Tumors - p. 778 143. Malignant Nonepithelial Tumors - p. 779 144. Benign Nonepithelial Tumors - p. 779 145. Part VII. Stomach and Duodenum - p. P7 146. 51. Anatomy, Histology, and Developmental Anomalies of the Stomach and Duodenum - p. 781 147. 52. Gastric Neuromuscular Function and Neuromuscular Disorders - p. 797 148. Electrophysiologic Basis for Normal Gastric Neuromuscular Function - p. 797 149. Regulation of Gastric Neuromuscular Activity After a Meal - p. 805 150. Gastric Sensory Activities - p. 809 151. The Stomach and the Regulation of Food Intake, Hunger, and Satiety - p. 809 152. Developmental Aspects of Gastric Neuromuscular Function - p. 811 153. Developmental Aspects of Gastric Neuromuscular Function - p. 811 154. Assessment of Gastric Neuromuscular Function - p. 812 155. Neuromuscular Disorders of the Stomach - p. 814 156. Diagnosis of Gastric Neuromuscular Disorders - p. 820 157. Treatment - p. 822 158. 53. Gastric Secretion - p. 827 159. Functional Anatomy - p. 827 160. Acid Secretion - p. 829 161. Nonacid Gastric Secretions - p. 847 162. 54. Gastritis and Gastropathy - p. 851 163. Definitions - p. 851 164. Acute Gastritis - p. 851 165. Chronic Gastritis - p. 852 166. Carditis - p. 862 167. Other Infectious Causes of Gastritis - p. 862 168. Granulomatous Gastritis - p. 866 169. Distinctive Causes of Gastritis - p. 867 170. Gastritis in Inflammatory Bowel Disease - p. 869 171. Gastritis Cystica Profunda - p. 870 172. Allergic Gastritis - p. 870 173. Reactive Gastropathies - p. 870 174. Gastric Antral Vascular Ectasia - p. 870 175. Hyperplastic Gastropathies, Including Ménétrier’s Disease - p. 873 176. Portal Hypertensive Gastropathy - p. 875 177. Differential Diagnosis - p. 875 178. Treatment - p. 875 179. 55. Peptic Ulcer Disease - p. 882 180. 56. Adenocarcinoma of the Stomach and Other Gastric Tumors - p. 897 181. Epidemiology - p. 897 182. Etiology and Pathogenesis - p. 898 183. Hp Infection - p. 900 184. Dietary Risk Factors - p. 902 185. Cigarette Smoking - p. 902 186. Alcohol - p. 902 187. Obesity - p. 903 188. Genetic Factors - p. 903 189. Tumor Genetics - p. 904 190. Premalignant Conditions - p. 906 191. Screening and Surveillance - p. 909 192. Prevention - p. 910 193. Clinical Features - p. 911 194. Diagnosis - p. 912 195. Classification and Staging - p. 913 196. Prognosis and Treatment - p. 915 197. Miscellaneous Gastric Tumors - p. 920 198. Part VIII. Pancreas - p. P8 199. 57. Anatomy, Histology, Embryology, and Developmental Anomalies of the Pancreas - p. 921 200. 58. Exocrine Pancreatic Secretion - p. 932 201. 59. Genetic Disorders of the Pancreas and Pancreatic Disorders in Childhood - p. 941 202. Background - p. 941 203. Definitions and Terminology - p. 941 204. γ-Glutamyl Transpeptidase (GGT1) - p. 957 205. Integration of Genetics and Patient Management - p. 959 206. Pancreatitis in Children - p. 960 207. Clinical Management of Mendelian Disorders of the Pancreas - p. 961 208. Rare Genetic Syndromes With Pancreatic Pathology - p. 972 209. Familial Metabolic Syndromes Associated With Recurrent Acute and Chronic Pancreatitis - p. 973 210. History of pancreatic disease diagnosis and management based on medical paradigms - p. 973 211. 60. Acute Pancreatitis - p. 974 212. Incidence and Burden of Acute Pancreatitis - p. 974 213. Definitions - p. 975 214. Acute Necrotic Collections and Walled-Off Pancreatic Necrosis - p. 976 215. Acute Nonnecrotic Fluid Collections and Pseudocysts - p. 976 216. Why Distinguish Between Necrotic and Nonnecrotic Collections? - p. 976 217. Clinical Course of Acute Pancreatitis - p. 976 218. Pathogenesis and Pathophysiology - p. 977 219. Initiating Cellular Events - p. 977 220. Host Response - p. 980 221. Predisposing Conditions - p. 982 222. Vascular Disease - p. 984 223. Clinical Features of AP - p. 987 224. Differential Diagnosis - p. 988 225. Laboratory Diagnosis - p. 988 226. Diagnostic Imaging - p. 990 227. Distinguishing Alcoholic From Gallstone Pancreatitis - p. 991 228. Predictors of Disease Severity - p. 991 229. Novel Biomarkers - p. 992 230. Treatment - p. 992 231. Antibiotics - p. 995 232. Urgent Endoscopic Retrograde Cholangiopancreatography (ERCP) - p. 995 233. 61. Chronic Pancreatitis - p. 1000 234. Epidemiology - p. 1000 235. Pathology - p. 1001 236. Pathophysiology - p. 1001 237. Etiology - p. 1003 238. Clinical Features - p. 1010 239. Physical Examination - p. 1012 240. Diagnosis - p. 1013 241. Diagnostic Strategy - p. 1018 242. Treatment - p. 1018 243. Complications - p. 1025 244. 62. Pancreatic Cancer, Cystic Neoplasms, and Other Tumors - p. 1030 245. Pancreatic Cancer - p. 1030 246. Pancreatic Cystic Neoplasms - p. 1042 247. Other Pancreatic Tumors - p. 1050 248. 63. Endoscopic Treatment of Pancreatic Disease - p. 1051 249. Part IX. Biliary Tract - p. P9 250. 64. Anatomy, Histology, Embryology, Developmental Anomalies, and Pediatric Disorders of the Biliary Tract - p. 1059 251. Embryology of the Liver and Biliary Tract - p. 1059 252. Anatomy and Histology of the Biliary Tree - p. 1061 253. Developmental Anomalies - p. 1064 254. Approach to Disorders of the Biliary Tract in Infants and Children - p. 1064 255. Pediatric Disorders of the Bile Ducts - p. 1066 256. Pediatric Disorders of the Gallbladder - p. 1077 257. 65. Biliary Tract Motor Function and Dysfunction - p. 1081 258. 