Category Archives: GI

A guide for managing coagulation in cirrhotics

Managing coagulation in cirrhotics is very difficult. A new practical guideline gives the following advice: For invasive procedures, keep platelets >50K, avoid FFP, and consider ddavp for dental extractions; for bleeding varices, also keep Hb around 7, and keep fibrinogen … Continue reading

Posted in GI | Comments Off

Prednisolone +/- pentoxifylline for acute alcoholic hepatitis

This trial randomized patients with acute alcoholic hepatitis to prednisolone +/- pentoxifylline and found no difference in outcomes between the groups (abstract)

Posted in GI | Comments Off

Oral similar to IV PPIs in bleeding PUD

This meta-analysis found no significant differences in outcomes (rebleeding, surgery, transfusion, or mortality) among patients with bleeding PUD on either oral or IV PPIs. However, the trials included were low overall quality, so best to wait for a randomized trial … Continue reading

Posted in GI | Comments Off

Probiotics do not prevent diarrhea in elderly

This large trial of ~3,000 patients age 65+ on 1 or more antibiotics randomized them to lactobacilli and bifidobacteria for 8 weeks, and found no significant difference in diarrhea or Cdiff between the groups (abstract).

Posted in GI, ID | Comments Off

Predicting bad outcomes of UGIB

In this study of patients with UGIB, researchers compared the Glasgow-Blatchford and Rockall scores in predicting outcomes with UGIB; they found the GBS was equivalent to the RS for predicting rebleeding, need for endoscopy, or death, but was better than … Continue reading

Posted in GI | Comments Off

NSAIDs reduce post-ERCP pancreatitis

This large systematic review found rectal NSAIDs significantly reduced the risk of post-ERCP pancreatitis compared to pancreatic duct stents (abstract).

Posted in GI | Comments Off

Drug induced liver injury

This large population-based cohort found the most common causes of drug induced liver injury to be augmentin and diclofenac, followed by herbal and nutritional supplements (abstract).

Posted in GI | Comments Off

Early TPN in ICU patients

This large trial of patients with a relative contraindication for enteral feeds were randomized to early TPN or usual care. There were no differences in the groups in 60 day mortality or LOS, but those on TPN did have a … Continue reading

Posted in GI, Pulmonary and Critical Care | Comments Off

Guidelines for the management of ascites

The American Association for the Study of Liver Disease has released guidelines on the management of ascites. Among the recommendations, some include: use caution when prescribing agents that lower arterial blood pressure (such as ACE/ARBs), avoid the vaptan drugs, and … Continue reading

Posted in GI | Comments Off

Calculator assists with determining risk-benefit of ASA

This online risk calculator can help clinicians weigh the risks and benefits of ASA for individual patients (calculator).

Posted in Cardiology, GI | Comments Off