The relationship between gastrointestinal conditions and halitosis is discussed. Few reports have suggested that gastrointestinal diseases may cause halitosis. H. pylori infection, which causes gastric ulcers, is considered as a possible cause for halitosis. Intensity of malodour of mouth air was found to be higher in H. pylori-positive patients than in negative patients. The levels of hydrogen sulphide and dimethyl sulphide in mouth air were also significantly higher in the positive patients than in the negative patients (P<0.05). When odour strength in exhaled breath was compared between the two groups, no significant difference was found. Hence, H. pylori infection might not cause a systemic condition producing breath odour. Although there were no significant differences in periodontal parameters or tongue coating between the positive and negative groups, H. pylori may be a frequent contributor to the production of malodour even though its role had not been suspected before. Further study would be necessary to clarify the reason for the increase of volatile sulphur compounds (VSCs) level in H. pylori infection.
Our results indicate that endoscopic ligation of esophageal varices combined with APC is superior to ligation alone. Since APC is theoretically well suited for mucosal fibrosis therapy, it can be used for the complete elimination of esophageal varices and for fibrosis of the distal esophageal mucosa.
The TG13 is practical, but some AC cases requiring urgent/early biliary drainage were underestimated as mild AC. The scoring system allows identification of high-risk AC patients and will improve the TG13.
Background: Gastric antral vascular ectasia (GAVE) is characterized by diffuse vasodilation mainly affecting the antrum and causes gastrointestinal hemorrhage. Argon plasma coagulation (APC) provides rapid coagulation of a wide region, and thus appears to be more useful than conventional methods for the treatment of extensive lesions with superficial oozing bleeding, such as GAVE. In this study, we evaluated the use of APC for GAVE. Methods: The study subjects were 22 patients with GAVE (10 men and 12 women, mean age 65.8 years, diffuse type (n = 19) and watermelon type (n = 3)) who developed gastrointestinal hemorrhage (melena, fall in hemoglobin (Hb, by ≥ 2.0 g/dL), or endoscopy-confirmed bleeding) and treated with APC. Endoscopic treatment was applied weekly, and considered successful if all detectable GAVE lesions were eradicated and the Hb stabilized without further transfusion. Clinical outcome was assessed. Results: The median total number of treatment sessions was four (range: 2-9 times), and the median observation period was 23.5 months. The cumulative recurrence-free rate was 49.7% after 1 year, 35.5% after 2 years, and 35.5% after 3 years. The survival rates after treatment were 94.4, 75.8 and 64.9% at 1, 2, and 3 years, respectively. No complications of APC were observed. Conclusion: APC appears to be effective for temporary control of hemorrhage and anemia due to GAVE, but is not always effective over the long term. For proper management of GAVE, drug therapy, blood transfusion and control of the underlying disease are necessary in addition to achieving hemostasis temporarily by APC.
Background: Nodular gastritis (NG) was considered a physiological change with little pathological significance, mostly in young women. In recent years, however, it has been often reported in patients with Helicobacter pylori (H. pylori) infection, or in patients with gastroduodenal ulcer/gastric cancer, suggesting possible clinical significance. Methods: From July 2003 to July 2006, 59 patients were diagnosed with NG among 32 404 patients examined endoscopically. The incidence of NG was evaluated in relation to age, sex, H. pylori infection status, symptoms leading to endoscopy, associated lesions in the upper digestive tract at the time of NG diagnosis, and existence of other systemic conditions. Results: The NG patients consisted of 13 out of 18 152 (0.07%) male patients and 46 out of 14 252 (0.32%) female patients, with a mean age of 45.3 ± 17.7 years. All 28 patients who were examined for H. pylori infection were positive. Endoscopic examination was performed for precordial pain and upper abdominal pain in 24 (40.7%) patients, symptoms of gastroesophageal reflux disease in eight (13.6%) patients, and symptoms of functional dyspepsia in six (10.2%) patients. NG was associated with duodenal ulcer in eight (13.6%) patients, hyperplastic gastric polyps in five (8.5%), gastric ulcer in one (1.7%), and gastric cancer in one (1.7%) patient. Conclusion: NG is a specific gastritis resulting from H. pylori infection that may be strongly associated with H. pylorirelated lesions.
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