Caustic substances injure tissue by means of a chemical reaction on direct physical contact. Often thought of as acids or bases, caustics broadly include desiccants, vesicants, and protoplasmic poisons. The term “corrosive” is often used interchangeably with “caustic,” but corrosion implies a mechanical degradation, which does not always apply to caustics. Continue reading
The Forrest classification is a widely used classification of ulcer-related upper gastrointestinal bleeding. It was initially developed to unify the description of ulcer bleeding for better communication amongst endoscopists. However, the Forrest Classification is now used as a tool to identify patients who are at an increased risk for bleeding, rebleeding and mortality. Continue reading
Once the clinical suspicion is established, the diagnosis is based on the combination of clinical, biochemical, endoscopic, histological and/or radiological criteria. Continue reading
Ulcerative colitis (UC) is a chronic immune-mediated inflammatory condition of the large intestine that is frequently associated with inflammation of the rectum but often extends proximally to involve additional areas of the colon. Once a diagnosis of UC is made, determining the severity of disease becomes important. Continue reading
Testing for H. pylori is recommended in patients with peptic ulcer disease, gastric cancer, or gastric mucosa–associated lymphoid tissue lymphoma (MALToma). Other recommended indications for testing include dyspepsia, prolonged use of nonsteroidal antiinflammatory drugs or aspirin, unexplained iron-deficiency anemia, and immune thrombocytopenia. Continue reading
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.