The lancet. Gastroenterology & hepatology
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Lancet Gastroenterol Hepatol · Feb 2017
Review Meta Analysis Comparative StudyRisk of gastrointestinal bleeding with direct oral anticoagulants: a systematic review and network meta-analysis.
Direct oral anticoagulants are increasingly used for a wide range of indications. However, data are conflicting about the risk of major gastrointestinal bleeding with these drugs. We compared the risk of gastrointestinal bleeding with direct oral anticoagulants, warfarin, and low-molecular-weight heparin. ⋯ Leeds Teaching Hospitals Charitable Foundation.
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Lancet Gastroenterol Hepatol · Feb 2017
Review Meta Analysis Comparative StudyRisk of gastrointestinal bleeding with direct oral anticoagulants: a systematic review and network meta-analysis.
Direct oral anticoagulants are increasingly used for a wide range of indications. However, data are conflicting about the risk of major gastrointestinal bleeding with these drugs. We compared the risk of gastrointestinal bleeding with direct oral anticoagulants, warfarin, and low-molecular-weight heparin. ⋯ Leeds Teaching Hospitals Charitable Foundation.
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Lancet Gastroenterol Hepatol · Feb 2017
ReviewManagement of the multiple symptoms of irritable bowel syndrome.
Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders. A stepwise management approach is advocated for patients with IBS. For a substantial proportion of patients with mild symptoms, general management principles, including making a confident diagnosis and offering explanation, reassurance, and dietary and lifestyle advice, are sufficient. ⋯ In these patients, use of pharmacotherapy on the basis of the predominant symptom (constipation, diarrhoea, pain, or bloating) or combination of symptoms is the next step. For patients with symptoms that are refractory to these initial treatment options and those who have comorbid conditions or psychological symptoms, a combination of therapies should be used, and the use of psychotropic drugs and psychological treatment alternatives is often effective. Finally, the key to successful treatment of patients with IBS is a good physician-patient relationship and use of person-centred care principles.