66. Bile Formation and Bile Acid Cycling in Health and Disease - p. 1087 259. 67. Gallstone Disease - p. 1103 260. Types of Gallstones - p. 1103 261. Epidemiology - p. 1103 262. Composition and Abnormalities of Bile - p. 1108 263. Pathophysiology - p. 1112 264. Genetics - p. 1116 265. Pigment Stones - p. 1117 266. Natural History - p. 1121 267. Diagnosis - p. 1122 268. Clinical Disorders - p. 1129 269. Uncommon Complications - p. 1134 270. 68. Treatment of Gallstone Disease - p. 1136 271. 69. Acalculous Biliary Pain, Acute Acalculous Cholecystitis, Cholesterolosis, Adenomyomatosis, and Gallbladder Polyps - p. 1154 272. 70. Primary and Secondary Sclerosing Cholangitis - p. 1168 273. Primary Sclerosing Cholangitis - p. 1168 274. Secondary Sclerosing Cholangitis - p. 1184 275. 71. Tumors of the Bile Ducts, Gallbladder, and Ampulla - p. 1187 276. 72. Endoscopic and Radiologic Treatment of Biliary Disease∗ - p. 1205 277. Volume 2 - p. V2 278. Part X. Liver - p. P10 279. 73. Embryology, Anatomy, Histology, and Developmental Anomalies of the Liver - p. 1221 280. 74. Liver Physiology and Energy Metabolism - p. 1228 281. 75. Liver Chemistry and Function Tests - p. 1249 282. 76. Overview of Cirrhosis - p. 1259 283. 77. Hemochromatosis - p. 1269 284. 78. Wilson Disease - p. 1279 285. 79. Other Inherited Metabolic Disorders of the Liver - p. 1289 286. Clinical Features of Metabolic Liver Disease - p. 1289 287. α1-Antitrypsin Deficiency - p. 1289 288. Glycogen Storage Diseases - p. 1292 289. Congenital Disorders of Glycosylation - p. 1295 290. Porphyrias - p. 1296 291. Tyrosinemia - p. 1300 292. Urea Cycle Defects - p. 1301 293. Bile Acid Synthesis and Transport Defects - p. 1304 294. Cystic Fibrosis - p. 1308 295. Mitochondrial Liver Diseases - p. 1309 296. 80. Hepatitis A - p. 1311 297. 81. Hepatitis B - p. 1318 298. Introduction - p. 1318 299. Epidemiology - p. 1318 300. Clinical Outcomes - p. 1319 301. Virology - p. 1320 302. Pathogenesis - p. 1323 303. Natural History - p. 1324 304. Clinical and Pathologic Features - p. 1326 305. Diagnosis - p. 1330 306. Treatment - p. 1331 307. Prevention - p. 1344 308. 82. Hepatitis C - p. 1347 309. Virology - p. 1347 310. Epidemiology - p. 1350 311. Pathogenesis - p. 1352 312. Clinical Features - p. 1353 313. Diagnosis - p. 1355 314. Liver Biopsy and Noninvasive Assessment of Fibrosis - p. 1356 315. Natural History - p. 1357 316. Treatment - p. 1359 317. 83. Hepatitis D - p. 1375 318. 84. Hepatitis E - p. 1386 319. 85. Hepatitis Caused by Other Viruses - p. 1393 320. 86. Bacterial, Parasitic, and Fungal Infections of the Liver, Including Liver Abscesses - p. 1401 321. 87. Vascular Diseases of the Liver - p. 1420 322. 88. Alcohol-Associated Liver Disease - p. 1436 323. Epidemiology - p. 1436 324. Spectrum of Disease - p. 1437 325. Pathogenesis - p. 1437 326. Diagnosis of Alcohol Misuse - p. 1443 327. Diagnosis of Alcohol-Associated Liver Disease - p. 1444 328. Cofactors That May Influence Progression of Alcohol-Associated Liver Disease - p. 1446 329. Prognosis - p. 1447 330. Treatment - p. 1449 331. 89. Metabolic Dysfunction-Associated Steatotic Liver Disease/Nonalcoholic Fatty Liver Disease - p. 1456 332. 90. Liver Disease Caused by Drugs - p. 1473 333. Hepatic Drug Metabolism - p. 1473 334. Liver Disease Caused by Drugs - p. 1475 335. Dose-Dependent Hepatotoxicity - p. 1487 336. Drug-Induced Acute Hepatitis - p. 1491 337. Drug-Induced Granulomatous Hepatitis - p. 1497 338. Drug-Induced Chronic Hepatitis - p. 1498 339. Drug-Induced Acute Cholestasis - p. 1499 340. Drug-Induced Chronic Cholestasis - p. 1501 341. Drug-Induced Steatohepatitis and Hepatic Fibrosis - p. 1501 342. Drug-Induced Vascular Toxicity - p. 1504 343. Liver Tumors - p. 1505 344. 91. Liver Disease Caused by Anesthetics, Chemicals, Toxins, and Herbal and Dietary Supplements - p. 1506 345. Anesthetic Agents - p. 1506 346. Chemicals - p. 1508 347. Metals - p. 1513 348. Drugs of Abuse - p. 1513 349. Botanical and Environmental Hepatotoxins - p. 1514 350. Vitamins - p. 1516 351. Herbal, Dietary, Weight-Loss, and Body-Building Supplements - p. 1517 352. 92. Autoimmune Hepatitis - p. 1524 353. 93. Primary Biliary Cholangitis - p. 1541 354. 94. Portal Hypertension and Variceal Bleeding - p. 1555 355. Normal Portal Circulation - p. 1555 356. Hemodynamic Principles of Portal Hypertension - p. 1556 357. Measurement of Portal Pressure - p. 1560 358. Detection of Varices - p. 1562 359. Causes of Portal Hypertension - p. 1564 360. Clinical Assessment - p. 1567 361. Treatment - p. 1567 362. Management of Specific Causes of Portal Hypertension-Related Bleeding - p. 1575 363. 95. Ascites and Spontaneous Bacterial Peritonitis - p. 1584 364. 96. Hepatic Encephalopathy, Hepatorenal Syndrome, Hepatopulmonary Syndrome, and Other Systemic Complications of Liver Disease - p. 1599 365. Hepatic Encephalopathy - p. 1599 366. Hepatorenal Syndrome - p. 1602 367. Hepatopulmonary Syndrome and Portopulmonary Hypertension - p. 1606 368. Cirrhotic Cardiomyopathy - p. 1609 369. Endocrine Dysfunction - p. 1611 370. Bone Disease - p. 1612 371. Coagulation Disorders - p. 1612 372. 97. Acute Liver Failure - p. 1614 373. 98. Hepatic Tumors and Cysts - p. 1629 374. Malignant Tumors - p. 1629 375. Benign Tumors - p. 1645 376. Tumor-Like Hepatic Lesions - p. 1650 377. Hepatic Cysts - p. 1651 378. Approach to the Patient with a Hepatic Mass - p. 1653 379. 