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Gastroenterology & Hepatology

Welcome to the gastroenterology and hepatology category for physicians and pharmacists. This clinical category has links to a wide range of resources such as clinical guidelines, prescribing guidance and medical journal articles on gastrointestinal and liver diseases.

British Society of Gastroenterology Clinical Guidelines

Source: bsg.org.uk
Clinical Resource: Guidelines
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Last Checked: 31/07/13 Link Error: Report It

 

American College of Gastroenterology Clinical Guidelines

Source: gi.org
Clinical Resource: Guidelines
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Last Checked: 31/07/13 Link Error: Report It

 

American Gastroenterological Association Guidelines

Source: gastro.org
Clinical Resource: Guidelines
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Last Checked: 19/08/15 Link Error: Report It

 

Canadian Association of Gastroenterology Clinical Practice Guidelines and Consensus Reports

Source: cag-acg.org
Clinical Resource: Guidelines and Consensus Reports
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Last Checked: 31/07/13 Link Error: Report It

 

Canadian Association of Gastroenterology Position Statements

Source: cag-acg.org
Clinical Resource: Position Statements
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Last Checked: 31/07/13 Link Error: Report It

 

World Gastroenterology Organisation Practice Guidelines

Source: worldgastroenterology.org
Clinical Resource: Guidelines
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Last Checked: 19/10/15 Link Error: Report It

 

American Society for Gastrointestinal Endoscopy Practice Guidelines

Source: asge.org
Clinical Resource: Guidelines
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Last Checked: 13/03/14 Link Error: Report It

 

National Institute for Health and Care Excellence (NICE) Guidance > Digestive tract conditions

Source: nice.org.uk
Clinical Resource: Guidance
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Last Checked: 18/05/15 Link Error: Report It

 

Digestive system - CLEAR: clinical enquiry and response service

The CLEAR service is delivered by a team of information professionals based at Healthcare Improvement Scotland and NHS Greater Glasgow and Clyde.

CLEAR aims to provide clinicians with summarised evidence relating to aetiology, diagnosis, prognosis and treatment queries about patient care.

Source: knowledge.scot.nhs.uk
Clinical Resource: Evidence Based Answers to Clinical Questions
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Last Checked: 22/04/13 Link Error: Report It

 

BestBETs
Gastrointestinal

BETs were developed in the Emergency Department of Manchester Royal Infirmary, UK, to provide rapid evidence-based answers to real-life clinical questions, using a systematic approach to reviewing the literature. BETs take into account the shortcomings of much current evidence, allowing physicians to make the best of what there is.

Source: bestbets.org
Clinical Resource: Evidence Based Answers to Clinical Questions
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Last Checked: 31/07/13 Link Error: Report It

 

The Cochrane Collaboration
Cochrane Reviews - Gastroenterology

The Cochrane Collaboration is an international, non-profit, independent organisation, established to ensure that up-to-date, accurate information about the effects of healthcare interventions is readily available worldwide. It produces and disseminates systematic reviews of healthcare interventions, and promotes the search for evidence in the form of clinical trials and other studies of the effects of interventions.

Source: cochrane.org
Clinical Resource: Systematic Reviews
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Last Checked: 13/07/15 Link Error: Report It

 

Bandolier Knowledge
Gastrointestinal problems

In these pages are collected the stories from Bandolier relating to gastrointestinal problems.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

First Principles of Gastroenterology
The Basis of Disease and an Approach to Management

It was over ten years ago that we identified the need for an introductory gastroenterology textbook that would be useful to students, residents, family physicians and specialists. We decided this textbook should be relatively concise and readable, with appropriate figures, tables and algorithms, providing a logical and practical approach to patient management. It should cover the pathological basis of gastrointestinal and hepatobiliary disease, provide a list of learning objectives and be well indexed.

Chapter 1 - Symptoms & Signs
Chapter 2 - Nutrition
Chapter 3 - Research
Chapter 4 - The Esophagus
Chapter 5 - The Stomach
Chapter 6 - The Small Intestine
Chapter 7 - Ischemic Disease
Chapter 8 - HIV Infection
Chapter 9 - IBD
Chapter 10 - The Colon
Chapter 11 - The Pancreas
Chapter 12 - The Biliary System
Chapter 13 - The Liver

Source: cag-acg.org
Clinical Resource: Textbook
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Last Checked: 31/07/13 Link Error: Report It

 

Disease Management Project Gastroenterology Chapters

The Disease Management Project is an online medical reference, designed to provide nationally established treatment guidelines for the most commonly seen diseases and conditions.

Disease Management Project Chapters

  • Acid Peptic Disorders
  • Acute Diarrhea
  • Antibiotic-Associated Diarrhea and Clostridium difficile
  • Celiac Disease and Malabsorptive Disorders
  • Colonic Diverticular Disease
  • Colorectal Neoplasia
  • Crohn's Disease
  • Irritable Bowel Syndrome
  • Pancreatic Disorders
  • Ulcerative Colitis
Source: clevelandclinicmeded.com
Clinical Resource: Medical Reference
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Last Checked: 31/07/13 Link Error: Report It

 

The Merck Manual for Health Care Professionals

Sections

Gastrointestinal Disorders
Hepatic and Biliary Disorders

Source: merckmanuals.com
Clinical Resource: Manual
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Last Checked: 31/07/13 Link Error: Report It

 

GastroenterologyWeb

GastroenterologyWeb is an independently produced e-publication created by and for practicing, teaching and student gastroenterologists as a comprehensive source of new information, practical knowledge, and educational resources pertinent to the evolving field of gastroenterology.

Source: gastroenterologyweb.com
Clinical Resource: Various
Register to Access Content: Yes - registration is FREE

Last Checked: 31/07/13 Link Error: Report It

 

American College of Gastroenterology Monograph
Pregnancy in Gastrointestinal Disorders

Table of Contents

I. Constipation, Diarrhea, Hemorrhoids and Fecal Incontinence
II. Endoscopy in Pregnancy
III. Heartburn, Nausea, Vomiting During Pregnancy
IV. Hyperemesis Gravidarum and Nutritional Support
V. Liver Diseases in Pregnancy
VI. Surgical Problems in the Pregnant Patient
VII. Pregnancy in Inflammatory Bowel Disease

Source: gi.org
Clinical Resource: Monograph
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Last Checked: 07/05/14 Link Error: Report It

 

Dyspepsia

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
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Last Checked: 24/04/15 Link Error: Report It

 

Oesophagus: Heartburn

Gastro-oesophageal reflux disease (GORD) is defined as symptoms or mucosal damage (oesophagitis) resulting from the exposure of the distal oesophagus to refluxed gastric contents.

