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Heartburn/Acid Reflux/Indigestion/Dyspepsia/Pyrosis/GERD
Published in Charles Theisler, Adjuvant Medical Care, 2023
There are many different functional disorders in gastroenterology, including heartburn and indigestion. Indigestion or dyspepsia is recurrent discomfort or pain in the upper abdomen, often described as fullness, bloating, nausea, or heartburn. When acidic gastric contents flow backwards into the esophagus, it produces the symptom of burning pain in the upper abdomen or behind the lower sternum and is known as heartburn. The discomfort may rise into the chest or throat and may be accompanied by belching, a bitter taste in the mouth, regurgitation, or water brash.
Gastrointestinal Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Gareth Davies, Chris Black, Keeley Fairbrass
Flexible endoscopy is the major diagnostic tool in gastroenterology (Figure 10.10). The abilities to detect small or flat mucosal lesions and take biopsies are advantages over radiological imaging. Possibilities for delivering therapy are ever-increasing.
Introduction
Published in Melissa G. Hunt, Aaron T. Beck, Reclaim Your Life From IBS, 2022
Melissa G. Hunt, Aaron T. Beck
Gastroenterologists: Practitioners in the field of gastroenterology are highly skilled and knowledgeable about the diagnosis and medical management of GI disorders and diseases. But you may be less comfortable managing psychiatric comorbidities like depression, social anxiety, or agoraphobia, which are present in up to 90% of treatment-seeking patients with IBS.1 In addition, as you probably already know, IBS doesn’t respond particularly well to standard medical care2,3 and managing IBS can be frustrating for both patients and their doctors.4 Even if you can help your patient achieve some reduction in GI symptom severity, that doesn’t always lead to improved health-related quality of life (HRQL).5 Indeed, the best predictors of HRQL in patients with IBS are perceived stress and anxiety about GI symptoms.6 Thus, best practice in the management of IBS should include treatment approaches focused on effective stress management training that target GI-specific anxiety and catastrophizing.7
Advances in the pharmacotherapeutic management of refractory peptic ulcers
Published in Expert Opinion on Pharmacotherapy, 2023
Cristina Borao Laguna, Angel Lanas
When facing patients with peptic ulcers that do not heal with standard therapy, the first step is to confirm adherence to treatment (PPI and/or H. pylori eradication). This is the main cause of apparent or false refractoriness. Persistence of H. pylori infection is one of the major causes of peptic ulcer recurrence, but also lack of H. pylori eradication has been linked with peptic ulcer refractoriness. A confirmatory test of H. pylori eradication [1,7,12] is not commonly performed outside the gastroenterology environment. Therefore, this should be the next step in patients whose ulcers do not heal after a first, second, or third course of H. pylori treatment. A molecular PCR analysis aimed to detect the presence of H. pylori in the gastric tissues may be warranted in some cases.
Impact of insufficient doses of medications on Helicobacter pylori eradication: a retrospective observational study
Published in Postgraduate Medicine, 2022
Xiaoye Shi, Chunmei Wang, Fanjun Meng, Shaoze Ma, Guangqin Xu, Tingwei Liu, Xiaozhong Guo, Hongyu Li, Xingshun Qi
The study protocol has been approved by the Medical Ethical Committee of the General Hospital of Northern Theater Command with an approval number of Y (2022) 048 and follows the rule of the Declaration of Helsinki. We retrospectively analyzed the data of 14C-urea breath test (14C-UBT) performed at the Department of Gastroenterology of our hospital from January 2017 to July 2020. Exclusion criteria were as follows: 1) detection values of 14C-UBT were lacking; 2) medical records were lacking; 3) 14C-UBT was not re-checked at our department; 4) patients were younger than 18 years old; 5) prescriptions for H. pylori eradication were lacking; 6) information on repeated 14C-UBT after H. pylori eradication at our department was lacking; 7) probiotics and/or Chinese medicine were concomitantly prescribed for H. pylori eradication; 8) detailed prescriptions of the BQT regimens were lacking; and 9) the interval of re-checking was less than 38 days, which is composed of at least a 10-day duration of taking medications and a 28-day duration of drug discontinuation.
Longitudinal evolution of catheter-related bloodstream infections, kidney function and liver status in a nationwide adult intestinal failure cohort
Published in Scandinavian Journal of Gastroenterology, 2022
Anne K. Pohju, Antti I. Hakkarainen, Mikko P. Pakarinen, Taina M. Sipponen
A subgroup of patients (n = 12) monitored in the gastroenterology clinic of Helsinki University Hospital had undergone more detailed imaging tests of the liver. Abdominal ultrasound revealed liver steatosis in eight patients, and gallstones in one patient. Transient elastography (TE; Fibroscan®; Echosens, Paris, France) suggested advanced fibrosis or cirrhosis (F3–F4) in five patients. Liver fat content (LFC) according to magnetic resonance spectroscopy (MRS) was increased (≥5.56%) in three patients. Liver biopsy was clinically indicated in three patients. Advanced fibrosis (Metavir classification F3 or F4) was present in two patients, and of these two, one had also moderate steatohepatitis. The third patient was diagnosed with mild steatohepatitis. Both patients with histologically confirmed advanced fibrosis had a TE result exceeding 10.3 kPa, suggestive of cirrhosis. The patient with moderate steatohepatitis had, according to MRS, an abnormal LFC, while LFC was normal in the patient with mild steatohepatitis.