A 38-year-old woman presents with hematemesis. Upper endoscopy reveals a duodenal ulcer with an actively spurting vessel. Hemostasis is achieved with injection of epinephrine followed by thermal coagulation. She also has several other non-bleeding shallow ulcers in other portions of the duodenum. Biopsies are negative for H pylori. This has been her third presentation of an upper GI bleed secondary to duodenal ulcers in the past 2 years. She complains of intermittent diarrhea and has unintentionally lost 5 lb over the past month.
What's your next step?
Here’s an opportunity for primary care to have a major impact on patients with a specialty-treated disease. Specialists will never boost vaccination rates to where they need to be. It’s just not what they do.
All patients with inflammatory bowel disease are at risk for anemia at any stage of their illness. In the past few years, there has been been increasing acceptance of the safety, efficacy, and speed of correcting deficiency with intravenous iron. Here: the pros and cons of oral vs IV supplementation.
These data suggest it may be worth a try—before moving on to potentially more dangerous drugs.
Fourteen state legislatures have passed legislation mandating that retail stores provide access to employee bathrooms for individuals with ulcerative colitis and Crohn disease and other medical needs.
Results are in on the maintenance phase of the TAXIT trial that employed infliXImab to treat patients with Crohn Disease and ulcerative colitis. Details here.
It's easy to mistake other serious gastrointestinal problems for inflammatory bowel disease. Here: clinical pearls that can help you recognize the IBD mimics.
This first report of effectiveness in a single case study should prompt additional research and placebo-controlled trials.
Recurrent C difficile requires pulse vancomycin therapy; fecal microbiota transplant shows promise.
The goals of therapy for patients with inflammatory bowel disorder include inducing and maintaining a steroid-free remission, preventing and treating the complications of the disease, minimizing treatment toxicity, achieving mucosal healing, and enhancing quality of life.
(AUDIO) There are disparities in the sensitivities and specificities of glucose and lactose hydrogen breath tests used to diagnose small intestine bacterial overgrowth and to distinguish patients with irritable bowel syndrome from healthy individuals. Just how useful are these tests? Insights from an expert here.
(AUDIO) Here, Christina Surawicz, MD, describes an organized approach to the evaluation and management of patients with chronic diarrhea.