Source: europepmc.org
Clinical Resource: Journal Article
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Last Checked: 07/04/14 Link Error: Report It

 

University of Michigan Health System Guideline for Gastroesophageal Reflux Disease

Source: med.umich.edu
Clinical Resource: Guideline
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Last Checked: 31/07/13 Link Error: Report It

 

Helicobacter pylori: diagnosis and treatment guide for primary care
Public Health England

Guidance for primary care on how to test for and treat Helicobacter pylori (H. pylori) in dyspepsia

Source: gov.uk
Clinical Resource: Guidance
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Last Checked: 23/02/15 Link Error: Report It

 

The Year in Helicobacter 2012

Review Articles

  • Epidemiology and Diagnosis of Helicobacter pylori Infection
  • Pathogenesis of Helicobacter pylori Infection
  • Inflammation, Immunity, and Vaccines for Helicobacter pylori Infection
  • Helicobacter pylori and Nonmalignant Diseases
  • Gastric Cancer: Basic Aspects
  • Helicobacter pylori: Gastric Cancer and Extragastric Intestinal Malignancies
  • Treatment of Helicobacter pylori infection 2012
  • Helicobacter pylori in Pediatrics
  • Extragastric Manifestations of Helicobacter pylori Infection
  • Helicobacter spp. Other than H. pylori
Source: eu.wiley.com
Clinical Resource: Supplement
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Last Checked: 31/07/13 Link Error: Report It

 

Management of Helicobacter pylori infection

This article discusses the current management of Helicobacter pylori infection in patients with dyspepsia with or without endoscopic abnormalities. We take an evidence based approach when possible and consider recent guidelines from national and international bodies pertaining to primary and secondary care.

Source: europepmc.org
Clinical Resource: Journal Article
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Last Checked: 07/04/14 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Acute Upper and Lower Gastrointestinal Bleeding

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

Drugs & Gastrointestinal Bleeding

This bulletin summarises the current evidence regarding some drugs less well known to increase the risk of GI bleeding including clopidogrel, selective serotonin reuptake inhibitors (SSRI’s), tricyclic antidepressants & calcium channel blockers.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Last Checked: 30/07/13 Link Error: Report It

 

Management of NSAID-Associated Upper GI Disorders

To describe risk factors and review appropriate management strategies for patients who experience nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) adverse events.

Source: amcp.org
Clinical Resource: Supplement
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Last Checked: 30/07/13 Link Error: Report It

 

Indigestion and non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are usually thought to pose a dilemma for doctors wishing to prescribe them. Their anti-inflammatory and analgesic properties have led to their widespread use for rheumatoid and (much more commonly) other conditions often regarded as more trivial.

Source: europepmc.org
Clinical Resource: Journal Article
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Last Checked: 07/04/14 Link Error: Report It

 

Cardiovascular and gastrointestinal safety of NSAIDs

This article summarises current evidence of relative CV and GI risks for non-aspirin NSAIDs and highly selective COX-2 inhibitors (coxibs), and provides prescribing advice which is consistent with previous advice from the Commission on Human Medicines.

Source: webarchive.org.uk
Clinical Resource: National Prescribing Centre Publication
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Last Checked: 24/04/15 Link Error: Report It

 

NSAID Selection: Consideration of Cardiovascular & Gastrointestinal Risk
Gwent Partnership Medicines & Therapeutics Committee

Source: wales.nhs.uk
Clinical Resource: Guideline
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Last Checked: 22/04/13 Link Error: Report It

 

Proton Pump Inhibitors (PPIs) – Prescribing Guidance
North of Tyne Area Prescribing Committee

Evidence suggests that the use of proton pump inhibitors may be associated with Clostridium difficile, pneumonia, bone fractures and hypomagnesaemia. In order to limit the occurrence of these adverse effects, the prescribing of PPIs should be limited to the following indications

Source: northoftyneapc.nhs.uk
Clinical Resource: Guidance
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Last Checked: 22/11/16 Link Error: Report It

 

Is Long-Term Proton Pump Inhibitor Treatment for GERD Worth the Risk?

This article will review the evidence for long-term PPI safety and efficacy, describe current FFS utilization trends, communicate FFS PPI policy changes, and present guidance to assist with weaning patients off of long-term PPIs.

Source: oregonstate.edu
Clinical Resource: Newsletter
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Last Checked: 23/10/15 Link Error: Report It

 

PPIs: Burning Questions

The 4 questions addressed for this topic are:

  1. Are there clinically important differences among standard-doses of PPIs?
  2. Is starting with a double-dose PPI better than starting with a standard daily dose?
  3. When is it reasonable to treat with H2RAs?
  4. What are the possible adverse effects of acid suppression?
Source: cme.medicine.dal.ca
Clinical Resource: CE / CPD / CME / Learning
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Last Checked: 31/07/13 Link Error: Report It

 

Summary of 2009 Drug Effectiveness Review Project (DERP) Report of Proton Pump Inhibitors (PPIs)

Key Questions for the DERP drug class review were:

  1. What is the comparative effectiveness of different PPIs in patients with symptoms of GERD?
  2. What is the comparative effectiveness of different PPIs in treating patients with peptic ulcer and NSAID induced ulcer?
  3. What is the comparative effectiveness of different PPIs in preventing ulcer in patients taking an NSAID?
  4. What is the comparative effectiveness of different PPIs in eradicating H.pylori infection?
  5. Is there evidence that a particular treatment strategy is more effective or safer than another for longer-term treatment (more than 8 weeks) in patients with GERD?
  6. What is the comparative safety of different PPIs in patients being treated for symptoms of GERD, peptic ulcer, and nonsteroidal anti-inflammatory drug-induced ulcer?
  7. Are there subgroups of patients based on demographics, other medications, or comorbidities for which a particular medication or preparation is more effective or associated with fewer adverse effects?
Source: oregonstate.edu
Clinical Resource: Newsletter
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Last Checked: 19/08/15 Link Error: Report It

 

Oral Proton Pump Inhibitors

Although studies exist comparing different PPIs, and some may suggest superiority of one agent over another, current NICE guidance does not recommend any particular PPI.

