Guidelines of the IBD working group of the Slovak Gastroenterology Society on the management of ulcerative colitis
Authors:
Society On The Management Of Ulcerative Colitis; T. Hlavatý 1
; A. Krajčovičová 1; M. Zakuciová 2; M. Greguš 1; I. Šturdík 1; T. Koller 1; J. Baláž 3; M. Huorka 1; Pracovná Skupina Pre Ibd Sgs
Authors place of work:
Gastroenterologické a hepatologické oddelenie, V. interná klinika LF UK a UN Bratislava
1; I. interná klinika LF UPJŠ a UN L. Pasteura, Košice
2; Hepatologicko-gastroenterologicko-transplantačné oddelenie, II. interná klinika SZU a FNsP F. D. Roosevelta Banská Bystrica
3
Published in the journal:
Gastroent Hepatol 2017; 71(3): 229-240
Category:
IBD: Guidelines
doi:
https://doi.org/10.14735/amgh2017csgh.info05
*Za skupinu členov Pracovnej skupiny pre IBD SGS: M. Bátovský, J. Malík, I. Bunganič, I. Čierna, L. Gombošová, M. Hlísta, M. Horáková, J. Janík, B. Kadlečková, P. Lietava, L. Lukáč, J. Tóth, J. Ušák, B. Valach, I. Valachová, E. Veselíny, J. Záň, Z. Zelinková
Summary
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.
Zdroje
1. Bátovský M, Jurgoš Ľ, Bielik J. Racionálna liečba chronických zápalov čreva. Metodický list racionálnej farmakoterapie 2002; 26 (2): 1–4.
2. Greguš M, Huorka M, Lukáč Ľ. Racionálna liečba chronických nešpecifických zápalov čreva. Metodický list racionálnej farmakoterapie 2007; 11 (5–6): 1–8.
3. Kužela L, Zakuciová M. Racionálna liečba chronických nešpecifických zápalov čreva. Štandardný diagnostický a terapeutický postup 2012; 15 (5–7): 1–12.
4. Brown BB. Delphi Process: a methodology used for the elicitation of opinions of experts. Santa Monica: The RAND Corporation 1968: 15.
5. Calvet X, Panés J, Alfaro N et al. Delphi consensus statement: quality indicators for inflammatory bowel disease comprehensive care units. J Crohns Colitis 2014; 8 (3): 240–251. doi: 10.1016/j.crohns.2013.10.010.
6. OCEBM Levels of Evidence Working Group. The Oxford levels of evidence 2 [online]. Available from: www.cebm.net/index.aspx?o=5653.
7. Howick J, Chalmers I, Glasziou P et al. The 2011 Oxford CEBM levels of evidence (introductory document). [online]. Available from: www.cebm.net/index.aspx?o= 5653.
8. Truelove ES, Witts LJ. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J 1955; 2 (4947): 1041–1048.
9. Vilela EG, Torres HO, Martins FP et al. Evaluation of inflammatory activity in Crohn’s disease and ulcerative colitis. World J Gastroenterol 2012; 18 (9): 872–881. doi: 10.3748/wjg.v18.i9.872.
10. Sutherland LR, Martin F, Greer S et al. 5-aminosalicylic acid enema in the treatment of distal ulcerative colitis, proctosigmoiditis, and proctitis. Gastroenterology 1987; 92 (6): 1894–1898.
11. Rizzello F, Gionchetti P, Venturi A et al. Review article: monitoring activity in ulcerative colitis. Aliment Pharmacol Ther 2002; 16 (Suppl 4): 3–6.
12. Annese V, Daperno M, Rutter MD et al. European evidence based consensus for endoscopy in inflammatory bowel disease. J Crohns Colitis 2013; 7 (12): 982–1018. doi: 10.1016/j.crohns.2013.09.016.
13. Silverberg MS, Satsangi J, Ahmad T et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol 2005; 19 (Suppl A): 5A–36A.
14. Seibold F, Fournier N, Beglinger C et al. Topical therapy is underused in patients with ulcerative colitis. J Crohns Colitis 2014; 8 (1): 56–63. doi: 10.1016/j.crohns.2013.03.005.
