January 26th 2024
Unplanned emergency service and medication utilization make up the majority of costs of IBD care, reported researchers.
Colorectal Cancer Screening: Which Tests, How Often?
February 1st 2007ABSTRACT: Screening options for colorectal cancer (CRC) include colonoscopy every 10 years, annual fecal occult blood testing, flexible sigmoidoscopy every 5 years, or double contrast barium enema every 5 years. In white patients at average risk, screening should begin at age 50; in African American patients, at age 45. Colonoscopy is preferred to sigmoidoscopy because it can detect proximal neoplasms and has the longest protection interval. High-risk patients include those with a family history of CRC or adenomas. These persons should begin colonoscopic screening at age 40, or 10 years earlier than the age at which CRC or adenomas were diagnosed in a first-degree relative. Other high-risk patients are those with a personal history of CRC, a genetic syndrome, or inflammatory bowel disease. In patients with CRC, the first follow-up colonoscopy is performed 1 year after surgery. If results are normal, the interval can be extended to every 3 years.
Acute Dx: What Cause of Sudden Illness?
December 31st 2006A 40-year-old man has had discomfort at the distal end of thefingers of both hands for several weeks. He has also noticed nail pitting andonycholysis. He denies any trauma or inciting event and has been otherwisehealthy. He has no family history of inflammatory bowel disease, althoughhe believes that some family members have had rashes.
Migrated Intracranial Aneurysm Clip
September 14th 2005A 53-year-old woman had complained of pain in the lower right quadrant of her abdomen for 1 year. She claimed that the pain intensified when she bent forward in a particular position but believed it was unrelated to food, bowel movements, or urination. There was no weight loss, vomiting, or melena. There was no family history of colon cancer or inflammatory bowel disease.
Postoperative Adhesive Obstructions
September 14th 2005Adhesions can form within the peritoneal cavity after abdominal surgery, especially if there is an underlying inflammatory condition such as appendicitis or inflammatory bowel disease. The incidence of adhesive intestinal obstruction following a laparotomy is approximately 2%. Most adhesive obstructions occur within 3 months of the laparotomy, and 80% occur within 2 years. Adhesive obstructions tend to be more common in children than in adults.
Pyoderma Gangrenosum: What to Include in the Differential Diagnosis
September 14th 2005Pyoderma gangrenosum (PG) is a chronic, recurrent condition characterized by cutaneous ulceration. In half of patients, PG is associated with an underlying illness, such as inflammatory bowel disease, RA, SLE, or a lymphoproliferative disorder.
Irritable Bowel Syndrome: A Diagnostic Approach
November 1st 2004ABSTRACT: The cardinal feature of irritable bowel syndrome (IBS) is abdominal pain or discomfort associated with altered bowel habits. Because no serologic marker or structural abnormality exists, the diagnosis is based on clinical findings. A systematic symptom-based approach, including the Rome II criteria, ensures diagnostic accuracy. Determine whether a specific event-such as gastroenteritis, antibiotic use, or a food-borne illness-precipitated the IBS symptoms. Be alert for warning signs of cancer, infection, or inflammatory bowel disease, such as fever or unexplained weight loss. Only minimal laboratory testing is required; however, further evaluation may be warranted if a patient does not respond to treatment or loses weight, if the dominant symptom changes, or if other "red flags" are identified.
Adhesive Obstruction: A Postoperative Complication
March 1st 2002Adhesions (A) can form within theperitoneal cavity after abdominalsurgery, especially if there is an underlyinginflammatory condition suchas appendicitis (B) or inflammatorybowel disease. The incidence of adhesiveintestinal obstruction following alaparotomy is approximately 2%. Mostadhesive obstructions occur within 3months of the laparotomy, and 80%occur within 2 years. Adhesive obstructionstend to be more commonin children than in adults.