Clinical Guide to Gastroenterology

Description

Clinical Guide to Gastroenterology is an accessible, quick-reference resource that provides practical, evidence-based information on investigations, interventions and management of clinical gastroenterological scenarios. It is packed full with bullet points, diagrams, tables, and algorithms of the important presentations and conditions within Clinical Gastroenterology. Divided into sections, the book offers in-depth coverage of presenting complaints in Gastroenterology, common conditions broken down by organ system, important investigations and procedures, and pharmacology. Detail is given to the sequence of clinical examination, investigations and management required to diagnose and treat a wide range of gastroenterological disorders. Provides information on symptoms, disorders and issues found in the clinical environmentGuides readers in decision-making, appropriate investigation, and conducting interventionsIncludes important guidelines and clinical trials within each chapterSupplemented by a companion website featuring a wealth of additional material, including more than 70 audio clips, over 50 clinical case studies, and almost 350 self-assessment questions, as well as key clinical trials and guidelines Clinical Guide to Gastroenterology is a must-have text for junior doctors and medical students as well as doctors, nurses and trainees working within Emergency Departments, Medical, or Surgical Assessment Units. Title Page Copyright Page Contents List of Contributors Acronyms and Abbreviations Podcast and Box Icons About the Companion Website Chapter 1.1 Examination Technique 1.1.1 Chapter at a Glance 1.1.2 Common Conditions 1.1.3 Clinical Examination – Peripheries 1.1.4 Clinical Examination – Abdomen Palpation and Percussion Specific Organomegaly Shifting Dullness Auscultation To Complete the Examination 1.1.5 How to Present Your Findings Safety First Approach Ward-Based Presenting 1.1.6 Eponymous Signs and Symptoms Chapter 2.1 Dysphagia 2.1.1 Chapter at a Glance 2.1.2 Definition 2.1.3 Diagnostic Algorithm 2.1.4 Differentials List Dangerous Diagnoses Common Diagnoses Diagnoses to Consider 2.1.5 Key History Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Common Diagnosis 4 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 2.1.6 Key Examination Features Dangerous Diagnosis 1 Dangerous Diagnosis 2 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Common Diagnosis 4 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 2.1.7 Key Investigations Bedside Tests Blood Tests Imaging Special Tests 2.1.8 When to Call a Senior Situations What Should be Arranged by the Time the Senior Arrives What Should be Completed by the Time the Senior Arrives 2.1.9 Key Clinical Trials Key Trial 2.1.1 Key Trial 2.1.2 Key Trial 2.1.3 2.1.10 Guidelines 2.1.11 Additional References Chapter 2.2 Dyspepsia 2.2.1 Chapter at a Glance 2.2.2 Definition 2.2.3 Diagnostic Algorithm 2.2.4 Differentials List Dangerous Diagnoses Common Diagnoses Diagnoses to Consider 2.2.5 Key History Features Dangerous Diagnosis 1 Dangerous Diagnosis 2 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Common Diagnosis 4 Common Diagnosis 5 Common Diagnosis 6 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 2.2.6 Key Examination Features Dangerous Diagnosis 1 Dangerous Diagnosis 2 Common Diagnosis 1, 2, 3, 4, 5, and 6 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 2.2.7 Key Investigations (with justification where appropriate) Bedside Blood Tests Imaging Special Tests 2.2.8 When to Call a Senior