Clinical nutrition in gastrointestinal diseases

2014 ◽  
Vol 155 (51) ◽  
pp. 2034-2040
Author(s):  
József Hamvas
Keyword(s):  
Medical Treatment ◽  
Crohn Disease ◽  
Hepatic Failure ◽  
Nutritional Support ◽  
Gastrointestinal Diseases ◽  
Nutrition Therapy ◽  
Morbidity And Mortality ◽  
Main Function ◽  
Intestinal Function ◽  
Therapeutic Modalities

The association between nutrition and intestinal function is based on facts. The main function of the gut is to digest and absorb nutrients in order to maintain life. Consequently, chronic gastrointestinal diseases commonly result in malnutrition and increased morbidity and mortality. Chronic malnutrition impairs digestive and absorptive function. Parenteral and enteral nutritions are effective therapeutic modalities in several diseases. In cases of gastrointestinal malfunctions, nutrition has a direct therapeutic role. The benefit of nutrition therapy is similar to medical treatment in patients with pancreatitis, Crohn disease, hepatic failure, and in those with gastrointestinal fistulas. Nutrition has both supportive and therapeutic roles in the management of chronic gastrointestinal diseases. With the development of modern techniques of nutritional support, the morbidity and mortality associated with chronic gastrointestinal diseases can be reduced. Orv. Hetil., 2014, 155(51), 2034–2040.

Pharmaconutrition: pharmacological approach to nutrition therapy

2014 ◽  
Vol 155 (51) ◽  
pp. 2021-2027
Author(s):  
István Télessy
Keyword(s):  
Fatty Acids ◽  
Nutritional Support ◽  
Pharmacological Action ◽  
Nutrition Therapy ◽  
Therapeutic Agents ◽  
Therapeutic Action ◽  
Treatment Results ◽  
Research Activity ◽  
Therapeutic Modalities ◽  
The Everyday

Reviewing the literature of nutrition therapy one can conclude that during the last decade the pharmacological action of several nutrients has been demonstrated. However, research activity is still at the beginning and it could be verified in a restricted number of nutrients only that in which conditions (illnesses), dose and duration we can expect therapeutic effect in addition to nutrition. The examples of glutamine, arginine, taurine, leucine, ω-3 fatty acids, however, support the possibility that complex reactions and treatment results observed in certain patients are not purely due to nutritional support but the consequence of additional pharmacological action as well. Evaluation of results of therapeutic intervention is especially difficult because in the everyday practice physicians try to use several therapeutic modalities that can be beneficial for the patient. Therefore, retrospective separation of beneficial components of the therapeutic agents is almost impossible. Only well designed, randomized and multicentric studies can verify specific therapeutic action of certain ingredients ie. nutrients. Orv. Hetil., 2014, 155(51), 2021–2027.

Approaches to common conditions of the gastrointestinal tract in pet hamsters

2021 ◽  
Vol 26 (3) ◽  
pp. 20-26
Author(s):  
Vicki Baldrey
Keyword(s):  
Nutritional Support ◽  
Gastrointestinal Disease ◽  
Parasitic Infection ◽  
Positive Contrast ◽  
Abdominal Ultrasound ◽  
Gastrointestinal Diseases ◽  
Indications For Surgery ◽  
Pet Trade ◽  
Free Environment ◽  
The Uk

Hamsters are popular pets in the UK. The Syrian or Golden hamster (Mesocricetus auratus) is the best known species in the pet trade, with a variety of dwarf species also encountered. Gastrointestinal disease occurs frequently, and diarrhoea is a common presenting complaint. This is most often associated with bacterial or parasitic infection, but can also be related to neoplasia or the use of certain antibiotics. Initial stabilisation of the hamster with diarrhoea should include provision of a warm stress-free environment, fluid therapy, nutritional support with an appropriate critical care diet and analgesia. Following a full history and clinical examination, further diagnostic steps include faecal parasitology and microbiology, routine biochemistry and haematology, radiography with or without positive contrast, and abdominal ultrasound. Indications for surgery include evidence of intestinal obstruction or prolapsed intussusception. This article gives an overview of the most common gastrointestinal diseases encountered in hamster species and provides a guide of how to logically approach the investigation and treatment of these cases, achievable in general practice.

