Endoscopy in Crohn's Disease Glossary of Terms

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Autoimmune: Pertaining to autoimmunity, a misdirected immune response that occurs when the immune system goes awry and attacks the body itself.
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Autoimmunity: A misdirected immune response that occurs when the immune system goes awry and attacks the body itself.
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Barium: 1. A metallic element belonging to the alkaline earths with an atomic number of 56 and an atomic weight of 137.34. The symbol for barium is Ba.
2. In medicine, refers to a chalky solution of barium used to coat the inside of organs so that they will show up on an x-ray.
See also: Barium enema; Barium swallow.

Barium enema: A series of x-rays of the lower intestine (colon) and rectum that are taken after the patient is given an enema with a white, chalky solution that contains barium. The barium outlines the intestines on the x-rays. These x-rays permit the detection of colon and rectal abnormalities including diverticulosis, diverticulitis, abnormal colon movement, dilation (widening) of the colon, polyps and cancers of the colon and rectum.
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Blood pressure: The blood pressure is the pressure of the blood within the arteries. It is produced primarily by the contraction of the heart muscle. It's measurement is recorded by two numbers. The first (systolic pressure) is measured after the heart contracts and is highest. The second (diastolic pressure) is measured before the heart contracts and lowest. A blood pressure cuff is used to measure the pressure. Elevation of blood pressure is called "hypertension".

Bowel: Another name for the intestine. The small bowel and the large bowel are the small intestine and large intestine, respectively.
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Chronic: This important term in medicine comes from the Greek chronos, time and means lasting a long time.
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Colectomy: Surgery during which all or part of the colon (also called the large intestine) is removed.
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Colitis: Inflammation of the large intestine (the colon). There are many forms of colitis, including ulcerative colitis, Crohn's disease, infectious, pseudomembranous, and spastic. For example, intermittent rectal bleeding, crampy abdominal pain and diarrhea can be symptoms of ulcerative colitis. Diagnosis can be made by barium enema, but direct visualization (sigmoidoscopy or colonoscopy) is the most accurate test. Long-standing ulcerative colitis increases the risk for colon cancer. Ulcerative colitis can also be associated with inflammation in joints, spine, skin, eyes, the liver and its bile ducts. Treatment of ulcerative colitis can involve medications and surgery.

Colon: The part of the large intestine that runs from the cecum to the rectum as a long hollow tube that serves to remove water from digested food and let the remaining material, solid waste called stool, move through it to the rectum and leave the body through the anus. .
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Colonoscopy: A procedure in which a long flexible viewing tube (a colonoscope) is threaded up through the rectum for the purpose of inspecting the entire colon and rectum and, if there is an abnormality, taking a biopsy of it or removing it. The colonoscopy procedure requires a thorough bowel cleansing to assure a clear view of the lining. Called also coloscopy.

Colostomy: An alternative exit from the colon created to divert waste through a hole in the colon and through the wall of the abdomen. A (colostomy is commonly performed by severing the colon to attach the end leading to the stomach to the skin through the wall of the abdomen. The end of the colon that leads to the rectum is closed off and becomes dormant. This is known as a "Hartmann's Colostomy". There are other types of colostomy procedures, but this one is the most common. Usually a colostomy is performed for infection, blockage, or in rare instances, severe trauma of the colon. This is not an operation to be taken lightly. It demands the close attention of both patient and doctor. A colostomy is often performed so that an infection can be stopped and/or the affected colon tissues can heal.

Complication: In medicine, an additional problem that arises following a procedure, treatment or illness and is secondary to it. A complication complicates the situation.