Situations What Should be Arranged by the Time the Senior Arrives What Should be Completed by the Time the Senior Arrives 2.2.9 Key Clinical Trials Key Trial 2.2.1 Key Trial 2.2.2 2.2.10 Guidelines 2.2.11 Additional References Chapter 2.3 Nausea and Vomiting 2.3.1 Chapter at a Glance 2.3.2 Definition 2.3.3 Diagnostic Algorithm 2.3.4 Differentials List Dangerous Diagnoses Common Diagnoses Diagnoses to Consider 2.3.5 Key History Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Dangerous Diagnosis 4 Dangerous Diagnosis 5 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Common Diagnosis 4 Diagnoses to Consider 1 Diagnoses to Consider 3 Diagnosis to Consider 4 Diagnosis to Consider 5 2.3.6 Key Examination Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Dangerous Diagnosis 4 Dangerous Diagnosis 5 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 Diagnoses to Consider 4 2.3.7 Key Investigations General Points Bedside Tests Blood Tests Imaging Special Tests 2.3.8 When to Call a Senior Situations What Should be Arranged by the Time the Senior Arrives What Should be Completed by the Time the Senior Arrives 2.3.9 Key Clinical Trials Key Trial 2.3.1 2.3.10 Guidelines 2.3.11 Additional References Chapter 2.4 Abdominal Pain 2.4.1 Chapter at a Glance 2.4.2 Definition 2.4.3 Diagnostic Algorithm 2.4.4 Differentials List Dangerous Diagnoses Common Diagnoses Diagnoses to Consider 2.4.5 Key History Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 2.4.6 Key Examination Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 2.4.7 Key Investigations Bedside Blood Tests Imaging Special 2.4.8 When to Call a Senior Situations What should be Arranged by the Time the Senior Arrives What should be Completed by the Time the Senior Arrives 2.4.9 Key Clinical Trials Key Trial 2.4.1 Key Trial 2.4.2 Key Trial 2.4.3 2.4.10 Guidelines 2.4.11 Additional References Chapter 2.6 GI Bleeding 2.6.1 Chapter at a Glance 2.6.2 Definition 2.6.3 Diagnostic Algorithm 2.6.4 Differentials List Dangerous Diagnoses Common Diagnoses Diagnoses to Consider 2.6.5 Key History Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Common Diagnosis 1 Common Diagnosis 2 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 Diagnoses to Consider 4 2.6.6 Key Examination Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Common Diagnosis 1 Common Diagnosis 2 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 Diagnoses to Consider 4 2.6.7 Key Investigations Bedside Blood Tests Imaging Special 2.6.8 When to Call a Senior Situations What should be Arranged by the Time the Senior Arrives What should be Completed by the Time the Senior Arrives? 2.6.9 Key Clinical Trials Key Trial 2.6.1 Key Trial 2.6.2 Key Trial 2.6.3 2.6.10 Guidelines 2.6.11 Additional References Chapter 2.7 Change in Bowel Habit 2.7.1 Chapter at a Glance 2.7.2 Definition 2.7.3 Diagnostic Algorithm 2.7.4 Differentials List Dangerous Diagnoses Common Diagnoses Diagnoses to Consider 2.7.5 Key History Features Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Common Diagnosis 4 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 2.7.6 Key Examination Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Common Diagnosis 4 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 2.7.7 Key Investigations Bedside Blood Tests Imaging Special 2.7.8 When to Call a Senior Situations What should be Arranged by the Time the Senior Arrives What should be Completed by the Time the Senior Arrives 2.7.9 Key Clinical Trials Key Trial 2.7.1 2.7.10 Guidelines 2.7.11 Additional References Chapter 2.8 Anaemia 2.8.1 Chapter