In this podcast, Brooks Cash, MD, speaks astir the absorption of patients with acute oregon chronic intestinal pseudo-obstruction. Dr Cash besides spoke connected this taxable astatine The American College of Gastroenterology Annual Scientific Meeting 2022 during a lecture titled “In the Belly of the Beast: Acute and Chronic Intestinal Pseudo-Obstruction” arsenic portion of the ACG pharmacology course.
This podcast was recorded anterior to the ACG Annual Scientific Meeting.
Additional Resource:
- Cash B. In the belly of the beast: acute and chronic intestinal pseudo-obstruction. Talk presented at: ACG 2022; October 21-26, 2022; Charlotte, NC. Accessed October 12, 2022. https://acgmeetings.gi.org/
Brooks D. Cash, MD, is the part manager of Gastroenterology, Hepatology, and Nutrition with McGovern Medical School astatine UTHealth Houston (Houston, TX).
TRANSCRIPTION:
Jessica Bard Hello everyone, and invited to different installment of Podcast 360, your go-to assets for aesculapian quality and objective updates. I'm your moderator, Jessica Bard, with Consultant 360, a multidisciplinary aesculapian accusation network. Dr Brooks Cash is present to talk with america contiguous astir his league astatine ACG 2022, titled "In the Belly of the Beast: Acute and Chronic Intestinal Pseudo-Obstruction." Dr Cash is the part manager of Gastroenterology, Hepatology, and Nutrition with McGovern Medical School astatine UTHealth successful Houston, Texas. Thank you for joining america today, Dr Cash. Firstly, could you delight supply america with an overview of your session?
Dr Brooks Cash: Sure. My lecture is portion of a larger people called the ACG Pharmacology Course. It's an other people during the gathering and during this course, we person a fig of experts speech astir illness states and conditions successful GI that trust connected pharmaceutical therapies for their management. One of the things that I'm talking astir is, arsenic you mentioned, acute colonic pseudo obstruction.
This is simply a comparatively communal information that we get consulted connected chiefly successful the hospital. It's a information that is characterized by atony oregon a deficiency of motility of the GI tract, chiefly the colon, and that leads to a dilation of the colon, which tin go precise terrible and really tin effect successful perforation oregon sepsis oregon infection. This is simply a information that occurs successful sick patients, truthful patients who are hospitalized for immoderate fig of reasons. Many are postoperative, immoderate whitethorn person travel successful with pneumonia oregon sepsis oregon bosom attacks oregon different conditions, but thing has pushed them implicit the edge. They're precise sick and for immoderate reason, and we don't cognize precisely why, though we judge there's an imbalance with regards to the mode that the tense strategy of the gut is maintained due to the fact that of the terrible unwellness that these patients person that leads to this dysmotility and this dilation of the colon, which tin beryllium life-threatening if not dealt with.
Jessica Bard: Then you besides speech astir successful your league chronic pseudo-obstruction. What bash you program to notation successful your session?
Dr Brooks Cash: Yeah, truthful chronic pseudo-obstruction is not precisely the other of that, but it's a overmuch little communal information than acute colonic pseudo-obstruction. Now, I failed to notation with acute colonic pseudo-obstruction, the mode that we negociate that information is mostly by trying to reverse immoderate the underlying unwellness is that the diligent has, but determination are immoderate medications that we tin usage that beforehand motility of the colon. In my lecture, I spell implicit those medications, however to usage them, immoderate investigational therapies that person been looked at, arsenic well. We besides speech astir the endoscopic absorption of this condition, successful presumption of the acute colonic pseudo-obstruction.
For the chronic, this is simply a overmuch rarer condition, arsenic I mentioned. Usually, we brushwood this successful the outpatient setting. It's precise akin successful presentation. These are patients who volition person an expanding abdominal girth and bloating, and what we find successful these patients is they person immense dilation of their colon and sometimes adjacent their tiny intestine. It's a uncommon condition, astir 1 retired of a 100 1000 radical successful presumption of prevalence, typically older patients.
I speech successful my lecture astir antithetic theories arsenic to wherever this whitethorn travel from. It's apt a multifactorial information and it apt has a akin etiology oregon origin arsenic acute colonic pseudo-obstruction, which is fundamentally a dysfunction of the enteric tense strategy specified that there's not effectual connection from the nerves to the muscles. There whitethorn really beryllium muscular issues successful presumption of the muscles that enactment the GI tract that origin it to compression and evacuate and propulsion aerial and contents down towards the bottommost for eventual evacuation. There's immoderate benignant of an imbalance with that.
In summation to the diagnostic process, we speech astir the therapeutic process. We bash usage immoderate antithetic medications than we usage for acute colonic pseudo-obstruction. The issues with chronic is due to the fact that it's truthful uncommon and we don't person precise bully trials, we don't person immoderate ample studies of effectual therapies. All the trials that we person are precise descriptive. They're precise small, truly much lawsuit bid and lawsuit reports. But determination are immoderate therapies that person been shown to beryllium effectual successful immoderate patients with chronic intestinal pseudo obstruction, truthful I speech astir those, erstwhile to usage those, however to usage those medications, and past different aspects of trying to attraction for these patients, arsenic well.
Jessica Bard: What would you accidental are the cardinal take-home messages from your session?
Dr Brooks Cash: I deliberation the cardinal take-home messages are that for the acute colonic pseudo-obstruction, determination are aesculapian therapies disposable and we should usage those successful conjunction with our blimpish management, making definite the patient's electrolytes are okay, making definite that they're up and ambulating and moving astir erstwhile possible, and besides perchance utilizing those medications successful conjunction with endoscopic therapy. The therapeutic attack to acute colonic obstruction is truly multifactorial and complimentary. The take-home connection from chronic intestinal pseudo-obstruction is knowing however we diagnose this information and what the imaginable etiologies are, and past immoderate of the much effectual therapies that person been shown successful the literature, recognizing that determination is simply a deficiency of beardown grounds to enactment a batch of those antithetic therapies. But for galore clinicians who are not acquainted oregon arsenic acquainted with these conditions, they don't cognize however to dainty this oregon they whitethorn beryllium unfamiliar with immoderate of the approaches, and truthful having immoderate of those options disposable and educating them astir immoderate of those medications that tin beryllium effectual successful these patients is I deliberation the existent take-home connection for the portion astir chronic intestinal pseudo-obstruction.
Jessica Bard: Well, convey you Dr Cash. We truly admit your time. Is determination thing other that you'd similar to add?
Dr Brooks Cash: No, I conscionable privation to convey you for giving maine the accidental to speech astir this. These are uncommon conditions and yet particularly for the acute colonic pseudo-obstruction, rather important. I deliberation that folks who are capable to enactment and be the gathering volition hopefully get immoderate utile accusation that they'll beryllium capable to past instrumentality location and assistance their patients, truthful I admit the accidental to sermon this and beforehand it.
Jessica Bard: Absolutely. My pleasure. Thank you
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