15. Gionchetti P, Rizzello F, Venturi A et al. Comparison of oral with rectal mesalazine in the treatment of ulcerative proctitis. Dis Colon Rectum 1998; 41 (1): 93–97.
16. Munkholm P, Michetti P, Probert CS et al. Best practice in the management of mild-to-moderately active ulcerative colitis and achieving maintenance of remission using mesalazine. Eur J Gastroenterol Hepatol 2010; 22 (8): 912–916.
17. Marshall J, Irvine E. Rectal corticosteroids versus alternative treatments in ulcerative colitis: a meta-analysis. Gut 1997; 40 (6): 775–781.
18. Regueiro M, Loftus EV, Steinhart AH et al. Medical management of left-sided ulcerative colitis and ulcerative proctitis: critical evaluation of therapeutic trials. Inflammatory bowel diseases 2006; 12 (10): 979–994.
19. Ng SC. Management of ulcerative colitis. In: Hart AL, Ng SC (eds). Inflammatory bowel disease: an evidence-based practical guide. Malta: Gutenberg Press Ltd 2012: 5–12.
20. Prokopová L, Ďuricová D, Bortlík M et al. Doporučené postupy pro podávání aminosalicylátů u nemocných s idiopatickými střevními záněty. Gastroent Hepatol 2012; 66 (5): 391–400.
21. Travis S, Stange E, Lémann M et al. European evidence-based consensus on the management of ulcerative colitis: current management. J Crohns Colitis 2008; 2 (1): 24–62. doi: 10.1016/j.crohns.2007.11. 002.
22. Dignass A, Lindsay JO, Sturm A et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohns Colitis 2012; 6 (10): 991–1030. doi: 10.1016/j.crohns.2012.09.002.
23. Meucci G, Vecchi M, Astegiano M et al. The natural history of ulcerative proctitis: a multicenter, retrospective study. Am J Gastroenterol 2000; 95 (2): 469–473.
24. Ruel J PS. Management of ulcerative colitis. In: Hart AL, Ng SC (eds). Inflammatory bowel disease: an evidence-based practical guide. Malta: Gutenberg Press Ltd 2012: 13–26.
25. Langholz E, Munkholm P, Davidsen M et al. Changes in extent of ulcerative colitis a study on the course and prognostic factors. Scand J Gastroenterol 1996; 31 (3): 260–266.
26. Safdi M, DeMicco M, Sninsky C et al. A double-blind comparison of oral versus rectal mesalamine versus combination therapy in the treatment of distal ulcerative colitis. Am J Gastroenterol 1997; 92 (10): 1867–1871.
27. Marteau P, Probert C, Lindgren S et al. Combined oral and enema treatment with Pentasa (mesalazine) is superior to oral therapy alone in patients with extensive mild/moderate active ulcerative colitis: a randomised, double blind, placebo controlled study. Gut 2005; 54 (7): 960–965.
28. Kruis W, Kiudelis G, Racz I et al. Once daily versus three times daily mesalazine granules in active ulcerative colitis: a double-blind, double-dummy, randomised, non-inferiority trial. Gut 2009; 58 (2): 233–240. doi: 10.1136/gut.2008.154 302.
29. Ford AC, Achkar J-P, Khan KJ et al. Efficacy of 5-aminosalicylates in ulcerative colitis: systematic review and meta-analysis. Am J Gastroenterol 2011; 106 (4): 601–616. doi: 10.1038/ajg.2011. 67.
30. d‘Albasio G, Pacini F, Camarri E et al. Combined therapy with 5-aminosalicylic acid tablets and enemas for maintaining remission in ulcerative colitis: a randomized double-blind study. Am J Gastroenterol 1997; 92 (7): 1143–1147.
31. Yokoyama H, Takagi S, Kuriyama S et al. Effect of weekend 5-aminosalicylic acid (mesalazine) enema as maintenance therapy for ulcerative colitis: results from a randomized controlled study. Inflamm Bowel Dis 2007; 13 (9): 1115–1120.
