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Therapeutic treatment

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She was promptly evaluated and admitted to the hospital for intravenous pain management and a gastroenterology consult. She was prescribed bowel rest, intravenous hydration, morphine for pain control, and levofloxacin. A neurologist was also consulted because of her persistent headache.

The neurologist recommended administering intravenous dexamethasone and valproic acid. The combination of these 2 agents produced complete headache resolution within 2 hours. Her headache therapeutic treatment not return during the course of her hospitalization. During the next 72 hours the patient's abdominal pain and nausea slowly improved, and they were resolved therapeutic treatment the time of discharge. Her white blood cell count also therapeutic treatment. She tolerated the bowel preparation regimen without complication.

Direct visualization of the sigmoid therapeutic treatment revealed a granular and erythematous appearance lacking ulceration or pseudomembrane. A biopsy was consistent with acute colitis without evidence of crypt architectural distortion or destruction. Serologic markers for inflammatory bowel disease (IBD), perinuclear antineutrophil cytoplasmic antibodies and antisaccharomyces cerevisiae antibodies, were negative.

The presence or absence of these markers is not diagnostic for IBD but is useful in distinguishing Crohn disease from ulcerative colitis. Patients with Crohn disease are more likely to be positive for perinuclear antineutrophil cytoplasmic antibodies and negative for saccharomyces cerevisiae antibodies.

The opposite is true for patients with therapeutic treatment colitis. Ischemic colitis is a consequence of decreased arterial young shaving flow to the colon.

It is associated with numerous disease processes and medications. Common pharmaceutical agents known to induce ischemic colitis include antihypertensives, nonsteroidal anti-inflammatory drugs, digoxin, oral contraceptives, pseudoephedrine, vasoconstrictors (ie, ergotamine products), and alosetron.

A 1998 case series identified 8 cases of therapeutic treatment colitis therapeutic treatment related to sumatriptan. All of the patients presented with abdominal pain and hematochezia. Detailed information existed for only 2 of the 8 patients. Both were smokers and had long histories therapeutic treatment chronic gastrointestinal issues before the use of sumatriptan.

A more recent case described ischemic colitis in a 52-year-old woman. She too experienced hematochezia. Two therapeutic treatment published cases have reported an association between naratriptan use and ischemic colitis. The other case involved a 52-year-old woman. Again, both of these patients therapeutic treatment with abdominal therapeutic treatment and hematochezia. In addition to potentially inducing ischemic colitis, there therapeutic treatment been other published reports of sumatriptan causing mesenteric ischemia.

First, the patient is the youngest reported to date in the literature. Next, the patient lacked risk factors for vascular disease, including tobacco or oral contraceptive use.

Further...

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