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abdomen, examining, 41-48 abdominal mass: about, 37-40; children, 571, 572; in duodenum, 166;     in gallbladder, 456; in GI tract, 309, 316, 353t, 357, 358, 435; in     pancreas, 426; in stomach, 14 abscesses: abdomen, 357t; anus, 311t, 380, 389-90; colon, 356-57;     intestine, 316-17; liver, 357t, 453; lung, 111; pancreas, 414-15,     417; perianal, 339t, 390; rectal, 323, 324f, 389-90 absorption: about, 601-2; carbohydrates, 200-203, 204f; colon, 350,     351-52; defined, 185; fats, 197-200; principles, 185, 404-5; protein,     204-6; vitamins and minerals, 185-90; water and electrolytes, 191-97 acanthosis, glycogen, esophageal, 124t acanthosis nigricans, 123 ACE inhibitors, 524 acetaminophen, 508t, 509 acetate, 351 acetic acid, 236, 250 acetyl-CoA, 52, 54 acetyl-CoA carboxylase, 54 acetylcholine, 144, 149-51 N-acetylcysteine, 509 achalasia: cricopharyngeal, 114t, 115; esophageal, 9-10, 96, 115-16,     116f, 117-18, 120f, 126t; and gas, 17; vigorous, 118 achlorhydria, 58t, 96, 143, 227, 251t, 431 acid perfusion test, 98 acid suppressants, 576 acidic drinks, 5 acidosis: alcoholic, 506; alcoholic cirrhosis, 505; hepatic encephalopathy,     539t; ischemia, 258; liver disease, 516; postsurgical, 548; ulcerative     colitis, 328 acids, 112 acinar cells, 400, 402t, 412, 433 acquired immunodeficiency syndrome see AIDS acrodermatitis enteropathica, 210t acute abdomen, 26-28 acute mesenteric arterial occlusion: clinical features, 269; investigating,     269-72; treatment, 272-75, 273f acute mesenteric venous occlusion, 275-76 acyclovir, 111, 293t, 300, 391 acyl-CoA-carnitine acyltransferase, 54 Addison’s disease, 23t, 241t adenocarcinoma: bile duct, 459; colon, 352-55; ductal cell, 425; esophagus,     103, 106, 110, 124t, 125; gallbladder, 456; islet cell, 425-26; small     intestine, 260; stomach, 140, 161, 171t, 174 adenoid cystic carcinoma, 124t adenoma: bile duct, 459; clinical features, 23t; colon, 354-55; drug-induced,     510t, 511; gallbladder, 456; liver cell, 550; small intestine, 259; stomach,     161 adenomatosis, syndrome 1 of multiple endocrine, 148 adenomyosis, 455 adenosquamous carcinoma, 124t S-adenosylmethionine, 555
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adenovirus, 478, 479t, 549 adenylate cyclase, 150-51, 224, 237 adhesions, colonic, 359t, 360 adrenal gland, 136 alpha-adrenergic agonists, 144 beta-adrenergic agonists, 108t adrenocorticosteroids, 196 aerophagia, 15, 16-17 afferent loop syndrome, 164t, 166 aflatoxins, 57t agar, 618 age factors: cholelithiasis, 444t; colitis, 232; colonic cancer, 353; H. pylori     infection, 178; hemochromatosis, 512; liver disease, 494-95, 504, 516;     pancreatic disease, 426; vomiting, 569-70; Whipple’s disease, 256 AIDS: and cholecystitis, 454; diagnosing, 289-90, 291, 295, 297-98,     304; and diarrhea, 23t, 24; and herpes simplex, 391 AIDS cholangiopathy, 303 Alagille’s syndrome, 457 alanine aminotransferase, 470-71 albendazole, 293t, 377 albumin, 33-34, 57, 245, 254, 463, 471 Alcock’s canal, 379 alcohol: causing cholestasis, 515t; causing cirrhosis, 520, 521t;     causing diarrhea, 23t, 24, 221, 241t; causing gastritis, 168, 170; causing     jaundice, 32; causing malnutrition, 25, 58t; causing pancreatitis, 