Crohn's disease: A chronic inflammatory disease, primarily involving the small and large intestine, but which can affect other parts of the digestive system as well. It is named for Burrill Crohn, the American gastroenterologist who first described the disease in 1932.
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Diabetes: Refers to diabetes mellitus or, less often, to diabetes insipidus. Diabetes mellitus and diabetes insipidus share the name "diabetes" because they are both conditions characterized by excessive urination (polyuria).
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Diagnosis: 1 The nature of a disease; the identification of an illness. 2 A conclusion or decision reached by diagnosis. The diagnosis is rabies. 3 The identification of any problem. The diagnosis was a plugged IV.
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Diarrhea: A familiar phenomenon with unusually frequent or unusually liquid bowel movements, excessive watery evacuations of fecal material. The opposite of constipation. The word "diarrhea" with its odd spelling is a near steal from the Greek "diarrhoia" meaning "a flowing through." Plato and Aristotle may have had diarrhoia while today we have diarrhea. There are myriad infectious and noninfectious causes of diarrhea.
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Duct: A passage or a tube with well-defined walls suitable for the conveyance of air or liquids, as the bile duct and the pancreatic duct.
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Duodenum: The first part of the small intestine. The duodenum extends from the pylorus at the bottom of the stomach to the jejunum, the second part of the small intestine. The duodenum is a common site for the formation of peptic ulcers. We often live with words without thinking where they come from or what they originally meant. That is the case for me with the duodenum. For decades, this writer knew the duodenum as a short but troubled sector of the small intestine. Only today did I learn that the duodenum began as the dodeka-daktulon, twelve fingers to the Greeks, who astutely observed that the duodenum is about 12 finger-breadths long. In German, the popular term for duodenum is Zwolffingerdarm, the 12-finger intestine.

Dyspepsia: Dyspepsia refers to a condition (disease) in which there are upper abdominal symptoms which may include upper abdominal pain, bloating (a feeling of abdominal fullness without objective abdominal distention), early satiety (a feeling of unusual fullness with very little intake of food), nausea, or belching. The symptoms often are provoked by eating.
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EGD: Esophagogastroduodenoscopy.

Endoscope: A lighted optical instrument used to get a deep look inside the body and examine organs such as the throat or esophagus. An endoscope can be rigid or flexible.
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Endoscopic retrograde cholangiopancreatography: Abbreviated ERCP. A procedure done to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. ERCP combines the use of x-rays and an endoscope (a long, flexible, lighted tube). Through it, the physician can see the inside of the stomach and duodenum and inject dye into the bile ducts and pancreas so they can be seen on x-ray. ERCP takes 30 minutes to 2 hours. Possible complications of ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the duodenum.
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Endoscopic ultrasound: Abbreviated EUS. A procedure that combines endoscopy and ultrasound to obtain images and information about the digestive tract and the surrounding tissue and organs. In EUS a small ultrasound transducer is installed on the tip of the endoscope allowing the transducer to get close to the organs inside the body so the resultant ultrasound images are often more accurate and detailed than ones obtained by traditional ultrasound.
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Endoscopy: Endoscopy is a broad term used to described examining the inside of the body using a lighted, flexible instrument called an endoscope. In general, an endoscope is introduced into the body through a natural opening like the mouth or anus. Although endoscopy can include examination of other organs, the most common endoscopic procedures evaluate the esophagus (swallowing tube), stomach, and portions of the intestine.

Enema: Liquid injected into the rectum. An enema may be used for therapeutic (such as to stimulate evacuation of the bowels) or diagnostic (such as imaging studies of the gastrointestinal tract - barium enema) purposes.

ERCP: Endoscopic retrograde cholangiopancreatography.

Esophagogastroduodenoscopy: Also known as EGD or upper endoscopy. A procedure that enables the examiner (usually a gastroenterologist) to examine the esophagus (the swallowing tube), stomach, and duodenum (the first portion of small bowel) using a thin flexible tube (a "scope") that can be looked through or seen on a TV monitor. (A great crossword puzzle/trivia term!)

Esophagus: The tube that connects the pharynx (throat) with the stomach. The esophagus lies between the trachea (windpipe) and the spine. It passes down the neck, pierces the diaphragm just to the left of the midline, and joins the cardiac (upper) end of the stomach. In an adult, the esophagus is about 25 centimeters (10 inches) long. When a person swallows, the muscular walls of the esophagus contract to push food down into the stomach. Glands in the lining of the esophagus produce mucus, which keeps the passageway moist and facilitates swallowing. Also known as the gullet or swallowing tube. From the Greek oisophagos, from oisein meaning to bear or carry + phagein, to eat.

