Chapter 6 The gastrointestinal tract
The stomach
Gastric disorders and investigation of gastric function
• low-grade gastritis, which is usually asymptomatic
• inflammation of the gastric antrum, with increased acid secretion and increased risk of duodenal ulcer
• pangastric inflammation, with normal or reduced acid secretion and an increased risk of both gastric ulceration and gastric adenocarcinoma.
The pancreas
Pancreatic disorders and their investigation
The major disorders of the exocrine pancreas are acute pancreatitis, chronic pancreatitis, pancreatic cancer and cystic fibrosis. Biochemical investigations are essential in the diagnosis and management of the first of these, of limited use in the second, and of little use in the third. Cystic fibrosis, an inherited metabolic disease causing progressive loss of pancreatic function, is discussed in Chapter 16. Clinical evidence of impaired exocrine function is usually only seen in advanced pancreatic disease. Endocrine function is usually well preserved, although glucose intolerance or frank diabetes can develop in severe or advanced disease. Endocrine disease of the pancreas is discussed in Chapter 11.
Acute pancreatitis
Case history 6.1
Investigations
Serum: urea | 10 mmol/L |
creatinine | 90 µmol/L |
eGFR | >60 mL/min/1.73 m2 |
calcium | 2.10 mmol/L |
albumin | 30 g/L |
glucose | 12 mmol/L |
amylase | 5000 U/L |
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