99. Liver Transplantation - p. 1655 380. Part XI. Small and Large Intestine - p. P11 381. 100. Anatomy, Histology, Embryology, and Developmental Anomalies of the Small and Large Intestine - p. 1674 382. 101. Small Intestinal Motor and Sensory Function and Dysfunction - p. 1704 383. 102. Colonic Motor and Sensory Function and Dysfunction - p. 1721 384. 103. Intestinal Electrolyte Absorption and Secretion - p. 1738 385. Intestinal Architecture and Transport - p. 1738 386. Basic Epithelial Cell Model - p. 1739 387. Segmental Heterogeneity of Transport - p. 1741 388. Movement Across the Intestinal Epithelium - p. 1742 389. Tight and Leaky Epithelia - p. 1743 390. Transepithelial Transport - p. 1743 391. Transcellular Transport - p. 1744 392. Water Movement - p. 1744 393. Channels, Carriers, and Pumps - p. 1744 394. Ion Transporters - p. 1745 395. Extracellular Regulation: Microbial, Autocrine, Luminal, Paracrine, Immunologic, Neural, and Endocrine Systems (MALPINES) - p. 1754 396. Systemic Effects - p. 1758 397. Osmotic Effects - p. 1758 398. Specific Regulatory Factors - p. 1759 399. Intracellular Mediators - p. 1763 400. Epithelial Regulation in Context - p. 1765 401. 104. Digestion and Absorption of Carbohydrate, Protein, and Fat - p. 1766 402. 105. Digestion and Absorption of Micronutrients - p. 1788 403. Water-Soluble Vitamins - p. 1788 404. Fat-Soluble Vitamins - p. 1800 405. Minerals and Trace Elements - p. 1805 406. 106. Maldigestion and Malabsorption - p. 1811.e8 407. Etiology and Pathophysiology - p. 1812 408. Fats - p. 1813 409. Proteins and Amino Acids - p. 1814 410. Carbohydrates - p. 1814 411. Vitamins - p. 1815 412. Minerals - p. 1815 413. Mechanisms that Compensate for Malabsorption - p. 1816 414. Clinical Features and Evaluation - p. 1817 415. Malabsorption in Specific Situations and Disease States - p. 1831 416. General Approach to Management - p. 1844 417. 107. Small Intestinal Bacterial Overgrowth - p. 1846 418. 108. Short Bowel Syndrome - p. 1856 419. 109. Celiac Disease - p. 1873 420. Definitions - p. 1873 421. History of Celiac Disease - p. 1873 422. Epidemiology - p. 1874 423. Pathology - p. 1874 424. Pathogenesis - p. 1876 425. Clinical Features - p. 1878 426. Diagnosis - p. 1881 427. Differential Diagnosis - p. 1885 428. Treatment - p. 1887 429. Nonresponsive Celiac Disease - p. 1889 430. Refractory Celiac Disease - p. 1889 431. Celiac Disease and Malignancy - p. 1892 432. Prognosis - p. 1893 433. Future Therapies - p. 1893 434. 110. Tropical Diarrhea and Malabsorption - p. 1894 435. 111. Whipple Disease - p. 1909 436. 112. Infectious Enteritis and Proctocolitis - p. 1919 437. Susceptibility to Intestinal Infection - p. 1919 438. General Principles of Infectious Enteritis and Proctocolitis - p. 1921 439. Enterotoxigenic Pathogens - p. 1925 440. Invasive Pathogens - p. 1933 441. Sexually Transmitted Infectious Proctitis - p. 1942 442. Viral Pathogens - p. 1943 443. Travelers’ Diarrhea - p. 1945 444. Tuberculosis of the Intestinal Tract - p. 1946 445. Overview of Treatment - p. 1948 446. 113. Food Poisoning - p. 1950 447. 114. Antibiotic-Associated Diarrhea and Clostridioides difficile Infection - p. 1958 448. Antibiotic-Associated Diarrhea - p. 1958 449. Pseudomembranous Enterocolitis - p. 1959 450. Clostridioides difficile Infection - p. 1959 451. 115. Intestinal Protozoa - p. 1975 452. 116. Intestinal Worms - p. 1988 453. Introduction - p. 1988 454. Nematodes - p. 1989 455. Hookworms (Necator americanus, Ancylostoma duodenale, A. Ceylanicum, and A. Caninum) - p. 1993 456. Cestodes - p. 1999 457. Trematodes - p. 2002 458. Liver Flukes - p. 2003 459. 117. Epidemiology, Pathogenesis, and Diagnosis of Inflammatory Bowel Diseases - p. 2008 460. Epidemiology - p. 2008 461. Etiology and Pathogenesis - p. 2011 462. Establishing the Diagnosis in IBD - p. 2027 463. Differential Diagnosis of IBD - p. 2034 464. Measuring Disease Activity in IBD - p. 2037 465. 118. Management of Inflammatory Bowel Diseases - p. 2040 466. Medical Therapy - p. 2040 467. Future Directions for Medical Therapy - p. 2065 468. Surgical Therapy - p. 2065 469. Management of Inflammatory Bowel Disease-Related Complications - p. 2069 470. Management of Inflammatory Bowel Disease in Special Situations - p. 2075 471. 119. Ileostomies, Colostomies, and Anastomoses - p. 2077 472. 120. Intestinal Ischemia - p. 2085 473. Anatomy of the Splanchnic Circulation - p. 2085 474. Pathophysiology and Pathology - p. 2086 475. Outcomes - p. 2095 476. Focal Segmental Ischemia of the Small Intestine - p. 2098 477. Chronic Mesenteric Ischemia (Intestinal Angina) - p. 2108 478. Vasculitis and Angiopathy of the Splanchnic Circulation - p. 2110 479. 121. Intestinal Ulcerations - p. 2113 480. 122. Appendicitis - p. 2127 481. 123. Diverticular Disease of the Colon - p. 2136 482. 124. Irritable Bowel Syndrome - p. 2151 483. 125. Intestinal Obstruction - p. 2166 484. 126. Ileus and Pseudo-Obstruction Syndromes - p. 2187 485. Ileus - p. 2187 486. Acute Colonic Pseudo-Obstruction - p. 2192 487. Megacolon and Megarectum - p. 2206 488. 127. Tumors of the Small Intestine - p. 2208 489. 