Of the five PPIs licensed for use in the UK (esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole), only lansoprazole and omeprazole are included on the NHSGGC Formulary. When choosing a PPI it should be noted that the licensed indications and the potential for interactions may differ between individual drugs.

Source: ggcprescribing.org.uk
Clinical Resource: Bulletin
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Last Checked: 28/11/16 Link Error: Report It

 

Use of proton pump inhibitors during pregnancy and breastfeeding

Data currently available suggest that omeprazole is not teratogenic in humans. While information on other PPIs is limited, a systematic review of the evidence suggests that they are also not teratogenic.

Source: europepmc.org
Clinical Resource: Journal Article
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Last Checked: 07/04/14 Link Error: Report It

 

Q: Can a patient with an allergic reaction to one PPI be re-challenged with another drug in the same category?

A: Cross-reactivity among the proton-pump inhibitors (PPIs) has been documented in several case reports. With the exception of lansoprazole, the product labeling for each of these agents describes them as contraindicated in patients with known hypersensitivity to PPIs or other substituted benzimidazoles.

Source: duq.edu
Clinical Resource: Pharmaceutical Information Centre Publication
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Last Checked: 15/04/14 Link Error: Report It

 

Clopidogrel and Possible Interaction with Proton Pump Inhibitors

The interaction between clopidogrel and PPIs has been examined recently in systematic reviews and metaanalyses. In general, the studies included in these reviews, investigate the effects of PPIs as a class on the incidence on major adverse cardiac events in patients who are treated with clopidogrel and include patients taking any PPI.

Source: ggcprescribing.org.uk
Clinical Resource: Bulletin
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Last Checked: 22/04/13 Link Error: Report It

 

American Association for the Study of Liver Diseases Practice Guidelines

Source: aasld.org
Clinical Resource: Guidelines
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Last Checked: 31/07/13 Link Error: Report It

 

Canadian Liver Foundation Position Statements

Source: liver.ca
Clinical Resource: Postion Statements
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Last Checked: 31/07/13 Link Error: Report It

 

Disease Management Project Hepatology Chapters

The Disease Management Project is an online medical reference, designed to provide nationally established treatment guidelines for the most commonly seen diseases and conditions.

Disease Management Project Hepatology Chapters

  • Alcoholic Liver Disease
  • Approach to the Patient with Liver Disease: A Guide to Commonly Used Liver Tests
  • Chronic Autoimmune Hepatitis
  • Cirrhotic Ascites
  • Gallbladder and Biliary Tract Disease
  • Hepatic Encephalopathy
  • Inherited Metabolic Liver Diseases
  • Liver Disease in Pregnancy
  • Nonalcoholic Fatty Liver Disease
  • Post-Liver Transplantation Management
  • Variceal Hemorrhage
  • Viral Hepatitis
Source: clevelandclinicmeded.com
Clinical Resource: Medical Reference
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Last Checked: 31/07/13 Link Error: Report It

 

Acute liver failure

Acute liver failure is a complex multisystemic illness that evolves quickly after a catastrophic insult to the liver leading to the development of encephalopathy. The underlying aetiology and the pace of progression strongly influence the clinical course. The commonest causes are paracetamol, idiosyncratic drug reactions, hepatitis B, and seronegative hepatitis. The optimal care is multidisciplinary and up to half of the cases receive liver transplants, with survival rates around 75%–90%. Artificial liver support devices remain unproven in efficacy in acute liver failure.

Source: europepmc.org
Clinical Resource: Journal Article
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Last Checked: 07/04/14 Link Error: Report It

 

The liver in pregnancy: Disease vs benign changes

Liver dysfunction in a pregnant woman may be caused by the pregnancy, it may be unrelated to the pregnancy, or it may be a chronic condition that existed before the pregnancy. In any case, the clinical clues of liver dysfunction in pregnancy are not specific, and certain ''abnormalities'' in liver function tests may represent benign changes of pregnancy.

Source: mdedge.com
Clinical Resource: Journal Article
Register to Access Content: Yes - registration is FREE

Last Checked: 19/06/17 Link Error: Report It

 

European Association for the Study of the Liver Clinical Practice Guidelines: Management of Cholestatic Liver Diseases

Source: easl.eu
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

Royal College of Obstetricians and Gynaecologists Guideline on Obstetric Cholestasis

Source: rcog.org.uk
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

European Association for the Study of the Liver Clinical Practical Guidelines: Management of Alcoholic Liver Disease

Source: easl.eu
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

CDC DVH - Division of Viral Hepatitis Home Page
Viral Hepatitis

The Division of Viral Hepatitis (DVH) is part of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at Centers for Disease Control and Prevention. In collaboration with domestic and global partners, DVH provides the scientific and programmatic foundation and leadership for the prevention and control of hepatitis virus infections and their manifestations.

For Health Professionals

Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E

Source: cdc.gov
Clinical Resource: Various
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Last Checked: 31/07/13 Link Error: Report It

 

Hepatitis - Clinical Care Options

CCO believes the way to optimize clinicians’ competence in providing the highest standards of evidence-based medicine are through effective education and the availability of the latest clinical information, whenever and wherever it is needed. CCO is dedicated to improving patient care by providing superior-quality, relevant educational content and clinical knowledge as delivered through its innovative and integrated online and mobile platforms, which provide comprehensive and personalized information solutions.

Source: clinicaloptions.com
Clinical Resource: Various
Register to Access Content: Yes - registration is FREE

Last Checked: 08/04/14 Link Error: Report It

 

Hepatitis Web Study

This site is intended for health care workers involved with the care of patients at risk for infection with hepatitis.

Case Based Modules

Hepatitis A
Hepatitis B
Hepatitis C
Common Management Issues

Source: washington.edu
Clinical Resource: Case Based Modules
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Last Checked: 31/07/13 Link Error: Report It

 

Guidance for hepatitis A and B vaccination of drug users in primary care and criteria for audit

Royal College of General Practitioners Drug Misuse Training Programme
Royal College of General Practitioners Sex, Drugs and HIV Task Group
Substance Misuse Management in General Practice

This paper contains guidance on how screening and immunisation should be carried out and suggests criteria to facilitate audits.

