Abdominal Migraine (ab-DOM-uh-nul MY-grayn) See Cyclic Vomiting Syndrome.

Absorption (ub-SORP-shun) The way nutrients from food move from the small intestine into the cells in the body.

Accessory Digestive Organs (ak-SES-uh-ree dy-JES-tiv or-gunz) Organs that help with digestion but are not part of the digestive tract. These organs are the tongue, glands in the mouth that make saliva, pancreas, liver, and gallbladder.

Achalasia (AK-uh- LAYZ-ya) A rare disorder of the esophagus. The muscle at the end of the esophagus does not relax enough for the passage to open properly.

Achlorhydria (AY-klor-HY-dree-uh) A lack of hydrochloric acid in stomach juice.

Activated Charcoal (AK-tuh-vay-ted CHAR-kohl) An over-the-counter product that may help relieve intestinal gas.

Acute (uh-KYOOT) A disorder that is sudden and severe but lasts only a short time.

Aerophagia (AIR-oh-FAY-jee-uh) A condition that occurs when a person swallows too much air. Causes gas and frequent belching.

Alactasia (ay-lak-TAYZ-ya) An inherited condition causing the lack of the enzyme needed to digest milk sugar.

Alagille Syndrome (al-uh-GEEL sin-drohm) A condition of babies in their first year. The bile ducts in the liver disappear, and the bile ducts outside the liver get very narrow. May lead to a buildup of bile in the liver and damage to liver cells and other organs.

Alimentary Canal (al-uh-MEN-tree kuh-NAL) See Gastrointestinal (GI) Tract.

Allergy (AL-ur-jee) A condition in which the body is not able to tolerate certain foods, animals, plants, or other substances.

Amebiasis (uh-mee-BY-uh-sis) An acute or chronic infection. Symptoms vary from mild diarrhea to frequent watery diarrhea and loss of water and fluids in the body. See also Gastroenteritis.

Amino Acids (uh-MEE-noh ASS-udz) The basic building blocks of proteins. The body makes many amino acids. Others come from food and the body breaks them down for use by cells. See also Protein.

Anal Fissure (AY-nul FISH-er) A small tear in the anus that may cause itching, pain, or bleeding.

Anal Fistula (AY-nul FIST-yoo-luh) A channel that develops between the anus and the skin. Most fistulas are the result of an abscess (infection) that spreads to the skin.

Anastomosis (AN-nuh-stuh-MOH-sis) An operation to connect two body parts. An example is an operation in which a part of the colon is removed and the two remaining ends are rejoined.

Anemia (uh-NEE-mee-uh) Not enough red blood, red blood cells, or hemoglobin (HEE-muh-gloh-bin) in the body. Hemoglobin is a protein in the blood that contains iron.

Angiodysplasia (AN-jee-oh-dis-PLAYZ-ya) Abnormal or enlarged blood vessels in the gastrointestinal tract.

Angiography (AN-jee-AW-gruh-fee) An x-ray that uses dye to detect bleeding in the gastrointestinal tract.

Anorectal Atresia (AY-noh-REK-tul uh-TREEZ-ya) Lack of a normal opening between the rectum and anus.

Anoscopy (ay-Naw-skuh-pee) A test to look for fissures, fistulae, and hemorrhoids. The doctor uses a special instrument, called an anoscope, to look into the anus.

Antacids (ant-ASS-idz) Medicines that balance acids and gas in the stomach. Examples are Maalox, Mylanta, and Di-Gel.

Anticholinergics (an-tee-koh-lih-NURJ-iks) Medicines that calm muscle spasms in the intestine. Examples are dicyclomine (dy-SY-kloh-meen) (Bentyl) and hyoscyamine (HY-oh-SY-uh-meen) (Levsin).

Antidiarrheals (AN-tee-dy-uh-REE-ulz) Medicines that help control diarrhea. An example is loperamide (lo-PEH-ruh-myd) (Imodium).

Antiemetics (an-tee-ee-MET-iks) Medicines that prevent and control nausea and vomiting. Examples are promethazine (pro-MEH-thuh-zeen) (Phenergan) and prochlorperazine (pro-klor-PEH-ruh-zeen) (Compazine).

Antispasmodics (an-tee-spaz-MAW-diks) Medicines that help reduce or stop muscle spasms in the intestines. Examples are dicyclomine (dy-SY-klo-meen) (Bentyl) and atropine (AH-tro-peen) (Donnatal).

Antrectomy (an-TREK-tuh-mee) An operation to remove the upper portion of the stomach, called the antrum. This operation helps reduce the amount of stomach acid. It is used when a person has complications from ulcers.

Anus (AY-nus) The opening at the end of the digestive tract where bowel contents leave the body. Appendectomy (AP-en-DEK-tuh-mee) An operation to remove the appendix.

Appendicitis (uh-PEN-duh-SY-tis) Reddening, irritation (inflammation), and pain in the appendix caused by infection, scarring, or blockage.

Appendix (uh-PEN-diks) A 4-inch pouch attached to the first part of the large intestine (cecum). No one knows what function the appendix has, if any.

Ascending Colon (uh-SEND-ing KOH-lun) The part of the colon on the right side of the abdomen.

Ascites (uh-SY-teez) A buildup of fluid in the abdomen. Ascites is usually caused by severe liver disease such as cirrhosis.

Asymptomatic (ay-sim-toh-MAT-ik) The condition of having a disease, but without any symptoms of it.

Atonic Colon (ay-TAW-nik KOH-lun) Lack of normal muscle tone or strength in the colon. This is caused by the overuse of laxatives or by Hirschsprung's disease. It may result in chronic constipation. Also called lazy colon. See Hirschsprung's Disease.

Atresia (uh-TREEZ-ya) Lack of a normal opening from the esophagus, intestines, or anus.

Atrophic Gastritis (ay-TROH-fik gah-STRY-tis) Chronic irritation of the stomach lining. Causes the stomach lining and glands to wither away.

Autoimmune Hepatitis (AW-toh-im-YOON heh-puh-TY-tis) A liver disease caused when the body's immune system destroys liver cells for no known reason.

B

Barium (BAIR-ee-um) A chalky liquid used to coat the inside of organs so that they will show up on an x-ray.

Barium Enema X-Ray (BAIR-ee-um EN-uh-muh EKS-ray) See Lower GI Series.

Barium Meal See Upper GI Series.

Barrett's Esophagus (BAH-ruts eh-SAW-fuh-gus) Peptic ulcer of the lower esophagus. It is caused by the presence of cells that normally stay in the stomach lining.

Belching (BELL-ching) Noisy release of gas from the stomach through the mouth. Also called burping.

Bernstein Test (BURN-styn test) A test to find out if heartburn is caused by acid in the esophagus. The test involves dripping a mild acid, similar to stomach acid, through a tube placed in the esophagus.

Bezoar (BEE-zor) A ball of food, mucus, vegetable fiber, hair, or other material that cannot be digested in the stomach. Bezoars can cause blockage, ulcers, and bleeding.

Bile (BY-ul) Fluid made by the liver and stored in the gallbladder. Bile helps break down fats and gets rid of wastes in the body.

Bile Acids (BY-ul ASS-idz) Acids made by the liver that work with bile to break down fats.

Bile Ducts (BY-ul dukts) Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion.

Biliary Atresia (BILL-ee-air-ee uh-TREEZ-ya) A condition present from birth in which the bile ducts inside or outside the liver do not have normal openings. Bile becomes trapped in the liver, causing jaundice and cirrhosis. Without surgery the condition may cause death.

Biliary Dyskinesia (BILL-ee-air-ee dis-kuh-NEEZ-ya) See postcholecystectomy syndrome.

Biliary Stricture (BILL-ee-air-ee STRIK-sher) A narrowing of the biliary tract from scar tissue. The scar tissue may result from injury, disease, pancreatitis, infection, or gallstones. See also Stricture.

Biliary System See Biliary Tract.

Biliary Tract The gallbladder and the bile ducts. Also called biliary system or biliary tree.

Biliary Tree See Biliary Tract.

Bilirubin (BILL-ee-ROO-bin) The substance formed when hemoglobin breaks down. Bilirubin gives bile its color. Bilirubin is normally passed in stool. Too much bilirubin causes jaundice.

Bismuth Subsalicylate (BIZ-muth SUB-sal-ih-SIL-ayt) A nonprescription medicine such as Pepto-Bismol. Used to treat diarrhea, heartburn, indigestion, and nausea. It is also part of the treatment for ulcers caused by the bacterium Helicobacter pylori

(HELL-uh-koh-BAK-tur py-LOH-ree). Bloating (BLO-ting) Fullness or swelling in the abdomen that often occurs after meals.

Borborygmi (BOR-boh-RIG-mee) Rumbling sounds caused by gas moving through the intestines (stomach "growling").

Bowel (BAH-wul) Another word for the small and large intestines.

Bowel Movement (BAH-wul MOOV-munt) Body wastes passed through the rectum and anus.

Bowel Prep The process used to clean the colon with enemas and a special drink. Used before surgery of the colon, colonoscopy, or barium x-ray. See also Lavage.

Budd-Chiari Syndrome (BUD kee-AH-ree sin-drohm) A rare liver disease in which the veins that drain blood from the liver are blocked or narrowed.

