Gastroenterology

A 47 y/o woman with cirrhosis, HCV, and chronic pancreatitis requests Demerol for the worst abdominal pain she has ever had. What's your diagnosis? 

True or False: Smoking causes IBD flares; peak IBD onset occurs in 3rd decade; UC affecting the rectum increases risk of colon cancer; plus 3 more.

True or False: Surgical removal of the colon will cure ulcerative colitis without significant long-term sequelae. Answer and 4 more statement challenges, here.

What might cause severe abdominal bloating & diarrhea 3 years after ileocolonic resection and adalimumab/methotrexate treatment? 

Two women with inflammatory bowel disease present in opposite states of health. How would you manage each?

On hospital day 3, abdominal pain continues for the 57-year-old man, made worse by oral intake. Abdominal US suggests next steps. What would you do?

These symptoms are recurrent despite patient's adherence to enzyme replacement therapy for pancreatitis. Your next step?

After endoscopic retrograde cholangiopancreatography with stone extraction, the picture gets complicated for this 40-year-old woman.

A 62-year-old man is transported to the ED after becoming incontinent in the middle of the night. He has a history of HCV. What do test results suggest?

The 31-year-old has not seen a healthcare provider in more than 10 years and claims good health until now. Lab and imaging results tell a different story.

The patient reports mild fatigue and pruritis but denies jaundice, scleral icterus, abdominal swelling. What’s your impression?

The patient also has a 2-year history of elevated ALP. Results of MRCP and liver biopsy guide next steps. What's your choice?

The 21-year-old recently immigrated from Mexico. She has had trouble swallowing both solids and liquids x4 months. The clue to diagnosis is a subtle one.

A bite of steak has been lodged in the patient's throat for 1 hour; why hasn't this bout of dysphagia resolved spontaneously?

A young woman presents with sharp LLQ pain, fever, and increased white count. What's your diagnosis? 

Two scenarios: a 42-y/o man with MRCP findings of concern and a 35-y/o woman s/p RNY and C-sections, with RUQ pain. Your solutions?

RUQ pain x3 days, fevers x24h. LFTs are elevated. Which of these tests should you order?

Slide Show: FDA drug approvals in the second quarter 2017 included these 10 for conditions seen in the primary care setting.

Test your knowledge by taking this quick quiz on new ACG prevention guidelines.

New ACG inflammatory bowel disease vaccination and screening guidelines call on primary care physicians as comanagers.

"Deep cleans" of UK hospitals was not the key to curtailing C diff infection; restricting use of one specific antibiotic was.

Controversy around dietary sugar guidelines and a study of red meat and diverticulitis top the latest research on food and GI disorders.

Does the abdominal CT shown offer a clue to the cause of this repeat but markedly more severe episode of hematochezia?

The "novel (and contradictory) finding..." say study authors, challenges conventional wisdom as well as current literature.