Additional Information
Book Details
Abstract
This issue of Clinics in Geriatric Medicine, guest edited by Seymour Katz, MD, is devoted to Gastroenterology. Articles in this outstanding issue include Constipation: Understanding Mechanisms and Management; Vaccination status/Prophylaxis with GI Diseases; Reflux and Acid Peptic Diseases in Elderly; Anorectal Physiology/Pathophysiology in Elderly; Endoscopic Challenges; Colorectal Cancer of Elderly; Pancreatic Disease; GI Drug Interactions; Microscopic/Collagenous Colitis; Hepatitis B and C; IBD of the Elderly; Imaging Techniques in GI Diseases of Elderly; Dysphagia/Swallowing disorders of Elderly; and Clostridium difficile infection in the elderly.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Gastroenterology\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Clinics In Geriatric Medicine\r | xi | ||
| Preface | xiii | ||
| Gastrointestinal Drug Interactions Affecting the Elderly | 1 | ||
| Key points | 1 | ||
| Introduction | 1 | ||
| Drugs used in acid peptic diseases | 2 | ||
| Hypertension Medications | 2 | ||
| Diabetes Medications | 3 | ||
| Hyperlipidemia Medications | 3 | ||
| Arthritis/Pain Medications | 3 | ||
| Psychotropic Medications | 4 | ||
| Constipation | 4 | ||
| Hypertension Medications | 4 | ||
| Diabetes Medications | 6 | ||
| Hyperlipidemia Medications | 6 | ||
| Arthritis/Pain Medications | 6 | ||
| Psychotropic Medications | 6 | ||
| Diarrhea | 6 | ||
| Hypertension Medications | 6 | ||
| Diabetes Medications | 8 | ||
| Hyperlipidemia Medications | 8 | ||
| Arthritis/Pain Medications | 8 | ||
| Psychotropic Medications | 8 | ||
| Endoscopic procedural sedation | 8 | ||
| Hypertension Medications | 9 | ||
| Diabetes Medications | 9 | ||
| Hyperlipidemia Medications | 9 | ||
| Arthritis/Pain Medications | 11 | ||
| Psychotropic Medications | 11 | ||
| Inflammatory Bowel Disease | 11 | ||
| Hypertension Medications | 11 | ||
| Diabetic Medications | 11 | ||
| Hyperlipidemia Medications | 12 | ||
| Arthritis/Pain Medications | 12 | ||
| Psychotropic Medications | 14 | ||
| Summary | 14 | ||
| References | 14 | ||
| Vaccinations in Older Adults with Gastrointestinal Diseases | 17 | ||
| Key points | 17 | ||
| Introduction | 17 | ||
| Elderly response to vaccination | 18 | ||
| Clinical vignettes | 18 | ||
| Case 1 | 18 | ||
| Case 2 | 18 | ||
| Vaccination principles for persons of age 60 and older | 18 | ||
| MMR Vaccination | 18 | ||
| Pneumococcal Vaccination | 18 | ||
| Zoster Vaccination | 22 | ||
| Influenza Vaccination | 22 | ||
| Hepatitis C, chronic liver disease, and infections in the elderly | 22 | ||
| Hepatitis C Virus | 22 | ||
| Autoimmune Hepatitis | 23 | ||
| Chronic Liver Disease and Cirrhosis | 23 | ||
| Summary of Vaccine Recommendations for Elderly Patients with Advanced Liver Disease and Cirrhosis | 24 | ||
| Inflammatory bowel disease | 24 | ||
| Vaccine Responses in IBD | 24 | ||
| Herpes Zoster Vaccine | 25 | ||
| Summary of Vaccine Recommendations for Elderly Patients with IBD | 25 | ||
| Summary | 26 | ||
| Clinical vignette answers | 26 | ||
| Case 1 | 26 | ||
| Case 2 | 26 | ||