Bulking Agents (BUL-king AY-jents) Laxatives that make bowel movements soft and easy to pass. Burping See Belching.

C

Calculi (KAL-kyoo-ly) Stones or solid lumps such as gallstones.

Campylobacter pylori (KAM-pee-loh-BAK-tur py-LOH-ree) The original name for the bacterium that causes ulcers. The new name is Helicobacter pylori. See also Helicobacter pylori.

Candidiasis (KAN-di-DY-uh-sis) A mild infection caused by the Candida

(KAN-di-duh) fungus, which lives naturally in the gastrointestinal tract. Infection occurs when a change in the body, such as surgery, causes the fungus to overgrow suddenly.

Carbohydrates (kar-boh-HY-drayts) One of the three main classes of food and a source of energy. Carbohydrates are the sugars and starches found in breads, cereals, fruits, and vegetables. During digestion, carbohydrates are changed into a simple sugar called glucose. Glucose is stored in the liver until cells need it for energy. Caroli's Disease (kuh-ROH-leez duh-zeez) An inherited condition. Bile ducts in the liver are enlarged and may cause irritation, infection, or gallstones.

Cathartics (kuh-THAR-tiks) See Laxatives.

Catheter (KATH-uh-tur) A thin, flexible tube that carries fluids into or out of the body.

Cecostomy (see-KAW-stuh-mee) A tube that goes through the skin into the beginning of the large intestine to remove gas or feces. This is a short-term way to protect part of the colon while it heals after surgery.

Cecum (SEEK-um) The beginning of the large intestine. The cecum is connected to the lower part of the small intestine, called the ileum.

Celiac Disease (SEL-ee-ak duh-zeez) Inability to digest and absorb gliadin, the protein found in wheat. Undigested gliadin causes damage to the lining of the small intestine. This prevents absorption of nutrients from other foods. Celiac disease is also called celiac sprue, gluten intolerance, and nontropical sprue.

Celiac Sprue (SEL-ee-ak sproo) See Celiac Disease.

Chlorhydria (klor-HY-dree-uh) Too much hydrochloric acid in the stomach. Cholangiography (koh-LAN-jee-AW-gruh-fee) A series of x-rays of the bile ducts.

Cholangitis (KOH-lan-JY-tis) Irritated or infected bile ducts.

Cholecystectomy (KOH-lee-sis-TEK-tuh-mee) An operation to remove the gallbladder.

Cholecystitis (KOH-lee-sis-TY-tis) An irritated gallbladder.

Cholecystogram, Oral (KOH-lee-SIS-tuh-gram, OH-rul) An x-ray of the gallbladder and bile ducts. The patient takes pills containing a special dye to make the organs show up in the x-ray. Also called oral cholecystography.

Cholecystography, Oral (KOH-lee-sis-TAW-gruh-fee) See Cholecystogram, Oral.

Cholecystokinin (KOH-lee-sis-tuh-KY-nin) A hormone released in the small intestine. Causes muscles in the gallbladder and the colon to tighten and relax.

Choledocholithiasis (KOH-lee-doh-koh-luh-THY-uh-sis) Gallstones in the bile ducts.

Cholelithiasis (KOH-lee-luh-THY-uh-sis) Gallstones in the gallbladder.

Cholestasis (KOH-lee-STAY-sis) Blocked bile ducts. Often caused by gallstones.

Cholesterol (koh-LES-tuh-rawl) A fat-like substance in the body. The body makes and needs some cholesterol, which also comes from foods such as butter and egg yolks. Too much cholesterol may cause gallstones. It also may cause fat to build up in the arteries. This may cause a disease that slows or stops blood flow.

Chronic (KRAW-nik) A term that refers to disorders that last a long time, often years.

Chyme (kym) A thick liquid made of partially digested food and stomach juices. This liquid is made in the stomach and moves into the small intestine for further digestion.

Cirrhosis (suh-ROH-sis) A chronic liver condition caused by scar tissue and cell damage. Cirrhosis makes it hard for the liver to remove poisons (toxins) like alcohol and drugs from the blood. These toxins build up in the blood and may affect brain function.

Clostridium difficile (C. difficile) (klaws-TRID-ee-um deef-ee-seel) Bacteria naturally present in the large intestine. These bacteria make a substance that can cause a serious infection called pseudomembranous colitis in people taking antibiotics.

Colectomy (koh-LEK-tuh-mee) An operation to remove all or part of the colon.

Colic (KAWL-ik) Attacks of abdominal pain, caused by muscle spasms in the intestines. Colic is common in infants.

Colitis (koh-LY-tis) Irritation of the colon.

Collagenous Colitis (koh-LAH-juh-nus koh-LY-tis) A type of colitis. Caused by an abnormal band of collagen, a thread-like protein.

Colon (KOH-lun) See Large Intestine. Colonic Inertia (koh-LAWN-ik ih-NUR-sha) A condition of the colon. Colon muscles do not work properly, causing constipation.

Colonoscopy (koh-luh-NAW-skuh-pee) A test to look into the rectum and colon. The doctor uses a long, flexible, narrow tube with a light and tiny lens on the end. This tube is called a colonoscope.

Colonoscopic Polypectomy (KOH-luh-nuh-SKAW-pik pawl-up-EK-tuh-mee) The removal of tumor-like growths (polyps) using a device inserted through a colonoscope.

Colon Polyps (KOH-lun PAWL-ups) Small, fleshy, mushroom-shaped growths in the colon.

Coloproctectomy (koh-loh-prahk-TEK-tuh-mee) See Proctocolectomy.

Colorectal Cancer (koh-loh-REK-tul-CAN-sir) Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome.

Colorectal Transit Study (koh-loh-REK-tul TRAN-zit STUH-dee) A test to see how food moves through the colon. The patient swallows capsules that contain small markers. An x-ray tracks the movement of the capsules through the colon.

Colostomy (koh-LAW-stuh-mee) An operation that makes it possible for stool to leave the body after the rectum has been removed. The surgeon makes an opening in the abdomen and attaches the colon to it. A temporary colostomy may be done to let the rectum heal from injury or other surgery.

Common Bile Duct (KAH-mun BY-ul dukt) The tube that carries bile from the liver to the small intestine.

Common Bile Duct Obstruction (KAH-mun BY-ul dukt ub-STRUK-shun) A blockage of the common bile duct, often caused by gallstones.

Computed Tomography (CT) Scan (kom-PYOO-ted tuh-MAW-gruh-fee) An x-ray that produces three-dimensional pictures of the body. Also known as computed axial tomography (CAT) scan.

Constipation(kon-stuh-PAY-shun) A condition in which the stool becomes hard and dry. A person who is constipated usually has fewer than three bowel movements in a week. Bowel movements may be painful. Common causes of constipation Not enough fiber in diet. Not enough liquids. Lack of exercise. Changes in life or routine such as pregnancy, older age, and travel. Ignoring the urge to have a bowel movement. Problems with the colon and rectum. Problems with intestinal function. Irritable bowl syndrome. Medications.

Continence (KON-tuh-nuns) The ability to hold in a bowel movement or urine.

Continent Ileostomy (KON-tuh-nunt il-ee-AW-stuh-mee) An operation to create a pouch from part of the small intestine. Stool that collects in the pouch is removed by inserting a small tube through an opening made in the abdomen. See also Ileostomy.

Corticosteroids (KOR-tuh-koh-STEER-oydz) Medicines such as cortisone and hydrocortisone. These medicines reduce irritation from Crohn's disease and ulcerative colitis. They may be taken either by mouth or as suppositories.

Crohn's Disease (krohnz duh-zeez) A chronic form of inflammatory bowel disease. Crohn's disease causes severe irritation in the gastrointestinal tract. It usually affects the lower small intestine (called the ileum) or the colon, but it can affect the entire gastrointestinal tract. Also called regional enteritis and ileitis. See also Inflammatory Bowel Disease (IBD) and Granuloma.

Cryptosporidia (KRIP-toh-spoh-RID-ee-uh) A parasite that can cause gastrointestinal infection and diarrhea. See also Gastroenteritis.

Cyclic Vomiting Syndrome (CVS) (SIK-lik VOM-uh-ting sin-drohm) Sudden, repeated attacks of severe vomiting (especially in children), nausea, and physical exhaustion with no apparent cause. Can last from a few hours to 10 days. The episodes begin and end suddenly. Loss of fluids in the body and changes in chemicals in the body can require immediate medical attention. Also called abdominal migraine.

Cystic Duct(SIS-tik dukt) The tube that carries bile from the gallbladder into the common bile duct and the small intestine.

Cystic Duct Obstruction (ub-STRUK-shun) A blockage of the cystic duct, often caused by gallstones.

D

Defecation (def-uh-KAY-shun) The passage of bowel contents through the rectum and anus.

Defecography (def-uh-CAW-gruh-fee) An x-ray of the anus and rectum to see how the muscles work to move stool. The patient sits on a toilet placed inside the x-ray machine.

Dehydration (dee-hy-DRAY-shun) Loss of fluids from the body, often caused by diarrhea. May result in loss of important salts and minerals.

Delayed Gastric Emptying (dee-LAYD GA-strik EM-tee-ing) See Gastroparesis.

