How does indomethacin prevent post-ERCP pancreatitis?

It is now established that indomethacin, a non-steroidal anti-inflammatory drug, at a dose of 100 mg, is effective in reducing the frequency and severity of pancreatitis (inflammation of the pancreas) after endoscopic retrograde cholangiopancreatography (ERCP) in high risk patients.

When to give indomethacin for ERCP?

In addition, administration of rectal indomethacin before ERCP is superior to administration after ERCP for the prevention of PEP. In conclusion, it is necessary to recommend rectal indomethacin before ERCP for the prevention of PEP in high-risk patients.

What is Post-ERCP pancreatitis?

Post-ERCP pancreatitis is diagnosed when patients develop signs and symptoms of acute pancreatitis (i.e. abdominal pain) in addition to elevation of pancreatic enzymes. But it is important to consider other causes of post-procedural abdominal pain, such as air insufflation and, less commonly, perforation.

Can ERCP cause chronic pancreatitis?

ERCP is associated with a 5%-10% risk of pancreatitis. The risk is increased in those cases where cannulation of the ducts is difficult, the pancreas is normal, or when a sphincterotomy is performed in the setting of sphincter of Oddi dysfunction. A prior history of ERCP-induced pancreatitis is also a risk factor.

Why is indomethacin given rectally?

Preliminary research suggests that rectally administered nonsteroidal antiinflammatory drugs may reduce the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).

How quickly does pancreatitis develop after ERCP?

Pancreatitis occurs when a patient experiences elevated levels of enzymes in the pancreas. The American Society for Gastrointestinal Endoscopy defines pancreatitis after ERCP as a threefold increase in pancreatic enzymes. This increase is present for more than 24 hours after the procedure.

How long after Indocid suppository Can I poop?

Push the suppository into the rectum with your finger. Remain lying down for a few minutes, and avoid having a bowel movement for at least an hour to allow the drug to be completely absorbed. The dosage is based on your medical condition and response to treatment. Adults should not use more than 200 milligrams per day.

What is Indocid 100mg used for?

Indocid is available in polyethylene glycol suppositories. Non-steroidal anti-inflammatory agent indicated for the active stages of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, acute musculoskeletal disorders, degenerative joint disease of the hip, low-back pain, and acute gouty arthritis.

How long does indomethacin stay in your system?

The mean half- life of indomethacin is estimated to be about 4.5 hours.

Can indomethacin cause intestinal bleeding?

This drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This side effect can occur without warning at any time during treatment with indomethacin. The elderly are at increased risk for serious stomach/intestinal bleeding.