Angiodysplasia medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
Pharmacological options like hormonal therapy, thalidomide and octreotide have been tried in patients with significant co-morbidities who cannot undergo invasive procedures. | Pharmacological options like hormonal therapy, thalidomide, and octreotide have been tried in patients with significant co-morbidities who cannot undergo invasive procedures. | ||
Studies have shown hormonal therapy with ethinylestradiol and norethisterone vs placebo have no difference in outcomes.<ref name="pmid11677198">{{cite journal| author=Junquera F, Feu F, Papo M, Videla S, Armengol JR, Bordas JM | display-authors=etal| title=A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. | journal=Gastroenterology | year= 2001 | volume= 121 | issue= 5 | pages= 1073-9 | pmid=11677198 | doi=10.1053/gast.2001.28650 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11677198 }} </ref> However, a few case series have shown positive results regarding the efficacy of hormonal therapy in chronic renal failure patients.<br /><ref name="pmid3488703">{{cite journal| author=Bronner MH, Pate MB, Cunningham JT, Marsh WH| title=Estrogen-progesterone therapy for bleeding gastrointestinal telangiectasias in chronic renal failure. An uncontrolled trial. | journal=Ann Intern Med | year= 1986 | volume= 105 | issue= 3 | pages= 371-4 | pmid=3488703 | doi=10.7326/0003-4819-105-3-371 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3488703 }} </ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 15:41, 9 October 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nikita Singh, M.D.[2]
Overview
Treatment is not required for incidentally found, asymptomatic, non-bleeding lesions. However, it is considered for non-bleeding angiodysplasia with symptoms of occult or overt GI bleed. The invasiveness of therapy depends on clinical severity of anemia, hemodynamic stability and recurrence of symptoms. Although endoscopic techniques are the first choice, hormonal therapy, thalidomide and octreotide are the pharmacological options that have been tried for patients with significant co-morbidities who cannot undergo invasive procedures.
Medical Therapy
Pharmacological options like hormonal therapy, thalidomide, and octreotide have been tried in patients with significant co-morbidities who cannot undergo invasive procedures.
Studies have shown hormonal therapy with ethinylestradiol and norethisterone vs placebo have no difference in outcomes.[1] However, a few case series have shown positive results regarding the efficacy of hormonal therapy in chronic renal failure patients.
[2]
References
- ↑ Junquera F, Feu F, Papo M, Videla S, Armengol JR, Bordas JM; et al. (2001). "A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia". Gastroenterology. 121 (5): 1073–9. doi:10.1053/gast.2001.28650. PMID 11677198.
- ↑ Bronner MH, Pate MB, Cunningham JT, Marsh WH (1986). "Estrogen-progesterone therapy for bleeding gastrointestinal telangiectasias in chronic renal failure. An uncontrolled trial". Ann Intern Med. 105 (3): 371–4. doi:10.7326/0003-4819-105-3-371. PMID 3488703.