Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
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Clin. Gastroenterol. Hepatol. · Feb 2009
Development and validation of the patient and clinician sedation satisfaction index for colonoscopy and upper endoscopy.
Recent increases in gastrointestinal endoscopic procedures and sedation options show a need for better sedation evaluation. This article describes the development and validation of 2 instruments: the Patient Satisfaction with Sedation Instrument (PSSI) and the Clinician Satisfaction with Sedation Instrument (CSSI) for assessing satisfaction in patients undergoing outpatient upper endoscopy and colonoscopy. ⋯ The PSSI and CSSI provide for feasible, reliable, and valid assessment of procedural sedation satisfaction for outpatient colonoscopy and esophagogastroduodenoscopies and can be used for future sedation studies.
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Clin. Gastroenterol. Hepatol. · Jan 2009
Prevalence, characteristics, and impact of bloating symptoms in patients with irritable bowel syndrome.
Bloating symptoms are common in patients with irritable bowel syndrome (IBS) seen in primary care and gastrointestinal clinics. However, the underlying mechanisms of IBS are poorly understood, and there are few data available about the epidemiology of this syndrome or the impact of its symptoms. We investigated the prevalence, characteristics, and impact of bloating symptoms in patients with IBS. ⋯ Bloating symptoms are common in patients with IBS, and their prevalence and relative severity differ on the basis of sex and IBS subtype. Bloating symptoms are associated with a decrease in the quality of life and increases in health care utilization and use of medications.
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Acute pancreatitis is a common inflammatory disorder of the pancreas resulting in considerable morbidity and a mortality rate of approximately 5%. Although there are no pharmacologic treatments known to improve important outcomes, aggressive intravenous fluid resuscitation generally is recommended in all patients. However, few human investigations have been performed and several important questions have not been answered. ⋯ Previous animal experiments are described, as are the limited human studies specifically addressing fluid resuscitation. Finally, current recommendations and goals for further investigation are highlighted. It is our hope that this review will stimulate interest in this often overlooked subject and lead to carefully designed human clinical trials using varying fluid solutions and rates, with an emphasis on patient monitoring and safety, in the near future.