Git GIB Variceal lower 2011 .
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The document discusses the management of variceal bleeding and lower gastrointestinal bleeding. It provides details on the causes, risk factors, evaluation, and treatment approaches for acute variceal bleeding and lower GI bleeding. The management involves initial evaluation and resuscitation followed by endoscopic or radiological interventions depending on the severity of bleeding and findings on endoscopy or colonoscopy. Secondary prophylaxis with medications or procedures is also discussed to prevent rebleeding in variceal hemorrhage and lower GI bleeding.
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Gi bleed
Upper GI bleed occurs proximal to the ligament of Treitz, while lower GI bleed occurs distal to it. Acute upper GI bleeding causes hematemesis or melena, while lower GI bleeding presents as hematochezia. Common causes of upper GI bleed include peptic ulcer disease, varices, and erosive gastritis. Management in the ER focuses on ABCs, IV fluids and blood products. Further workup includes UGI endoscopy to identify the source and determine risk of rebleeding. Surgery is considered if bleeding cannot be controlled otherwise. Common causes of lower GI bleed are diverticulosis and vascular ectasias in older patients, and infectious colitis in younger patients.
Gib for 4th 2011.
This document discusses gastrointestinal bleeding (GIB). It defines upper and lower GIB and variceal and non-variceal causes. Common causes of upper GIB include peptic ulcer disease, esophagitis, gastritis, and Mallory-Weiss tears. Evaluation involves history, physical exam, and labs. Treatment focuses on hemodynamic stabilization, endoscopic localization of bleeding, and prevention of rebleeding. Endoscopic therapies include injection, thermal coagulation, and clips. Surgery or interventional radiology may be needed if endoscopy fails. Management of high risk patients includes ICU monitoring after endoscopic intervention. Common causes of lower GIB include diverticulosis, angiectasia, and ischemic colitis
Git Gib 2010 plus Pictures.
This document provides an overview of gastrointestinal bleeding (GIB), focusing on upper gastrointestinal bleeding (UGIB) and lower gastrointestinal bleeding (LGIB). It discusses evaluation, management, and treatment of acute GIB. For UGIB, initial management includes hemodynamic stabilization, finding the source of bleeding, and controlling the source. Most recurrent UGIB occurs within 3-4 days. For LGIB, common causes and initial evaluation are outlined. Colonoscopy is usually the initial test, and hemodynamic stabilization is the primary management focus for both UGIB and LGIB.
Imaging and intervention in hemetemesis
This document discusses various imaging modalities for evaluating gastrointestinal bleeding, including hematemesis. It provides details on angiography, computed tomography angiography, and endoscopy. The key points are:
- Endoscopy is the primary initial investigation but additional techniques like CT angiography and catheter angiography may be needed when endoscopy is negative or fails to identify the bleeding source.
- CT angiography has advantages over catheter angiography as it is more widely available, non-invasive, and allows detection of bleeding sources throughout the GI tract.
- Both endoscopy and CT angiography play important roles in evaluating GI bleeding, with endoscopy also allowing for therapeutic interventions when a source is identified.
Git bleeding 2
This document discusses gastrointestinal (GI) bleeding. It begins by stating that GI bleeding is a common gastrointestinal emergency, with 50% being upper GI bleeding and 40% being lower GI bleeding. Upper GI bleeding is more common and a major cause of morbidity and mortality. The document then discusses the classification, causes, risk factors, clinical presentation, diagnosis, management including endoscopy, and prevention of both upper and lower GI bleeding. It also covers obscure GI bleeding, differentiation of upper vs. lower GI bleeding, and references.
upper gi bleeding
This document discusses gastrointestinal tract bleeding. It defines upper and lower GI bleeding and provides epidemiological data. Common causes of upper GI bleeding include peptic ulcers, varices, Mallory-Weiss tears, and angiodysplasia. Lower GI bleeding is commonly caused by diverticular disease, angiodysplasia, and ischemic colitis. Management involves resuscitation, endoscopy for diagnosis and treatment, and angiography for severe or obscure bleeding. The mortality of GI bleeding remains significant.
Upper GI bleeding
Upper Gastrointestinal Bleeding
The document discusses upper gastrointestinal bleeding (UGIB), which refers to bleeding proximal to the ligament of Treitz. UGIB can manifest as hematemesis, melena, or blood in a nasogastric tube. The most common causes of UGIB are peptic ulcer disease, gastritis/erosions, esophagitis, and varices. Evaluation involves history, physical exam, laboratory tests, imaging like endoscopy. Endoscopy allows for diagnosis and treatment with interventions like injection, cauterization, or clips. Resuscitation, pharmacologic agents, and endoscopy are used to manage acute bleeding, while treatments like beta-blockers can prevent var
ACUTE GASTROINTESTINAL HAEMORRHAGE - NON VARICEAL BLEEDING
Peptic ulcer disease is the most common cause of non-variceal upper GI bleeding, accounting for 30-50% of cases. Initial management involves resuscitation followed by endoscopy within 24 hours to locate the source of bleeding and apply appropriate treatment such as thermal therapy or hemoclip application. Surgery is reserved for cases with continued or recurrent bleeding despite endoscopic treatment. Proper risk stratification and management can reduce mortality rates from GI bleeding.
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Gi bleed
Upper GI bleed occurs proximal to the ligament of Treitz, while lower GI bleed occurs distal to it. Acute upper GI bleeding causes hematemesis or melena, while lower GI bleeding presents as hematochezia. Common causes of upper GI bleed include peptic ulcer disease, varices, and erosive gastritis. Management in the ER focuses on ABCs, IV fluids and blood products. Further workup includes UGI endoscopy to identify the source and determine risk of rebleeding. Surgery is considered if bleeding cannot be controlled otherwise. Common causes of lower GI bleed are diverticulosis and vascular ectasias in older patients, and infectious colitis in younger patients.
Gib for 4th 2011.
This document discusses gastrointestinal bleeding (GIB). It defines upper and lower GIB and variceal and non-variceal causes. Common causes of upper GIB include peptic ulcer disease, esophagitis, gastritis, and Mallory-Weiss tears. Evaluation involves history, physical exam, and labs. Treatment focuses on hemodynamic stabilization, endoscopic localization of bleeding, and prevention of rebleeding. Endoscopic therapies include injection, thermal coagulation, and clips. Surgery or interventional radiology may be needed if endoscopy fails. Management of high risk patients includes ICU monitoring after endoscopic intervention. Common causes of lower GIB include diverticulosis, angiectasia, and ischemic colitis
Git Gib 2010 plus Pictures.
This document provides an overview of gastrointestinal bleeding (GIB), focusing on upper gastrointestinal bleeding (UGIB) and lower gastrointestinal bleeding (LGIB). It discusses evaluation, management, and treatment of acute GIB. For UGIB, initial management includes hemodynamic stabilization, finding the source of bleeding, and controlling the source. Most recurrent UGIB occurs within 3-4 days. For LGIB, common causes and initial evaluation are outlined. Colonoscopy is usually the initial test, and hemodynamic stabilization is the primary management focus for both UGIB and LGIB.
Imaging and intervention in hemetemesis
This document discusses various imaging modalities for evaluating gastrointestinal bleeding, including hematemesis. It provides details on angiography, computed tomography angiography, and endoscopy. The key points are:
- Endoscopy is the primary initial investigation but additional techniques like CT angiography and catheter angiography may be needed when endoscopy is negative or fails to identify the bleeding source.
- CT angiography has advantages over catheter angiography as it is more widely available, non-invasive, and allows detection of bleeding sources throughout the GI tract.
- Both endoscopy and CT angiography play important roles in evaluating GI bleeding, with endoscopy also allowing for therapeutic interventions when a source is identified.
Git bleeding 2
This document discusses gastrointestinal (GI) bleeding. It begins by stating that GI bleeding is a common gastrointestinal emergency, with 50% being upper GI bleeding and 40% being lower GI bleeding. Upper GI bleeding is more common and a major cause of morbidity and mortality. The document then discusses the classification, causes, risk factors, clinical presentation, diagnosis, management including endoscopy, and prevention of both upper and lower GI bleeding. It also covers obscure GI bleeding, differentiation of upper vs. lower GI bleeding, and references.
upper gi bleeding
This document discusses gastrointestinal tract bleeding. It defines upper and lower GI bleeding and provides epidemiological data. Common causes of upper GI bleeding include peptic ulcers, varices, Mallory-Weiss tears, and angiodysplasia. Lower GI bleeding is commonly caused by diverticular disease, angiodysplasia, and ischemic colitis. Management involves resuscitation, endoscopy for diagnosis and treatment, and angiography for severe or obscure bleeding. The mortality of GI bleeding remains significant.
