By Robert Logan, Adam Harris, J. J. Misiewicz, J. H. Baron
(BMJ Books) Univ. sanatorium, Nottingham, united kingdom. presents a concise advisor to issues of the higher gastrointestinal tract. hugely illustrated with charts, diagrams, and colour pictures. displays newest advances in figuring out the pathophysiology and pathogenesis of this illness. For scientific scholars, nurses, and clinicians. Softcover.
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Additional resources for ABC of the Upper Gastrointestinal
The best test to confirm eradication is the 13C-urea breath test. The recently described stool antigen test may be an alternative in future. “Near patient tests” or laboratory based blood serology tests are not suitable because antibody titres take at least six months to decrease. Treatment of H pylori is difficult because of the rapid development of resistance to antibacterial drugs, especially to nitroimidazoles, which occurs more commonly in women and patients from developing countries because of previous treatment for gynaecological infections or infective diarrhoeas.
2 Causes of gastric ulcer x x x x x x H pylori infection Non-steroidal anti-inflammatory drugs Neoplasia (carcinoma, lymphoma, leiomyosarcoma) Stress Crohn’s disease Infections (herpes simplex, cytomegalovirus) Gastro-oesophageal reflux disease The interaction between H pylori, gastro-oesophageal reflux disease (GORD), and treatment with antisecretory drugs is extremely complex and highly contentious. Epidemiological studies have shown that the prevalence of H pylori infection is no higher in patients with GORD than in healthy controls matched for age and sex.
3 Blood tests on admission to hospital Haemoglobin concentration—May be normal during the acute stages until haemodilution occurs Urea and electrolyte concentrations—Elevated blood urea suggests severe bleeding Cross match for transfusion—Two units of blood are sufficient unless bleeding is extreme. If transfusion not needed urgently group the blood and save the serum Liver function tests Prothrombin time Acute upper gastrointestinal haemorrhage Resuscitation Endoscopy Varices Sclerotherapy or banding plus intravenous terlipressin Bleeding controlled Bleeding continues or recurs TIPSS or surgical referral 1.