Colonoscopy

Colonoscopy can be both diagnostic and therapeutic. Studies have shown that it is a safe and accurate test early in the course of acute lower GI bleeding. Urgent colonoscopy is usually done within 6 to 24 hours of admission after a rapid colonic lavage using 4 to 8 L of a polyethylene glycol solution given orally or via NG tube over 3 to 5 hours until the rectal effluent is clear. There is ample evidence that a colonic purge is safe and will not reactivate or increase the rate of bleeding. The likelihood of finding a bleeding source is increased by performing urgent colonoscopy. The yield increases if the colonoscopy is performed while the patient is actively bleeding. The patient should be adequately resuscitated prior to performing urgent colonoscopy so that he or she can tolerate bowel purge and conscious sedation. As with peptic ulcer disease, criteria have been used to identify a colonic bleeding site. These include the finding of active bleeding, a nonbleed-ing visible vessel or an adherent clot, in conjunction with a diverticulum or angiodysplasia. Although these findings have been associated with increased bleeding severity in several studies, they lack validation. If colonoscopy does not reveal a bleeding source, an upper GI endoscopy is performed immediately. Colonoscopy can also be useful in localizing the bleeding source to the small bowel when fresh blood is seen in the terminal ileum, but not in the colon, and upper GI endoscopy is negative.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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