Klinika Gastroenterologii

Pomnik, Poland

Klinika Gastroenterologii

Pomnik, Poland

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Lipinski P.,Klinika Gastroenterologii | Jankowska I.,Klinika Gastroenterologii | Grenda R.,Klinika Nefrologii
Pediatria Polska | Year: 2016

Ciliopathies constitute a group of disorders characterized by cilia abnormalities and an extremely heterogeneous clinical presentation. The liver and kidneys are the most commonly affected organs and the term hepatorenal fibrocystic disorders is used to describe ciliopathies with combined liver and kidney involvement. Liver disorders in ciliopathies can be grouped into three categories: congenital hepatic fibrosis, Caroli's disease and polycystic liver disease. Kidney disorders related to primary cilia abnormalities include autosomal dominant and recessive polycystic kidney diseases and nephronophthisis. © 2016 Polish Pediatric Society.


Szczeblowska D.,Klinika Chorob Wewnetrznych | Serwin D.,Klinika Chorob Wewnetrznych | Hebzda A.,Klinika Chorob Wewnetrznych | Wojtun S.,Klinika Gastroenterologii | Grys I.,Klinika Chorob Wewnetrznych
Pediatria i Medycyna Rodzinna | Year: 2011

The non-specific enteritis include ulcerative inflammation of the large intestine and the Crohn's disease. As the peak of incidence of the diseases is between 15 and 35 years old and these concerns people in procreative period, some questions and doubts on the influence of the diseases and their treatment on fertility, the course of gestation, labour and the safety of breast feeding are born. In the paper, some rules on the treatment of nonspecific enteritis in males and females planning having offspring as well as pregnant and feeding females are showed. It should be underlined that non-specific enteritis are not contraindication to become pregnant. Gestation also does not constitute indication for the non-specific enteritis treatment interruption. It should be underlined that gestation is not indication for the non-specific enteritis treatment interruption as their exacerbation relates to higher risk for offspring than implementation of an invasive but successful treatment. The disease activation increases the risk of miscarriage, preterm labours and intrauterine death of foetus. Continuous pharmacotherapy of the enteritis with non-carcinogenic substances has great influence on the birth of a healthy child. The best time to become pregnant is the period after at least 3 months of the disease remission. At the time of gestation planning, folic acid supplementation is indicated. © Pediatr Med Rodz 2011.


Lodyga M.,Klinika Chorob Wewnetrznych i Gastroenterologii | Eder P.,Klinika Gastroenterologii | Bartnik W.,Klinika Gastroenterologii i Hepatologii | Gonciarz M.,Oddzial Gastroenterologii | And 6 more authors.
Przeglad Gastroenterologiczny | Year: 2012

This paper discusses 42 statements on the diagnosis and treatment of Crohn's disease in adults. Treatment statements report recommendations on medical treatment and surgery. The members of the Working Group of the Polish National Consultant in Gastroenterology and the Polish Society of Gastroenterology voted on the statements using a 5-grade score, where A meant total approval, B approval with any exception, C approval with serious exception, D disapproval with any exception and E total disapproval. Results of the voting are presented with a brief comment on each statement.


Nowak A.,Technical University of Lodz | Slizewska K.,Technical University of Lodz | Libudzisz Z.,Technical University of Lodz | Socha J.,Klinika Gastroenterologii
Zywnosc. Nauka. Technologia. Jakosc/Food. Science Technology. Quality | Year: 2010

Beneficial effects of probiotics on human health were discussed in this paper, and, in particular, their role in reducing risks of civilization diseases, such as: tumours, obesity, allergies. A separate chapter was devoted to the safety aspects of using (consuming) probiotic products.


Groszewski K.,Pracownia Endoskopii Gastroenterologicznej | Pastuszak M.,Pracownia Endoskopii Gastroenterologicznej | Wojtun S.,Klinika Gastroenterologii | Gil J.,Klinika Gastroenterologii
Pediatria i Medycyna Rodzinna | Year: 2012

Ectopic pancreas is a developmental anomaly which marks the presence of pancreas tissue in various localizations beyond the pancreas, without both anatomic and vascular connection to a properly situated organ. Thanks to development of vivid technology it is found more often. As far as etiopathological factors causing ectopic pancreas are concerned, they are as follows: intrafetal pancreas development disorder, multipotential cells metaplasia, and, basing on models of animals, also mutation of specific genes. The abundance of possible localizations and disparate histopathological types may result in the anomaly having diverse clinical course, ranging from mute to more intensified subjective and object symptoms. To diversify one should take malignant changes into consideration. A reliable diagnosis may be stated after the presence of pancreas tissue has been confirmed in histopathological examination. Yet, in peculiar circumstances it is possible to push a reliable diagnosis forward basing only on endoscopic and vivid examination. During diagnostics there may be a problem concerning, on the one hand, diagnosis when patients suffer from intrafetally irrelevant developmental anomaly and the doctor's job is to save them from invasive conduct. On the other hand, however, malignant changes wrongly recognized as ectopic pancreas cannot be overlooked. Treatment is undertaken only if there are clinical symptoms or tumour in ectopia has been recognized, whereas the method of treatment depends on the size and localization of the change. The prognosis is auspicious even if distant results have been observed. This work presents a case report of a patient suffering from ectopic pancreas as well as the issue of clinical meaning and difficulties in recognizing and treating this developmental defect. Copyright © Pediatr Med Rodz 2012.