Source: smmgp.org.uk
Clinical Resource: Guidance
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Last Checked: 22/04/14 Link Error: Report It

 

European Association for the Study of the Liver Clinical Practice Guidelines: Management of Chronic Hepatitis B Virus Infection

Source: easl.eu
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

Management of chronic hepatitis B: Consensus guidelines
Canadian Consensus Guidelines

Source: bccdc.ca
Clinical Resource: Guideline
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Last Checked: 31/07/13 Link Error: Report It

 

A professional's guide to hepatitis B

This publication reviews current understanding about hepatitis B and provides a framework for optimal management of the disease by health professionals.

Source: britishlivertrust.org.uk
Clinical Resource: Publication
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Last Checked: 22/11/13 Link Error: Report It

 

British Viral Hepatitis Group Consensus Statement – Initial Testing and Referral of Individuals who are HBsAg Positive

Source: basl.org.uk
Clinical Resource: Consensus Statement
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Last Checked: 31/07/13 Link Error: Report It

 

Chronic Hepatitis B in Pregnancy: Consensus Recommendations

New consensus recommendations for the evaluation and management of pregnant women with hepatitis B are featured in Part 1 and Part 2 of The Female Patient. The recommendations resulted from a workshop that the Hepatitis B Foundation convened with prominent practitioners to help improve hepatitis B–related outcomes during and after pregnancy.

Source: hepb.org
Clinical Resource: Consensus Recommendations
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Last Checked: 07/05/14 Link Error: Report It

 

British Viral Hepatitis Group Consensus Statement – UK guidelines for the management of babies born to women who are HBsAg positive

Source: basl.org.uk
Clinical Resource: Consensus Statement
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Last Checked: 31/07/13 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Hepatitis C

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

European Association for the Study of the Liver Clinical Practice Guidelines: Management of Hepatitis C Virus Infection

Source: easl.eu
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

European Association for the Study of the Liver Recommendations on Treatment of Hepatitis C

Source: easl.eu
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

Guidance for the prevention, testing, treatment and management of hepatitis C in primary care

Royal College of General Practitioners Substance Misuse Unit
Royal College of General Practitioners Sex, Drugs & HIV Task Group
Substance Misuse Management in General Practice
Hepatitis C Trust
UK Hepatitis C Resource Centre
Release

This guidance has been produced to aid medical practitioners and others in the management of hepatitis C infection in primary care.

Source: rcgp.org.uk
Clinical Resource: Guidance
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Last Checked: 02/12/16 Link Error: Report It

 

Hepatitis C - Get Tested. Get treated.
Healthcare Professionals

  • What is hepatitis C?
  • How is hepatitis C transmitted? 
  • Testing for hepatitis C
  • Treating hepatitis C 
  • Resources for you
  • Resources for your patients
  • Case studies 
Source: nhs.uk
Clinical Resource: Various
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Last Checked: 31/07/13 Link Error: Report It

 

A professional's guide to hepatitis C and injecting drug use

This booklet provides up-to-date information about hepatitis C and injecting drug use. It has been designed for professionals working with injecting drug users (IDUs).

Source: britishlivertrust.org.uk
Clinical Resource: Publication
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Last Checked: 22/11/13 Link Error: Report It

 

HIVandHepatitis.com

The goal of HIVandHepatitis.com is to produce high-quality, accurate, and timely online information about treatment, management, and prevention of HIV, hepatitis B and C, HIV/HBV and HIV/HCV coinfection, and related conditions.

Since the website's founding in 1999, our editors and contributors have sought to offer cutting-edge information -- including coverage of relevant conferences and summaries of medical literature -- in a format useful to both clinicians and people living with HIV and viral hepatitis.

Source: hivandhepatitis.com
Clinical Resource: Various
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Last Checked: 20/05/14 Link Error: Report It

 

 

HEP Drug Interactions
University of Liverpool

This web site was established in 2010 by members of the Department of Pharmacology at the University of Liverpool to offer a resource for healthcare providers, researchers and patients to be able to understand and manage drug-drug interactions.

Source: hep-druginteractions.org
Clinical Resource: Various
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Last Checked: 25/04/16 Link Error: Report It

 

HIV and HCV Drug Interactions: A Quick Guide for Clinicians

HCV guidelines including specific information for treating patients with HIV/HCV co-infection HCV (NS5b polymerase inhibitor & NS3/4A protease inhibitor included)

Source: nynjaetc.org
Clinical Resource: Table
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Last Checked: 20/05/14 Link Error: Report It

 

European Association for the Study of the Liver Clinical Practice Guidelines: Hepatic Encephalopathy in Chronic Liver Disease

Source: easl.eu
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

 

Recognizing and treating cutaneous signs of liver disease

This article reviews the important cutaneous manifestations of specific liver diseases. We focus first on skin conditions that may represent liver disease, and then we discuss several major liver diseases and their typical cutaneous manifestations.

Source: mdedge.com
Clinical Resource: Journal Article
Register to Access Content: Yes - registration is FREE

Last Checked: 19/06/17 Link Error: Report It

 

Off-Label Drug Uses
Ondansetron: Cholestatic Pruritus (Adults)

Source: thomasland.com
Clinical Resource: Journal Article
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Last Checked: 26/11/15 Link Error: Report It

 

European Association for the Study of the Liver Clinical Practice Guidelines: Non-Invasive Tests for Evaluation of Liver Disease Severity and Prognosis

Source: easl.eu
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

Special Considerations in Interpreting Liver Function Tests

A number of pitfalls can be encountered in the interpretation of common blood liver function tests. These tests can be normal in patients with chronic hepatitis or cirrhosis.

Source: aafp.org
Clinical Resource: Journal Article
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Last Checked: 13/03/14 Link Error: Report It

 

Management of Abnormal LFT in Adult Asymptomatic Patients
Western Sussex Hospitals NHS

These guidelines are aimed at Gastroenterologists and General Practitioners who manage patients with no symptoms, vague symptoms, or symptoms not attributable to liver disease who are found to have abnormal LFTs.