| References | 26 | ||
| Reflux and Acid Peptic Diseases in the Elderly | 29 | ||
| Key points | 29 | ||
| Introduction | 29 | ||
| Epidemiology | 29 | ||
| Symptoms | 30 | ||
| Diagnosis | 31 | ||
| Complications | 32 | ||
| Treatment | 33 | ||
| Goals of GERD Therapy in an Elderly Population | 33 | ||
| Dietary and Lifestyle Modifications | 33 | ||
| Over-The-Counter Drugs | 33 | ||
| Prescription Medications | 34 | ||
| Pharmacokinetic Considerations and Long-Term Tolerability of PPIs | 34 | ||
| Antireflux Surgery | 35 | ||
| Summary | 36 | ||
| References | 36 | ||
| Dysphagia in the Elderly | 43 | ||
| Key points | 43 | ||
| Introduction | 43 | ||
| Anatomy and physiology of swallowing | 44 | ||
| Pathophysiology of deglutition in the elderly | 45 | ||
| Approach to diagnosis | 45 | ||
| History and Physical Examination | 45 | ||
| Testing and Referral | 46 | ||
| Specific disorders | 47 | ||
| Oropharyngeal Dysphagia | 47 | ||
| Neuromuscular disorders | 47 | ||
| Microscopic Colitis | 55 | ||
| Key points | 55 | ||
| Introduction | 55 | ||
| Clinical findings | 55 | ||
| Epidemiology | 57 | ||
| Diagnosis | 58 | ||
| Pathophysiology | 58 | ||
| Genetic Predisposition | 58 | ||
| Reaction to Luminal Antigen | 58 | ||
| Abnormalities in Fluid Homeostasis | 59 | ||
| Bile Acid Malabsorption | 59 | ||
| Infection | 59 | ||
| Medication Side Effect | 59 | ||
| Hormonal Influence | 60 | ||
| Abnormal Collagen Metabolism | 60 | ||
| Treatment | 60 | ||
| Pharmacologic Treatment Options | 60 | ||
| Surgical Treatment Options | 62 | ||
| Summary | 62 | ||
| References | 62 | ||
| Medical Management of Inflammatory Bowel Disease in the Elderly | 67 | ||
| Key points | 67 | ||
| Introduction | 67 | ||
| Goals of Medical Therapy for Older Patients with IBD | 68 | ||
| 5-Aminosalicylate Treatment in the Elderly | 69 | ||
| Corticosteroid Treatment in the Elderly | 70 | ||
| Immunomodulator Treatment in the Elderly | 70 | ||
| Biological Treatment in the Elderly | 71 | ||
| Medication Utilization Among Elderly Patients with IBD | 72 | ||
| Polypharmacy and the Older Patient with IBD | 73 | ||
| Summary | 74 | ||
| References | 74 | ||
| Clostridium difficile Infection in the Elderly | 79 | ||
| Key points | 79 | ||
| Introduction | 79 | ||
| Clinical overview | 80 | ||
| Risk factors | 81 | ||
| Age | 81 | ||
| Antibiotics | 82 | ||
| Hospitalization and Long-term Care Facilities | 83 | ||
| Other Factors | 83 | ||
| Management strategies | 84 | ||
| Diagnosis | 84 | ||
| Therapy | 85 | ||
| Recurrent CDI | 85 | ||
| Prophylaxis | 85 | ||
| Prevention | 87 | ||
| Summary | 88 | ||
| References | 88 | ||
| Anorectal Physiology and Pathophysiology in the Elderly | 95 | ||
| Key points | 95 | ||
| Introduction | 95 | ||
| Functional anatomy and physiology | 96 | ||
| Biophysiologic and molecular effects of aging on neuromuscular function | 99 | ||
| Implications of aging neuromuscular function on anorectal disorders | 101 | ||
| Constipation and dyssynergic defecation | 102 | ||
| Fecal incontinence | 102 | ||
| Summary | 103 | ||
| References | 103 | ||
| Constipation | 107 | ||
| Key points | 107 | ||