Non-steroidal anti-inflammatory drugs are drugs of choice for chronic pain, which is most common in chronic conditions, rheumatism in particular. According to current recommendations, these medications should be used continuously or intermittently, and their choice should be tailored to each patient. Unfortunately, non-steroidal anti-inflammatory drugs have multiple adverse effects ranging from the most insignificant dyspepsia to severe upper gastrointestinal bleeding. Therefore, gastroscopy and, in the case of confirmed Helicobacter pylori infection, eradication is advisable for planned long-term treatment with these agents. Long-term use of proton pump inhibitors is recommended in rheumatic patients chronically receiving non-selective non-steroidal anti-inflammatory drugs, while celecoxib (a selective COX-2 inhibitor) combined with proton pump inhibitor should be administered in patients at high risk of gastrointestinal complications. In rheumatic patients, the type of non-steroidal anti-inflammatory drug and the route of its administration should be tailored to each patient in terms of strength and duration of drug action, the type of disease and comorbidities as well as contraindications. Adverse gastrointestinal effects are due to the mechanism of action of non-steroidal anti-inflammatory drugs, and therefore independent of the route of administration. The use of proton pump inhibitors with cardioprotective doses of aspirin should be limited to patients with risk factors for gastrointestinal complications. High non-steroidal anti-inflammatory drug doses are limited to gout attack, acute pain and axial spondyloarthropathy showing high clinical activity. In other cases, the lowest effective non-steroidal anti-inflammatory drug dose is recommended. Advancing age is characterised by impairment in the function of all organs, therefore elderly patients should receive lower non-steroidal anti-inflammatory drug doses. Concomitant use of two or more non-steroidal anti-inflammatory drugs in rheumatic diseases is not recommended. According to the latest recommendations, non-steroidal anti-inflammatory drugs can be combined with paracetamol and medicinal products with different mechanisms of action. © Pediatr Med Rodz 2016.


Osiecki M.,Klinika Gastroenterologii | Wozniak M.,Klinika Gastroenterologii | Kierkus J.,Klinika Gastroenterologii
Pediatria Polska | Year: 2016

Cyclosporin A is an immunosuppressive cyclic peptide. It has not only been a milestone in a transplantology, but is also a treatment's option in gastrology and hepatology. Cyclosporin A primarily affects T lymphocytes activation and proliferation through a calcineurin inhibition. Cyclosporin's A pharmacokinetic features force a dose modification based on its blood concentration and expected therapeutic level. The most frequent adverse effects are renal function impairment, hypertension, and hirsutism. CsA is metabolized mainly in the liver by cytochrome P450 enzymes, hence many drug interactions may occur. Although CsA presents variable bioavailability and poses a threat of adverse effects development, it induces remission in refractory paediatric ulcerative colitis and autoimmune hepatitis. © 2015 Polish Pediatric Society.


Socha J.,Klinika Gastroenterologii | Socha P.,Klinika Gastroenterologii | Weker H.,Instytut Matki i Dziecka w Warszawie | Neuhoff-Murawska J.,Klinika Gastroenterologii
Pediatria Wspolczesna | Year: 2010

We present the influence of nutrition on health in concern of changing knowledge during last centuries and with future perspectives. © 2010 Almamedia Press.


Inflammatory bowel diseases (IBD) affect mainly the young population and therefore fertility and pregnancy-related issues are important clinical considerations. Generally, men and women with IBD do not have decreased fertility compared to the general population. Drugs used for IBD do not affect significantly fertility in humans, except sulfasalazine, which causes a temporary reduction in spermatogenesis, but does not reduce fertility itself. The disease course during pregnancy and the risk of pregnancy-related complications depend mainly on the disease activity at the time of conception, therefore, pregnancy should be planned during a phase of remission. Except for methotrexate, mycophenolate mofetil and thalidomide, which are strongly contraindicated, drugs used for IBD appear safe in pregnancy, if they are administered carefully. The highest degree of safety was proved for 5-ASA- -containing agents, thiopurines and corticosteroids. The use of TNFα agents remains disputable, especially in the third trimester of pregnancy, due to their high concentration in the infant`s blood and the lack of data concerning its long-term safety. Surgery, if necessary, should be delayed if possible, although pregnancy is not a contraindication for surgical procedures. The management of IBD in reproductive age and pregnant women remains still controversial, because literature data comes mostly from retrospective studies. The aim of this paper was to summarize and to present proper management of patients with IBD prior to conception, as well as pregnant women and breast-feeding mothers with IBD, based on current European Crohn's and Colitis Organisation (ECCO) guidelines and available literature.


PubMed | Klinika Gastroenterologii
Type: Journal Article | Journal: Medycyna wieku rozwojowego | Year: 2013

Inflammatory bowel diseases (IBD) affect mainly the young population and therefore fertility and pregnancy-related issues are important clinical considerations. Generally, men and women with IBD do not have decreased fertility compared to the general population. Drugs used for IBD do not affect significantly fertility in humans, except sulfasalazine, which causes a temporary reduction in spermatogenesis, but does not reduce fertility itself. The disease course during pregnancy and the risk of pregnancy-related complications depend mainly on the disease activity at the time of conception, therefore, pregnancy should be planned during a phase of remission. Except for methotrexate, mycophenolate mofetil and thalidomide, which are strongly contraindicated, drugs used for IBD appear safe in pregnancy, if they are administered carefully. The highest degree of safety was proved for 5-ASA- -containing agents, thiopurines and corticosteroids. The use of TNF agents remains disputable, especially in the third trimester of pregnancy, due to their high concentration in the infant`s blood and the lack of data concerning its long-term safety. Surgery, if necessary, should be delayed if possible, although pregnancy is not a contraindication for surgical procedures. The management of IBD in reproductive age and pregnant women remains still controversial, because literature data comes mostly from retrospective studies. The aim of this paper was to summarize and to present proper management of patients with IBD prior to conception, as well as pregnant women and breast-feeding mothers with IBD, based on current European Crohns and Colitis Organisation (ECCO) guidelines and available literature.

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