Upper GI bleeding
Upper Gastrointestinal Bleeding
The document discusses upper gastrointestinal bleeding (UGIB), which refers to bleeding proximal to the ligament of Treitz. UGIB can manifest as hematemesis, melena, or blood in a nasogastric tube. The most common causes of UGIB are peptic ulcer disease, gastritis/erosions, esophagitis, and varices. Evaluation involves history, physical exam, laboratory tests, imaging like endoscopy. Endoscopy allows for diagnosis and treatment with interventions like injection, cauterization, or clips. Resuscitation, pharmacologic agents, and endoscopy are used to manage acute bleeding, while treatments like beta-blockers can prevent var
ACUTE GASTROINTESTINAL HAEMORRHAGE - NON VARICEAL BLEEDING
Peptic ulcer disease is the most common cause of non-variceal upper GI bleeding, accounting for 30-50% of cases. Initial management involves resuscitation followed by endoscopy within 24 hours to locate the source of bleeding and apply appropriate treatment such as thermal therapy or hemoclip application. Surgery is reserved for cases with continued or recurrent bleeding despite endoscopic treatment. Proper risk stratification and management can reduce mortality rates from GI bleeding.
Variceal Bleeding
This document discusses the management of variceal bleeding, specifically focusing on esophageal and gastric varices. It provides an overview of endoscopic and medical therapies for controlling acute esophageal variceal bleeding such as endoscopic band ligation, sclerotherapy, and pharmacologic therapies like octreotide. For gastric varices, it describes different classification systems and challenges in managing bleeding, noting endoscopic therapies like sclerotherapy, ligation, and glue injection can control acute bleeding but have high rebleeding risks. It emphasizes a multidisciplinary approach is often needed for gastric variceal management.
Upper gi bleeding
This document discusses the causes and management of upper gastrointestinal bleeding. It begins by listing common causes such as portal hypertension, peptic ulcer disease, angiomatous malformations, and neoplasms. For portal hypertension, it focuses on variceal bleeding and techniques for controlling acute variceal hemorrhage such as band ligation, sclerotherapy, and cyanoacrylate injection. For peptic ulcer disease, it covers risk assessment using the Forrest classification and Rockall score, medical and endoscopic treatment options, and the role of H. pylori eradication. It also briefly discusses less common causes of upper GI bleeding like Dieulafoy lesions and telangectasia.
Approach to patients with upper gi bleeding
This document provides an overview of a seminar on gastrointestinal bleeding. It begins with an introduction and outline. It then covers topics like the anatomy of the GI tract and sources of bleeding. Diagnostic assessments including history, exams, and tests are reviewed. Approaches to resuscitation, classification of shock, and fluid management are outlined. Etiologies of upper and lower GI bleeding like ulcers, varices, and tumors are summarized. Endoscopic and surgical management strategies are also discussed. Risk factors for poor prognosis with GI bleeding are listed. The document concludes with a risk score to predict need for intervention in GI bleeding cases.
Approach to gastrointestinal bleeding
This document discusses the approach to gastrointestinal bleeding. It begins by describing the clinical presentations of GI bleeding and how to assess the severity. Resuscitation is proportional to bleeding severity. The history, physical exam, and diagnostic tests are discussed. Common and less frequent causes of upper GI bleeding are outlined. Treatment depends on the cause, with endoscopic therapy and pharmacologic agents used for bleeding peptic ulcers and varices.
Lower GI bleed
This document provides an overview of lower gastrointestinal bleeding, including definitions, epidemiology, causes, diagnosis, and management. Some key points:
- Lower GI bleed most commonly originates from the colon, with diverticular disease and angiodysplasias being the most frequent underlying causes.
- Diagnosis involves digital rectal exam, endoscopic procedures like sigmoidoscopy and colonoscopy, and imaging tests like radionuclide scanning.
- Specific colonic conditions that may cause bleeding include diverticular disease, angiodysplasias, colitis, infections, radiation proctitis, and anorectal diseases.
- Small bowel sources of bleeding include angiodysplasias,
Lower git bleeding
This document discusses lower gastrointestinal bleeding (LGIB), which occurs in the small and large intestines, presenting as hematochezia or melaena. Common causes of LGIB include diverticular disease, inflammatory bowel diseases like Crohn's disease and ulcerative colitis, ischemic colitis, vascular malformations, polyps, tumors, and anal issues. LGIB is typically chronic and self-limiting, though some cases are acute and require blood transfusion. The diagnostic workup depends on the patient's age and symptoms, and may involve endoscopy, imaging, or angiography to identify the source of bleeding.
Approach to Gastrointestinal bleeding
This document provides an overview of approaches to gastrointestinal bleeding. It discusses the common clinical presentations including hematemesis, melena, hematochezia, and occult bleeding. For hematemesis, the most common causes are discussed such as stress ulcers, Mallory-Weiss tears, peptic ulcer disease, gastroesophageal varices, and Dieulafoy's lesion. For hematochezia, common causes include colonic diverticula, internal hemorrhoids, colon cancer, and inflammatory bowel disease. The document provides details on evaluating each potential cause and characteristics to consider in the clinical history and examination.
Upper gi bleeding
This document discusses the management of gastrointestinal bleeding. It begins with an overview of the upper and lower GI tract as sources of bleeding. It then covers initial patient assessment, history taking, differential diagnosis, investigations and conservative versus therapeutic management approaches. Specific topics discussed in more detail include fluid resuscitation, endoscopic diagnostic and therapeutic options, predictors of rebleeding and need for surgery, as well as approaches to managing various underlying causes of GI bleeding.
Upper gi bleeding
This document provides an overview of the approach to upper GI bleeding. It begins with definitions of terms like hematemesis, melena, and hematochezia. It then discusses the causes of upper GI bleeding, which can be variceal or non-variceal. For patients presenting with upper GI bleeding, the summary provides that history, physical exam, and investigations like endoscopy are important to determine the cause and guide management. Management may involve treating any active bleeding, administering PPIs for non-variceal bleeding, or using vasoactive agents, balloon tamponade, or endoscopic therapies for variceal bleeding.
Upper Gastro-Intestinal Hemorrhage
This document provides an overview of upper gastrointestinal hemorrhage. It discusses the initial assessment and resuscitation of patients, including fluid resuscitation and blood transfusions. The identification of the source of bleeding is important, and endoscopy is the gold standard investigation. The main causes of upper GI bleeding are discussed, including peptic ulcer disease, variceal bleeding, and Mallory-Weiss tears. Treatment options are outlined for each cause, including pharmacologic, endoscopic, interventional, and surgical approaches.
Upper GI bleed Approach and Management
A 45-year-old male presented with hematemesis after vomiting blood the previous night. When confronted with a patient with hematemesis, the doctor should determine if it is truly hematemesis, assess the stability and estimated blood loss of the patient, consider possible lesions and their locations and blood supplies. A thorough history and examination is needed to correctly diagnose the source of bleeding. Initial management includes resuscitation with fluids and blood products as needed, passing a nasogastric tube, and arranging for urgent endoscopy within 18 hours. Long-term management depends on the findings and may include treatments like antibiotics, pharmacotherapy, endoscopic therapy, TIPS, or surgery.
Lower GastroIntestinal Bleeding
This document discusses lower gastrointestinal (GI) bleeding, including its causes, presentation, evaluation, and management. Some key points:
- The most common causes of major LGI bleed are diverticulosis, colonic neoplasms, and angiodysplasias. Colonoscopy is the investigation of choice.
- Occult LGI bleeding is first evaluated with fecal occult blood testing (FOBT). CT angiography can help localize bleeding if it persists or patients are unstable.
- Evaluation involves history, physical exam including rectal exam, blood tests, stool tests, endoscopy, imaging studies like colonoscopy, angiography or nuclear scans depending on findings.
