Scandinavian journal of gastroenterology
-
Opioid-induced constipation (OIC) is a very troublesome, difficult to manage and a nearly universal complication of chronic opioid use to control pain associated with advanced illness. Some studies have reported that OIC is so intolerable in some patients that they skip their opioid medications and bear pain instead of OIC. ⋯ This review will update the new options and strategies available for treating OIC along with the relevant clinical trials. Finally, this review also provides a recommendation on the preferred way to approach a patient with OIC in the modern era as well as highlight on the importance of doctor-patient communication in this setting.
-
Scand. J. Gastroenterol. · Jan 2015
Randomized Controlled Trial Comparative StudyAlternative sedation for the higher risk endoscopy: a randomized controlled trial of ketamine use in endoscopic retrograde cholangiopancreatography.
Sedation for endoscopy carries an element of cardiorespiratory risk, more significant for certain procedures and in certain patient groups. Ketamine has features which make it an attractive agent for sedation during the higher risk endoscopy; the objectives of this pilot trial were to assess the effectiveness and tolerability of ketamine as a primary agent for sedation during endoscopy. ⋯ In this pilot study, sedation for endoscopy with ketamine and midazolam was as effective as conventional sedation, as acceptable to patients, and was not associated with dysphoric events. Ketamine may have potential as an agent for sedation in higher risk patients.
-
Scand. J. Gastroenterol. · Jan 2015
Treatment of Clostridium difficile infection in a French university hospital.
The management of Clostridium difficile infection (CDI) has become very daunting over the past decade because of increased incidence and severity both in hospital and the community. Guidelines recommend metronidazole, vancomycin, or fidaxomicin, depending on clinical presentation. ⋯ This study identified significant gaps in our knowledge of CDI treatment. Increasing disease severity highlights the need to investigate antibiotic treatment in severely ill CDI patients, as data on this group are currently lacking.
-
Scand. J. Gastroenterol. · Dec 2014
Comparative Study Clinical TrialFecal calprotectin is an effective diagnostic tool that differentiates inflammatory from functional intestinal disorders.
The clinical pictures of functional gastrointestinal disorders and inflammatory diseases can be quite similar leading to inappropriate and expensive investigations. Objective. To investigate fecal calprotectin (FC) diagnostic performance in different gastrointestinal conditions. ⋯ FC appears to be a reliable noninvasive biomarker of intestinal inflammation useful to improve the appropriateness of colonoscopy requests.
-
Scand. J. Gastroenterol. · Dec 2014
No antibiotics in acute uncomplicated diverticulitis: does it work?
The first randomized multicenter study evaluating the need for antibiotic treatment in patients with acute uncomplicated diverticulitis (AUD) could not demonstrate any benefit gained from antibiotic use. The aim of this study was to review the application of the no antibiotic policy and its consequences in regard to complications and recurrence. ⋯ The no-antibiotic policy for AUD is safe and applicable in clinical practice. The previous results of a low complication and recurrence rate in AUD are confirmed. There is no need for antibiotic treatment for AUD. What does this paper add to the literature? Despite published papers with excellent results, there are still doubts about patient safety against the policy to not use antibiotics in acute uncomplicated diverticulitis. This is the first paper, in actual clinical practice, to confirm that the no antibiotic policy for acute uncomplicated diverticulitis is applicable and safe.