RE: GI Information from the UMDF Conference

[Guest guest]

Thanks Bridget!

Kara Strittmatter

Communications Director,

UMDF

8085 Saltsburg Road,

Suite 201

Pittsburgh, PA 15239

Voice: , ext.

106

Fax:

Email: kara@...

GI Information from the

UMDF Conference

Sorry so long overdue!!!! Featured speaker

Mahmoud Sabri, MD from C.H.O.P.S. I thought this was a great talk with

lots of new info.

" Dysmotility & Pseudo-Obstruction "

Outline/Presentation

overview:

Identify if the patients GI issues are due to a

Neuropathy (contractions not coordinated) or a Myopathy (contractions weak)

Various Motility tests that can be done:

Esophageal Manometry, Antro-Duodena mano, colonic mano, anorectal mano, biliary

mano, barostat, etectrogastrography (non- invasive), transit study, and sitz

markers

Intestine (submucosal plexus and myentericplecus= the

" gut brain " )

·

The gut has as many neurones as the

spianl cord

·

Manometry can be done in the

office--go home results will record and then you can go

back(no overnight stay needed)

·

Barostat tests more the function of

the stomache. (the stomache has 3 units they are: 1) fundus 2)

body 3) pyloric antrum

·

Anal achalesia is when the anus

will not relax. Treatment that can be used--BOTOX!!

·

Motilitiy drugs--prokinetics/meto

clopramide, bethanechol, cisparide

·

" off label drug uses " :

erthromycin (in a high dose for gastroparesis, octreotide (delays

GI bleeding and gastric emptying) Peppermint oil for patients

with spastic abdominal pain

·

Cisparide-was one of the most

effective drugs but it was taken off the market it is available under

some circumstances.

·

Neostigmine is used to treat acute

colonic pseudo obstruction (2 mg IV over 2 minutes. A BM usually

occurs after 4 minutes. This MUST be given in an ICU setting. No

side effects.

·

Domperidone--Available in New

Mexico, Canadan. Good for adults w/diabetic gastropathy. Intestianl

and possibly esophageal motility. * some pharmacys can compound this drug

(legality??)

·

Serotonin-95% is in GI tract, 5% in

the CNS

·

Alosteron-Used in IBS of the

" diarhea " trype. withdrawn on 11/28/00. Available on

limited basis. Need to apply for it.

·

Tegaserod-found to stimulate

peristalitic relex in animals, increases colonic motility.

·

Small

Bowel Transplant 25 have been done at C.H.O.P.S. (only done when morbidity is evident)

·

Pacemaker--Gastric Electric Stimulator (approval within the next few years)

Prokinetics/The Future:

1. Erythromycin deritivatives Motildes

2. Enterokinetics more selective serotonin

agonists

3. Nitric oxide synthase inhibitors

4. Botulum toxins

Dr. Sabri is going to try to have his PowerPoint

presentation posted at the Children's Hospital of Pittsburgh web site.

Also, you can buy video or audio tapes of this or any other presentation at

: Encore Audio Archives 1- (cost is very low)