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European interlaboratory comparison of breath 13CO2 analysis. (1/442)
The BIOMED I programme Stable Isotopes in Gastroenterology and Nutrition (SIGN) has focused upon evaluation and standardisation of stable isotope breath tests using 13C labelled substrates. The programme dealt with comparison of 13C substrates, test meals, test conditions, analysis techniques, and calculation procedures. Analytical techniques applied for 13CO2 analysis were evaluated by taking an inventory of instrumentation, calibration protocols, and analysis procedures. Two ring tests were initiated measuring 13C abundances of carbonate materials. Evaluating the data it was found that seven different models of isotope ratio mass spectrometers (IRMS) were used by the participants applying both the dual inlet system and the continuous flow configuration. Eight different brands of certified 13C reference materials were used with a 13C abundance varying from delta 13CPDB -37.2 to +2.0/1000. CO2 was liberated from certified material by three techniques and different working standards were used varying from -47.4 to +0.4/1000 in their delta 13CPDB value. The standard deviations (SDs) found for all measurements by all participants were 0.25/1000 and 0.50/1000 for two carbonates used in the ring tests. The individual variation for the single participants varied from 0.02 /1000 (dual inlet system) to 0.14/1000 (continuous flow system). The measurement of the difference between two carbonates showed a SD of 0.33/1000 calculated for all participants. Internal precision of IRMS as indicated by the specifications of the different instrument suppliers is < 0.3/1000 for continuous flow systems. In this respect it can be concluded that all participants are working well within the instrument specifications even including sample preparation. Increased overall interlaboratory variation is therefore likely to be due to non-instrumental conditions. It is possible that consistent differences in sample handling leading to isotope fractionation are the causes for interlaboratory variation. Breath analysis does not require sample preparation. As such, interlaboratory variation will be less than observed for the carbonate samples and within the range indicated as internal precision for continuous flow instruments. From this it is concluded that pure analytical interlaboratory variation is acceptable despite the many differences in instrumentation and analytical protocols. Coordinated metabolic studies appear possible, in which different European laboratories perform 13CO2 analysis. Evaluation of compatibility of the analytical systems remains advisable, however. (+info)Management of coeliac disease: a changing diagnostic approach but what value in follow up? (2/442)
OBJECTIVE: To assess the management of patients with coeliac disease in relation to a change in diagnostic method from jejunal suction biopsy to endoscopic biopsy. DESIGN: 16 item questionnaire survey of consultant members of the British Society of Gastroenterology. SUBJECTS: 359 consultant physician and gastroenterologist members of the society. MAIN MEASURES: Type of routine biopsy; repeat biopsy after gluten withdrawal; gluten rechallenge; follow up measurements; screening for malignancy; and methods of follow up, including special clinics. RESULTS: 270(70%) members replied; 216(80%) diagnosed coeliac disease routinely by endoscopic duodenal biopsy, 30(11%) by jejunal capsule biopsy, and the remainder by either method. Only 156(58%) repeated the biopsy after gluten withdrawal, though more did so for duodenal than jejunal biopsies (134/216, 62% v 13/30, 43%; p < 0.02). Follow up biopsies featured more duodenal than jejunal biopsies (133/156, 82% v 23/156, 15%; p < 0.02). Regular follow up included assessments of weight (259, 96%) and full blood count (238, 88%) but limited assessment of serum B-12 and folate (120, 44%) and calcium (105, 39%) concentrations. Routine screening for malignancy is not performed, and there are few specialist clinics. 171(63%) respondents thought that patients should be followed up by a hospital specialist and 58(21%) by family doctors. CONCLUSIONS: The practice of diagnosing coeliac disease varies appreciably from that in many standard texts. Many patients could be effectively cared for by their family doctor. IMPLICATIONS: The British Society of Gastroenterology should support such management by family doctors by providing clear guidelines for them. (+info)Feasibility of monitoring patient based health outcomes in a routine hospital setting. (3/442)
OBJECTIVE: To assess the feasibility of monitoring health outcomes in a routine hospital setting and the value of feedback of outcomes data to clinicians by using the SF 36 health survey questionnaire. DESIGN: Administration of the questionnaire at baseline and three months, with analysis and interpretation of health status data after adjustments for sociodemographic variables and in conjunction with clinical data. Exploration of usefulness of outcomes data to clinicians through feedback discussion sessions and by an evaluation questionnaire. SETTING: One gastroenterology outpatient department in Aberdeen Royal Hospitals Trust, Scotland. PATIENTS: All (573) patients attending the department during one month (April 1993). MAIN MEASURES: Ability to obtain patient based outcomes data and requisite clinical information and feed it back to the clinicians in a useful and accessible form. RESULTS: Questionnaires were completed by 542 (95%) patients at baseline and 450 (87%) patients at follow up. Baseline health status data and health outcomes data for the eight different aspects of health were analysed for individual patients, key groups of patients, and the total recruited patient population. Significant differences were shown between patients and the general population and between different groups of patients, and in health status over time. After adjustment for differences in sociodemography and main diagnosis patients with particularly poor scores were identified and discussed. Clinicians judged that this type of assessment could be useful for individual patients if the results were available at the time of consultation or for a well defined group of patients if used as part of a clinical trial. CONCLUSIONS: Monitoring routine outcomes is feasible and instruments to achieve this, such as the SF 36 questionnaire, have potential value in an outpatient setting. IMPLICATIONS: If data on outcomes are to provide a basis for clinical and managerial decision making, information systems will be required to collect, analyse, interpret, and feed it back regularly and in good time. (+info)Gastroenterology research in the United Kingdom: funding sources and impact. (4/442)
