WELCOME

GASTROENTEROLOGY

Presented by;
ASHWIN SHIBU
VITH PHARM D
• Gastroenterology is the study of the diseases of the gastrointestinal tract
which includes esophagus, stomach, small intestine, colon and rectum,
pancreas, gallbladder, bile ducts and liver.
COMMON TERMS
• Esophagitis
• Esophageal varices
• Portal hypertensive gastropathy
• Ascites
• Dyspepsia
• Malena
• Hematemesis
• Pancreatitis
• Delirium tremens
COMMON DISEASES
• Chronic liver disease (Fatty liver, Liver cirrhosis)
• Pancreatitis
• Ulcerative colitis
• Hepatitis B
• Peptic ulcer
• GERD
• Enteritis
RARE DISEASES

• Intestinal obstruction
• Short bowel syndrome
• Colon cancer
• Anorexia nervosa
• Hepatocellular carcinoma
DIAGNOSTIC TESTS
• Blood tests
-Liver function tests ( SGPT,SGOT, ALP, Ser. Alb, Glob)
• Imaging
- Ultrasonography
- Computed tomography
- MRI
• Endoscopy
- Esophagogastroduodenoscopy
- Colonoscopy
- Sigmoidoscopy
• Barium enema used X ray
• Urea breath test, Rapid urease test
COMMONLY USED DRUGS
• PPI’s (Pantoprazole, Omeprazole, Rabeprazole)
• T. Ursodeoxycholic acid
• T. Atorvastatin
• Antacids ( Calcium carbonate, Sodium hydroxide, Magnesium hydroxide)
• T. Rifaximin
• T. Dicyclomine
• T. Domperidone
• T. Ondansetron
• T. Drotaverine
• T. Levosulpiride
• T. Surbex XT (Multivitamin)
• T. Antoxid
• BZDs (Clonazepam, Lorazepam)
• Enterogermina capsules
• Creon capsules (Pancrelipase)
• Probiotic capsules (Lactic acid bacillus)
• Polybion CZS (Multivitamins)
• C.Evion (Vitamin E)
• Peg fiber powder (Polyethylene glycol)
• Syp. Lactulose
• Syp. Sucralfate
• Syp. Aristozyme
• Syp. Heptagon (Silymarin,Lecithin,Zinc)
• Syp. Cremaffin plus (Liquid paraffin)
CASE PRESENTATION ON
LIVER CIRRHOSIS
Case study
• A 32 year old male patient came with complaints of abdominal pain
for few weeks and had 3 episodes of hematemesis today morning. The
patient also had two episodes of vomiting which contained only food
materials.

PERSONAL HISTORY
K/C/O CLD
GENERAL EXAMINATION-
BP-140/90mmHg
SPO2- 97% IN RA
PR- 88BPM
RS- AEBE
CNS- NFND
CVS-S1S2 +
P/A SOFT, NONTENDER
LAB DATA
PARAMETERS VALUE NORMAL VALUE
RBC 3.4 4.5-6 MIL/µL
PCV 34 42-52 %
MCV 100 76-96 fL
HB 10.2 14-17 g/dl
ESR 37 0-20 mm/hr
SGOT 89 5-45 U/L
PROTHROMBIN TIME 15.3 9-13 sec
Na 133 135-145 mEq/l
THIAMINE 1.8 2.5-7.5 µg

US ABDOMEN-
CHRONIC LIVER DISEASE/ CIRRHOSIS, MODERATE HEPATOMEGALY, MODERATE
SPLENOMEGALY AND PORTAL HYPERTENSION

ENDOSCOPY- SEVERE GASTROPATHY, ESOPHAGEAL VARICES

DIAGNOSIS
• From the subjective and objective date the patient was diagnosed with
liver cirrhosis with portal hypertension
 THERAPEUTIC PLAN
BRAND NAME GENERIC NAME ROUTE AND DAY1 DAY2 DAY3 DAY4 DAY5
FREQUENCY
INJ MAGNEX CEFOPERAZONE+S 1.5g IV BD     
FORTE ULBACTAM
INJ THIAMINE THIAMINE 100µg IV BD  - - - -
INJ PANTOCID PANTOPRAZOLE 40mg IV OD     
INJ TERLIPRESSIN TERLIPRESSIN 1AMP IN 10 ML     
NS OD
SYP LACTULOSE LACTULOSE 10ML, TID     
SYP SUCRALFATE SUCRALFATE 10ML, TID     
ENTEROGERMINA BACILLUS CLAUSII 1VIAL, OD - -   
SPORES
T. CARDIVAS CARVEDILOL 3.125MG, 1-0-1     
T. PHENERGAN PROMETHAZINE 25MG, BD     
HEPA PRO NUTRITIONAL PO, 2 SCOOPS - -   
SUPPLEMENT
DISCHARGE MEDICATIONS
• T. PANTOPRAZOLE 40MG 1-0-0
• T. DOMSTAL 10MG 1-0-1
• T. CARVEDILOL 3.125MG 1-0-1
• T. SURBEX GOLD OD
• SYP LOOZ 10ML OD
• HEPA PRO 2 SCOOPS TID
R/A 10 DAYS
THANK YOU