Octreotide for small bowel bleeds . . . and other stories

Gastrointestinal angiodysplasiaAngiodysplasias are sometimes a cause of intractable small bowel bleeding, particularly among older people. Recurrent episodes of occult bleeding lead to iron deficiency anaemia and a need for red blood cell transfusions. An open label trial from the Netherlands suggests that the somatostatin analogueue octreotide is beneficial. Monthly intramuscular injections of long acting octreotide reduced transfusion requirements and the need for endoscopic therapy by around half compared with controls receiving usual care (Gastroenterology doi:10.1053/j.gastro.2023.12.020).Empathy in doctors treating chronic painThe secret of success is sincerity. Once you can fake that, you’ve got it made. This cynical bit of advice is variously attributed but, regardless of who said it first, doctors should substitute empathy for sincerity. In a large series of adults with chronic low back pain, patients who rated their doctors as very empathetic had better outcomes for pain, function, and health related quality of life than those who judged…
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