128. Colonic Polyps and Polyposis Syndromes - p. 2227 490. Conventional Adenomas - p. 2227 491. Sessile Serrated Adenomas and Hyperplastic Polyps - p. 2241 492. Nonneoplastic Polyps and Polypoid Lesions - p. 2246 493. 129. Colorectal Cancer - p. 2261 494. Epidemiology - p. 2261 495. Etiology - p. 2263 496. Biology - p. 2270 497. Familial Colorectal Cancer - p. 2277 498. Predisposing Factors - p. 2278 499. Pathology - p. 2282 500. Natural History and Staging - p. 2283 501. Prognosis - p. 2286 502. Clinical Features - p. 2289 503. Diagnosis and Screening - p. 2290 504. Treatment - p. 2300 505. Other Malignant Colonic Tumors - p. 2308 506. 130. Other Diseases of the Colon - p. 2309 507. 131. Anal Diseases - p. 2324 508. Part XII. Additional Treatments for Patients with Gastrointestinal and Liver Disease - p. P12 509. 132. Complementary, Alternative, and Integrative Medicine - p. 2343 510. Definitions - p. 2343 511. Epidemiology - p. 2343 512. Demographics of Complementary and Alternative Medicine Users - p. 2343 513. Types of Therapies - p. 2344 514. Rationale for and Satisfaction With Use - p. 2344 515. Patient-Provider Communication Regarding CAM - p. 2345 516. Physician Knowledge of CAM - p. 2345 517. Gastrointestinal Disorders Amenable to Complementary and Alternative Therapies - p. 2345 518. Constipation and Diarrhea - p. 2352 519. Cannabis and Cannabinoids - p. 2358 520. Regulation of Complementary and Alternative Medicine Therapies - p. 2359 521. Safety of Complementary and Alternative Medicine Therapies - p. 2360 522. Medical Misinformation, Social Media, and CAM - p. 2360 523. Conclusion - p. 2360 524. Resources for Healthcare Professionals - p. 2360 525. 133. Palliative Care Medicine in Patients With Advanced Gastrointestinal and Hepatic Disease - p. 2361 526. Index - p. I1
For more than 50 years, Sleisenger & Fordtran’s Gastrointestinal and Liver Disease has been the definitive reference for gastroenterology and hepatology physicians, students and trainees, and the broader multi-disciplinary GI care team. Now guided by a new generation of leaders in the field, this two-volume masterwork brings together the knowledge and expertise of hundreds of global experts who keep you up to date with all aspects of GI and liver disease—everything from basic science to new techniques and technologies. A consistent organization, more than 1,100 full-color illustrations, and clinically practicable algorithms ensure quick access to updated and current information on the diagnosis, treatment, and management of gastrointestinal and liver diseases. The 12th edition welcomes a new senior editorial team of Drs. Raymond T. Chung, David T. Rubin, and C. Mel Wilcox, and features many improvements and additions.
1. Introduction - p. 244 2. Definition - p. 244 3. Evaluation - p. 250 4. Physical Examination - p. 252 5. Differential Diagnosis - p. 252 6. Diagnostic Approach - p. 254 7. Management - p. 262 8. 18. Intestinal Gas - p. 264 9. 19. Fecal Incontinence - p. 273 10. Epidemiology - p. 273 11. Pathophysiology - p. 273 12. Evaluation - p. 277 13. Treatment - p. 283 14. 20. Constipation - p. 292 15. Definition and Presenting Symptoms - p. 292 16. Epidemiology - p. 293 17. Risk Factors - p. 293 18. Colonic Function - p. 295 19. Classification - p. 297 20. Pathophysiology - p. 297 21. Causes - p. 298 22. Clinical Assessment - p. 303 23. Diagnostic Tests - p. 304 24. Defecography - p. 306 25. Treatment - p. 307 26. 21. Gastrointestinal Bleeding - p. 319 27. Initial Assessment and Management of Acute Gastrointestinal Bleeding - p. 319 28. Upper Gastrointestinal Bleeding - p. 326 29. Lower Gastrointestinal Bleeding - p. 342 30. Risk Factors and Risk Stratification - p. 343 31. Mortality - p. 343 32. Diagnostic and Therapeutic Approach - p. 344 33. Causes and Management - p. 345 34. Obscure Overt Gastrointestinal Bleeding - p. 350 35. Causes - p. 351 36. Diagnostic Tests - p. 353 37. Obscure Occult Gastrointestinal Bleeding and Iron Deficiency Anemia - p. 355 38. 22. Jaundice - p. 357 39. 23. Factitious Gastrointestinal Diseases - p. 369 40. Part IV. Processes Involving Multiple Organs - p. P4 41. 24. Oral Diseases and Oral Manifestations of Gastrointestinal and Liver Diseases - p. 378 42. 25. Cutaneous Manifestations of Gastrointestinal and Liver Diseases - p. 388 43. 26. Diverticula of the Pharynx, Esophagus, Stomach, and Small Intestine - p. 401 44. 27. Abdominal Hernias and Gastric Volvulus - p. 410 45. Diaphragmatic Hernias - p. 410 46. Gastric Volvulus - p. 416 47. Inguinal and Femoral Hernias - p. 418 48. Other Ventral Hernias - p. 421 49. Incisional Hernias - p. 421 50. Pelvic and Perineal Hernias - p. 424 51. Lumbar Hernias - p. 424 52. Internal Hernias - p. 425 53. 28. Foreign Bodies, Bezoars, and Caustic Ingestions - p. 429 54. 29. Abdominal Abscesses and Gastrointestinal Fistulas - p. 442 55. 30. Eosinophilic Disorders of the Gastrointestinal Tract - p. 455 56. 31. Protein-Losing Gastroenteropathy - p. 462 57. 32. Gastrointestinal and Hepatic Manifestations of Coronavirus Infection - p. 469 58. 33. Gastrointestinal Consequences of Infection With Human Immunodeficiency Virus - p. 477 59. 