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radiation injury, 168 radiography, 99, 151-53, 473-74 radiotherapy: complications, 176, 556; to treat esophageal neoplasms,     127; to treat gastric cancer, 175 Ramstedt’s procedure, 176 ranitidine: to treat dysphagia, 10; to treat GERD, 107t, 576; to treat     pancreatic insufficiency, 613; to treat pancreatitis, 424; to treat PUD,     155, 157-59 Ranson’s criteria, 413 RAP (recurrent abdominal pain) see pain, abdominal, children rapamycin, 547 rash: in carcinoid syndrome, 256; in hepatitis, 489; in HIV-associated     infection, 298; in homosexual men, 391; in parasitic infection, 376 Raynaud’s osteoporosis, 517 Raynaud’s phenomenon, 95 rectal examination, 20
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rectum: anatomy, 378; bleeding, 255, 322-27, 357, 360, 380-81,     386-88, 392; prolapse, 311t, 339t, 367, 371, 381-82, 610;     trauma, 290-91 reflex, vagal cholinergic, 8 reflux, gastroesophageal see GERD refractory sprue, 247 regurgitation see also GERD; vomiting; in achalasia, 118; in     esophageal disorders, 96, 105, 119, 128, 130; in Zenker’s diverticulum,     130; nasal, 95 rehydration therapy: children, 596t, 598-600; cholecystitis, 451;     gastroenteritis, 225; HIV-associated infection, 297; ischemic colitis,     285; pancreatic insufficiency, 435-36; secretory diarrhea, 239; solutions,     192-93; toxic megacolon, 341 renal colic, 29 renal disease, 59t, 69, 572 renal failure: and gastric secretions, 150; in fatty liver, 553; in hepatorenal     syndrome, 540; in liver disease, 466t, 488; in pancreatitis, 415; in PUD,     160-61; investigating, 408 renal function disturbances, 269 renal insufficiency, 409t, 545 reovirus, 223t reperfusion injury, 268-69 research: clinical trials, 77-78, 82-87; Declaration of Helsinki, 80, 86;     ethical concerns, 77-78; methodology, 83-84; preclinical studies, 81-82;     regulations, 80-81 resection: colon, 274-76, 286, 321-22, 353, 355, 357; complications,     165, 234t, 318; and Crohn’s disease, 310t; gastric, 161; hepatic,     551; ileal, 313; palliative, 175; pancreatic, 431; pancreatoduodenal, 428;     small intestine, 25, 160, 234t, 248-49, 258-59 respiratory failure, 415 resuscitation, of ischemic patient, 272 retching, 13 rheumatoid arthritis, 150, 160-61, 516-17 riboflavin see vitamin B2 ricinoleic acid, 238t, 582 rickets, 59t, 210t, 213, 243 rifabutin, 292t, 294 rifampin, 292t, 517, 555, 624t rigidity, 537 rings, esophageal, 128 ritonivir, 290 RNAase, 204 rotavirus, 223t, 228, 229, 592 Rotor’s syndrome, 478 roundworms, 229, 375-76 Roux-en-Y anastomosis, 164, 172, 457-58 rubber-band ligation, 387-88 rumination, 5, 96 rupture, gastric, 176 -S- sacroiliitis: in Crohn’s disease, 313; in inflammatory bowel disease, 311t;     in ulcerative colitis, 339t, 343 Salmonella: about, 372-73; causing diarrhea, 223t, 224, 594-95; causing     gastroenteritis, 226-28; HIV-associated, 291, 292t Sandifer’s syndrome, 575t sarcoidosis, 112, 171, 516, 525t satiety center, 15 Schatzki’s ring, 9, 128, 132 Schilling test, 408 schistosomiasis, 525t scleroderma: causing bacterial overgrowth, 251t; causing diarrhea, 23t,     241t; esophageal, 95, 116f, 119, 121f, 122-24 sclerosis, 114t, 525t sclerotherapy, 529-31 scurvy, 58t seborrhea, 210t secondary iron overload, 512 secretagogues, 238t, 239 secretin, 140, 150, 400, 405 secretion: basal, 404-5; postprandial, 404-5 secretory studies, 405 seizures, 58t, 213 selenium, 57 senecio alkaloids, 57t senna, 238t Septata intestinalis, 297 serine, 