Dermatitis Herpetiformis (dur-muh-TY-tis hur-PEH-tee-for-mis) A skin disorder associated with celiac disease. See also Celiac Disease.

Descending Colon (dee-SEND-ing KOH-lun) The part of the colon where stool is stored. Located on the left side of the abdomen.

Diaphragm (DY-uh-fram) The muscle wall between the chest and the abdomen. It is the major muscle that the body uses for breathing.

Diarrhea (DY-uh-REE-uh) Frequent, loose, and watery bowel movements. Common causes include gastrointestinal infections, irritable bowel syndrome, medicines, and malabsorption.

Dietitian (DY-uh-TISH-un) An expert in nutrition who helps people plan what and how much food to eat.

Digestants (dy-JES-tants) Medicines that aid or stimulate digestion. An example is a digestive enzyme such as Lactaid for people with lactase deficiency.

Digestion (dy-JES-tchun) The process the body uses to break down food into simple substances for energy, growth, and cell repair.

Digestive System (dy-JES-tuv sis-tum) The organs in the body that break down and absorb food. Organs that make up the digestive system are the mouth, esophagus, stomach, small intestine, large intestine, rectum, and anus. Organs that help with digestion but are not part of the digestive tract are the tongue, glands in the mouth that make saliva, pancreas, liver, and gallbladder.

Digestive Tract (dy-JES-tuv trakt) See Gastrointestinal (GI) Tract.

Distention (dis-TEN-shun) Bloating or swelling of the abdomen.

Diverticula (dy-vur-TIK-yoo-lah) Plural form of diverticulum. See Diverticulum.

Diverticulitis (dy-vur-tik-yoo-LY-tis) A condition that occurs when small pouches in the colon (diverticula) become infected or irritated. Also called left-sided appendicitis.

Diverticulosis (dy-vur-tik-yoo-LOH-sis) A condition that occurs when small pouches (diverticula) push outward through weak spots in the colon.

Diverticulum (dy-vur-TIK-yoo-lum) A small pouch in the colon. These pouches are not painful or harmful unless they become infected or irritated.

Dry Mouth See Xerostomia.

Dubin-Johnson Syndrome (DOO-bun JAWN-sun sin-drohm) An inherited form of chronic jaundice (yellow tint to the skin and eyes) that has no known cause.

Dumping Syndrome (DUM-peeng sin-drohm) A condition that occurs when food moves too fast from the stomach into the small intestine. Symptoms are nausea, pain, weakness, and sweating. This syndrome most often affects people who have had stomach operations. Also called rapid gastric emptying.

Duodenal Ulcer (doo-AW-duh-nul UL-sur) An ulcer in the lining of the first part of the small intestine (duodenum).

Duodenitis (doo-AW-duh-NY-tis) An irritation of the first part of the small intestine (duodenum).

Duodenum (doo-AW-duh-num) The first part of the small intestine.

Dysentery (DIS-un-tair-ee) An infectious disease of the colon. Symptoms include bloody, mucus-filled diarrhea; abdominal pain; fever; and loss of fluids from the body.

Dyspepsia (dis-PEP-see-uh) See Indigestion.

Dysphagia (dis-FAY-jee-uh) Problems in swallowing food or liquid, usually caused by blockage or injury to the esophagus.

E

Eagle-Barrett Syndrome (EE-gul BAH-rut sin-drohm) See Prune Belly Syndrome.

Electrocoagulation (ee-LEK-troh-koh-ag-yoo-LAY-shun) A procedure that uses an electrical current passed through an endoscope to stop bleeding in the digestive tract and to remove affected tissue.

Electrolytes (ee-LEK-troh-lyts) Chemicals such as salts and minerals needed for various functions in the body.

Encopresis (en-koh-PREE-sis) Accidental passage of a bowel movement. A common disorder in children.

Endoscope (EN-doh-skohp) A small, flexible tube with a light and a lens on the end. It is used to look into the esophagus, stomach, duodenum, colon, or rectum. It can also be used to take tissue from the body for testing or to take color photographs of the inside of the body. Colonoscopes and sigmoidoscopes are types of endoscopes.

Endoscopic Papillotomy (en-doh-SKAW-pik pah-pih-LAW-tuh-mee) See Endoscopic Sphincterotomy.

Endoscopic Retrograde Cholangiopancreatography (ERCP) (en-doh-SKAW-pik REH-troh-grayd koh-LAN-jee-oh-PANG-kree-uh-TAW-gruh-fee) A test using an x-ray to look into the bile and pancreatic ducts. The doctor inserts an endoscope through the mouth into the duodenum and bile ducts. Dye is sent through the tube into the ducts. The dye makes the ducts show up on an x-ray.

Endoscopic Sphincterotomy (en-doh-SKAW-pik sfeenk-tuh-RAW-tuh-mee) An operation to cut the muscle between the common bile duct and the pancreatic duct. The operation uses a catheter and a wire to remove gallstones or other blockages. Also called endoscopic papillotomy.

Endoscopy (en-DAW-skuh-pee) A procedure that uses an endoscope to diagnose or treat a condition.

Enema (EN-uh-muh) A liquid put into the rectum to clear out the bowel or to administer drugs or food.

Enteral Nutrition (EN-tuh-rul noo-TRISH-un) A way to provide food through a tube placed in the nose, the stomach, or the small intestine. A tube in the nose is called a nasogastric or nasoenteral tube. A tube that goes through the skin into the stomach is called a gastrostomy or percutaneous endoscopic gastrostomy (PEG). A tube into the small intestine is called a jejunostomy or percutaneous endoscopic jejunostomy (PEJ) tube. Also called tube feeding. See also Gastrostomy and Jejunostomy.

Enteritis (en-tuh-RY-tis) An irritation of the small intestine.

Enterocele (EN-tuh-roh-seel) A hernia in the intestine. See also Hernia.

Enteroscopy (en-tuh-RAW-skuh-pee) An examination of the small intestine with an endoscope. The endoscope is inserted through the mouth and stomach into the small intestine.

Enterostomal Therapy (ET) Nurse (en-tuh-roh-STOH-mul THEH-ruh-pee nerss) A nurse who cares for patients with an ostomy. See also Ostomy.

Enterostomy (en-tuh-RAW-stuh-mee) An ostomy, or opening, into the intestine through the abdominal wall.

Enzyme-Linked Immunosorbent Assay (ELISA) (EN-zym linkt IM-yoo-noh SOR-bent ASS-ay) A blood test used to find Helicobacter pylori bacteria. Also used to diagnose an ulcer.

Eosinophilic Gastroenteritis (ee-oh-sin-oh-FIL-ik gah-stroh-en-tuh-RY-tis) Infection and swelling of the lining of the stomach, small intestine, or large intestine. The infection is caused by white blood cells (eosinophils).

Epithelial Cells (eh-puh-THEE-lee-ul selz) One of many kinds of cells that form the epithelium and absorb nutrients. See also Epithelium.

Epithelium (eh-puh-THEE-lee-um) The inner and outer tissue covering digestive tract organs.

ERCP See Endoscopic Retrograde Cholangiopancreatography (ERCP).

Eructation (ee-ruk-TAY-shun) Belching.

Erythema Nodosum (EH-rih-THEE-muh noh-DOH-sum) Red swellings or sores on the lower legs during flareups of Crohn's disease and ulcerative colitis. These sores show that the disease is active. They usually go away when the disease is treated.

Escherichia coli (eh-shuh-RIK-ee-uh KOH-ly) Bacteria that cause infection and irritation of the large intestine. The bacteria are spread by unclean water, dirty cooking utensils, or undercooked meat. See also Gastroenteritis.

Esophageal Atresia (eh-saw-fuh-JEE-uhl uh-TREEZ-ya) A birth defect. The esophagus lacks the opening to allow food to pass into the stomach.

Esophageal Manometry (eh-saw-fuh-JEE-ul mah-NAW-muh-tree) A test to measure muscle tone inthe esophagus.

Esophageal Ph Monitoring (eh-saw-fuh-JEE-ul pee-aytch mah-nih-tuh-reeng) A test to measure the amount of acid in the esophagus.

Esophageal Reflux (eh-saw-fuh-JEE-ul REE-fluks) See Gastroesophageal Reflux Disease.

Esophageal Spasms (eh-saw-fuh-JEE-ul SPAH-zumz) Muscle cramps in the esophagus that cause pain in the chest.

Esophageal Stricture (eh-saw-fuh-JEE-ul STRIK-sher) A narrowing of the esophagus often caused by acid flowing back from the stomach. This condition may require surgery.

Esophageal Ulcer (eh-saw-fuh-JEE-ul UL-sur) A sore in the esophagus. Caused by long-term inflammation or damage from the residue of pills. The ulcer may cause chest pain.

Esophageal Varices (eh-saw-fuh-JEE-ul VAIR-uh-seez) Stretched veins in the esophagus that occur when the liver is not working properly. If the veins burst, the bleeding can cause death.

Esophagitis (eh-saw-fuh-JY-tis) An irritation of the esophagus, usually caused by acid that flows up from the stomach.

Esophagogastroduodenoscopy (EGD) (eh-SAW-fuh-goh-GAH-stroh-doo-AW-duh-NAW-skuh-pee) Exam of the upper digestive tract using an endoscope. See Endoscopy.