34. Gastrointestinal and Hepatic Complications of Solid Organ and Hematopoietic Cell Transplantation - p. 489 60. Complications of Solid Organ Transplantation - p. 489 61. Kidney and Kidney/Pancreas Transplantation - p. 491 62. Liver Transplantation - p. 492 63. Heart, Lung, and Heart-Lung Transplantation - p. 493 64. Intestinal Transplantation - p. 494 65. Problem-Oriented Approach to Diagnosis in Solid Organ Transplantation Recipients - p. 494 66. Complications of Hematopoietic Cell Transplantation - p. 496 67. 35. Gastrointestinal and Hepatic Manifestations of Systemic Diseases - p. 511 68. Collagen Vascular and Inflammatory Diseases - p. 511 69. Oncologic and Hematologic Diseases - p. 520 70. Endocrine Diseases - p. 527 71. Disorders of Lipid Metabolism - p. 530 72. Renal Diseases - p. 531 73. Neurologic Diseases - p. 532 74. Pulmonary Disease - p. 534 75. Critical Illness - p. 534 76. Sepsis - p. 535 77. Cardiovascular Diseases - p. 535 78. Infiltrative Diseases - p. 536 79. Primary Immunodeficiency Diseases - p. 541 80. 36. Vascular Lesions of the Gastrointestinal Tract - p. 543 81. 37. Surgical Peritonitis and Other Diseases of the Peritoneum, Mesentery, Omentum, and Diaphragm - p. 563 82. 38. Gastrointestinal and Hepatic Disorders in the Pregnant Patient - p. 577 83. Gastrointestinal and Hepatic Function in Normal Pregnancy - p. 577 84. Drug Safety in Pregnant Patients - p. 578 85. Endoscopy During Pregnancy - p. 578 86. Imaging and Radiation Exposure During Pregnancy - p. 578 87. GI Disorders and Pregnancy - p. 579 88. Gallbladder and Pancreatic Disorders and Pregnancy - p. 582 89. Hepatic Disorders Unique to Pregnancy - p. 582 90. Other Hepatic Disorders and Pregnancy - p. 587 91. 39. Acute and Chronic Gastrointestinal Side Effects of Radiation Therapy - p. 591 92. 40. Preparation for and Complications of GI Endoscopy - p. 605 93. Part V. Neoplasia Involving Multiple Organs - p. P5 94. 41. Gastrointestinal Lymphomas∗ - p. 615 95. 42. Gastrointestinal Stromal Tumors - p. 632 96. Pathology - p. 632 97. Molecular Pathogenesis - p. 634 98. Molecular Pharmacology - p. 636 99. Epidemiology - p. 636 100. Clinical Features - p. 636 101. Diagnosis - p. 638 102. Treatment - p. 640 103. Special Considerations - p. 646 104. 43. Neuroendocrine Tumors - p. 647 105. Historical Aspects - p. 647 106. Epidemiology - p. 647 107. Origin and Histochemical Features - p. 648 108. Classification - p. 649 109. Molecular Pathogenesis - p. 650 110. Multiple Endocrine Neoplasia and Other Inherited Syndromes - p. 650 111. Functional Tumors - p. 651 112. Gastrinomas - p. 654 113. Glucagonomas - p. 657 114. VIPomas - p. 659 115. Other Functional pNETs - p. 660 116. Nonfunctional pNETs - p. 660 117. GI-NETs (Carcinoids) - p. 660 118. Carcinoid Syndrome - p. 666 119. Tumor Localization - p. 668 120. Treatment of Metastatic Disease - p. 669 121. 44. Enterocolitis and Hepatitis Induced by Cancer Immunotherapy - p. 673 122. Part VI. Esophagus - p. P6 123. 45. Anatomy, Histology, Embryology, and Developmental Anomalies of the Esophagus - p. 681 124. 46. Esophageal Neuromuscular Function and Motility Disorders - p. 694 125. 47. Esophageal Disorders Caused by Medications, Trauma, and Infection - p. 720 126. 48. Gastroesophageal Reflux Disease - p. 729 127. Epidemiology - p. 729 128. Health care Impact - p. 731 129. Clinical Features - p. 737 130. Differential Diagnosis - p. 738 131. Associated Conditions - p. 738 132. Diagnosis - p. 739 133. Clinical Course - p. 743 134. Complications - p. 743 135. Treatment of Uncomplicated Disease - p. 744 136. Treatment of Peptic Esophageal Strictures - p. 750 137. 49. Barrett Esophagus - p. 751 138. 50. Esophageal Tumors - p. 761 139. Conflicts of Interest and Acknowledgement - p. 761 140. Carcinomas - p. 761 141. Other Malignant Epithelial Tumors - p. 778 142. Benign Epithelial Tumors - p. 778 143. Malignant Nonepithelial Tumors - p. 779 144. Benign Nonepithelial Tumors - p. 779 145. Part VII. Stomach and Duodenum - p. P7 146. 51. Anatomy, Histology, and Developmental Anomalies of the Stomach and Duodenum - p. 781 147. 52. Gastric Neuromuscular Function and Neuromuscular Disorders - p. 797 148. Electrophysiologic Basis for Normal Gastric Neuromuscular Function - p. 797 149. Regulation of Gastric Neuromuscular Activity After a Meal - p. 805 150. Gastric Sensory Activities - p. 809 151. The Stomach and the Regulation of Food Intake, Hunger, and Satiety - p. 809 152. Developmental Aspects of Gastric Neuromuscular Function - p. 811 153. Developmental Aspects of Gastric Neuromuscular Function - p. 811 154. Assessment of Gastric Neuromuscular Function - p. 812 155. Neuromuscular Disorders of the Stomach - p. 814 156. Diagnosis of Gastric Neuromuscular Disorders - p. 820 157. Treatment - p. 822 158. 53. Gastric Secretion - p. 827 159. Functional Anatomy - p. 827 160. Acid Secretion - p. 829 161. Nonacid Gastric Secretions - p. 847 162. 54. Gastritis and Gastropathy - p. 851 163. Definitions - p. 851 164. Acute Gastritis - p. 851 165. Chronic Gastritis - p. 852 166. Carditis - p. 862 167. Other Infectious Causes of Gastritis - p. 862 168. Granulomatous Gastritis - p. 866 169. Distinctive Causes of Gastritis - p. 867 170. Gastritis in Inflammatory Bowel Disease - p. 869 171. Gastritis Cystica Profunda - p. 870 172. Allergic Gastritis - p. 870 173. Reactive Gastropathies - p. 870 174. Gastric Antral Vascular Ectasia - p. 870 175. Hyperplastic Gastropathies, Including Ménétrier’s Disease - p. 873 176. Portal Hypertensive Gastropathy - p. 875 177. Differential Diagnosis - p. 875 178. Treatment - p. 875 179. 