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the GASTROLAB Digestive Dictionary
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C reactive protein (CRP), a clinical laboratory test used as an acute phase marker of tissue injury, inflammation or infection in the clinical management of many diseases. CRP is high in inflammatory states and goes down when the disease responds to treatment. It has lately been shown, that an elevated CRP also predicts a risk of coronary events in a patient with stable or unstable angina, and similar associations have been found concerning stroke and peripheral vascular disease. CA 125 See Tumour marker CA 19-9 See Tumour marker CA 242 See Tumour marker Caecum (lat) See Cecum CAH (Abbr) Chronic active hepatitis Cal (U) Calorie(s) Campylobacter pylori The mane first used for Helicobacter pylori. The name was changed when it became obvius that this bacteria did not belong to the Campylobacter group. see Helicobacter. Cancer A malignant tumour, where the cells have lost their normal division control. The uncontrolled division make the tumour grow, destroying surrounding tissues. The tumour can invade surrounding organs and it can spread via the lymphatic vessels or via the blood vessels (metastasis). Cancerophobia Fear of cancer Candida Yeast
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 Candida oesophagitis |
Candida oesophagitis An oesophageal inflammation due to candida, and the most common type of nonpeptic oesophagitis. Predisponing factors are diabetes, corticosteroid treatmen (also as aerosols in the treatment of bronchial asthma), antibiotic treatment and malignancies, especieally if treated with immunosuppressive drugs. The typical endoscopic finding is whitish plaques that in severe cases may be confluent. The best treatment is removal of the predisponing factor, if possible. Candica oesophagitis is often strikingly symptomfree but can cause odynophagia.
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Candida oesophagitis, Kodsi classification See Kodsi classification Candidosis A candida, yeast, infection of the moist regions of the body, e.g the mouth, oesophagus and genitals. Also called trush. Capsule A soluble case in which many drugs are adminestered, usually made of gelatin.
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 A wireless endoscopy capsule in the duodenal bulb |
Capsule endoscopy A new endoscopy technique, where a small television camera inside a swallowed capsule transmits images from the entire small bowel. The main indication for this endoscopic technique is gastrointestinal bleeding, where the source has not been found in conventional upper or lower endoscopy.
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Carcino- (Pre) Cancer related Carcinoembryonal Antigen CEA, See Tumour marker
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 A malignant carcinoid tumour in the gastric body (corpus) on the smaller curvature
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Carcinoid tumours are neuroendocrine malignant tumours with a characteristic pathologic appearance occuring in the gastrointestinal channel. About 4000 new cases of this disease is found in USA every year, main age of the patients is near 60. The etiology of this disease is not known. Small carcinoid tumours are often found in the appendix (about 40% of all cases), about one third is found in the small intestine. Carcinoid tumours are malignant, however small tumours in the appendix rarely cause metastatic lesions. A few percent of all malignant tumours in the stomach are carcinoid tumours. Small, clinically quite innocent, carcinoid tumours can be found in the stomach associated with atrophic gastritis. Carcinoid tumours in the colorectal area are twice as common in the the rectum than in the colon. Carcinoid tumours produce several active substanses like serotonin, histamine and other vasoactive peptides. If these substances are not inactivated in the liver they can cause a syndrome called carcinoid syndrome, the main symptom of which is flushing attacks, abdominal cramps, diarrhea and elevated blood pressure. Carcinoid syndrome is most often a sign of disseminated disease with mestastatic tumours in the liver. Surgery is the treatment of choice if possible. Symptoms in disseminated disease with carcinoid syndrome can be relieved by medical therapy.
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Carcinoid syndrome A syndrome occuring in patients with a malignant carcinoid tumour with hepatic metastases. The tumor (and liver metastases) produce active substanses, mainly 5-hydroxytryptamine, causing the typical symptoms: flushing attacks, abdominal cramps, diarrhoea, blood pressure elevation and weight loss. Carcinophobia Fear of cancer Carcinosarcoma A rare type of malignant tumor occuring a.o. in the oesophagus, gall bladder and lung and consisting of both carcinomatous and sarcomatous components.
