Second Look Endoscopy

Scheduled endoscopic retreatment and surveillance "second-look" endoscopy are controversial approaches to bleeding peptic ulcer management. Although some studies have shown lower recurrent bleeding rates with repeated treatments, most studies have shown no benefit. The caveats of repeated endoscopy are at least twofold. Firstly, the delay of a definitive surgical intervention may be deleterious, particularly if the patient's clinical status deteriorates during that time (Olejnik et al, 2003). Secondly, endoscopic retreatment may increase the risk to the gastric or duodenal tissues, including necrosis which could lead to perforation. Most studies suggest that the number needed to treat (NNT) to prevent one episode of recurrent bleeding is too high to recommend routine second-look endoscopy. Selection of high risk patients based on clinical and endoscopic parameters may make the NNT smaller.

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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