Lawrence Schiller | Texas A&M University (original) (raw)

Papers by Lawrence Schiller

The American Journal of Gastroenterology, May 22, 2012

Gastroenterology, Jul 1, 1982

Current Gastroenterology Reports, Oct 1, 1999

Diarrhea, defined as loose stools, occurs when the intestine does not complete absorption of elec... more Diarrhea, defined as loose stools, occurs when the intestine does not complete absorption of electrolytes and water from luminal contents. This can happen when a nonabsorbable, osmotically active substance is ingested ("osmotic diarrhea") or when electrolyte absorption is impaired ("secretory diarrhea"). Most cases of acute and chronic diarrhea are due to the latter mechanism. Secretory diarrhea can result from bacterial toxins, reduced absorptive surface area caused by disease or resection, luminal secretagogues (such as bile acids or laxatives), circulating secretagogues (such as various hormones, drugs, and poisons), and medical problems that compromise regulation of intestinal function. Evaluation of patients with secretory diarrhea must be tailored to find the likely causes of this problem. Specific and nonspecific treatment can be valuable.

Gastroenterology, 1987

We studied radiolabeled fecal bile acid excretion in 11 normal subjects and 17 patients with idio... more We studied radiolabeled fecal bile acid excretion in 11 normal subjects and 17 patients with idiopathic chronic diarrhea for three major purposes: (a) to establish normal values for this test in the presence of increased stool volumes (induced in normal subjects by ingestion of poorly absorbable solutions); [b) to test for bile acid malabsorption in the patients and to correlate this with an independent test of ilea function, the SchiIIing test; and [c) to compare the results of the bile acid excretion test with the subsequent effect of a bile acid binding agent (cho-Iestyramine) on stool weight. In normal subjects fecal excretion of the radiolabel was increased with increasing stool volumes. As a group, patients with idiopathic chronic diarrhea excreted radiolabeled bile acid more rapidly than normal subjects with induced diarrhea (t 1,2 56 + 8 vs. 236 k 60 h, respectively, p < 0.005). There was a statistically significant positive correlation between t1/2 of radiolabeled bile acid and SchiIIing test results in these patients. Although 14 of 17 patients absorbed Iabeled taurocholic acid less we11 than any of the normal subjects with comparable volumes of induced diarrhea, cholestyramine had no statistically significant effect on stool weight in the patient

Gastroenterology, Jun 1, 1980

We studied the effect of vagal stimulation by sham feeding on gastric emptying in normal human su... more We studied the effect of vagal stimulation by sham feeding on gastric emptying in normal human subjects. When a saline test meal was infused into th€ stomach, simultaneous sham feeding did not alter the emptying of a nonabsorbable marker added to the meal or the volume of fluid emptied from the stomach. When a homogenized steak meal was infused, sham feeding caused a slight acceleration of •emptying (47 ± 2 vs. 53 ± 2% marker recovered from the stomach 45 min after the meal, P < 0.05). Gastric •acid secretion in response to both meals was significantly augmented by sham feeding. Our results suggest that vagal stimulation by sham feeding has no effect on the emptying of isotonic saline and only a minor effect on gastric emptying of homogenized food in humans. The influence of the vagus nerves on gastric motor 'function is poorly understood.' Experiments in animals using electrical vagal stimulation suggest the existence of some pathways which stimulate and others which inhibit gastric emptying. 2 On the other hand, it is generally accepted that truncal vagotomy (in the absence of pyloroplasty or gastroenterost()rnY) slows gastric emptying."-a Taken together, ~h,ese observations suggest that the vagi can both

American Journal of Health-system Pharmacy, Nov 1, 1996

The association between upper gastrointestinal (GI) motility disorders and respiratory problems i... more The association between upper gastrointestinal (GI) motility disorders and respiratory problems is reviewed. Upper GI motility disorders, such as gastroesophageal reflux disease, gastroparesis, and achalasia, have been associated with respiratory problems, including aspiration, airway obstruction, asthma, bronchospasm, chronic cough, and laryngitis. These associations, which had been based solely on clinical observation, have recently been supported by physiologic studies and treatment trials. The association of reflux disease with asthma has the most support. Up to 80% of persons with asthma have evidence of pathologic gastroesophageal reflux, and in several studies antireflux therapy with prokinetic agents, antisecretory drugs, or fundoplication surgery has been found to reduce asthma symptoms and the need for medication in some patients. Reflux has also been associated with chronic cough and laryngitis, and antireflux therapy can reduce respiratory symptoms. Gastroesophageal reflux, gastroparesis, and achalasia are all associated with aspiration. In addition, in rare instances, the megaesophagus associated with achalasia can produce mechanical airway obstruction. Effective therapy for these GI motility disorders can eliminate complicating respiratory problems.