Source: gp.westernsussexhospitals.nhs.uk
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

Revised Newcastle, North Tyneside and Northumberland Guidelines for the Management of Adults with Asymptomatic Liver Function Abnormalities

This local guideline is revised from the Newcastle, North Tyneside and Northumberland guidelines based on previous Newcastle West PCT guidance. It relates to adults with only vague or no symptoms or signs of liver disease, found to have abnormal LFTs.

Source: northoftyneapc.nhs.uk
Clinical Resource: Guideline
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Last Checked: 22/11/16 Link Error: Report It

 

Model for End-Stage Liver Disease (MELD)

The Model for End-Stage Liver Disease (MELD) is a reliable measure of mortality risk in patients with end-stage liver disease. It is used as a disease severity index to help prioritize allocation of organs for transplant.

Source: mayoclinic.org
Clinical Resource: Calculators
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Last Checked: 11/05/15 Link Error: Report It

 

Clinical Calculators

This page contains a set of clinical calculators

Clinical Calculators

  • Rockall score
  • Childs/Pugh score
  • Maddrey's Coefficient
Source: bsg.org.uk
Clinical Resource: Calculators
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Last Checked: 17/05/13 Link Error: Report It

 

Q: What is the Child-Pugh scoring system and how does it relate to drug dosage?

The Child-Pugh or Child-Turcotte-Pugh grading scale utilizes five criteria to estimate the severity of liver disease.

Source: duq.edu
Clinical Resource: Pharmaceutical Information Centre Publication
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Last Checked: 17/02/14 Link Error: Report It

 

LiverTox

LIVERTOX is a freely available website that provides up-to-date, comprehensive and unbiased information about drug induced liver injury caused by prescription and nonprescription drugs, herbals and dietary supplements.

LiverTox is a joint effort of the Liver Disease Research Branch of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Division of Specialized Information Services of the National Library of Medicine (NLM), National Institutes of Health.

Source: nih.gov
Clinical Resource: Database
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Last Checked: 17/02/14 Link Error: Report It

 

Prescribing in liver disease

As the liver is responsible for the metabolism of many compounds, knowledge of a patient's hepatic function is required for the safe prescribing of many drugs. Assessing liver function by way of a patient history, examination and blood tests such as serum albumin and bilirubin, as well as prothrombin time, is recommended before prescribing some medications.

Source: nps.org.au
Clinical Resource: Journal Article
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Last Checked: 08/08/16 Link Error: Report It

 

Drug Use in Liver Impairment

Drugs that are predominantly hepatically cleared may require dosage adjustment in the presence of significant liver impairment. This bulletin discusses the general principles of the assessment of liver impairment with respect to drug metabolism, and the subsequent adjustment of drug doses.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Drug-induced liver injury: Is it somehow foreseeable?

The classic view on the pathogenesis of drug-induced liver injury is that the so-called parent compounds are made hepatotoxic by metabolism (formation of neo-substances that react abnormally), mainly by cytochromes P-450 (CYP), with further pathways, such as mitochondrial dysfunction and apoptosis, also playing a role. Risk factors for drug-induced liver injury include concomitant hepatic diseases, age and genetic polymorphisms of CYP.

Source: nih.gov
Clinical Resource: Journal Article
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Drug-Induced Hepatotoxicity

Drugs are an important cause of liver injury. More than 900 drugs, toxins, and herbs have been reported to cause liver injury, and drugs account for 20-40% of all instances of fulminant hepatic failure.

Source: medscape.com
Clinical Resource: Article
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Drug-induced Liver Disease

Twenty to thirty percent of all acute liver failure is drug-induced. It ranges from reversible changes in liver enzyme function tests (LFTs) to fatal hepatic necrosis.

Source: adr.org.uk
Clinical Resource: Factsheet
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Antiretroviral Dosing Recommendations in Patients with Renal or Hepatic Insufficiency

Dosing in Renal Insufficiency (Including with chronic ambulatory peritoneal dialysis and hemodialysis)
Dosing in Hepatic Impairment

Source: ashm.org.au
Clinical Resource: Table
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Comprehensive Antiretroviral Table: Adult Dosing, Dosage Form Modifications, Adverse Reactions and Interaction Potential
Renal/Hepatic Dose Adjustments

Source: nccc.ucsf.edu
Clinical Resource: Table
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ARV Hepatic Dose Adjustments

Source: washington.edu
Clinical Resource: Table
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How to use statins in patients with chronic liver disease

In this article we review the data on statin-induced hepatotoxicity and offer our recommendations on the use of statins in patients with chronic liver disease, which are based on data from patients without liver disease and on our own clinical experience.

Source: mdedge.com
Clinical Resource: Journal Article
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Antituberculosis Drugs and Hepatotoxicity

The three key anti-tuberculosis drugs, viz isoniazid, pyrazinamide and rifampicin, are potentially hepatotoxic. Deaths due to fulminant liver necrosis have been reported, albeit rare in occurrence. With the changing demographics and clinical characteristics of tuberculosis patients in many parts of the world, hepatotoxicity is of increasing concern in the treatment of this disease.

Source: fmshk.org
Clinical Resource: Bulletin
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Assessing and Managing the Risk of Liver Disease in the Treatment of LTBI

Source: heartlandntbc.org
Clinical Resource: Flow Diagram
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The European Society for Clinical Nutrition and Metabolism guidelines for nutrition in liver disease and transplantation

Source: espen.org
Clinical Resource: Guideline
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Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas

These guidelines were prepared by the Department of Surgical Education, Orlando Regional Medical Center

Source: surgicalcriticalcare.net
Clinical Resource: Guideline
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Diagnosis and management of chronic pancreatitis

This review emphasises the various manifestations that patients with chronic pancreatitis may have and describes recent advances in medical and surgical therapy.

Source: europepmc.org
Clinical Resource: Journal Article
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Drug-induced acute pancreatitis

Reports of drug-induced acute pancreatitis (AP) have been published since the 1950s, and each year the list of drugs associated with AP increases. There are many etiological risk factors for AP, including a history of alcohol abuse, gallstones, endoscopic retrograde cholangiopancreatography and manometry, trauma or surgical procedures near the pancreas, certain medications, hyperlipidemia, infection, and chronic hypercalcemia. Knowledge of the true incidence of drug-induced AP is dependent on clinicians excluding other possible causes and reporting the event.