Fetus: The unborn offspring from the end of the 8^th week after conception (when the major structures have formed) until birth. Up until the eighth week, the developing offspring is called an embryo.

Gallbladder: A pear-shaped organ just below the liver that stores the bile secreted by the liver. During a fatty meal, the gallbladder contracts, delivering the bile through the bile ducts into the intestines to help with digestion. Abnormal composition of bile leads to formation of gallstones, a process termed cholelithiasis. The gallstones cause cholecystitis, inflammation of the gallbladder.

Gastroenteritis: Inflammation of the stomach and the intestines. Can cause nausea and vomiting and/or diarrhea. Gastroenteritis has numerous causes: including infectious organisms (viruses, bacteria, etc.), food poisoning, and stress.

Gastroenterologist: A physician who specializes in the diagnosis and treatment of disorders of the gastrointestinal tract, including the esophagus, stomach, small intestine, large intestine, pancreas, liver, gallbladder, and biliary system.

Gastroenterology: The medical specialty devoted to the study, diagnosis and treatment of disorders of the digestive system. These disorders may affect the esophagus (swallowing tube), stomach, small intestine, large intestine (colon), rectum, liver, gallbladder, or pancreas.
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Ileostomy: An opening into the ileum, part of the small intestine, from the outside of the body. An ileostomy provides a new path for waste material to leave the body after part of the intestine has been removed. An opening into the ileum, part of the small intestine, from the outside of the body. An ileostomy provides a new path for waste material to leave the body after part of the intestine has been removed.

Ileum: The lowest part of the small intestine, located beyond the duodenum and jejunum, just before the large intestine (the colon). Pronounced "il-eum" in the US and "eye-leum" in the UK.
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Immune: Protected against infection. The Latin immunis means free, exempt.

Immune system: A complex system that is responsible for distinguishing us from everything foreign to us, and for protecting us against infections and foreign substances. The immune system works to seek and kill invaders.
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Infection: The growth of a parasitic organism within the body. (A parasitic organism is one that lives on or in another organism and draws its nourishment therefrom.) A person with an infection has another organism (a "germ") growing within him, drawing its nourishment from the person.
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Inflammation: A basic way in which the body reacts to infection, irritation or other injury, the key feature being redness, warmth, swelling and pain. Inflammation is now recognized as a type of nonspecific immune response.
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Inflammatory bowel disease: A group of chronic intestinal diseases characterized by inflammation of the bowel -- the large or small intestine. The most common types of inflammatory bowel disease (IBD) are ulcerative colitis and Crohn disease.
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Informed consent: A process in which a person learns key facts about a clinical trial, including potential risks and benefits, before deciding whether or not to participate in a study. Informed consent continues throughout the trial.

Internal medicine: A medical specialty dedicated to the diagnosis and medical treatment of adults. A physician who specializes in internal medicine is referred to as an internist. A minimum of seven years of medical school and postgraduate training are focused on learning the prevention, diagnosis, and treatment of diseases of adults. Subspecialties of internal medicine include allergy and immunology, cardiology (heart), endocrinology (hormone disorders), hematology (blood disorders), infectious diseases, gastroenterology (diseases of the gut), nephrology (kidney diseases), oncology (cancer), pulmonology (lung disorders), and rheumatology (arthritis and musculoskeletal disorders).

Intestine: The long, tubelike organ in the abdomen that completes the process of digestion. It consists of the small and large intestines.

Kidney: One of a pair of organs located in the right and left side of the abdomen which clear "poisons" from the blood, regulate acid concentration and maintain water balance in the body by excreting urine. The kidneys are part of the urinary tract. The urine then passes through connecting tubes called "ureters" into the bladder. The bladder stores the urine until it is released during urination.

Lab test: A test that is done in the laboratory where the appropriate equipment, supplies, and certified expertise are available.

Large intestine: Comes after the small intestine. Large because it is wider than the small intestine.

Liver: An organ in the upper abdomen that aids in digestion and removes waste products and worn-out cells from the blood. The liver is the largest solid organ in the body. The liver weighs about three and a half pounds (1.6 kilograms). It measures about 8 inches (20 cm) horizontally (across) and 6.5 inches (17 cm) vertically (down) and is 4.5 inches (12 cm) thick.

