Front Cover -- Digestive Diseases in Sub-Saharan Africa: Changes and Challenges -- Copyright -- Contents -- Contributors -- Dedication -- Foreword -- Preface -- References -- Acknowledgments -- Introduction -- Reference -- Chapter 1: Alcohol and Smoking: Impact of Behavioral Risk Factors -- Introduction -- Alcohol Consumption -- Global situation -- Alcohol Use in SSA -- Smoking -- Epidemiology of Esophageal Cancer-Relationship to Smoking, Alcohol, and Diet [7,8] -- Predictions for the 21st Century -- References -- Chapter 2: Urbanization, Upward Mobility, Demographics, Environmental Changes, and Availability of Natural Resources in Sub... -- Urbanization -- Upward Mobility -- Demography -- Environmental Influences and Impacts -- Xenobiotics -- Smoking -- Alcohol -- Volatile Hydrocarbons -- Occupations -- Air Pollution -- Dietary Changes -- Climate Change -- Sustainability -- Resources Availability -- References -- Chapter 3: Review of Traditional Digestive Diseases Common in SSA -- Introduction -- Cancer of the Esophagus -- Gerd -- Gastric Ulcer in SSA -- Gastric Cancer (GC) -- Duodenal Ulcer -- Duodenal Ulcer Prevalence in Africa South of the Sahara [14] -- DU in an Urban Milieu -- Acute and Chronic Pancreatitis -- Tropical Pancreatitis -- Large Bowel Disease -- Appendicitis -- Sigmoid Volvulus -- Diverticular Disease (DD) -- Conclusion -- Inflammatory Bowel Disease (IBD) -- Colorectal Cancer (CRC) -- Biliary Disease -- Liver Disease -- Viral Hepatitis [41] -- Hepatitis A -- Hepatitis B (HBV) -- Hepatitis C (HCV) -- Hepatitis D (HDV) -- Hepatitis E -- Hepatocellular Carcinoma in SSA -- Comments -- References -- Further Reading -- Chapter 4: Epidemiology of Digestive Diseases in SSA: Trends That are Occurring -- Cancer of the Esophagus -- Gerd [5] -- Gastric Ulcer (GU) -- Gastric Cancer -- Duodenal Ulcer (DU) -- Pancreatitis. Alcoholic Pancreatitis -- Acute Alcohol-Induced Pancreatitis (AAIP) -- Chronic Calcific Pancreatitis [24-26] -- Biliary Pancreatitis -- Tropical Pancreatitis -- Large Bowel Disease -- Appendicitis -- Inflammatory Bowel Disease -- Diverticular Disease (DD) -- Conclusions -- Sigmoid Volvulus -- Colorectal Cancer (CRC) -- Comments -- Biliary Diseases in SSA -- Gallstones (Cholecystolithiasis) -- Gallstone Pancreatitis -- Choledocholithiasis -- Bile Duct Injuries -- Gallbladder Cancer -- Parasitic Infections of the Biliary Tree -- Obstructive Jaundice (OJ) -- Conclusions -- Viral Hepatitis in SSA -- Hepatitis A (HAV) -- Hepatitis B (HBV) -- Hepatitis C -- Hepatitis D -- Hepatitis E -- Hepatocellular Carcinoma (HCC) -- Epidemiology in SSA -- References -- Further Reading -- Chapter 5: Emerging Nonintestinal Diseases Arising in SSA -- Obesity -- Cardiovascular Disease (CVD) [4] -- Diabetes Mellitus [5] -- Mental Disorders -- Extraintestinal Cancers in SSA -- References -- Chapter 6: Changes in Nutritional Status of Africans: Dietary Recommendations for Sub-Saharan Africa -- Introduction -- The Nutrition Transition (NT): Characteristics, Consequences, and Causes -- Characteristics of Dietary and Nutrient Changes -- Consequences -- Possible Causes of the Double Burden -- The biological link -- The sociocultural responses to economic development -- Dietary and Policy Recommendations for SSA -- Dietary Recommendations: Development of Food-Based Dietary Guidelines -- Policy Recommendations -- Improve the food environment -- Create opportunities for increased physical activity -- Educate consumers to make the right choices -- Recommended Reading -- Chapter 7: Cancer of the Esophagus in Sub-Saharan Africa -- Introduction -- Smoking and CE -- Relationship to Alcohol and Diet -- Clinical Characteristics -- Investigations -- Treatment -- The Way Forward. References -- Chapter 8: Duodenal Ulcer and Diet in Sub-Saharan Africa -- Introduction -- Duodenal Ulcer South of the Sahara [3, 4] -- Particular Areas of Interest -- Nile-Congo Watershed -- Tanzani a -- Kenya -- The Masai and Other Milk- and Blood-Eating Tribes -- South Africa and Southern Africa -- Swaziland -- Ethiopia -- Duodenal Ulcer Characteristics and Effect of Urbanization -- Evidence Relating to the Effect of Staple Diets on Duodenal Ulcer Prevalence -- Helicobacter pylori ( H. pylori) Infection and Duodenal Ulcer Prevalence -- Protective Factors in the Staple Diet of Low Prevalence Areas of Duodenal Ulceration -- Role of Dietary Fiber -- Role of Dietary Lipids -- The Nature and Activity of the Protective Lipids [29, 30] -- Rice and Rice Bran Oil [31-33] -- Maize and Maize Oil [31, 34] -- Investigations Into the Nature and Activity of Components of HGL [30] -- Phospholipids [30, 35] -- Sterols [30, 35, 44] -- Sterol