Evidence-Based Gastroenterology and Hepatology by John W. D. McDonald, Andrew K. Burroughs, Brian G. Feagan,
By John W. D. McDonald, Andrew K. Burroughs, Brian G. Feagan, M. Brian Fennerty
The one evidence-based source combining gastroenterology and hepatology, this significant textbook seriously appraises the facts for analysis, screening, and therapy of gastrointestinal and hepatic ailments, and offers transparent innovations for management.A distinctive characteristic is the grading of either the facts (randomized managed trials, systematic reports, or decrease caliber trials) and the therapy techniques. This constitution presents the reader with invaluable information on implementation.The 3rd variation has been absolutely revised, supplying the latest reviews of the facts. it's also more desirable with new issues that experience major facts for remedy, including;Esinophilic esophagitisAcute dysenteriesPrevention and remedy of travelers’ diarrhoeaFrequency of difficult drug results on bowel functionManagement of hepatitis B Management of Hepatitis CVascular sickness of the liver Non invasive analysis of liver fibrosisDrug brought about liver disorder
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Extra info for Evidence-Based Gastroenterology and Hepatology
In summary, these data indicate that a therapeutic trial of a PPI for 1–2 weeks may be a reasonably useful clinical tool but it is by no means a gold-standard test for the diagnosis of GERD. The advantages of this approach include simplicity, noninvasiveness, ease of prescription and consumption, tolerability, and savings in terms of direct costs and time lost by the patient, but it does not demonstrate optimal sensitivity or specificity. A positive therapeutic trial may also predict longer term therapeutic response, but data confirming this notion are limited.
In contrast, Fass et al. studied patients with GERD and controls without GERD and determined that patients showed enhanced perception of acid perfusion but not of esophageal distension . They concluded that chronic acid reflux by itself was not the cause of esophageal hypersensitivity to distension in patients with non-cardiac chest pain, although subsequent data from this group 22 suggest that the esophagus can be primed to be hypersensitive by repeated reflux events. Carlsson et al.  have also demonstrated an impaired esophageal mucosal barrier in symptomatic GERD patients by measuring the transmucosal epithelial potential difference, suggesting a role for alteration in cell barrier function as a cause for reflux symptoms in some individuals.
Patients with gastrointestinal disorders have decreased functional status and well-being . Those patients with chronic gastrointestinal disorders, including GERD, and congestive heart failure have the poorest health perceptions. These perceptions are worse than those that characterize some other chronic conditions such as hypertension and arthritis [79, 99, 100]. In patients with heartburn there was a substantial impairment of all aspects of health-related QoL when measured using the GSRS, QOLRAD, SF-36 and the Hospital Anxiety and Depression (HAD) scale .