32. Ho GT. Management of ulcerative colitis. In: Inflammatory bowel disease: an evidence-based practical guide. Malta: Gutenberg Press Ltd 2012: 27–36.
33. Probert CS, Dignass AU, Lindgren S et al. Combined oral and rectal mesalazine for the treatment of mild-to-moderately active ulcerative colitis: rapid symptom resolution and improvements in quality of life. J Crohns Colitis 2014; 8 (3): 200–207. doi: 10.1016/j.crohns.2013.08. 007.
34. Moody GA, Eaden JA, Helyes Z et al. Oral or rectal administration of drugs in IBD? Aliment Pharmacol Ther 1997; 11 (5): 999–1000.
35. Verna EC, Lucak S. Use of probiotics in gastrointestinal disorders: what to recommend? Therap Adv Gastroenterol 2010; 3 (5): 307–319. doi: 10.1177/ 1756283X10373814.
36. Sang L-X, Chang B, Zhang W-L et al. Remission induction and maintenance effect of probiotics on ulcerative colitis: a meta-analysis. World J Gastroenterol 2010; 16 (15): 1908–1915.
37. Cain AM, Karpa KD. Clinical utility of probiotics in inflammatory bowel disease. Altern Ther Health Med 2011; 17 (1): 72–79.
38. Do VT, Baird BG, Kockler DR. Probiotics for maintaining remission of ulcerative colitis in adults. Ann Pharmacother 2010; 44 (3): 565–571. doi: 10.1345/aph.1M 498.
39. Wang Y, Parker CE, Bhanji T et al. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2016; 4: CD000 543. doi: 10.1002/14651858.CD000543. pub4.
40. Ford AC, Kane SV, Khan KJ et al. Efficacy of 5-aminosalicylates in Crohn’s disease: systematic review and meta-analysis. Am J Gastroenterol 2011; 106 (4): 617–629. doi: 10.1038/ajg. 2011.71.
41. Lichtenstein GR, Ramsey D, Rubin DT. Randomised clinical trial: delayed-release oral mesalazine 4.8 g/day vs. 2.4 g/day in endoscopic mucosal healing – ASCEND I and II combined analysis. Aliment Pharmacol Ther 2011; 33 (6): 672–678. doi: 10.1111/j.1365-2036.2010.04 575.x.
42. Truelove SC, Watkinson G, Draper G. Comparison of corticosteroid and sulphasalazine therapy in ulcerative colitis. Br Med J 1962; 2 (5321): 1708–1711.
43. Dignass A, Lindsay JO, Sturm A et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohns Colitis 2012; 6 (10): 991–1030. doi: 10.1016/j.crohns.2012.09. 002.
44. Rutgeerts P, Sandborn WJ, Feagan BG et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 2005; 353 (23): 2462–2476.
45. Reinisch W, Sandborn WJ, Hommes DW et al. Adalimumab for induction of clinical remission in moderately to severely active ulcerative colitis: results of a randomised controlled trial. Gut 2011; 60 (6): 780–787. doi: 10.1136/gut.2010.221 127.
46. Sandborn WJ, van Assche G, Rein-isch Wet al. Adalimumab induces and maintains clinical remission in patients with moderate-to-severe ulcerative colitis. Gastroenterology 2012; 142 (2): 257–265. doi: 10.1053/j.gastro.2011.10. 032.
47. Sandborn WJ, Feagan BG, Marano C et al. Subcutaneous golimumab induces clinical response and remission in patients with moderate-to-severe ulcerative colitis. Gastroenterology 2014; 146 (1): 85–95. doi: 10.1053/j.gastro.2013.05.048.
48. Feagan BG, Rutgeerts P, Sands BE et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 2013; 369 (8): 699–710. doi: 10.1056/NEJMoa1215734.
49. Chen X, Hou J, Yuan Y et al. Adalimumab for moderately to severely active ulcerative colitis: a systematic review and meta-analysis. BioDrugs 2016; 30 (3): 207–217. doi: 10.1007/s40259-016-0173-6.
50. Ben-Horin S, Casteele NV, Schreiber S et al. Biosimilars in inflammatory bowel disease: facts and fears of extrapolation. Clinical Gastroenterol Hepatol 2016; 14 (12): 1685–1696. doi: 10.1016/j.cgh.2016.05.023.
