A 55-year-old man is admitted to the ICU with an upper GI bleed. Urgent endoscopy demonstrates a duodenal ulcer with recent stigmata of bleeding. He reports using NSAIDs occasionally for back pain and he takes a daily PPI for heartburn. Which of the following would be the recommended method to check for Helicobacter pylori?
The GERD symptom of regurgitaton does not typically respond to acid suppressants.
Persistent GERD symptoms such as regurgitation may indicate poor response to PPI therapy.
Which of these GI and skin lesions should you worry about most? Is rhabdomyolysis usually the result of infection? See how well you do with this week’s questions. . .
The gram negative bacterium is a potential cause of dyspeptic symptoms, gastric/duodenal ulcers, and has been linked to gastric cancer.
Is H pylori a WHO class I carcinogen?
A new regulation provides a uniform standard definition to help patients who have celiac disease, up to 3 million Americans.
A 38-year-old woman presents with her third upper GI bleed secondary to duodenal ulcers in 3 years. Biopsies have been negative for Helicobacter pylori. She complains of diarrhea and an unintentional 5-lb weight loss. What test next?
Elevated serum gastrin will help confirm the presence of gastrinoma or multiple endocrine neoplasia type 1.
Proton pump inhibitors in GERD-associated heartburn are indicated to heal mucosal damage (erosive esophagitis).
GERD symptoms (regurgitation, heartburn, cough, globus) do not all respond to proton-pump inhibitor therapy.
Celiac disease and antibiotic exposure showed a significant statistical correlation in this study.
In Crohn disease patients, the algorithm evaluates infliximab bioavailability (serum levels) and immunogenicity (antibody testing)to guide further treatment.
Fermentable, oligo-, di-, mono-saccharides and polyols (FODMAPs), found in wheat and other foods, may cause GI symptoms for some affected patients.
Abdominal cramping develops in a 31-year-old healthy woman after she runs a marathon. Which of the following is most likely?
The majority of the cases that occur in marathon running are mild and self-limited with supportive care.
What is the best guide to the differential diagnosis of liver disease in a pregnant woman?
ACG recommendations for overt upper GI bleeding include assessment of hemodynamic status and initiation of resuscitative measures, as needed, as a first step.
Which of the following statements accurately describe(s) diverticular disease of the colon?
Chronic or recurrent pain or discomfort centered in the upper abdomen distinguishes dyspepsia from GERD, with a dominant symptom of heartburn.
Societal recommendations include surveillance esophagogastroduodenoscopy every 3 to 5 years for patients with Barrett esophagus, and proton pump inhibitor therapy for symptom control.
Because pregnancy can alter results of standard liver tests, use of the gestational age of the pregnancy is the best guide to the differential diagnosis.
Upper endoscopy demonstrates salmon-colored tongues that extend 2 cm above the squamocolumnar junction in a 42-year-old man with chronic GERD. Biopsies reveal intestinal metaplasia with no dysplasia. What now?
What do the American College of Gastroenterology recommendations for initial assessment and risk stratification for patients with ulcer bleeding include?
A 31-year-old woman had intermittent abdominal cramping for years. Which test should be ordered next to rule out celiac disease?
