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the GASTROLAB Digestive Dictionary

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Gall Bile

Gallbladder A saclike organ functioning as a reservoir of bile, situated just below the right lobe of the liver. Bile passes through the hepatic duct and the cystic duct to the gallbladder. Under the influence of the hormon cholecystokinin (formed in the duodenum after food intake) the bile is released from the gallbladder into the duodenum.

Gallbladder dysfunction A functional disorder of the gallbladder. The Rome II diagnostic criteria for this disorder are: Episodes of severe steady pain located in the epigastrium and right upper quadrant. Symptoms last of over 30 minutes, with pain free intervals, the pain is steady and interrupts daily activities. No structural abnormalities can be found in hte gallbladder or biliary tree, but abnormal emptying of the gallbladder can be seen.

Gallon A liquid measure, measuring capacity. 1 gallon is 4.546 litre and 1 litre is 0.220 gallons. 1 U.S. gallon is 3.786 litre, and one litre is 0.264 U.S. gallons

Gallstone in the gallbladder, an ultrasound image

Gallstone A hard concrement in the gallbladder or the bile ducts, composed of bile pigments, calium salts or cholesterol. Gallstones can cause bile colics, inflammation of the gallbladder (cholecystitis) or obstruction of the bile ducts. Treatment is usually surgical, and the gallbladder can nowadays be removed laparoscopically. In selected cases, gallstones can be dissolved by a drug named ursodeoxycholic acid or they can be shuttered by ultrasound waves.

Gardner´s syndrome A subgroup of the familial adenomatosis coli-syndrome, where the patient typically has hundreds of adenomas in the colon, osteomas most often in the skull or the mandible, dental cysts, cutaneous fibromas and epidermoid cysts.

Gaster (gr) Stomach

Gastrectomy The surgical removal of the stomach (total gastrectomy) or a part of it (partial gastrectomy). A total gastrectomy is often needed in the treatment of gastric cancer. A partial gastrectomy was formerly a often used therapy for gastric or duodenal ulcer (but has nowadays been partly replaced by medical therapy).

Gastric Relating to the stomach

Gastric Antral Vascular Ectasia (GAVE-syndrome) A gastric condition shere the mucosa especially in the antrum is red and angiomatous because of dilated blood wessels. This condition is also called Watermelon stomach because the gastric mucosa resembles markings on watermelon. Watermelon stomach can cause gastrointestinal bleeding. The cause of this syndrome is not entirely known, but it can be associated with liver cirrhosis. The dilated mucosal blood vessels can be treated by coagulation (for example Argon Plasma Coagulation) endoscopically.

Gastric inhibitory polypeptide (GIP) A gastrointestinal hormone normally produced in the upper small bowel. The main physiological effect is stimulation of insulin secretion.

Gastrin A gastrointestinal hormone, normally produced in the gastric antrum. The main physiological effect is stimulation of the gastric acid secretion. Excess procuction of this hormone is seen in patients with a gastrin producing tumour, gastrinoma.

Gastrinoma A hormon-producing tumor usually located in the pancreas, producing gastrin, which cause a severe hyperacidity. The main features of the syndrome caused by this excess gastrin production are multiple atypical oesophageal, gastric and/or duodenal ulcers and diarrhea. This syndrome is called Zollinger-Ellison Syndrome (ZES). Fasting serum gastrin is elevated, and this is used as a screening test for gastrinomas. Part of the gastrinomas are malignant. Treatment is surgical if possible, and to prevent ulcers massive doses of PPI´s are used.

Gastroduodenoscope An instrument - fiberoptic or video - used in endoscopic examinations of the stomach and duodenum. A gastroduodenoscope can be end-viewing (looking forward) or side-viewing (looking to one side). The side-viewing instruments are used for the cannulation of the pancreas and bile duct.

Gastroenteritis An inflammation affecting the stomach and the intestine

Gastroenterology The science describing the stomach (Gaster) and the bowel (Enter, gr)

A gastric Gastrointestinal Stromal Tumour (GIST)
A GIST-tumour in the distal small bowel

Gastrointestinal Stromal Tumour (GIST), a sarcoma (a tumour arising from the connective tissue) of the gastrointestinal tract. GIST is rare, only about 1-3% of all malignant tumours in the gastrointestinal canal are of this kind. About two thirds of these tumours occur in the stomach, one fifth in the small intestine and one tenth in the oesophagus. GISTs are often benign, but larger tumours can cause liver and peritoneal metastases. Bleeding causing anaemia is the main symptom. Nausea, vomiting and weight loss are other common symptoms. Diagnose is most often made by endoscopy and biopsies taken during this examination. Surgical therapy is curative if the disease is not disseminated. These tumours have recently been found to respond very favourably to treatment with Imatinib (Glivec). Tumours formerly called leiomyomas and leiomyosarcomas are considered to be GISTs.

