Endoscopic Therapy

Endoscopic Sclerotherapy

Endoscopic sclerotherapy has an efficacy rate of 75 to 90%. Endoscopic band ligation is an alternative to sclerotherapy. Meta-analytical studies have shown that hemostasis rates with band ligation are comparable to sclerotherapy in patients with active variceal bleeding. However, no specific benefits have been shown for this technique over injection sclerotherapy during active bleeding. Band ligation has been found to be safe in children with acute variceal bleeding. Although endoscopic treatment may be marginally better than somatostatin/octreotide in some meta-analytical studies, many carefully performed studies and a recent meta-analysis have failed to show any significant advantage for either form of treatment when used alone. Moreover, sclerotherapy was associated with more adverse events than somatostatin/ octreotide.

Band Ligation, Tissue Adhesives

About 15 to 20% of patients treated with endoscopic scle-rotherapy develop complications such as bleeding postscle-rotherapy ulcers, esophageal stenosis, or perforation of esophagus. it is likely that the complication rates are lower with band ligation. Tissue adhesives such as n-butyl-2-cyaoacrylate have also been used by intravariceal injection to obliterate varices. Tissue adhesives are not approved for intravariceal injection in the United States, but studies from elsewhere have claimed control of bleeding in approximately 90% of cases. The specific role for this treatment may be to obliterate fundal varices that respond unreliably to intravariceal injection of sclerosant or band ligation. Cerebral toxicity has been reported with the use of intravariceal injection of tissue adhesives. Currently there is no convincing evidence to recommend routine use of tissue adhesives for esophageal variceal obliteration.

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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