Gastroenterology

Sodium Phosphate, a More Acceptable Bowel Cleanser

Sodium Phosphate, a More Acceptable Bowel Cleanser – MM1608

Colorectal cancer is one of the most common malignancies worldwide. In 2012 the crude incidence of colorectalcancer in Sub-Saharan Africa for both sexes was found to be 4.04 per 100 000 population (4.38 for men and 3.69 for women).

Currently, colonoscopy has been identified as a highly recommended method for cancer surveillance and diagnosis of the large intestine, owing to its cost-effectiveness and exclusive function that allows direct observation and biopsy synchronously. As is well recognized, an adequate bowel cleansing is essential for colon mucosa assessment during the examination procedure, while an incomplete preparation prolongs the procedure time and increases the likelihood of missing lesions with cancerous potential. Accordingly, bowel preparation evaluation is proposed as a crucial quality indicator of colonoscopy.

Modern Medicine – August 2016

August 29, 2016 by Colonoscopy Gastroenterology

Barrett’s Oesophagus Does it Matter?

Barrett’s Oesophagus Does it Matter? – MM1607

Barrett’s oesophagus is a premalignant condition characterised by the replacement of normal stratified squamous epithelium of the oesophagus with metaplastic columnar epithelium. It can predispose patients to oesophageal adenocarcinoma, in whom the frequency has increased sevenfold in the past four decades. Most patients with heartburn do not have Barrett’s oesophagus.
Although Barrett’s oesophagus is a premalignant condition, the risk of progression to malignancy is low and surveillance intervals should be guided by the presence and degree of dysplasia. There is currently insufficient evidence to support routine medical or surgical intervention for regression or prevention of progression of disease.

Modern Medicine – July 2016

July 22, 2016 by Gastroenterology

Ulcerative Colitis | Unravelling the uncertainty in diagnosis and management

Ulcerative Colitis | Unravelling the uncertainty in diagnosis and management – MM1603

Ulcerative colitis (UC) is a chronic inflammatory disorder of the colon characterised by a relapsing–remitting pattern in most patients. UC affects men and women equally, and the age at onset is between the ages of 15 and 30 years in most patients, with a smaller second peak in patients over 50 years. Although the cause of UC remains unknown, the pathogenesis is likely to be multifactorial with interplay between genetic, microbial and other environmental factors.

Prompt diagnosis of UC and timely management of flares are crucial to good patient outcomes. GPs play an important role in identifying new cases, the ongoing management of mild to moderately active UC and also in identifying and referring acutely unwell patients for specialty care.

Modern Medicine – March 2016

March 18, 2016 by Gastroenterology Ulcerative Colitis

Pantoprazole Reduces GI Damage in Critical Patients

Pantoprazole Reduces GI Damage in Critical Patients – MM1507

Pantoprazole is an irreversible proton pump inhibitor (PPI) that reduces gastric acid secretion. PPIs achieve a greater degree and longer duration of gastric acid suppression and better healing rates in various gastric acid-related disorders than histamine H2 receptor antagonists, making them essential in the management of gastrooesophageal reflux disease, peptic ulcer disease and Zollinger–Ellison syndrome.

Modern Medicine – July 2015

July 30, 2015 by Critical Care Gastroenterology

Effective Bowel Cleansing Improves Examination Results

Effective Bowel Cleansing Improves Examination Results – MM1504

Colonoscopy constitutes the principal investigation for colorectal neoplasms due to its ability to detect and remove most of precancerous lesions. Diagnostic accuracy and therapeutic safety of colonoscopy strictly depends upon the quality of bowel cleansing. The ideal preparation for colonoscopy should reliably empty the colon from all faecal material allowing the optimal visualisation of the entire colonic mucosa without causing great patient discomfort or significant shifts in fluids and electrolytes.

Modern Medicine – April 2015

April 28, 2015 by Colonoscopy Gastroenterology

Pointers for Increasing Colonoscopy Efficacy

Pointers for Increasing Colonoscopy Efficacy – MM1504

In the past decade, the colonoscopy procedure has been largely studied to improve colorectal lesions detection resulting in the identification of quality indicators for colonoscopy procedure. Successful colonoscopy depends upon a number of factors including correct cecum intubation, cleaning of the colon, careful mucosal inspection and operator experience. With the rapidly rising costs of healthcare and the need to rationalise spending, it is important to spare costly repeat procedures, as in the cases of incomplete colonoscopy. Bowel preparation is essential for both the quality of the colonoscopy and the adenoma or adenocarcinoma detection rate.)

Modern Medicine – April 2015

April 28, 2015 by Colonoscopy Gastroenterology

Novel Treatment for Ulcerative Colitis Improves Compliance

Novel Treatment for Ulcerative Colitis Improves Compliance – MM1503

Ulcerative Colitis is a form of inflammatory bowel disease producing inflammation and ulcers along the inside of the colon, which can interfere with the normal function of the colon, often causing cramping, bloating, diarrhoea, bleeding, fatigue, weight loss and frequent bowel movements, which may also strongly affect quality of life. The 2011 reported incidence of ulcerative colitis was 1.2 to 20.3 cases per 100 000 persons per year with a prevalence of 7.6 to 246 cases per 100 000 per year.

Modern Medicine – March 2015

March 31, 2015 by Gastroenterology Ulcerative Colitis

Human Intestinal Microbiome Changes Over Time

Human Intestinal Microbiome Changes Over Time – MM1501

Recent developments in next generation sequencing (NGS) methods have facilitated the performance of metagenomic studies to determine gut microbiome composition. These methods, together with the use of gnotobiotic animals have demonstrated the importance of the microbiota for host health, providing the basis for the use of dietary interventions aimed at counteracting microbiota aberrancies.

Modern Medicine – January 2015

January 27, 2015 by Gastroenterology Probiotics

Small Bowel Video Capsule Endoscopy

Small Bowel Video Capsule Endoscopy – MM1410

Video capsule endoscopy (VCE) is an important and useful tool in assessing the small intestine. Its main indication is in patients with recurrent and/or persistent bleeding in the small bowel for which no source has been found on gastroscopy and colonoscopy. VCE is the most sensitive and specific non-invasive test available for detecting mucosal changes in the small bowel.

Modern Medicine – October 2014

October 28, 2014 by Endoscopy Gastroenterology
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