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 Cardia |
Cardia The opening between the oesophagus and the stomach.
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Carey capsule An instrument formerly used for obtaining small bowel biopsies in order to verify a possible gluten enteropathy.
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 Highly dilatated intrahepatic bile ducts in a patient with Caroli´s syndrome |
Caroli´s syndrome A congenital malformation of the bile ducts. Although the bile ducts are dilated from the birth, the patient can be free of symptoms for years, perhaps for decades and in some instances får all his life. However, this syndrome is often complicated by recurrent febrile cholangitis, which are treated with antibiotics. The prevention of these episodes is difficult. Partial hepatectomy is sometimes possible and in difficult cases might liver transplantation be considered.
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Carter´s sign The roentgenologic distgans between the gastric fundus and the diaphragm is increased when the patient is placed in Trendelenburg´s position, if the patient has a leftsided subphrenic abscess. Cast syndrome See Superior mesenteric artery syndrome (SMAS) Cathartic laxatives Drugs stimulation the bowel movements and fluid secretion used in the treatment of obstipation. Cascara, bisacodyl and senna preparations are typical cathartic laxatives. Chronic use of this type of drugs can result on loss of normal bowel function causing dependency of these drugs. CCFA (Abbr) Crohn´s & Colitis Foundation of America, Inc CCK (Abbr) Cholecystokinin CCU (Abbr) Coronary Care Unit CD (Abbr) Crohn´s Disease CD (Abbr) Coeliac Disease CDAI (Abbr) Crohn´s disease activity index CEA (Abbr) Carcinoembryonic Antigen, see Tumour marker
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 Cecum, the ileocecal valve to the left |
Cecum The first part of the large bowel, situated in the right lower abdominal fossa. The small intestine opens into the large bowel through the ileocecal valve in the upper part of the cecum. The appendix is attached to the bottom of the cecum.
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Celecoxib A highly selective COX-2 inhibitor. This drug is used as treatment for pain and inflammation for example in arthritis and lack many of the gastrintestinal side effects of NSAID´s. Celiac Disease See Coeliac Disease Celiac Sprue See Coeliac Disease -centesis (Suf) Puncture
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 A cervical inlet patch |
Cervical Inlet patch A small area of heterotopic gastric epithelium in the cervical part of the oesophagus. This finding is common, about 2-4 % of all patients undergoing upper endoscopi have an inlet patch. The finding is considered clinically insignificant, the patch does not cause any symptoms, and there is no risk of cancer. A coincidence of Barrett oesophagus and inlet patch has been found, suggesting some kind of shared embryonic etiology.
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Chagas´ disease A disease caused by the infection of a protozoan parasite, Trypanosoma cruzi. Chronic infection causes denervation of many parts of the gastrointestinal canal, resulting in a severely dilated oesophagus, megaoesophagus, resembling achalasia cardiae, and megacolon, resembloin Hirssprung´s disease. This disease is common in South and Central America, including Mexico. About 20 million people are infected every year, and 50.000 die of this disease. Megaoesophagus due to Chagas´ disease is treated in the same manner as Achalasia. Charbon A synonym for Anthrax Cheilitis Inflammation of the lips
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 Chicken skin mucosa |
Chicken Skin Mucosa Slight mucosal changes that are frequently seen adjacent to a colorectal cancer or adenoma. First described by Shatz BA et al, they are called Chicken Skin Mucosa (CMS), and are supposed to occur as a result of fat accumulation in macrophages in the lamina propria adjacent to colonic neoplasms. In a series of 852 consecutive colonoscopies CMS was found adjacent to eight of 10 distal colorectal cancers, one of four of proximal colon cancers and 16 of 42 distal adenomas.