- Treatment depends on
Management of upper gi bleed
This document summarizes the management of upper gastrointestinal bleed. It begins with two clinical scenarios of patients presenting with GI bleed and then covers the epidemiology, causes, signs and symptoms, risk scores for prognosis, and approaches to treatment. It emphasizes the importance of early endoscopy and acid suppression treatment. Medications discussed include PPIs, somatostatin analogs like octreotide, terlipressin, antibiotics and tranexamic acid which is being studied in the HALT-IT trial to reduce mortality from GI bleed. Discharge instructions include avoiding NSAIDs and treating H. pylori infection.
upper gastrointestinal bleeding
This document discusses the approach to patients with upper gastrointestinal bleeding and its management. It covers the following key points in 3 sentences:
The document outlines sources of GI bleeding, signs of blood loss severity, immediate assessment steps, diagnostic testing, endoscopic treatment options for variceal and non-variceal bleeding, risk stratification tools like the Rockall score, and angioembolization as a treatment option. Management involves fluid resuscitation, identifying the bleeding source, stopping active bleeding endoscopically, treating underlying causes, preventing rebleeding, and considering a second look endoscopy or other interventions based on risk stratification. Outpatient management may be appropriate for low risk patients while higher risk patients require intensive
Managementof lowergib 2018
- Management of lower GI bleeding (LGIB) requires identifying high-risk patients, optimizing medical management, and performing endoscopy within 24 hours for diagnosis and treatment.
- For ongoing or recurrent LGIB after endoscopy, angiography may be considered to locate the bleeding site.
- Coordinated care between emergency department, ICU, GI specialists, and interventional radiology is important to optimize outcomes for patients with LGIB.
Risk stratification ugi
This document discusses risk stratification and management of upper GI bleeding. It covers epidemiology, clinical presentations, risk scoring systems used to stratify patients pre-endoscopy like the Blatchford score, Rockall score, and AIMS65 score. It describes the approach to patients including history, physical exam, resuscitation, indications for endoscopy, and endoscopic hemostasis techniques. The goal is to assess bleeding severity, identify sources, determine risk factors, and guide appropriate management.
Esophageal varices and its management
This document discusses oesophageal varices, which are dilated and tortuous veins in the oesophageal wall that occur secondary to portal hypertension. It defines oesophageal varices and portal hypertension, and discusses the epidemiology, etiology, risk factors, clinical manifestations, diagnostic evaluations, medical and surgical management, nursing management, and complications of oesophageal varices. It also summarizes two research articles on using wireless capsule endoscopy to diagnose and grade varices, and using blood ammonia levels to predict the presence of varices and bleeding risk. The document concludes by emphasizing the importance for nurses to understand oesophageal varices to provide appropriate care and counseling to patients.
Upper gi bleed
Upper GI bleeding refers to bleeding from the GI tract proximal to the ligament of Trietz. Non-variceal bleeding accounts for 80% of cases, with peptic ulcer disease being the most common cause at 30-40%. Portal hypertensive bleeding from gastroesophageal varices accounts for the remaining 20% of cases. Early endoscopy within 24 hours of bleeding results in reduced transfusions, decreased need for surgery, and shorter hospital stays. Endoscopic therapies like epinephrine injection and thermal coagulation are effective first-line treatments for actively bleeding ulcers. Surgery is indicated if bleeding cannot be controlled or for recurrent bleeding. Variceal bleeding requires resuscitation, vasoactive drugs, and endoscopic
GI Bleeds
The document discusses gastrointestinal (GI) bleeds, including trends showing decreases in upper GI bleeds and increases in lower GI bleeds from 1998-2006. It covers the causes, classifications, presentations, and management of upper and lower GI bleeds, noting the most common causes are ulcers, varices, and diverticulosis. Risk scoring systems and initial management involves fluid resuscitation, transfusions based on stability rather than hemoglobin level, medications, and procedures to locate the source of bleeding.
Lower gi bleed
This document provides an overview of lower gastrointestinal bleeding (LGIB), including its definition, etiology, clinical features, diagnostic and therapeutic approaches. It discusses how LGIB accounts for 20% of gastrointestinal bleeding cases and can be safely managed in an outpatient setting once initial resuscitation and risk evaluation is complete. Colonoscopy is highlighted as the first-line investigation, while angiography and surgery are reserved for more severe or refractory cases. The overall mortality rate of LGIB is reported to be less than 5%.
Git pathology m scyear2011 12
This document provides information on diseases of the gastrointestinal tract, beginning with diseases of the oral cavity. It discusses common inflammatory disorders like herpes labialis and aphthous stomatitis. It also covers benign and malignant tumors that can occur in the oral cavity, such as papilloma, fibroma, hemangioma, leukoplakia, and erythroplakia. It then discusses diseases that can affect other parts of the GI tract, including the esophagus, stomach, small intestine, large intestine, and salivary glands. For each organ, it outlines common congenital anomalies, inflammatory conditions, tumors, and other pathological entities. It also provides histological images and details on epidemi
Pathology of git€2
This document discusses pathology of the gastrointestinal tract. It mentions pleomorphic adenoma and lists the most common malignant stomach tumors as adeno carcinoma, leiomyosarcoma, carcinoid tumor, and lymphoma. It also lists premalignant lesions of the stomach, including chronic atrophic gastritis, gastric ulcer, adenomatous polyps, and hyperplastic polyps that can occur after partial gastrectomy.
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Variceal Bleeding
This document discusses the management of variceal bleeding, specifically focusing on esophageal and gastric varices. It provides an overview of endoscopic and medical therapies for controlling acute esophageal variceal bleeding such as endoscopic band ligation, sclerotherapy, and pharmacologic therapies like octreotide. For gastric varices, it describes different classification systems and challenges in managing bleeding, noting endoscopic therapies like sclerotherapy, ligation, and glue injection can control acute bleeding but have high rebleeding risks. It emphasizes a multidisciplinary approach is often needed for gastric variceal management.
Upper gi bleeding
This document discusses the causes and management of upper gastrointestinal bleeding. It begins by listing common causes such as portal hypertension, peptic ulcer disease, angiomatous malformations, and neoplasms. For portal hypertension, it focuses on variceal bleeding and techniques for controlling acute variceal hemorrhage such as band ligation, sclerotherapy, and cyanoacrylate injection. For peptic ulcer disease, it covers risk assessment using the Forrest classification and Rockall score, medical and endoscopic treatment options, and the role of H. pylori eradication. It also briefly discusses less common causes of upper GI bleeding like Dieulafoy lesions and telangectasia.
Approach to patients with upper gi bleeding
This document provides an overview of a seminar on gastrointestinal bleeding. It begins with an introduction and outline. It then covers topics like the anatomy of the GI tract and sources of bleeding. Diagnostic assessments including history, exams, and tests are reviewed. Approaches to resuscitation, classification of shock, and fluid management are outlined. Etiologies of upper and lower GI bleeding like ulcers, varices, and tumors are summarized. Endoscopic and surgical management strategies are also discussed. Risk factors for poor prognosis with GI bleeding are listed. The document concludes with a risk score to predict need for intervention in GI bleeding cases.
Approach to gastrointestinal bleeding
This document discusses the approach to gastrointestinal bleeding. It begins by describing the clinical presentations of GI bleeding and how to assess the severity. Resuscitation is proportional to bleeding severity. The history, physical exam, and diagnostic tests are discussed. Common and less frequent causes of upper GI bleeding are outlined. Treatment depends on the cause, with endoscopic therapy and pharmacologic agents used for bleeding peptic ulcers and varices.
Lower GI bleed
This document provides an overview of lower gastrointestinal bleeding, including definitions, epidemiology, causes, diagnosis, and management. Some key points:
- Lower GI bleed most commonly originates from the colon, with diverticular disease and angiodysplasias being the most frequent underlying causes.
- Diagnosis involves digital rectal exam, endoscopic procedures like sigmoidoscopy and colonoscopy, and imaging tests like radionuclide scanning.
- Specific colonic conditions that may cause bleeding include diverticular disease, angiodysplasias, colitis, infections, radiation proctitis, and anorectal diseases.
- Small bowel sources of bleeding include angiodysplasias,
Lower git bleeding
This document discusses lower gastrointestinal bleeding (LGIB), which occurs in the small and large intestines, presenting as hematochezia or melaena. Common causes of LGIB include diverticular disease, inflammatory bowel diseases like Crohn's disease and ulcerative colitis, ischemic colitis, vascular malformations, polyps, tumors, and anal issues. LGIB is typically chronic and self-limiting, though some cases are acute and require blood transfusion. The diagnostic workup depends on the patient's age and symptoms, and may involve endoscopy, imaging, or angiography to identify the source of bleeding.
Approach to Gastrointestinal bleeding
This document provides an overview of approaches to gastrointestinal bleeding. It discusses the common clinical presentations including hematemesis, melena, hematochezia, and occult bleeding. For hematemesis, the most common causes are discussed such as stress ulcers, Mallory-Weiss tears, peptic ulcer disease, gastroesophageal varices, and Dieulafoy's lesion. For hematochezia, common causes include colonic diverticula, internal hemorrhoids, colon cancer, and inflammatory bowel disease. The document provides details on evaluating each potential cause and characteristics to consider in the clinical history and examination.