Esophagus (eh-SAW-fuh-gus) The organ that connects the mouth to the stomach. Also called gullet.

Excrete (ek-SKREET) To get rid of waste from the body.

Extrahepatic Biliary Tree (ek-strah-heh-PAH-tik BILL-ee-air-ee tree) The bile ducts located outside the liver.

F

Failure to Thrive (FAYL-yoor too THRYV) A condition that occurs when a baby does not grow normally.

Familial Polyposis (fuh-MIL-ee-ul pah-luh-POH-sis) An inherited disease causing many polyps in the colon. The polyps often cause cancer.

Fats One of the three main classes of food and a source of energy in the body. Bile dissolves fats, and enzymes break them down. This process moves fats into cells.

Fatty Liver (FAH-tee LIH-vur) The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis.

Fecal Fat Test (FEE-kul fat test) A test to measure the body's ability to break down and absorb fat. The patient eats a fat-free diet for 2 to 3 days before the test and collects stool samples for examination.

Fecal Incontinence (FEE-kul in-KAN-tuh-nuns) Being unable to hold stool in the colon and rectum.

Fecal Occult Blood Test (FOBT) (FEE-kul uh-KULT blud test) A test to see whether there is blood in the stool that is not visible to the naked eye. A sample of stool is placed on a chemical strip that will change color if blood is present. Hidden blood in the stool is a common symptom of colorectal cancer.

Feces (FEE-seez) Stool.

Fermentation (FER-mun-TAY-shun) The process of bacteria breaking down undigested food and releasing alcohols, acids, and gases.

Fiber (FY-bur) A substance in foods that comes from plants. Fiber helps with digestion by keeping stool soft so that it moves smoothly through the colon. Soluble (SAWL-yoo-buhl) fiber dissolves in water. Soluble fiber is found in beans, fruit, and oat products. Insoluble (IN-sawl-yoo-buhl) fiber does not dissolve in water. Insoluble fiber is found in whole-grain products and vegetables.

Fistula (FIST-yoo-luh) An abnormal passage between two organs or between an organ and the outside of the body. Caused when damaged tissues come into contact with each other and join together while healing.

Flatulence (FLAT-yoo-lunss) Excessive gas in the stomach or intestine. May cause bloating.

Flatus (FLAH-tus) Gas passed through the rectum.

Foodborne Illness (FOOD-born IL-nus) An acute gastrointestinal infection caused by food that contains harmful bacteria. Symptoms include diarrhea, abdominal pain, fever, and chills. Also called food poisoning.

Fulminant Hepatic Failure (FHF) (FOOL-muh-nunt heh-PAT-ik FAYL-yoor) Liver failure that occurs suddenly in a previously healthy person. The most common causes of FHF are acute hepatitis, acetaminophen overdose, and liver damage from prescription drugs.

Functional Disorders (FUNK-shun-ul dis-or-durz) Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders.

Fungus (FUN-gus) A mold or yeast such as Candidiasis that may cause infection.

G

Galactose(guh-LAK-tos) A type of sugar in milk products and sugar beets. The body also makes galactose.

Galactosemia (guh-LAK-toh-SEE-mee-uh) Buildup of galactose in the blood. Caused by lack of one of the enzymes needed to break down galactose into glucose.

Gallbladder (GAWL-blah-dur) The organ that stores the bile made in the liver. Connected to the liver by bile ducts. The gallbladder can store about 1 cup of bile. Eating signals the gallbladder to empty the bile through the bile ducts to help digest fats.

Gallstones (GAWL-stonz) The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts.

Gardner's Syndrome (GARD-nurz sin-drohm) A condition in which many polyps form throughout the digestive tract. Because these polyps are likely to cause cancer, the colon and rectum are often removed to prevent colorectal cancer.

Gas (gas) Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp).

Gastrectomy (gah-STREK-tuh-mee) An operation to remove all or part of the stomach.

Gastric (GAH-strik) Related to the stomach.

Gastric Juices (GAH-strik JOO-suz) Liquids produced in the stomach to help break down food and kill bacteria.

Gastric Resection (GAH-strik ree-SEK-shun) An operation to remove part or all of the stomach.

Gastric Ulcer (GAH-strik UL-sur) See Stomach Ulcer.

Gastrin (GAH-strin) A hormone released after eating. Gastrin causes the stomach to produce more acid.

Gastritis (gah-STRY-tis) An inflammation of the stomach lining.

Gastrocolic Reflex (GAH-stroh-KAW-lick REE-fleks) Increase of muscle movement in the gastrointestinal tract when food enters an empty stomach. May cause the urge to have a bowel movement right after eating. Gastroenteritis (GAH-stroh-en-tuh-RY-tis) An infection or irritation of the stomach and intestines. May be caused by bacteria or parasites from spoiled food or unclean water. Other causes include eating food that irritates the stomach lining and emotional upsets such as anger, fear, or stress. Symptoms include diarrhea, nausea, vomiting, and abdominal cramping. See also Infectious Diarrhea and Travelers' Diarrhea. Causes of gastroenteritis Bacteria Escherichia coli. Salmonella. Shigella. Viruses Norwalk virus. Rotavirus. Parasites Cryptosporidia. Entamoeba histolytica. Giardia lamblia.

Gastroenterologist (GAH-stroh-en-tuh-RAW-luh-jist) A doctor who specializes in digestive diseases.

Gastroenterology (GAH-stroh-en-tuh-RAW-luh-jee) The field of medicine concerned with the function and disorders of the digestive system.

Gastroesophageal Reflux Disease (GERD) (GAH-stroh-eh-SAW-fuh-JEE-ul REE-fluks duh-zeez) Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis.

Gastrointestinal (GI) (GAH-stroh-in-TES-tuh-nul) Related to the gastrointestinal tract.

Gastrointestinal (GI) Tract (GAH-stroh-in-TES-tuh-nul trakt) The large, muscular tube that extends from the mouth to the anus, where the movement of muscles and release of hormones and enzymes digest food. Also called the alimentary canal or digestive tract.

Gastroparesis (GAH-stroh-puh-REE-sis) Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying.

Gastrostomy (gah-STRAW-stuh-mee) An artificial opening from the stomach to a hole (stoma) in the abdomen where a feeding tube is inserted. See also Enteral Nutrition.

GERD See Gastroesophageal Reflux Disease.

GI See Gastrointestinal.

Giant Hypertrophic Gastritis (JY-unt hy-pur-TROH-fik gah-STRY-tis) See Ménétrier's Disease.

Giardiasis (jee-ar-DY-uh-sus) An infection with the parasite Giardia lamblia from spoiled food or unclean water. May cause diarrhea. See also Gastroenteritis.

Gilbert Syndrome (GIL-burt sin-drohm) A buildup of bilirubin in the blood. Caused by lack of a liver enzyme needed to break down bilirubin. See also Bilirubin.

Globus Sensation (GLOH-bus sen-SAY-shun) A constant feeling of a lump in the throat. Usually related to stress.

Glucose (GLOO-kohss) A simple sugar the body manufactures from carbohydrates in the diet. Glucose is the body's main source of energy. See also Carbohydrates.

Gluten (GLOO-ten) A protein found in wheat, rye, barley, and oats. In people who can't digest it, gluten damages the lining of the small intestine or causes sores on the skin.

Gluten Intolerance (GLOO-ten in-TAH-luh-runs) See Celiac Disease.

Gluten Sensitive Enteropathy (GLOO-ten SEN-suh-tiv en-tuh-RAW-puh-thee) A general term that refers to celiac disease and dermatitis herpetiformis.

Glycogen (GLY-koh-jen) A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body.

Glycogen Storage Diseases (GLY-koh-jen STOR-ij duh-ZEEZ-uz) A group of birth defects. These diseases change the way the liver breaks down glycogen. See also Glycogen.

Granuloma (gran-yoo-LOH-ma) A mass of red, irritated tissue in the GI tract found in Crohn's disease.

Granulomatous Colitis (gran-yoo-LOH-muh-tus koh-LY-tis) Another name for Crohn's disease of the colon.

Granulomatous Enteritis (gran-yoo-LOH-muh-tus en-tuh-RY-tis) Another name for Crohn's disease of the small intestine.

Gullet (GUH-let) See Esophagus.

Gut (gut) See Intestines.

H

H2-Blockers (aytch-too BLAH-kurz) Medicines that reduce the amount of acid the stomach produces. They block histamine2 (HIH-stuh-min-too). Histamine signals the stomach to make acid. Prescription H2-blockers are cimetidine (suh-MEH-tuh-deen) (Tagamet), famotidine (fuh-MAH-tuh-deen) (Pepcid), nizatidine (nih-ZAH-tuh-deen) (Axid), and ranitidine (ruh-NIH-tuh-deen) (Zantac). They are used to treat ulcer symptoms. Nonprescription H2-blockers are Zantac 75, Axid AR, Pepcid-AC, and Tagamet-HB. They are for GERD, heartburn, and acid indigestion.

