Health Matters: 3 June

This week’s Health Matters public lecture will look at an innovative pilot project in East Cheshire which will see doctors ‘Skype’ with patients in local nursing homes.

The talk, entitled Telehealth in East Cheshire – the future of care?, will be delivered by consultant gastroenterologist Dr Ramasamy Saravanan.  It will take place at Macclesfield District General Hospital’s Lecture Theatre on Tuesday, June 3rd, from 7pm to 8pm.

Abstract included in BMJ ‘Gut’

Abstract PTU-028 

SYMPTOM ASSESSMENT OF PATIENTS IN THE CHESHIRE BOWEL CANCER SCREENING PROGRAMME WITH A FINDING OF CANCER
doi:10.1136/gutjnl-2013-304907.120

1,*A Bond, 2J Everall, 2I London, K Koss. Gastroenterology, East Cheshire NHS Trust, Macclesfield; 2Gastroenterology/BCSP, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK

Introduction:
When attending the bowel cancer screening (BSC) programme patients undergo pre-colonoscopy assessment of their symptoms. This is conducted by the specialist screening practitioner for the BCS programme. Following a diagnosis of bowel cancer at colonoscopy the questions were asked again, after a 3–6 month period. Comparison could then be made to assess the validity of the pre-assessment questionnaire. It would also allow us to look at whether patients reported all symptoms during pre-assessment.

New guideline on the management of acute upper gastrointestinal bleeding

NICE publishes new guideline on the management of acute upper gastrointestinal bleeding

NICE, the healthcare guidance body, has today (Wednesday 13 June) published a new guideline on the management of acute upper gastrointestinal (GI) bleeding.

Bleeding in the oesophagus, stomach or duodenum is the most common emergency managed by gastroenterologists in the UK, with at least 50,000 hospital admissions per year.

Despite changes in management, mortality has not improved over the past 50 years. It is estimated that around one in ten hospital admissions for upper gastrointestinal bleeding results in the patient’s death – around 5000 deaths per year in the UK.

Upper gastrointestinal bleeding is usually caused by peptic ulcers, which can bleed as the ulcer erodes into an underlying artery, or oesophago-gastric varices (dilated veins in the oesophagus).

The guideline makes a number of key recommendations, including:

Offer endoscopy to unstable patients with severe acute upper gastrointestinal bleeding immediately after resuscitation.

Offer endoscopy within 24 hours of admission to all other patients with upper gastrointestinal bleeding.

Offer interventional radiology to unstable patients who re-bleed after endoscopic treatment. Refer urgently for surgery if interventional radiology is not promptly available.

Continue low-dose aspirin for secondary prevention of vascular events in patients with upper gastrointestinal bleeding in whom haemostasisi has been achieved.

via NICE publishes new guideline on the management of acute upper gastrointestinal bleeding.