Huge gastric diospyrobezoars successfully treated by oral intake and endoscopic injection of Coca-Cola

A diospyrobezoar is a type of phytobezoar that is considered to be harder than any other types of phytobezoars. Here, we describe a new treatment modality, which effectively and easily disrupted huge gastric diospyrobezoars. A 41-year-old man with a history of diabetes mellitus was admitted with lower abdominal pain and vomiting. Upper gastrointestinal endoscopy revealed three huge, round diospyrobezoars in the stomach. He was made to drink two cans of Coca-Cola every 6 h. At endoscopy the next day, the bezoars were partially dissolved and turned to be softened. We performed direct endoscopic injection of Coca-Cola into each bezoar. At repeated endoscopy the next day, the bezoars were completely dissolved.

Gastric disorders and nutritional management

Protein calorie malnutrition is a frequent complication of HIV and AIDS. Malnutrition has been one of the most common AIDS-defining conditions recognized by the Centers for Disease Control and Prevention. Proper nutritional management can have a positive impact on the clinical course of HIV-infected patients. Further information is required in order to assign nutrition its proper priority in the clinical management of HIV-infected individuals. The use of gastrostomy feedings in patients with AIDS is similar to the use of these feedings in other diseases.

Dietary fibre in the diet of the growing pig: effects on apparent digestibility and resultant implications for its use in reducing the incidence of oesophagogastric parakeratosis

The effects on apparent digestibility of increasing dietary fibre concentrations in barley-based diets by substituting for barley either bran, oatmeal by-product, guar gum or pectin were studied using 72 pigs. Increasing substitutions of bran up to a maximum of 300 g kg-1 gave progressive decreases in apparent digestibility of dry matter, ether extract and gross energy fractions and in digestible and metabolisable energy contents, progressive increases in apparent digestibility of modified acid detergent fibre but had no consistent effect on either nitrogen or extract free of nitrogen fractions. Increasing substitution of oatmeal by-product up to the same maximum gave significant linear decreases in apparent digestibility of dry matter, extract free of nitrogen and gross energy, significant depressions in apparent digestibility of modified acid detergent fibre and significant increases in ether extract. Guar gum and pectin, both substituted to a maximum of 50 g kg-1 had no significant effects on apparent digestibility. The results are discussed in the context of the concentrations of dietary fibre needed to reduce the incidence of oesophagogastric parakeratosis.

A case of hypertrophic protein losing gastropathy

A 3 1/2 year old boy presented with a history of vomiting and generalized oedema. Biochemically proven protein losing enteropathy was associated with huge gastric fundal rugae on barium examination. Gastroscopy confirmed the barium findings but biopsy material demonstrated normal mucosa. The condition regressed on a high protein diet. Cytomegalovirus (CMV) was found in the urine after the illness had subsided.

Diet therapy in gastrointestinal disease: a commentary

Dietary regimens in gastrointestinal disease can be divided into two categories: First, those of proven value include: (a) Disaccharide elimination for disaccharidase deficiency and exclusion of monosaccharides for sugar malabsorption; (b) gluten-free diet for celiac/sprue; (c) elimination of certain allergens because of food allergies; (d) protein restriction for portal systemic encephalopathy; (e) low-carbohydrate diet for dumping syndrome; (f) low-fiber diet for diarrheal syndromes; and (g) low-fat diet for steatorrhea. Second, controversial diets include a bland diet for acid-peptic disorders, a high-fiber diet for colonic disorders, and a low-fat diet for gallbladder disease. It is important to separate facts from fancy in the dietary management of patients with gastrointestinal disease and base the recommendations for a particular diet on available objective evidence, not on traditional or fashionable trends.

[Significance of ruminal juice examination in the diagnosis of subclinical rumen dysfunction]

The suitability of the metabolic test of rumen liquor for the diagnosis of subclinical rumen dysfunction was tested. The test for the assessment of the metabolic profile of the rumen included: the determination of pH, total titration acidity in clinical units, lactic acid in mg%, fatty acids in mmol 1-1, ammonia N in mg%, urea N in mg% and the number of infusorians in 1 ml of rumen liquor. This test enabled, on the basis of the examination of rumen liquor, to determine not only the kind and form of the disease but also its cause, with an incomplete clinical syndrome. Therapeutic measures, either direct (in the rumen liquor) or indirect (adjusted monodiet) improved the health condition and provided optimum rumen fermentation of permanent character. The resuption of rumen fermentation also enabled an increased production of fatty acids which favourably influenced the content of butterfat in milk.