at a Glance 2.8.2 Definition 2.8.3 Diagnostic Algorithm 2.8.4 Differentials List Dangerous Diagnoses Common Diagnoses Diagnoses to Consider 2.8.5 Key History Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Dangerous Diagnosis 4 Dangerous Diagnosis 5 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Common Diagnosis 4 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 2.8.6 Key Examination Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Dangerous Diagnosis 4 Dangerous Diagnosis 5 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Common Diagnosis 4 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 2.8.7 Key Investigations Bedside Blood Tests Imaging Special tests 2.8.8 When to Call a Senior Situations 2.8.9 Key Clinical Trials Key Trial 2.8.1 2.8.10 Guidelines 2.8.11 Additional References Chapter 2.9 Jaundice 2.9.1 Chapter at a Glance 2.9.2 Definition 2.9.3 Diagnostic Algorithm 2.9.4 Differentials List Dangerous Diagnoses Common Diagnoses Diagnoses to Consider 2.9.5 Key History Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Dangerous Diagnosis 4 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Diagnosis to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 Diagnosis to Consider 4 2.9.6 Key Examination Features General Points Dangerous Diagnosis 1 Dangerous Diagnosis 2 Dangerous Diagnosis 3 Dangerous Diagnosis 4 Common Diagnosis 1 Common Diagnosis 2 Common Diagnosis 3 Diagnoses to Consider 1 Diagnoses to Consider 2 Diagnoses to Consider 3 Diagnoses to Consider 4 2.9.7 Key Investigations Bedside Tests Blood Tests Imaging Special Tests 2.9.8 When to Call a Senior Situations What should be Arranged by the Time the Senior Arrives What should be Completed by the Time the Senior Arrives For Upper GI Bleed 2.9.9 Guidelines 2.9.10 Additional References Chapter 3.2 Oesophagus 3.2.1 Chapter at a Glance 3.2.2 Definition 3.2.3 Underlying Concepts Gross Anatomy Sphincters Vascular Supply and Drainage of Oesophagus Histology Gastro-Oesophageal Junction Physiology 3.2.4 Achalasia Key Data Presenting Features Differentials Key Investigations Management Options 3.2.5 Barrett’s Oesophagus Key Data Presenting Features Differentials Key Investigations Management Options 3.2.6 Oesophageal Malignancy Key Data Presenting Features Differentials Key Investigations Management Options 3.2.7 Gastro-Oesophageal Reflux Disease Key Data Presenting Features Differentials Key Investigations Management Options 3.2.8 Eosinophilic Oesophagitis Key Data Presenting Features Differentials Key Investigations Management Options 3.2.9 Oesophageal Candidiasis Key Data Presenting Features Differentials Key Investigations Management Options 3.2.10 Mallory–Weiss Syndrome Key Data Presenting Features Differentials Key Investigations Management Options 3.2.11 Other Conditions 3.2.12 Key Clinical Trials Key Trial 3.2.1 Key Trial 3.2.2 3.2.13 Guidelines 3.2.14 Additional References Chapter 3.3 Stomach 3.3.1 Chapter at a Glance 3.3.2 Definition 3.3.3 Underlying Concepts Anatomy Nerve Supply Microanatomy Functions 3.3.4 H. pylori Infection Pathophysiology Key Data Presenting Features Differentials Investigations Management 3.3.5 Peptic Ulcer Disease Pathophysiology Key Data Presenting Features Differentials Investigations Management 3.3.6 Gastritis Pathophysiology Key Data Presenting Features Differentials Investigations Management 3.3.7 Gastric Polyps Pathophysiology Key Data Presenting Features Differentials Investigations Management 3.3.8 Lymphoma Pathophysiology Key Data Presenting Features Differentials Investigations Management 