GASTROENTEROLOGY

From Big Medical Encyclopedia

GASTROENTEROLOGY (grech, gaster a stomach + enteron a gut + logos the doctrine) — the section of internal diseases studying an etiology, a pathogeny and a wedge, forms of preferential noninfectious diseases of bodies of the alimentary system. Develops also diagnostic methods, treatments and prevention of these diseases.

G.'s allocation in the independent section of medicine was promoted by achievements of physiology, a wedge, medicine (hl. obr. internal diseases and surgery), patol, anatomy.

Diseases of digestive organs take among the general incidence of the population the second place after cardiovascular diseases. Statistically in the USSR diseases of the digestive system occur at 56 people on 1000 inhabitants (S. V. Kurashov, 1965), in the USA in 1969 at 64 people on 1000 inhabitants.

History

Diseases of the digestive system are mentioned in works of an extreme antiquity. Hippocrates's provisions about need of various diet at different diseases are known. In works K. Galen stomach ulcer and ways of its treatment were described. In «A canon of medical science» Ibn-Xing also gives the description of stomach ulcer and its complications (bleeding, perforation). In the manuscript of Ancient Russia (the end of 15 century) «Gate the Aristotelian» among diagnostic receptions Aesculapians recommend palpation of a stomach for a research of abdominal organs.

G.'s emergence belongs to the first half of 19 century when there were systematic descriptions of diseases of digestive organs, an ulcer and a carcinoma of the stomach, cirrhoses of a liver, etc. I. Boas together with Evald (To. A. Ewald) the wedge, a method of a research of secretory function of a stomach by studying of gastric contents, aspirirovanny through an elastic rubber tube offered in 1884 (see. Breakfast trial , Sounding , stomach).

Use of thick, and then thin probes [A. Kussmaul, 1867; Eyngorn (M. Einhorn) and Lyon (V. Lyon), 1911; M. A. Gorshkov, 1922] for a research of gastric and duodenal contents promoted development of the functional direction in.

The scientific and practical foundation of domestic G. is laid by representatives of the advanced therapeutic schools of Russia — S. P. Botkin, A. A. Ostroumov, G. A. Zakharyin. S. P. Botkin described clinic of cholelithiasis, studied mechanisms of extrahepatic formations of bilirubin and viscerovisceral reflexes at cholelithiasis. A. A. Ostroumov emphasized in the lectures value of viscerovisceral reflexes at patol, conditions of digestive organs. Ways of development wedge. In many respects are defined by influence fiziol. I. P. Pavlov's schools, edge laid the foundation of studying of physiology and pathology of digestion, having enriched the maintenance of the functional direction a wedge, medicine, created the scientific concept of a nervosism.

At the beginning of 20 century for the first time in clinical practice by V.P. Obraztsov: and were offered N. D. Strazhesko physical. methods of a research of abdominal organs, in particular a method of the deep sliding topographical palpation, and physical. methods for diagnosis of a perigastritis, a periduodenitis, colitis, a splanchnoptosia. Century of X. Vasilenko offered palpatorny reception for identification of the gastrectasia, and also for a palpation which is descending and the ascending departments of a large intestine.

Methods of a research of digestive organs were widely adopted rentgenol: rentgenokimografiya (see), angiography (see), a relaxation duodenografiya (see. Duodenografiya relaxation ), holedokhoduodenografiya, transdermal holegrafiya (see), etc. The technique of a relaxation duodenografiya and a holedokhoduodenografiya allows to reveal damages of a pancreas, a zone of a faterov of a nipple, a duodenum and zhelchevydelitelny system. Methods of an endoscopic research of a gullet, stomach and duodenum, the general bilious channel, a pancreatic channel, a large intestine are developed (see. Endoscopy ). Widely use in G. and morfol, methods of a research of biopsy material — gistokhy., gistoenzimol., immunomorfol. and elektronnomikroskopichesky techniques. In clinicodiagnostic researches in G. began to use radioactive drugs and marked connections. By means of isotopes information on dynamics of their accumulation and allocation is reached, the form, topography, size and function of the studied body is defined (e.g., a liver, a pancreas). Gastroenterol. the clinic was enriched with new methods of a research of secretion of gastric contents, bile and pancreatic juice. Measurement of intragastric and pristenochny pH was especially informative rather acid-forming function of a stomach. Multimoment duodenal sounding of a duodenum gives a better understanding of passability of bilious ways and evakuatorny function of a gall bladder (see. Duodenal sounding). Using radio electronics in clinic synchronous registration of several parameters characterizing functions of digestive organs, in particular pH of the environment in a stomach, a duodenum and initial department of a jejunum and also pressure in these departments became possible.