Upper gi bleeding
This document discusses the management of gastrointestinal bleeding. It begins with an overview of the upper and lower GI tract as sources of bleeding. It then covers initial patient assessment, history taking, differential diagnosis, investigations and conservative versus therapeutic management approaches. Specific topics discussed in more detail include fluid resuscitation, endoscopic diagnostic and therapeutic options, predictors of rebleeding and need for surgery, as well as approaches to managing various underlying causes of GI bleeding.
Upper gi bleeding
This document provides an overview of the approach to upper GI bleeding. It begins with definitions of terms like hematemesis, melena, and hematochezia. It then discusses the causes of upper GI bleeding, which can be variceal or non-variceal. For patients presenting with upper GI bleeding, the summary provides that history, physical exam, and investigations like endoscopy are important to determine the cause and guide management. Management may involve treating any active bleeding, administering PPIs for non-variceal bleeding, or using vasoactive agents, balloon tamponade, or endoscopic therapies for variceal bleeding.
Upper Gastro-Intestinal Hemorrhage
This document provides an overview of upper gastrointestinal hemorrhage. It discusses the initial assessment and resuscitation of patients, including fluid resuscitation and blood transfusions. The identification of the source of bleeding is important, and endoscopy is the gold standard investigation. The main causes of upper GI bleeding are discussed, including peptic ulcer disease, variceal bleeding, and Mallory-Weiss tears. Treatment options are outlined for each cause, including pharmacologic, endoscopic, interventional, and surgical approaches.
Upper GI bleed Approach and Management
A 45-year-old male presented with hematemesis after vomiting blood the previous night. When confronted with a patient with hematemesis, the doctor should determine if it is truly hematemesis, assess the stability and estimated blood loss of the patient, consider possible lesions and their locations and blood supplies. A thorough history and examination is needed to correctly diagnose the source of bleeding. Initial management includes resuscitation with fluids and blood products as needed, passing a nasogastric tube, and arranging for urgent endoscopy within 18 hours. Long-term management depends on the findings and may include treatments like antibiotics, pharmacotherapy, endoscopic therapy, TIPS, or surgery.
Lower GastroIntestinal Bleeding
This document discusses lower gastrointestinal (GI) bleeding, including its causes, presentation, evaluation, and management. Some key points:
- The most common causes of major LGI bleed are diverticulosis, colonic neoplasms, and angiodysplasias. Colonoscopy is the investigation of choice.
- Occult LGI bleeding is first evaluated with fecal occult blood testing (FOBT). CT angiography can help localize bleeding if it persists or patients are unstable.
- Evaluation involves history, physical exam including rectal exam, blood tests, stool tests, endoscopy, imaging studies like colonoscopy, angiography or nuclear scans depending on findings.
- Treatment depends on
Management of upper gi bleed
This document summarizes the management of upper gastrointestinal bleed. It begins with two clinical scenarios of patients presenting with GI bleed and then covers the epidemiology, causes, signs and symptoms, risk scores for prognosis, and approaches to treatment. It emphasizes the importance of early endoscopy and acid suppression treatment. Medications discussed include PPIs, somatostatin analogs like octreotide, terlipressin, antibiotics and tranexamic acid which is being studied in the HALT-IT trial to reduce mortality from GI bleed. Discharge instructions include avoiding NSAIDs and treating H. pylori infection.
upper gastrointestinal bleeding
This document discusses the approach to patients with upper gastrointestinal bleeding and its management. It covers the following key points in 3 sentences:
The document outlines sources of GI bleeding, signs of blood loss severity, immediate assessment steps, diagnostic testing, endoscopic treatment options for variceal and non-variceal bleeding, risk stratification tools like the Rockall score, and angioembolization as a treatment option. Management involves fluid resuscitation, identifying the bleeding source, stopping active bleeding endoscopically, treating underlying causes, preventing rebleeding, and considering a second look endoscopy or other interventions based on risk stratification. Outpatient management may be appropriate for low risk patients while higher risk patients require intensive
Managementof lowergib 2018
- Management of lower GI bleeding (LGIB) requires identifying high-risk patients, optimizing medical management, and performing endoscopy within 24 hours for diagnosis and treatment.
- For ongoing or recurrent LGIB after endoscopy, angiography may be considered to locate the bleeding site.
- Coordinated care between emergency department, ICU, GI specialists, and interventional radiology is important to optimize outcomes for patients with LGIB.
Risk stratification ugi
This document discusses risk stratification and management of upper GI bleeding. It covers epidemiology, clinical presentations, risk scoring systems used to stratify patients pre-endoscopy like the Blatchford score, Rockall score, and AIMS65 score. It describes the approach to patients including history, physical exam, resuscitation, indications for endoscopy, and endoscopic hemostasis techniques. The goal is to assess bleeding severity, identify sources, determine risk factors, and guide appropriate management.
Esophageal varices and its management
This document discusses oesophageal varices, which are dilated and tortuous veins in the oesophageal wall that occur secondary to portal hypertension. It defines oesophageal varices and portal hypertension, and discusses the epidemiology, etiology, risk factors, clinical manifestations, diagnostic evaluations, medical and surgical management, nursing management, and complications of oesophageal varices. It also summarizes two research articles on using wireless capsule endoscopy to diagnose and grade varices, and using blood ammonia levels to predict the presence of varices and bleeding risk. The document concludes by emphasizing the importance for nurses to understand oesophageal varices to provide appropriate care and counseling to patients.
Upper gi bleed
Upper GI bleeding refers to bleeding from the GI tract proximal to the ligament of Trietz. Non-variceal bleeding accounts for 80% of cases, with peptic ulcer disease being the most common cause at 30-40%. Portal hypertensive bleeding from gastroesophageal varices accounts for the remaining 20% of cases. Early endoscopy within 24 hours of bleeding results in reduced transfusions, decreased need for surgery, and shorter hospital stays. Endoscopic therapies like epinephrine injection and thermal coagulation are effective first-line treatments for actively bleeding ulcers. Surgery is indicated if bleeding cannot be controlled or for recurrent bleeding. Variceal bleeding requires resuscitation, vasoactive drugs, and endoscopic
GI Bleeds
The document discusses gastrointestinal (GI) bleeds, including trends showing decreases in upper GI bleeds and increases in lower GI bleeds from 1998-2006. It covers the causes, classifications, presentations, and management of upper and lower GI bleeds, noting the most common causes are ulcers, varices, and diverticulosis. Risk scoring systems and initial management involves fluid resuscitation, transfusions based on stability rather than hemoglobin level, medications, and procedures to locate the source of bleeding.
Lower gi bleed
This document provides an overview of lower gastrointestinal bleeding (LGIB), including its definition, etiology, clinical features, diagnostic and therapeutic approaches. It discusses how LGIB accounts for 20% of gastrointestinal bleeding cases and can be safely managed in an outpatient setting once initial resuscitation and risk evaluation is complete. Colonoscopy is highlighted as the first-line investigation, while angiography and surgery are reserved for more severe or refractory cases. The overall mortality rate of LGIB is reported to be less than 5%.
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Git pathology m scyear2011 12
This document provides information on diseases of the gastrointestinal tract, beginning with diseases of the oral cavity. It discusses common inflammatory disorders like herpes labialis and aphthous stomatitis. It also covers benign and malignant tumors that can occur in the oral cavity, such as papilloma, fibroma, hemangioma, leukoplakia, and erythroplakia. It then discusses diseases that can affect other parts of the GI tract, including the esophagus, stomach, small intestine, large intestine, and salivary glands. For each organ, it outlines common congenital anomalies, inflammatory conditions, tumors, and other pathological entities. It also provides histological images and details on epidemi
Pathology of git€2
This document discusses pathology of the gastrointestinal tract. It mentions pleomorphic adenoma and lists the most common malignant stomach tumors as adeno carcinoma, leiomyosarcoma, carcinoid tumor, and lymphoma. It also lists premalignant lesions of the stomach, including chronic atrophic gastritis, gastric ulcer, adenomatous polyps, and hyperplastic polyps that can occur after partial gastrectomy.
Pathology of Upper GIT
Mr. E.K., a 55-year-old Torres Strait Islander man, presents with worsening abdominal pain, nausea, vomiting, and weight loss. His physical exam and lab results indicate shock. The top differential diagnoses are perforated peptic ulcer or gastric cancer due to his history of NSAID use, smoking, and stress. Further investigations including ultrasound and surgery referral are needed.
BACTERIAL MENINGITIS BY DR BASHIR AHMED DAR ASSOCIATE PROFESSOR MEDICINE CHIN...
