Gastrointestinal Critical Care

The function of the gastrointestinal system is digestion and absorption of food, and it also provides energy to the body to perform routine activities. Disease in any organ of the digestive system results in digestive and absorptive dysfunction, leading to several symptoms. Sometimes, the condition is acute and serious, such as acute liver failure or acute pancreatitis, and requires immediate medical intervention.

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Disease and conditions

  • Acute Liver Failure: It is a condition with rapid deterioration of the liver function in patients with no medical history of liver disease. The causes include medications, such as paracetamol and hepatitis infection.
  • Management of Cirrhosis: Cirrhosis is a liver disease in which the scar tissues replace the healthy tissues of the liver. Treatment includes reducing alcohol consumption, drugs for treating hepatitis, and weight management.
  • Gastrointestinal Bleeds: Causes of gastrointestinal bleeding are peptic ulcer, esophageal varices, esophagitis, inflammatory bowel disease, gastrointestinal cancer, hemorrhoids, and anal fissures. Symptoms include black, tarry stools, vomiting blood, and rectal bleeding.
  • Acute Pancreatitis: It is a condition characterized by rapid inflammation in the pancreas. Symptoms of acute pancreatitis are fever, upper abdominal pain, nausea and vomiting, and rapid pulse.
  • Acute Intestinal Disorders: These include acute intestinal ischemia, acute intestine diverticulitis, acute intestinal obstruction, and acute vascular insufficiency of the intestine.
  • Abdominal Compartment Syndrome: It is characterized by organ dysfunction due to intra-abdominal hypertension. It requires prompt medical intervention, failure of which may lead to increased morbidity and mortality.
  • Procedures and treatments

    • Management of Encephalopathy : The management options for encephalopathy include antibiotics and laxatives. The other measures to improve the symptoms of encephalopathy are a change in dietary habits, avoiding alcohol consumption, treating constipation and urinary blockages, and avoiding certain medications (narcotics and sedatives).
    • Enteral and Parenteral Nutrition: These types of nutrition are provided to patients who cannot eat or digest food. Enteral nutrition involves delivering nutrition into the stomach or intestine by a tube. Parenteral nutrition is a method of delivering nutrition through an intravenous route.
    • Management of Paralytic Ileu : It is characterized by the paralysis of the muscles that move food through the intestine. The treatments of paralytic ileus include treating the underlying cause, such as infection, inflammation, or electrolytic balance, avoiding certain medications, resting the bowel (shifting to parenteral nutrition), and using prokinetic drugs (to promote peristalsis).
    • Management of Intra-abdominal Pressure: Management of intra-abdominal hypertension can be through drainage for the evacuation of fluid, decompression through a nasogastric tube for evacuation of the gastrointestinal content, and fluid resuscitation to correct a positive fluid balance. In some cases, the doctor may advise surgical decompression.
    • Post-Endoscopy Care: After endoscopy, the patient should drink a sufficient volume of water to quickly flush the sedatives, avoid alcohol consumption for at least 24 hours post-endoscopy, eat soft food to ease swallowing and reduce discomfort due to throat soreness, and walk to ease bloating.
    • Post-GI surgery care: The patient should follow all the instructions of the surgeon. Avoid taking a shower for at least 48 hours after surgery, take appropriate care of the wound, avoid wearing tight clothing, follow a healthy diet (as directed by the surgeon), and do not miss follow-up visits.
    • Post Liver Transplant Care: The patient after the liver transplant should take all medications as directed, eat a healthy diet, incorporate exercise into their daily routine, avoid alcohol consumption and smoking, avoid driving, weight lifting, and sexual activities until directed by the doctor, and consult the doctor in case of any symptoms.