Many patients who are seen by gastroenterologists are overweight or obese. Moreover, gastroenterologists often are consulted to help manage obesity-related gastrointestinal diseases or gastrointestinal complications of weight loss therapy. Therefore, it is important for gastroenterologists to understand the key clinical issues associated with obesity that are discussed in this issue. In addition, gastroenterologists can provide a valuable clinical service by becoming actively involved in helping their obese patients lose weight.
Author(s): David Johnson MD
Series: Gastroenterology Clinics of North America Volume 34, Issue 1, Pages 1-172 (March 2005)
Edition: 1
Publisher: Saunders
Year: 2005
Language: English
Pages: 165
Cover......Page 1
Preface......Page 2
Cost......Page 5
Prevalence......Page 6
Age......Page 8
Summary......Page 9
References......Page 10
Metabolic implications of obesity: before and after gastric bypass......Page 12
Causes of the obesity epidemic......Page 14
Pathophysiology of metabolic syndrome and its relation to obesity......Page 16
Summary of pathophysiology......Page 17
Lifestyle......Page 18
Pharmacologic......Page 19
Benefits of weight loss on metabolic syndrome risk factors, diabetes complications, and mortality......Page 20
Polycystic ovaries syndrome......Page 21
Changes in the political and health care financing of obesity......Page 22
References......Page 23
Metabolic complications of bariatric surgery: diagnosis and management issues......Page 28
Anemia......Page 29
Vitamin D deficiency and bone disease......Page 30
Vitamin A deficiency......Page 32
Recommendations......Page 33
References......Page 34
Effect of food on reflux......Page 37
Symptoms......Page 39
Erosive esophagitis......Page 40
Weight loss and gastrointestinal reflux disease......Page 41
Approach to the patient......Page 42
References......Page 43
Epidemiology of obesity-related liver disease......Page 46
General pathobiology......Page 47
Histologic spectrum and histology-specific pathogenesis......Page 48
Clinical manifestations and natural history......Page 50
Diagnosis......Page 51
History and physical examination......Page 52
Liver enzymes......Page 53
Imaging studies......Page 55
Primary prevention......Page 56
Evidence-based treatments......Page 57
Summary......Page 59
References......Page 60
Definition of obesity......Page 63
Obesity and gastroesophageal reflux disease symptoms......Page 64
Esophageal adenocarcinoma......Page 70
Adenocarcinoma of the gastric cardia......Page 71
Estrogen......Page 74
Obesity and colorectal cancer......Page 75
Colon polyps......Page 76
Physical activity......Page 78
References......Page 79
Diet Options of Obesity: Fad or Famous?......Page 83
The Atkins diet......Page 84
Sugar Busters......Page 86
The zone diet......Page 88
The protein power diet......Page 89
References......Page 90
Pharmacological therapies for obesity......Page 91
Medications approved for treating obesity......Page 92
Phentermine......Page 93
Sibutramine......Page 94
Orlistat......Page 96
Metformin......Page 97
Zonisamide......Page 98
Pharmacological treatment of drug-induced weight gain......Page 99
Future considerations......Page 101
References......Page 103
Gastrointestinal management of the bariatric surgery patient......Page 105
Preoperative evaluation......Page 106
Postoperative care......Page 107
Screening for gastric disorders......Page 108
Screening for iron deficiency and occult gastrointestinal bleeding......Page 110
Screening for hepatobiliary disease......Page 111
Screening for micronutrient deficiency......Page 112
Gastritis, erosions and ulcers......Page 113
Micronutrient deficiencies......Page 116
Assessment of abdominal pain, nausea and vomiting......Page 117
Assessment of diarrhea......Page 120
Assessment of gastrointestinal bleeding......Page 121
Calcium and vitamin D......Page 123
Summary......Page 124
References......Page 125
Surgical options for obesity......Page 126
Jejunoileal bypass......Page 127
Biliopancreatic diversion......Page 129
Biliopancreatic diversion with duodenal switch......Page 130
Roux-en-Y gastric bypass......Page 131
Vertical band gastroplasty......Page 134
Adjustable gastric banding......Page 136
Summary......Page 138
References......Page 139
Garren-Edwards gastric bubble......Page 142
Other balloons......Page 144
BioEnterics intragastric balloon system......Page 145
Gastric restrictive and bypass endosurgery......Page 147
References......Page 148
Understanding the anatomy in the bariatric surgical patient......Page 150
Vertical banded gastroplasty......Page 151
Biliopancreatic diversion and duodenal switch......Page 152
Indications for endoscopy......Page 154
Endoscopic principles......Page 155
Vertical banded gastroplasty......Page 156
Stomal stenosis......Page 157
Staple line dehiscence......Page 159
Endoscopic dilation of stomal stenosis......Page 160
Endoscopic management of staple line dehiscence, gastric fistulas, and dilated stomas......Page 161
Summary......Page 162
References......Page 163
