Gastrointestinal History
Gastrointestinal History

 

 

 

 

Hepatitis B

 
 
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Overview

    • Ask About

    • Diagnosis - cause (if known), when diagnosed
    • Manifestations - cirrhosis, polyarteritis nodosa, membranous glomerulonephropathy
    • Management - antivirals, surveillance

    • Risk Factors for Hepatitis B Infection

    • Certain ethnic groups
    • Children of hepatitis B positive mothers
    • Iatrogenic exposure - surgery, colonoscopy, haemodialysis, blood transfusion prior to 1990
    • High risk sexual behaviour
    • Healthcare workers
    • IV drug use
    • Prisoners
    • Tattoos

Manifestations

    • Manifestations of Hepatitis B Infection

    • Hepatic

    • Acute hepatitis
    • Chronic hepatitis
    • Cirrhosis
    • Hepatitis D infection

    • Extrahepatic

    • Polyarteritis nodosa
    • Membranous glomerulonephropathy
    • Serum sickness-like syndrome (fevers, rash, myalgias, arthralgias)

    • Phases of Hepatitis B Infection

    • Immune tolerant - very early infection, prior to significant hepatitis
    • Immune active - attempted clearance of the virus by the immune system
    • Immune control - low viraemia due to clearance
    • Immune escape - recrudescence of viral replication and hepatitis

Management

    • Management of Hepatitis B

    • Non-Pharmacologic

    • Cirrhosis surveillance
    • HCC surveillance

    • Pharmacologic

    • Nucleoside analogues - entecavir, lamivudine
    • Nucleotide analogues - tenofovir
    • Pegylated interferon
 