AIMS: To determine the sources of founding for UK gastroenterology research papers and the relative impact of papers funded by different groups and of unfunded ones. METHODS: UK gastroenterology papers from 1988-94 were selectively retrieved from the Science Citation Index by means of a specially constructed filter based on their title keywords and journal names. They were looked up in libraries to determine their funding sources and these, together with their numbers of authors, numbers of addresses, and research category (clinical/basic) were considered as input parameters to the research. Output parameters analysed were mean journal impact category, citation counts by papers, and the frequency of citation by a US patient. RESULTS: Gastroenterology papers comprise about 7% of all UK biomedical research and 46% of them have no acknowledged funding source. One quarter of the papers acknowledged government support, and a similar fraction a private, non-profit source; 11% were funded by the pharmaceutical industry. The papers acknowledging funding had significantly more impact than the others on all three measures. The citing patents had six times more UK inventors than the average for all US Patent and Trademark Office patents in the relevant classes and were mostly generic in application. CONCLUSION: The variation in impact of papers funded by different sources can mostly be explained by a simple model based on the input factors (numbers of funding bodies, numbers of authors, numbers of addresses, and research type). The national science base in gastroenterology is important for the underpinning of UK invented patents citing to it. (+info)Gastrointestinal surgical workload in the DGH and the upper gastrointestinal surgeon. (5/442)
Workload implications of upper gastrointestinal (UGI) subspecialisation within the district general hospital (DGH) have been assessed by prospective data collection over a 12-month period in a DGH with six general surgeons serving a population of 320,000. The single UGI surgeon (UGIS) performed all ten oesophageal resections, ten of 11 gastric resections for malignancy and all eight pancreatic operations. He also performed 91 of the 182 cholecystectomies, 164 of the 250 endoscopic retrograde cholangiopancreatograms (ERCP) and all endoscopic procedures for the palliation of unresected oesophageal tumours. The UGIS was responsible for the management of all patients with severe pancreatitis, yet he also performed 51 colorectal resections over the 12-month period. Successful management of severely ill patients with upper GI disease requires consultant supervision on a day-to-day basis. If such UGI disease is to be managed in the DGH, two surgeons with UGI experience will be required if high quality care and reasonable working conditions are to be achieved. Such UGIS will continue to perform some colorectal surgery. (+info)Management of uninvestigated and functional dyspepsia: a Working Party report for the World Congresses of Gastroenterology 1998. (6/442)
BACKGROUND: The management of dyspepsia is controversial. METHODS: An international Working Party was convened in 1998 to review management strategies for dyspepsia and functional dyspepsia, based on a review of the literature and best clinical practice. RESULTS: Dyspepsia, defined as pain or discomfort centred in the upper abdomen, can be managed with reassurance and over-the-counter therapy if its duration is less than 4 weeks on initial presentation. For patients with chronic symptoms, clinical evaluation depends on alarm features including patient age. The age cut off selected should depend on the age specific incidence when gastric cancer begins to increase, but in Western nations 50 years is generally an acceptable age threshold. In younger patients without alarm features, Helicobacter pylori test and treatment is the approach recommended because of its value in eliminating the peptic ulcer disease diathesis. If, after eradication of H. pylori, symptoms either are not relieved or rapidly recur, then an empirical trial of therapy is recommended. Similarly, in H. pylori-negative patients without alarm features, an empirical trial (with antisecretory or prokinetic therapy depending on the predominant symptom) for up to 8 weeks is recommended. If drugs fail, endoscopy should be considered because of its reassurance value although the yield will be low. In older patients or those with alarm features, prompt endoscopy is recommended. If endoscopy is non-diagnostic, gastric biopsies are recommended to document H. pylori status unless already known. While treatment of H. pylori is unlikely to relieve the symptoms of functional dyspepsia, the long-term benefits probably outweigh the risks and treatment can be considered on a case-by-case basis. In H. pylori-negative patients with documented functional dyspepsia, antisecretory or prokinetic therapy, depending on the predominant symptom, is reasonable, assuming reassurance and explanation are insufficient, unless patients have already failed this approach. Other treatment options include antidepressants, antispasmodics, visceral analgesics such as serotonin type 3 receptor antagonists, and behavioural or psychotherapy although these are all of uncertain efficacy. Long-term drug treatment in functional dyspepsia should be avoided; intermittent short courses of treatment as needed is preferred. CONCLUSION: The management of dyspepsia recommended is based on current best evidence but must be tailored to local factors such as practice setting, the background prevalence of H. pylori and structural disease, and costs. (+info)National trends in gastroesophageal reflux surgery. (7/442)
