Document 0479
 DOCN  M9490479
 TI    AIDS and the gut.
 DT    9411
 AU    Chui DW; Owen RL; Department of Medicine, University of California, San
       Francisco.
 SO    J Gastroenterol Hepatol. 1994 May-Jun;9(3):291-303. Unique Identifier :
       AIDSLINE MED/94331616
 AB    There are increasing challenges for the practising gastroenterologist in
       treating AIDS-related gastrointestinal diseases. The differential
       diagnoses of dysphagia and odynophagia include cytomegalovirus (CMV) and
       herpes simplex virus (HSV) infection, non-specific aphthous ulceration
       and non-AIDS oesophageal diseases, especially reflux oesophagitis.
       Chronic subacute abdominal pain with nausea, vomiting, early satiety and
       weight loss is suggestive of an obstructive lesion caused by lymphoma or
       Kaposi's sarcoma. Severe acute abdominal pain can indicate pancreatitis
       or intestinal perforation due to cytomegalovirus. Right upper quadrant
       pain (with or without fever, vomiting or abnormal liver function tests
       with a cholestatic profile) is suggestive of hepatobiliary pathology
       including cholecystitis, cholangitis, acalculous cholecystitis and AIDS
       cholangiopathy. Diarrhoea is the most common gastrointestinal symptom of
       AIDS, affecting 50-90% of patients. Causes of AIDS diarrhoea include
       protozoa (Cryptosporidium parvum, Isospora belli, Enterocytozoon
       bieneusi, Septata intestinalis, Cyclospora spp, Entamoeba histolytica
       and Giardia lamblia), bacteria (Mycobacterium avium-intracellulare,
       Clostridium difficile, Salmonella, Shigella and Campylobacter jejuni),
       and viruses (CMV, HSV and possibly HIV). Chronic diarrhoea, malnutrition
       and weight loss can shorten the life-span of patients with AIDS.
       Elemental diets, isotonic formulas, medium chain triglycerides and total
       parenteral nutrition have been tried with little success in AIDS
       patients with severe diarrhoea and wasting.
 DE    Abdominal Pain/ETIOLOGY  Acquired Immunodeficiency
       Syndrome/*COMPLICATIONS  AIDS-Related Opportunistic
       Infections/COMPLICATIONS  Bacterial Infections/COMPLICATIONS
       Candidiasis/COMPLICATIONS  Cytomegalovirus Infections/COMPLICATIONS
       Deglutition Disorders/ETIOLOGY  Diagnosis, Differential
       Diarrhea/DIAGNOSIS/ETIOLOGY  Esophageal Diseases/COMPLICATIONS
       Esophagitis/COMPLICATIONS  Gastrointestinal
       Diseases/*COMPLICATIONS/DIAGNOSIS  Gastrointestinal
       Neoplasms/COMPLICATIONS  Human  Intestinal Perforation/COMPLICATIONS
       Lymphoma, AIDS-Related/COMPLICATIONS  Pancreatitis/COMPLICATIONS
       Protozoan Infections/COMPLICATIONS  Sarcoma, Kaposi's/COMPLICATIONS
       Support, U.S. Gov't, Non-P.H.S.  Support, U.S. Gov't, P.H.S.
       Ulcer/COMPLICATIONS  Virus Diseases/COMPLICATIONS  Weight Loss  JOURNAL
       ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).