Oesophageal disorders

2021 ◽  
pp. 16-38
Author(s):  
Thomas Marjot
Keyword(s):  
Chest Pain ◽  
Foreign Body ◽  
Reflux Disease ◽  
Therapeutic Approach ◽  
Core Curriculum ◽  
Curriculum Material ◽  
Eosinophilic Oesophagitis ◽  
Diagnostic Features ◽  
Curriculum Topics

This chapter covers core curriculum topics relating to disorders of the oesophagus. A diagnostic and therapeutic approach to symptoms of gastro-oesophageal reflux disease is covered including physiology testing and the role of anti-reflux surgery. Other benign conditions causing dysphagia and chest pain are presented incorporating disorders of motility, infections, and the management of eosinophilic oesophagitis and oesophageal stricturing. Coverage is given to the investigation and management of patients with foreign body or caustic substance ingestions. There is particular focus on the investigation and management of oesophageal malignancy including in palliative stages, along with the various stages of Barret’s oesophagus. This includes diagnostic features, surveillance intervals and management of dysplasia associated with Barrett’s. Additional curriculum material regarding disorders of the oesophagus will also be covered in the mock examination chapter.

Gastrointestinal haemorrhage

2021 ◽  
pp. xxxii-15
Author(s):  
Thomas Marjot
Keyword(s):  
Gastrointestinal Bleeding ◽  
Core Curriculum ◽  
Management Strategies ◽  
Gastrointestinal Haemorrhage ◽  
Ulcer Bleeding ◽  
Shock Index ◽  
Small Bowel Endoscopy ◽  
Curriculum Topics ◽  
Upper Gastrointestinal

This chapter covers core curriculum topics relating to gastrointestinal haemorrhage. This includes risk assessment for upper gastrointestinal haemorrhage incorporating natural history and prediction of rebleed following peptic ulcer bleeding. Comprehensive coverage of assessment and management of variceal bleeding (gastric and oesophageal) is included including the role of stenting. Causes of presentations with lower gastrointestinal bleeding, including following radiotherapy, are presented along with guidance on assessing shock index, investigation and management strategies. The role of acute imaging versus endoscopic intervention is discussed. Furthermore, investigation and management of obscure and occult gastrointestinal bleeding is covered including small bowel endoscopy and specialist imaging. Additional curriculum material regarding gastrointestinal haemorrhage will also be covered in the mock examination chapter.

Inflammatory bowel disease and colonic disorders

2021 ◽  
pp. 150-208
Author(s):  
Thomas Marjot
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Core Curriculum ◽  
Therapeutic Drug ◽  
Biologic Therapies ◽  
Inflammatory Bowel ◽  
Prevention Of Cancer ◽  
Curriculum Topics

This chapter covers core curriculum topics relating to inflammatory bowel disease (IBD) and colonic disorders. A diagnostic approach to IBD is covered including the role of imaging, endoscopy, histopathology and clinical features. Pathophysiology and epidemiology of IBD is detailed. Management of Ulcerative colitis and Crohn’s disease includes assessment of disease severity, imaging modalities and therapeutic management. Particular focus is given to therapeutic drug monitoring and indications for biologic therapies. Surgical management of IBD is broadly covered including indications, timing and approach. Coverage is also given to the diagnosis and management of extra-intestinal manifestations of IBD, IBD in special situations (pregnancy, elderly, transition) and the prevention of cancer in IBD. Colorectal cancer and benign conditions including constipation, functional gut disorders and other colitides are also featured.

Pancreatic disorders

2021 ◽  
pp. 100-122
Author(s):  
Thomas Marjot
Keyword(s):  
Acute Pancreatitis ◽  
Core Curriculum ◽  
Cell Types ◽  
Exocrine Insufficiency ◽  
Pancreatic Exocrine ◽  
Pancreatic Disorders ◽  
Walled Off Necrosis ◽  
Different Cell Types ◽  
Curriculum Topics

This chapter covers core curriculum topics relating to pancreatic disorders. This includes the investigation and management of acute pancreatitis incorporating knowledge on aetiology, staging of acute pancreatitis, complications including pseudocyst and walled off necrosis, nutritional support, and role of imaging and endoscopy. The chapter also covers genetic pancreatic disorders, anatomical variants of the pancreas, and describes the different cell types of the pancreas. These is also an emphasis on the aetiology and complications of chronic pancreatitis including pancreatic exocrine insufficiency and chronic pain. Finally the chapter also covers the presentation, diagnosis and management of benign and malignant pancreatic tumours. Additional curriculum material regarding pancreatic disorders will also be covered in the mock examination chapter.

Benign oesophageal disease

2018 ◽  
Author(s):  
Satish Keshav ◽  
Alexandra Kent
Keyword(s):  
Chest Pain ◽  
Reflux Disease ◽  
Mucosal Injury ◽  
High Amplitude ◽  
Lower Oesophageal Sphincter ◽  
Oesophageal Motility ◽  
Eosinophilic Oesophagitis ◽  
Distal Oesophagus ◽  
Low Amplitude ◽  
Oesophageal Dysmotility

Benign oesophageal disease includes several conditions. Gastro-oesophageal reflux disease (GORD) is the reflux of gastric juices into the oesophagus with or without mucosal injury (oesophagitis). Achalasia is an oesophageal dysmotility disorder characterized by aperistalsis in the distal oesophagus, and failure of lower oesophageal sphincter relaxation. Motility disorders include oesophageal spasm, which is characterized by simultaneous, non-propagated contractions; nutcracker oesophagus, which is diagnosed by high-amplitude (≥180 mm Hg) contractions associated with chest pain; and ineffective oesophageal motility, which is characterized by low-amplitude contractions (≤30 mm Hg) in the distal oesophagus. Eosinophilic oesophagitis is diagnosed on a combination of clinical features and oesophageal biopsies confirming the presence of >15 eosinophils per high-powered film

scholarly journals The role of oesophageal physiological testing in the assessment of noncardiac chest pain