OBJECTIVES: To assess the surgical technique and the frequency of different types of antireflux surgery used in Canada after the introduction of laparoscopic antireflux surgery. DESIGN: Gastroesophageal reflux (GER) surgery and population data in fiscal years 1992 through 1996. were accessed through the Canadian Institute of Health Information, provincial health ministries, MED ECHO and Statistics Canada databases. Data were also analysed by province and nationally for type of surgery (e.g., open abdominal, thoracic, thoracoscopic and laparoscopic). RESULTS: National data showed a slight increase in GER surgery in the last 5 years. Laparoscopic surgery increased 2.8 fold in 1993 and 1.6 fold in 1995 over the previous years. Open abdominal cases decreased 1.1 fold from 1992 to 1996. Thoracic cases remained essentially unchanged. Provincial and regional disparities in procedures per 100,000 population exist (Ontario 7.1 versus Nova Scotia 20.7). Areas in which little or no laparoscopic surgery was done had an average increase of 3%, whereas areas in which laparoscopic surgery was done had an average increase of 16% in GER surgery during the course of the study. In provinces west of Quebec (with the exception of Manitoba) more than 50% of GER surgery is laparoscopic; in areas east of Ontario less than 25% of GER surgery is performed laparoscopically. Five provinces (Manitoba, Quebec, Nova Scotia, Prince Edward Island and Newfoundland) performed significantly fewer laparoscopic procedures than the national average. CONCLUSIONS: The frequency of GER surgery is increasing modestly in Canada and is performed most often by the open abdominal route. Regional disparities in open and laparoscopic techniques are apparent. Laparoscopic surgery for GER is increasing rapidly and accounts for the decrease in open GER surgery. (+info)Differences between generalists and specialists in characteristics of patients receiving gastrointestinal procedures. (8/442)
BACKGROUND: As a result of market forces and maturing technology, generalists are currently providing services, such as colonoscopy, that in the past were deemed the realm of specialists. OBJECTIVE: To determine whether there were differences in patient characteristics, procedure complexity, and clinical indications when gastrointestinal endoscopic procedures were provided by generalists versus specialists. DESIGN: Retrospective cohort study. PATIENTS: A random 5% sample of aged Medicare beneficiaries who underwent rigid and flexible sigmoidoscopy, colonoscopy, and esophagogastroduodenoscopy (EGD) performed by specialists (gastroenterologists, general surgeons, and colorectal surgeons) or generalists (general practitioners, family practitioners, and general internists). MEASUREMENTS: Characteristics of patients, indications for the procedure, procedural complexity, and place of service were compared between generalists and specialists using descriptive statistics and logistic regression. MAIN RESULTS: Our sample population had 167,347 gastrointestinal endoscopies. Generalists performed 7.7% of the 57, 221 colonoscopies, 8.7% of the 62,469 EGDs, 42.7% of the 38,261 flexible sigmoidoscopies, and 35.2% of the 9,396 rigid sigmoidoscopies. Age and gender of patients were similar between generalists and specialists, but white patients were more likely to receive complex endoscopy from specialists. After adjusting for patient differences in age, race, and gender, generalists were more likely to have provided a simple diagnostic procedure (odds ratio [OR] 4.2; 95% confidence interval [95% CI] 4.0, 4.4), perform the procedure for examination and screening purposes (OR 4.9; 95% CI, 4. 3 to 5.6), and provide these procedures in rural areas (OR 1.5; 95% CI 1.4 to 1.6). CONCLUSIONS: Although generalists perform the full spectrum of gastrointestinal endoscopies, their procedures are often of lower complexity and less likely to have been performed for investigating severe morbidities. (+info)Types of Gastrointestinal Diseases:
1. Irritable Bowel Syndrome (IBS): A common condition characterized by abdominal pain, bloating, and changes in bowel movements.
2. Inflammatory Bowel Disease (IBD): A group of chronic conditions that cause inflammation in the digestive tract, including Crohn's disease and ulcerative colitis.
3. Gastroesophageal Reflux Disease (GERD): A condition in which stomach acid flows back into the esophagus, causing heartburn and other symptoms.
4. Peptic Ulcer Disease: A condition characterized by ulcers in the lining of the stomach or duodenum.
5. Diverticulitis: A condition in which small pouches form in the wall of the colon and become inflamed.
6. Gastritis: Inflammation of the stomach lining, often caused by infection or excessive alcohol consumption.
7. Esophagitis: Inflammation of the esophagus, often caused by acid reflux or infection.
8. Rectal Bleeding: Hemorrhage from the rectum, which can be a symptom of various conditions such as hemorrhoids, anal fissures, or inflammatory bowel disease.
9. Functional Dyspepsia: A condition characterized by recurring symptoms of epigastric pain, bloating, nausea, and belching.
10. Celiac Disease: An autoimmune disorder that causes the immune system to react to gluten, leading to inflammation and damage in the small intestine.
Causes of Gastrointestinal Diseases:
1. Infection: Viral, bacterial, or parasitic infections can cause gastrointestinal diseases.
2. Autoimmune Disorders: Conditions such as Crohn's disease and ulcerative colitis occur when the immune system mistakenly attacks healthy tissue in the GI tract.
3. Diet: Consuming a diet high in processed foods, sugar, and unhealthy fats can contribute to gastrointestinal diseases.
4. Genetics: Certain genetic factors can increase the risk of developing certain gastrointestinal diseases.
5. Lifestyle Factors: Smoking, excessive alcohol consumption, stress, and lack of physical activity can all contribute to gastrointestinal diseases.
6. Radiation Therapy: Exposure to radiation therapy can damage the GI tract and increase the risk of developing certain gastrointestinal diseases.
7. Medications: Certain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids can cause gastrointestinal side effects.
Some common examples of digestive system diseases include:
1. Irritable Bowel Syndrome (IBS): This is a chronic condition characterized by abdominal pain, bloating, and changes in bowel habits such as constipation or diarrhea.
2. Inflammatory Bowel Disease (IBD): This includes conditions such as Crohn's disease and ulcerative colitis, which cause chronic inflammation in the digestive tract.
3. Gastroesophageal Reflux Disease (GERD): This is a condition where stomach acid flows back up into the esophagus, causing heartburn and other symptoms.
4. Peptic Ulcer: This is a sore on the lining of the stomach or duodenum (the first part of the small intestine) that can cause pain, nausea, and vomiting.
5. Diverticulosis: This is a condition where small pouches form in the wall of the colon, which can become inflamed and cause symptoms such as abdominal pain and changes in bowel habits.
6. Constipation: This is a common condition where the stool is hard and difficult to pass, which can be caused by a variety of factors such as poor diet, dehydration, or certain medications.
7. Diabetes: This is a chronic condition that affects how the body regulates blood sugar levels, which can also affect the digestive system and cause symptoms such as nausea, vomiting, and abdominal pain.