Gastroscopy

Gastroscopy An examination of the stomach. Endoscopic gastroscopy is a routine procedure in patients with symptoms from the upper gastrointestinal canal. A gastroscope is a slim flexible tube easily swallowed by the patient. Formerly fiberoptic instruments were used, nowadays the gastroscopes have a small television camera with which the linings of the oesophagus, stomach and duodenum can be examined. During the examination biopsies and cell samples can be taken, as well as photographs. Small procedures such as polypectomy can be performed. The patient should not eat or drink for 6 - 8 hours preceding the examination.

Gastrospirillum hominis See Helicobacter heilmannii

GAVE syndrome See Gastric Antral Vascular Ectasia

Gay bowel disease A chronic rectal inflammation in homosexual men, caused by bacterial (chlamydia, gonococcal) or viral (herpes-virus) infections.

Gee, Samuel Jones (1839 - 1911) A British physician, who in 1888 published a good description of the disease now known as coeliac disease.

Gee-Herter-Heubner´s disease An old name of coeliac disease.

GEEMO (Abbr) Groupe Europeen Etude Maladies Oesophage

Gee-Thayssen´s disease An old name of the disease now known as coeliac disease or gluten enteropathy

GEJ (Abbr) Gastro-esophageal Junction

Gene: HFE The C282Y and H63D mutations in this gene is the genetic cause of hemochromatosis.

Gene: NOD2 Variations in this gene has been shown to be associated with fibrostenotic Crohns disease in the small bowel.

GERD (Abbr) Gastroesophageal Reflux Disease

GFD (Abbr) Gluten-Free Diet

GGT (Abbr) Gamma Glutamyl Transpeptidase

GI (Abbr) Gastro-Intestinal

Cysts of Giardia lamblia

Giardia Lamblia A protozoan parasite infecting the human small intestine. This organism was found in 1681 by Anton Van Leeuwenhoek. The parasite exists as a trophozoite in the small intestine, and as a cyst outside the human body. The transmission route is faecal-oral, commonly through infected water. The main symptom is diarrhea, which can be severe, and weight loss. Metronidazol is the main treatment for this infection.

Giardiasis A small intestine infection with Giardia Lamblia, a protozoan parasite. (Photo: H.D.A. Lindquist, U.S. EPA )

Gingivitis, acute ulcerative An inflammation in the mouth caused by a bacterial infection (Fusobacterium fusiformis, Borrelia vincenti). Main symptoms are pain, fever, fetor and lymphadenitis. Treatment with penicillin or metronidazole is usually effectiv. This disease is also called Vincent´s angina.

Ginzburg, Leon An american physician who together with Burrill B. Crohn and Gordon D. Oppenheimer in 1931 published an article about termnal ileitis, a disease since then known as Crohn´s disease.

GIP (Abbr) Gastric inhibitory polypeptide

GIST Gastrointestinal Stromal Tumour, a sarcoma of the gastrointestinal tract. The presenting symptoms are usually anaemia due to gastrointestinal bleeding and/or small bowel perforation. The usual treatment is surgical, but these tumours have recently been found to respond very favourably to treatment with Imatinib (Glivec).

Slideshow:

A gastric ulcerated GIST

A gastric Gastrointestinal Stromal Tumour (GIST) with typical deep ulcers

GIST (Abbr) Gastrointestinal Stromal Tumour, a sarcoma (a tumour arising from the connective tissue) of the gastrointestinal tract. GIST is rare, only about 1-3% of all malignant tumours in the gastrointestinal canal are of this kind. About two thirds of these tumours occur in the stomach, one fifth in the small intestine and one tenth in the oesophagus. GISTs are often benign, but larger tumours can cause liver and peritoneal metastases. Bleeding causing anaemia is the main symptom. Nausea, vomiting and weight loss are other common symptoms. Diagnose is most often made by endoscopy and biopsies taken during this examination. Surgical therapy is curative if the disease is not disseminated. These tumours have recently been found to respond very favourably to treatment with Imatinib (Glivec). Tumours formerly called leiomyomas and leiomyosarcomas are considered to be GISTs.