Heartburn (HART-burn) A painful, burning feeling in the chest. Heartburn is caused by stomach acid flowing back into the esophagus. Changing the diet and other habits can help to prevent heartburn. Heartburn may be a symptom of GERD. See also Gastroesophageal Reflux Disease (GERD). Tips to control heartburn Avoid foods and beverages that affect lower esophageal sphincter pressure or irritate the esophagus lining. Lose weight if overweight. Stop smoking. Elevate the head of the bed 6 inches. Avoid lying down 2 to 3 hours after eating. Take an antacid.

Helicobacter pylori (H. pylori) (HELL-uh-koh-BAK-tur py-LOH-ree) A spiral-shaped bacterium found in the stomach. H. pylori damages stomach and duodenal tissue, causing ulcers. Previously called Campylobacter pylori.

Hemochromatosis (HEE-moh-kroh-muh-toh-sis) A disease that occurs when the body absorbs too much iron. The body stores the excess iron in the liver, pancreas, and other organs. May cause cirrhosis of the liver. Also called iron overload disease.

Hemorrhoidectomy (HEM-roy-DEK-tuh-mee) An operation to remove hemorrhoids.

Hemorrhoids (HEM-roydz) Swollen blood vessels in and around the anus and lower rectum. Continual straining to have a bowel movement causes them to stretch and swell. They cause itching, pain, and sometimes bleeding.

Hepatic (heh-PAT-ik) Related to the liver.

Hepatic Coma (heh-PAT-ik KOH-muh) See Hepatic Encephalopathy.

Hepatic Encephalopathy (heh-PAT-ik en-SEF-uh-LAWP-uh-thee) A condition that may cause loss of consciousness and coma. It is usually the result of advanced liver disease. Also called hepatic coma.

Hepatitis (heh-puh-TY-tis) Irritation of the liver that sometimes causes permanent damage. Hepatitis may be caused by viruses or by medicines or alcohol. Hepatitis has the following forms:

Hepatitis A A virus most often spread by unclean food and water.

Hepatitis B A virus commonly spread by sexual intercourse or blood transfusion, or from mother to newborn at birth. Another way it spreads is by using a needle that was used by an infected person. Hepatitis B is more common and much more easily spread than the AIDS virus and may lead to cirrhosis and liver cancer.

Hepatitis C A virus spread by blood transfusion and possibly by sexual intercourse or sharing needles with infected people. Hepatitis C may lead to cirrhosis and liver cancer. Hepatitis C used to be called non-A, non-B hepatitis.

Hepatitis D (Delta) A virus that occurs mostly in people who take illegal drugs by using needles. Only people who have hepatitis B can get hepatitis D.

Hepatitis E A virus spread mostly through unclean water. This type of hepatitis is common in developing countries. It has not occurred in the United States.

Hepatitis B Immunoglobulin (HBIg) (heh-puh-TY-tis BEE im-YOON-oh-GLAWB-yoo-lun) A shot that gives short-term protection from the hepatitis B virus.

Hepatitis B Vaccine (heh-puh-TY-tis BEE vak-SEEN) A shot to prevent hepatitis B. The vaccine tells the body to make its own protection (antibodies) against the virus.

Hepatologist (HEH-puh-TAW-luh-jist) A doctor who specializes in liver diseases.

Hepatology (HEH-puh-TAW-luh-jee) The field of medicine concerned with the functions and disorders of the liver.

Hepatotoxicity (heh-PAT-oh-tawk-SIS-uh-tee) How much damage a medicine or other substance does to the liver.

Hernia (HUR-nee-uh) The part of an internal organ that pushes through an opening in the organ's wall. Most hernias occur in the abdominal area.

Herniorrhaphy (hur-nee-AWR-uh-fee) An operation to repair a hernia.

Hiatal Hernia (Hiatus Hernia) (hy-AY-tul HUR-nee-uh) A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. See also Diaphragm.

Hirschsprung's Disease (HURSH-sprungz duh-zeez) A birth defect in which some nerve cells are lacking in the large intestine. The intestine cannot move stool through, so the intestine gets blocked. Causes the abdomen to swell. See also Megacolon.

Hormone (HOR-moan) A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine.

Hydrochloric Acid (hy-droh-KLOR-ik ASS-id) An acid made in the stomach. Hydrochloric acid works with pepsin and other enzymes to break down proteins.

Hydrogen Breath Test(HY-droh-jen breth test) A test for lactose intolerance. It measures breath samples for too much hydrogen. The body makes too much hydrogen when lactose is not broken down properly in the small intestine.

Hyperalimentation (HY-pur-al-uh-men-TAY-shun) See Parenteral Nutrition.

Hyperbilirubinemia (HY-pur-bil-ee-roo-buh-NEE-mee-uh) Too much bilirubin in the blood. Symptoms include jaundice. This condition occurs when the liver does not work normally. See also Jaundice.

I

IBD See Inflammatory Bowel Disease (IBD).

IBS See Irritable Bowel Syndrome (IBS).

Ileal (IL-ee-ul) Related to the ileum, the lowest end of the small intestine.

Ileal Pouch (IL-ee-ul powtch) See Ileoanal Reservoir.

Ileitis (il-ee-EYE-tis) See Crohn's Disease.

Ileoanal Anastomosis (il-ee-oh-AY-nul AN-nuh-stuh- MOH-sis) See Ileoanal Pull-Through.

Ileoanal Pull-Through (il-ee-oh-AY-nul PUL-throo) An operation to remove the colon and inner lining of the rectum. The outer muscle of the rectum is not touched. The bottom end of the small intestine (ileum) is pulled through the remaining rectum and joined to the anus. Stool can be passed normally. Also called ileoanal anastomosis.

Ileoanal Reservoir (il-ee-oh-AY-nul REZ-uh-vwar) An operation to remove the colon, upper rectum, and part of the lower rectum. An internal pouch is created from the remaining intestine to hold stool. The operation may be done in two stages. The pouch may also be called a J-pouch or W-pouch.

Ileocecal Valve (il-ee-oh-SEE-kul valv) A valve that connects the lower part of the small intestine and the upper part of the large intestine (ileum and cecum). Controls the flow of fluid in the intestines and prevents backflow.

lleocolitis (il-ee-oh-koh-LY-tis) Irritation of the lower part of the small intestine (ileum) and colon.

Ileostomy (il-ee-AW-stuh-mee) An operation that makes it possible for stool to leave the body after the colon and rectum are removed. The surgeon makes an opening in the abdomen and attaches the bottom of the small intestine (ileum) to it.

Ileum (il-ee-um) The lower end of the small intestine.

Impaction (im-PAK-shun) The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon.

Imperforate Anus (im-PUR-fuh-rut AY-nus) A birth defect in which the anal canal fails to develop. The condition is treated with an operation.

Indigestion (in-duh-JES-tchun) Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia.

Infectious Diarrhea (in-FEK-shus dy-uh-REE-uh) Diarrhea caused by infection from bacteria, viruses, or parasites. See also Travelers' Diarrhea and Gastroenteritis.

Infectious Gastroenteritis (in-FEK-shus gah-stroh-en-tuh-RY-tis) See Gastroenteritis.

Inflammatory Bowel Disease (IBD) (in-FLAM-uh-toh-ree BAH-wul duh-zeez) Long-lasting problems that cause irritation and ulcers in the GI tract. The most common disorders are ulcerative colitis and Crohn's disease.

Inguinal Hernia (IN-gwuh-nul HUR-nee-uh) A small part of the large or small intestine or bladder that pushes into the groin. May cause pain and feelings of pressure or burning in the groin. Often requires surgery.

Intestines (in-TES-tinz) See Large Intestine and Small Intestine. Also called gut.

Intestinal Flora (in-TES-tuh-nul FLOR-uh) The bacteria, yeasts, and fungi that grow normally in the intestines.

Intestinal Mucosa (in-TES-tuh-nul myoo-KOH-zuh) The surface lining of the intestines where the cells absorb nutrients.

Intestinal Pseudo-Obstruction (in-TES-tuh-nul SOO-doh ub-STRUK-shun) A disorder that causes symptoms of blockage, but no actual blockage. Causes constipation, vomiting, and pain. See also Obstruction.

Intolerance (in-TAH-luh-runs) Allergy to a food, drug, or other substance.

Intussusception (IN-tuh-suh-SEP-shun) A rare disorder. A part of the intestines folds into another part of the intestines, causing blockage. Most common in infants. Can be treated with an operation.

Iron Overload Disease (EYE-urn OH-vur-lohd duh-zeez) See Hemochromatosis.

Irritable Bowel Syndrome (IBS) (EER-uh-tuh-bul BAH-wul sin-drohm) A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis.

Ischemic Colitis (is-KEE-mik koh-LY-tis) Decreased blood flow to the colon. Causes fever, pain, and bloody diarrhea.

J

Jaundice (JAWN-dus) A symptom of many disorders. Jaundice causes the skin and eyes to turn yellow from too much bilirubin in the blood. See also Hyperbilirubinemia.

Jejunum (juh-JOON-um) The middle section of the small intestine between the duodenum and ileum.

Jejunostomy (juh-joo-NAW-stuh-mee) An operation to create an opening of the jejunum to a hole (stoma) in the abdomen. See also Enteral Nutrition.

K

Kupffer's Cells (KOOP-furz selz) Cells that line the liver. These cells remove waste such as bacteria from the blood.

