Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · Jul 2011
An alginate-antacid formulation (Gaviscon Double Action Liquid) can eliminate or displace the postprandial 'acid pocket' in symptomatic GERD patients.
Recently, an 'acid pocket' has been described in the proximal stomach, particularly evident postprandially in GERD patients, when heartburn is common. By creating a low density gel 'raft' that floats on top of gastric contents, alginate-antacid formulations may neutralise the 'acid pocket'. ⋯ Gaviscon can eliminate or displace the 'acid pocket' in GERD patients. Considering that EGJ length was unchanged throughout, this effect was likely attributable to the alginate 'raft' displacing gastric contents away from the EGJ. These findings suggest the alginate-antacid formulation to be an appropriately targeted postprandial GERD therapy.
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Aliment. Pharmacol. Ther. · Jul 2011
Long-term results of treatment of malignant carcinoid syndrome with prolonged release Lanreotide (Somatuline Autogel).
Somatostatin analogues are the mainstay of therapy for malignant carcinoid syndrome. There is clear evidence that the once monthly intramuscular formulation, Octreotide LAR, controls symptoms of carcinoid syndrome, and recent data also suggests an antitumour effect. There is limited data on prolonged release Lanreotide (Somatuline Autogel, Ipsen Pharma Biotech, Signes, France) and no long-term data to date. ⋯ Prolonged release Lanreotide provides good symptomatic control of diarrhoea and flushing as well as tumour stability in patients with malignant carcinoid syndrome.
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Aliment. Pharmacol. Ther. · Jul 2011
Meta AnalysisMeta-analysis: erythromycin before endoscopy for acute upper gastrointestinal bleeding.
Studies evaluating the effect of erythromycin on patients with acute upper gastrointestinal bleeding (UGIB) had been reported, but the results were inconclusive. ⋯ Prophylactic erythromycin is useful for patients with upper gastrointestinal bleeding to decrease the amount of blood in the stomach and reduce the need for second endoscopy, amount of blood transfusion. It may shorten the length of hospital stay, but its effects on mortality need further larger trials to be confirmed.
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Aliment. Pharmacol. Ther. · Jul 2011
Randomized Controlled TrialRandomised clinical trial: a 'nudge' strategy to modify endoscopic sedation practice.
In behavioural economics, a 'nudge' describes configuration of a choice to encourage a certain action without taking away freedom of choice. ⋯ These findings demonstrate that 'nudge' strategies may hold promise in modifying endoscopic sedation practice. Further research is required to explore the utility of 'nudges' in impacting other aspects of endoscopic practice.
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Aliment. Pharmacol. Ther. · Jul 2011
Optimising the care of patients with cirrhosis and gastrointestinal haemorrhage: a quality improvement study.
Patients with cirrhosis and gastrointestinal haemorrhage are a complex group with high thirty-day mortality rates. ⋯ Implementation of quality improvement initiatives, such as targeted educational efforts and standardised order sets, can improve the quality of care delivered and patient outcomes in patients with cirrhosis and GI haemorrhage.