Management of GI Disorders

Mucosal Protective Agents

Sucralfate Sucralfate is a basic nonabsorbable aluminum salt of sucrose octasulfate. Despite weak antacid properties, the protective effect of sucralfate is not mediated by acid suppression or neutralization, but by a mucosal protective effect on the gastric mucosa….

The Management of Nonulcer Dyspepsia

Dyspepsia is one of the most common problems encountered in gastroenterology practice, and it accounts for 2 to 5% of primary care visits. Prevalence estimates for dyspepsia range from 12 to 45%, with an average estimate of about…

Current Management of Whipple’s Disease

With the identification of the causative bacterium, Tropheryma whippelii, Whipples disease has grown out from its niche in textbooks and has colonized high ranked journals. Nevertheless, it is an uncommon multisystem disorder and not just an intestinal bacterial…

Specific Investigations in Nonulcer Dyspepsia

Esophagogastroduodenoscopy and Helicobacter Pylori Although most dyspepsia in clinical practice is functional, the diagnosis of functional dyspepsia is a diagnosis of exclusion. A search for organic etiologies should be undertaken, because therapy for many organic causes is more…

Therapy

General Measures As stated above, the risk of overt gastrointestinal hemorrhage and subsequent death due to stress-related erosive syndrome are closely related to the underlying disease. Therapy must therefore be directed at treating the cause of physiologic stress….

Management of Stress-Related Erosive Syndrome

The clinical features of stress-related erosive syndrome have been well characterized since the initial endoscopic description by Lucas and colleagues in 1971. Stress-related lesions in the stomach and duodenum can be detected endoscopically within several hours of a…

Management of Acute Variceal Bleeding

Gastroesophageal variceal bleeding is an unpredictable complication of cirrhosis with an associated mortality of 15 to 30% with each bleeding episode, and about one-third of all deaths in patients with cirrhosis could be directly attributed to acute variceal…

Current Use

Acid suppressive therapy may be of benefit in patients with functional dyspepsia and the benefit appears greatest in patients with ulcer-like symptoms. A 2 to 4 week trial of antisecretory therapy at standard doses is reasonable. Therapy should…

Nausea and vomiting

Vomiting follows stimulation of the vomiting centre in the medulla of the brain. This may be via the chemoreceptor trigger zone, which is sensitive to many drugs and to certain metabolic disturbances, or from actions on other areas…