PAEDIATRIC POSTERIOR FOSSA TUMORS : AN EPIDEMIOLOGICAL AND ANALYTICAL STUDY AT TERTIARY CARE CENTRE IN EASTERN INDIA

2021 ◽  
pp. 54-56
Author(s):  
S. I. Sadique ◽  
Md. Shahid Alam ◽  
S. Chatterjee ◽  
S. Ghosh
Keyword(s):  
Early Diagnosis ◽  
Posterior Fossa ◽  
Tertiary Care ◽  
Male Dominance ◽  
Morbidity And Mortality ◽  
Posterior Fossa Tumors ◽  
Tertiary Care Centre ◽  
Therapeutic Modalities ◽  
Common Location ◽  
Group 5

Introduction: Posterior fossa is the commonest site of primary intracranial tumors in children, accounting for 45-60% of 1 all pediatric tumors . The aims and objectives of the study is to analyse the incidence, clinical features, surgical outcome and complications in paediatric patients with posterior fossa tumor. Material and Methods: The present study is a non-randomized prospective observational study, conducted in the department of neurosurgery, Bangur Institute of Neurosciences (B.I.N), IPGME & R, Kolkata from January 2019 to December 2020. Sample size is 50. Observations & Results: Out of 480 cases of total CNS tumors who presented in the study period, 96 cases(20%) were of paediatric posterior fossa tumors. Male dominance was seen i.e. 32 cases(64%). Most of them were in the age group 5-12 years i.e. 30 cases(60%). Headache and vomiting was the most common presenting complain present in 41 cases(82%). Fourth Ventricle was the most common location, 30 cases(60%) with Medulloblastoma being the most common tumor, 24 cases(48%). Brainstem involvement was seen in 22 cases(44%). Post-op hydrocephalus and cerebellar mutism were seen in 6 cases(12%) each. Overall mortality was 8%(4 cases). Conclusion: Posterior fossa tumors are critical brain lesions with signicant neurological morbidity and mortality. Early diagnosis of posterior fossa tumors is vital to prevent potential risks of Brain stem compression, herniation, hydrocephalus and death. With rapid advancement in radiology and the advent of modern therapeutic modalities, early diagnosis and treatment reduced the morbidity and mortality rate and improved prognosis among the patients.

scholarly journals Fulminant hepatitis B

2003 ◽  
Vol 60 (3) ◽  
pp. 353-360
Author(s):  
Milomir Djokic ◽  
Vesna Begovic ◽  
Radmila Rajic-Dimitrijevic ◽  
Rada Aleksic ◽  
Svetlana Popovic ◽  
...  
Keyword(s):  
Hepatic Failure ◽  
Fulminant Hepatitis ◽  
Clinical Care ◽  
Basic Research ◽  
Clinical Syndrome ◽  
Intensive Care Treatment ◽  
Therapeutic Modalities ◽  
Liver Function Impairment ◽  
Function Impairment ◽  
Therapeutic Measures

Fulminant hepatitis, or fulminant hepatic failure, is defined as a clinical syndrome of severe liver function impairment, which causes hepatic coma and the decrease in synthesizing capacity of liver, and develops within eight weeks of the onset of hepatitis. Several independent factors influence the survival of patients: age, the cause of liver disease, the degree and the duration of encephalopathy in relation to the onset of the disease, and the prevention of complications. Over the years many intensive treatments have been practiced. Liver transplantation is expensive, and patients who survive transplantation require life-long immunosupression, clinical care and complications management. Without transplantation fulminant hepatitis and hepatic failure might be completely recovered spontaneously, and the patient could expect a normal life. Two cases of fulminant B hepatitis with intensive care treatment, and their survival despite unfavorable prognosis are presented in this paper. The menagement of patients with fulminant hepatitis required intensive monitoring and therapeutic measures, including corticosteroids. The prognosis for survival without transplantation in fulminant hepatitis is limited by the measures of medical treatment and new specific therapeutic modalities which must be developed through basic research.