410,     412, 418-19; effects on liver, 57t; and esophageal trauma, 131;     metabolized by liver, 465; and neoplasms, 126t, 126; and PUD, 148, 149t alcohol withdrawal, 14 alcoholic hepatitis: cause, 57t, 303, 479t; clinical features, 501,     503-4; sequelae, 504, 515t, 525t, 526 alcoholic lipemia, 472 alcoholic liver disease: about, 502-6; cirrhosis, 504-5; clinical features,     467, 469; fatty liver, 503; management, 506 aldosterone, 193-94, 350 alginate compounds, 7 alginic acid, 107t alkaline phosphatase tests, 471 alkalis, 112 alkalosis, 539t allograft rejection, 548 aloe, 238t alopecia, 210t alpha-fetoprotein test, 472-73 aluminum hydroxide, 164, 172, 221t, 249 amebiasis, 24, 230-31, 374-75 amenorrhea, 208t, 466t, 501 amikacin, 292t amiloride, 534 amino acids: absorption, 192; digestion, 204-5, 250, 402, 405, 464;     and malnutrition, 57; metabolism, 50; replacement, 71 aminoglycosides, 228, 418, 524 aminosalicylic acid, 251, 377 5-aminosalicylic acid mesalazine see mesalamine aminotransferases, 450, 470-71 amiodarone, 511 amitriptyline, 364t ammonia, 250, 465, 538 amoxicillin, 180 amphotericin B, 111, 292t, 295, 296 ampicillin, 226, 227, 372, 373, 375 amylase, 403, 408-10, 414-15, 420, 450 alpha-amylase, 201-3 amyloidosis, 23t, 114t, 241t, 311t, 339t amylopectin, 201 amylose, 201 amyotrophic lateral sclerosis, 114t anabolic hormone, 50 anaerobes, 250 anal canal: anatomy, 364-66, 378-79; carcinoma, 302; examination,     383-85; fissures, 388-89; fistula-abscess disease, 389-90; hemorrhoids,     385-88; pilonidal disease, 390; presenting complaints, 379-83 anal sphincter: anatomy, 364-66, 378; defecation, 366f; and fecal     incontinence, 364-67; injury, 388; spasm, 388 analgesics: causing gastritis, 168; to treat biliary pain, 444; to treat     cholecystitis, 451; to treat hemorrhoids, 386; to treat pancreatitis, 418,     422; to treat STDs, 391 anastomosis: complications, 165, 312; for bile duct disease, 457-58;     portacaval, 160; Roux-en-Y, 164, 172, 457-58; to treat diarrhea, 167 anemia: children, 572, 575t; and cholelithiasis, 444t; and diagnosis, 3;     hemolytic, 31, 227, 343; in cancer, 260, 353t, 431; in celiac disease,     243t, 243, 245; in GI bleeding, 35, 393; in inflammatory bowel disease,     312t, 313, 314, 326, 328, 339t, 343; in ischemia, 284; in liver disease,     505; in malassimilation, 22, 209t, 210t, 212; in toxic megacolon, 338;     iron deficiency, 9, 343; microangiopathic hemolytic, 343; pernicious, 58t,     143, 150, 160, 169-70, 172-73; postgastrectomy, 164t, 167; with     abdominal pain, 30; with heartburn, 7
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aneurysm, aortic, 26 angiodysplasia, 34t, 35t, 393-94 angioedema, 489 angioma, 259 angiomatosis, 301 angioplasty, balloon, 276 angiosarcoma, 57t, 511 angiotensin converting enzyme (ACE) inhibitors, 524 anismus, 371 ankylosing spondylitis, 311t, 313, 327, 339t, 343 anorectal spaces, 379 anorexia: about, 14-15; in acute abdomen, 27; in celiac disease, 243;     in cholecystitis, 450; in Crohn’s disease, 310t; in     gastritis, 168; in gastroenteritis, 229; in liver disease, 31, 33, 466t,     467, 485, 503-4; in malassimilation, 64t, 206, 212; in malnutrition, 25,     57, 58t; in ulcerative colitis, 326, 333; nutritional intervention, 68 anoscopy, 