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| *Women health>>>Hepatitis |
Is hepatitis b cirrhotic patients have a GERD complications.? |
Is hepatitis b cirrhotic patients have a GERD complications.? Hi. For this problem is better you see "google". It's the better way to resolve your problem. Good luck. It is possible to develop GERD's unrelated to hepatitis B with cirrhosis of the liver. GERD means gastrointestinal reflux disease. Do you have reflux? If so, the medication may be causing that. Discuss with your physician. You can be given something to help with this. Please do. Thanks medical education training. no MAJOR RECOMMENDATIONS The recommendations that follow are those from the guideline's executive summary; detailed recommendations can be found in the original guideline document. Each recommendation is rated based on the level of the evidence and the grades of recommendation. Definitions of the grades of the recommendations (A, B, C, Good Practice Points) and level of the evidence (Level I-Level IV) are presented at the end of the Major Recommendations field. Hepatitis B Screening and Vaccination A - Serological screening for hepatitis B surface (HBs) antigen and antibody (HBs Ag, anti-HBs IgG) should be done within 6 months pre-vaccination for all, except newborns (Alderman et al., 1998). Hepatitis B vaccinations, except for newborns, should be given at months 0, 1, and 6, and anti-HBs IgG should be checked within 3 months after the booster dose at month 6. For newborns, vaccinations are given at months 0, 1, and 5. Newborns of hepatitis B virus鈥搃nfected mothers who are hepatitis B e antigen (HBeAg) positive should also be given hepatitis B immunoglobulin at birth. (Grade A, Level Ib) Hepatocellular Carcinoma (HCC) Surveillance for Patients with Chronic Hepatitis B Virus (HBV) Infection GPP - Patients should be told of the risks of hepatocellular carcinoma (HCC) associated with chronic hepatitis B infection and offered the option of hepatocellular carcinoma surveillance. For patients who are agreeable to surveillance, ultrasonography and serum alpha-fetoprotein should be done at regular intervals. Ultrasonography should be done at 6- and 12-monthly intervals for cirrhotic and non-cirrhotic patients, respectively. Patients' blood should be sampled for alpha-fetoprotein every 3 to 6 months and 6 to 12 months for cirrhotic and non-cirrhotic patients, respectively. (GPP) Surveillance of Exacerbation of Hepatitis B GPP - Patients with normal serum alanine transaminase (ALT) levels should have 6-monthly outpatient follow-up visits with repeat serum ALT done at each visit. Patients with elevated serum ALT levels should have more frequent follow-up visits, with repeat liver function tests carried out based on the physician-in-charge's discretion. (GPP) Treatment of Chronic Hepatitis B B - Viraemic patients (i.e., patients who are hepatitis B e antigen [HBeAg] positive and/or hepatitis B virus deoxyribonucleic acid [HBV DNA] positive) should be considered for treatment if the serum ALT is persistently (three or more readings) above twice the upper limit of normal. The three currently available choices of therapeutic agents are interferon鈥揳lpha, thymosin alpha-1, and lamivudine. Choice of the available therapeutic agents should be individualised, taking into consideration the contraindications for use in specific patients. (Grade A, Levels Ia & Ib) Definitions: Grades of Recommendations Grade A (evidence levels Ia, Ib): Requires at least one randomised controlled trial as part of the body of literature of overall good quality and consistency addressing the specific recommendation. Grade B (evidence levels IIa, IIb, III): Requires availability of well conducted clinical studies but no randomised clinical trials on the topic of recommendation. Grade C (evidence level IV): Requires evidence obtained from expert committee reports or opinions and/or clinical experiences of respected authorities. Indicates absence of directly applicable clinical studies of good quality. Good Practice Points: Recommended best practice based on the clinical experience of the guideline development group. Levels of Evidence Level Ia: Evidence obtained from meta-analysis of randomised controlled trials. Level Ib: Evidence obtained from at least one randomised controlled trial. Level IIa: Evidence obtained from at least one well-designed controlled study without randomisation. Level IIb: Evidence obtained from at least one other type of well-designed quasi-experimental study. Level III: Evidence obtained from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies, and case studies. Level IV: Evidence obtained from expert committee reports or opinions and/or clinical experiences of respected authorities. CLINICAL ALGORITHM(S) An algorithm is provided in the original guideline document for the assessment and management of chronic hepatitis B virus infection. talk to your family doctor and see what his advise is |
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