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Child, Charles Gardner (1908-1991) American surgeon best known for his investigations concerning chronic pancreatitis and portal hypertension, and for the classification of liver impairment still used and carrying his name (See Child Classification). Editor of The Journal of Surgical Research, chairman of the American Board of Surgery. Child classification A classification of liver function in liver diseases, e.g. cirrhosis. This classification is used in order to estimate the prognose and operability. The classification has later been modified by RNH Pugh and others. Child group A has the best prognose and group C the worst.
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The Child Classification
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Points
1 2 3
Encephalopathy No Slight Severe
Ascites No Slight Severe
Bilirubin (normal <21) 1-35 35-50 >50
Albumin (normal >33) >35 28-35 <28
NT/TT (normal >70) 80-120 50-80 <50
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Child group A: 5-6 points
Child group B: 7-9 points
Child group C: 10-15 points
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Cholangitis Inflammation in the bile ducts Cholangitis, sclerosing See Sclerosing cholangitis Cholangiocarcinoma A primary liver malignant tumour arising from the biliary tree. The term is nowadays also used to desribe extrahepatic tumours. Perihilar tumours are known as Klatskin tumours. Cholangiocarcinoma is an uncommon disease, with less than 3000 new cases in the USA annually. Primary sclerosing cholangitis, most often associated with inflammatory bowel diseaes, is the main risk factor. Treatment is surgical if possible, if not possible the prognose is poor, and radiation therapy and chemotherapy are only palliative. Cholecystectomy Surgical removal of the gall bladder, most often because of gallstone disease Cholecystolithiasis Gallstone in the gall bladder Cholecystography An X-ray contrast examination of the gallbladder. Cholecystokinin A gastrointestinal hormone produced in the duodenum. Tha main physiolocal effect is stimulation of the pancreatic enzyme secretion and stimulation of the gallbladder contraction. Choledocholithiasis Gallstone(s) in the bile ducts Cholelithiasis Gallstone Cholescintigraphy An examination of the gallbladder usging technetium 99m labeled iminodiacetic acid analogs. Cholestasis of pregnancy A rare condition during the last trimester of pregnancy causing pruritus and a painless jaundice, probably caused by high level of oestrogen. The disease resolves after birth, but tends do recur during following pregnancies. Pruritus can be treated with cholestyramin. Chronic nonspecific diarrhea See Functional diarrhea Chronic proctalgia See Levator ani syndrome Churg-Strauss syndrome A rare syndrome probably of autoimmune origin where the main event is vasculitis mostly involving small and medium-sized blood vessels. The main features of this syndrome are arthma and hypereosiniphilia and it can affect any organ system. Symptoms from the gastrointestanal tract are diarrhea and abdominal pain, more severe symptoms are bleeding and intestinal perforation. Eosinophilia can be found in biopsies. The syndrome usually responds to treatment with corticosteroids. Cyclophosphamide is used in severe cases. Chylous ascites Turbid and slightly opalescent intra-abdominal fluid which microscopically contains a great amount of fat globules. Chylous ascites is a result of disruption of the abdominal thoracis duct, most often due to trauma. Cilansetron A new drug experimentally used in the treatment of irritable bowel syndrome (IBS). Cilansetron is a 5-HT3 antagonist blocking serotonin, which is the main pain mediator in IBS. CIPO (Abbr) Chonic Intestinal Pseudo-Obstruction Cirrhosis An irreversible change in the liver characterised by disorganization of the lobular architecture, fibrosis and regeneration nodules. Many chronic liver diseases can cause cirrhosis. Cirrhotic cardimyopathy Heart abnormalities seen in patients with liver cirrhosis of different etiologies. The mycardic abnormality is usually mild or latent, and reversible after liver transplantation. Clonorchis sinensis A liver fluke that causes Oriental cholangiohepatitis with a clear association with cholangiocarcinoma, cancer in the bile ducts. The infection is common in the Far East. Treatment with praziquantel might be effective. Clopidogrel A new drug with antiplatelet effects and used in the prevention of vascular ischaemic events instead of Aspirin in patients, where Aspirin is contraindicated because of gastrointestinal damage. CMV (Abbr) Cytomegalovirus CNS (Abbr) Central Nervous System CNS drugs Drugs whose main effect is on the central nervous system Codex alimentarius gluten-free diet One deifinition of gluten-free diet allowing less than 0.3% gluten from grains
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 Duodenal mucosa in Coeliac Disease |
Coeliac Disease (Gluten-sensitive enteropathy) A disease the typical feature of which is an intestinal mucosa damage secondary to the intake of gluten, a protein found in wheat, rye and barley. Symptoms may start in early childhood or in adult life. The clinical picture is of two types: intestinal symptoms or symptoms due to nutritional deficiencies (anaemia, osteoporosis). If untreated there is an elevated risk of intestinal malignancies. The prevalence of coeliac disease is probably about 1/100. A preliminary diagnose can be made by serology (Gliadin-, endomysium and reticulin-antibodies) but to get a firm diagnose a small bowel biopsy is needed. The treatment of this disease is a lifelong och strict glutenfree diet, and when properly treated, the prognosis is excellent.
