Iron Deficiency: Excluding serious causes
Iron deficiency is a common issue among patients presenting to general practice. Management requires oral or intravenous iron replacement coupled with clinical assessment and consideration of further investigations to exclude serious causes.
Modern Medicine – Issue 2 2023
GI Disruption May Underlie Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction which can have a considerable impact on quality of life. Following diagnosis, timely evidence-based management is vital to the care of patients with IBS, aiming to improve outcomes, and enhance patient satisfaction.
Modern Medicine – Issue 3 2022
The Tricky Task of Bowel Preparation for Colonoscopy
Colonoscopy procedures are routinely used for evaluating the colon, mostly for screening and early detection of colorectal cancer, which has a high incidence and mortality rate. Extensive data show that adequate bowel preparation is instrumental for the success of any colonoscopy procedure. Poor bowel preparation accounts for nearly 20% of failed colonoscopies, limiting the procedure’s diagnostic/therapeutic value.
Modern Medicine – Issue 2 2022
Diagnosing and Managing Lactose Intolerance
Lactose intolerance is a relatively new disease increasingly recognised in medicine in the last 50 years, although the symptoms were described by Hippocrates more than 2000 years ago. In the 1960s, research revealed that lactose intolerance was correlated with race and that lactose intolerance was more common globally than lactose tolerance. More recently, genetic causes of lactose intolerance have been identified.
Modern Medicine – Issue 6 2021
Managing PEI after Gastrointestinal Surgery
Pancreatic exocrine insufficiency (PEI) is associated with disorders of the pancreas such as chronic pancreatitis, acute necrotising pancreatitis and pancreatic cancer, but can also occur as a consequence of gastrointestinal (GI) and pancreatic surgery.
Modern Medicine – Issue 2 2021
Is it IBD? Making an Accurate and Prompt Diagnosis
Abdominal symptoms thought to be related to the lower gut (ileum and colon) are common, and most do not represent inflammatory bowel disease. Making an accurate and prompt diagnosis in general practice can be challenging at times. However, being aware of the range of differential diagnoses and the ways in which one can best estimate the pretest probability of each condition to enhance diagnostic accuracy is relatively straightforward
Modern Medicine – Issue 2 2021
More Than Just Reflux: The Era of Eosinophilic Oesophagitis
Eosinophilicoesophagit is (EoE) is a unique form of nonimmunoglobulin E (IgE) mediated food allergy. Adults with EoE typically present with food bolus impaction and/or dysphagia to solid foods. Children can have a more varied presentation, such as heartburn, failure to thrive, persistent vomiting or chronic abdominal pain. Allergy tests are not useful. First-line management options include proton pump inhibitors (PPIs), topical corticosteroids or dietary management. Response to PPIs and resolution of eosinophilia will occur in many patients with EoE.
Modern Medicine – Issue 4 2020
All Colonoscopies are not Created Equal
Colorectal cancer is the second‑most common cause of cancer-related deaths in the world. The natural history of colorectal cancer carcinogenesis through the adenoma-carcinoma sequence permits screening programmes to detect and remove pre-cancerous lesions. Inadequate bowel preparation has been associated with a 47% lower likelihood of adenoma detection, compared with adequate preparation – defined in terms of the proportion of the bowel visible. Poor bowel preparation results in longer or repeated procedures, with further cost and risk to the patient.
Modern Medicine – Issue 3 2020
Chronic Diarrhoea – It Happens!
Diarrhoea that persists beyond a few weeks can be functionally debilitating and an indication of a significant underlying medical problem. A systematic approach to diagnosis involving a thorough history, examination and carefully targeted investigations allows for identification of cause in most cases. Appropriate treatment of the underlying problem is associated with improved outcomes for patients compared with symptomatic management alone.
Modern Medicine – Issue 2 2020
The Risks and Benefits of PPIs Are they safe?
In recent years, barely a month goes by without another report linking use of proton pump inhibitors with adverse health outcomes, yet they remain among the most used classes of drugs worldwide. What is the story? Are they safe or not, and who should take them?
Modern Medicine – Issue 6 2019