Lower GI series: Short for lower gastrointestinal series. A series of x-rays of the rectum, colon and lower section of the small intestine taken after the patient has a barium enema. Barium is a white, chalky substance that coats the organs so they will show up on the x-ray. Also called a barium enema or a barium enema x-ray.

Malabsorption: The impaired absorption by the intestines of nutrients from food. Malabsorption can be specific and involve sugars, fats, proteins, or vitamins. Alternatively, malabsorption can be general and nonspecific.
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Microscope: An optical instrument that augments the power of the eye to see small objects. The name microscope was coined by Johannes Faber (1574-1629) who in 1628 borrowed from the Greek to combined micro-, small with skopein, to view. Although the first microscopes were simple microscopes, most (if not all) optical microscopes today are compound microscopes.

Mouth: 1. The upper opening of the digestive tract, beginning with the lips and containing the teeth, gums, and tongue. Foodstuffs are broken down mechanically in the mouth by chewing and saliva is added as a lubricant. Saliva contains amylase, an enzyme that digests starch. 2. Any opening or aperture in the body. The mouth in both senses of the word is also called the os, the Latin word for an opening, or mouth. The o in os is pronounced as in hope. The genitive form of os is oris from which comes the word oral.

Nasogastric: Referring to the passage from the nose to the stomach. A nasogastric tube is one that is passed through the nose (via the nasopharynx and esophagus) down into the stomach. The abbreviation for nasogastric is NG. The tube is an NG tube.
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Nasogastric tube: A tube that is passed through the nose and down through the nasopharynx and esophagus into the stomach. Abbreviated NG tube. It is a flexible tube made of rubber or plastic, and it has bidirectional potential. It can be used to remove the contents of the stomach, including air, to decompress the stomach, or to remove small solid objects and fluid, such as poison, from the stomach. An NG tube can also be used to put substances into the stomach, and so it may be used to place nutrients directly into the stomach when a patient cannot take food or drink by mouth.
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Nausea: Nausea, is the urge to vomit. It can be brought by many causes including, systemic illnesses, such as influenza, medications, pain, and inner ear disease. When nausea and/or vomiting are persistent, or when they are accompanied by other severe symptoms such as abdominal pain, jaundice, fever, or bleeding, a physician should be consulted.

NG tube: See: Nasogastric tube.

Nutrition: 1) The science or practice of taking in and utilizing foods. 2) A nourishing substance, such as nutritional solutions delivered to hospitalized patients via an IV or IG tube.

Ostomy: An operation to create an opening from an area inside the body to the outside.

Oxygen: A colorless, odorless and tasteless gas that makes up about 20% of the air we breathe (and at least half the weight of the entire solid crust of the earth) and which combines with most of the other elements to form oxides. Oxygen is essential to human, animal and plant life.
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PA-C: Physician Assistant - Certified.

Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia. Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors.
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Pancreas: A fish-shaped spongy grayish-pink organ about 6 inches (15 cm) long that stretches across the back of the abdomen, behind the stomach. The head of the pancreas is on the right side of the abdomen and is connected to the duodenum (the first section of the small intestine). The narrow end of the pancreas, called the tail, extends to the left side of the body.

Pediatric: Pertaining to children.

Pharmacy: A location where prescription drugs are sold. A pharmacy is, by law, constantly supervised by a licensed pharmacist.

Primary care: The "medical home" for a patient, ideally providing continuity and integration of health care. All family physicians and most pediatricians and internists are in primary care. The aims of primary care are to provide the patient with a broad spectrum of care, both preventive and curative, over a period of time and to coordinate all of the care the patient receives.

Primary care provider: In insurance parlance, a physician chosen by or assigned to a patient, who both provides primary care and acts as a gatekeeper to control access to other medical services.

Rectum: The last 6 to 8 inches of the large intestine. The rectum stores solid waste until it leaves the body through the anus. The word rectum comes from the Latin rectus meaning straight (which the human rectum is not).

Regimen: With the accent on the first syllable (reg as in Reggie Jackson), a regimen is a plan, a regulated course such as a diet, exercise or treatment, designed to give a good result. A low-salt diet is a regimen.