55. Peptic Ulcer Disease - p. 882 180. 56. Adenocarcinoma of the Stomach and Other Gastric Tumors - p. 897 181. Epidemiology - p. 897 182. Etiology and Pathogenesis - p. 898 183. Hp Infection - p. 900 184. Dietary Risk Factors - p. 902 185. Cigarette Smoking - p. 902 186. Alcohol - p. 902 187. Obesity - p. 903 188. Genetic Factors - p. 903 189. Tumor Genetics - p. 904 190. Premalignant Conditions - p. 906 191. Screening and Surveillance - p. 909 192. Prevention - p. 910 193. Clinical Features - p. 911 194. Diagnosis - p. 912 195. Classification and Staging - p. 913 196. Prognosis and Treatment - p. 915 197. Miscellaneous Gastric Tumors - p. 920 198. Part VIII. Pancreas - p. P8 199. 57. Anatomy, Histology, Embryology, and Developmental Anomalies of the Pancreas - p. 921 200. 58. Exocrine Pancreatic Secretion - p. 932 201. 59. Genetic Disorders of the Pancreas and Pancreatic Disorders in Childhood - p. 941 202. Background - p. 941 203. Definitions and Terminology - p. 941 204. γ-Glutamyl Transpeptidase (GGT1) - p. 957 205. Integration of Genetics and Patient Management - p. 959 206. Pancreatitis in Children - p. 960 207. Clinical Management of Mendelian Disorders of the Pancreas - p. 961 208. Rare Genetic Syndromes With Pancreatic Pathology - p. 972 209. Familial Metabolic Syndromes Associated With Recurrent Acute and Chronic Pancreatitis - p. 973 210. History of pancreatic disease diagnosis and management based on medical paradigms - p. 973 211. 60. Acute Pancreatitis - p. 974 212. Incidence and Burden of Acute Pancreatitis - p. 974 213. Definitions - p. 975 214. Acute Necrotic Collections and Walled-Off Pancreatic Necrosis - p. 976 215. Acute Nonnecrotic Fluid Collections and Pseudocysts - p. 976 216. Why Distinguish Between Necrotic and Nonnecrotic Collections? - p. 976 217. Clinical Course of Acute Pancreatitis - p. 976 218. Pathogenesis and Pathophysiology - p. 977 219. Initiating Cellular Events - p. 977 220. Host Response - p. 980 221. Predisposing Conditions - p. 982 222. Vascular Disease - p. 984 223. Clinical Features of AP - p. 987 224. Differential Diagnosis - p. 988 225. Laboratory Diagnosis - p. 988 226. Diagnostic Imaging - p. 990 227. Distinguishing Alcoholic From Gallstone Pancreatitis - p. 991 228. Predictors of Disease Severity - p. 991 229. Novel Biomarkers - p. 992 230. Treatment - p. 992 231. Antibiotics - p. 995 232. Urgent Endoscopic Retrograde Cholangiopancreatography (ERCP) - p. 995 233. 61. Chronic Pancreatitis - p. 1000 234. Epidemiology - p. 1000 235. Pathology - p. 1001 236. Pathophysiology - p. 1001 237. Etiology - p. 1003 238. Clinical Features - p. 1010 239. Physical Examination - p. 1012 240. Diagnosis - p. 1013 241. Diagnostic Strategy - p. 1018 242. Treatment - p. 1018 243. Complications - p. 1025 244. 62. Pancreatic Cancer, Cystic Neoplasms, and Other Tumors - p. 1030 245. Pancreatic Cancer - p. 1030 246. Pancreatic Cystic Neoplasms - p. 1042 247. Other Pancreatic Tumors - p. 1050 248. 63. Endoscopic Treatment of Pancreatic Disease - p. 1051 249. Part IX. Biliary Tract - p. P9 250. 64. Anatomy, Histology, Embryology, Developmental Anomalies, and Pediatric Disorders of the Biliary Tract - p. 1059 251. Embryology of the Liver and Biliary Tract - p. 1059 252. Anatomy and Histology of the Biliary Tree - p. 1061 253. Developmental Anomalies - p. 1064 254. Approach to Disorders of the Biliary Tract in Infants and Children - p. 1064 255. Pediatric Disorders of the Bile Ducts - p. 1066 256. Pediatric Disorders of the Gallbladder - p. 1077 257. 65. Biliary Tract Motor Function and Dysfunction - p. 1081 258. 66. Bile Formation and Bile Acid Cycling in Health and Disease - p. 1087 259. 67. Gallstone Disease - p. 1103 260. Types of Gallstones - p. 1103 261. Epidemiology - p. 1103 262. Composition and Abnormalities of Bile - p. 1108 263. Pathophysiology - p. 1112 264. Genetics - p. 1116 265. Pigment Stones - p. 1117 266. Natural History - p. 1121 267. Diagnosis - p. 1122 268. Clinical Disorders - p. 1129 269. Uncommon Complications - p. 1134 270. 68. Treatment of Gallstone Disease - p. 1136 271. 69. Acalculous Biliary Pain, Acute Acalculous Cholecystitis, Cholesterolosis, Adenomyomatosis, and Gallbladder Polyps - p. 1154 272. 70. Primary and Secondary Sclerosing Cholangitis - p. 1168 273. Primary Sclerosing Cholangitis - p. 1168 274. Secondary Sclerosing Cholangitis - p. 1184 275. 71. Tumors of the Bile Ducts, Gallbladder, and Ampulla - p. 1187 276. 72. Endoscopic and Radiologic Treatment of Biliary Disease∗ - p. 1205 277. Volume 2 - p. V2 278. Part X. Liver - p. P10 279. 73. Embryology, Anatomy, Histology, and Developmental Anomalies of the Liver - p. 1221 280. 74. Liver Physiology and Energy Metabolism - p. 1228 281. 75. Liver Chemistry and Function Tests - p. 1249 282. 76. Overview of Cirrhosis - p. 1259 283. 77. Hemochromatosis - p. 1269 284. 78. Wilson Disease - p. 1279 285. 79. Other Inherited Metabolic Disorders of the Liver - p. 1289 286. Clinical Features of Metabolic Liver Disease - p. 1289 287. α1-Antitrypsin Deficiency - p. 1289 288. Glycogen Storage Diseases - p. 1292 289. Congenital Disorders of Glycosylation - p. 1295 290. Porphyrias - p. 1296 291. Tyrosinemia - p. 1300 292. Urea Cycle Defects - p. 1301 293. Bile Acid Synthesis and Transport Defects - p. 1304 294. Cystic Fibrosis - p. 1308 295. Mitochondrial Liver Diseases - p. 1309 296. 