3.3.9 Gastric Adenocarcinoma Pathophysiology Key Data Presenting Features Differentials Investigations Management 3.3.10 Zollinger–Ellison Syndrome 3.3.11 Gastric Dysmotility Pathophysiology Key Data Presenting Features Differentials Investigations Management 3.3.12 Key Clinical Trials Key Trial 3.3.1 3.3.13 Guidelines 3.3.14 Additional References Chapter 3.4 Small Intestine 3.4.1 Chapter at a Glance 3.4.2 Definition 3.4.3 Underlying Concepts Anatomy Histology Vascular Supply and Lymphatics Physiology Pathophysiology 3.4.4 Coeliac Disease Key Data Presenting Features Differentials Key Investigations Management Options 3.4.5 Small Bowel Obstruction Key Data Presenting Features Differentials Key Investigations Management Options 3.4.6 Small Bowel Ischaemia Key Data Presenting Features Differentials Key Investigations Management Options 3.4.7 Malignancies of the Small Intestine Key Data Presenting Features Differentials Key Investigations Management Options 3.4.8 Other Conditions Small Intestinal Bacterial Overgrowth Angiodysplasia Short Bowel Syndrome Whipple’s Disease Tropical Sprue 3.4.9 Key Clinical Trials Key Trial 3.4.1 Key Trial 3.4.2 Key Trial 3.4.3 3.4.10 Guidelines 3.4.11 Additional References Chapter 3.5 Large Intestine 3.5.1 Chapter at a Glance 3.5.2 Definition 3.5.3 Underlying Concepts Anatomy Vascular and Nerve Supply Physiology 3.5.4 C. difficile-Associated Diarrhoea (CDAD) Key Data Presenting Features Differentials Key Investigations Management Options 3.5.5 Infectious Diarrhoea Key Data Presenting features Differentials Key Investigations Management Options 3.5.6 Ischaemic Colitis Key Data Presenting Features Differentials Key Investigations Management Options 3.5.7 Microscopic Colitis Key Data Presenting Features Differentials Key Investigations Management Options 3.5.8 Diverticular Disease Key Data Presenting Features Differentials Key Investigations Management Options 3.5.9 Large Bowel Obstruction Key Data Presenting Features Differentials Key Investigations Management Options 3.5.10 Pseudo-Obstruction Key Data Presenting Features Differentials Management Options 3.5.11 Irritable Bowel Syndrome (IBS) 3.5.12 Colorectal Cancer Key Data Presenting Features Differentials Investigations Management Options 3.5.13 Key Clinical Trials Key Trial 3.5.1 Key Trial 3.5.2 Key Trial 3.5.3 Key Trial 3.5.4 3.5.14 Guidelines 3.5.15 Additional References Chapter 3.6 Inflammatory Bowel Disease and Irritable Bowel Syndrome 3.6.1 Chapter at a Glance 3.6.2 Definition 3.6.3 Underlying Concepts IBD IBS 3.6.4 Crohn’s Disease Key Data Presenting Features Differentials Key Investigations Management Options 3.6.5 Ulcerative Colitis Key Data Presenting Features Differentials Key Investigations Management Options for Acute Flare of Ulcerative Colitis Management Options for Chronic Active Ulcerative Colitis in Outpatient Clinical Setting 3.6.6 Irritable Bowel Syndrome Key Data Presenting Features Differentials Key Investigations Management Options 3.6.7 Key Clinical Trials Key Trial 3.6.1 Key Trial 3.6.2 Key Trial 3.6.3 3.6.8 Guidelines 3.6.9 Additional References Chapter 3.7 Liver 3.7.1 Chapter at a Glance 3.7.2 Definition 3.7.3 Underlying Concepts Anatomy Vasculature Biliary Drainage Functions Damage to Hepatocytes 3.7.4 Viral Hepatitis 3.7.5 Hepatitis B Virus Key Data Presenting Features Differentials Key Investigations Management Options 3.7.6 Hepatitis C virus Key Data Presenting Features Differentials Key Investigations Management Options 3.7.7 Hepatitis A and E Viruses Key Data Presenting Features Differentials Key Investigations