Gastroenterology

null

null

null

null

null

null

Gastroenterology

Resources for managing gastroenterology patients

8  articles in this collection
Written by Laurie-Anne Duquette, Audrey Mathieu, Ilyas-Abdi Mohamed, 

Overview of Liver Injuries

Clinical parameters and known mechanisms:     The main viral entry receptor of COVID19 is angiotensin converting enzyme 2 (ACE2). Because this receptor is expressed in different organs, like the liver, SARS-CoV-2 causes a systemic disease1.     14% to 53%of hospitalized patients with COVID-19 show elevated serum liver biochemistries such as ALT, AST and […]

Written by
03/29/2020

Management of Infected or Symptomatic IBD Patients

Direct management :  If immunosuppressants are taken, a careful monitoring should be offered if the patient show signs and symptoms suggestive for Covid-191. Temporarily withhold immunomodulators seems to be a reasonable strategy2-3. However, in a systematic review, 27% of patient who discontinued TNFa-inhibitor had IBD relapse after one year. This could lead to higher frequentation medical institutions […]

Written by
04/19/2020

Is Diarrhea a Frequent Symptom?

The incidence of diarrhea is varying from 2% to 33% and may be underestimated in clinical publications ACE2, a known receptor used by SARS-CoV2 to enter cells, is more expressed in proximal and distal enterocytes SARS-CoV2 appears to invade mucosal cells of the stomach, small intestine and colon where it multiplies and creates virions.2 SARS-CoV […]

Written by
04/06/2020

GI Symptoms Association with Disease Severity

Diarrhea, vomiting, and nausea are symptoms identified in 11,4 % of patients.1 A study done in China demonstrated that patients with GI symptoms had a more severe case based on symptoms, radiologic aspect and laboratory results.1 Another study, done in Zhuhai (China), demonstrated that the presence of SARS-CoV-2 RNA in feces does not necessarily correlate with more severe GI […]

Written by
04/01/2020

Risk and Complications Associated with IBD

No increased risk of contracting Covid-19 have been proved for patients  with inflammatory bowel disease (IBD) with present available data1.   Potential risk factors of SARS-CoV-2 infection for IBD patients is suspected if 2 : Immunosuppressive agents are taken The disease is in an active-stage combined with malnutrition Patient frequently visits medical clinic Underlying health conditions are […]

Written by
04/18/2020

Is Pancreas Injury Common?

17% of the patients had abnormal lipase or amylase. Though no histopathological abnormalities were observed in pancreas of deceased patients, ACE2, a known receptor used by SARS-CoV2 to enter cells, is highly expressed in pancreas islets. Pancreatic injury could be related to local cytopathic effect of COVID-19 or systematic response to respiratory failure. Drug-induced pancreatic injury could also explain the phenomenom. […]

Written by
04/16/2020

Endoscopy During COVID-19 Outbreak

Upper gastrointestinal (GI) endoscopy is a high-risk procedure.  All patients scheduled for endoscopy should be classified according to their risk of COVID-19 based on the presence of respiratory symptoms, risk contacts and recent travel.  AGA recommends wearing N95 instead of the surgical mask for upper and lower endoscopy. AGA recommends wearing double gloves for all endoscopies. Endoscopies should […]

Written by
03/29/2020

Viral RNA in Fecal Samples

Fecal samples for SARS-CoV-2 RNA remained positive for around 11,2 days after negative respiratory tract samples for SARS-CoV-2 RNA.  Precautions should be installed as fecal-oral transmission remains possible, even after a clearance in the respiratory tract is proven.  Compared to a respiratory tract sample, a fecal sample can take longer to turn positive. Testing of […]

Written by
03/27/2020