8. Celiac Disease: This is an autoimmune disorder where the immune system reacts to gluten, a protein found in wheat, barley, and rye, causing inflammation and damage to the small intestine.
9. Lipidosis: This is a condition where there is an abnormal accumulation of fat in the body, which can cause symptoms such as abdominal pain, nausea, and vomiting.
10. Sarcoidosis: This is a chronic inflammatory disease that can affect various organs in the body, including the digestive system, causing symptoms such as abdominal pain, diarrhea, and weight loss.
It's important to note that this list is not exhaustive and there are many other conditions that can cause abdominal pain. If you are experiencing persistent or severe abdominal pain, it's important to seek medical attention to determine the underlying cause and receive proper treatment.
The definition of constipation varies depending on the source, but it is generally defined as having fewer than three bowel movements per week, or as experiencing difficulty passing stools for more than half of the time during a two-week period. In addition, some people may experience "functional constipation," which means that they have normal bowel habits but still experience symptoms such as bloating and discomfort.
There are several factors that can contribute to constipation, including:
* Poor diet and dehydration: A diet low in fiber and high in processed foods can lead to constipation, as can not drinking enough water.
* Lack of physical activity: Sedentary lifestyles can contribute to constipation by slowing down the digestive process.
* Medical conditions: Certain medical conditions, such as irritable bowel syndrome (IBS), thyroid disorders, and diabetes, can increase the risk of constipation.
* Medications: Some medications, such as painkillers and antidepressants, can cause constipation as a side effect.
* Hormonal changes: Changes in hormone levels during pregnancy, menopause, or other life events can lead to constipation.
Treatment for constipation depends on the underlying cause and may include dietary changes, lifestyle modifications, and medication. In severe cases, surgery may be necessary. It is important to seek medical advice if symptoms persist or worsen over time, as untreated constipation can lead to complications such as bowel obstruction, hemorrhoids, and fecal incontinence.
Dyspepsia is not a specific disease but rather a symptom complex that can be caused by a variety of factors, such as:
1. Gastritis (inflammation of the stomach lining)
2. Peptic ulcer
3. Gastroesophageal reflux disease (GERD)
4. Functional dyspepsia
5. Inflammatory conditions such as Crohn's disease or ulcerative colitis
6. Food allergies or intolerances
7. Hormonal changes during pregnancy or menstruation
8. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics
The diagnosis of dyspepsia is based on a combination of medical history, physical examination, and diagnostic tests such as endoscopy, gastric emptying studies, and blood tests. Treatment depends on the underlying cause of dyspepsia and may include medications, lifestyle changes, and dietary modifications.
The primary symptoms of celiac disease include diarrhea, abdominal pain, fatigue, weight loss, and bloating. However, some people may not experience any symptoms at all, but can still develop complications if the disease is left untreated. These complications can include malnutrition, anemia, osteoporosis, and increased risk of other autoimmune disorders.
The exact cause of celiac disease is unknown, but it is believed to be triggered by a combination of genetic and environmental factors. The disease is more common in people with a family history of celiac disease or other autoimmune disorders. Diagnosis is typically made through a combination of blood tests and intestinal biopsy, and treatment involves a strict gluten-free diet.
Dietary management of celiac disease involves avoiding all sources of gluten, including wheat, barley, rye, and some processed foods that may contain hidden sources of these grains. In some cases, nutritional supplements may be necessary to ensure adequate intake of certain vitamins and minerals.
While there is no known cure for celiac disease, adherence to a strict gluten-free diet can effectively manage the condition and prevent long-term complications. With proper management, people with celiac disease can lead normal, healthy lives.
Crohn's disease can affect any part of the GI tract, from the mouth to the anus, and causes symptoms such as abdominal pain, diarrhea, fatigue, and weight loss. Ulcerative colitis primarily affects the colon and rectum and causes symptoms such as bloody stools, abdominal pain, and weight loss.
Both Crohn's disease and ulcerative colitis are chronic conditions, meaning they cannot be cured but can be managed with medication and lifestyle changes. Treatment options for IBD include anti-inflammatory medications, immunosuppressants, and biologics. In severe cases, surgery may be necessary to remove damaged portions of the GI tract.
There is no known cause of IBD, although genetics, environmental factors, and an abnormal immune response are thought to play a role. The condition can have a significant impact on quality of life, particularly if left untreated or poorly managed. Complications of IBD include malnutrition, osteoporosis, and increased risk of colon cancer.
Preventing and managing IBD requires a comprehensive approach that includes medication, dietary changes, stress management, and regular follow-up with a healthcare provider. With proper treatment and lifestyle modifications, many people with IBD are able to manage their symptoms and lead active, fulfilling lives.
The causes of abdominal pain are numerous and can include:
1. Gastrointestinal disorders: Ulcers, gastritis, inflammatory bowel disease, diverticulitis, and appendicitis.
2. Infections: Urinary tract infections, pneumonia, meningitis, and sepsis.
3. Obstruction: Blockages in the intestines or other hollow organs.
4. Pancreatic disorders: Pancreatitis and pancreatic cancer.
5. Kidney stones or other kidney disorders.
6. Liver disease: Hepatitis, cirrhosis, and liver cancer.
7. Hernias: Inguinal hernia, umbilical hernia, and hiatal hernia.
8. Splenic disorders: Enlarged spleen, splenic rupture, and splenectomy.
9. Cancer: Colorectal cancer, stomach cancer, pancreatic cancer, and liver cancer.
10. Reproductive system disorders: Ectopic pregnancy, ovarian cysts, and testicular torsion.
The symptoms of abdominal pain can vary depending on the underlying cause, but common symptoms include:
* Localized or generalized pain in the abdomen
* Cramping or sharp pain
* Difficulty breathing or swallowing
* Nausea and vomiting
* Diarrhea or constipation
* Fever and chills
* Abdominal tenderness or guarding (muscle tension)
Abdominal pain can be diagnosed through a variety of methods, including:
1. Physical examination and medical history
2. Imaging studies such as X-rays, CT scans, and MRI scans
3. Blood tests and urinalysis
4. Endoscopy and laparoscopy
5. Biopsy
Treatment for abdominal pain depends on the underlying cause, but may include:
1. Medications such as antibiotics, anti-inflammatory drugs, and pain relievers
2. Surgery to repair hernias or remove tumors
3. Endoscopy to remove blockages or treat ulcers
4. Supportive care such as intravenous fluids and oxygen therapy
5. Lifestyle modifications such as dietary changes and stress management techniques.
Some common types of gastrointestinal neoplasms include:
1. Gastric adenocarcinoma: A type of stomach cancer that starts in the glandular cells of the stomach lining.
2. Colorectal adenocarcinoma: A type of cancer that starts in the glandular cells of the colon or rectum.
3. Esophageal squamous cell carcinoma: A type of cancer that starts in the squamous cells of the esophagus.
4. Small intestine neuroendocrine tumors: Tumors that start in the hormone-producing cells of the small intestine.
5. Gastrointestinal stromal tumors (GISTs): Tumors that start in the connective tissue of the GI tract.
The symptoms of gastrointestinal neoplasms can vary depending on the location and size of the tumor, but they may include:
* Abdominal pain or discomfort
* Changes in bowel habits (such as diarrhea or constipation)
* Weight loss
* Fatigue
* Nausea and vomiting
If you have any of these symptoms, it is important to see a doctor for further evaluation and diagnosis. A gastrointestinal neoplasm can be diagnosed through a combination of endoscopy (insertion of a flexible tube into the GI tract to visualize the inside), imaging tests (such as CT or MRI scans), and biopsy (removal of a small sample of tissue for examination under a microscope).
Treatment options for gastrointestinal neoplasms depend on the type, location, and stage of the tumor, but they may include:
* Surgery to remove the tumor
* Chemotherapy (use of drugs to kill cancer cells)
* Radiation therapy (use of high-energy X-rays or other particles to kill cancer cells)
* Targeted therapy (use of drugs that target specific molecules involved in cancer growth and development)
* Supportive care (such as pain management and nutritional support)
The prognosis for gastrointestinal neoplasms varies depending on the type and stage of the tumor, but in general, early detection and treatment improve outcomes. If you have been diagnosed with a gastrointestinal neoplasm, it is important to work closely with your healthcare team to develop a personalized treatment plan and follow up regularly for monitoring and adjustments as needed.
The severity of GIH can vary widely, ranging from mild to life-threatening. Mild cases may resolve on their own or with minimal treatment, while severe cases may require urgent medical attention and aggressive intervention.
Gastrointestinal Hemorrhage Symptoms:
* Vomiting blood or passing black tarry stools
* Hematemesis (vomiting blood)
* Melena (passing black, tarry stools)
* Rectal bleeding
* Abdominal pain
* Fever
* Weakness and dizziness
Gastrointestinal Hemorrhage Causes:
* Peptic ulcers
* Gastroesophageal reflux disease (GERD)
* Inflammatory bowel disease (IBD)
* Diverticulosis and diverticulitis
* Cancer of the stomach, small intestine, or large intestine
* Vascular malformations
Gastrointestinal Hemorrhage Diagnosis:
* Physical examination
* Medical history
* Laboratory tests (such as complete blood count and coagulation studies)
* Endoscopy (to visualize the inside of the gastrointestinal tract)
* Imaging studies (such as X-rays, CT scans, or MRI)
Gastrointestinal Hemorrhage Treatment:
* Medications to control bleeding and reduce acid production in the stomach
* Endoscopy to locate and treat the site of bleeding
* Surgery to repair damaged blood vessels or remove a bleeding tumor
* Blood transfusions to replace lost blood
Gastrointestinal Hemorrhage Prevention:
* Avoiding alcohol and spicy foods
* Taking medications as directed to control acid reflux and other gastrointestinal conditions
* Maintaining a healthy diet and lifestyle
* Reducing stress
* Avoiding smoking and excessive caffeine consumption.
A peptic ulcer is a break in the lining of the stomach or duodenum (the first part of the small intestine), which can cause pain and bleeding. The stomach acid and digestive enzymes flowing through the ulcer can irritate the surrounding tissue, leading to inflammation and discomfort.
Peptic ulcers are commonly caused by an infection with Helicobacter pylori (H. pylori) bacteria or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin. Other contributing factors include stress, smoking, and excessive alcohol consumption.
Symptoms of a peptic ulcer may include abdominal pain, nausea, vomiting, and loss of appetite. Treatment options typically involve antibiotics to eradicate H. pylori infection or stopping NSAID use, along with medications to reduce acid production in the stomach and protect the ulcer from further damage. Surgery may be necessary for severe cases or if other treatments fail.
Prevention methods include avoiding NSAIDs, maintaining a healthy lifestyle, managing stress, and getting regular screenings for H. pylori infection. Early detection and proper treatment can help alleviate symptoms and prevent complications such as ulcer perforation or bleeding.
In summary, peptic ulcers are painful and potentially harmful conditions that can be caused by various factors. Proper diagnosis and treatment are essential to prevent complications and improve quality of life.
UC can be challenging to diagnose and treat, and there is no known cure. However, with proper management, it is possible for people with UC to experience long periods of remission and improve their quality of life. Treatment options include medications such as aminosalicylates, corticosteroids, and immunomodulators, as well as surgery in severe cases.
It's important for individuals with UC to work closely with their healthcare provider to develop a personalized treatment plan that takes into account their specific symptoms and needs. With the right treatment and support, many people with UC are able to manage their symptoms and lead active, fulfilling lives.