Source: baylorhealth.edu
Clinical Resource: Journal Article
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The European Society for Clinical Nutrition and Metabolism guidelines on nutrition in acute pancreatitis

Source: espen.org
Clinical Resource: Guideline
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The Challenge of Chronic Pancreatitis Pain

Pain reportedly occurs in up to 94% of patients with chronic pancreatitis. The pain is burning, intermittent, and shooting, suggesting that it has both inflammatory and neuropathic components. The pain is caused by sustained peripheral sensitization secondary to both inflammatory and neuropathic damage to nerve endings in the pancreas, as well as central sensitization. Pancreatic fibrotic strictures and calcifications develop, increasing ductal and interstitial pressure.

Source: iasp-pain.org
Clinical Resource: Newsletter
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Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Diagnosis and Management of Colorectal Cancer

Source: sign.ac.uk
Clinical Resource: Guideline
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The Association of Coloproctology of Great Britain and Ireland Guidelines for the Management of Colorectal Cancer

Source: acpgbi.org.uk
Clinical Resource: Guideline
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The Association of Coloproctology of Great Britain and Ireland Position Statement for Management of Anal Cancer

Source: acpgbi.org.uk
Clinical Resource: Position Statement
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Position Statements on Malignant Large Bowel Obstruction and Anal Fistula
The Association of Coloproctology of Great Britain and Ireland

Source: acpgbi.org.uk
Clinical Resource: Position Statements
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Position Statements: Management of Anal Fissure & Management of Acute Severe Colitis
The Association of Coloproctology of Great Britain and Ireland

Source: acpgbi.org.uk
Clinical Resource: Position Statements
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Haemorrhoids (piles) treatment in Breastfeeding Mothers

Source: breastfeedingnetwork.org.uk
Clinical Resource: Drug Information Factsheet
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Last Checked: 08/08/16 Link Error: Report It

 

European Crohn's and Colitis Organisation Guidelines

Source: ecco-ibd.eu
Clinical Resource: Guidelines
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Interview With an Expert: Answers to Key Questions in Inflammatory Bowel Diseases

This content of the FREE virtual lecture was derived from a live, educational teleconference/webcast presented by the Crohn’s & Colitis Foundation of America on Thursday, May 7, 2009.

At the conclusion of this activity, participants should be better able to:

  • Outline the current and emerging therapies for inflammatory bowel disease (IBD)
  • Identify the differences between “top-down” and “bottom-up” approaches to treatment
  • Identify lifestyle factors, including diet, smoking, and stress that affect IBD disease course
  • Cite the physical and monetary costs of IBD
  • Describe current research involving genetics, causation, and novel treatments for IBD
  • Review quality-of-life issues in living with IBD
Source: ccfa.org
Clinical Resource: CE / CPD / Learning
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Last Checked: 01/08/13 Link Error: Report It

 

An Evidence-Based Systematic Review on Medical Therapies for Inflammatory Bowel Disease

The College and the ACG Institute published a new evidence-based systematic review on the management of Inflammatory Bowel Disease as a supplement to The American Journal of Gastroenterology (AJG) for April 2011This clinical monograph, based on a comprehensive meta-analysis, offers new graded recommendations on medical management of IBD by distinguished expert Task Force lead by Nicholas J. Talley, M.D., Ph.D., FACG with contributions from a talented group of IBD experts.

Source: gi.org
Clinical Resource: Monograph
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Last Checked: 01/08/13 Link Error: Report It

 

Update in inflammatory bowel disease

Inflammatory bowel disease (IBD) refers to a group of conditions characterised by inflammation in the intestinal tract. Crohn disease (CD) and ulcerative colitis (UC) account for the majority of these conditions. The aim of this article is to review recent breakthroughs in IBD investigation and management.

Source: racgp.org.au
Clinical Resource: Journal Article
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Crohn's Disease: Current Management and Prospective Therapies

Inflammatory bowel disease (IBD) is a relapsing-remitting gastrointestinal (GI) disorder involving areas from the mouth to the anus. Crohn's disease (CD) is a chronic form of IBD that can extend through the various layers of the GI tract, resulting in intestinal and extraintestinal complications. Another form of IBD is ulcerative colitis (UC), which primarily affects the rectum and colon; however, this article will address only CD.

Source: uspharmacist.com
Clinical Resource: Journal Article
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The pharmacologic management of Crohn's disease

Treatment options for CD include anti-inflammatory agents (eg, sulfasalazine, mesalamine) and corticosteroids for the induction of response in patients with mild-to-moderate CD. Immunomodulators, antibiotics, and biologic agents may be used for the maintenance of remission.

Source: modernmedicine.com
Clinical Resource: Journal Article
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Common questions around medicines used for inflammatory bowel disease

Drugs used to maintain or induce remission in inflammatory bowel disease (IBD) should always be started by a specialist but they may be continued and monitored by a GP under a shared-care protocol. To help inform the decision making around these arrangements, this Bulletin considers some common questions in primary care around medicines used for IBD. It focuses particularly on the role and use of aminosalicylates, corticosteroids and tumour necrosis factor alpha (TNF) inhibitors in both ulcerative colitis and Crohn’s disease. It does not consider other management options, such as immunosuppressants, nor is it a comprehensive review of the management of IBD.

Source: webarchive.org.uk
Clinical Resource: National Prescribing Centre Bulletin
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What are the differences between different brands of mesalazine tablets?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

Available formulations have differences in licensed indications, tablet strengths, dose frequency, interactions, pharmaceutical, pharmacological and pharmacokinetic properties.