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 Ananthakrishnan AN. Epidemiology and risk factors for IBD. Nature reviews Gastroenterology & hepatology. 2015 Apr;12(4):205. Apau D. Assessing abdominal pain through history taking and physical examination. Gastrointestinal Nursing. 2010 Sep; 8(7): 50 - 53.
Arce DA, Ermocilla CA, Costa HI. Evaluation of constipation. American family physician. 2002 Jun 1;65(11):2283-98.
 Argyrou A, Legaki E, Koutserimpas C, Gazouli M, Papaconstantinou I, Gkiokas G, Karamanolis G. Risk factors for gastroesophageal reflux disease and analysis of genetic contributors. World journal of clinical cases. 2018 Aug 16;6(8):176. Armstrong MJ, Adams LA, Canbay A, Syn WK. Extrahepatic complications of nonalcoholic fatty liver disease. Hepatology. 2014 Mar;59(3):1174-97. Astor FC, Hanft KL, Ciocon JO. Xerostomia: a prevalent condition in the elderly. Ear, nose, & throat journal. 1999 Jul;78(7):476-9.
Bates CM, Plevris JN. Clinical evaluation of abdominal pain in adults. Medicine. 2013 Feb 28;41(2):81-6.
 Chlabicz S, Flisiak R, Grzeszczuk A, Kovalchuk O, Prokopowicz D, Chyczewski L. Known and probable risk factors for hepatitis C infection: a case series in north-eastern Poland. World Journal of Gastroenterology: WJG. 2006 Jan 7;12(1):141. Collin GR, Russell JC. Endometriosis of the colon. Its diagnosis and management. The American surgeon. 1990 May;56(5):275-9. Corinaldesi R, Stanghellini V, Barbara G, Tomassetti P, De Giorgio R. Clinical approach to diarrhea. Internal and Emergency Medicine. 2012 Oct; 7(3 Suppl): 255-262. Drossman DA, Dumitrascu DL. Rome III: New standard for functional gastrointestinal disorders. Journal of Gastrointestinal and Liver Diseases. 2006 Sep;15(3):237. Elias E. Clinical and biochemical diagnosis of jaundice. Bailliere's Clinical Gastroenterology. 1989 Apr; 3(2): 357-385. Eskelinen M. Usefulness of history-taking in non-specific abdominal pain: a prospective study of 1333 patients with acute abdominal pain in Finland. In vivo 2012 Mar; 26 (2): 335. Feuerstein JD, Cheifetz AS. Ulcerative colitis: epidemiology, diagnosis, and management. InMayo Clinic Proceedings 2014 Nov 30 (Vol. 89, No. 11, pp. 1553-1563). Fields JM, Dean AJ. Systemic causes of abdominal pain. Emergency medicine clinics of North America. 2011 May 31;29(2):195-210.
Galossi A, Guarisco R, Bellis L, Puoti C. Extrahepatic manifestations of chronic HCV infection. Journal of Gastrointestinal and Liver Diseases. 2007 Mar 1;16(1):65.
 Gaude GS. Pulmonary manifestations of gastroesophageal reflux disease. Annals of thoracic medicine. 2009 Jul;4(3):115. Han SH. Extrahepatic manifestations of chronic hepatitis B. Clinics in liver disease. 2004 May;8(2):403-18. Hu XY, Li Y, Li LQ, Zheng Y, Lv JH, Huang SC, Zhang W, Liu L, Zhao L, Liu Z, Zhao XJ. Risk factors and biomarkers of non-alcoholic fatty liver disease: an observational cross-sectional population survey. BMJ open. 2018 Apr 1;8(4):e019974. Ingelfinger FJ. Differential diagnosis of jaundice. Disease-a-Month. 1958 Nov; 4(11): 1-42. Jamshed N, Lee ZE, Olden KW. Diagnostic Approach to Constipation in Adults. American Family Physician. 2011; 84(3): 299-306. Jensen T, Niwa K, Hisatome I, Kanbay M, Andres-Hernando A, Roncal-Jimenez CA, Sato Y, Garcia G, Ohno M, Lanaspa MA, Johnson RJ. Increased serum uric acid over five years is a risk factor for developing fatty liver. Scientific reports. 2018 Aug 6;8(1):11735. Johnson CM, Wei C, Ensor JE, Smolenski DJ, Amos CI, Levin B, Berry DA. Meta-analyses of colorectal cancer risk factors. Cancer causes & control. 2013 Jun 1;24(6):1207-22. Kappus MR, Sterling RK. Extrahepatic manifestations of acute hepatitis B virus infection. Gastroenterology & hepatology. 2013 Feb;9(2):123. Kirchhoff P, Clavien PA, Hahnloser D. Complications in colorectal surgery: risk factors and preventive strategies. Patient safety in surgery. 2010 Dec;4(1):5.
Lee L, Blaker P, Wilkinson M. Chronic constipation: current assessment and management. Prescriber-London. 2012 Dec 1;23(23):13.
 Levine JS, Burakoff R. Extraintestinal manifestations of inflammatory bowel disease. Gastroenterology & hepatology. 2011 Apr;7(4):235. Locke III GR, Talley NJ, Fett SL, Zinsmeister AR, Melton III LJ. Risk factors associated with symptoms of gastroesophageal reflux. The American journal of medicine. 1999 Jun 1;106(6):642-9. Macaluso CR, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. International journal of general medicine. 2012;5:789. McNamara R, Dean Aj. Approach to Acute Abdominal Pain. Emergency Medicine Clinics of North America. 2011 May; 29(2):159-173. Metz A, Hebbard G. Nausea and vomiting in adults: A diagnostic approach. Australian family physician. 2007 Sep 1;36(9):688. Milosavljevic T, Kosti?-Milosavljevi? M, Jovanovi? I, Krsti? M. Complications of peptic ulcer disease. Digestive diseases. 2011;29(5):491-3. Molodecky NA, Kaplan GG. Environmental risk factors for inflammatory bowel disease. Gastroenterology & hepatology. 2010 May;6(5):339. Napenas JJ, Brennan MT, Fox PC. Diagnosis and treatment of xerostomia (dry mouth). Odontology. 2009 Jul 1;97(2):76-83. Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Lifestyle related risk factors in the aetiology of gastro-oesophageal reflux. Gut. 2004 Dec 1;53(12):1730-5. Pfenninger JL, Zainea GG. Common anorectal conditions: Part I. Symptoms and complaints. American family physician. 2001 Jun;63(12):2391-8. Quigley EM, Hasler WL, Parkman HP. AGA technical review on nausea and vomiting. Gastroenterology. 2001 Jan 31;120(1):263-86. R SM. Evaluating dysphagia. Am Fam Physician. 2000;61:3639-3648. Rabinovitz M, Pitlik SD, Leifer M, Garty M, Rosenfeld JB. Unintentional weight loss: a retrospective analysis of 154 cases. Archives of internal medicine. 1986 Jan 1;146(1):186-7. Ramakrishnan K, Salinas RC. Peptic ulcer disease. American family physician. 2007 Oct 1;76(7). Roden DF, Altman KW. Causes of dysphagia among different age groups: a systematic review of the literature. Otolaryngologic Clinics of North America. 2013 Dec 31;46(6):965-87. Schechter GL. Systemic causes of dysphagia in adults. Otolaryngologic Clinics of North America. 1998 Jun 1;31(3):525-35. Schiller LR. Chronic diarrhea. Gastroenterology. 2004 Jul 31;127(1):287-93. Segal WN, Greenberg PD, Rockey DC, Cello JP, McQuaid KR. The outpatient evaluation of hematochezia. The American journal of gastroenterology. 1998 Feb 1;93(2):179-82. Vanni E, Marengo A, Mezzabotta L, Bugianesi E. Systemic complications of nonalcoholic fatty liver disease: when the liver is not an innocent bystander. InSeminars in liver disease 2015 Aug (Vol. 35, No. 03, pp. 236-249). Thieme Medical Publishers. Walker CL, Sack D, Black RE. Etiology of diarrhea in older children, adolescents and adults: a systematic review. PLoS Negl Trop Dis. 2010 Aug 3;4(8):e768. Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology. 1992 Jul;77(1):162-84. White GN, O'Rourke F, Ong BS, Cordato DJ, Chan DK. Dysphagia: causes, assessment, treatment, and management. Geriatrics. 2008 May 1;63(5). Yeh EL. Abdominal Pain. Clinics in geriatric medicine. 2007 May; 23 (2): 255.
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