Abstract
Many gastrointestinal disease show specific changes morphologically, and these morphological changes may affect the function resulting in manifestation of clinical feature. Therefore, it is important to evaluate the functional disturbance using gastroenterological endoscopy in the understanding of the pathophysiological mechanisms underlying the gastrointestinal diseases. Vascular pattern in the gastrointestinal mucosa reflects the blood flow in the submucosa. The peptic ulcer tends to relapse frequently when surrounding microvessels are few, irregular or interrupted. Thus, assessment of not only endoscopic findings but microvascular appearance is necessary to judge whether the structure of ulcer scar is mature or immature. The microvascular pattern in the duodenal mucosa changes after administration of gastrointestinal hor-mone such as CCK. This result suggests the possibility that endoscopic observation can indicate the process of digestion or absorption. It is necessary to establish the clinical entity of duodenitis and the concept of bulbitis, which is differ-ent from panduodenitis in pathological feature. The true purpose of therapy for peptic ulcers is to get the complete ulcer healing without relapse. We introduced a new concept of "Quality of ulcer hear-ing ; QOUH"to evaluate the therapy for peptic ulcers. Electronic endoscopy, fluorescence endoscopy and ultrasonic endoscopy are very useful for the assessment of QOUH. The presence of Helicobacter pylori (HP) may affect healing of gastric ulcer and gastritis. However, infection of HP is local or patchy in the stomach. We succeeded in showing the distribution of HP in gastric mucosa during endoscopy using pigments of red cabbage, which changes its color by NH3 produced by HP. I would like to emphasize that correction of basic and primary pathophysiological findings supplies useful many information in order to recognized the pathology of gastrointestinal tract and its therapy. And, at the same time, these findings contribute the elucidation of cause of disease.