The understanding of regulation of functions of the alimentary system was promoted by discovery of the hormones cosecreted by bodies went. - kish. a path — gastrin (see), secretin (see), cholecystokinin (see). The combined secretin-pankreoziminovy the test for studying of hydrocarbonate and fermentovydelitelny functions of a pancreas is offered.

Considerable success is achieved in studying peptic ulcer (see). Existence of the functional (predjyazvenny) period of a peptic ulcer is proved. The clinic and differential diagnosis of ulcers of the peloric channel, ulcers of extra bulbous localization, an ulcer form of a carcinoma of the stomach is carefully studied.

To the correct understanding of questions of a pathogeny and clinic hron. gastritis (see) M. P. Konchalovsky, R. A. Luriya, O. L. Gordon, Yu. M. Lazovsky, S. M. Ryss, R. Schindler, Palmer's classical researches promoted (E. Palmer). Classification hron, gastritis is developed (N. S. Molchanov, Yu. I. Fishzon-Ryss, G. M. Ryss). On the basis of data of gastroscopy and gastrobiopsiya (see. Gastroscopy ) criteria of diagnosis and differentiation separate morfol, forms of gastritises are developed.

An essential contribution to studying of pathology of digestion was so-called pristenochny, or membrane, the digestion for the first time described

by A. A. U goal; methods of a research membrane were developed digestion (see) for a wedge, practicians. Modern G. is characterized by further specialization; it promoted allocation in it new independent sections, napr, proctologies (see), hepathologies (see).

Research establishments

Exist three research institutes — in Moscow, Dushanbe, Dnipropetrovsk, and also numerous gastroenterol. the laboratories specialized gastroenterol. departments and sanatoria. Studying of diseases of bodies of system of digestion at medical institutes is carried out it is aware of internal diseases, and also at departments of pediatrics and surgery. After the termination of medical institute doctors receive specialization and professional development in G. in a wedge, an internship specialized gastroenterol. clinics, in in-ta of improvement.

In 1948 were created all-Union gastroenterol. about-va and under their management republican and regional (city) gastroenterol. about-va. Questions of the organization gastroenterol were discussed at the first All-Union congress of gastroenterologists which took place in Moscow (1973). services in the USSR, a peptic ulcer and pathology of bilious ways. The World association of gastroenterologists is created. Many Soviet gastroenterologists were participants international gastroenterol. congresses.

Results of scientific research on problems G. are covered in magazines «Therapeutic Archive», «Clinical Medicine», «Medical Business», «Surgery», «Archive of Pathology», in the Medical abstract magazine (section 1 and 17). In a number of the countries the magazines devoted to questions G. are issued: in the USA — American Journal of Gastroenterology, American Journal of Digistive Diseases; in England — Gut; in France — Archives of fran$aises des maladies de l’appareil digestif; in the Scandinavian countries — Scandinavian Journal of Gastroenterology.


Bibliography: Topical issues of gastroenterology, under the editorship of V. of X. Vasilenko and A.S. Loginov, century 1 — 8, M., 1968 — 1975; Diseases of digestive organs, under red, S. M. Ryssa, L., 1966; Cooper 3. A. Clinical lectures on gastroenterology, century 1 — 2, M., 1967 — 1973; Modern methods of researches in gastroenterology, under the editorship of V. of X. Vasilenko, M., 1971, bibliogr.; Tashev T., etc. Stomach diseases, intestines and a peritoneum, the lane with bolg., Sofia, 1964, bibliogr.; In about with-kus H. L. Gastroenterology, v. 1 — 3, Philadelphia — L., 1963 — 1965; Gastroen-terologische Endoskopie, Biopsie und Zy-tologie, hrsg. v. R. Ottenjann u. a., Stuttgart, 1970; SleisengerM. H. a. Ford-t r a n J. S. Gastrointestinal disease, pathophysiology, diagnosis, management, Philadelphia, 1973; Spiro H. M. Clinical gastroenterology, L., 1970.

Periodicals — Medical business, M., since 1918; Clinical medicine, M., since 1920; Therapeutic archive, M., since 1923; Acta gastro-enterologica Belgica, Bruxelles, since 1933; American Journal of Digestive Diseases, N. Y., since 1934; American Journal of Gastroenterology (1934 — 1953 — • Revue of Gastroenterology), N. Y. since 1954; Archives des maladies de l’appareil digestif et des maladies de la nutrition, P., since 1907; Digestion, International Journal of Gastroenterology (1938 — 1967 — Gastroentero-logia), Basel — N. Y., since 1968; Gastroenterology, Baltimore, since 1943; Scandinavian Journal of Gastroenterology, Oslo — Bergen, since 1966; Zeitschrift fur Gastroentero-logie, Miinchen, since 1965.

Century of X. Vasilenko, K. I. Shirokov.

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