Esters [30] -- Review of Protective Activity -- Conclusion -- References -- Chapter 9: Helicobacter pylori in Sub-Saharan Africa -- Introduction -- Africa: The Home of Helicobacter pylori -- The Epidemiology of Helicobacter pylori Infection in Sub-Saharan Africa -- The African Enigma -- Helicobacter pylori -Related Disease in Patients With Dyspepsia -- Duodenal Ulcer -- Gastric Ulcer -- Gastric Cancer -- H. pylori Genotypes and Disease -- H. pylori Genotypes in Sub-Saharan Africa -- Antibiotic Resistance -- H. pylori and Association With Other Diseases in Africa -- Conclusion -- References -- Further Reading -- Chapter 10: Pancreatitis in Sub-Saharan Africa -- Introduction -- Clinical Aspects [1,7] -- Diagnosis -- Initial diagnostic tests -- Imaging Studies -- Management of Acute Pancreatitis -- Prognosis -- Complications -- When to Refer the Patient? -- Conclusions -- Chronic Pancreatitis. Etiology (Braganza-Manchester Hypothesis) [9] -- HIV/AIDS and Pancreatitis -- Biliary Pancreatitis -- Clinical Signs and Symptoms -- Laboratory investigations -- Assessment of Severity Using Prognostic Scoring Systems -- Scoring Systems-Predict Severity -- Management -- Major Complications [21] -- Conclusions -- Tropical Pancreatitis -- Epidemiology -- Pathology -- Etiology and Pathogenesis -- Clinical Presentation [22,23] -- Radiology -- Treatment -- References -- Chapter 11: HIV and the Digestive System -- Introduction -- Epidemiology -- ART and the Gastrointestinal Tract -- Clinical Approach -- Esophagitis -- Peptic Ulceration -- Diarrhea -- Helminth Infections and HIV -- Hepatobiliary Disease -- Hepatitis B Virus -- Hepatitis C -- Hepatocellular Carcinoma -- Causes of Jaundice or Symptomatic "Hepatitis" in the Patient on ART -- Pancreatitis -- Conclusions -- References -- Chapter 12: Characteristics of Inflammatory Bowel Disease in Sub-Saharan Africa -- IBD in SSA -- UC in SSA -- Crohn's Disease in SSA -- Validity of the data -- The Association of CD and TB [8,9] -- Conclusions With Regard to IBD in SSA -- Aspects of IBD in HICs -- Ulcerative Colitis -- Epidemiology -- Clinical Signs and Symptoms -- Treatment -- Management of IBD in HICs: Problems in LMICs -- Narrowing the Gap -- References -- Chapter 13: Abdominal Tuberculosis in Sub-Saharan Africa (SSA) -- Gastrointestinal Involvement -- Peritoneum -- Intestinal -- Lymphadenopathy -- Other Intestinal Organs -- Clinical Presentation -- Investigations -- Clinical Signs -- Intestinal ATB -- The Ascites of ATB -- Peritoneal Involvement -- Lymphadenopathy -- Visceral Solid Organ Involvement -- Laboratory Investigations -- Ultrasonography -- Intestines -- Lymphadenoathy -- Peritoneum -- Solid Organs -- Radiology -- Barium Enema -- CT Scan -- Endoscopy -- Laparoscopy -- Mri -- Microbiology. Histopathology -- Treatment -- Summary -- References -- Chapter 14: Colorectal Cancer in Sub-Saharan Africa -- Epidemiology -- Etiology -- Diet, Environmental, and Lifestyle Factors -- Precursor Lesions -- Pathology -- Clinical Features -- Diagnosis -- Treatment -- Adjunctive Therapy -- Prognosis -- Follow-up -- Follow-up Investigations -- Screening -- Challenges for Sub-Saharan Africa -- References -- Chapter 15: Aspects of Viral Hepatitis in Sub-Saharan Africa in the 21st Century -- Introduction -- Hepatitis A -- Hepatitis B -- Hepatitis C -- Hepatitis D -- Hepatitis E -- References -- Chapter 16: Hepatocellular Carcinoma in Africa -- Introduction -- Global Importance -- Epidemiology in Sub-Saharan Africa -- Etiological Risk Factors -- Viral Hepatitis -- Hepatitis B -- Hepatitis C -- Aflatoxin -- Alcohol -- Cirrhosis -- Iron Overload -- Family History -- HIV and Its Association with HCC -- Clinical Presentation -- Symptoms -- Signs -- Unusual Presentations ( Table 16.1) -- Paraneoplastic Manifestations of HCC -- Diagnosis -- Radiological Diagnosis -- Tissue Diagnosis -- The Barcelona Clinic Liver Cancer Staging System ( Fig. 16.2, [38a]) -- Treatment -- Liver Transplantation -- Surgical Resection -- Percutaneous Ablation -- Transarterial Embolization and Chemoembolization -- Sorafenib -- Other Treatments -- Conclusions -- Take Home Messages -- References -- Chapter 17: Biliary Disease in Sub-Saharan Africa -- Introduction -- Gallstones (Cholecystolithiasis) -- Gallstone Pancreatitis -- Choledocholithiasis -- Bile Duct Injuries -- Bile Duct Cysts -- Gallbladder Cancer -- Cholangiocarcinoma -- Obstructive Jaundice -- Conclusions -- References -- Chapter 18: Amoebiasis In Sub-Saharan Africa -- Introduction -- Epidemiology -- Life Cycle -- Pathophysiology -- Clinical Features -- Gastrointestinal -- Extraintestinal -- Pulmonary -- Brain. Other Presentations.