The Gastrointestinal
Encyclopedia
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The 
Dictionary
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the GASTROLAB Digestive Dictionary
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D The latin letter for 500. DALM See Dysplasia Associated Lesion or Mass Dance“s sign Palpable "emptiness" ofver the right lower quadrant in a patient, usually infant, with advaning invagination of the caecum. DDW See Digestive Disease Week Deferoxamine A drug used in iron intoxication, chronic iron overload after multiple blood transfusions and hemochromatosis, if phebotomies are not possible. An investigational use is treatment of aluminium overload in renal failure. Registered trade mark in USA Desferal. Deglutition Swallowing Delirium A transient state of confusion,which can be caused by high fever or intoxication Delirium tremens A state of confusion caused by alchohol abuse, often seen during a withdrawal period. Delta The Greek letter D Dent- (Pre) Tooth related Desferal See deferoxamine DesipramineA tricyclic antidepresant used in the treatment of depression. This type of drugs are also frequently used for functional gastrointestinal disorders as they alter pain perception and have effects on gastrointestinal motility and secretion. The main adverse effects are dry mouth, constipation and sexual dysfunction. Derm- (Pre) Skin related. For example Dermatitis, skin inflammation
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 Dermatitis herpetiformis |
Dermatitis herpetiformis Skin Celiac Disease, a dermatologic disease related to food gluten. An itching papulovesicular rash is most often found on the elbows and the buttocks. The diagnose can easily be verified by a skin biopsy showing IgA deposits in immunofluorescent staining. Most of the patients with dermatitis herpetiformis also have villous atrophy, and both the skin and the bowel lesions respond to gluten free diet, which should be very thorouhgly maintained in the skin disease. Some patients respont only partially to glutenfree diet, and need medical treatment with dapsone, which can have severe side effects however (heamolytic anaemia and methaemoglobinaeia)
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 DEXA-equipment |
DEXA Dual Energy X-ray Absorptiometry, a method of measuring bone density in the diagnostic work-up of osteoporosis.
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Di- (Pre) Double Diarrhea More than three bowel movements per day with loose stools. The stool weight is over 200 gram per day and the water content is elevated (over 75 - 85%). Diarrhea with less than four weeks duration is acute diarrhea, with over four weeks duration is chronic diarrhea. DiBiCol A new genetic test made from biopsies taken from the large bowel. With this test can inflammatory bowel disease be excluded, and if there is an inflammatory bowel disease it is possible to differentiate between ulcerative colitis and Crohns disease, which sometimes can be very difficult in the initial phase of the disease. Dicke, Willem Karel (1905 - 1962) A Dutch pediatrician, who published his thesis in 1950 showing that gluten in wheat was the substance that cause the mucosal damage in coeliac disease. Willem Karel Dicken can be considered to be the father of modern treatment of coeliac disease. DIC (Abbr) Disseminated Intravascular Coagulation Dientamoeba fragilis An amoeba (protozoa) without any cyst form, causing diarrhea.
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 Drawing made by Georges Dieulafoy. a = artery, h = opening in the vessel wall |
Dieulafoy, Georges (1839 - 1911) A French doctor, who in 1898 published a case report concering three of his own and four referred patients, who had suffered from a massive gastrointestinal bleed from a seemingly very small gastric mucosal lesion. This type of small ulcer which can cause massive bleeding are called Dieulafoy“s lesion or Exulceratio Simplex Dieulafoy. Dieulafoy“s lesion A rare cause of massive gastrointestinal bleeding, usually in the stomach but can occur in the duodenum or the rest of the small bowel. The bleeding is caused by a ruptured artery. The bleeding is massive and mortality due to bleeding is significant. The lesion can be treated endoscopically when it is in the stomach or proximal duodenum.
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 Plenary session at the DDW in Atlanta |
Digestive Disease Week (DDW) The premier gastroenterology meeting in the USA arranged yearly in May. In 2001 this congress took place in Atlanta, Georgia. DDW is the second most important meeting in gastroenterology, surpassed only by the World Congress. About 15.000 visitors are attending the DDW every year.
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Digital Rectal Exam An exam of the rectum by a doctor using his gloved lubricated finger. Diphyllobotriasis Fish tapeworm infection, for example Diphyllobothrium latum
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 Part of a broad tapeworm |
Diphyllobothrium latum, the broad tapeworm, is an intestinal parasite with a complex life cycle (humans, freshwater crustaceans and fishes and then again humans are infected in this order). The worm can be up to 12 meters long and it can survive for 10 years or more in the human intestine. This infection was common in the northern Europe, including Finland, but it is now rare. This worm has a great affinity for vitamin B12, sometimes causing deficiency in the human host, very seldom however anaemia.