There are several subtypes of IBS, including:
* IBS-C (constipation-predominant)
* IBS-D (diarrhea-predominant)
* IBS-M (mixed)
The symptoms of IBS can vary in severity and frequency from person to person, and may include:
* Abdominal pain or cramping
* Bloating
* Gas
* Diarrhea or constipation
* Mucus in the stool
* Feeling of incomplete evacuation after bowel movements
There is no cure for IBS, but symptoms can be managed with dietary changes, stress management techniques, and medications such as fiber supplements, antispasmodics, and antidepressants. It is important to seek medical advice if symptoms persist or worsen over time, as IBS can have a significant impact on quality of life and may be associated with other conditions such as anxiety or depression.
Crohn disease can occur in any part of the GI tract, from the mouth to the anus, but it most commonly affects the ileum (the last portion of the small intestine) and the colon. The inflammation caused by Crohn disease can lead to the formation of scar tissue, which can cause narrowing or blockages in the intestines. This can lead to complications such as bowel obstruction or abscesses.
The exact cause of Crohn disease is not known, but it is believed to be an autoimmune disorder, meaning that the immune system mistakenly attacks healthy tissue in the GI tract. Genetic factors and environmental triggers such as smoking and diet also play a role in the development of the disease.
There is no cure for Crohn disease, but various treatments can help manage symptoms and prevent complications. These may include medications such as anti-inflammatory drugs, immunosuppressants, and biologics, as well as lifestyle changes such as dietary modifications and stress management techniques. In severe cases, surgery may be necessary to remove damaged portions of the GI tract.
Crohn disease can have a significant impact on quality of life, and it is important for individuals with the condition to work closely with their healthcare provider to manage their symptoms and prevent complications. With proper treatment and self-care, many people with Crohn disease are able to lead active and fulfilling lives.
Functional colonic diseases include:
1. Irritable Bowel Syndrome (IBS): A common condition characterized by recurring abdominal pain, bloating, and changes in bowel habits (diarrhea or constipation).
2. Functional dyspepsia: A condition characterized by recurring symptoms of epigastric pain, discomfort, bloating, and nausea, without any identifiable organic cause.
3. Functional constipation: A condition characterized by infrequent bowel movements, hard or difficult-to-pass stools, and sensation of incomplete evacuation.
4. Functional diarrhea: A condition characterized by frequent, loose, and watery bowel movements.
5. Functional abdominal pain: Recurring abdominal pain without any identifiable organic cause.
The exact causes of functional colonic diseases are not fully understood, but they are thought to be related to abnormalities in the functioning of the enteric nervous system, immune system, and gut microbiome. These conditions are often associated with stress, dietary factors, and other lifestyle factors.
The diagnosis of functional colonic diseases is based on a combination of clinical symptoms, physical examination, and laboratory tests (such as stool studies and gastrointestinal imaging). Treatment typically involves lifestyle modifications (such as dietary changes and stress management) and medications (such as antispasmodics, antidepressants, and laxatives) to manage symptoms and improve quality of life.
1. Ulcerative colitis: This is a chronic condition that causes inflammation and ulcers in the colon. Symptoms can include abdominal pain, diarrhea, and rectal bleeding.
2. Crohn's disease: This is a chronic condition that affects the digestive tract, including the colon. Symptoms can include abdominal pain, diarrhea, fatigue, and weight loss.
3. Irritable bowel syndrome (IBS): This is a common condition characterized by recurring abdominal pain, bloating, and changes in bowel movements.
4. Diverticulitis: This is a condition where small pouches form in the colon and become inflamed. Symptoms can include fever, abdominal pain, and changes in bowel movements.
5. Colon cancer: This is a type of cancer that affects the colon. Symptoms can include blood in the stool, changes in bowel movements, and abdominal pain.
6. Inflammatory bowel disease (IBD): This is a group of chronic conditions that cause inflammation in the digestive tract, including the colon. Symptoms can include abdominal pain, diarrhea, fatigue, and weight loss.
7. Rectal cancer: This is a type of cancer that affects the rectum, which is the final portion of the colon. Symptoms can include blood in the stool, changes in bowel movements, and abdominal pain.
8. Anal fissures: These are small tears in the skin around the anus that can cause pain and bleeding.
9. Rectal prolapse: This is a condition where the rectum protrudes through the anus. Symptoms can include rectal bleeding, pain during bowel movements, and a feeling of fullness or pressure in the rectal area.
10. Hemorrhoids: These are swollen veins in the rectum or anus that can cause pain, itching, and bleeding.
It's important to note that some of these conditions can be caused by other factors as well, so if you're experiencing any of these symptoms, it's important to see a doctor for an accurate diagnosis and treatment.
The exact cause of colonic polyps is not fully understood, but they are thought to be related to inflammation, genetic mutations, and abnormal cell growth. Some risk factors for developing colonic polyps include:
1. Age (they become more common with age)
2. Family history of colon cancer or polyps
3. Inflammatory bowel disease (such as ulcerative colitis or Crohn's disease)
4. Previous history of colon cancer or polyps
5. A diet high in fat and low in fiber
6. Obesity
7. Lack of physical activity
There are several types of colonic polyps, including:
1. Adenomatous polyps: These are the most common type of polyp and have the potential to become malignant (cancerous) over time if left untreated.
