By Harry Dalton BSc DPhil MRCP Dip Med Ed
Derriford health center, Plymouth, U.K. consultant for relatives medical professionals operating with gastroenterologists. details at the popularity, follow-up, and carrying on with administration of sufferers with continual gastrointestinal problems. U.K. standpoint.
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Extra resources for Shared Care in Gastroenterology
As infection is acquired in childhood, the low prevalence at a young age is a feature of improving socioeconomic conditions in recent decades and is not expected to change (a ‘cohort’ effect). 3 Prevalence of H. pylori in developing countries. In many countries, over 85% of 20-year-olds are already infected. therefore reflects the socioeconomic conditions in the 1930s, 40s and 50s. Longitudinal studies on stored serum suggest that the prevalence of H. pylori has fallen over the last two decades in the developed world as living conditions have improved.
Gastro-oesophageal reflux is the commonest couse of dyspepsia in the community. Only a minority of symptomatic people come to medical Shared care in gastroenterology 24 attention and a very small minority develop complications. , eds. Gastroesophageal Reflux Disease. ) Presentation Abnormal reflux is more reliably diagnosed clinically than by endoscopy or barium studies. Consequently, patients should initially be treated symptomatically and not investigated; however, as only a minority of people with symptomatic reflux seek medical advice, the family doctor must also find out the reason for consulting.
Use antacids or alginates (GavisconTM, GastrocoteTM) for symptomatic relief and at bedtime; they work by forming a floating, viscous layer on top of gastric contents and present a physical barrier to reflux. Formation of this raft, however, requires a low pH, so combination with acid-suppressive measures is theoretically inappropriate. Prokinetic drugs (such as cisapride 10–20 mg twice daily, metoclopramide or domperidone 10 mg three times daily) accelerate oesophageal clearance of acid and gastric emptying, as well as increasing lower oesophageal sphincter pressure.