L

Lactase (LAK-tayss) An enzyme in the small intestine needed to digest milk sugar (lactose).

Lactase Deficiency (LAK-tayss duh-FISH-en-see) Lack of the lactase enzyme. Causes lactose intolerance.

Lactose (LAK-tohss) The sugar found in milk. The body breaks lactose down into galactose and glucose.

Lactose Intolerance (LAK-tohss in-TAH-luh-runs) Being unable to digest lactose, the sugar in milk. This condition occurs because the body does not produce the lactase enzyme.

Lactose Tolerance Test (LAK-tohss TAH-luh-runs test) A test for lactase deficiency. The patient drinks a liquid that contains milk sugar. Then the patient's blood is tested; the test measures the amount of milk sugar in the blood.

Laparoscope (LAP-uh-ruh-skohp) A thin tube with a tiny video camera attached. Used to look inside the body and see the surface of organs. See also Endoscope.

Laparoscopic Cholecystectomy (LAP-uh-ruh-SKAWP-ik KOH-luh-sis-TEK-tuh-mee) An operation to remove the gallbladder. The doctor inserts a laparoscope (see above) and other surgical instruments through small holes in the abdomen. The camera allows the doctor to see the gallbladder on a television screen. The doctor removes the gallbladder through the holes.

Laparoscopy (LAP-uh RAW-skuh-pee) A test that uses a laparoscope to look at and take tissue from the inside of the body.

Laparotomy (LAP-uh-RAW-tuh-mee) An operation that opens up the abdomen.

Large Intestine (LARJ in-TES-tin) The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon.

Lavage (lah-VAJ) A cleaning of the stomach and colon. Uses a special drink and enemas. See also Bowel Prep.

Laxatives (LAK-suh-tivz) Medicines to relieve long-term constipation. Used only if other methods fail. Also called cathartics.

Lazy Colon (LAY-zee KOH-lun) See Atonic Colon.

Levator Syndrome (luh-VAY-tur sin-drohm) Feeling of fullness in the anus and rectum with occasional pain. Caused by muscle spasms.

Lithotripsy, Extracorporeal Shock Wave (ESWL) (LITH-uh-trip-see, EK-struh-cor-POH-ree-ul SHAHK wayv) A method of breaking up bile stones and gallstones. Uses a specialized tool and shock waves.

Liver (LIH-vur) The largest organ in the body. The liver carries out many important functions, such as making bile, changing food into energy, and cleaning alcohol and poisons from the blood.

Liver Enzyme Tests (LIH-vur EN-zym tests) Blood tests that look at how well the liver and biliary system are working. Also called liver function tests.

Liver Function Tests (LIH-vur FUNK-shun tests) See Liver Enzyme Tests.

Lower Esophageal Ring (LOH-wur uh-saw-fuh-JEE-ul Ring) An abnormal ring of tissue that may partially block the lower esophagus. Also called Schatzki's ring.

Lower Esophageal Sphincter (LOH-wur uh-saw-fuh-JEE-ul SFEENK-tur) The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. Lower GI Series (LOH-wur jee-eye SEER-eez) X-rays of the rectum, colon, and lower part of the small intestine. A barium enema is given first. Barium coats the organs so they will show up on the x-ray. Also called barium enema x-ray.

M

Magnetic Resonance Imaging (MRI) (mag-NEH-tik REH-zuh-nuns IM-uh-jing) A test that takes pictures of the soft tissues in the body. The pictures are clearer than x-rays.

Malabsorption Syndromes (MAL-ub-SORP-shun sin-drohmz) Conditions that happen when the small intestine cannot absorb nutrients from foods.

Mallory-Weiss Tear (MAH-luh-ree-WYSS tair) A tear in the lower end of the esophagus. Caused by severe vomiting. Common in alcoholics.

Malnutrition (mal-noo-TRISH-un) A condition caused by not eating enough food or not eating a balanced diet.

Manometry (muh-NAW-muh-tree) Tests that measure muscle pressure and movements in the GI tract. See also Esophageal Manometry and Rectal Manometry.

Meckel's Diverticulum (MEH-kulz dy-vur-TIK-yoo-lum) A birth defect in which a small sac forms in the ileum.

Megacolon (MEG-uh-koh-lun) A huge, swollen colon. Results from severe constipation. In children, megacolon is more common in boys than girls. See also Hirschsprung's Disease.

Melena (muh-LEE-nuh) Blood in the stool.

Ménétrier's Disease (may-NAY-tree-ayz duh-zeez) A long-term disorder that causes large, coiled folds in the stomach. Also called giant hypertrophic gastritis.

Metabolism (muh-TAH-buh-lih-zum) The way cells change food into energy after food is digested and absorbed into the blood.

Motility (moh-TIL-uh-tee) The movement of food through the digestive tract.

Motility Disorders (moh-TIL-uh-tee dis-or-durz) See Functional Disorders.

Mucosal Protective Drugs(myoo-KOH-zul proh-TEK-tiv drugz) Medicines that protect the stomach lining from acid. Examples are sucralfate (soo-CRAL-fayt) (Carafate), misoprostol (MIH-soh-PROH-stawl) (Cytotec), antacids (Mylanta and Maalox), and bismuth subsalicylate (Pepto-Bismol).

Mucous Colitis (MYOO-kus koh-LY-tis) See Irritable Bowel Syndrome.

Mucosal Lining (myoo-KOH-zul LY-ning) The lining of GI tract organs that makes mucus.

Mucus (MYOO-kus) A clear liquid made by the intestines. Mucus coats and protects tissues in the GI tract.

N

Nausea (NAW-zee-uh) The feeling of wanting to throw up (vomit).

Necrosis (nuh-KROH-sis) Dead tissue that surrounds healthy tissue in the body.

Necrotizing Enterocolitis (NEK-roh-TY-zing EN-tuh-roh-koh-LY-tis) A condition in which part of the tissue in the intestines is destroyed. Occurs mainly in under-weight newborn babies. A temporary ileostomy may be necessary.

Neonatal Hepatitis (nee-oh-NAY-tul heh-puh-TY-tis) Irritation of the liver with no known cause. Occurs in newborn babies. Symptoms include jaundice and liver cell changes.

Neoplasm (NEE-oh-plaz-um) New and abnormal growth of tissue that may or may not cause cancer. Also called tumor.

Nissen Fundoplication (NIH-sun FUN-doh-plih-KAY-shun) An operation to sew the top of the stomach (fundus) around the esophagus. Used to stop stomach contents from flowing back into the esophagus (reflux) and to repair a hiatal hernia.

Nontropical Sprue (NAWN-TRAH-pih-kul SPROO) See Celiac Disease.

Nonulcer Dyspepsia (nawn-UL-sur dis-PEP-see-uh) Constant pain or discomfort in the upper GI tract. Symptoms include burning, nausea, and bloating, but no ulcer. Possibly caused by muscle spasms.

Norwalk Virus (NAWR-wawk VY-rus) A virus that may cause GI infection and diarrhea. See also Gastroenteritis.

Nutcracker Syndrome (NUT-KRAK-ur sin-drohm) Abnormal muscle tightening in the esophagus.

O

Obstruction (ub-STRUK-shun) A blockage in the GI tract that prevents the flow of liquids or solids.

Occult Bleeding (uh-KULT) Blood in stool that is not visible to the naked eye. May be a sign of disease such as diverticulosis or colorectal cancer.

Oral Dissolution Therapy (OR-ul dih-soh-LOO-shun theh-ruh-pee) A method of dissolving cholesterol gallstones. The patient takes the oral medications chenodiol (KEE-noh-DY-awl) (Chenix) and ursodiol (ERS-oh-DY-awl) (Actigall). These medicines are most often used for people who cannot have an operation.

Ostomate (AH-stuh-mayt) A person who has an ostomy. Called ostomist in some countries.

Ostomy (AH-stuh-mee) An operation that makes it possible for stool to leave the body through an opening made in the abdomen. An ostomy is necessary when part or all of the intestines are removed. Colostomy and ileostomy are types of ostomy.

P

Pancreas (PAN-kree-ahs) A gland that makes enzymes for digestion and the hormone insulin.

Pancreatitis (PAN-kree-uh-TY-tis) Irritation of the pancreas that can make it stop working. Most often caused by gallstones or alcohol abuse.

Papillary Stenosis (PAH-pih-lair-ee stuh-NOH-sis) A condition in which the openings of the bile ducts and pancreatic ducts narrow.

Parenteral Nutrition (puh-REN-tuh-rul noo-TRISH-un) A way to provide a liquid food mixture through a special tube in the chest. Also called hyperalimentation or total parenteral nutrition.

Parietal Cells (puh-RY-uh-tul selz) Cells in the stomach wall that make hydrochloric acid.

Pediatric Gastroenterologist (pee-dee-AT-trik GAH-stroh-en-tuh-RAW-luh-jist) A doctor who treats children with digestive diseases.

Pepsin (PEP-sin) An enzyme made in the stomach that breaks down proteins.

Peptic (PEP-tik) Related to the stomach and the duodenum, where pepsin is present.

Peptic Ulcer (PEP-tik UL-sur) A sore in the lining of the esophagus, stomach, or duodenum. Usually caused by the bacterium Helicobacter pylori. An ulcer in the stomach is a gastric ulcer; an ulcer in the duodenum is a duodenal ulcer.

