tailieunhanh - Chapter 039. Nausea, Vomiting, and Indigestion (Part 8)

Table 39-3 Alarm Symptoms in GERD Odynophagia Unexplained weight loss Recurrent vomiting Occult or gross gastrointestinal bleeding Jaundice Palpable mass or adenopathy Family history of gastrointestinal malignancy Upper endoscopy is performed as the initial diagnostic test in patients with unexplained dyspepsia who are 55 years old or have alarm factors because of the elevated risks of malignancy and ulcer in these groups. | Chapter 039. Nausea Vomiting and Indigestion Part 8 Table 39-3 Alarm Symptoms in GERD Odynophagia Unexplained weight loss Recurrent vomiting Occult or gross gastrointestinal bleeding Jaundice Palpable mass or adenopathy Family history of gastrointestinal malignancy Upper endoscopy is performed as the initial diagnostic test in patients with unexplained dyspepsia who are 55 years old or have alarm factors because of the elevated risks of malignancy and ulcer in these groups. The management approach to patients 55 years old without alarm factors is dependent on the prevalence of H. pylori infection in the local population. For individuals who reside in regions with low H. pylori prevalence 10 a 4-week trial of a potent acid-suppressing medication such as a proton pump inhibitor is recommended. If this fails a test and treat approach is most commonly applied. H. pylori status is determined with urea breath testing stool antigen measurement or blood serology testing. Those who are H. pylori positive are given therapy to eradicate the infection. If symptoms resolve on either of these regimens no further intervention is required. For patients in areas with high H. pylori prevalence 10 an initial test and treat approach is advocated with a subsequent trial of an acid-suppressing regimen offered for those who fail H. pylori treatment or for those who are negative for the infection. In each of these patient subsets upper endoscopy is reserved for those who fail to respond to therapy. Further testing is indicated if other factors are present. If bleeding is reported a blood count is obtained to exclude anemia. Thyroid chemistries or calcium levels screen for metabolic disease whereas specific serologies may suggest celiac disease. For suspected pancreaticobiliary causes pancreatic and liver chemistries are obtained. If abnormalities are found abdominal ultrasound or CT may give important information. Gastric emptying scintigraphy is considered to exclude gastroparesis in .

• Y học thường thức
• Nausea
• Vomiting
• Indigestion
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu học ngành y
• Harrisons Internal Medicine
• BMC Pharmacology and Toxicology
• Dexamethasone against nausea
• Moderately emetogenic chemotherapy
• Gynecological cancers
• Acute nausea
• Postoperative nausea and vomiting
• Intravenous patient controlled analgesia
• Double blind trial
• 5 hydroxytryptamine3
• Meta analysis
• Prophylactic ondansetron
• Unique properties
• 5 HT3 receptor antagonists
• Chemotherapy induced nausea and vomiting
• Quality of life
• Chemotherapeutic agents
• BMC Cancer
• Pediatric patients
• Emetogenic chemotherapy
• Chemotherapy induced nausea
• Antiemetic prophylaxis
• Non interventional observation study
• Bone metastases
• Radiation induced nausea and vomiting
• Lung cancer
• Aggressive antiemetic prophylaxis
• Multivariate analysis
• Colorectal cancer
• Moderate emetic risk
• Female patients
• BMC Anesthesiology
• Oculocardiac reflex
• Strabismus surgery
• Anticholinergic agent
• Postoperative ileus
• Gastric ultrasound
• Gastric emptying
• Acute care surgery
• Emetic neuronal pathway
• Neurobiological mechanism
• Non vagotomy patients
• Clinical trial
• Selective outcome reporting
• Systematic review
• Trial registration
• Spinal blockade
• Perioperative factors
• Suboptimal prophylaxis
• Laparoscopic surgery
• Patient controlled analgesia
• High risk patient population
• Cross sectional studies
• Machine learning
• Cannabis legalization
• Spinal anesthesia
• Neuraxial anesthesia
• General anesthesia
• Overall incidence of PONV