Management Options 3.7.8 Autoimmune Hepatitis Key Data Presenting Features Differentials Key Investigations Management Options 3.7.9 Alcoholic Liver Disease and Alcoholic Hepatitis Key Data Clinical Types Presenting Features Differentials Key Investigations Management Options 3.7.10 Non-alcoholic Fatty Liver Disease Key Data Clinical Types Presenting Features Differentials Key Investigations Management Options 3.7.11 Cirrhosis Key Data Presenting Features Differentials Key Investigations Management Options 3.7.12 Ascites 3.7.13 Liver Failure and Hepatic Encephalopathy Key Data Differentials Key Investigations Management Options 3.7.14 Hepatocellular Carcinoma Key Data Presenting Features Differentials Key Investigations Management Options 3.7.15 Other conditions Wilson’s Disease Hereditary Haemochromatosis α1-Antitrypsin Deficiency 3.7.16 Key Clinical Trials Key Trial 3.7.1 Key Trial 3.7.2 3.7.17 Guidelines 3.7.18 Additional References Chapter 3.8 Biliary Tract 3.8.1 Chapter at a Glance 3.8.2 Definition 3.8.3 Underlying Concepts Anatomy Vascular and Nerve Supply Biliary Physiology Enterohepatic Circulation 3.8.4 Gallstones Key Data Presenting Features Differentials Key Investigations Management Options 3.8.5 Ascending Cholangitis Key Data Presenting Features Differentials Key Investigations Management Options 3.8.6 Primary Sclerosing Cholangitis Key Data Presenting Features Differentials Key Investigations Management Options 3.8.7 Primary Biliary Cholangitis Key Data Presenting Features Differentials Key Investigations Management Options 3.8.8 Cholangiocarcinoma Key Data Presenting Features Differentials Key Investigations Management Options 3.8.9 Gallbladder Carcinoma Key Data Presenting Features Differentials Key Investigations Special (anything unusual please give practical details) Management Options 3.8.10 Key Clinical Trials Key Trial 3.8.1 Key Trial 3.8.2 Key Trial 3.8.3 3.8.11 Guidelines 3.8.12 Additional References Chapter 3.9 Pancreas 3.9.1 Chapter at a Glance 3.9.2 Definition 3.9.3 Underlying Concepts Anatomy Ducts 3.9.4 Acute Pancreatitis Key Data Presenting Features Differentials Key Investigations Management Options Conservative Medical Invasive 3.9.5 Chronic Pancreatitis Key Data Presenting Features Differentials Key Investigations Management Options 3.9.6 Pancreatic Cancer Key Data Presenting Features Differentials Key Investigations Management Options 3.9.7 Key Clinical Trials Key Trial 3.9.1 Key Trial 3.9.2 3.9.8 Guidelines 3.9.9 Additional References Chapter 4.1 Liver Biochemistry and Faecal Tests 4.1.1 Chapter at a Glance 4.1.2 Definition 4.1.3 Outline of Procedure 4.1.4 Indications LFTs Faecal Tests 4.1.5 Requesting the Investigation 4.1.6 Peri-Investigation Management 4.1.7 Interpretation of Results 4.1.8 Complications Blood Tests Faecal Testing 4.1.9 Guidelines 4.1.10 Additional References Chapter 4.2 Abdominal Ultrasound (US) 4.2.1 Chapter at a Glance 4.2.2 Definition 4.2.3 Outline of Procedure 4.2.4 Indications 4.2.5 Requesting the Investigation 4.2.6 Peri-Investigation Management Pre-procedure Post-procedure 4.2.7 Interpretation of Results Gallbladder Common bile duct stones (choledocholithiasis) Liver Pancreas Ascites Bladder and Urinary Tract Kidney Gynaecological Structures 4.2.8 Complications 4.2.9 Key Clinical Trials Key Trial 4.2.1 4.2.10 Guidelines 4.2.11 Additional References Chapter 4.3 Abdominal X-ray 4.3.1 Chapter at a Glance 4.3.2 Definition 4.3.3 Outline of Procedure 4.3.4 Indications 4.3.5 Contraindications 4.3.6 Requesting the Investigation 4.3.7 Peri-Investigation Management