2018 ◽  
Vol 9 (12) ◽  
pp. 257-267 ◽  
Author(s):  
Henriette Heinrich ◽  
Rami Sweis
Keyword(s):  
Chest Pain ◽  
High Resolution ◽  
Noncardiac Chest Pain ◽  
Eosinophilic Oesophagitis ◽  
Common Cause ◽  
High Resolution Manometry ◽  
Oesophageal Dysmotility ◽  
Ambulatory Ph ◽  
Rule Out

Oesophageal physiology testing plays an important role in the diagnosis of noncardiac chest pain (NCCP) after cardiac, structural and mucosal abnormalities have been ruled out. Endoscopy can establish the presence of structural causes of chest pain such as cancer, oesophageal webs and diverticula. Even if macroscopically normal, eosinophilic oesophagitis is a common cause of chest pain and needs to be ruled out with an adequate biopsy regimen. In the remaining cases, diagnosis is focused on the identification of often subtle mechanisms that lead to NCCP. The most common oesophageal aetiologies for NCCP are gastro-oesophageal reflux disease (GORD), oesophageal dysmotility and functional chest pain. Ambulatory pH studies (with or without impedance or wireless measurements) can establish the presence of GORD, nonerosive reflux as well any association with symptoms of chest pain. High-resolution manometry, particularly with the inclusion of adjunctive testing, can rule out major motility disorders such as spasm, hypercontraction or achalasia. The EndoFLIP device can help define disorders with reduced distensibility, not easily appreciated with endoscopy or manometry. When all tests remain negative, a diagnosis of oesophageal hypersensitivity is normally made and therapy is shifted from targeting a disease to treating symptoms and patient affect.

The Role of Laparoscopic Anti-Reflux Surgery in Obese Patients with Gastroesophageal Reflux Disease

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Flores Edgar Vargas ◽  
Cortez Juan Carlos Quintana ◽  
Contreras Jose Luis Ledesma ◽  
Medina Yazmin Berrones ◽  
Zhou Lucero Chao
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Obese Patients

The Role of the Coagulase-negative Staphylococci (CoNS) in Infective Endocarditis; A Narrative Review from 2000 to 2020

2020 ◽  
Vol 21 (12) ◽  
pp. 1140-1153 ◽  
Author(s):  
Mohammad A. Noshak ◽  
Mohammad A. Rezaee ◽  
Alka Hasani ◽  
Mehdi Mirzaii
Keyword(s):  
Foreign Body ◽  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Human Life ◽  
Prosthetic Valve Endocarditis ◽  
Surgical Site Infections ◽  
Coagulase Negative Staphylococci ◽  
Native Valve ◽  
Native Valve Endocarditis

Coagulase-negative staphylococci (CoNS) are part of the microbiota of human skin and rarely linked with soft tissue infections. In recent years, CoNS species considered as one of the major nosocomial pathogens and can cause several infections such as catheter-acquired sepsis, skin infection, urinary tract infection, endophthalmitis, central nervous system shunt infection, surgical site infections, and foreign body infection. These microorganisms have a significant impact on human life and health and, as typical opportunists, cause peritonitis in individuals undergoing peritoneal dialysis. Moreover, it is revealed that these potential pathogens are mainly related to the use of indwelling or implanted in a foreign body and cause infective endocarditis (both native valve endocarditis and prosthetic valve endocarditis) in patients. In general, approximately eight percent of all cases of native valve endocarditis is associated with CoNS species, and these organisms cause death in 25% of all native valve endocarditis cases. Moreover, it is revealed that methicillin-resistant CoNS species cause 60 % of all prosthetic valve endocarditis cases. In this review, we describe the role of the CoNS species in infective endocarditis, and we explicated the reported cases of CoNS infective endocarditis in the literature from 2000 to 2020 to determine the role of CoNS in the process of infective endocarditis.

scholarly journals The Quality of Life Definition: Where Are We Going?

Uro ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 14-22
Author(s):  
Tommaso Cai ◽  
Paolo Verze ◽  
Truls E. Bjerklund Johansen
Keyword(s):  
Quality Of Life ◽  
Extra Dimension ◽  
Sexual Partner ◽  
Therapeutic Approach ◽  
Well Being ◽  
Narrative Review ◽  
Laboratory Findings

The quality of life (QoL) concept now includes new aspects related to patients’ well-being because QoL has become more of a personal perception than an an objective and measurable entity. Here, we discuss the principal aspects of QoL-related aspects in urology and andrology by using a narrative review. Some aspects concerning the QoL are essential when managing uro-andrological patients. The aim of treatments should not only include the absence of disease or symptoms relief but also the improvement of a patient’s QoL with regard to his/her internal status and relationship with others. In this sense, any therapeutic approach should be based on the patient’s perspectives and not only on the instrumental and laboratory findings. Finally, we discussed the role of a patient’s sexual partner adding an extra dimension to the patient-centerd approach as part of the QoL concept in andrology.

Su1887 The Role of Esophageal Manometry and 24 Hour pH With Impedance Studies in the Evaluation of Patients With Non-Cardiac Chest Pain

2013 ◽  
Vol 144 (5) ◽  
pp. S-501
Author(s):  
Rashad C. Wilkerson ◽  
Fouad J. Moawad ◽  
Corinne L. Maydonovitch ◽  
Lavern Belle ◽  
Yen-Ju Chen
Keyword(s):  
Chest Pain ◽  
Esophageal Manometry
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