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Coeliac sprue Another name for Coeliac disease Colectomy Surgical removal of the large bowel (colon) or a part of it. Colitis Inflammation of the large bowel Colitis ulcerosa Ulcerative colitis, see ulcerative colitis
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 A collagen subepithelial layer due to collagenous colitis |
Collagenous colitis A "new" inflammatory bowel disease described by C.G. Lindstrom, a Swedish pathologist, in 1976. In this disease there is an increased subepithelial collagen deposition in the colon mucosa and colitis. Chronic watery diarrhea is the typical symptom. Collagenous colitis can be found in patients of any age, most patients are women from 50 to 70 years of age. The diagnosis canb easily be established by biopsies from the colorectal mucosa. Drugs used in the treatment of this disease are loperamide, 5-ASA, sulfasalazin, metronidazole and prednison. The prognosis is generally good, spontaneous remissions occur, many patients have watery diarrhea for years, but complications are extremely rare. Collagenous colitis is one of the microscopic colitides, the other one is lymphocytic colitis.
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Colon The large bowel, beginning at the caecum and ending at the rectum.
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 A typical colon cancer |
Colon Cancer (adenocarcinoma) is the most important gastrointestinal cancer, with a high and rising incidence in the developed world. The yearly incidence in USA is about 50 new cases per 100.000, in Finland slightly above 20. The main symptom is occult or manifest bleeding, changed bowel habits and anaemia. Colonoscopy is the diagnostic method of choice, and should always be done in elderly patients with bleeding or unexplained iron deficiency anaemia. Surgical treatment if possible is curative, radiation and medical therapy are palliative.
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Colonoscope An instrument, endoscope, used in the endoscopic examination of the large bowel. Colonoscopy An endoscopic examination of the large bowel with and instrument called colonoscope, a thin tube (fomerly fiberoptic, nowadays the instrument has a small television camera in the end). Biopsies of the colonic mucosa can be taken during colonoscopy and polyps can be removed. Colonic cleaning is essential before this examination. Colostomy An artificial, surgically created, opening between the large bowel (colon) and the body surface. Compliance The extent to which a patient follows medical or health advice. Condyloma acuminatum Anal warts, a common disorder caused by the quite contagious human papilloma virus, almost always transmitted by direct contact. Small warts can be treated with local medications or electrical cautery. Larger warts and warts within the anal canal may require surgical removal. Congenital (Adj) Present at birth Congenital intestinal aganglionosis See Hirschsprung´s disease Conjugated hyperbilirubinemia See bilirubin. Constipation Obstipation. The passage of hard and dry bowel moements fewer than two-three times a week, associated with an uncomfortable abdominal feeling. The most common causes of obstipation are a relative lack of fiber in the diet and not enough liquids. Some medications may predispose for constipation. Some neurological, metabolic and endocrine disorders may cause obstipation. The main treatment is a diet with enough fiber content (up to 35 grams a day). Continent ileostomy See Koch ileostomy Contra- (Pre) Against COPD (Abbr) Chronic Obstructive Pulmonary Disease, a disease affecting every second of all longterm smokers.