Percutaneous (PUR-kyoo-TAY-nee-us) Passing through the skin.

Percutaneous Transhepatic Cholangiography (PUR-kyoo-TAY-nee-us tranz-heh-PAT-ik koh-LAN-jee-AW-gruh-fee) X-rays of the gallbladder and bile ducts. A dye is injected through the abdomen to make the organs show up on the x-ray.

Perforated Ulcer (PUR-fuh-ray-ted UL-sur) An ulcer that breaks through the wall of the stomach or the duodenum. Causes stomach contents to leak into the abdominal cavity.

Perforation (PUR-fuh-RAY-shun) A hole in the wall of an organ.

Perianal (PEH-ree-AY-nul) The area around the anus.

Perineal (PEH-rih-NEE-ul) Related to the perineum.

Perineum (PEH-rih-NEE-um) The area between the anus and the sex organs.

Peristalsis (PEH-ree-STAWL-sis) A wavelike movement of muscles in the GI tract. Peristalsis moves food and liquid through the GI tract.

Peritoneum (PEH-rih-toh-NEE-um) The lining of the abdominal cavity.

Peritonitis (PEH-rih-toh-NY-tis) Infection of the perit`oneum.

Pernicious Anemia (pur-NIH-shus uh-NEE-mee-uh) Anemia caused by a lack of vitamin B12. The body needs B12 to make red blood cells.

Peutz-Jeghers Syndrome (POYTS-YAY-gurz sin-drohm) An inherited condition. Many polyps grow in the intestine. There is little risk of cancer.

Pharynx (FAR-ingks) The space behind the mouth. Serves as a passage for food from the mouth to the esophagus and for air from the nose and mouth to the larynx.

Polyp (PAH-lip) Tissue bulging from the surface of an organ. Although these growths are not normal, they often are not cause for concern. However, people who have polyps in the colon may have an increased risk of colorectal cancer.

Polyposis (PAH-lih-POH-sis) The presence of many polyps.

Porphyria (por-FEER-ee-uh) A group of rare, inherited blood disorders. When a person has porphyria, cells fail to change chemicals (porphyrins) to the substance (heme) that gives blood its color. Porphyrins then build up in the body. They show up in large amounts in stool and urine, causing the urine to be colored blue. They cause a number of problems, including strange behavior.

Portal Hypertension (POR-tul hy-pur-TEN-shun) High blood pressure in the portal vein. This vein carries blood into the liver. Portal hypertension is caused by a blood clot. This is a common complication of cirrhosis.

Portal Vein (POR-tul vayn) The large vein that carries blood from the intestines and spleen to the liver.

Portosystemic Shunt (POR-toh-sih-STEM-ik shunt) An operation to create an opening between the portal vein and other veins around the liver.

Postcholecystectomy Syndrome (POST-koh-luh-sis-TEK-tuh-mee sin-drohm) A condition that occurs after gallbladder removal. The muscle between the gallbladder and the small intestine does not work properly, causing pain, nausea, and indigestion. Also called biliary dyskinesia.

Postgastrectomy Syndrome (POST-gah-STREK-tuh-mee sin-drohm) A condition that occurs after an operation to remove the stomach (gastrectomy). See also Dumping Syndrome.

Postvagotomy Stasis (POST-vay-GAW-tuh-mee STAY-sis) Delayed stomach emptying. Occurs after surgery on the vagus nerve.

Pouch (powtch) A special bag worn over a stoma to collect stool. Also called an ostomy appliance.

Primary Biliary Cirrhosis (PRY-muh-ree BILL-ee-air-ee suh-ROH-sis) A chronic liver disease. Slowly destroys the bile ducts in the liver. This prevents release of bile. Long-term irritation of the liver may cause scarring and cirrhosis in later stages of the disease.

Primary Sclerosing Cholangitis (PRY-muh-ree skluh-ROH-sing KOH-lun-JY-tis) Irritation, scarring, and narrowing of the bile ducts inside and outside the liver. Bile builds up in the liver and may damage its cells. Many people with this condition also have ulcerative colitis.

Proctalgia Fugax(prahk-TAL-jee-uh FYOO-gaks) Intense pain in the rectum that occasionally happens at night. Caused by muscle spasms around the anus.

Proctectomy (prahk-TEK-tuh-mee) An operation to remove the rectum.

Proctitis (prahk-TY-tis) Irritation of the rectum.

Proctocolectomy (PRAHK-toh-koh-LEK-tuh-mee) An operation to remove the colon and rectum. Also called coloproctectomy.

Proctocolitis (PRAHK-toh-koh-LY-tis) Irritation of the colon and rectum.

Proctologist (prahk-TAW-luh-jist) A doctor who specializes in disorders of the anus and rectum.

Proctoscope (PRAHK-tuh-skohp) A short, rigid metal tube used to look into the rectum and anus.

Proctoscopy (prahk-TAW-skuh-pee) Looking into the rectum and anus with a proctoscope.

Proctosigmoiditis (PRAHK-toh-SIG-moy-DY-tis) Irritation of the rectum and the sigmoid colon. Proctosigmoidoscopy

(PRAHK-toh-SIG-moy-DAW-skuh-pee) An endoscopic examination of the rectum and sigmoid colon. See also Endoscopy.

Prokinetic Drugs (PROH-kih-NET-ik drugz) Medicines that cause muscles in the GI tract to move food. An example is cisapride (SIS-uh-pryd) (Propulsid).

Prolapse (PROH-laps) A condition that occurs when a body part slips from its normal position.

Protein (PROH-teen) One of the three main classes of food. Protein is found in meat, eggs, and beans. The stomach and small intestine break down proteins into amino acids. The blood absorbs amino acids and uses them to build and mend cells. See also Amino Acids.

Proton Pump Inhibitors (PROH-tawn pump in-HIH-bih-turz) Medicines that stop the stomach's acid pump. Examples are omeprazole (oh-MEH-prah-zol) (Prilosec) and lansoprazole (lan-SOH-prah-zol) (Prevacid).

Prune Belly Syndrome (PROON bel-ee sin-drohm) A condition of newborn babies. The baby has no abdominal muscles, so the stomach looks like a shriveled prune. Also called Eagle-Barrett syndrome.

Pruritus Ani (proo-RY-tus AY-ny) Itching around the anus.

Pseudomembranous Colitis (SOO-doh-MEM-bray-nus koh-LY-tis) Severe irritation of the colon. Caused by Clostridium difficile bacteria. Occurs after taking oral antibiotics, which kill bacteria that normally live in the colon.

Pyloric Sphincter (py-LOR-ik SFEENK-tur) The muscle between the stomach and the small intestine.

Pyloric Stenosis (py-LOR-ik stuh-NOH-sis) A narrowing of the opening between the stomach and the small intestine.

Pyloroplasty (py-LOR-oh-plah-stee) An operation to widen the opening between the stomach and the small intestine. This allows stomach contents to pass more freely from the stomach.

Pylorus (py-LOR-us) The opening from the stomach into the top of the small intestine (duodenum).

R

Radiation Colitis (ray-dee-AY-shun koh-LY-tis) Damage to the colon from radiation therapy.

Radiation Enteritis (ray-dee-AY-shun en-tuh-RY-tis) Damage to the small intestine from radiation therapy

Radionuclide Scans (RAY-dee-oh-NOO-clyd skanz) Tests to find GI bleeding. Radioactive material is injected to highlight organs on a special camera. Also called scintigraphy (sihn-TIHG-ruh-fee).

Rapid Gastric Emptying (RAH-pid GAH-strik EM-tee-ying) See Dumping Syndrome.

Rectal Manometry (REK-tul muh-NAW-muh-tree) A test that uses a thin tube and balloon to measure pressure and movements of the rectal and anal sphincter muscles. Usually used to diagnose chronic constipation and fecal incontinence.

Rectal Prolapse (REK-tul PRO-laps) A condition in which the rectum slips so that it protrudes from the anus.

Rectum (REK-tum) The lower end of the large intestine, leading to the anus.

Reflux (REE-fluks) A condition that occurs when gastric juices or small amounts of food from the stomach flow back into the esophagus and mouth. Also called regurgitation.

Reflux Esophagitis (REE-fluks uh-SAW-fuh-JY-tis) Irritation of the esophagus because stomach contents flow back into the esophagus.

Regional Enteritis (REE-juh-nul en-tuh-RY-tis) See Crohn's Disease.

Regurgitation (ree-GUR-juh-TAY-shun) See Reflux. Retching Dry vomiting.

Rotavirus (ROH-tuh-vy-rus) The most common cause of infectious diarrhea in the United States, especially in children under age 2.

Rupture (RUP-tchur) A break or tear in any organ or soft tissue.

S

Saliva (suh-LY-vuh) A mixture of water, protein, and salts that makes food easy to swallow and begins digestion.

Salmonella (SAH-moh-NEL-uh) A bacterium that may cause intestinal infection and diarrhea. See also Gastroenteritis.

Sarcoidosis (SAR-koy-DOH-sis) A condition that causes small, fleshy swellings in the liver, lungs, and spleen.

