Diagnosis and treatment of gastroenterologic disease have been progressed after twentieth century. Nowdays a lot of diseases, which were called incurable diseases before have been treated or managed successfully. But, there are still many incurable diseases left, including advanced cancer and inflammatory bowel disease in gastroenterology. Here we reviewed some cases of celebrities' gastroenterologic incurable diseases. We hoped to widen our understandings of those diseases and give opportunities for the better treatment. Embracements of patients suffering from gastroenterologic incurable diseases were diverse. We can find out they ended their lives doing the most precious things. Among them, the love for their family members were the most universal and important concerns. We hope the patients suffering from gastroenterologic incurable diseases can have more opportunities for better treatments and to be understood in their situations.
Comprehension ; Famous Persons ; Gastrointestinal Diseases/*psychology ; Gastrointestinal Neoplasms/psychology ; Humans

Combined Modality Therapy ; Disease Progression ; Gastrointestinal Neoplasms ; diagnosis ; therapy ; Humans ; Physicians ; psychology

PURPOSE: The purpose of this study was to identify the factors influencing quality of life after analyzing the relationship between depression, health promotion and quality of life in patients with gastrointestinal neoplasms. METHODS: The subjects of this study were 63 people who underwent treatments from 2 general hospitals in Seoul and Daejeon and had no recurrence in stages I & II of gastrointestinal neoplasms. Data was collected from March 1 to April 30, 2006. A questionnaire consisting of Center for Epidemiologic Studies Depression (CES-D), Health Promoting Lifestyle Profile II (HPLP II) and Functional Assessment of Cancer Therapy-Colorectal (FACT-C) was given. The collected data was analyzed with the SPSS program which was used for descriptive statistics, Pearson correlation coefficients and hierarchical multiple regression. RESULTS: The major findings of this study were as follows: 1) There was a significant relationship between depression (r=-.639, p=.000), health promotion (r=.407, p=.001) and quality of life. 2) Significant factors were depression (F=-4.091, p=.000) and health promotion (F=2.375, p=.021) that explained 46% of quality of life (F=10.022, p=.000). CONCLUSION: Cancer patients experienced extreme depression which led to a negative effect on quality of life. Health promotion was an important variable to the quality of life and it gave the patients motivation for having a will and belief for better health.
Adult ; Aged ; Data Interpretation, Statistical ; Depression/psychology ; Female ; Gastrointestinal Neoplasms/*psychology ; Health Promotion ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; *Quality of Life ; Questionnaires

OBJECTIVETo investigate the impact of depression and anxiety assessment performed in gastrointestinal cancer patients on postoperative depression and anxiety symptom and mental health service visit.

METHODSA total of 254 gastrointestinal cancer patients who underwent surgical procedure were assigned into assessment group (n=121) and control group (n=133). Depression and anxiety assessment were performed with PHQ-9 and GAD-7 in assessment group on admission, discharge and at 3-month follow-up while in control group only at 3-month follow-up. The point prevalence of depression and anxiety were evaluated in assessment group with established cut-off reported by ASCO defining depression as a PHQ-9 score no less than 8 and anxiety as a GAD-7 score no less than 5. PHQ-9 and GAD-7 scores at 3-month follow-up were compared using Mann-Whitney U test.

RESULTSAccording to the PHQ-9 and GAD-7 score, the prevalence of depression was 28.9%(35/121) and anxiety was 37.2%(45/121) in assessment group, and depression was found in 9.9%(12/121) with comorbid anxiety. During the 3-month follow-up, the PHQ-9 and GAD-7 score in assessment group (6.02±4.67 and 4.19±3.95) were both lower than those in control group (8.83±6.63 and 6.41±5.80) with statistically significant differences (all P<0.05). Patients in assessment group were more likely to seek for help in mental health service than those in control group [10.7%(13/121) vs. 3.0%(4/133), χ(2)=9.726, P=0.014] in 3-month follow-up after surgery.

CONCLUSIONSThe prevalence of depression and anxiety is high in gastrointestinal cancer patients. Depression and anxiety assessment routinely performed for gastrointestinal cancer patients can enhance utilization of mental health service and reduce postoperative depression and anxiety symptom thus potentially improve quality of life.

Anxiety ; diagnosis ; Depression ; diagnosis ; Gastrointestinal Neoplasms ; psychology ; surgery ; Humans ; Mental Health Services ; Postoperative Period ; Quality of Life ; Surveys and Questionnaires

Gastrointestinal cancer and related treatments (surgery and chemoradiotherapy) are associated with declined functional status (FS) that has impact on quality of life, clinical outcome and continuum of care. Psychological distress drives an impressive burden of physiological and psychiatric conditions in oncologic care. Cancer patients often experience anxiety, depression, low self-esteem and fears of recurrence and death. Cancer prehabilitation is a process from cancer diagnosis to the beginning of treatment, which includes psychological, physical and nutritional assessments for a baseline functional level, identification of comorbidity, and targeted interventions that improve patient's health and functional capacity to reduce the incidence and the severity of current and future impairments with cancer, chemoradiotherapy and surgery. Multimodal prehabilitation program encompasses a series of planned, structured, repeatable and purposive interventions including comprehensive physical exercise, nutritional therapy, and relieving anxiety and depression, which integrates into best perioperative management ERAS pathway and aims at using the preoperative period to prevent or attenuate the surgery-related functional decline, to cope with surgical stress and to improve the consequences. However, a number of questions remain in regards to prehabilitation in gastrointestinal cancer surgery, which consists of the optimal makeup of training programs, the timing and approach of the intervention, how to improve compliance, how to measure functional capacity, and how to make cost-effective analysis. Therefore, more high-level evidence-based studies are expected to evaluate the value of implementation of prehabilitation into standard practice.
Chemoradiotherapy/adverse effects* ; Digestive System Surgical Procedures/psychology* ; Gastrointestinal Neoplasms/therapy* ; Humans ; Preoperative Care ; Preoperative Exercise ; Quality of Life ; Recovery of Function