BACTERIAL MENINGITIS BY DR BASHIR AHMED DAR ASSOCIATE PROFESSOR MEDICINE CHIN...Prof Dr Bashir Ahmed Dar
Meningitis is an infection of the protective membranes (meninges) surrounding the brain and spinal cord. It is usually caused by bacteria, viruses, or fungi. The disease is contagious and can spread through respiratory and fecal-oral routes. Common symptoms include headache, fever, and neck stiffness. Bacterial meningitis requires prompt antibiotic treatment to prevent serious complications like brain damage.Pediatric Uti
This document provides an overview of pediatric urinary tract infections (UTIs). It discusses the typical presentation of UTIs in children, risk factors, diagnostic testing including urine culture and imaging, and treatment including antibiotics. Imaging plays an important role in diagnosis of conditions like vesicoureteral reflux that can lead to recurrent infections or renal scarring. While routine antibiotics or surgery are options for certain high risk cases, there is debate around their clinical benefits.
Meningitis
Meningitis is an inflammation of the protective membranes covering the brain and spinal cord known as the meninges. It is usually caused by a viral or bacterial infection of the fluid surrounding the brain and spinal cord. Meningitis can be life-threatening and is considered a medical emergency due to the inflammation's proximity to the brain and spinal cord. The meninges have three layers - dura mater, arachnoid mater, and pia mater - with a subarachnoid space between the arachnoid and pia mater filled with cerebrospinal fluid. Meningitis can be caused by bacteria, viruses, fungi, parasites, or physical injuries. A lumbar puncture is required for diagnosis to examine
GI Conditions & Diseases
Our Orlando Gastroenterologists are the leading experts when it comes to evaluating, diagnosing, and treating GI conditions and diseases.
http://gastro-specialists.com/
Becoming a Git Master
This document provides tips and techniques for becoming a Git master, including:
1. Creating aliases to simplify common Git commands like committing and adding remotes. Aliases allow parameters and bash functions for complex commands.
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Gi+biology,+pathology,+and+treat
The document discusses gastrointestinal issues in autism from several perspectives:
- Autism is considered a neuroimmune condition affecting the gut and brain, with inflammation originating in the gut. Treating gut issues is one of the most successful biomedical interventions.
- The gut microbiome plays an important role in digestion, immune function, and communication with the brain. Dysbiosis and infections like measles virus and clostridia have been linked to autism.
- Common gastrointestinal dysfunctions seen in autism include maldigestion, malabsorption, immune dysregulation, and motility issues. Treatment focuses on cleaning up the diet, supporting digestion and the microbiome.
Git case of the week4212.
A 43-year-old Arabic woman presented with dyspepsia, vomiting, and weight loss for one month. On examination, she had evident weight loss but no other abnormalities. She was diagnosed with pancreatic head cancer and sent to surgery for bypass surgery and a histological diagnosis. This case demonstrates that dyspepsia with alarm features like weight loss and anemia in those over 45 should prompt consideration of pancreatobiliary causes and appropriate imaging if upper GI pathology is not found.
Variceal bleeding management
This document summarizes guidelines for managing varices and variceal hemorrhage in patients with cirrhosis. It discusses risk factors for variceal bleeding, methods for risk stratification, and recommendations for primary prevention of bleeding in patients with and without varices. Key points include using nonselective beta-blockers or endoscopic variceal ligation for primary prevention in patients with medium or large varices, monitoring patients without varices for development of varices, and using the hepatic venous pressure gradient to further stratify risk and guide treatment decisions.
C:\Fakepath\Gi Part 1 Revised
The document discusses various gastrointestinal disorders, classifying them into categories such as impaired digestion/absorption, altered secretion/transit, immune dysregulation, and neoplastic degeneration. Specific disorders of the esophagus are then discussed in more detail, including reflux esophagitis, infections, webs/rings, and motility disorders like achalasia and diffuse esophageal spasm. Common symptoms and clinical features of esophageal diseases are also outlined.
Acid fast staining, A PRESENTATION FOR BIOTECHNIC AND BIOTECHNOLOGY CLASS
The document summarizes the history and process of acid-fast staining. It describes how in 1882, Robert Koch discovered the tubercle bacillus and developed an early staining method, which was then improved by others including Ziehl and Neelsen, whose combined method became standard. The Ziehl-Neelsen method uses heat to drive stain into acid-fast bacteria's waxy cell walls. It reliably identifies bacteria with mycolic acid in their cell walls, including Mycobacterium tuberculosis. The process involves staining, heating, decolorizing with acid, and counterstaining to identify acid-fast bacteria as red and non-acid fast as blue.
Drugs act on mucosa membrane of git by abu bakar tariq
In this presentation slide my main concern is the pharmacology of GIT MUCOUS MEMBRANE but you will also know briefly about the anatomy,physiology and pathology of it.
Gastrointestinal Pathology
This document is a 14-chapter textbook on surgical pathology of the gastrointestinal tract written by Dr. Ketan Vagholkar. The chapters cover various diseases and conditions that affect the esophagus, stomach, small intestine, and colon, including carcinomas, ulcers, tuberculosis, diverticulitis, hemorrhoids, and more. The textbook provides an overview of the clinical presentation, diagnosis, and treatment of common gastrointestinal surgical diseases.
Extrapulmonary tuberculosis
This document discusses extrapulmonary tuberculosis, which can affect any organ outside of the lungs. It affects around 15% of tuberculosis cases. Diagnosis and management may differ from pulmonary tuberculosis. Standard antitubercular treatment is usually HRZE for 2 months followed by HR for 4 months, though treatment duration varies depending on the specific extrapulmonary site affected such as the lymph nodes, pleura, pericardium, peritoneum, meninges, gastrointestinal tract, skeletal system, genitourinary tract, or disseminated miliary tuberculosis. Surgery may sometimes be needed for complications or management.
Acid fast staining procedure for staining mycobacteria
This document provides detailed procedures for staining mycobacteria using acid-fast staining methods, including Ziehl-Neelsen and fluorescent auramine-rhodamine staining. It describes each step of the staining process, highlights potential issues, and emphasizes the importance of quality control with positive and negative control slides. The document also covers examining stained smears, reporting results, and preparing quality control slides to validate acid-fast staining procedures.
Management of acute variceal bleeding
This clinical practice guideline summarizes the management of variceal bleeding due to liver cirrhosis. Variceal bleeding occurs in 10-30% of people with cirrhosis and is a major cause of death. The causes of cirrhosis in Malaysia are mainly hepatitis B and alcohol use. Treatment involves stopping the bleeding episode, preventing rebleeding, and prophylaxis. Pharmacological therapies use vasoactive drugs. Endoscopic therapies include sclerotherapy, banding, and adrenaline injection. Antibiotic prophylaxis is also recommended.
Pathology of Upper GIT - Quiz
The document contains quotes from Muhammad Ali emphasizing the importance of perseverance and courage in overcoming challenges to achieve success. It highlights that accomplishing goals requires taking risks and having the determination to continue training even when finding it difficult in order to become a champion.
Tuberculosis (extra pulmonary)
The document summarizes tuberculosis (TB) pathology. It describes the bacteriology of Mycobacterium tuberculosis and M. bovis, which are common causes of TB. The pathogenesis of TB involves an initial inflammatory response followed by macrophage infiltration and formation of granulomas containing epithelioid cells and Langhans giant cells. TB lesions can be either productive or exudative depending on the organ involved. Microscopic findings include caseous necrosis surrounded by epithelioid and giant cells. TB can spread locally, via lymphatics or bloodstream to cause extrapulmonary or miliary disease. Organ involvement and response depends on factors like bacterial load, host immunity, and previous exposure.
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Acid fast staining, A PRESENTATION FOR BIOTECHNIC AND BIOTECHNOLOGY CLASS
Acid fast staining, A PRESENTATION FOR BIOTECHNIC AND BIOTECHNOLOGY CLASS
Drugs act on mucosa membrane of git by abu bakar tariq
Drugs act on mucosa membrane of git by abu bakar tariq
Acid fast staining procedure for staining mycobacteria
Acid fast staining procedure for staining mycobacteria
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GI-Bleeding.ppt
This document outlines the management of gastrointestinal bleeding. It discusses primary, secondary and acute variceal bleeding management. For primary prophylaxis of variceal bleeding, propranolol or nadolol are recommended. For acute variceal bleeding, endoscopic interventions like band ligation or cyanoacrylate injection along with antibiotics and vasoconstrictors are used. Secondary prophylaxis involves medications like propranolol, nadolol or isosorbide to prevent rebleeding. It also discusses portal hypertensive gastropathy, acute lower gastrointestinal bleeding and provides an algorithm for management of acute LGIB.
