CPD: Gastrointestinal system

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CPD articles in this section reflect content in chapter one of the British National Formulary and relate to the gastrointestinal system

Helping cancer patients in the community

Cancer patients are spending more time out of hospital and in the community. Steve Williamson describes cancer services in the UK and looks at how community pharmacists can support those undergoing treatment

Supplying stoma products and services

Cherry Bwalya and Jo Sica continue with their look at how pharmacists can support  people with a stoma. They explain stoma products and the services that pharmacists can offer

Supporting patients with a stoma

In December 2010 community pharmacies in England and Wales wishing to supply ostomy appliances will have to meet new service specifications. In the first of two articles, Cherry Bwalya and Jo Sica look at how pharmacists can support patients with a stoma, which includes considering how stomas might interact with medicines

Emerging concerns with PPI therapy

Proton pump inhibitors have transformed the management of upper gastrointestinal acid-related disorders but potential consequences of potent acid suppression are now emerging. With this year marking the 21st anniversary of the launch of these medicines in the UK and pantoprazole recently joining omeprazole as an over-the-counter option, Angus Thompson highlights some of the concerns

Mesalazine: is changing to the cheapest really cost-effective?

With over a dozen mesalazine products available for ulcerative colitis, choosing between them can be difficult. Anja St.Clair Jones discusses some of the factors that prescribers should consider. Choice should not be based on cost alone, she says, but should take into account current management strategies and adherence

Opioid-induced bowel dysfunction

Although lifestyle changes and laxative treatment can offer limited benefit for patients with constipation caused by opioid medicines, opioid-receptor antagonists target the cause of constipation in such patients

Diarrhoea and vomiting in a child

No matter how hygienic a household, most children will experience bouts of gastroenteritis. To complement a previous CPD article on acute diarrhoea in adults, Sarah Marshall looks at the condition in children

Gastro-oesophageal reflux disease and its management

Gastro-oesophageal reflux is a normal physiological phenomenon occurring during brief periods of gastro-oesophageal sphincter relaxation. However, when refluxed acid exceeds normal limits this can affect quality of life and expose sufferers to risks of complications. Gareth Nickless and Paula Morgan give an overview of the management of gastro-oesophageal reflux disease 

Helicobacter pylori testing is an invest-to-save opportunity for PCOs

Gareth Malson looks at what is involved in offering Helicobacter pylori testing and eradication treatment from pharmacies (27 June 2009)

Management of constipation in palliative care

There is a lack of professional awareness and clear, practical guidance on the assessment, diagnosis and management of constipation in palliative care patients, say Ray Bunn, Gina Starnes and Catherine Gleeson. In this article, they share the clinical protocols for constipation that are used by the St Catherine’s Hospice inpatient unit and community specialist palliative care team in West Sussex 

Ulcerative colitis and nicotine

I’ve got ulcerative colitis and have  heard that nicotine has been used to treat it, but I don’t smoke. In fact, I hate cigarette smoke. What do you suggest? (24 January 2009)

Probiotics may improve irritable bowel syndrome (POEM)

Clinical question: Are probiotics beneficial in the treatment of irritable bowel syndrome?

Bariatric surgery

Two Life-long learning articles: A summary of current practice; Prescribing issues

Pretreatment eradication of Helicobacter pylori improves NSAID safety

Does eradication of Helicobacter pylori before initiating non-steroidal anti-inflammatory drug therapy prevent gastrointestinal complications? (POEM — Patient Oriented Evidence that Matters)

Sequential therapy better for H pylori eradication

Is sequential antibiotic therapy better than standard triple-drug therapy for Helicobacter pylori eradication? (POEM — Patient Oriented Evidence that Matters)

Treating acute diarrhoea in adults

Diarrhoea is one of the most common problems on which pharmacists are consulted: about one in five people in the UK suffer an episode at least once a year. Alan Nathan gives an overview of the symptom and looks at the advice pharmacists can give 

How to deal with constipation

Susan Allen outlines the causes of, and treatments for, constipation and discusses special groups pharmacists should consider

Haemorrhoids and anal fissures

Susan Allen looks at two common anorectal problems that pharmacists might encounter

Inflammatory bowel disease

Inflammatory bowel diseases are characterised by chronic, relapsing intestinal inflammation. Most of the currently available drug treatments aim to reduce the inflammation.

• Inflammatory bowel disease - the disease and its diagnosis (PDF 60K)
• Inflammatory bowel disease - drug treatment and its implications (PDF 65K)

All PPIs are equivalent for treatment of GORD

Is there any difference between proton pump inhibitors for the treatment of gastro-oesophageal reflux disease?

Management of gallstone disease

Gallstones are a major cause of health care expenditure and affect an estimated 5.5 million people in the UK. They are found in 12 per cent of men and 24 per cent of women.

Can hangovers be prevented or cured

Pam Mason takes a look at some old and new hangover remedies and the theories behind how they might work

Dealing with cases of hiccups

Although almost everyone has experienced hiccups, little is known about their cause or significance

Non-steroidal anti-inflammatory drugs

Three articles on minimising the gastrointestinal risks posed by NSAIDs

• Strategies against NSAID-induced gastrointestinal side effects: part 1
• Strategies against NSAID-induced gastrointestinal side effects: part 2
• How to change NSAID prescribing

Herbal therapeutics (8) Gastrointestinal system and liver disorders

This article considers evidence for the efficacy and safety of herbal medicines used to treat certain gastrointestinal system and liver disorders

Diseases of the liver

Two articles on the aetiology, management and complications of acute liver failure and the drug treatments available for a range of other liver diseases

• (1) Acute liver disease
• (2) Chronic liver disease

Coeliac disease – A case study

With the advent of more sensitive testing, it is estimated that the prevalence of coeliac disease has risen to as many as one in 300. Pharmacists need to have an appreciation of the difficulties faced by patients with coeliac disease and be able to offer good practical advice