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Non-Variceal Upper GI Bleeding
The term "non-variceal upper gastrointestinal bleeding" (UVIB) refers to bleeding close to the ligament of Treitz that is not caused by oesophageal, gastric, or duodenal varices. It might be a life-threatening incident, especially in elderly people with comorbidities. Non-variceal UGIB is mostly brought on by peptic ulcer bleeding. The primary risk factors for UGIB include the use of non-steroidal anti-inflammatory medicines, low-dose aspirin usage, and Helicobacter pylori infections. The therapeutic management of NVUGIB is challenging due to the requirement to balance the risk of gastrointestinal bleeding episodes and adverse cardiovascular events in an older population treated with antiplatelet and/or anticoagulant medicines.
About the Speaker
Dr Sushovan Guha
Professor Of Medicine, McGovern Medical School Division Of Gastroenterology, Hepatology And Nutrition; Depart Of Internal Medicine Co-Director, Center For Interventional Gastroenterology At UTHealth (IGUT)
Case Discussion on Neonatal Jaundice
Neonatal jaundice, characterized by yellowing of a newborn's skin and eyes, is a common occurrence in the first days of life. It occurs due to the accumulation of bilirubin, a yellow pigment produced from the breakdown of red blood cells. In most cases, neonatal jaundice is physiological, resulting from the immature liver's inability to process bilirubin efficiently. Physiological jaundice typically appears within the first two to three days after birth and usually resolves within a week. Insufficient breast milk intake can lead to breastfeeding jaundice, where bilirubin levels rise due to fewer bowel movements and less bilirubin elimination. This occurs later, usually after the first week, and is associated with certain components in breast milk that interfere with bilirubin metabolism. Sometimes, elevated bilirubin levels can indicate an underlying issue, such as blood type incompatibility, genetic disorders, or infections.
Intensive Care Management of Acute Liver Failure
Acute liver failure is a rare but serious medical condition characterized by the rapid loss of liver function within a short period, typically days to weeks. It can be caused by various factors such as viral infections (like hepatitis), drug toxicity (such as acetaminophen overdose), autoimmune disorders, and metabolic diseases. Symptoms may include jaundice (yellowing of the skin and eyes), confusion, bleeding, and abdominal swelling. Immediate medical attention is crucial, often requiring hospitalization and intensive care. Treatment involves addressing the underlying cause, managing complications, and, in severe cases, evaluating the need for a liver transplant. Early intervention and close medical monitoring are vital for improving outcomes in acute liver failure.
Case Discussion on Management of GERD
Gastroesophageal reflux disease (GERD) is a chronic condition characterized by the backward flow of stomach acid and digestive juices into the esophagus. Lifestyle modifications play a crucial role in managing GERD, such as avoiding trigger foods, maintaining a healthy weight, and elevating the head of the bed during sleep. Dietary changes, such as reducing acidic and fatty foods, can alleviate GERD symptoms and prevent exacerbation. Over-the-counter antacids provide short-term relief by neutralizing stomach acid, but they are not a long-term solution for managing GERD. Proton pump inhibitors (PPIs) are commonly prescribed medications that reduce stomach acid production and promote healing of the esophagus. H2 receptor antagonists are another class of medications that block histamine production and decrease acid production in the stomach. Regular exercise can aid in managing GERD by promoting weight loss and improving overall digestive health. Avoiding smoking and excessive alcohol consumption is crucial, as both can worsen GERD symptoms and interfere with treatment.
Understanding and managing Irritable Bowel Syndrome
Irritable Bowel Syndrome (IBS) is a common digestive disorder. It affects the large intestine and causes abdominal pain and changes in bowel habits. Symptoms of IBS include bloating, gas, diarrhea, and constipation. It is a chronic condition that requires long-term management. The exact cause of IBS is unknown, but factors like diet, stress, and genetics may play a role. A healthy diet is crucial for managing IBS symptoms. High-fiber foods like fruits, vegetables, and whole grains can help regulate bowel movements. Certain foods may trigger IBS symptoms, such as spicy foods, caffeine, and fatty foods. Keeping a food diary can help identify trigger foods. Drinking plenty of water and staying hydrated is important for managing IBS. Regular exercise can help relieve IBS symptoms by reducing stress and promoting healthy digestion. Stress management techniques like deep breathing, meditation, and yoga can be beneficial for IBS. FODMAPs are certain types of carbohydrates that can trigger IBS symptoms. The low FODMAP diet involves avoiding high FODMAP foods and gradually reintroducing them to identify triggers.