scholarly journals NO002. Introduction of an inflammatory bowel disease nurse flexible sigmoidoscopy clinic improves patient care by initiating earlier treatment and saves clinic slots

2016 ◽  
Vol 10 (suppl 1) ◽  
pp. S493.2-S494
2019 ◽  
Author(s):  
Myung S. Ko ◽  
Vivek A. Rudrapatna ◽  
Patrick Avila ◽  
Uma Mahadevan

AbstractI.Background and AimsLower gastrointestinal endoscopy is the gold standard for the diagnosis and staging of Inflammatory Bowel Disease (IBD). However, there is limited safety data in pregnant populations, resulting in conservative society guidelines and practice patterns favoring diagnostic delay. The aim of this study is to investigate if the performance of flexible sigmoidoscopy is associated with adverse events in pregnant patients with known or suspected IBD.II.MethodsA retrospective cohort study was conducted at the University of California San Francisco (UCSF) between April 2008 and April 2019. Female patients aged between 18 and 48 years who were pregnant at the time of endoscopy were identified. All patient records were reviewed to determine disease, pregnancy course, and lifestyle factors. Two independent reviewers performed the data abstraction. Adverse events were assessed for temporal relation (defined as within 4 weeks) with endoscopy. Any discrepancies in the two reviewers’ data were reviewed by a third independent investigator. Descriptive statistics of data were calculated, and comparison of continuous and categorical data were made using a one-sided Wilcoxon rank-sum test and Fisher’s exact test, respectively.III.ResultsWe report the outcomes of 48 pregnant patients across all trimesters who underwent lower endoscopy for suspected or established IBD. There were no hospitalizations or adverse obstetric events temporally associated with sigmoidoscopy. 78% of patients experienced a change in treatment following sigmoidoscopy. 12% of the patients with known IBD were found to have no endoscopic evidence of disease activity despite symptoms.IV.ConclusionsLower endoscopy in the pregnant patient with known or suspected IBD is low risk and affects therapeutic decision making. It should not be delayed in patients with appropriate indications.


1991 ◽  
Vol 5 (5) ◽  
pp. 167-170 ◽  
Author(s):  
Hugh J Freeman ◽  
Urs P Steinbrecher ◽  
WC Peter Kwan ◽  
Stephanie Ensworth

An 18-year-old female with ankylosing spondylitis developed fever, abdominal pain and diarrhea on two occasions after starting sulphasalazine therapy. Flexible sigmoidoscopy revealed pseudomembranous colitis; fecal cultures were positive forClostridium difficile; andC difficiletoxin assay was positive. Despite the frequent use of sulphasalazine in the management of inflammatory bowel disease, this complication has been apparently rare. Clinicians should be wary of the onset of diarrhea in patients receiving sulphasalazine, whether for inflammatory bowel disease or other conditions.


2017 ◽  
Vol 152 (5) ◽  
pp. S746-S747 ◽  
Author(s):  
Sarah Quinton ◽  
Alyse Bedell ◽  
Meredith Craven ◽  
Livia Guadagnoli ◽  
Tiffany Taft

2020 ◽  
Vol 43 (7) ◽  
pp. 408-413
Author(s):  
Ignacio Marín-Jiménez ◽  
Yamile Zabana ◽  
Iago Rodríguez-Lago ◽  
Laura Marín ◽  
Manuel Barreiro-de Acosta ◽  
...  

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ashwini Venkatesh ◽  
Barrie Keeler ◽  
Achal Khanna

Abstract Aims To identify presentations of LGI bleeds, assimilate learning and make appropriate recommendations to improve management in hospital. Methods 336 patients with ‘PR bleed’ on their coding summary in 2019 were identified. Data obtained through eCare and EDM was analysed as outlined: Results 69% were emergency presentations of LGI bleed and the remaining 31% were elective admissions. 5% of emergency LGI bleed patients were discharged on the same day as compared to 97.4% of elective patients. The remaining 80% of emergency patients went on to have outpatient investigations. Positive cases included haemorrhoids, inflammatory bowel disease and diverticulitis. Conclusions All emergency presentations occurred during inpatient stay creating disparities in manner of presentation and duration of admission between cohorts. However, outcomes between the cohorts were broadly similar, suggesting absence of significant disparities in management. Colonoscopy is the gold standard diagnostic investigation in LGI bleeds however, flexible-sigmoidoscopy can be considered in under 50’s. 80% of patients had a colonoscopy during admission as per guidelines. No reasoning was documented for patients who underwent other methods of investigation as first-line, thus creating a need for improved documentation when deviating from guidelines. Recommendation to re-audit in 1 year to assess changes.


2014 ◽  
Vol 8 ◽  
pp. S54-S55
Author(s):  
G. D'Haens ◽  
B.L. Bressler ◽  
S. Danese ◽  
P.R. Gibson ◽  
S.B. Hanauer ◽  
...  

2020 ◽  
Vol 65 (10) ◽  
pp. 2979-2985 ◽  
Author(s):  
Myung S. Ko ◽  
Vivek A. Rudrapatna ◽  
Patrick Avila ◽  
Uma Mahadevan

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