Glasgow criteria for acute pancreatitis The modified Glasgow criterias used in the classification of acute pancreatitis are:
*Age >55 years
*White cell count >15 x10*9/l
*Blood glucose >10 mmol/l
*Urea >16 mmol/l
*Arterial oxygen partial pressure <8 kPa
*Albumin <32 g/l
*Calcium <2.0 mmol/l
*Lactat dehydrogenase >600U/l
A severe acute pancreatitis is present if 3 or more factors are detected within 48 hours.

Gliadin A protein fraction in wheat responsible for the mucosal damage seen in coeliac disease. See Prolamines

Glioma A tumour arising from the non-nervous cells of the nervous system.

Globus, Globus sensation A feeling of a lump or tightness in the throat, often a functional symptom which can occur without any organic abnormalities in the oesophagus. The Rome II diagnostic criteria for globus are: At least 12 weeks, which need not be consecutive, in the preceding 12 months of: 1. The persistent or intermittent sensation of a lump of foreign body in the throat; 2. Occurence of the sensation between meals; 3. Absence of dysphagia or odynophagia (painful swallowing); 4. Absence of pathologic gastro-oesophageal reflux, achalasia or other recognized motility disorder.

Globus hystericus An old name for globus, not appropriate, because this symptom is not only found in psychiatric disorders.

Glossitis Inflammation of the tounge. Vitamin B12-deficiency, candida infection and Crohn´s disease are possible causes of glossitis.

Glucagon A hormone produced in the pancreas. The main effect of glucagon is an increase in the blood sugar level, and glucacon is used in the therapy of hypoglycaemia.

Glucagonoma An endocrine tumour usually found in the pancreas. The tumour produces glucagon. An elevatad blood sugar level is a usual finding, and a skin disease, erythema necrolytica migrans, is an very typical, nearly pathognomonic finding.

Gluten The protein fraction of wheat, barley and rye that allows the baking of bread. Gluten can be divided into ethanol-soluble prolamines and ethanol-insoluble gluteins. The prolamin fraction is probably responsible for the mucosal damage seen in coeliac disease.

Gluten-sensitive enterpathy Another name for Coeliac Disease

Glycogenic Acanthosis

Glycogenic Acanthosis Small discrete elevations in the oesophageal mucosa and a quite frequent endoscopic finding especially in the elderly population. These small have a whiter colour than the surrounding mucosa, due to a high content of glycogen. They do not have any clinical significance, and there is no need for biopsy or therapy.

Gopalan´s syndrome Prominent hyperhidrosis and paresthesias in a patient with anorexia nervosa

GOR (Abbr) Gastro-Oesophageal Reflux

GORD (Abbr) Gastro-Oesophageal Reflux Disease

Graft-versus-host disease A disease that can occur when immunologically active lymphocytes are transplanted into a new host for example in connection with a bone marrow transplantation. The lymphocytes try to reject organ tissues of the new host, causing symptoms from the skin, the gastrointestinal canal and the liver.

Granulomatous colitis Another name for Crohn´s disease.

Grasbeck-Imerslund syndrome A hereditary disorder causing a selective malabsorption of vitamin B12. This syndrome was found by Grasbeck from Finland and Imerslund from Norway in 1960, and Najman and Brausil had described a patient with this disorder in 1952, an so this syndrome is also called the Imerslund-Najman-Grasbeck syndrome. This is a rare syndrome and the main findings are low vitamin B12 causing a megaloblastic anaemia and proteinuria.

Grey-Turner´s sign Left flank purpura sometimes seen in haemorrhagic pancreatitis, due to dissection of blood along the fascias.

GRFoma An endocrine neoplasm of the pancreas. The tumour, about one third of which are malignant, secretes growth factor and the symptoms are those of acromegaly. The incidence of this tumour is not known, but it is probably very rare.

GRP (Abbr) Gastrin-releasing peptide

Gullet Oesophagus

Gut flora All the microbes living in the gut. About 400 - 500 species live in the gut, and the total amount of microbes is 100.000.000.000.000. One can compare that to the total amounts of cells in our body, which is about 10 times less. The gut flora influences the function of our bowel in many ways, partly still unknown.

GVHD Graft-versus-host disease

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