Medical Treatment of Perianal Crohn Disease Fistulae

2012 ◽  
pp. 385-397
Author(s):  
Mark T. Osterman ◽  
Gary R. Lichtenstein
Keyword(s):  
Medical Treatment ◽  
Crohn Disease

Fulminant viral hepatitis: molecular and cellular basis, and clinical implications

2001 ◽  
Vol 3 (10) ◽  
pp. 1-19 ◽  
Author(s):  
Mingfeng Liu ◽  
Camie W.Y. Chan ◽  
Ian McGilvray ◽  
Qin Ning ◽  
Gary A. Levy
Keyword(s):  
Viral Hepatitis ◽  
Fulminant Hepatic Failure ◽  
Hepatic Failure ◽  
Sudden Onset ◽  
Cell System ◽  
Multiple Organ ◽  
Hepatic Regeneration ◽  
Hypoxic Injury ◽  
Therapeutic Modalities ◽  
Molecular Therapeutic

Fulminant hepatic failure is defined by the sudden onset of severe liver injury accompanied by hepatic encephalopathy in an individual who previously had no evidence of liver disease. This disease causes multiple organ failure and is associated with a high mortality. The most frequently recognised cause of fulminant or subfulminant hepatic failure is viral hepatitis. Data are now emerging to support the hypothesis that, irrespective of the aetiology of fulminant hepatic failure, the host's immune response (including production of proinflammatory cytokines and mediators) contributes to microcirculatory disturbances that result in hypoxic injury and cell death (apoptosis). Impairment of the scavenger function of the reticuloendothelial cell system further contributes to reduced hepatic blood flow and ischaemic necrosis. An increased understanding of the molecular pathogenesis of fulminant hepatic failure now enables new molecular therapeutic modalities to be tested. Given the complexity of this multi-dimensional disorder, the challenge is to provide a rational basis for treatment. This might include enhancement or suppression of immune responsiveness by manipulation of endogenous cytokine synthesis or by cytokine administration and, at the same time, use of strategies to increase hepatic regeneration.

scholarly journals Levels of Patient Satisfaction on Integrative Medicine Before and After Implementation of Diagnosis-related Groups

2018 ◽  
Vol 7 ◽  
pp. 216495611875925 ◽  
Author(s):  
Tobias Romeyke ◽  
Elisabeth Noehammer ◽  
Hans Christoph Scheuer ◽  
Harald Stummer
Keyword(s):  
Patient Satisfaction ◽  
Medical Treatment ◽  
Diagnosis Related Groups ◽  
Hospital Setting ◽  
Nutrition Therapy ◽  
Study Patient ◽  
Patient Centered ◽  
General Evaluation ◽  
Conventional Medical Treatment ◽  
Before And After

Objectives The aim of this article is to study patient satisfaction with complementary and alternative medicine (CAM) in an in-hospital setting before and after the introduction of diagnosis-related groups (DRGs). Methods Patients were interviewed regarding a general evaluation of their hospital stay, the psychological talking therapy, the nutrition therapy, and the overall success of the treatment. Results The medical treatment was evaluated by 1158 patients. A very good success was reported by 347, a good by 609, a moderate by 181, and none by 21 patients. DRG implementation showed no significant effects. Psychological talking therapy was evaluated as “very good” ( P ≤ .05). With regard to the success of the medical talking and nutrition therapy, there were no significant differences ( P ≥ .05) between the time before and after DRG implementation. Conclusion Broadening conventional medical treatment with CAM practices can lead to a parallel treatment of DRGs in hospitals working with complementary medicine. This results in very patient-centered therapies, which may impact patient satisfaction.

scholarly journals Malnutrition in healthcare settings and the role of gastrostomy feeding

2016 ◽  
Vol 76 (3) ◽  
pp. 352-360 ◽  
Author(s):  
Matthew Kurien ◽  
Jake Williams ◽  
David S. Sanders
Keyword(s):  
Nutritional Support ◽  
Feeding Tube ◽  
Morbidity And Mortality ◽  
Future Research ◽  
Economic Costs ◽  
Psychological Function ◽  
Feeding Tubes ◽  
Healthcare Settings