57 serotonin, 238t, 239 serotonin antagonists, 256 serum biochemical tests, 470-72 serum immunologic tests, 472-73 sex drive, 208t sex factors: alcoholic cirrhosis, 505; alcoholic liver disease, 502; anorectal     pruritus, 382; cholelithiasis, 440, 444t; constipation, 371, 578-79;      Crohn’s disease, 308t; esophageal cancer, 125-26; gastric cancer,      174; hemochromatosis, 512; hepatitis, 500; HIV-associated diseases,     289; irritable bowel syndrome, 362; liver neoplasms, 550-51; pancreatic     carcinoma, 425; pancreatitis, 419; pilonidal disease, 390; pyloric     stenosis, 176; RAP, 565; rectal prolapse, 381; ulcerative colitis,     308t, 308;
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Whipple’s disease, 256 sexual activity, 289, 290, 486 sexual orientation see also heterosexuality; homosexuality, 24, 289, 486 sexually transmitted disease (STD) see also HIV, 24, 290, 390-92, 482,     491, 499-500 Shigella dysenteriae: about, 371-72; causing diarrhea, 223t, 226, 595;     causing ulcerative colitis, 323; and HIV, 291, 292t; in gastroenteritis, 228 shock: in GI bleeding, 392; in ischemia, 269; in pancreatitis, 412-14 shock liver, 471 shock-wave lithotripsy, 447, 453 short bowel syndrome, 150, 248-49 short-chain fatty acids, 351-52 sicca syndrome, 516-17 sickle cell disease, 277 sigmoidoscopy, 20, 24, 384-85 simethicone, 364t sinus tract formation, 111 sinusoidal lining, liver, 462-63 siquinavir, 290 sitophobia, 64t skin, dry, 25, 208t skin tags, 386 small bowel disease, 62 small for gestational age, 588-89 small intestine: absorption of carbohydrates, 200-203, 204f; absorption     of fats, 197-200; absorption of protein, 204-6; absorption of vitamins     and minerals, 185-90; absorption of water and electrolytes, 191-97;     absorption principles, 185; anatomy, 183-84; bacterial overgrowth,     251-53; biopsies, 246-47; flora, 249-51; motility, 184-85, 236-37;     postgastrectomy problems, 164t, 166-67; tumors, 259-60;     vascular disorders, 257-59 small-cell carcinoma, esophageal, 124t smoking: affects LES, 108t; causing gastritis, 170; causing neoplasms,     126t, 126; causing pancreatic cancer, 426; causing PUD, 148-49, 149t socioeconomic status, 126, 178 sodium: absorption, 191-95, 192f-93f, 202-3, 350; depletion, 434;     replacement, 334; secretion, 195-96 sodium bicarbonate, 176 sodium biophosphate, 582 sodium citrate, 235t, 235 sodium phosphate, 235t, 235, 582 sodium pump, 192-93, 202, 350 sodium sulfate, 235t, 235 soiling, 579, 580-81, 582 somatostatin: affects electrolyte secretion, 196-97; in digestion, 150;     secreted by islet cell tumors, 430-31; secreted by pancreas, 400;     secreted by stomach, 139, 145; to treat portal hypertension, 529 somatostatinomas, 431 sorbitol, 21, 23t, 233, 235t speech pathologists, 115 sphincteroplasty, 432 sphincterotomy: choledocholithiasis, 453; fistula-abscess disease, 389;     pancreas divisum, 432; pancreatitis, 417; postcholecystectomy     syndrome, 455; to treat AIDS cholangiopathy, 303 spider nevi: in alcoholic cirrhosis, 505; in alcoholic hepatitis, 504; in     hepatitis, 501; in liver disease, 31, 466t spinal cord degeneration, 243t spinal lesion, 20 spiramycin, 231 spironolactone, 34, 194, 534 spleen: anatomy, 136; enlarged see hepatosplenomegaly; splenomegaly;     examining, 46-47 splenomegaly: in alcoholic cirrhosis, 505; in cirrhosis, 523; in liver disease,     528; in portal hypertension, 525t; in portal vein thrombosis, 557;     investigating, 35, 38 sprue, 247-48; celiac see celiac disease