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Gastrointestinal stomas constitute an evident anatomical modification, but their perception by patients represents a serious and unacceptable alteration of the body schema. Esophagostomy, gastrostomy, and jejunostomy are usually temporary, but ileostomy and colostomy are permanent in many cases. Two purposes characterize the two types of intestinal stomas: to divert intestinal content and to allow enteral nutrition. The purpose of the stoma in the therapeutic program is surrounded by many misunderstandings and this notice given by surgeons is horrifying to patients. In this therapeutic scenario the enterostomal therapist plays a central role. This book pays great attention to the care of the stoma and its therapeutic role, but overall the need is to prevent diagnostic and therapeutic procedures for this surgical alteration to the body's anatomy.
The etiologic link between H. pylori infection and gastric chronic inflammation and related complications has been well established, but pathogenic pathways are still widely discussed and not sufficiently clear. The introduction of culture-independent molecular techniques has allowed better understanding of the gastric microbiota and has revealed that, when present, H. pylori represents the main colonizer but is part of a far more complex and dynamic microbiota than previously thought. This conceptual shift has made way for new pathogenic theories, focused on the interrelations between H. pylori and other gastric microbiota. Main factors that affect the gastric microbiota are gastric acidity, inflammation, and environmental factors, such as diet and drugs. Previous studies have made progress in explaining the complex interactions between gastric microorganisms in healthy individuals and their role in the development of related gastroduodenal (peptic ulcers and gastric cancer (GC)) and extraintestinal diseases, but more scientific proof is needed. This review presents current knowledge on gastric microbiota and its role in health and in the development of gastroduodenal diseases.
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