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 A foreign body, a coin in the stomach |
Corpus alienum A foreign body, an object in a place where it should not normally be. A coin or a small toy swallowed by a child is a typical foreign body. An object swallowed ofted departs from the gastrointestal channel by the normal route, bigger objects can be removed endoscopically. Small batteries used in electronic toys are dangerous especially if the remain in the oesophagus, and they should be removed immediately, othervise they can cause serious burns.
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Coryza "Cold in the head", irritation of the mucous membranes in the nose, usually as a sign of viral infection or allergy. Coryza can be an initial symptom of infectious hepatitis. Couric, Katie Co-host of NBC`s "Today-"show in the USA, co-founder of the National Colorectal Cancer Research Alliance Awareness (NCCRA) the mission of which is to increase the awareness of colorectal cancer and preventive testing to exclude this disease. Courvoisier´s law "Common bile duct obstruction due to a stone is not generally accompanied by distension av the gallbladder, because of the presence of a chronic cholecystitis. If, however, the obstruction is due to a tumor, the gallbladder is distended and palpable." COX (Abbr) Cyclooxygenase, an prostaglandin H synthase. This enzyme fconvert arachidonic acid to prostanoids. There are two distinct forms of this enzyme. COX-1 produces arachidonic acid metabolites with mainly protecting functions in the gastrointestinal channel, while COX-2 mainly is active in sites of inflammation mediating the pain and inflammation in many diseases. NSAID´s inhibit both COX-1 and COX-2, the inhibition of COX-1 is thought to be the reason for gastroinstestinal side effects. COX-2 selective inhibitors Drugs with antiinflammatory and analgesic effects without the side-effects in the gastrointestinal tract typical for NSAID´s. Two highly selective COX-2 inhibitors are celecoxib and rofecoxib. CPM (Abbr) Counts per minute CRC (Abbr) Colorectal Cancer Crigler-Najjar Syndrome type I A severe familial autosomal recessive hyperbilirubinemia where there is a complete lack of glucuronyl transferase leading to a severe unconjugated hyperbilirubinemia. Nearly all patients die during their first year of life due to brain damage (kernicterus) and the only curative treatment is liver transplantation. Crigler-Najjar Syndrome type II A familial hyperbilirubinemia, where the excess bilirubin is of the unconjugated type. This type is less severe than the type I and patients usually survive into adulthood. Phototherapy is partly effective and Phenobarbitone is used to reduce the jaundice. Crohn, Burrill B. (1884 - 1983) An American physician, best known for his description of "Terminal Ileitis" in 1931, the disease now known as Crohn´s disease. The landmark publication describing Crohn´s disease was made in cooperation with M. D. Leon Ginzburg and Gordon D. Oppenheimer. The Burrill B. Crohn Research Foundation at Mt. Sinai Medical School support research concerning inflammatory bowel diseases.
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 Crohn´s disease in its typical location, the terminal part of ileum |
Crohn´s disease A chronic bowel inflammatory disease of unknown etiology. Crohn´s disease can occur in a single or in several areas of the gastrointestinal tract, from the mouth to the anus (the typical lokalisation being the terminal ileum) and the inflammatory process can involve the whole of the intestinal wall. The earliest lesion is a small aphthous ulcer. The disease can begin at any age, but is most frequent during the third and fourth decade. In contrast to ulcerative colitis, smoking has a markedly bad influence on this disease. Corticosteroids, 5-ASA-preparations and metronidazol are the main drugs used in the treatment, infliximab being a new innovation especially effective in a severe perianal disease. Surgical treatment is often necessery, the main indications are intractable disease, stenosis, stricture or bleeding.
