For at least three centuries, Holland has been at the centre of research on intestinal malabsorption. In the 17th and 18th centuries, early descriptions of coeliac disease and tropical sprue were published by physicians trained in Holland, and it was in 1950 that Dicke published his painstaking and vital observations that coeliac disease in children was caused by the inges tion of wheat flour. Subsequent careful work with van de Kamer and Weijers showed that the harmful agent was gluten. Since these discoveries were made, research in intestinal malabsorption, particularly in the adult, has continued in several centres in Holland. At Nijmegen, for example, dr. Cluysenaer, dr. van Tongeren and their as sociates have been involved in long-term studies of patients with intestinal disease for the past fifteen years. In this book they describe their experience of the investigation and treatment of fifty patients with the adult form of coeliac disease. Their monograph gives an account of the history, definition and incidence of the disorder, and then goes on to undertake a critical review of the pathogenesis of the coeliac lesion. Before embarking on the different patterns of malabsorption seen in adult coeliac disease, the authors describe the normal small intestine, its morphology and function.
Sprache
Verlagsort
Verlagsgruppe
Illustrationen
Dateigröße
ISBN-13
978-94-010-1093-1 (9789401010931)
DOI
10.1007/978-94-010-1093-1
Schweitzer Klassifikation
1. Introduction.- 1.1 History.- 1.2 Terminology.- 1.3 Definition of coeliac sprue.- 1.4 Incidence.- 2. Pathogenesis of Coeliac Sprue.- 2.1 Introduction.- 2.2 Causative factor.- 2.3 Pathogenesis.- 3. Morphology of the Small Intestine Under Normal Conditions and in Coeliac Sprue.- 3.1 General introduction.- 3.2 The normal small intestine.- 3.3 The small intestine in coeliac sprue.- 3.4 Morphogenesis of the coeliac mucosa.- 3.5 Morphometry of the mucosa.- 4. Physiology of the Small Intestine.- 4.1 General introduction.- 4.2 Motility.- 4.3 Innervation.- 4.4 Circulation.- 4.5 Lymphatic system.- 4.6 Digestive secretions.- 4.7 Intestinal hormones.- 4.8 Intestinal mucus.- 4.9 Exfoliation of enterocytes.- 4.10 Enteric plasma protein loss.- 4.11 Intestinal flora.- 5. Intestinal Digestion and Absorption.- 5.1 General introduction.- 5.2 Water and electrolytes.- 5.3 Carbohydrate.- 5.4 Fat.- 5.5 Protein.- 5.6 Calcium.- 5.7 Magnesium.- 5.8 Haematopoietic factors.- 5.9 Water-soluble vitamins.- 6. Pathophysiology of Coeliac Sprue.- 6.0 Introduction.- 6.1 Composition of the group of patients studied.- 6.2 Motility.- 6.3 Innervation.- 6.4 Circulation.- 6.5 Lymphatic system.- 6.6 Digestive secretions.- 6.7 Intestinal hormones.- 6.8 Intestinal mucus.- 6.9 Exfoliation of enterocytes.- 6.10 Enteric plasma protein loss.- 6.11 Intestinal flora.- 7. Malabsorption in Coeliac Sprue.- 7.1 Introduction.- 7.2 Water and electrolytes.- 7.3 Carbohydrate.- 7.4 Fat.- 7.5 Protein.- 7.6 Calcium.- 7.7 Magnesium.- 7.8 Haematopoietic factors.- 7.9 Water-soluble vitamins.- 8. Clinical Features.- 8.1 Introduction.- 8.2 Incidence of the various symptoms.- 8.3 General complaints and symptoms.- 8.4 Gastrointestinal tract.- 8.5 Haematopoiesis and blood coagulation.- 8.6 Musculoskeletal system.- 8.7 Skin, hair and nails.- 8.8 Reproductive functions.- 8.9 Nervous system.- 8.10 Psyche.- 9. Clinical Course and Response to Treatment.- 9.1 Spontaneous course.- 9.2 Treatment by the gluten-free diet.- 9.3 Additional measures.- 9.4 Complications.- 9.5 Conclusions.- 10. Association with Other Diseases.- 10.1 Introduction.- 10.2 Dermatitis herpetiformis.- 10.3 Concomitant diseases.- 11. Special Forms of Sprue.- 11.1 Introduction.- 11.2 Ulcerative duodenojejunoileitis.- 11.3 'Collagenous'sprue.- 11.4 Refractory sprue.- 12. Methods and Procedures.- 12.1 Biochemical assays.- 12.2 Statistical analysis.- 12.3 Biopsy of the small intestine.- References.- Survey of References to Patients.
