Guidelines for the investigation of chronic diarrhoea, 2nd edition

Abstract

Genomics was initiated when robotics made possible the characterisation of large numbers of DNA fragments and when ever improving computers with dedicated software were applied to the localisation in the genome of these sequences and to the analysis of their content. By enabling the generation and management of large amounts of DNA based sequences these tools have changed our perception of the genomes of living organisms. These data, as applied to humans, are contributing to the understanding of gene function, disease processes, and evolution of our species. Presently they are changing the research strategies for identifying genetic variations influencing disease susceptibility and response to treatment. These advances will have a profound impact in biomedicine.

Should we Investigate Gastroenterology Patients for Pancreatic Exocrine Insufficiency? A Dual Centre UK Study

“…It is the most widely used indirect test of pancreatic function and is superior to other tests such as faecal chymotrypsin [13,14]. The British Society of Gastroenterology (BSG) guidelines for investigation of chronic diarrhoea advocate routine FEL-1 measurement as a first line assessment of pancreatic function [10].…”

“…This potential error in diagnosis can be reduced by centrifuging or drying the sample prior to analysis [17,18]. Overall, given its ready availability and acceptability to patients, FEL-1 is the most appropriate initial measure of exocrine pancreatic function [10].…”

Uma causa pouco habitual de diarreia

“…Assim, em termos pragmáticos, a diarreia é a passagem anormal de fezes moles ou líquidas, mais de três vezes ao dia e/ou de volume de fezes maior do que 200 g / dia, sendo considerada crónica quando os sintomas persistem para além das 4 semanas. Estima-se que a prevalência da diarreia cró-nica seja 4 a 5% nos países ocidentais 1 . Na prática clínica, uma miríade de patologias gastrointestinais cursam com diarreia crónica (tabela 1), podendo cursar com síndromes de má absorção e consequente défices nutricionais e má nutrição.…”

“…Nos países desenvolvidos, a doença inflamatória intestinal, o síndrome de intestino irritável, as síndromas de má absorção e infecções crónicas são as causas mais comuns. O tratamento da diarreia cró-nica deve ser dirigido à causa e à correção dos distúrbios hidrolectrolíticos e nutricionais 1 A função renal, tiroideia e hepática estavam preservadas. As serologias para HBV, HCV e HIV foram negativas; E o estudo microbiológico das fezes foi negativo.…”

The steatocrit as a measure of fecal fat excretion: uses and pitfalls

“…1,2 In the laboratory this may be accomplished by a variety of methods including chemical (chemical titration and gas chromatography), physical (gravimetric methods, near infrared spectrometry), and microscopy.…”