The New England Journal of Medicine, Jun 10, 1993

Point sources of Brainerd diarrhea are rarely identified, though cases of sporadic illness indist... more Point sources of Brainerd diarrhea are rarely identified, though cases of sporadic illness indistinguishable from Brainerd diarrhea have been reported in many states2,4. The recognition of point-source outbreaks of Brainerd diarrhea is complicated by the low rate of attack2 and a long and ...

The American Journal of Gastroenterology, Nov 1, 2018

The Lancet Gastroenterology & Hepatology, Nov 1, 2019

Constipation is a symptom that affects around 11-20% of the adult population yearly. Most physici... more Constipation is a symptom that affects around 11-20% of the adult population yearly. Most physicians consider infrequency of defecation as a hallmark of constipation. However, most patients view excessive straining as the biggest component of constipation and only a minority of patients with constipation have infrequent bowel movements. Constipation might be due to many different medical conditions or occur as a side-effect of drug therapy. When these medical conditions or drug therapies are not present, a diagnosis of functional constipation, chronic idiopathic constipation, or irritable bowel syndrome with constipation is often made. In all patients with constipation, rectal outlet dysfunction should be excluded by physical examination because this condition occurs in approximately 25% of patients diagnosed with idiopathic constipation and can be improved with different therapeutic approaches than administration of laxatives. Because of the availability of over-the-counter laxatives, most patients consider themselves able to self-manage constipation, and patients have often tried many different treatments before seeking professional help. The physician must carefully assess these previous efforts of self-treatment, optimise them, and strategically use the increasing list of prescription medications for management.

John Wiley & Sons, Ltd eBooks, Aug 1, 2016

Current Gastroenterology Reports, Oct 1, 2003

For some time, diarrhea caused by Clostridium difficile has been a serious problem in hospitals. ... more For some time, diarrhea caused by Clostridium difficile has been a serious problem in hospitals. Recently, more virulent strains of this pathogen have started to show up in hospitals.

Gastroenterology, Feb 1, 1994

Digestive Diseases and Sciences, 2021

The American Journal of Gastroenterology, 2001

Current Treatment Options in Gastroenterology, 2005

Diarrhea lasting longer than 2 weeks is considered chronic diarrhea. Your child should have an ex... more Diarrhea lasting longer than 2 weeks is considered chronic diarrhea. Your child should have an examination and possibly tests to find out why he or she is having continued problems with diarrhea. Many causes of chronic diarrhea are possible but most are not serious.

Encyclopedia of Gastroenterology, 2004

Drugs & Therapy Perspectives, 2006

Adapted and reproduced from Drugs 2006; 66 (6): 873-81[1-3] New pharmacological treatments for ch... more Adapted and reproduced from Drugs 2006; 66 (6): 873-81[1-3] New pharmacological treatments for chronic constipation are needed that are based on an understanding of the underlying pathophysiology. Lubiprostone (AmitizaTM)1 is an oral bicyclic fatty acid that selectively activates type 2 chloride channels in the apical membrane of the gastrointestinal epithelium.[4] An increase in the secretion of chloride-rich intestinal fluid increases intestinal motility and facilitates the passage of softened stool through the intestines and relieves the symptoms of constipation.[5] In two pivotal, randomised, double-blind, multicentre phase III studies in patients with chronic idiopathic constipation, the frequency of spontaneous bowel movements was significantly greater in patients receiving lubiprostone 24μg twice daily than in those receiving Features and properties of lubiprostone (AmitizaTM)[1]

Gastrointestinal Endoscopy, Jul 1, 2012