Gastrointestinal emergencies

2017 ◽  
Author(s):  
Ashis Banerjee ◽  
Clara Oliver
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Liver Disease ◽  
Scoring Systems ◽  
Lower Gastrointestinal Bleeding ◽  
Common Presentation ◽  
Gastrointestinal Problem ◽  
Inflammatory Bowel ◽  
Related Liver Disease ◽  
Key Aspects

This chapter covers the medical aspects of patients presenting to the emergency department with a gastrointestinal problem. It covers both upper and lower gastrointestinal bleeding, including the management and scoring systems available for risk stratification. This chapter also includes a section on diarrhoea and vomiting, as well as the management of individuals with inflammatory bowel disease. In addition to bowel-related pathology, another common presentation includes liver and alcohol-related pathology. This chapter summarizes the key aspects of liver failure. Included in this are the key investigation and indications for transplant, as well as the management of alcohol-related liver disease and alcohol withdrawal.

A nurse-led day-case gastroenterology service in the emergency department

2021 ◽  
Vol 19 (Sup10) ◽  
pp. S18-S23
Author(s):  
Maria Tan ◽  
Shyam Menon
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Liver Disease ◽  
Blood Transfusion ◽  
Ascitic Fluid ◽  
Bowel Disease ◽  
Day Case ◽  
Front Door ◽  
Inflammatory Bowel

The incidence of liver disease has been steadily increasing, and patients with severe, symptomatic ascites need paracentesis (drainage) of the ascitic fluid for management. The authors and colleagues have previously developed a nurse-led and nurse-managed day-case gastroenterology service that provides paracentesis and other treatments, such as blood transfusion and specialist biologic infusions to patients with inflammatory bowel disease (IBD) and other gastroenterological conditions. This article describes the development of a similar novel nurse-led day-case service within the emergency department (ED) to provide a front-door urgent service for patients attending ED and needing paracentesis/infusions. It also reflects on the journey to developing this service, as well as the challenges faced during to the COVID-19 pandemic.

Gastroenterology

2013 ◽  
Author(s):  
Victoria Stacey
Keyword(s):  
Inflammatory Bowel Disease ◽  
Liver Disease ◽  
Gastrointestinal Bleeding ◽  
Liver Failure ◽  
Upper Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Bleeding ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Inflammatory Bowel ◽  
Withdrawal Syndromes ◽  
Upper Gastrointestinal

Acute gastrointestinal bleeding - Acute upper gastrointestinal bleeding - Acute lower gastrointestinal bleeding - Vomiting - Diarrhoea - Inflammatory bowel disease (IBD) - Liver failure - Alcoholic liver disease/withdrawal syndromes - SAQs

scholarly journals Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin?

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 643
Author(s):  
Angela Saviano ◽  
Mattia Brigida ◽  
Alessio Migneco ◽  
Gayani Gunawardena ◽  
Christian Zanza ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Human Health ◽  
Bowel Disease ◽  
Chronic Constipation ◽  
Lactobacillus Reuteri ◽  
Current Knowledge ◽  
Gastrointestinal Symptoms ◽  
Inflammatory Bowel

Background and Objectives: Lactobacillus reuteri DSM 17938 (L. reuteri) is a probiotic that can colonize different human body sites, including primarily the gastrointestinal tract, but also the urinary tract, the skin, and breast milk. Literature data showed that the administration of L. reuteri can be beneficial to human health. The aim of this review was to summarize current knowledge on the role of L. reuteri in the management of gastrointestinal symptoms, abdominal pain, diarrhea and constipation, both in adults and children, which are frequent reasons for admission to the emergency department (ED), in order to promote the best selection of probiotic type in the treatment of these uncomfortable and common symptoms. Materials and Methods: We searched articles on PubMed® from January 2011 to January 2021. Results: Numerous clinical studies suggested that L. reuteri may be helpful in modulating gut microbiota, eliminating infections, and attenuating the gastrointestinal symptoms of enteric colitis, antibiotic-associated diarrhea (also related to the treatment of Helicobacter pylori (HP) infection), irritable bowel syndrome, inflammatory bowel disease, and chronic constipation. In both children and in adults, L. reuteri shortens the duration of acute infectious diarrhea and improves abdominal pain in patients with colitis or inflammatory bowel disease. It can ameliorate dyspepsia and symptoms of gastritis in patients with HP infection. Moreover, it improves gut motility and chronic constipation. Conclusion: Currently, probiotics are widely used to prevent and treat numerous gastrointestinal disorders. In our opinion, L. reuteri meets all the requirements to be considered a safe, well-tolerated, and efficacious probiotic that is able to contribute to the beneficial effects on gut-human health, preventing and treating many gastrointestinal symptoms, and speeding up the recovery and discharge of patients accessing the emergency department.

scholarly journals P129 The utility of routine operative swab culture in uncomplicated peri-anal abscesses

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Apoorva Khajuria ◽  
Tuba Rahim ◽  
Mariam Baig ◽  
Kai Leong ◽  
Apoorva Khajuria
Keyword(s):  
Inflammatory Bowel Disease ◽  
Perianal Abscess ◽  
Female Ratio ◽  
Incision And Drainage ◽  
Common Presentation ◽  
History Of ◽  
Inflammatory Bowel ◽  
Operative Findings ◽  
The Cost ◽  
Male To Female

Abstract Introduction Despite perianal abscess being a common presentation, certain aspects of its management remain controversial, especially the routine use of intra-operative swab cultures. Methods A retrospective review of patients that underwent incision and drainage procedures for a perianal abscess over a six-month period was undertaken. Results Over 6 months, 50 patients were identified. The male to female ratio was 3:1 and median ASA score was 1. Only 6/50 patients presented with recurrent abscess and 1 patient had history of inflammatory bowel disease. On the basis of operative findings, 39 patients (78%) had uncomplicated abscess (not associated with cellulitis, sinus or fistula); swab cultures were performed in 26 (67%) of these patients. All patients were discharged on the same day; microbiology reports did not impact the treatment and no patients were followed up in clinic post-operatively or presented with recurrence. The number of unnecessary microbiology swabs undertaken in this cohort equates to approximately 52 unnecessary swabs a year. The cost of one swab is £10.10p, which means £520 could potentially be saved annually. Conclusion Routine intra-operative swab cultures do not impact management decisions, add to unnecessary costs and therefore should not be undertaken in uncomplicated or first presentation of peri-anal abscesses.

Rectal Bleeding in Prader-Willi Syndrome

PEDIATRICS ◽  
1996 ◽  
Vol 97 (2) ◽  
pp. 265-267
Author(s):  
SANGEETA A. BHARGAVA ◽  
PHILIP E. PUTNAM ◽  
SAMUEL A. KOCOSHIS ◽  
MARC ROWE ◽  
JEANNE M. HANCHETT
Keyword(s):  
Inflammatory Bowel Disease ◽  
Gastrointestinal Bleeding ◽  
Rectal Bleeding ◽  
Bowel Disease ◽  
Lower Gastrointestinal Bleeding ◽  
Prader Willi Syndrome ◽  
Anorectal Disease ◽  
Skin Picking ◽  
Inflammatory Bowel

Individuals with Prader-Willi syndrome manifest severe skin picking behavior. We report three patients with this syndrome in whom an extension of this behavior to rectal picking resulted in significant lower gastrointestinal bleeding and anorectal disease. The recognition of this behavior is important to avoid misdiagnosing inflammatory bowel disease in this group of patients.

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