First introduced in 1989, proton pump inhibitors (PPIs) are among the most widely utilized medications worldwide, both in the ambulatory and inpatient clinical settings. The PPIs are currently approved by the US Food and Drug Administration (FDA) for the management of a variety of gastrointestinal disorders including symptomatic peptic ulcer disease, gastroesophageal reflux disease, and nonulcer dyspepsia as well as for prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy. Continue reading
Endoscopy is the gold standard for diagnosis of peptic ulcer disease. Apart from exclusion of malignant disease, detection of H pylori infection with histology or rapid urease tests is essential to the subsequent treatment plan. Continue reading
In 2005, the CT Colonography Reporting and Data System (C-RADS) was established to provide a means of classifying findings of CT colonography (CTC) and of applying the advantages of structured reporting to the setting of colorectal cancer screening.
Grading of hepatic encephalopathy categorizes it in clinical stages of stepwise worsening. The description of each grade varies somewhat in the literature, but differences between adjacent grades are clear enough to be helpful in clinical practice, although neurologic descriptors are sparse. One study showed that for patients who become comatose, the Full Outline of Unresponsiveness (FOUR) score is more discriminating than the West Haven grading system because it includes brain-stem and respiration assessment, which are not further differentiated in the West Haven system.
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown cause that is characterized pathologically by an inflammatory and fibrotic process centered on the epithelium, leading to diffuse biliary stenosis and increased wall thickness throughout the intra- and extra-hepatic biliary trees.
According to the Rome III criteria, functional dyspepsia is defined as the presence of one or more of the following: postprandial fullness, early satiation, epigastric pain or burning and no evidence of structural disease (including at upper endoscopy) to explain the symptoms.
Grading and staging refers to a semiquantitative assessment of the necroinflammatory activity (grade) and degree of fibrosis (stage) in relation to chronic hepatitis.
Recent guidelines published by the American College of Gastroenterology suggest that urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 hours after admission) is indicated in patients with biliary pancreatitis who have concurrent acute cholangitis, but it is not needed in most patients who do not have evidence of ongoing biliary obstruction.
Alcoholic liver disease (ALD) encompasses a spectrum of injury, ranging from simple steatosis to frank cirrhosis.
Celiac disease is a systemic immune-mediated disorder triggered by dietary gluten in genetically susceptible persons. Gluten is a protein complex found in wheat, rye, and barley. Celiac disease is characterized by a broad range of clinical presentations, a specific serum autoantibody response, and variable damage to the smallintestinal mucosa.