384 antacids: causing diarrhea, 22, 23t, 223t, 233, 234t, 235, 241t; in liver     transplantation, 545; to treat esophagitis, 111; to treat GERD, 7, 107t,     108; to treat pancreatitis, 424; to treat PUD, 155, 157, 159 anthraquinones, 582 antiarrhythmics, 233 antibiotics: causing diarrhea, 23t, 24, 223t, 231-33, 241t;     causing esophagitis, 113; and Clostridium infection, 373; to treat     bacterial overgrowth, 253; to treat bile duct disease, 456, 458; to treat     cholangitis, 459; to treat cholecystitis, 451; to treat colonic infection,     372-75; to treat Crohn’s disease, 318; to treat cystic fibrosis, 433; to     treat diarrhea, 166, 229, 600; to treat diverticulosis, 357; to treat     esophagitis, 112; to treat H. pylori infection, 179; to treat hepatic     encephalopathy, 539; to treat HIV-associated infection, 291, 292t-93t;     to treat ischemia, 272; to treat pancreatitis, 418; to treat     pseudo-obstruction, 257; to treat PUD, 155; to treat Whipple’s     disease, 256 anticholinergics: affect LES, 108t, 113, 143; to treat chest pain, 123; to     treat gastrinoma, 163; to treat gastritis, 171; to treat irritable bowel,     364t; to treat PUD, 155, 159; to treat pyloric stenosis, 176 anticoagulants, 276 antidepressants, 19t, 364t antifungal agents, 295 antigastrin agents, 155 antihistamines, 14 anti-inflammatory agents, 319 antilymphocyte products, 547 antimetabolites, 23t, 233, 241t antimitochondrial antibody tests, 472 antimotility agents, 364t antinuclear factor test, 472 antiretroviral drugs, 289-90, 301 antismooth muscle antibody test, 472 antithymocyte globulin, 548 alpha1-antitrypsin deficiency, 476, 493, 495t, 513-14, 521t, 521, 551 antituberculous drugs, 293-94 antral G-cell hyperfunction, 147 antrectomy, 161, 165, 167 antrum, retained, 150, 160-61, 165 anxiety, 4-5 aorto-SMA graft, 259 aortovisceral bypass, 276 apathy, 56, 212 aperistalsis, 117 apnea, 575t, 575 apolipoproteins, 52 apoprotein, 465 appendicitis, 27-28 appetite, 14-15, 208t arachidonic acid, 144 areflexia, 59t arginine, 205 arsenicals, 57t, 511 arterial reconstruction, 274 arthralgia, 95, 256 arthritis: and gastric secretions, 150; in inflammatory bowel disease, 311t,     313, 327, 339t, 343; in liver disease, 489, 501, 512, 516-17; in PUD,     160-61 artificial sweeteners, 21, 23t, 233, 235t ASA, 35, 144, 146, 524 5-ASA see mesalamine ascites: about, 33-34, 531-32, 533f; dietary therapy, 65-66; examining for,     47-48; in congestive heart failure, 555-56; in hepatic vein thrombosis,     556; in liver disease, 466t, 467, 504, 517, 523-24, 527-28, 531-37, 551;     in veno-occlusive disease, 556; pancreatic, 420 ascorbic acid see vitamin C aspartate aminotransferase, 470-71 aspiration: children, 569; in deglutition disorders, 115; in     esophageal neoplasms, 126; in GERD, 97, 109-10; in Zenker’s     diverticulum, 130 assimilation see absorption; digestion asterixis, 537
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ataxia, 25, 209t, 210t, 212 atelectasis, 417 atherosclerosis, 276, 277, 280 atonic colon, 19t atresia: biliary, 457-58, 620; dietary therapy, 66; duodenal, 572; esophageal,     99-100 Auerbach’s plexus, 90, 137 auscultation, 43-44 azathioprine, 319t, 321, 337, 501, 556 azotemia, 538, 539t azotorrhea, 405, 419, 424 AZT, 290