[Adults celiac disease--the tip of the iceberg].

In recent years the clinical course of celiac disease (CD; gluten enteropathy) has changed. It has been diagnosed more and more frequently in adults. Celiac disease in adults may manifest itself as active, silent, latent and late onset.

[Cyclosporine in the treatment of atypical celiac sprue. A case report].

We present a 45-year-old woman with atypical celiac sprue who was unresponsive to gluten-free diet. Cyclosporine therapy was applied (5 mg/kg body weight daily for 2 months). The patient demonstrated a remarkable clinical and histological response to this drug.

Side effects of botulinum toxin injection for benign anal disorders.

Background: Botulinum toxin A (BT-A) is a powerful biological toxin. Nevertheless, it has proved to be a remarkable therapeutic agent for the treatment of benign anal disorders. Higher doses of BT-A could change the outcome of treatment.

[Nitric oxide donors and their potentiating effects after botulinum toxin application for treatment of chronic anal fissure].

Pharmacological sphincterotomy with the use of botulinum toxin (BT) that inhibits acetylcholine secretion from neural endings in the motor plate or of nitric oxide (NO) donors should be a method applied earlier than surgical treatment due to its safety. BT mechanism of action on internal anal sphincter is not yet fully understood similarly to the effect of loosening of this sphincter under influence of NO donors applied after BT. Likewise paradoxical vasoconstrictive reaction on acetylcholine in the muscular layer of coronary arteries and decrease of tonic, vasodilative action of NO on the vessels may be observed in the patients with arterial hypertension.

One week of treatment with esomeprazole-based triple therapy eradicates Helicobacter pylori and heals patients with duodenal ulcer disease.

Background: Proton pump inhibitor (PPI) monotherapy is commonly continued for 3 weeks after Helicobacter pylori eradication with PPI-based triple therapy regimens to ensure duodenal ulcer (DU) healing. This randomized, double-blind, multicentre study evaluated whether only 1 week of triple therapy with the new PPI esomeprazole was sufficient to ensure high rates of ulcer healing and H. pylori eradication.

Topical nitrates and the higher doses of botulinum toxin for chronic anal fissure.

Background/aims: Combined BT-A (botulinum toxin A) therapy and local application of nitrates can be more effective than BT-A alone for chronic anal fissure treatment, but so far the optimal dose of BT-A is not known. The aim of our study was to learn if BT-A doses higher than those used so far could change the outcome of fissure treatment.

Methodology: We enrolled 14 consecutive patients suffering from idiopathic chronic anal fissure who did not respond to previous local treatment of nitric oxide donor and subsequent BT-A therapy (25 U of Botox).

[Pancreatic ascites].

Two cases of pancreatic ascites have been presented. 1. A 29 year old man, heavy alcoholic, with fast growing ascites presented since long biochemic features of pancreatitis.

[Attempt at evaluation of certain parameters of gastric secretion in patients with duodenogastric reflux].

There were four groups of patients: duodenal ulcer patients (32), duodeno-gastric reflux patients (31), patients with duodenal ulcer and reflux (33) and 12 healthy men. All of them aged 20-40. In all patients we performed gastroscopy, cholecystography, Kay's test for secretion and isotope proteolytic secretion test.

Disturbances of the pulmonary perfusion after endoscopic sclerotherapy of oesophageal varices.

Haemorrhage from oesophageal varices is one of the most common reason of death of patients with liver cirrhosis. The possibility of treatment and prevention of the haemorrhage by endoscopic sclerotherapy (ES) has become one of the achievements of contemporary medicine. Nevertheless there are some complications described after this procedure, the most severe being the pulmonary embolia.

[Difficulties of diagnosing gluten enteropathies in adults].

Seven cases of adult patients with gluten enteropathy (1 male and 6 female patients, including 1 patient with Duhring's disease) are presented. These patients suffered from diarrhoea lasting for 1-10 years prior to the diagnosis of gluten enteropathy. Transient diarrhoea was noted in one female patient in her childhood.