51. Gisbert JP, Marin AC, Chaparro M. The risk of relapse after anti-TNF discontinuation in inflammatory bowel disease: systematic review and meta-analysis. Am J Gastroenterol 2016; 111 (5): 632–647. doi: 10.1038/ajg.2016.54.
52. Sutherland L, Macdonald JK. Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev 2006; 2: CD000 544.
53. Feagan BG, Macdonald JK. Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev 2012; 10: CD000544. doi: 10.1002/14651858.CD000544. pub3.
54. d‘Albasio G, Pacini F, Camarri E et al. Combined therapy with 5-aminosalicylic acid tablets and enemas for maintaining remission in ulcerative colitis: a randomized double-blind study. Am J Gastroenterol 1997; 92 (7): 1143–1147.
55. Losurdo G, Iannone A, Contaldo A et al. Escherichia coli Nissle 1917 in Ulcerative colitis treatment: systematic review and meta-analysis. J Gastrointestin Liver Dis 2015; 24 (4): 499–505. doi: 10.15403/ jgld.2014.1121.244.ecn.
56. Timmer A, Patton PH, Chande N et al. Azathioprine and 6-mercaptopurine for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev 2016; 5: CD000478. doi: 10.1002/14651858.CD000 478.pub4.
57. Sandborn WJ, Feagan BG, Marano C et al. Subcutaneous golimumab maintains clinical response in patients with moderate-to-severe ulcerative colitis. Gastroenterology 2014; 146 (1): 96–109. doi: 10.1053/j.gastro.2013.06.010.
58. Panaccione R, Ghosh S, Middleton S et al. Combination therapy with infliximab and azathioprine is superior to monotherapy with either agent in ulcerative colitis. Gastroenterology 2014; 146 (2): 392–400.
59. Turner D, Walsh CM, Steinhart AH et al. Response to corticosteroids in severe ulcerative colitis: a systematic review of the literature and a meta-regression. Clinical Gastroenterol Hepatol 2007; 5 (1): 103–110.
60. Bernstein CN, Ng SC, Lakatos PL et al. A review of mortality and surgery in ulcerative colitis: milestones of the seriousness of the disease. Inflamm Bowel Dis 2013; 19 (9): 2001–2010. doi: 10.1097/ MIB.0b013e318281f3bb.
61. Arnott ID, Leiper K, Down C et al. Outcome of acute severe ulcerative colitis: data from the UK National IBD Audit. Gut 2009; 58: A33.
62. Travis SP, Farrant JM, Ricketts C et al. Predicting outcome in severe ulcerative colitis. Gut 1996; 38 (6): 905–910.
63. Lindgren SC, Flood LM, Kilander AF et al. Early predictors of glucocorticosteroid treatment failure in severe and moderately severe attacks of ulcerative colitis. Eur J Gastroenterol Hepatol 1998; 10 (10): 831–835.
64. Järnerot G, Hertervig E, Friis-Liby I et al. Infliximab as rescue therapy in severe to moderately severe ulcerative colitis: a randomized, placebo-controlled study. Gastroenterology 2005; 128 (7): 1805–1811.
65. Ho GT, Mowat C, Goddard CJ et al. Predicting the outcome of severe ulcerative colitis: development of a novel risk score to aid early selection of patients for second-line medical therapy or surgery. Aliment Pharmacol Ther 2004; 19 (10): 1079–1087.
66. Mowat C, Cole A, Windsor A et al. Guidelines for the management of inflammatory bowel disease in adults. Gut 2011; 60 (5): 571–607. doi: 10.1136/gut.2010.224 154.
67. van Assche G, Dignass A, Bokemeyer B et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis Part 3: Special situations. J Crohns Colitis. 2013; 7 (1): 1–33. doi: 10.1016/j.crohns.2012.09. 005.
68. Harbord M, Annese V, Vavricka SR et al. The First european evidence-based consensus on extra-intestinal manifestations in inflammatory bowel disease. J Crohns Colitis 2016; 10 (3): 239–254. doi: 10.1093/ecco-jcc/jjv213.
