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A case of recurrent epiploic appendagitis [Meeting Abstract]

Mian, Naima; Bernstein, David; Bonapace, Eugene; Katz, Seymour
ISSN: 0002-9270
CID: 3387132

Small bowel pseudopolyps: A unique finding on capsule endoscopy in a patient with Crohn's disease [Meeting Abstract]

Mian, Naima; Bernstein, David; Bonapace, Eugene; Katz, Seymour
ISSN: 0002-9270
CID: 3387142

Inflammatory fibroid polyp mimicking Crohn's disease [Meeting Abstract]

Jha, R; Tepper, R; Bonapace, ES
ISSN: 0002-9270
CID: 3388222

Simultaneous occurrence of inflammatory bowel disease and thyroid disease

Bonapace, E S; Srinivasan, R
We report a case of simultaneous occurrence of inflammatory bowel disease (IBD) and Graves' disease. A review of reported cases of simultaneous onset of ulcerative colitis (UC) and autoimmune hyperthyroidism is presented. A discussion of the prevalence of thyroid disease in patients with UC and possible common autoimmune etiology is entertained. The concurrent presentation has implications for the diagnosis and treatment of both diseases. At the time of suspected initial presentation or exacerbation or preexisting IBD, we emphasize the need to consider both IBD and thyroid disease in the differential diagnosis for optimal patient management.
PMID: 11419852
ISSN: 0002-9270
CID: 3887122

Whole gut transit scintigraphy in the clinical evaluation of patients with upper and lower gastrointestinal symptoms [Meeting Abstract]

Bonapace, ES; Maurer, AH; Davidoff, S; Krevsky, B; Fisher, RS; Parkman, HP
OBJECTIVE: In a single noninvasive, quantitative test, whole gut transit scintigraphy (WGTS) measures gastric emptying (GE), small bowel transit (SBT), and colonic transit (CT). The aim of this study was to investigate the clinical utility of WGTS in patients with functional gastrointestinal (GI) symptoms.
ISSN: 0002-9270
CID: 3388202

Does fasting serum gastrin predict gastric acid suppression in patients on proton-pump inhibitors?

Bonapace, E S; Fisher, R S; Parkman, H P
Proton pump inhibitors (PPIs) block gastric acid secretion and may increase serum gastrin concentration. The aim of this study was to determine whether fasting serum gastrin concentration predicts gastric acid suppression in patients on PPI therapy. Ambulatory pH monitoring with one pH probe in the distal esophagus and a second probe in the stomach was performed in patients with persistent symptoms of GERD despite PPI treatment. Upon completion of pH monitoring, blood was drawn for measurement of fasting serum gastrin concentration. In all, 51 patients were studied: 26 on PPIs, 1 on H2-receptor antagonists, and 24 off acid suppression. Fasting serum gastrin correlated inversely with percent time of gastric pH < 4 for all patients (r = -0.553; P<0.001) and for the subgroup of 26 patients on PPIs (r = -0.435; P = 0.027). In patients on PPIs, an elevated gastrin (> or =100 pg/ml) was associated with gastric pH < 4 for 25+/-7% of the time compared to 54+/-5% when the gastrin was normal (P = 0.004). Therapeutic gastric acid suppression (gastric pH < 4 for <50% of time) was present in 6 of 7 (86%) patients with an elevated fasting serum gastrin, compared with only 8 of 19 (42%) patients with a normal serum gastrin (P<0.05). In conclusion, there is a significant inverse correlation between the fasting serum gastrin concentration and gastric acid profile in patients with GERD. An elevated fasting serum gastrin concentration while on PPI therapy suggests that gastric acid secretion is adequately suppressed.
PMID: 10695611
ISSN: 0163-2116
CID: 3885872

Clinical utility of gastroenterocolonic scintigraphy (GECS) in the evaluation of patients with upper and lower gastrointestinal (GI) symptoms [Meeting Abstract]

Bonapace, ES; Davidoff, S; Krevsky, B; Maurer, AH; Parkman, HP; Fisher, RS
ISSN: 0016-5085
CID: 3388182

Simultaneous endoluminal sonography and manometry to assess anal sphincter complex in normal subjects

Wong, R F; Bonapace, E S; Chung, C Y; Liu, J B; Parkman, H P; Miller, L S
The purpose of this study was to use simultaneous anal manometry and high-frequency endoluminal ultrasonography (EUS) to determine the relationship between resting anal pressure and cross-sectional area of the internal and external anal sphincters. Eleven normal subjects underwent simultaneous anal EUS and manometry using catheters containing both pressure ports and ultrasound transducers. Resting pressure and cross-sectional area of the sphincters were made throughout the anal sphincter complex. The length of the internal anal sphincter (IAS) by sonography (27+/-5 mm) was significantly less than the length of the high pressure zone (HPZ) by manometry (44+/-8 mm; P < 0.001). Maximum IAS cross-sectional area (CSA) occurred 10+/-6 mm proximal to the peak resting pressure. The resting anal pressure correlated with external anal sphincter (EAS) CSA (r = 0.77), but not with IAS CSA (r = -0.17). The sum of EAS CSA and IAS CSA correlated strongly with resting pressure (r = 0.85). In conclusion, the IAS is shorter than the HPZ, with a significant distance separating maximum IAS CSA from peak resting pressure. The sum of the IAS and EAS CSAs, but not that of the IAS alone, correlated with resting pressure. Thus, this study suggests that the EAS, in addition to the IAS, contributes to resting anal pressure.
PMID: 9824120
ISSN: 0163-2116
CID: 3895202

Edrophonium provocative testing during electrogastrography (EGG) - Effects on dyspeptic symptoms and the EGG

Bonapace, ES; Parkman, HP; Fisher, RS
The aim of this study was to determine whether edrophonium induces dyspeptic symptoms and/or gastric myoelectric changes in normal subjects and patients with functional dyspepsia. Eighteen normal controls and 28 patients with functional dyspepsia underwent electrogastrography (EGG) with edrophonium administration. After EGG recording with l-hr fasting and 2-hr postprandial periods, subjects received an intravenous infusion of saline (placebo) followed by edrophonium 10 mg. After each injection, the EGG was recorded for 15 min and symptoms scored. Patients with functional dyspepsia had significantly more frequent gastrointestinal symptoms in response to edrophonium than normal controls. Edrophonium had no effect on EGG dominant frequency, but increased the power of the dominant frequency in both controls and dyspeptic patients. In the dyspeptic patients, reproduction of the patient's symptoms was associated with an increase in the power of the dominant frequency, whereas when no symptoms were produced, there was no change in power. Overall, 21 of 28 dyspeptic patients (75%) had either an abnormal baseline EGG (N = 10) or a normal EGG and positive edrophonium test (N = 11). In conclusion, edrophonium administration can reproduce symptoms in some dyspeptic patients. Symptoms after edrophonium administration may be related to either more vigorous gastric contractions and/or increased visceral perception of normal gastric contractions.
ISSN: 0163-2116
CID: 3388162

Constipation and diarrhea in pregnancy

Bonapace, E S; Fisher, R S
Constipation and diarrhea are common during pregnancy, occurring in up to one-third of women. Constipation is often the result of physiologic changes that occur during pregnancy, usually from hormonal effects on gastrointestinal motility. Diarrhea, on the other hand, is often caused by the same disorders responsible for diarrhea in the nonpregnant patient. The incidence, pathophysiology, evaluation, and treatment of constipation and diarrhea during pregnancy are reviewed in this article.
PMID: 9546090
ISSN: 0889-8553
CID: 3894842