GASTROINTESTINAL-BLEEDING.ppt
The document provides information on gastrointestinal bleeding (GIB), including epidemiology, presentation, etiology, evaluation, and management. It notes that GIB can be divided into upper or lower sources. Upper GIB is more common and accounts for approximately 67 cases per 100,000 people annually. Clinical presentations include hematemesis, melena, and hematochezia. Risk stratification guides management, with unstable patients admitted to the ICU. Initial evaluation involves hemodynamic monitoring, labs, and upper endoscopy within 24 hours for diagnosis and treatment. Endoscopy allows for control of bleeding in 85-90% of actively bleeding cases.
Git 4th gib ulsi21
This document discusses gastrointestinal bleeding (GIB), summarizing its main causes and approaches to management. It notes that upper GIB accounts for 80% of cases, with the most common causes being peptic ulcer disease, esophageal varices, esophagitis, and Mallory-Weiss tears. Lower GIB is more common in the elderly and can be caused by conditions like diverticulosis, colitis, ischemia, and hemorrhoids. Small intestinal bleeding is relatively uncommon but can now be identified in most patients using video capsule endoscopy, deep enteroscopy, or radiological imaging. The document provides guidance on assessing severity, differentiating upper from lower sources, initial resuscitation measures, the role of endoscopy,
Git 4th gib ulsi21
This document discusses gastrointestinal bleeding (GIB), summarizing its main causes and approaches to management. It notes that upper GIB accounts for 80% of cases, with the most common causes being peptic ulcer disease, esophageal varices, esophagitis, and Mallory-Weiss tears. Lower GIB is more common in the elderly and can be caused by conditions like diverticulosis, colitis, ischemia, and hemorrhoids. Small intestinal bleeding is relatively uncommon but can now be identified in most patients using video capsule endoscopy, deep enteroscopy, or radiological imaging. The document provides guidance on assessing severity, differentiating upper from lower sources, initial resuscitation measures, the role of endoscopy,
UPPER AND LOWER GASTROINTESTINAL BLEEDINGBLEEDING.ppt
Upper gastrointestinal bleeding (UGIB) is more common than lower gastrointestinal bleeding (LGIB). UGIB presents with hematemesis, melena, or coffee ground vomiting while LGIB presents with hematochezia. The most common causes of UGIB are peptic ulcer disease and esophageal varices. Initial evaluation involves assessing hemodynamic stability, nasogastric aspiration, and labs. Resuscitation focuses on IV fluids and blood products while endoscopy within 24 hours allows for diagnosis and treatment. Endoscopic therapies include thermal coagulation, injection, clips, and band ligation to achieve hemostasis.
Lower Gastrointestinal Bleed
This document discusses lower gastrointestinal (GI) bleeding, including:
- Causes of lower GI bleeding in adults include diverticulosis, angiodysplasia, and colorectal cancers and polyps. Risk factors include low fiber diet and medications like NSAIDs.
- Evaluation involves history, physical exam, labs, and endoscopic procedures like colonoscopy to identify the bleeding source and provide treatment.
- Colonoscopy is the gold standard for diagnosis and treatment but must be performed carefully in unstable patients. Angiography and nuclear scans can help localize bleeding in severe cases.
GIT Kurdistan Board GEH Journal club gastric varices..
The prevalence of gastric variceal cirrhosis is estimated to be 17%. For actively bleeding gastric varices, the first-line treatment is cyanoacrylate injection endoscopically. After initial stabilization, repeated cyanoacrylate injections every 2-4 weeks until obliteration is recommended for secondary prophylaxis. TIPS is very effective for controlling acute bleeding from gastric varices and may be considered for those who fail endoscopic therapies or are at high risk of treatment failure.
Surgical disorder of spleen --basheer oudah
This document summarizes splenectomy for various hematologic diseases and disorders. It discusses how splenectomy can alleviate symptoms for certain conditions like autoimmune hemolytic anemia, sickle cell disease, and idiopathic thrombocytopenic purpura, but does not cure the underlying disease. The document also reviews splenectomy indications, techniques, complications, and post-operative management for traumatic splenic injuries and various splenic tumors, cysts, and abscesses.
Gastroenterology
The document provides an overview of esophageal disorders, including their symptoms, diagnosis, and management. Key points include:
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Ugi bleeding muneshwar
Upper gastrointestinal (UGI) bleeding can originate from the esophagus, stomach, or duodenum. The document discusses the causes, clinical presentations, associated conditions, and endoscopic findings of UGI bleeding. The major causes include peptic ulcers, esophageal or gastric varices, esophagitis, vascular ectasias, tumors, and Dieulafoy's lesions. An evaluation of UGI bleeding involves assessing severity based on history and labs, and identifying potential bleeding sources and comorbidities to guide management. Endoscopy allows visualization of the source and features to determine the risk of rebleeding.
Git Gib Variceal
This document discusses the management of variceal hemorrhage, a lethal complication of cirrhosis. It covers the natural history of varices, including that 7% of patients develop or see variceal growth each year. Large varices, presence of red signs, advanced liver disease, and previous hemorrhage predict the 1-year risk of first hemorrhage, which is 12-15%. The risk of recurrent hemorrhage within 1 year is 60%, with 15-20% mortality per acute bleeding episode. It also discusses methods of risk stratification for portal hypertension and their ability to predict outcomes.
variceal bleeding 2.pdf
1. Acute variceal hemorrhage refers to bleeding from enlarged veins (varices) in the esophagus or stomach that is caused by portal hypertension from liver cirrhosis. Variceal bleeding is a severe complication and is the cause of bleeding in 70% of upper GI bleeds in cirrhotic patients.
2. Varices develop due to increased pressure in the portal vein system from cirrhosis. Once varices form, there is a risk of 15% annual bleeding for large varices. Bleeding can often be controlled with medical and endoscopic therapy but there is a high risk (60%) of rebleeding without intervention.
3. Varices are classified based on location
Acute Variceal Hemorrhage
This document provides definitions and background information about acute variceal hemorrhage. It defines acute variceal bleeding as hematemesis or melena within the last 48 hours in a known or suspected case of portal hypertension. Varices are the accepted source of bleeding if blood is seen arising from or clotted on top of an esophageal varix. Failure to control the bleeding is defined as rebleeding within 48 hours of treatment. The document discusses the anatomy of varices, risk factors for bleeding such as varix size, and complications associated with acute variceal hemorrhage such as high rebleeding and mortality rates.
Lower Gastrointestinal Bleeding
This document discusses lower gastrointestinal bleeding, including its definition, causes, symptoms, diagnosis, and management. The most common causes of lower GI bleeding are diverticular disease and angiodysplasia. Diagnostic tests include colonoscopy, angiography, and radionuclide scanning. Colonoscopy allows for diagnosis and treatment but requires bowel prep, while angiography and scanning are less invasive but also less accurate. Management depends on the severity and cause of bleeding, and may include blood transfusions, endoscopic therapies, angiography, or surgery in severe cases.
Gi bleed
This document provides guidance on the management of acute gastrointestinal bleeding. It discusses:
1) Performing a thorough history and physical exam to assess bleeding severity, risk factors, and stability. Guaiac testing has limited utility for inpatients.
2) Initial stabilization including IV access, fluid resuscitation, PPI administration, and consideration of ICU care for unstable patients.
3) Etiologies of upper and lower GI bleeding and their typical clinical presentations. Endoscopic therapies are usually first-line but angiography or surgery may be needed for active or refractory bleeding.
Git j club PU bleed16.
This document summarizes guidelines for the management of upper gastrointestinal bleeding (UGIB). It discusses initial patient assessment and risk stratification, the role of endoscopy within 24 hours, endoscopic findings that predict risk of rebleeding, endoscopic therapies, post-endoscopy management including PPI infusion, and strategies to prevent recurrent bleeding related to causes like H. pylori and NSAID use. Endoscopy is important to determine the source of bleeding and apply therapies when needed to reduce risks of additional bleeding, surgery, and mortality. Post-endoscopy care involves PPI therapy and follow up based on risk level.
APPROACH TO GASTROINTESINAL BLEEDING
1. Obscure gastrointestinal bleeding accounts for 1% of GI hemorrhage and remains undiagnosed in 25% of cases, mostly of lower GI origin.
2. Video capsule endoscopy has a high success rate of 90% for evaluating obscure GI bleeding and identifying sources such as small intestinal ulcers or colonic polyps.
3. For patients with transfusion-dependent obscure-occult bleeding, intraoperative endoscopy using a pediatric colonoscope introduced through the mouth, anus, or entereotomy can examine the whole bowel to locate bleeding sources.
