Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
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Clin. Gastroenterol. Hepatol. · Feb 2012
Randomized Controlled TrialAdding triamcinolone to endoscopic ultrasound-guided celiac plexus blockade does not reduce pain in patients with chronic pancreatitis.
The efficacy of endoscopic ultrasound-guided celiac plexus blockade (EUS-CPB) for painful chronic pancreatitis (CP) is uncertain. Triamcinolone is often mixed with bupivacaine to lengthen the analgesic effect. We investigated whether addition of triamcinolone increases and lengthens pain relief compared with EUS-CPB with only bupivacaine. ⋯ Triamcinolone does not increase pain relief or lengthen the effects of EUS-CPB.
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Clin. Gastroenterol. Hepatol. · Aug 2011
Randomized Controlled Trial Multicenter Study Comparative StudyLactated Ringer's solution reduces systemic inflammation compared with saline in patients with acute pancreatitis.
Aggressive fluid resuscitation is recommended for initial management of acute pancreatitis. We performed a randomized controlled trial to evaluate the impact of a goal-directed fluid resuscitation protocol on systemic inflammation in patients with acute pancreatitis. We then determined the impact of resuscitation with lactated Ringer's solution, compared with normal saline. ⋯ Patients with acute pancreatitis who were resuscitated with lactated Ringer's solution had reduced systemic inflammation compared with those who received saline.
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Clin. Gastroenterol. Hepatol. · Jul 2011
Randomized Controlled Trial Multicenter StudyOral bisacodyl is effective and well-tolerated in patients with chronic constipation.
Although stimulant laxatives have been used for many years to treat patients with constipation, their clinical value has been questioned, and there have been few high-quality trials to assess their efficacy. We tested the efficacy and safety of 4 weeks of treatment with oral bisacodyl tablets in patients with chronic constipation, defined by Rome III criteria. ⋯ Oral bisacodyl is an effective and well-tolerated treatment for patients with chronic constipation. It improves bowel function, constipation-related symptoms, and disease-related QOL.
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Clin. Gastroenterol. Hepatol. · Oct 2009
Randomized Controlled Trial Comparative StudyA randomized controlled trial of enemas in combination with oral laxative therapy for children with chronic constipation.
After 5 years of intensive oral laxative use, up to 30% of constipated children still have an unsuccessful outcome. Children refractory to oral laxatives might benefit from regular rectal evacuation by enemas. This randomized controlled trial compared the effects of additional treatment with rectal enemas (intervention) with conventional treatment alone (oral laxatives, control) in severely constipated children. ⋯ There is no additional effect of enemas compared with oral laxatives alone as maintenance therapy for severely constipated children.
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Clin. Gastroenterol. Hepatol. · Jul 2008
Randomized Controlled Trial Multicenter StudyEffect of the antidepressant venlafaxine in functional dyspepsia: a randomized, double-blind, placebo-controlled trial.
Antidepressants could be effective in the treatment of functional gastrointestinal disorders through their anticholinergic and pain-modulating effects. Previous studies with these drugs lacked sufficient power and were predominantly conducted in patients with irritable bowel syndrome. This study aimed to assess the effectiveness of the serotonin and norepinephrine reuptake inhibitor venlafaxine in patients with functional dyspepsia. ⋯ Treatment with the selective serotonin and norepinephrine reuptake inhibitor venlafaxine is not more effective than placebo in patients with functional dyspepsia.