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Cronkhite-Canada syndrome A rare disease of unknown etiology characterized by polyposis of the juvenile type in the stomach, small intestine and colon. There is a risk of malignancy associated with these polyps, and periodic surveillance is advisable. The patients also have extraintestinal symptoms, hair loss and cutaneous hyperpigmentation. The prognosis is variable, in some patients the disease goes into a spontaneous remission. Crosby capsule See Crosby-Kugler capsule
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 Crosby-Kugler capsule |
Crosby-Kugler capsule A device used for obtaining small bowel mucosa biopsies needed for the diagnosis of gluten enteropathy. The capsule was swallowed and when in the small bowel suction was applied, by which a small part of the mucosa got into the capsule. A small knife inside the capsule then cut of a biopsy. From about 1980 it has been possible to get adequate biopsies during an upper endoscopy, and the Crosby capsule has after that mainly been used in children.
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CRP (Abbr) C reactive protein, a clinical laboratory test used as an acute phase marker of tissue injury, inflammation or infection in the clinical management of many diseases. CRP is high in inflammatory states and goes down when the disease responds to treatment. It has lately been shown, that an elevated CRP also predicts a risk of coronary events in a patient with stable or unstable angina, and similar associations have been found concerning stroke and peripheral vascular disease. Crusell, Gustav Samuel (1810-1858) A Finnish doctor, who introduced a glowing platinum wire used for surgical burning, and the forerunner of today´s diathermy. Cruveilhier´s ulcer Gastric ulcer Cryo- (Pre) Cold Cryoglobulin An abnormal protein (immunoglobulin) which becomes insoluble in low temperatures and can then cause obstruction of small blood vessels. Certain infections and autoimmune diseases can cause the formation of cryoglobulins. Cryoglobulinemia The presence of cryoglobulin in the blood of a patient. Crypt- (Pre) Concealed, hidden. For example cryptogenic, with concealed etiology CSF (Abbr) Cerebrospinal Fluid CT Computed (computerized) tomography Cubic foot Cubic measure, measuring volume. 1 cubic foot is 0.028 cubic meters. 1 cubic meter is 35.32 cubic feet. Cubic inch Cubic measure, measuring volume. 1 cubic inch is 16.39 cubic centimeters. 1 cubic centimeter is 0.061 cubic inches. Cubic yard Cubic measure, measuring volume. 1 cubic yard is 0.765 cubic meters. 1 cubic meter is 1.308 cubic yards. Cullen´s sign Periumbilical purpura sometimes seen in haemorrhagic pancreatitis, due to dissection of blood along the fascias. Cushing-Rokitansky ulcer Ulcerative lesions in the lower third of the oesophagus, gastric fundus or duodenum associated with and probably due to severe brain lesions. Cushing´s ulcer A peptic ulcer (gastric or duodenal) caused by an acute or chronic brain lesion. CVP Central venous pressure CVS Cyclic vomiting syndrome, see Cyclic vomiting syndrome Cyancobolamin Vitamin B12, which is needed for the synthesis of hemoglobin and for the proper function of the nerves. The absorption of vitamin B12 is disturbed in pernicious anemia and in diseases that affect the distal small bowel, especially Crohn´s Disease. Vitamin B12 is mainly absorbed in the distal part of the ileum, the terminal ileum. Cyclic vomiting syndrome A rare disease of unknown etiology mostly among children. Characterized by severe attacks of nausea and vomiting at frequent intervals. Between these attacks the patient is symptomfree. This syndrome wast firstly described by dr S. Gee in 1882. Treatment is symptomatic. This syndrome was formerly called abdominal migraine, and the patients typically have a family history of migraine. Cyclic vomiting syndrome association An organization in the USA and Canada, for patients, families and professionals providing support and education for Cyclic vomiting syndrome. Cyt- (Pre) Cell -cyte (Suf) Cell Cyto- (Pre) Cell Cytomegalovirus oesophagitis Inflammation in the oesophagus due to Cytomegalovirus(CMV)-infection, and mainly occuring in patients with immunosuppression after kidney or bone marrow tranplantation or patients with HIV-infection.
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