Acute GI Bleedding .ppt
This document discusses the management of gastrointestinal bleeding. It covers the clinical presentation and definitions of acute upper and lower GI bleeding. The core principles of GI bleeding management are outlined as assessing and stabilizing hemodynamic status, determining the source of bleeding, stopping active bleeding, treating any underlying abnormalities, and preventing recurrent bleeding. Specific causes, diagnostic evaluations, endoscopic and surgical treatments are described for various types of acute GI bleeding.
UGIB - ppt 2023.pptx
This document provides an overview of upper gastrointestinal bleeding (UGIB), including its definition, classification, epidemiology, clinical features, diagnostic evaluation, and management. Some key points:
1. UGIB is more common than lower GI bleeding, with a reported incidence of 170 patients per 100,000 population per year. The most common cause is peptic ulcer disease (40% of cases).
2. Risk of rebleeding is higher in patients on antiplatelet therapy and those with recurrent bleeding within 48-72 hours. Mortality is 5-10% for severe UGIB.
3. Diagnostic evaluation includes endoscopy within 24 hours to identify the source of bleeding, as well as
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Git j club fiber in git20
Dietary fiber from whole foods like grains, legumes, vegetables, and fruits has demonstrated benefits for gastrointestinal (GIT) health. Isolated and extracted fibers also show promising regulatory effects on the gut and microbiome. However, fibers have varying physicochemical properties depending on their origin and processing that influence their functional characteristics and clinical applications. More research is needed, including well-designed randomized controlled trials, to determine which fiber sources, characteristics, doses and durations optimize GIT health benefits and manage gastrointestinal disorders. Combining fibers with different physiological effects may be a promising therapeutic strategy.
Med j club mm covid20
- Coronaviruses typically cause common colds but SARS-CoV and MERS-CoV can cause pneumonia, respiratory failure, and death. A novel coronavirus, SARS-CoV-2, emerged in Wuhan, China in late 2019 and caused a global pandemic.
- SARS-CoV-2 spreads mainly through respiratory droplets when people cough, sneeze or talk within 6 feet of each other. Asymptomatic and pre-symptomatic people are highly infectious.
- COVID-19 symptoms range from mild to critical illness. The elderly and those with pre-existing conditions are at higher risk for severe disease. Diagnosis involves PCR testing of respiratory samples.
GIT J Club IBD- sexual dysfunction20.
- Sexual dysfunction and infertility are more prevalent in men with IBD compared to the general population.
- Depression is the most consistent negative predictive factor of sexual function among men with IBD.
- Sulfasalazine can reversibly reduce male fertility, so it is recommended to discontinue 3-4 months prior to conception. Most other IBD medications do not significantly impact fertility.
- Men with IBD have an increased risk of prostate cancer and prostate cancer screening guidelines for higher risk patients should be followed.
GIT J Club IBD- pregnancy2020
The document summarizes a consensus clinical care pathway for women with inflammatory bowel disease (IBD) who are considering pregnancy or are pregnant. The pathway was created by an expert multidisciplinary team representing multiple societies to provide standardized, evidence-based recommendations for gastroenterology and obstetric providers to ensure healthy pregnancies for women with IBD. It addresses the lack of consistent advice available previously by compiling available data on therapeutic options for IBD that have increased over the last 15 years and putting them into an easily accessible format for clinical practice.
Med 5th geriatrics20
This document provides an overview of geriatrics and common issues in caring for elderly patients. It discusses how biological age is more important than chronological age in clinical decision making. Frailty and disability are also addressed. Common geriatric problems like falls, delirium, incontinence and adverse drug reactions are examined in terms of presentation, evaluation, and management strategies. The importance of a comprehensive assessment, considering multiple comorbidities and functional status, is emphasized in developing treatment plans for elderly patients.
GIT 4th abd wall pain
Here are the answers to the CME questions:
1. b
2. e
3. a
4. b
5. d
6. b
7. Inguinal hernias
8. E
GIT 4th endoscopy indications20
Upper and lower GI endoscopies have diagnostic, therapeutic, and screening indications. For upper endoscopy, common diagnostic indications include dyspepsia in patients over age 60 or with red flags, upper GI bleeding, and dysphagia. Therapeutic uses include treatment of bleeding, removal of foreign bodies, dilation of strictures, and stenting. Screening is done for portal hypertension, Barrett's esophagus, eosinophilic esophagitis, and cancers. Lower endoscopy indications involve diagnostic evaluation of bleeding, abdominal pain, diarrhea, and screening of average-risk adults over 50 and high-risk groups. Therapeutic colonoscopy is used for polypectomy, bleeding treatment, and stricture dilation
GIT J Club from UEG Week 2018.
Dr. Hiwa Abubakir and Dr. Mohamed Alshekhani discuss the management of nonvariceal gastrointestinal bleeding. They recommend endoscopy within 24 hours, or earlier for high-risk patients, to identify and treat the bleeding source. A variety of endoscopic tools can be used for hemostasis, including injection of adrenaline combined with clips, bands, electrocautery, or laser coagulation. Newer tools like over-the-scope clips are best for high-risk or recurrent bleeders. Doppler probes help ensure complete vessel occlusion. Additional prothrombotic agents or interventions may be needed in some cases.
Med j club dm antithrombosis19
The document discusses antithrombotic strategies for patients with diabetes who are at risk of cardiovascular events. It proposes strategies for primary prevention, stable coronary artery disease, acute coronary syndromes, ischemic stroke, peripheral artery disease, atrial fibrillation, and venous thromboembolism. More aggressive antithrombotic therapies are associated with greater reduction in recurrent cardiovascular events for patients with diabetes. However, these strategies must be weighed against the risk of bleeding. Further clinical trials are still needed to better understand optimal antithrombotic treatment for cardiovascular patients with diabetes.
Git 4th GC18.
1) Gastric carcinoma is the third leading cause of cancer death worldwide, with highest incidence in East Asia and parts of South America.
2) Risk factors include H. pylori infection, smoking, diet high in salted/preserved foods, and family history of gastric cancer.
3) Early detection through endoscopy in dyspeptic patients over 50 years old or with red flags can improve outcomes, as resection allows for potential cure in early gastric cancer confined to mucosa or submucosa.
GIT J Club IBS NEJM17.
This document summarizes guidelines for the diagnosis and management of irritable bowel syndrome (IBS). It defines IBS and its subtypes based on the Rome IV criteria. It recommends diagnosing IBS based on symptoms in the absence of alarm features or abnormal test results. Limited testing like fecal calprotectin can help distinguish IBS from inflammatory bowel disease. Treatment involves dietary changes, probiotics, antispasmodics, antidepressants, and targeted therapies depending on IBS subtype and predominant symptoms. For refractory cases, a multidisciplinary approach including psychological support may help manage persistent symptoms.
GIT 4th indication for upper GI endoscopy.
Upper gastrointestinal endoscopy has diagnostic, therapeutic, and screening indications. Diagnostically, it is used to detect diseases causing dyspepsia like gastric cancer, investigate upper GI bleeding, diagnose dysphagia, remove foreign bodies, assess GERD, detect esophageal varices, and diagnose celiac disease. Therapeutically, it treats upper GI bleeding, removes foreign bodies, dilates strictures, treats achalasia, places stents, treats GERD, eradicates Barrett's esophagus, inserts feeding tubes, and performs bariatric procedures. Screening indications include detecting Barrett's esophagus, portal hypertension, and cancers of the esophagus and stomach in high-risk patients
GIT Cholestatic AI HBD 17
The document discusses various autoimmune and cholestatic liver diseases including primary biliary cholangitis, primary sclerosing cholangitis, and intrahepatic cholestasis of pregnancy. It provides details on the epidemiology, clinical features, diagnosis, and management of these conditions. It also includes several multiple choice questions to test understanding of topics covered in the document.
GiIT 4th CRC 2017.
- Screening and surveillance are recommended for CRC starting at age 50 to detect and remove precancerous polyps through colonoscopy.
Git j club colonoscopy mistakes.
1. The document outlines 19 potential mistakes that can occur during colonoscopy procedures. These include doing colonoscopies without proper indications or patient evaluation, failing to adequately prepare the colon, misdiagnosing conditions like ulcerative colitis or hemorrhoids, not performing important parts of the exam like ileal intubation or biopsies, and not adhering to quality standards. Addressing these issues can help improve safety, accuracy of diagnoses, and overall quality of colonoscopy.