Regional enteritis: Crohn's disease, a chronic inflammatory disease of the intestine primarily in the small and large intestines but which can occur anywhere in the digestive system between the mouth and the anus.
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Sedative: A drug that calms a patient down, easing agitation and permitting sleep. Sedatives generally work by modulating signals within the central nervous system. These sedatives can dangerously depress important signals needed to maintain heart and lung function if they are misused or accidentally combined, as in the case of combining prescription sedatives with alcohol. Most sedatives also have addictive potential. For these reasons, sedatives should be used under supervision, and only as needed.

Sigmoid: In human anatomy, the lower colon (the lower portion of the large bowel). "Sigmoid" is short for "sigmoid colon."
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Sigmoidoscopy: Inspection of the rectum and lower colon using a thin lighted tube called a sigmoidoscope. Samples of tissue or cells may be collected for examination under a microscope. Also called proctosigmoidoscopy.

Small bowel: Another name for the small intestine.
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Small intestine: The part of the digestive tract that extends from the stomach to the large intestine.

Stoma: An opening into the body from the outside created by a surgeon.

Stomach: 1. The sac-shaped digestive organ that is located in the upper abdomen, under the ribs. The upper part of the stomach connects to the esophagus, and the lower part leads into the small intestine.
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Stool: The solid matter discharged in a bowel movement.

Syndrome: A set of signs and symptoms that tend to occur together and which reflect the presence of a particular disease or an increased chance of developing a particular disease.
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Terminal ileitis: Crohn's disease, a chronic inflammatory disease of the intestine involving only the end of the small intestine (the terminal ileum). Crohn's disease affects primarily the small and large intestines but which can occur anywhere in the digestive system between the mouth and the anus. Named after Burrill Crohn who described the disease in 1932. The disease often strikes persons in their teens or early twenties. It tends to be chronic, recurrent with periods of remission and exacerbation. In the early stages, It causes small scattered shallow crater-like areas (erosions) called aphthous ulcers in the inner surface of the bowel. With time, deeper and larger ulcers develop, causing scarring and stiffness of the bowel and the bowel becomes increasingly narrowed, leading to obstruction. Deep ulcers can puncture holes in the bowel wall, leading to infection in the abdominal cavity (peritonitis) and in adjacent organs Abdominal pain, diarrhea, vomiting, fever, and weight loss can be symptoms. Crohn's disease can be associated with reddish tender skin nodules, and inflammation of the joints, spine, eyes, and liver. Diagnosis is by barium enema, barium x-ray of the small bowel, and colonoscopy. Treatment includes medications for inflammation, immune suppression, antibiotics, or surgery.

Therapy: The treatment of disease.
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Ulcer: An area of tissue erosion, for example, of the skin or lining of the gastrointestinal (GI) tract. Due to the erosion, an ulcer is concave. It is always depressed below the level of the surrounding tissue.
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Ulcerative colitis: A relatively common disease that causes inflammation of the large intestine (the colon). The cause is unknown.
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Ultrasound: High-frequency sound waves. Ultrasound waves can be bounced off of tissues using special devices. The echoes are then converted into a picture called a sonogram. Ultrasound imaging, referred to as ultrasonography, allows physicians and patients to get an inside view of soft tissues and body cavities, without using invasive techniques. Ultrasound is often used to examine a fetus during pregnancy. There is no convincing evidence for any danger from ultrasound during pregnancy.

Womb: The womb (uterus) is a hollow, pear-shaped organ located in a woman's lower abdomen between the bladder and the rectum. The narrow, lower portion of the uterus is the cervix; the broader, upper part is the corpus. The corpus is made up of two layers of tissue.

X-ray: 1. High-energy radiation with waves shorter than those of visible light. X-rays possess the properties of penetrating most substances (to varying extents), of acting on a photographic film or plate (permitting radiography), and of causing a fluorescent screen to give off light (permitting fluoroscopy). In low doses X-rays are used for making images that help to diagnose disease, and in high doses to treat cancer. Formerly called a Roentgen ray. 2. An image obtained by means of X-rays.