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Faculty of Sexual & Reproductive Healthcare Clinical Guidance
Sexual and Reproductive Health for Individuals with Inflammatory Bowel Disease

Source: fsrh.org
Clinical Resource: Guidance
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Last Checked: 10/06/15 Link Error: Report It

 

Vaccination Strategies for Patients with Inflammatory Bowel Disease on Immunomodulators and Biologics

This review discusses the rationale for currently recommended vaccinations, as well as issues pertaining to vaccine safety and immunogenicity in immunosuppressed patients with inflammatory bowel disease and their household contacts.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Immunizations in Patients with Inflammatory Bowel Disease

Patients receiving immunosuppressive therapies may be at increased risk for complications of vaccine preventable diseases, including influenza, varicella, and pneumococcus. However, studies suggest that patients with chronic illness may be inadequately immunized. In part, this is because of a paucity of formal vaccine studies in immune compromised populations. This review discusses the methods one uses to assess vaccine efficacy and provides an update on currently known data on the vaccine antibody responses in immune compromised hosts.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Off-Label Drug Uses
Nicotine (Transdermal): Ulcerative Colitis

Source: thomasland.com
Clinical Resource: Journal Article
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Irritable bowel syndrome

This article discusses the causes, diagnosis and management of IBS.

Source: racgp.org.au
Clinical Resource: Journal Article
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Last Checked: 01/08/13 Link Error: Report It

 

An Evidence-Based Systematic Review on the Management of Irritable Bowel Syndrome

In order to critically evaluate the rapidly expanding research about IBS and to assess the evidence of efficacy of new IBS drugs and treatments, an ACG IBS Task Force lead by Nicholas J. Talley, M.D, Ph.D., FACG, in 2008 performed a comprehensive meta-analysis of the evidence on therapies for IBS. The group updated its 2002 evidence-based position statement on IBS therapies. This Systematic Review on the Management of Irritable Bowel Syndrome was published in January 2009 as a supplement to The American Journal of Gastroenterology. These peer-reviewed recommendations were adopted by the College and offer clinicians new graded recommendations on testing and treatment.

Source: gi.org
Clinical Resource: Monograph
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Last Checked: 01/08/13 Link Error: Report It

 

Irritable bowel syndrome
The role of complementary medicines in treatment

This article discusses the use of complementary medicines in the treatment of IBS.

Source: racgp.org.au
Clinical Resource: Journal Article
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Off-Label Drug Uses
Naltrexone: Irritable Bowel Syndrome

Source: thomasland.com
Clinical Resource: Journal Article
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Last Checked: 26/11/15 Link Error: Report It

 

Bandolier Knowledge
Laxatives and constipation

Constipation and laxative use is a huge problem, one that Bandolier is looking to expand upon. This is the first attempt to gather together material for this site.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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The management of constipation

This bulletin describes the management of constipation using a case-based approach. It provides an overview of the management of constipation in adults based on the Clinical Knowledge Summaries (CKS) review of this topic. It briefly discusses management in children, pregnant and breastfeeding women and outlines some issues for healthcare professionals to consider. NICE guidance on the diagnosis and management of constipation in children and young people is also used to highlight any differences from the conventional management of adults. A detailed review of the causes of constipation, its prevalence, and its management in other situations (e.g. when associated with irritable bowel syndrome, or in palliative care patients) are not covered by this bulletin.

Source: webarchive.org.uk
Clinical Resource: National Prescribing Centre Bulletin
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Last Checked: 24/04/15 Link Error: Report It

 

Getting Critical About Constipation

Gastrointestinal motility is a complex process, which is often altered during critical illness, an effect that can lead to constipation.

Source: virginia.edu
Clinical Resource: Journal Article
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Diagnosis and management of constipation in older people

Our series Prescribing in older people gives practical advice for successful management of the special problems experienced by this patient group. Here, the authors define constipation and describe assessment and management in older patients.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Nutrients and Constipation: Cause or Cure?

This paper will briefly review the evidence for nutrients as a cause or cure for constipation.

Source: virginia.edu
Clinical Resource: Journal Article
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Last Checked: 25/04/16 Link Error: Report It

 

Medication Induced Constipation and Diarrhea

This article discusses the most common medications associated with constipation and diarrhea as well as diagnosis, treatment and prevention of the disorder; the diagnosis is especially important when the offending medication cannot be discontinued.

Source: practicalgastro.com
Clinical Resource: Journal Article
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Drug-Associated Diarrhoea and Constipation in Older People
1. Diarrhoea

The first part of this review explains the mechanisms involved in drug-induced diarrhoea and gives examples of drugs commonly involved.

Drug-Associated Diarrhoea and Constipation in Older People
2. Constipation

This second part of the review explains the mechanisms of drug-induced constipation and presents examples of drugs commonly associated with this abnormality of bowel function.

Source: shpa.org.au
Clinical Resource: Journal Articles
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Infectious Diseases Society of America Practice Guidelines for the Management of Infectious Diarrhea

Source: idsociety.org
Clinical Resource: Guideline
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Focus on acute diarrhoeal disease

Diarrhoea is an alteration of normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Diarrhoea needs to be classified according to the trends over time (acute or chronic) and to the characteristics of the stools (watery, fatty, inflammatory). Secretory diarrhoeas, mostly acute and of viral aetiology in more than 70% of cases, are by far the most important subtype of diarrhoeas in terms of frequency, incidence and mortality (over 2.5 million deaths/year in developing countries).

Source: nih.gov
Clinical Resource: Journal Article
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Antibiotic-Associated Diarrhoea

Antibiotic-associated diarrhoea (AAD) is a common side effect. The incidence varies between antibiotics, and has been estimated to occur in 15% of patients taking beta-lactams (although up to 25% of those taking amoxicillin/clavulanate), 2 to 5% of those taking cephalosporins, fluoroquinolones or macrolides. Rates with intravenous administration (particularly if a drug undergoes enterohepatic circulation) are similar to those with oral administration.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Acute diarrhoea and fever

Diarrhoeal disease is an important cause of morbidity worldwide and represents a leading cause of childhood death in the developing world. In the developed world, the mortality rate has fallen sharply, due to a decline in illness caused by Clostridium perfringens and Salmonellas. The elderly remain especially susceptible to the complications of diarrhoea and account for 85% of related deaths.

Source: rcpe.ac.uk
Clinical Resource: Journal Article
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Diarrhoea (Acute) and Breastfeeding Mothers

Source: breastfeedingnetwork.org.uk
Clinical Resource: Drug Information Factsheet
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Management of Clostridium difficile infection

Clostridium difficile-associated diarrhoea is the most common cause of nosocomial diarrhoea and has a high morbidity and mortality among infected patients. Its prevalence and recurrence rates increase with age. Influencing local antibiotic practice can have an impact on infection rates, and this and other specific strategies to reduce the incidence and relapse rates of C. difficile-associated diarrhoea are needed. Reduction of C. difficile-associated diarrhoea rates would have enormous positive resource implications for health services, primarily by reducing length of hospital stay, and would also reduce mortality and morbidity in hospital inpatients.