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Diversion colitis A chronic inflammatory large bowel process affecting segments of the large bowel that are excluded from the fecal stream, e.g. in a patient with ileostomy. The treatment of choise is reanastomosis, the diversion colitis soon disappear when colonic continuity is reestablished. If reanastomosis is not possible, this disase can be treated with topical short-chain fatty acids.
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 Diverticulas in the sigmoid colon |
Diverticula, colonic Herniations of mucosa and submucosa through the wall of the large bowel, commonest in the sigmoid colon, but can be seen anywhere in the colon. Diverticulosis sigmoidei (Diverticular disease of the sigmoid colon) is a common disease affecting perhaps every third of the older population in industrialized countries. Often the diverticula (a sac or pouch formed at a weak point in the bowel wall) do not cause any symtoms. They can however cause pain most commonly in the left lower quadrant, altered bowel habits and bleeding. A diverticulum may become inflamed, causing diverticulitis. Colonoscopy is a diagnostic examination, and the diverticulas are also easily seen in a large bowel x-ray examination. A diet rich of fibre is the most important treatment. Surgical treatment is seldomly needed.
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Diverticulum A sac or pouch formed at a weak point of the wall of the alimentary canal. Diverticula may be lokalized almost anywhere in the gastrointestinal tract, e.g. in the oesophagus, stomach, small bowel and large bowel. Diverticulas in the sigmoid colon is a very common finding in the elderly population, see Diverticulosis sigmoidei. DoxepinA tricyclic antidepresant used in the treatment of depression. This type of drugs are also frequently used for functional gastrointestinal disorders as they alter pain perception and have effects on gastrointestinal motility and secretion. The main adverse effects are dry mouth, constipation and sexual dysfunction.
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 Oesophagitis and oesophageal ulceration due to the use of Alendronate |
Drug induced oesophagitis Many drugs taken orally can cause oesophagitis, for example doxicycline, potassium-preparations, iron tablets, NSAID“s and alendronate, a drug used in the treatment of osteoporosis. Potassium chloride and alendronate typically causes ulcerations and stricture formation. Taking the medicine at bed-time, any previous disease interferring with the transit in the oesophagus and using too little water are risk factors.
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DU (Abbr) Duodenal Ulcer
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DEXA-equipment |
Dual Energy X-ray Absorptiometry DEXA (sometimes abbreviated as DXA), a method of measuring bone density in the diagnostic work-up of osteoporosis.
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Dubin-Johnson Syndrome A familial hyperbilirubinemia, where the hyperbilirubinemia is of the conjugated type. This is a quite rare and benign conditiion, the jaundice is mild and intermittent and no treatment is needed. The liver is macroscopically very dark, nearly black, due to a pigment of unknown nature. Ductus (Lat) Tube, canal, duct Ductus cysticus Duct of the gallbladder, connecting the gall bladder to the common hepatic duct. The gallbladder is both filled and drained through this duct. Dukes, Cuthbert Esquire (1890 -1977) an English doctor known for his classification of colon and rectum cancer called the Dukes classification. Duo- (Pre) Two
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 Duodenal diverticula |
Duodenal diverticula A pouch in the duodenal wall, most often an insidental finding near the papilla Vater - sometimes the papilla can be localized inside a diverticulum - and they rarely cause any symptoms and no treatment is needed. However, the incidence of common bile duct stones is probably elevated when the patient has a duodenal diverticulum and the risk of cholangitis might be higher than normal.
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Duodenoscope An instrument - fiberoptic or video - used in endoscopic examinations of the duodenum. The same instrument can be used for examining the stomach (gastroduodenoscope). Duodenum The first part of the small intestine, starting at the pylorus. The first part of duodenum is c/alled bulbus duodeni or duodenal bulb, and this is the usual localization in duodenal ulcer disease. Dys- (pre) Difficult, abnormal, from the Greek word dys = bad Dyschezia Difficult defecation. Often defined as difficulties during at least 25% of bowel movements during a 3 month period. Dysmotility Motility disorder Dyspepsia Persistent or recurrent abdominal pain or abdominal discomfort centered in the upper abdomen. Dyspepsia can be organic - having a clear cause, e.g. ulcer disease - or functional, that is without any structural or biochemical abnormality explaining the symptom. Functional dyspepsia can be divided into three categories, ulcer-like dyspesia, dysmotility-like dyspepsia and unspecified (nonspecific) dyspepsia. Dysphagia Difficulty in swallowing, sensation of food or liquid stinging in the oesophagus
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 A dysplasia associated lesion or mass in the rectum |
Dysplasia Associated Lesion or Mass (Abbr. DALM) A mucosal mass found in patients with longstanding ulcerative colitis. A DALM-finding indicates a high risk of cancer, either in the lesion or mass itself or somewhere else in the large bowel, and a finding like this is usually thought to be an indication for surgical treatment.
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