69. Fumery M, Xiaocang C, Dauchet L et al. Thromboembolic events and cardiovascular mortality in inflammatory bowel diseases: a meta-analysis of observational studies. J Crohns Colitis 2014; 8 (6): 469–479. doi: 10.1016/j.crohns.2013.09. 021.
70. Ananthakrishnan AN, Cagan A, Gainer VS et al. Thromboprophylaxis is associated with reduced post-hospitalization venous thromboembolic events in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol 2014; 12 (11): 1905–1910. doi: 10.1016/j.cgh.2014.02. 034.
71. Mantzaris GJ, Hatzis A, Kontogiannis P et al. Intravenous tobramycin and metronidazole as an adjunct to corticosteroids in acute, severe ulcerative colitis. Am J Gastroenterol 1994; 89 (1): 43–46.
72. Chapman RW, Selby WS, Jewell DP. Controlled trial of intravenous metronidazole as an adjunct to corticosteroids in severe ulcerative colitis. Gut 1986; 27 (10): 1210–1212.
73. Mantzaris GJ, Petraki K, Archavlis E et al. A prospective randomized controlled trial of intravenous ciprofloxacin as an adjunct to corticosteroids in acute, severe ulcerative colitis. Scand J Gastroenterol 2001; 36 (9): 971–974.
74. Laharie D, Bourreille A, Branche J et al. Ciclosporin versus infliximab in patients with severe ulcerative colitis refractory to intravenous steroids: a parallel, open-label randomised controlled trial. Lancet 2012; 380 (9857): 1909–1915. doi: 10.1016/S0140-6736 (12) 61084-8.
75. Narula N, Marshall JK, Colombel JF et al. Systematic review and meta-analysis: infliximab or cyclosporine as rescue therapy in patients with severe ulcerative colitis refractory to steroids. Am J Gastroenterol 2016; 111 (4): 477–491. doi: 10.1038/ajg.2016.7.
76. Van Assche G, D‘Haens G, Noman M et al. Randomized, double-blind comparison of 4 mg/kg versus 2 mg/kg intravenous cyclosporine in severe ulcerative colitis. Gastroenterology 2003; 125 (4): 1025–1031.
77. Monterubbianesi R, Aratari A, Armuzzi A et al. Infliximab three-dose induction regimen in severe corticosteroid-refractory ulcerative colitis: early and late outcome and predictors of colectomy. J Crohns Colitis 2014; 8 (8): 852–858. doi: 10.1016/j.crohns.2014.01.006.
78. Gibson DJ, Heetun ZS, Redmond CE et al. An accelerated infliximab induction regimen reduces the need for early colectomy in patients with acute severe ulcerative colitis. Clin Gastroenterol Hepatol 2015; 13 (2): 330–335. doi: 10.1016/j.cgh.2014.07.041.
79. Øresland T, Bemelman WA, Sampietro GM et al. European evidence based consensus on surgery for ulcerative colitis. J Crohns Colitis 2015; 9 (1): 4–25. doi: 10.1016/j.crohns.2014.08.012.
80. Randall J, Singh B, Warren BF et al. Delayed surgery for acute severe colitis is associated with increased risk of postoperative complications. Br J Surg 2010; 97 (3): 404–409. doi: 10.1002/bjs. 6874.
81. Coakley BA, Telem D, Nguyen S et al. Prolonged preoperative hospitalization correlates with worse outcomes after colectomy for acute fulminant ulcerative colitis. Surgery 2013; 153 (2): 242–248. doi: 10.1016/j.surg.2012.08.002.
82. Chowdhury MM, Dagash H, Pierro A. A systematic review of the impact of volume of surgery and specialization on patient outcome. Br J Surg 2007; 94 (2): 145–161.
83. Burns EM, Bottle A, Aylin P et al. Volume analysis of outcome following restorative proctocolectomy. Br J Surg 2011; 98 (3): 408–417. doi: 10.1002/bjs. 7312.