Source: rcpe.ac.uk
Clinical Resource: Journal Article
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The Role of Probiotics in the Prevention of Antibiotic-Associated Diarrhoea

Diarrhea is a common complication of antibiotic therapy occurring within several days of starting therapy to weeks after the antibiotic has been discontinued. Any antibiotic can induce diarrhea but broad spectrum antibiotics such as ampicillin, amoxicillin, cephalosporins, and clindamycin are the major culprits.

Source: ufl.edu
Clinical Resource: Publication
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Probiotics for the prevention of antibiotic-associated diarrhoea

The findings from a recent meta-analysis show that some probiotics significantly reduce the development of antibiotic associated diarrhoea (AAD). There are various different preparations of probiotics that are available but very few have evidence of effectiveness supported by controlled trials.

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletin
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Probiotics: which, when and why?

The normal gut microflora, aside from aiding digestion, provides protection against pathogenic organisms. Probiotics have been manufactured with the idea of maximising the effect of gut microflora, also known as “good bacteria”, thus reducing the risk of infection. This theory has proved scientists right on several occasions however stronger evidence is necessary to establish the efficacy, safety and cost-effectiveness of these products.

Source: mcppnet.org
Clinical Resource: Journal Article
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Probiotics

Probiotic supplementation is widely used to increase the number of beneficial bacteria and/or yeast in the digestive tract. If the “good” bacteria start to decline, it leaves opportunity for “bad” bacteria to overgrow and causes illness.

Source: uwyo.edu
Clinical Resource: Newsletter
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Probiotics and Prebiotics

Source: patient.co.uk
Clinical Resource: Article
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Drug Therapy and the Compromised Bowel

Several factors can alter the absorption of drugs taken orally in patients with a compromised digestive system. The most important determinations are the length of bowel available for drug absorption, and which section of the bowel has been removed.

Source: badgut.org
Clinical Resource: Article
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Stoma Care

An ostomy is a surgically made opening from the inside of an organ to the outside. Stoma is the greek for mouth or opening. The stoma is the part of the ostomy attached to the skin. A stoma bag is then attached to the opening in the case of colostomies, ileostomies and urostomies so that either faeces or urine drain into this bag.

Source: patient.co.uk
Clinical Resource: Article
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Stoma Information Package for GPs

A package for GPs has been produced by Stomal Therapists from Austin Health, Northern Health & Eastern Health. This package contains information on:

Source: nevdgp.org.au
Clinical Resource: Information Package
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Can high dose loperamide be used to reduce stoma output?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

Loperamide has been used in the management of colostomies or ileostomies, to reduce the volume of discharge and is preferred to opiate drugs (for example, codeine phosphate) as it is not sedative, addictive, and does not cause fat malabsorption.

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Recommended assessment and treatment of nausea and vomiting

The causes of nausea and vomiting are multifarious and a full clinical history is required before commencing treatment. Our Drug review discusses the diagnosis and the available drug options and their properties, followed by sources of further information.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Oral erythromycin for gastroparesis: The more stable choice?

Erythromycin is a macrolide antibiotic that has been available since the 1950s. It is rarely used as an antibiotic today and is primarily used for its “prokinetic” effect on the gastrointestinal (GI) tract. It has been used successfully off-label for the treatment of gastroparesis and other GI hypomotility disorders.

Source: ufhealth.org
Clinical Resource: Drug and Therapy Bulletin
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Q: How effective is erythromycin in the management of gastroparesis?

A: Gastroparesis is a condition of delayed gastric emptying often seen in patients with long-standing diabetes. Injury to the vagus nerve is the most likely cause of gastroparesis in diabetics. Other etiologies of gastroparesis include post-viral syndromes, anorexia nervosa, Parkinson’s disease, amyloidosis, scleroderma, hypothyroidism, and medications such as anticholinergic agents and opiates.

Source: duq.edu
Clinical Resource: Pharmaceutical Information Centre Publication
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Last Checked: 01/08/13 Link Error: Report It

 

Drug Therapy-Related Issues in Patients Who Received Bariatric Surgery (Part I)

This is part 1 of a two-article series that is aimed to address how pharmacotherapy is affected by bariatric surgery. The current article is aimed to provide a detailed review of process and factors that affect drug absorption from the gastrointestinal tract. The discussion may help clinicians better predict how bariatric procedures may affect oral drug absorption and pharmacotherapy.

Drug Therapy-Related Issues in Patients Who Received Bariatric Surgery (Part II)

This is part 2 of a two-article series that is aimed to address how pharmacotherapy is affected by bariatric surgery. The focus of this article is to review how each of the established bariatric procedures can affect pharmacokinetics based on information available in the literature. Other pertinent pharmacotherapy-related issues in patients with bariatric surgery, such as the risk of pill esophagitis, hormonal contraception, anticoagulant therapy, will be also addressed.

Source: virginia.edu
Clinical Resource: Journal Articles
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Q: What medication adjustments should be made for gastric bypass (bariatric) surgery patients?

A: Obesity is an increasing epidemic and estimated to affect about 30 percent of the American population. Many obese patients elect to undergo surgery after failed attempts at other alternatives for weight loss. There are three types of bariatric or gastric bypass surgery.

Source: duq.edu
Clinical Resource: Pharmaceutical Information Centre Publication
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Last Checked: 17/02/14 Link Error: Report It

 

The Surgical Management of Patients with Acute Intestinal Failure
Association of Surgeons of Great Britain and Ireland

The aim of this booklet is to increase awareness of acute IF and to provide advice on its prevention and management. The facilities, training and expertise that we believe are required for successful and cost-effective management of patients with acute IF are highlighted, as well as criteria which define the group of patients for whom referral to a specialised centre should be considered.

Source: asgbi.org.uk
Clinical Resource: Publication
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Last Checked: 03/01/13 Link Error: Report It

 

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