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5‐aminosalicylic acid (5‐ASA) is a commonly used medication for treatment of mild and moderately active ulcerative colitis (UC) and UC in remission. When UC affects only the lower third of the colon, 5‐ASA can be delivered as a rectal suppository, foam or liquid enema. This review includes nine randomized trials with a total of 484 participants. The limited data available suggest that rectal 5‐ASA is effective and safe for maintenance of remission in UC. Rectal 5‐ASA was found to be superior to placebo (e.g. enema or suppository with no active medicine). There was no difference in the incidence of side effects between rectal 5‐ASA and placebo groups. Side effects were generally mild in nature and common side effects included anal irritation and abdominal pain. Studies comparing rectal 5‐ASA with oral 5‐ASA (pills) found no differences in effectiveness for maintenance therapy. Well designed randomized trials are needed to investigate different doses of rectal 5‐ASA for maintenance therapy, Future studies should assess the effectiveness of combination therapy of oral 5‐ASA with rectal 5‐ASA as this has been found to be effective in active UC and has not been investigated for maintenance therapy. Future studies should also compare rectal 5‐ASA with rectal corticosteroids.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

This review compared double-contrast barium enema (DCBE) with computed tomographic colonography (CTC) for detection of colorectal polyps and concluded that DCBE had lower sensitivity and specificity than CTC for detecting colorectal polyps of at least 6mm. The reliability of the conclusions is unclear due to possible publication and language biases, failure to assess study quality and limitations in the analysis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Cancer is an important condition, both in terms of the number of people affected and the impacts on those people and the people close to them. Around one third of a million new cancers are diagnosed annually in the UK, across over 200 different cancer types. Each of these cancer types has different presenting features, though there may be overlap. More than one third of the population will develop a cancer in their lifetime. Although there have been large advances in treatment and survival, with a half of cancer sufferers now living at least ten years after diagnosis, it remains the case that more than a quarter of all people alive now will die of cancer.

NICE Guideline - National Collaborating Centre for Cancer (UK).

Version: June 2015

The purpose of this project was to provide national guidance on the optimal use of 99mTc during a situation of reduced supply. To accomplish this, our objective at CADTH was:

Optimal Use Report - Canadian Agency for Drugs and Technologies in Health.

Version: 2012

Venous thromboembolism (VTE) is a term used to include the formation of a blood clot (a thrombus) in a vein which may dislodge from its site of origin to travel in the blood, a phenomenon called embolism. A thrombus most commonly occurs in the deep veins of the legs; this is called deep vein thrombosis. A dislodged thrombus that travels to the lungs is known as a pulmonary embolism.

NICE Clinical Guidelines - National Clinical Guideline Centre – Acute and Chronic Conditions (UK).

Version: 2010

Without early diagnosis and treatment, an acute episode of constipation can lead to anal fissure and become chronic. By the time the child or young person is seen they may be in a vicious cycle. Children and young people and their families are often given conflicting advice and practice is inconsistent, making treatment potentially less effective and frustrating for all concerned. Early identification of constipation and effective treatment can improve outcomes for children and young people. This guideline provides strategies based on the best available evidence to support early identification, positive diagnosis and timely, effective management. Implementation of this guideline will provide a consistent, coordinated approach and will improve outcomes for children and young people.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: 2010

This guideline covers areas relevant to the diagnosis and management of irritable bowel syndrome (IBS) reflecting the complete patient journey, from the person presenting with IBS symptoms, positive diagnosis and management, targeted at symptom control. The guideline incorporates Cochrane reviews, published NICE clinical and public health guidance, Health Technology Assessment reports, systematic and health economic reviews produced by the National Collaborating Centre for Nursing and Supportive Care. Recommendations are based on clinical and cost effectiveness evidence, and where this is insufficient, the GDG used all available information sources and experience to make consensus recommendations using nominal group technique.

NICE Clinical Guidelines - National Collaborating Centre for Nursing and Supportive Care (UK).

Version: February 2008

Study finds that faecal calprotectin can be a highly sensitive way of detecting inflammatory bowel disease (IBD); in most cases, a negative calprotectin test result rules out IBD, thereby sparing most people with irritable bowel syndrome from having to undergo invasive investigations, such as colonoscopy.

Health Technology Assessment - NIHR Journals Library.

Version: November 2013

To create a systematic synthesis of the published evidence about the prevalence of eight geriatric syndromes and their association with survival and institutionalization, and to provide a review of models that report survival in elderly populations.

Evidence Syntheses/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: July 2011

For many people faecal incontinence is the result of a complex interplay of contributing factors, many of which can co-exist. Some may be relatively simple to reverse.

NICE Clinical Guidelines - National Collaborating Centre for Acute Care (UK).

Version: 2007

The gastrointestinal (GI) tract stretches from the mouth to the anus and gastrointestinal bleeding describes any bleeding that starts in the GI tract. Acute GI bleeding refers to the passage of a clinically significant amount of blood (i.e., the passage of more than a scant amount of blood) Acute bleeding in the upper part of the GI tract often presents with hematemesis (i.e., vomiting of blood or coffee-ground-like material) and/or melena (i.e., black, tarry stools). Patients with acute bleeding in the lower part of the GI tract often present with hematochezia (i.e., bright red blood in the stool). Acute GI bleeding represents a serious medical emergency that can result in death. For example, the mortality rate associated with acute lower GI bleeding is two to four percent.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: May 1, 2015

Expert-reviewed information summary about constipation, impaction, bowel obstruction, and diarrhea as complications of cancer or its treatment. The management of these problems is discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 6, 2016

Expert-reviewed information summary about constipation, impaction, bowel obstruction, and diarrhea as complications of cancer or its treatment. The management of these problems is discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: May 10, 2017

Multiplex testing in suspected infectious gastroenteritis has uncertain clinical value: testing generally identifies pathogens identified by conventional testing but also additional positive results of uncertain clinical importance.

Health Technology Assessment - NIHR Journals Library.

Version: April 2017

Expert-reviewed information summary about the treatment of gastrointestinal carcinoid tumors.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 19, 2016

Expert-reviewed information summary about the treatment of Gastrointestinal Stromal Tumors

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: May 10, 2017

The purpose of this report is to retrieve and review existing evidence of clinical efficacy, safety, and guidelines for bismuth treatment of diarrhea, nausea, indigestion, heartburn, and upset stomach. This report also aims to retrieve and review the existing evidence for the clinical efficacy and safety of bismuth as part of bismuth-containing quadruple therapy (BCQT) in the treatment of H. pylori infection. Finally this report will retrieve and review the existing guidelines on the use of BCQT for H. pylori eradication treatment.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 24, 2015

The incidence of acute upper gastrointestinal haemorrhage in the United Kingdom ranges between 84–172 /100,000/year, equating to 50–70,000 hospital admissions per year. This is therefore a relatively common medical emergency; it is also one that more often affects socially deprived communities.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: June 2012

Imatinib dose escalation is advocated for gastrointestinal stromal tumour (GIST) treatment, but its effectiveness compared with sunitinib and best supportive care (BSC) after failure at the 400 mg/day dose is unknown.

Health Technology Assessment - NIHR Journals Library.

Version: June 2011

Expert-reviewed information summary about the treatment of gastrointestinal carcinoid tumors.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 8, 2015

Systematic Reviews in PubMed

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