GI treatments Flashcards
Tx for anal fissures
- 1st line= fluid and fiber
- stool softeners
- protective ointments, sitz baths
- NTG ointment, topical CCB, Botox injection
Triad for chronic anal fissure
- fissure
- sentinel pile
- hypertrophied anal papilla
tx for anal fissures following failure of conservative tx
lateral anal sphicterotomy
symptomatic tx for internal hemorrhoids
- Stool softeners (docusate, psyllium)
- warm sitz bath
- Anesthetic ointments contining lidocain
- Witch hazel (Hamamelis) compresses
tx for bleeding internal hemorrhoids
injection sclerotherapy w/ 5% phenol in vegetable oil
Tx for larger, prolapsing internal hemorrhoids or those that don’t respond to conservative tx
rubber band ligation
Tx for thrombosed external hemorrhoids
excision
which 2 anticholinergic drug can be used as an antispasmodic in IBS
Hyoscyamine or dycyclomine 30-60 min before meals
Tx for large bowel obstruction (4)
NPO
nasogastric suction
IV fluids
Monitoring
Tx of large bowel obstruction if mechanical obstruction is expected
Urgent surgery
What are 2 things you can do to prevent medication induced esophagitis (NSAIDs, bisphosphonates)
- Drinking pills with at least 4 ounces of water
- avoid laying down for at least 30-60 min after ingestion
Tx for eosinophilic esophagitis (2)
- remove foods that incite allergic response
- topical steroids via inhaler
how do you tx corrosive esophagitis
steroid
Tx for HSV esophagitis
Acyclovir
Tx for CMV esophagitis
Ganciclovir
Tx for uncomplicated GERD (lifestyle)? What should be avoided
- elevating head of the bed 15cm (6in)
- avoiding eating w/in 2-3 hrs of bedtime
- avoid stimulants of acid secretion (coffee, alcohol)
- avoid drugs (anticholinergics)
- Foods (fats, chocolates, etc)
- Avoid smoking
drug therapy for GERD
- start w/ a low-dose H2 receptor antagonist (“-tidine”) QD then increasing to BID if needed
- Switch to PPI (“-prazole”) if sxs persist (start low and increase)
tx for at least 8 wks once sxs controlled
What are the 4 H2 receptor antagonists used to tx GERD
Famotidine
Ranitidine
Nizatidine
Cimetidine
What class of meds are used to tx GERD and end w/ “-prazole”
ex: omeprazole, pantoprazole
PPIs
Tx for NSAID induced gastritis
stop NSAIDs, empiric therapy w/ acid suppression 4-8wk of PPI
Tx for H.pylori gastritis
Clarithromycin
Amoxicillin +/- metronidazole
PPI (omeprazole)
What surgical procedure is indicated for refractory GERD
Nissen fundoplication