squamous cell carcinoma, esophageal, 112-13, 124t, 125-28 squamous cell papilloma, esophageal, 123, 124t staging, colorectal cancer, 353t, 353 Staphylococcus aureus, 223t, 224, 536, 594 starch, 200-203, 403 starvation, 54 stavudine, 290 STD see sexually transmitted disease (STD) steatohepatitis, 57t, 493, 495t, 502, 520 steatorrhea see also fat, malabsorption; in bacterial overgrowth, 252-53;     in celiac disease, 245; in Crohn’s disease, 310t, 314; in cystic fibrosis,     434t, 434-35; in giardiasis, 230, 296; in liver disease, 517; in     malnutrition, 60-62, 64t; in pancreatic insufficiency, 405, 407-8; in     pancreatitis, 419-20, 422, 424-25; in small bowel ischemia, 259; and     infants, 457; postresection, 249 steatosis, 56, 57t, 503 stenosis: esophageal, 100; hypertrophic pyloric, 176, 572 steroids, 64t, 172, 285, 378 stomach: acute diseases, 175-76; anatomy,
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135-38, 136f; chronic diseases, 176-81; functions, 139t; gastritis,     168-72; motility, 139-41; mucosal barrier, 143-45; neoplasms,     172-75; peptic ulcer disease, 146-55, 147t, 152f-53f, 156-63;     physiology, 138-39; postgastrectomy problems,164t, 165-66;     premalignant conditions, 172-74 stomal fibrosis, 165 stomatitis: angular, 59t, 208t; postgastrectomy, 164t; and ulcerative     colitis, 327 stool: bloody see blood in stool; color, 31; consistency, 19-20, 206-7,     361; fatty see steatorrhea; formation, 351; frequency, 21-22, 197,     206, 221, 228, 361, 371; mucus in, 221, 230, 361-62, 382; odor, 206-7,     434; pus in, 20, 22, 24, 221; straining at, 19-20, 361; volume, 21-22,     206-7, 221-23, 239 strawberry gallbladder, 455 Streptococcus species, 250 Streptococcus pneumoniae, 536 Streptococcus viridans, 536 streptomycin, 292t stress see also psychological trauma; diarrhea, 349; heartburn, 6; PUD,     148-49; RAP, 566, 568 stress hormones, 52 strictures: biliary, 420-21, 443, 455, 458-59, 515t, 516, 518; colonic,     286, 312, 339t, 342, 357, 359-60; esophageal, 7-10, 92, 103, 111-13,     132, 165, 529; peptic, 109-10; reflux-induced, 95; small intestine, 230,     234t, 247, 251t stricturoplasty, 286 stridor, 112 “string sign,” 307f Strongyloides stercoralis, 177, 223t, 298, 376-77 subacute bowel obstruction, 29 substrates, 49, 54 succinic acid, 235 succinylsulfathiazole, 251 sucralfate: to treat esophagitis, 164; to treat gastritis, 172; to treat GERD,     107t; to treat PUD, 155, 157-59 sucrase-isomaltase, 201-2 sucrose: absorption, 200-203; deficiency, 240 sugars see also specific types, 252, 351-52 sulfapyridine, 65, 251, 336 sulfasalazine: digestion, 251; malabsorption, 186; malnutrition, 64t, 65;     to treat inflammatory bowel disease, 319t, 321, 335-37 sulfathiazole, 251 sulfonamides, 303, 510 superficial gastritis, 170 supraclavicular lymphadenopathy, 97 suprahyoid muscles, 92 surgery: anal fissures, 389; Barrett’s esophagus, 110; bile duct disease,     456-60; cholecystitis, 451-52, 454; choledocholithiasis, 453;     cholelithiasis, 448; colon cancer, 355; colonic obstruction, 360, 370;     colonic stricture, 342; complications, 163-67, 172, 173, 175, 455, 519,     539t; condylomata acuminata, 391; esophageal neoplasms, 127; fecal     incontinence, 367; fistula-abscess disease, 389-90; gastric cancer,     175; gastrinoma, 161-63; gastritis, 171; GERD, 109, 576-77;     hemorrhoids, 386-88; Hirschsprung’s disease, 370; inflammatory bowel     disease, 321-22, 335; ischemia, 272, 274, 275, 276, 277; islet cell     tumors, 431; meconium ileus, 