Pre-procedure Post-procedure 4.3.8 Interpretation of Results Small Bowel Obstruction Large Bowel Obstruction Volvulus Bowel Perforation Inflammation of Bowel or Organs as Liver/Biliary Tract Constipation 4.3.9 Complications 4.3.10 Guidelines 4.3.11 Additional References Chapter 4.4 CT Imaging 4.4.1 Chapter at a Glance 4.4.2 Definition 4.4.3 Outline of Procedure 4.4.4 Indications 4.4.5 Requesting the Investigation 4.4.6 Peri-Investigation Management Pre-procedure Post-procedure 4.4.7 Interpretation of Results 4.4.8 Complications 4.4.9 Guidelines 4.4.10 Additional References Chapter 4.5 Oesophagogastroduodenoscopy (OGD) 4.5.1 Chapter at a Glance 4.5.2 Definition 4.5.3 Outline of Procedure 4.5.4 Indications Diagnostic Therapeutic Other Indications may Include 4.5.5 Contraindications 4.5.6 Requesting the Investigation 4.5.7 Peri-Investigation Management Pre-procedure Post-procedure 4.5.8 Interpretation of Results Oesophagus Stomach Duodenum 4.5.9 Complications 4.5.10 Guidelines Chapter 4.6 Barium Swallow 4.6.1 Chapter at a Glance 4.6.2 Definition 4.6.3 Outline of Procedure 4.6.4 Indications 4.6.5 Requesting the Investigation 4.6.6 Peri-Investigation Management Pre-procedure Post-procedure 4.6.7 Interpretation of Results 4.6.8 Complications 4.6.9 Key Trial Key Trial 4.6.1 4.6.10 Guidelines 4.6.11 Additional References Chapter 4.8 Magnetic Resonance Cholangiopancreatography 4.8.1 Chapter at a Glance 4.8.2 Definition 4.8.3 Outline of Procedure 4.8.4 Indications 4.8.5 Contraindications 4.8.6 Requesting the Investigation 4.8.7 Peri-investigation Management Pre-procedure Post-procedure 4.8.8 Interpretation of Results 4.8.9 Complications 4.8.10 Guidelines 4.8.11 Additional References Chapter 4.9 Endoscopic Retrograde Cholangiopancreatography 4.9.1 Chapter at a Glance 4.9.2 Definition 4.9.3 Outline of Procedure 4.9.4 Indications 4.9.5 Contraindications 4.9.6 Requesting the Investigation 4.9.7 Interpretation of Results 4.9.8 Peri-Investigation Management Pre-procedure Post-procedure 4.9.9 Complications 4.9.10 Guidelines 4.9.11 Additional References Chapter 4.10 Enteral and Parenteral Feeding 4.10.1 Chapter at a Glance 4.10.2 NG Tube Insertion Definition Outline of procedure Indications Contraindications Requesting the Procedure Peri-procedure Management Interpretation of Results Complications Typical Feeding Regimens 4.10.3 PEG Definition Outline of procedure Indications Contraindications Requesting the procedure Peri-procedure Management Interpretation of Results Complications Typical Feeding Regimen 4.10.4 Total Parenteral Nutrition Definition Outline of Procedure Indications Contraindications Requesting the Procedure Peri-procedure Management Interpretation of Results Complications Typical feeding regimen 4.10.5 Guidelines 4.10.6 Additional Reference Chapter 4.12 Flexible Sigmoidoscopy 4.12.1 Chapter at a Glance 4.12.2 Definition 4.12.3 Outline of Procedure 4.12.4 Indications 4.12.5 Contraindications Absolute Relative 4.12.6 Peri-Investigation Management Pre-procedure Post-procedure 4.12.7 Interpretation of Results 4.12.8 Complications 4.12.9 Guidelines 4.12.10 Additional References Chapter 4.13 Colonoscopy 4.13.1 Chapter at a Glance 4.13.2 Definition 4.13.3 Outline of Procedure 4.13.4 Indications 4.13.5 Contraindications Absolute Relative 4.13.6 Peri-Investigation Management Pre-procedure Post-procedure 4.13.7 Interpretation of Results 4.13.8 Complications 4.13.9 Guidelines 4.13.10 Additional Reference Chapter 4.14 Abdominal Paracentesis 4.14.1 Chapter at a Glance 4.14.2 Definition 4.14.3 Outline of Procedure If Continuing