Constipation is a common gastrointestinal disease affecting approximately 16.5% of the population in Korea. Systemic diseases such as hypothyroidism or colon cancer and drugs can cause constipation in some patients with constipation, there is no obstructive mucosal or structural cause in the vast majority of patients with constipation. Evaluation for secondary causes of constipation is needed to provide appropriate management. Once secondary causes have been excluded, constipation may be classified into normal or slow transit constipation, evacuation disorder of the spastic or flaccid varieties, or both. Treatment of chronic constipation based on the underlying pathophysiology is generally successful. The aims of this review are to discuss the management of functional constipation based on guidelines for the treatment of constipation published in Korean Journal of Gastroenterology in 2011: lifestyle changes; bulking agents and stool softeners; osmotic agents; stimulant laxatives; prokinetics; biofeedback and surgical treatments. Exercise and dietary fiber are helpful in some patients with constipation. Laxatives including bulking agents, stool softeners, osmotic agents, stimulant laxatives have been found to be more effective than placebo at relieving symptoms of constipation. New enterokinetic agents such as 5-hydroxytryptamine-4 receptor agonists, intestinal secretagogues, and peripheral opioid antagonists could be effective in patients with constipation who cannot get adequate relief from current laxatives. Biofeedback could relieve symptoms in selected patients with constipation due to pelvic floor dyssynergia. Surgical treatments can be helpful in some patients with refractory constipation.
Ataxia ; Biofeedback, Psychology ; Colonic Neoplasms ; Constipation ; Dietary Fiber ; Gastroenterology ; Gastrointestinal Diseases ; Humans ; Hypothyroidism ; Korea ; Laxatives ; Life Style ; Muscle Spasticity ; Narcotic Antagonists ; Pelvic Floor ; Receptors, Serotonin, 5-HT4

Subepithelial lesions occasionally found in the stomach of patients undergoing endoscopy may be either benign lesions or tumors with malignant potential. They may also appear due to extrinsic compression. Discrimination of gastric subepithelial lesions begins with meticulous endoscopic examination for size, shape, color, mobility, consistency, and appearance of the overlying mucosa. Accurate diagnosis can be achieved with endoscopic ultrasonography, which provides useful information on the exact size, layer-of-origin, and characteristic morphologic features to support a definitive diagnosis. Endoscopic ultrasonography also aids in the prediction of malignant potential, especially in gastrointestinal stromal tumors. Features of subepithelial lesions identified on endoscopic ultrasonography can be used to determine whether further diagnostic procedures such as endoscopic resection, fine needle aspiration, or core biopsy are required. Endoscopic ultrasonography is a valuable tool for diagnosis and clinical decision making during follow-up of gastric subepithelial lesions.
Biopsy ; Biopsy, Fine-Needle ; Clinical Decision-Making ; Diagnosis* ; Discrimination (Psychology) ; Endoscopy ; Endosonography* ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Humans ; Mucous Membrane ; Stomach ; Stomach Neoplasms

Estimating the risk of Helicobacter pylori (H. pylori)-induced gastric cancer during endoscopic examination is important. Owing to recent advances in gastrointestinal endoscopy, the gross appearance of the background gastric mucosa has enabled discrimination of subjects with active, chronic, and past H. pylori infection from those with no history of infection. To provide subjective criteria for H. pylori infection-related endoscopic findings with increased risk of gastric cancer, the Kyoto classification of gastritis was proposed at the 85th annual meeting of the Japanese Society for Gastrointestinal Endoscopy in May 2013 in Kyoto. The main contents focus on determining the gastric cancer risk by scoring the endoscopic findings of the background gastric mucosa from 0 to 8. These important findings are not described in the Kyoto Global Consensus Conference proceedings published in English. To better estimate the gastric cancer risk during screening endoscopy in an H. pylori-prevalent population, knowledge of the Japanese version of the Kyoto classification is important. This new classification emphasizes the discrimination of subjects with H. pylori infection by assessing 19 endoscopic findings (presence of atrophy, intestinal metaplasia, diffuse redness, spotty redness, mucosal swelling, enlarged folds, sticky mucus, chicken skin-like nodularity, foveolar-hyperplastic polyp, xanthoma, depressed erosion, regular arrangement of collecting venules, fundic gland polyp, linear red streak, raised erosion, hematin deposit, multiple white and flat-elevated lesions, patchy redness, and map-like redness). In this review, the validity of the Kyoto classification is summarized in conjunction with several suggestions to resolve emerging H. pylori infection-related problems in Korea.
Asian Continental Ancestry Group ; Atrophy ; Chickens ; Classification ; Consensus ; Discrimination (Psychology) ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastric Mucosa ; Gastritis ; Helicobacter pylori ; Helicobacter ; Hemin ; Humans ; Korea ; Mass Screening ; Metaplasia ; Mucus ; Polyps ; Stomach Neoplasms ; Venules ; Xanthomatosis