| Introduction | 107 | ||
| Chronic Constipation: Definitions | 107 | ||
| Primary Constipation | 108 | ||
| Secondary Constipation | 109 | ||
| Clinical evaluation | 110 | ||
| Diagnostic Testing | 110 | ||
| Nonpharmacologic management of constipation | 111 | ||
| Dietary Changes | 111 | ||
| Biofeedback | 112 | ||
| Pharmacologic management of constipation | 112 | ||
| Bulk Fiber | 113 | ||
| Stimulant Laxatives | 113 | ||
| Stool Softeners | 113 | ||
| Lubricants | 113 | ||
| Osmotic Laxatives | 113 | ||
| Chloride-Channel Activator | 113 | ||
| Guanylate Cyclase C Activator | 113 | ||
| Serotonin Agonists | 114 | ||
| Summary | 114 | ||
| References | 114 | ||
| Colorectal Cancer and the Elderly | 117 | ||
| Key points | 117 | ||
| Introduction | 117 | ||
| Epidemiology | 118 | ||
| Screening modalities for colorectal cancer | 120 | ||
| Colonoscopy in elderly patients | 121 | ||
| Adverse Events | 121 | ||
| Bowel Preparation | 122 | ||
| Completion of Colonoscopy | 122 | ||
| Decisions regarding not screening and not treating colorectal cancer | 123 | ||
| Treatment | 125 | ||
| Summary | 126 | ||
| References | 126 | ||
| Endoscopy in the Elderly | 133 | ||
| Key points | 133 | ||
| Introduction | 133 | ||
| Age-related changes in physiology | 134 | ||
| Preprocedure assessment | 134 | ||
| Bowel preparation | 135 | ||
| Sedation | 135 | ||
| Upper endoscopy | 136 | ||
| Colonoscopy | 137 | ||
| Screening colonoscopy in the elderly | 138 | ||
| Endoscopic retrograde cholangiopancreatography | 140 | ||
| Endoscopic ultrasound | 140 | ||
| Percutaneous endoscopic gastrostomy | 141 | ||
| Videocapsule endoscopy | 141 | ||
| Deep enteroscopy | 141 | ||
| Summary | 142 | ||
| References | 142 | ||
| Hepatitis B and C | 149 | ||
| Key points | 149 | ||
| Hepatitis B | 149 | ||
| Introduction | 149 | ||
| Serologic Assays | 149 | ||
| Screening | 150 | ||
| Acute Hepatitis B | 150 | ||
| Chronic Hepatitis B | 152 | ||
| Phases of infection | 152 | ||
| Replicative phase: immune tolerance | 152 | ||
| Replicative phase: immune clearance | 152 | ||
| Low or nonreplication phase/inactive carrier state | 153 | ||
| Resolution of chronic HBV infection | 153 | ||
| Prognosis with chronic infection | 153 | ||
| Confection with Hepatitis C Virus or Hepatitis D Virus | 154 | ||
| Treatment of HBV | 154 | ||
| HBeAg-positive patients | 154 | ||
| HBeAg-negative patients | 154 | ||
| Treatment options | 155 | ||
| Interferon | 155 | ||
| Lamivudine | 155 | ||
| Adefovir | 156 | ||
| Telbivudine | 156 | ||
| Entecavir | 156 | ||
| Tenofovir | 156 | ||
| Treatment End Points | 156 | ||
| Hepatitis B in the Elderly: Special Considerations | 156 | ||
| Hepatitis C | 157 | ||
| Introduction | 157 | ||
| Screening for Hepatitis C | 157 | ||
| Management of Hepatitis C | 158 | ||
| Counseling | 158 | ||
| Symptom management | 158 | ||
| Antiviral Therapy | 159 | ||
| Fibrosis | 160 | ||
| Treatment options | 160 | ||
| Future Directions in Hepatitis C Therapy | 161 | ||
| Hepatitis C in the Elderly: Special Considerations | 162 | ||
| Summary | 162 | ||
| References | 163 | ||
| Index | 169 |