Malnutrition can adversely affect physical and psychological function, influencing both morbidity and mortality. Despite the prevalence of malnutrition and its associated health and economic costs, malnutrition remains under-detected and under-treated in differing healthcare settings. For a subgroup of malnourished individuals, a gastrostomy (a feeding tube placed directly into the stomach) may be required to provide long-term nutritional support. In this review we explore the spectrum and consequences of malnutrition in differing healthcare settings. We then specifically review gastrostomies as a method of providing nutritional support. The review highlights the origins of gastrostomies, and discusses how endoscopic and radiological advances have culminated in an increased demand and placement of gastrostomy feeding tubes. Several studies have raised concerns about the benefits derived following this intervention and also about the patients selected to undergo this procedure. These studies are discussed in detail in this review, alongside suggestions for future research to help better delineate those who will benefit most from this intervention, and improve understanding about how gastrostomies influence nutritional outcomes.

scholarly journals Acute necrotising pancreatitis – early management in the district general hospital and tertiary hepato-pancreatico-biliary unit

2018 ◽  
Vol 20 (3) ◽  
pp. 263-267
Author(s):  
Rajiv P Lahiri ◽  
Nariman D Karanjia
Keyword(s):  
Acute Pancreatitis ◽  
Nutritional Support ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Early Management ◽  
Surgical Emergency ◽  
High Dependency ◽  
Necrotising Pancreatitis ◽  
Acute Necrotising Pancreatitis ◽  
Acute Necrotising

Acute pancreatitis is a common general surgical emergency presentation. Up to 20% of cases are severe and can involve necrosis with high associated morbidity and mortality. It is most commonly due to gallstones and excess alcohol consumption. All patients with acute pancreatitis need to be scored for severity and patients with severe acute pancreatitis should be managed on the high dependency unit. The mainstay of early treatment is supportive, with care to ensure strict fluid balance and optimisation of end organ perfusion. There is no role for early antibiotic use in acute necrotising pancreatitis and antibiotics should only be used in the presence of positive cultures. Nutritional support is vitally important in improving outcomes in necrotising pancreatitis. This should ideally be provided enterally using an naso-jejunal tube if the patient cannot tolerate oral intake. Patients with significant early necrosis, persisting organ dysfunction, infected walled off necrosis requiring intervention or haemorrhagic pancreatitis should be referred to a regional hepato-pancreatico-biliary unit for advice or transfer. Percutaneous and endoscopic necrosectomy has replaced open surgery due to improved outcomes. Acute necrotising pancreatitis remains a complex surgical emergency with high morbidity and mortality that requires a multidisciplinary approach to attain optimum outcomes. The mainstay of treatment is supportive care and nutritional support. Patients with significant pancreatic necrosis or infected collections requiring drainage require input from a tertiary HPB unit to guide management.

scholarly journals Endoscopic Methods for the Treatment of Nonvariceal Upper Gastrointestinal Hemorrhage

1989 ◽  
Vol 3 (2) ◽  
pp. 72-76 ◽  
Author(s):  
Z.W. Li ◽  
F. Urrutia ◽  
R. Wensel ◽  
A.B.R. Thomson
Keyword(s):  
Gastrointestinal Disease ◽  
Gastrointestinal Diseases ◽  
Ulcer Bleeding ◽  
Therapeutic Modalities ◽  
Visible Vessel ◽  
Hemostatic Therapy ◽  
Poor Outcomes ◽  
Bleeding Ulcers ◽  
Endoscopic Methods ◽  
Upper Gastrointestinal

In the l970s, diagnostic fibreoptic endoscopy became part of the standard practice for evaluation of gastrointestinal disease. In the 1980s, therapeutic fibreoptic endoscopy is emerging as standard therapy for many gastrointestinal diseases. As the already sophisticated technology continues to blossom, it promises to become even more a part of the management of an increasing number of gastroenterological problems. Endoscopy can provide both a specific diagnosis as well as an identification of the high risk subgroup of patients with either active bleeding, or a non bleeding visible vessel that might benefit from endoscopic treatment. At endoscopy, patients with active ulcer bleeding have either arterial spurting, oozing or oozing beneath an overlying clot. These have poor outcomes: for example, when a non bleeding visible vessel is identified, the chances for rebleeding are approximately 50% during the period of that hospitalization . With an overlying clot without oozing, where dark spots are noted, there is less than a 10% chance of rebleeding. There are certain limitations for endoscopic hemostatic therapy and there are a few bleeding ulcers with an artery too large to expect endoscopic success. The kind of treatment chosen will be dictated by the availability of the therapeutic modalities and the skill of the surgeon.

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