80. Hepatitis A - p. 1311 297. 81. Hepatitis B - p. 1318 298. Introduction - p. 1318 299. Epidemiology - p. 1318 300. Clinical Outcomes - p. 1319 301. Virology - p. 1320 302. Pathogenesis - p. 1323 303. Natural History - p. 1324 304. Clinical and Pathologic Features - p. 1326 305. Diagnosis - p. 1330 306. Treatment - p. 1331 307. Prevention - p. 1344 308. 82. Hepatitis C - p. 1347 309. Virology - p. 1347 310. Epidemiology - p. 1350 311. Pathogenesis - p. 1352 312. Clinical Features - p. 1353 313. Diagnosis - p. 1355 314. Liver Biopsy and Noninvasive Assessment of Fibrosis - p. 1356 315. Natural History - p. 1357 316. Treatment - p. 1359 317. 83. Hepatitis D - p. 1375 318. 84. Hepatitis E - p. 1386 319. 85. Hepatitis Caused by Other Viruses - p. 1393 320. 86. Bacterial, Parasitic, and Fungal Infections of the Liver, Including Liver Abscesses - p. 1401 321. 87. Vascular Diseases of the Liver - p. 1420 322. 88. Alcohol-Associated Liver Disease - p. 1436 323. Epidemiology - p. 1436 324. Spectrum of Disease - p. 1437 325. Pathogenesis - p. 1437 326. Diagnosis of Alcohol Misuse - p. 1443 327. Diagnosis of Alcohol-Associated Liver Disease - p. 1444 328. Cofactors That May Influence Progression of Alcohol-Associated Liver Disease - p. 1446 329. Prognosis - p. 1447 330. Treatment - p. 1449 331. 89. Metabolic Dysfunction-Associated Steatotic Liver Disease/Nonalcoholic Fatty Liver Disease - p. 1456 332. 90. Liver Disease Caused by Drugs - p. 1473 333. Hepatic Drug Metabolism - p. 1473 334. Liver Disease Caused by Drugs - p. 1475 335. Dose-Dependent Hepatotoxicity - p. 1487 336. Drug-Induced Acute Hepatitis - p. 1491 337. Drug-Induced Granulomatous Hepatitis - p. 1497 338. Drug-Induced Chronic Hepatitis - p. 1498 339. Drug-Induced Acute Cholestasis - p. 1499 340. Drug-Induced Chronic Cholestasis - p. 1501 341. Drug-Induced Steatohepatitis and Hepatic Fibrosis - p. 1501 342. Drug-Induced Vascular Toxicity - p. 1504 343. Liver Tumors - p. 1505 344. 91. Liver Disease Caused by Anesthetics, Chemicals, Toxins, and Herbal and Dietary Supplements - p. 1506 345. Anesthetic Agents - p. 1506 346. Chemicals - p. 1508 347. Metals - p. 1513 348. Drugs of Abuse - p. 1513 349. Botanical and Environmental Hepatotoxins - p. 1514 350. Vitamins - p. 1516 351. Herbal, Dietary, Weight-Loss, and Body-Building Supplements - p. 1517 352. 92. Autoimmune Hepatitis - p. 1524 353. 93. Primary Biliary Cholangitis - p. 1541 354. 94. Portal Hypertension and Variceal Bleeding - p. 1555 355. Normal Portal Circulation - p. 1555 356. Hemodynamic Principles of Portal Hypertension - p. 1556 357. Measurement of Portal Pressure - p. 1560 358. Detection of Varices - p. 1562 359. Causes of Portal Hypertension - p. 1564 360. Clinical Assessment - p. 1567 361. Treatment - p. 1567 362. Management of Specific Causes of Portal Hypertension-Related Bleeding - p. 1575 363. 95. Ascites and Spontaneous Bacterial Peritonitis - p. 1584 364. 96. Hepatic Encephalopathy, Hepatorenal Syndrome, Hepatopulmonary Syndrome, and Other Systemic Complications of Liver Disease - p. 1599 365. Hepatic Encephalopathy - p. 1599 366. Hepatorenal Syndrome - p. 1602 367. Hepatopulmonary Syndrome and Portopulmonary Hypertension - p. 1606 368. Cirrhotic Cardiomyopathy - p. 1609 369. Endocrine Dysfunction - p. 1611 370. Bone Disease - p. 1612 371. Coagulation Disorders - p. 1612 372. 97. Acute Liver Failure - p. 1614 373. 98. Hepatic Tumors and Cysts - p. 1629 374. Malignant Tumors - p. 1629 375. Benign Tumors - p. 1645 376. Tumor-Like Hepatic Lesions - p. 1650 377. Hepatic Cysts - p. 1651 378. Approach to the Patient with a Hepatic Mass - p. 1653 379. 99. Liver Transplantation - p. 1655 380. Part XI. Small and Large Intestine - p. P11 381. 100. Anatomy, Histology, Embryology, and Developmental Anomalies of the Small and Large Intestine - p. 1674 382. 101. Small Intestinal Motor and Sensory Function and Dysfunction - p. 1704 383. 102. Colonic Motor and Sensory Function and Dysfunction - p. 1721 384. 103. Intestinal Electrolyte Absorption and Secretion - p. 1738 385. Intestinal Architecture and Transport - p. 1738 386. Basic Epithelial Cell Model - p. 1739 387. Segmental Heterogeneity of Transport - p. 1741 388. Movement Across the Intestinal Epithelium - p. 1742 389. Tight and Leaky Epithelia - p. 1743 390. Transepithelial Transport - p. 1743 391. Transcellular Transport - p. 1744 392. Water Movement - p. 1744 393. Channels, Carriers, and Pumps - p. 1744 394. Ion Transporters - p. 1745 395. Extracellular Regulation: Microbial, Autocrine, Luminal, Paracrine, Immunologic, Neural, and Endocrine Systems (MALPINES) - p. 1754 396. Systemic Effects - p. 1758 397. Osmotic Effects - p. 1758 398. Specific Regulatory Factors - p. 1759 399. Intracellular Mediators - p. 1763 400. Epithelial Regulation in Context - p. 1765 401. 104. Digestion and Absorption of Carbohydrate, Protein, and Fat - p. 1766 402. 105. Digestion and Absorption of Micronutrients - p. 1788 403. Water-Soluble Vitamins - p. 1788 404. Fat-Soluble Vitamins - p. 1800 405. Minerals and Trace Elements - p. 1805 406. 