84. Shen B, Achkar JP, Lashner BA et al. A randomized clinical trial of ciprofloxacin and metronidazole to treat acute pouchitis. Inflamm Bowel Dis 2001; 7 (4): 301–305.
85. Sambuelli A, Boerr L, Negreira S et al. Budesonide enema in pouchitis – a double-blind, double-dummy, controlled trial. Aliment Pharmacol Ther 2002; 16 (1): 27–34.
86. Isaacs KL, Sandler RS, Abreu M et al. Rifaximin for the treatment of active pouchitis: a randomized, double-blind, placebo-controlled pilot study. Inflamm Bowel Dis 2007; 13 (10): 1250–1255.
87. Gionchetti P, Rizzello F, Morselli C et al. High-dose probiotics for the treatment of active pouchitis. Dis Colon Rectum 2007; 50 (12): 2075–2082.
88. Mimura T, Rizzello F, Helwig U et al. Four-week open-label trial of metronidazole and ciprofloxacin for the treatment of recurrent or refractory pouchitis. Aliment Pharmacol Ther 2002; 16 (5): 909–917.
89. Gionchetti P, Rizzello F, Venturi A et al. Antibiotic combination therapy in patients with chronic, treatment-resistant pouchitis. Aliment Pharmacol Ther 1999; 13 (6): 713–718.
90. Abdelrazeq A, Kelly S, Lund J et al. Rifaximin-ciprofloxacin combination therapy is effective in chronic active refractory pouchitis. Colorectal Dis 2005; 7 (2): 182–186.
91. Gionchetti P, Rizzello F, Poggioli G et al. Oral budesonide in the treatment of chronic refractory pouchitis. Aliment Pharmacol Ther 2007; 25 (10): 1231–1236.
92. Ferrante M, D‘Haens G, Dewit O et al. Efficacy of infliximab in refractory pouchitis and Crohn‘s disease-related complications of the pouch: a Belgian case series. Inflamm Bowel Dis 2010; 16 (2): 243–249. doi: 10.1002/ibd.21037.
93. Calabrese C, Gionchetti P, Rizzello F et al. Short-term treatment with infliximab in chronic refractory pouchitis and ileitis. Aliment Pharmacol Ther 2008; 27 (9): 759–764. doi: 10.1111/j.1365-2036. 2008.03656.x.
94. Barreiro-de Acosta M, García-Bosch O, Gordillo J et al. Efficacy of adalimumab rescue therapy in patients with chronic refractory pouchitis previously treated with infliximab: a case series. Eur J Gastroenterol Hepatol 2012; 24 (7): 756–758. doi: 10.1097/MEG.0b013e3283 525a7b.
95. Gionchetti P, Rizzello F, Helwig U et al. Prophylaxis of pouchitis onset with probiot-ic therapy: a double-blind, placebo-controlled trial. Gastroenterology 2003; 124 (5): 1202–1209.
96. Gionchetti P, Rizzello F, Venturi A et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 2000; 119 (2): 305–309.
97. Mimura T, Rizzello F, Helwig U et al. Once daily high dose probiotic therapy (VSL# 3) for maintaining remission in recurrent or refractory pouchitis. Gut 2004; 53 (1): 108–114.
98. Gosselink MP, Schouten WR, van Lieshout LM et al. Delay of the first onset of pouchitis by oral intake of the probiotic strain Lactobacillus rhamnosus GG. Dis Colon Rectum 2004; 47 (6): 876–884.
Štítky
Paediatric gastroenterology Gastroenterology and hepatology SurgeryČlánok vyšiel v časopise
Gastroenterology and Hepatology
2017 Číslo 3
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole vs. Tramadol in Postoperative Analgesia
- Spasmolytic Effect of Metamizole
- Possibilities of Using Metamizole in the Treatment of Acute Primary Headaches
- Current Insights into the Antispasmodic and Analgesic Effects of Metamizole on the Gastrointestinal Tract
Najčítanejšie v tomto čísle
- Rifaximin
- Guidelines of the IBD working group of the Slovak Gastroenterology Society on the management of ulcerative colitis
- Difficult diagnostics and serious biliary complications of liver echinococcosis
- Colonic decompression in daily practice