to Drain Insertion 4.14.4 Indications Abdominal Aspiration Abdominal Paracentesis 4.14.5 Contraindications 4.14.6 Requesting the Procedure 4.14.7 Peri-Procedure Management Pre-procedure Post-procedure 4.14.8 Interpretation of Results 4.14.9 Complications 4.14.10 Guidelines 4.14.11 Additional Reference Chapter 5.1 Pharmacology – Dyspepsia 5.1.1 Chapter at a Glance 5.1.2 Proton Pump Inhibitors Drug Examples Pharmacology Indications Contra-Indications Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Dose 5.1.3 Histamine Receptor-2 Antagonists Drug Examples Pharmacology Indications Contraindications Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Dose 5.1.4 Antacids and Alginates Drug Examples Pharmacology Indications Contraindications Cautions Interactions Side effects Excretion/Metabolism Routes Starting Dose 5.1.5 Key Trials Key Trial 5.1.1 Key Trial 5.1.2 5.1.6 Guidelines 5.1.7 Additional References Chapter 5.2 Pharmacology – IBD 5.2.1 Chapter at a Glance 5.2.2 Aminosalicylates Drug Examples Pharmacology Indications Contraindications Caution Interactions Side Effects Excretion/Metabolism Routes Starting Dose 5.2.3 Corticosteroids Drug Examples Pharmacology Gastroenterology Indications Contraindications Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Dose 5.2.4 First-line Immunomodulatory Drugs Drug Examples Pharmacology Gastroenterology Indications Contraindications Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Doses 5.2.5 Calcineurin Inhibitors Drug Examples Pharmacology Indications Contraindications Malignancy Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Doses 5.2.6 TNF- Inhibitors Drug Examples Pharmacology Indications Contraindications Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Doses 5.2.7 Key Trials Key Trial 5.2.1 Key Trial 5.2.2 Key Trial 5.2.3 5.2.8 Guidelines 5.2.9 Additional References Chapter 5.3 Pharmacology – Liver Disease 5.3.1 Chapter at a Glance 5.3.2 Benzodiazepines Drug Examples Pharmacology Indications (Chlordiazepoxide) Contraindications Cautions Interactions Side Effects Excretion/Metabolism Starting Dose 5.3.3 Vitamin Supplementation Drug Examples Pharmacology Indications Contraindications Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Dose 5.3.4 Antiviral Agents Drug Examples Pharmacology Contraindications Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Dose 5.3.5 Chelators Drug Examples Pharmacology Indications Contraindications Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Doses 5.3.6 Key Trial Key Trial 5.3.1 5.3.7 Guidelines 5.3.8 Additional References Chapter 5.4 Pharmacology: : Biliary and Pancreatic Disease 5.4.1 Chapter at a Glance 5.4.2 Secondary Bile Acids Drug Examples Pharmacology Indications Contraindications Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Dose 5.4.3 Bile Acid Sequestrants Drug Examples Pharmacology Indications Contraindications Cautions Interactions Side Effects Excretion/Metabolism Routes Starting Dose 5.4.4 Pancreatic Enzyme Products Drug Examples Pharmacology Indications Contraindications Cautions Interactions Side Effects Excretion/Metabolism 5.4.5 Key Trial Key Trial 5.4.1 5.4.6 Guidelines 5.4.7 Additional References Chapter 5.5 Pharmacology – Paracetamol Overdose 5.5.1 Chapter at a Glance 5.5.2 Paracetamol Overdose Context When to Offer Treatment When Pharmacotherapy Fails 5.5.3 Paracetamol Overdose Antidotes Drug Examples Pharmacology Contraindications Cautions Side Effects Excretion/Metabolism Routes Starting Dose 5.5.4 Key Trial Key Trial 5.5.1 5.5.5 Guidelines 5.5.6 Additional References Index EULA