106. Maldigestion and Malabsorption - p. 1811.e8 407. Etiology and Pathophysiology - p. 1812 408. Fats - p. 1813 409. Proteins and Amino Acids - p. 1814 410. Carbohydrates - p. 1814 411. Vitamins - p. 1815 412. Minerals - p. 1815 413. Mechanisms that Compensate for Malabsorption - p. 1816 414. Clinical Features and Evaluation - p. 1817 415. Malabsorption in Specific Situations and Disease States - p. 1831 416. General Approach to Management - p. 1844 417. 107. Small Intestinal Bacterial Overgrowth - p. 1846 418. 108. Short Bowel Syndrome - p. 1856 419. 109. Celiac Disease - p. 1873 420. Definitions - p. 1873 421. History of Celiac Disease - p. 1873 422. Epidemiology - p. 1874 423. Pathology - p. 1874 424. Pathogenesis - p. 1876 425. Clinical Features - p. 1878 426. Diagnosis - p. 1881 427. Differential Diagnosis - p. 1885 428. Treatment - p. 1887 429. Nonresponsive Celiac Disease - p. 1889 430. Refractory Celiac Disease - p. 1889 431. Celiac Disease and Malignancy - p. 1892 432. Prognosis - p. 1893 433. Future Therapies - p. 1893 434. 110. Tropical Diarrhea and Malabsorption - p. 1894 435. 111. Whipple Disease - p. 1909 436. 112. Infectious Enteritis and Proctocolitis - p. 1919 437. Susceptibility to Intestinal Infection - p. 1919 438. General Principles of Infectious Enteritis and Proctocolitis - p. 1921 439. Enterotoxigenic Pathogens - p. 1925 440. Invasive Pathogens - p. 1933 441. Sexually Transmitted Infectious Proctitis - p. 1942 442. Viral Pathogens - p. 1943 443. Travelers’ Diarrhea - p. 1945 444. Tuberculosis of the Intestinal Tract - p. 1946 445. Overview of Treatment - p. 1948 446. 113. Food Poisoning - p. 1950 447. 114. Antibiotic-Associated Diarrhea and Clostridioides difficile Infection - p. 1958 448. Antibiotic-Associated Diarrhea - p. 1958 449. Pseudomembranous Enterocolitis - p. 1959 450. Clostridioides difficile Infection - p. 1959 451. 115. Intestinal Protozoa - p. 1975 452. 116. Intestinal Worms - p. 1988 453. Introduction - p. 1988 454. Nematodes - p. 1989 455. Hookworms (Necator americanus, Ancylostoma duodenale, A. Ceylanicum, and A. Caninum) - p. 1993 456. Cestodes - p. 1999 457. Trematodes - p. 2002 458. Liver Flukes - p. 2003 459. 117. Epidemiology, Pathogenesis, and Diagnosis of Inflammatory Bowel Diseases - p. 2008 460. Epidemiology - p. 2008 461. Etiology and Pathogenesis - p. 2011 462. Establishing the Diagnosis in IBD - p. 2027 463. Differential Diagnosis of IBD - p. 2034 464. Measuring Disease Activity in IBD - p. 2037 465. 118. Management of Inflammatory Bowel Diseases - p. 2040 466. Medical Therapy - p. 2040 467. Future Directions for Medical Therapy - p. 2065 468. Surgical Therapy - p. 2065 469. Management of Inflammatory Bowel Disease-Related Complications - p. 2069 470. Management of Inflammatory Bowel Disease in Special Situations - p. 2075 471. 119. Ileostomies, Colostomies, and Anastomoses - p. 2077 472. 120. Intestinal Ischemia - p. 2085 473. Anatomy of the Splanchnic Circulation - p. 2085 474. Pathophysiology and Pathology - p. 2086 475. Outcomes - p. 2095 476. Focal Segmental Ischemia of the Small Intestine - p. 2098 477. Chronic Mesenteric Ischemia (Intestinal Angina) - p. 2108 478. Vasculitis and Angiopathy of the Splanchnic Circulation - p. 2110 479. 121. Intestinal Ulcerations - p. 2113 480. 122. Appendicitis - p. 2127 481. 123. Diverticular Disease of the Colon - p. 2136 482. 124. Irritable Bowel Syndrome - p. 2151 483. 125. Intestinal Obstruction - p. 2166 484. 126. Ileus and Pseudo-Obstruction Syndromes - p. 2187 485. Ileus - p. 2187 486. Acute Colonic Pseudo-Obstruction - p. 2192 487. Megacolon and Megarectum - p. 2206 488. 127. Tumors of the Small Intestine - p. 2208 489. 128. Colonic Polyps and Polyposis Syndromes - p. 2227 490. Conventional Adenomas - p. 2227 491. Sessile Serrated Adenomas and Hyperplastic Polyps - p. 2241 492. Nonneoplastic Polyps and Polypoid Lesions - p. 2246 493. 129. Colorectal Cancer - p. 2261 494. Epidemiology - p. 2261 495. Etiology - p. 2263 496. Biology - p. 2270 497. Familial Colorectal Cancer - p. 2277 498. Predisposing Factors - p. 2278 499. Pathology - p. 2282 500. Natural History and Staging - p. 2283 501. Prognosis - p. 2286 502. Clinical Features - p. 2289 503. Diagnosis and Screening - p. 2290 504. Treatment - p. 2300 505. Other Malignant Colonic Tumors - p. 2308 506. 130. Other Diseases of the Colon - p. 2309 507. 131. Anal Diseases - p. 2324 508. Part XII. Additional Treatments for Patients with Gastrointestinal and Liver Disease - p. P12 509. 132. Complementary, Alternative, and Integrative Medicine - p. 2343 510. Definitions - p. 2343 511. Epidemiology - p. 2343 512. Demographics of Complementary and Alternative Medicine Users - p. 2343 513. Types of Therapies - p. 2344 514. Rationale for and Satisfaction With Use - p. 2344 515. Patient-Provider Communication Regarding CAM - p. 2345 516. Physician Knowledge of CAM - p. 2345 517. Gastrointestinal Disorders Amenable to Complementary and Alternative Therapies - p. 2345 518. Constipation and Diarrhea - p. 2352 519. Cannabis and Cannabinoids - p. 2358 520. Regulation of Complementary and Alternative Medicine Therapies - p. 2359 521. Safety of Complementary and Alternative Medicine Therapies - p. 2360 522. Medical Misinformation, Social Media, and CAM - p. 2360 523. Conclusion - p. 2360 524. Resources for Healthcare Professionals - p. 2360 525. 133. Palliative Care Medicine in Patients With Advanced Gastrointestinal and Hepatic Disease - p. 2361 526. Index - p. I1