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1994-09-19
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Document 0479
DOCN M9490479
TI AIDS and the gut.
DT 9411
AU Chui DW; Owen RL; Department of Medicine, University of California, San
Francisco.
SO J Gastroenterol Hepatol. 1994 May-Jun;9(3):291-303. Unique Identifier :
AIDSLINE MED/94331616
AB There are increasing challenges for the practising gastroenterologist in
treating AIDS-related gastrointestinal diseases. The differential
diagnoses of dysphagia and odynophagia include cytomegalovirus (CMV) and
herpes simplex virus (HSV) infection, non-specific aphthous ulceration
and non-AIDS oesophageal diseases, especially reflux oesophagitis.
Chronic subacute abdominal pain with nausea, vomiting, early satiety and
weight loss is suggestive of an obstructive lesion caused by lymphoma or
Kaposi's sarcoma. Severe acute abdominal pain can indicate pancreatitis
or intestinal perforation due to cytomegalovirus. Right upper quadrant
pain (with or without fever, vomiting or abnormal liver function tests
with a cholestatic profile) is suggestive of hepatobiliary pathology
including cholecystitis, cholangitis, acalculous cholecystitis and AIDS
cholangiopathy. Diarrhoea is the most common gastrointestinal symptom of
AIDS, affecting 50-90% of patients. Causes of AIDS diarrhoea include
protozoa (Cryptosporidium parvum, Isospora belli, Enterocytozoon
bieneusi, Septata intestinalis, Cyclospora spp, Entamoeba histolytica
and Giardia lamblia), bacteria (Mycobacterium avium-intracellulare,
Clostridium difficile, Salmonella, Shigella and Campylobacter jejuni),
and viruses (CMV, HSV and possibly HIV). Chronic diarrhoea, malnutrition
and weight loss can shorten the life-span of patients with AIDS.
Elemental diets, isotonic formulas, medium chain triglycerides and total
parenteral nutrition have been tried with little success in AIDS
patients with severe diarrhoea and wasting.
DE Abdominal Pain/ETIOLOGY Acquired Immunodeficiency
Syndrome/*COMPLICATIONS AIDS-Related Opportunistic
Infections/COMPLICATIONS Bacterial Infections/COMPLICATIONS
Candidiasis/COMPLICATIONS Cytomegalovirus Infections/COMPLICATIONS
Deglutition Disorders/ETIOLOGY Diagnosis, Differential
Diarrhea/DIAGNOSIS/ETIOLOGY Esophageal Diseases/COMPLICATIONS
Esophagitis/COMPLICATIONS Gastrointestinal
Diseases/*COMPLICATIONS/DIAGNOSIS Gastrointestinal
Neoplasms/COMPLICATIONS Human Intestinal Perforation/COMPLICATIONS
Lymphoma, AIDS-Related/COMPLICATIONS Pancreatitis/COMPLICATIONS
Protozoan Infections/COMPLICATIONS Sarcoma, Kaposi's/COMPLICATIONS
Support, U.S. Gov't, Non-P.H.S. Support, U.S. Gov't, P.H.S.
Ulcer/COMPLICATIONS Virus Diseases/COMPLICATIONS Weight Loss JOURNAL
ARTICLE REVIEW REVIEW, TUTORIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).