GIT 4th ibd 2017
This document provides an overview of inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease. It discusses risk factors, clinical manifestations, diagnostic testing, and treatment approaches. The main points are:
- IBD is characterized by idiopathic inflammation of the gastrointestinal tract. The two main types are ulcerative colitis and Crohn's disease.
- Genetic and environmental factors contribute to risk. Smoking increases risk for Crohn's but decreases risk for ulcerative colitis.
- Symptoms vary based on disease location but may include abdominal pain, diarrhea, bleeding, weight loss, and nutritional deficiencies. Extraintestinal manifestations are more common with Crohn's.
GIT 4th IBS 2017
This document provides information on irritable bowel syndrome (IBS), including its definition, diagnostic criteria, subtypes, differential diagnosis, evaluation, and management approaches. Some key points:
- IBS is a common functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits. It affects 10-15% of the population.
- Diagnosis is based on fulfilling the Rome symptom criteria, with subtyping based on predominant stool pattern. Additional testing is usually not needed in absence of alarm features.
- Treatment involves reassurance, dietary modifications, antispasmodics, laxatives/antidiarrheals based on subtype, and tricyclic antidepressants/SSRIs for refractory cases.
Ppi seminar hiwa.
This document discusses the classical and long-term indications for PPI use, including GERD, Barrett's esophagus, use with NSAIDs, use with anti-platelets, and non-ulcer dyspepsia. For GERD, guidelines recommend daily PPI for erosive esophagitis but intermittent PPI courses may be sufficient for many patients. For Barrett's esophagus, the absolute cancer risk reduction with daily PPI is low. For NSAID and anti-platelet users at high risk of bleeding, the benefits of daily PPI are well documented. Intermittent PPI courses are often sufficient for non-ulcer dyspepsia, though some patients may require long-
Ppi symposium araz.
This document discusses potential long-term side effects of PPI use including increased risk of dementia, chronic kidney disease, and fractures. It notes that the evidence for associations between PPI use and these conditions is not conclusive. The document advises using the lowest effective dose of PPIs for indicated conditions and avoiding long-term daily use when possible. It also stresses the importance of only prescribing PPIs for appropriate indications and discontinuing them when no clear benefit exists.
Ppi symposium muhsin
The document summarizes short-term side effects of PPIs (proton pump inhibitors), which are generally well tolerated. The most common side effects are headache, diarrhea, abdominal pain and nausea. Diarrhea appears to be related to acid suppression and the overall incidence is less than 5%, though it may be dosage and age related. PPIs are considered safe for short-term use and have similar safety profiles to H2 blockers. PPIs should be used cautiously in patients with liver disease.
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LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UP
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
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Git GIB Variceal lower 2011 .
- 1. GIT Bleeding: VGIB LGIB Dr. Mohamed Shekhani CABM-FRCP
- 3. Variceal bleeding: Clinical decompensation (i.e., ascites, encephalopathy,a previous episode of hemorrhage, or jaundice). Gastric fundal varices Or GEV Esophageal varices Portal hypertensive gastropathy Common lethal complication of cirrhosis(50% at diagnosis, 7%/year), particularly with: 1 Types Portal hypertensive Biliopathy
- 4. Variceal bleeding: Clinical decompensation (i.e., ascites, encephalopathy,a previous episode of hemorrhage, or jaundice). Treatment of the acute bleeding episode: Mortality 15-20% Primary prophylaxis to prevent a first episode of VH. Secondary prophylaxis (prevention of recurrent VH). 60%/year. Common lethal complication of cirrhosis(50% at diagnosis, 7%/year), particularly with: 1 MANAGEMENT
- 5. Small varices Large varices No varices 7-8%/year 7-8%/year Varices Increase in Diameter Progressively Merli et al. J Hepatol 2003;38:266 VARICES INCREASE IN DIAMETER PROGRESSIVELY
- 7. Class A: 5-6 Class B: 7-9 Class C: 10-15
- 8. Portal HT Risk stratification Portal HT Risk stratification Varices or colaterlas detected on imaging studies as Abd U/S,EUS,Dopler Varices on VCE Fibroscan measuring liver stiffness predicts portal HT Plateletes/spleen maximal bipolar diameter<909 Decompensated liver cirrhosis: Child-Pough or MELD class Gastroesophageal varices. 2 HVPG: gold standard&Best predictor of PHT & EV, but invasive ¬ widely available. >5 mm Hg PHT >10 mm Hg clinically significant
- 9. Primary prophylaxis of bleeding eso varices: Propranolol FU OGD after Obliteration: 3 MONTHLY For 1 year Then Yearly Indefintely. Or Nadolol EBL Sessions every 4 weeks PP of EV bleed Propranolol 20mgm*2 untill PR 55/min Indefinite Nadolol 40mgm once daily Untill PR 55/min Indefinite Endoscopic band ligation Evey 4 weeks untill total obliteration Follow up: 3 /12 for 1 year, yearly 3
- 10. Management of acute variceal bleeding: Endoscopic Intervention EBL Sclerotherapy Sigestaken Tube temponade Cyanoacrylate Injection Sclerotherapy For gastric Varices. Antibiotics: Ceftriaxone Ciprofloxacin 5 days Vasoconstrictor Octreotite Somatostatin Telipresin 5 days Esophageal stenting Acute variceal Bleeding. 4
- 11. Secondary prophylaxis( prevention of recurrent) of bleeding EV: propranolo Nadolol Cyanoacrylate for GV EBL for EV Interventional Radiology for GV Isosorbide Secondary prophylaxis Propranolol Same as for primary prophylaxis. Nadolol Same as for primary prophylaxis. Isosorbide dinitrate 10 mgm*10-20 mgm*2 EBL Same as for primary prophylaxis. Cyanoacrylate injection sclerotherapy or IR for gastric varices not EBL. 5
- 14. Causes in Our locality: Perianal diseases(piles/Fissure) IBD(UC>CD) Infectious colitis Neoplasms(adenoma or cancer) Solitary rectal ulcer syndrome (SRUS) Meckel’s diverticulum. Ischemic colitis. Angiodysplasia
- 15. Hemorrhoids/ fissures: Bleeding after/or with defecation Pain & bleeding with defecation Careful perianal exam+ anoscopy assist in the diagnosis Piles Fissure 1 2
- 16. Acute LGIB: Management algorythm Initial evaluation/ resuscitation Triage to OP vs Ward vs ICU Mild scanty bleeding Anorectal pathology susspected Rigid Anoscopy or sigmoidoscopy to confirm diagnosis Outpatient management Anorectal pathology(piles/fissure) is the most common pathology in our locality But this should be diagnosed on solid basis not to miss serious pathologies as IBD or cancer.
- 17. Acute LGIB: Management algorythm Severe bleeding Severe exanguinating bleeding Emergency angiography for bleeding control by gel form or coils Or emergency surgical consult. If emergency angio succeeded just observe for recurrence but if fails refer to surgery SURGERY Severe exanguinating bleeding needs urgent action either emergency surgery or emegency therapeutic interventional radiology.
- 18. Acute LGIB: Management algorythm Moderate severe bleeding Consider NGT aspirate Bloody NGT aspirate Risk for UGIB OGD If +ve treat accordingly Most of the cases of LGIB fall in this category & require 1 st NGT aspiration & if +ve bloody aspirate , urgent upper GIT endoscopy.
- 19. Acute LGIB: Management algorythm Moderate severe bleeding NGT not done or –ve aspirate Polyethelene glycol(PEG) solution laxative for preparation for emergency colonoscopy in few hours. Colonoscopy within 12-24 hours Manage according to colonoscopic findings If the NGT aspirate is not bloody or NGT was not inserted, urgent prep with PEG is needed for urgent colonoscopy within12-24 hours.
- 20. Acute LGIB: Management algorythm Moderate severe bleeding On colonoscopy bleeding site & cause is identified so treat as appropriate. If the colonoscopy identifies the site/cause of bleeding the problem is solved
- 21. Acute LGIB: Management algorythm Moderate severe bleeding If On colonoscopy there is visual impairment because of ongoing bleeding Angiography. If on colonoscopy there was visual impairment due to bloody field urgent angiography is indicated fordiagnosis & therapy.
- 22. Acute LGIB: Management algorythm Moderate severe bleeding On colonoscopy bleeding site not identified but bleeding had stopped OGD Or Repeat colonoscopy Or SI evaluation /Or Others( RBC scan,angiography) for rebleeding. If on colonoscopy the bleeding had stopped & no lesion was identified, upper GI endoscopy is considered(if had already been done) or RBC scan/angigraphy Is done fordiagnosis/treatment specially if bleeding recurred.
- 24. Hope i t helps