436; pancreas divisum, 432; pancreatic     cancer, 428-29; pancreatic pseudocyst, 420; pancreatitis, 417-18,     423-24; peptic stricture, 110; portal hypertension, 530-31;     postcholecystectomy syndrome, 455; PUD, 160-61, 162f; pyloric     stenosis, 176; small bowel ischemia, 258; small bowel obstruction,     312; stomal fibrosis, 165; thrombocytosis, 343; thrombosis, 557; to     treat AIDS cholangiopathy, 303; to treat ischemic colitis, 286;     Zenker’s diverticulum, 130 swallowing: difficulty see dysphagia; pain see odynophagia syphilis, 171, 290, 391 -T- tabes dorsalis, 114t tachycardia: in cholecystitis, 451; in pancreatitis, 414; in toxic megacolon,     338; in ulcerative colitis, 325; with vomiting, 12 tapeworms, 229 taurine, 251 3TC, 290 technology, ethics, 74-76 tenesmus: in anorectal disorders, 380; in homosexual men, 391-92;     in rectosigmoid disorders, 221; in shigellosis, 371 testicular abnormalities, 505 testicular atrophy, 466t tetany: in celiac disease, 243t, 244; in malassimilation, 206, 209t;     in pancreatitis, 425 tetracycline: to treat bacterial overgrowth, 253; to treat infection, 180,     292t, 375; to treat inflammatory bowel disease, 318; to treat STDs, 392 theophylline, 108t, 155
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thiabendazole, 298, 377 thiamine see vitamin B1 thoracic rosary, 208t thrombocytopenia, 466t, 467, 505 thrombocytosis, 312t, 314, 339t, 343 thromboembolic disease, 339t thrombophlebitis, 426 thrombosis: embolic obstruction, 257; hepatic vein, 556; in pancreatitis,     414-15; inferior vena cava, 556; mesenteric     arteries, 272, 274; mesenteric veins, 257, 258-59, 275-76; portal vein,     557; postsurgery, 548; splenic, 525t thrush, oral, 111 thyroiditis, 516 thyroxin, 57 tin-protoporphyrin, 618 tissue loss, 56 toenails, 56 tolbutamide, 167 tomography, computerized, 473 tongue, 208t, 212 total parenteral nutrition (TPN), 71-73 toxemia of pregnancy, 555 toxins, causing hepatitis, 479t TPN see total parenteral nutrition (TPN) tracheoesophageal fistula, 99-100 tracheotomy, 115 transaminases, 54, 470-71 transcobalamin II, 143 transferrin, 57 transjugular intrahepatic portal-systemic (TIPS) shunt, 535, 539t transplantation: bone marrow, 556; ethics, 75-76; kidney, 540; liver,     456-59, 541-50 trauma: anorectal, 366; and cholecystitis, 454; esophageal, 131; liver,     557; pancreas, 409t; rectal, 290-91 travel: diarrhea risk, 22, 24, 228t, 228-29; HIV risk, 289 traveler’s diarrhea, 22, 24, 228t, 228-29 trefoil deformity, 153 trehalose deficiency, 240 trematodes, 229 Treponema pallidum, 391 triamterene, 534 trichobezoars, 165 Trichuris, 223t tricyclic antidepressants, 108t, 123, 158 triglycerides see also fat; absorption, 199; deficiency, 25, 52, 61,     254-55; digestion, 140, 401, 403, 601t, 603-4; in cholesterolosis,     455; lypolysis of, 197, 198f; replacement, 222t; role of liver, 465;     tests, 472; to treat inflammatory bowel disease, 317 trimebutine, 364t trimethoprim-sulfamethoxazole: to treat colonic infection, 372, 373; to treat     HIV-associated infection, 292t-93t, 298; to treat peritonitis, 536; to treat     Whipple’s disease, 256 trimipramine, 159 tripotassium dicitrato bismuthate, 159 trophozoites, 230 Trousseau’s sign, 213 Trypanosoma cruzi, 118 trypsin, 204, 402, 405, 410-11 trypsinogen, 408, 416 tryptophan, 205, 250 tube feeding see enteral nutrition tuberculosis, 171, 294, 409t tubulovesicles, 142 tumor necrosis factor, 323 tumors see neoplasms tylosis, 123, 126t tyrosine, 205 tyrosinemia, 67t