Gastrointestinal Disorders

Guidelines for GERD: A practical approach

By Carl Sherman December 03, 2009

Start with antisecretory drugs, i.e., proton-pump inhibitors, then make medication, dosage, and lifestyle changes to suit the individual patient.
 

Colorectal cancer rising among younger patients

By Myra Dembrow July 13, 2009

New data support current screening recommendations, but family and other history will help you identify which patients need colonoscopy regardless of age.
 

More colonoscopies in your future?

By Myra Dembrow January 15, 2009

Primary-care physicians are performing colonoscopies as safely and effectively as specialists, a meta-analysis found. The American College of Gastroenterology disagrees.
 

Colonoscopy less useful in right-side cancer

By Delicia Yard December 17, 2008

A large Canadian study has found that complete colonoscopy is strongly associated with fewer deaths from colorectal cancer that develops on the left side, but the same can't be said when the cancer is located on the right.
 

Administering B12

Question asked by Isaac Blum, MD, Bronx, N.Y., and answered by Christopher Ruser, MD December 16, 2008

How should vitamin B12 be administered? I have read that injections are not necessary for administering vitamin B12—even in gastrectomy patients.
 

Fibrate used in combination with statin approved

December 16, 2008

The FDA has approved Trilipix (fenofibric acid), a delayed-release capsule for use along with diet to treat dyslipidemia. Trilipix is the first fibrate to be approved for use in combination with a statin.
 

Antibiotic-induced diarrhea

Submitted by Patricia L. Kress, MD, Eau Claire, Wis. November 21, 2008

To reduce the risk of antibiotic-associated diarrhea, I recommend yogurt with live cultures. The yogurt also helps settle diarrhea after a bout of gastroenteritis....
 

Differences in PPIs

Question asked by Steven Schwartz, MD, Bronx, N.Y., and answered by Christopher Ruser, MD November 21, 2008

Over many years, the difference in cost between omeprazole and some of the other proton-pump inhibitors (PPIs) can add up to thousands of dollars. There seems to be a widespread belief that other PPIs work better. Do they?
 

Recognizing celiac disease when there is no malabsorption

By Carl Sherman November 17, 2008

In more and more cases, celiac disease doesn't look the way you might expect.
 

Unusual epigastric pain and retching

CASE AND ANALYSIS BY EVERETT W. SCHLAM, MD September 30, 2008

Vague symptoms brought this patient to the ED three times before physicians made a rare diagnosis.
 

Who should be screened for celiac disease?

Question asked by Nathan W. Keever, DO, and answered by Laura G. Kehoe, MD July 22, 2008

It seems that I am seeing celiac disease diagnosed more frequently. I suspect this is because the antigliadin serology is available, but I worry that this is going to become an attention deficit disorder/fibromyalgia "diagnosis du jour." How good are these tests?
 

Rationale for DRE

Question by Daniel Konold, DO, Canal Winchester, Ohio May 30, 2008

If DRE is not recommended to screen for prostate or colon cancer, why do we do it?
 

Atypical GI symptoms with zoster

Question raised by Frank S. Sutton, MD, Encinitas, Calif. and answered by Cedric W. Spak, MD, MPH May 15, 2008

An 81-year-old man experienced five days of prodromic GI symptoms (distension, hyperactive peristalsis but no diarrhea, no emesis) prior to the onset of left lower-quadrant herpes zoster. The pain, which was unrelated to food intake, appeared to be the result of distension and was relieved by....
 

Colonoscopy for a healthy patient?

Question raised by Joseph R. Arulandu, MD and answered by Michael Flamm, MD April 17, 2008

Does a 50-year-old patient with parents in their 90s, no family history of cancer, and no bowel problems need a colonoscopy?
 

Easing esopageal spasms

Submitted made by Yanina M. Benikova, MD, Portland, Ore. and answered by Daniel G. Tobin, MD May 22, 2007

In most cases, drinking fluid (tea, water, etc.) as hot as possible without burning yourself will relieve painful esophageal spasms in seconds....
 

Thyroid-interferon interaction

Question raised by Butch Tubera, MD, Fort Worth, Tex., and answered by Susan Kashaf, MD, MPH March 14, 2007

A hepatitis C patient being treated with pegylated interferon alfa-2b and ribavirin has a low TSH and free thyroxine of 3.7 ng/dL.
 

CLINICAL PEARL: Another use for fish oil

Topic raised by Craig A. Freyer, MD, Ft. Worth, Tex. and answered by Susan Kashaf, MD, MPH April 18, 2006

 

Acute diarrhea: When and how to treat

Christina M. Surawicz, MD February 15, 2006

If a bacterium or parasite is involved, you could have a very sick patient on your hands. The earlier treatment begins, the better.
 

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