Schatzki's Ring (SHAHTS-keez ring) See Lower Esophageal Ring. Scintigraphy (sin-TIG-ruh-fee) See Radionuclide Scans.

Sclerotherapy (SKLAIR-oh-THEH-ruh-pee) A method of stopping upper GI bleeding. A needle is inserted through an endoscope to bring hardening agents to the place that is bleeding.

Secretin (suh-KREE-tin) A hormone made in the duodenum. Causes the stomach to make pepsin, the liver to make bile, and the pancreas to make a digestive juice.

Segmentation (SEG-men-TAY-shun) The process by which muscles in the intestines move food and wastes through the body.

Shigellosis (SHIH-geh-LOH-sis) Infection with the bacterium Shigella. Usually causes a high fever, acute diarrhea, and dehydration. See also Gastroenteritis.

Short Bowel Syndrome (short BAH-wul sin-drohm) Problems related to absorbing nutrients after removal of part of the small intestine. Symptoms include diarrhea, weakness, and weight loss. Also called short gut syndrome. Short Gut Syndrome See Short Bowel Syndrome.

Shwachman's Syndrome (SHWAHK-munz sin-drohm) A digestive and respiratory disorder of children. Certain digestive enzymes are missing and white blood cells are few. Symptoms may include diarrhea and short stature.

Sigmoid Colon (SIG-moyd KOH-lun) The lower part of the colon that empties into the rectum.

Sigmoidoscopy (SIG-moy-DAW-skuh-pee) Looking into the sigmoid colon and rectum with a flexible or rigid tube, called a sigmoidoscope.

Sitz Bath (SITS bath) A special plastic tub. A person sits in a few inches of warm water to help relieve discomfort of hemorrhoids or anal fissures.

Small Bowel Enema (smal BAH-wul EN-uh-muh) X-rays of the small intestine taken as barium liquid passes through the organ. Also called small bowel follow-through. See also Lower GI Series.

Small Bowel Follow-Through (smal BAH-wul FAH-loh-throo) See Small Bowel Enema.

Small Intestine Organ where most digestion occurs. It measures about 20 feet and includes the duodenum, jejunum, and ileum.

Solitary Rectal Ulcer (SAH-luh-tair-ee REK-tul UL-sur) A rare type of ulcer in the rectum. May develop because of straining to have a bowel movement.

Somatostatin (SOH-muh-toh-STAH-tun) A hormone in the pancreas. Somatostatin helps tell the body when to make the hormones insulin, glucagon, gastrin, secretin, and renin.

Spasms (SPAH-zumz) Muscle movements such as those in the colon that cause pain, cramps, and diarrhea.

Spastic Colon (SPAH-stik KOH-lun) See Irritable Bowel Syndrome (IBS).

Sphincter (SFEENK-tur) A ring-like band of muscle that opens and closes an opening in the body. An example is the muscle between the esophagus and the stomach known as the lower esophageal sphincter.

Sphincter of Oddi (SFEENK-tur uv AH-dee) The muscle between the common bile duct and pancreatic ducts.

Spleen The organ that cleans blood and makes white blood cells. White blood cells attack bacteria and other foreign cells.

Splenic Flexure Syndrome (SPLEN-ik FLEK-shur sin-drohm) A condition that occurs when air or gas collects in the upper parts of the colon. Causes pain in the upper left abdomen. The pain often moves to the left chest and may be confused with heart problems.

Squamous Epithelium (SKWAH-mus eh-pih-THEE-lee-um) Tissue in an organ such as the esophagus. Consists of layers of flat, scaly cells.

Steatorrhea (STEE-ah-toh-REE-uh) A condition in which the body cannot absorb fat. Causes a buildup of fat in the stool and loose, greasy, and foul bowel movements.

Steatosis (stee-ah-TOH-sis) See Fatty Liver.

Stoma (STOH-muh) An opening in the abdomen that is created by an operation (ostomy). Must be covered at all times by a bag that collects stool.

Stomach (STUH-muk) The organ between the esophagus and the small intestine. The stomach is where digestion of protein begins.

Stomach Ulcer (STUH-muk UL-sur) An open sore in the lining of the stomach. Also called gastric ulcer.

Stool The solid wastes that pass through the rectum as bowel movements. Stools are undigested foods, bacteria, mucus, and dead cells. Also called feces.

Stress Ulcer (STRES UL-sur) An upper GI ulcer from physical injury such as surgery, major burns, or critical head injury.

Stricture (STRIK-sher) The abnormal narrowing of a body opening. Also called stenosis. See also Esophageal Stricture and Pyloric Stenosis.

T

Tenesmus (tuh-NEZ-mus) Straining to have a bowel movement. May be painful and continue for a long time without result.

Total Parenteral Nutrition (TPN) (TOH-tul puh-REN-tuh-rul noo-TRISH-un) See Parenteral Nutrition.

Tracheoesophageal Fistula (TEF) (TRAY-kee-oh-uh-SAW-fuh-JEE-ul FIST-yoo-luh) A condition that occurs when there is a gap between the upper and lower segments of the esophagus. Food and saliva cannot pass through.

Transverse Colon (TRANZ-vurs KOH-lun) The part of the colon that goes across the abdomen from right to left.

Travelers' Diarrhea (TRAV-lurz dy-uh-REE-uh) An infection caused by unclean food or drink. Often occurs during travel outside one's own country. See also Gastroenteritis.

Triple-Therapy (TRIH-pul THEH-ruh-pee) A combination of three medicines used to treat Helicobacter pylori infection and ulcers. Drugs that stop the body from making acid are often added to relieve symptoms.

Tropical Sprue (TRAH-pih-kul sproo) A condition of unknown cause. Abnormalities in the lining of the small intestine prevent the body from absorbing food normally.

Tube Feeding (TOOB feeding) See Enteral Nutrition.

U

Ulcer (UL-sur) A sore on the skin surface or on the stomach lining.

Ulcerative Colitis (UL-sur-ay-tuv koh-LY-tis) A serious disease that causes ulcers and irritation in the inner lining of the colon and rectum. See also Inflammatory Bowel Disease (IBD).

Upper GI Endoscopy (UH-pur jee-eye en-DAW-skuh-pee) Looking into the esophagus, stomach, and duodenum with an endoscope. See also Endoscopy.

Upper GI Series (UH-pur jee-eye SEE-reez) X-rays of the esophagus, stomach, and duodenum. The patient swallows barium first. Barium makes the organs show up on x-rays. Also called barium meal.

Urea Breath Test (yoo-REE-uh breth test) A test used to detect Helicobacter pylori infection. The test measures breath samples for urease, an enzyme H. pylori makes.

V

Vagotomy (vay-GAH-tuh-mee) An operation to cut the vagus nerve. This causes the stomach to make less acid.

Vagus Nerve (VAY-gus nurv) The nerve in the stomach that controls the making of stomach acid.

Valve (valv) A fold in the lining of an organ that prevents fluid from flowing backward.

Varices (VAIR-uh-seez) Stretched veins such as those that form in the esophagus from cirrhosis.

VATER (VAY-tur) A word made from the first letters of a group of birth defects. It is used when all of these birth defects affect the same child. The birth defects are Vertebral defects, Anal malformations, Tracheoesophageal fistula, Esophageal atresia, and Renal defects.

Villi (VIL-eye) The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients.

Viral Hepatitis (VY-rul heh-puh-TY-tis) Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. See Hepatitis. Viral Hepatitis Type of Hepatitis Mode of Transmission Hepatitis A Contaminated food and water. Hepatitis B Sexual intercourse. Sharing infected needles. Hepatitis C Sexual intercourse. Sharing infected needles. Hepatitis D Must have hepatitis B. Found mainly in intravenous drug users. Hepatitis E Contaminated water from poor sanitation.

Volvulus (VAHLV-yoo-lus) A twisting of the stomach or large intestine. May be caused by the stomach being in the wrong position, a foreign substance, or abnormal joining of one part of the stomach or intestine to another. Volvulus can lead to blockage, perforation, peritonitis, and poor blood flow.

Vomiting (VAH-muh-ting) The release of stomach contents through the mouth.

W

Watermelon Stomach (WAH-tur-MEH-lun STUH-muk) Parallel red sores in the stomach that look like the stripes on a watermelon. Frequently seen with cirrhosis.

Wilson's Disease (WIL-sunz duh-zeez) An inherited disorder. Too much copper builds up in the liver and is slowly released into other parts of the body. The overload can cause severe liver and brain damage if not treated with medication.

X

Xerostomia(ZEE-roh-STOH-mee-uh) Dry mouth. The condition can be caused by a number of things, including rheumatoid arthritis, diabetes, kidney failure, infection with HIV (the virus that causes AIDS), drugs used to treat depression, and radiation treatment for mouth or throat cancer.

Z

Zenker's Diverticulum (ZEN-kurz dy-vur-TIK- yoo-lum) Pouches in the esophagus from increased pressure in and around the esophagus.

Zollinger-Ellison Syndrome (ZAH-lun-jur EL-uh-sun sin-drohm) A group of symptoms that occur when a tumor called a gastrinoma forms in the pancreas. The tumor, which may cause cancer, releases large amounts of the hormone gastrin. The gastrin causes too much acid in the duodenum, resulting in ulcers and bleeding.