2. Hyperplastic polyps: These are benign growths that are usually small and have a smooth surface.
3. Inflammatory polyps: These are associated with inflammation in the colon and are usually benign.
4. Villous adenomas: These are precancerous growths that can develop into colon cancer if left untreated.
Colonic polyps do not always cause symptoms, but they can sometimes cause:
1. Blood in the stool
2. Changes in bowel movements (such as diarrhea or constipation)
3. Abdominal pain or discomfort
4. Weakness and fatigue
If colonic polyps are suspected, a doctor may perform several tests to confirm the diagnosis, including:
1. Colonoscopy: A flexible tube with a camera and light on the end is inserted through the rectum and into the colon to visualize the inside of the colon and look for polyps.
2. Fecal occult blood test (FOBT): This test detects small amounts of blood in the stool.
3. Barium enema: A barium solution is inserted into the rectum and x-rays are taken to visualize the inside of the colon.
4. CT colonography (virtual colonoscopy): This test uses a CT scan to create detailed images of the colon and detect polyps.
If colonic polyps are found, they may be removed during a colonoscopy procedure. The type of treatment will depend on the size, location, and number of polyps, as well as the patient's overall health. Polyps that are small and few in number may be removed by snare polypectomy, where a thin wire loop is used to remove the polyp. Larger polyps or those that are more numerous may require surgical removal of a portion of the colon.
It is important for individuals to be screened for colonic polyps regularly, as they can potentially develop into colon cancer if left untreated. The American Cancer Society recommends that individuals with an average risk of colon cancer begin screening at age 50 and continue every 5 years until age 75. Individuals with a higher risk, such as those with a family history of colon cancer or a personal history of inflammatory bowel disease, may need to begin screening earlier and more frequently.
Gastroenterology
Pediatric gastroenterology
Gastroenterology (journal)
World Gastroenterology Organisation
United European Gastroenterology
Nature Reviews Gastroenterology & Hepatology
Canadian Association of Gastroenterology
Clinical and Translational Gastroenterology
Indian Journal of Gastroenterology
American College of Gastroenterology
British Society of Gastroenterology
Clinical and Experimental Gastroenterology
World Journal of Gastroenterology
Instruments used in gastroenterology
Clinical Gastroenterology and Hepatology
Journal of Clinical Gastroenterology
Scandinavian Journal of Gastroenterology
European Journal of Gastroenterology & Hepatology
The American Journal of Gastroenterology
Expert Review of Gastroenterology & Hepatology
Journal of Pediatric Gastroenterology and Nutrition
Canadian Journal of Gastroenterology and Hepatology
Andrew Wakefield
Syntaxin 3
Bilirubin glucuronide
Iron overload
Gastrin
SeHCAT
Gastrointestinal disease
Rectal examination
Daniel Chung, MD - Gastroenterology
Biosimilar Drugs Will Disrupt Gastroenterology
Gastroenterology
E-books: Gastroenterology | HSLS
Chronic Stomach or Gas Pain At Night - Gastroenterology - MedHelp
Sugary drinks and fatty liver-a bitter-sweet relationship | Nature Reviews Gastroenterology & Hepatology
Gastroenterology in Sierra Leone | Bizcommunity
Dr Amit Chattree, Gastroenterology | Nuffield Health
Biopsy Forceps - Gastroenterology - Olympus Medical Systems
Gastroenterology
Gastroenterology CME
Official journal of the American College of Gastroenterology | ACG
World Journal of Gastroenterology - Baishideng Publishing Group
World Journal of Gastroenterology - Baishideng Publishing Group
Trustees - American College of Gastroenterology
Gastroenterology Nursing | March/April 2010 Vol.33 Issue 2 | NursingCenter
Gastroenterology Articles (Examination, Diagnosis, Treatment, Prognosis, Follow-up) - Medscape Reference
Gastroenterology and Mitochondrial Disease | Children's Hospital of Philadelphia
Journal of Gastroenterology and Hepatology | EndNote
Gastroenterology | KARL STORZ Endoskope | United States
Browsing by Subject "Gastroenterology"
Dr. Larry Adler, MD, Gastroenterology Specialist - Ypsilanti, MI | Sharecare
Consultations in Gastroenterology | Gut
IU Health Arnett Physicians Gastroenterology | IU Health
Danny T. Shearer, MD| Gastroenterology | MedStar Health
Ovid - Gastroenterology Nursing | Wolters Kluwer
Gastroenterology and Liver Diseases - The Transplant Hepatology Fellowship at Moses Campus
Kati Choi, MD | Gastroenterology | Kelsey-Seybold
Hepatology9
- The Key Advances in Gastroenterology & Hepatology collection offers expert insight into the most important discoveries made each year, and is an essential resource for students, physicians and clinical researchers. (nature.com)
- Here, Nature Reviews Gastroenterology & Hepatology explores areas vital to meeting this ambitious target, from basic viral research to public policy. (nature.com)
- In this Collection, we bring you articles published by Nature Reviews Gastroenterology & Hepatology that cover the COVID-19 pandemic and its implications for the care of patients with gastrointestinal and liver diseases. (nature.com)
- In this article series by Nature Reviews Gastroenterology & Hepatology, basic, translational and clinical topics in neurogastroenterology are explored. (nature.com)
- In this article series, Nature Reviews Gastroenterology & Hepatology examines the cutting-edge techniques and technologies currently applied in gastrointestinal and liver research and clinical practice, and the approaches that might be available to investigators, clinicians and surgeons in the future. (nature.com)
- In this article series, Nature Reviews Gastroenterology & Hepatology explores the epidemiology of NAFLD, disease mechanisms and therapeutics, and clinical approaches to diagnosis and management. (nature.com)
- In this article series, Nature Reviews Gastroenterology & Hepatology explores different cell biology and developmental pathways involved in gastrointestinal health and disease, the role of stem and progenitor cells in tissue development and regeneration and recent advances in bioengineering, which might shape clinical approaches in the near future. (nature.com)
- He sees a wide variety of gastroenterology and hepatology cases. (nuffieldhealth.com)
- Other association is also committed to the promotion of educa- measures such as practicing cough etiquette and general tion and training in all fields of Gastroenterology and respiratory hygiene, social distancing and avoidance of Hepatology and to the offering of professional/technical crowds are important in the control of the COVID-19 advice to the relevant authorities of the Ghana govern- pandemic. (who.int)
American College of Gastr3
20231
- Due to the greatly increased administrative requirements for the market approval of medical devices - particularly as a result of the new MDR Regulation in the European Union, but also in other approval areas - we have decided, with regard to a future-oriented focus, to change our business segment strategy in gastroenterology as of January 2023 and to phase out related products in the field of human medicine. (karlstorz.com)
Practice4
- The representative group assures that the College continues to meet the changing needs of clinical gastroenterology regardless of practice setting. (gi.org)
- They currently practice at Huron Gastroenterology Assocs and are affiliated with St. Joseph Mercy Ann Arbor. (sharecare.com)
- The practice of gastroenterology has been affected especially gastrointestinal (GI) endoscopy which is considered high risk for transmission of the virus. (who.int)
- Best Practice & Research: Clinical Gastroenterology, Volume 24, Issue 4, Pages 381-396 (August 2010). (who.int)
Colorectal1
- Dr Chattree is the lead author of the British Society of Gastroenterology Guidelines for the management of large colorectal polyps and also developed the world's first framework for the management of large polyps. (nuffieldhealth.com)
Specialty1
- At IU Health Arnett Physicians Gastroenterology, you'll have access to a broad range of specialty care services. (iuhealth.org)
20221
- You can continue to purchase our gastroenterology product portfolio until December 31, 2022 - after which we will discontinue sales. (karlstorz.com)
Clinicians2
- The BoardVitals Gastroenterology CME Review offers clinicians 35 AMA PRA Category 1 Credits TM , 35 ABIM MOC points, and over 650 Gastroenterology board review questions. (cmelist.com)
- This question bank will assist clinicians with Gastroenterology certification and recertification. (cmelist.com)
Specializes2
- Cadila specializes in providing time-tested therapeutic solutions that cover the vast spectrum of sub-specialties of gastroenterology. (cadilapharma.com)
- Dr. Adler in specializes in Gastroenterology. (sharecare.com)
Internal Medicine2
- Physicians specializing in Gastroenterology must complete at least 1 MOC activity every 2 years and earn 200 MOC points (40 which must be medical knowledge) every 10 years to meet the American Board of Internal Medicine Maintenance of Certification requirements. (cmelist.com)
- Yes, Dr. Larry Adler, MD holds board certification in Gastroenterology and Internal Medicine. (sharecare.com)
Oncology1
- Interventional gastroenterology in oncology. (bvsalud.org)
Digestive2
- Our gastroenterology team helps patients with a range of digestive and liver diseases. (baptisthealth.net)
- Expand your knowledge on the most important topics including digestive system disorders with this selection of Gastroenterology CME courses, board reviews, and other activities. (cmelist.com)
Gastrointestinal1
- The gastroenterology specialists at Baptist Health South Florida have decades of experience treating gastrointestinal disorders. (baptisthealth.net)
Specialist2
- Dr Amit Chattree qualified from Bart's and The London School of Medicine and Dentistry and undertook specialist gastroenterology training on the North East Thames Gastroenterology Training Programme. (nuffieldhealth.com)
- Dr. Larry Adler, MD is a Gastroenterology Specialist in Ypsilanti, MI. (sharecare.com)
Journal1
- The American Journal of Gastroenterology. (lww.com)
Medicine1
- The professorship, established by the Evans Medical Foundation in 2016, recognizes the enduring impact of Dr. Franz J. Ingelfinger (1910-1980) on the field of gastroenterology and the Department of Medicine at BUSM. (bu.edu)
Board1
- Dr. Adler is board certified in Gastroenterology and accepts accepts multiple insurance plans. (sharecare.com)
Center1
- Founded in 1945, the Section of Gastroenterology at Boston University and Boston Medical Center has a long and distinguished history in both academic and clinical service. (bu.edu)
Meet1
- Looking to meet your Gastroenterology CME requirements? (cmelist.com)
Visit1
- When you visit IU Health Arnett Physicians Gastroenterology in Frankfort, you'll receive care designed for your specific needs. (iuhealth.org)
Disease1
- View this webinar to learn more about gastroenterology and mitochondrial disease led by Kristin Fiorino, MD. (chop.edu)
NIDDK1
- The goal of the University of Maryland/NIH Clinical Scholars Gastroenterology Fellowship Program is to train clinical researchers in Gastroenterology utilizing the extensive resources of the NIH Clinical Center and faculty members of the National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK). (nih.gov)
Fellowship Program1
- Qualified candidates must be board-eligible in internal medicine prior to starting the gastroenterology fellowship program. (nih.gov)
Consultations2
- Fellows carry out inpatient consultations in gastroenterology at the University of Maryland Medical Center (UMMC), R Adams Cowley Shock Trauma Center (STC), or the Baltimore VA Medical Center (BVAMC). (nih.gov)
- Fellows carry out inpatient consultations in gastroenterology at the NIH Clinical Center during their second and third years. (nih.gov)
Program1
- 3) to provide first year training for two fellows in GI training per year as part of a joint NIH Gastroenterology training program including providing continuity clinics required for board-certification which are accessible within 30 minutes of NIH, and 4) to provide continuity for the ongoing clinical research protocols involving endoscopic procedures at NIH by continuing to provide the same gastroenterologist throughout the term of the contract. (nih.gov)
List1
- A list of recent University of Maryland/NIH Clinical Scholars Gastroenterology Fellowship Programpublications is available below. (nih.gov)