Gastroenterology
- Fundic gland polyps: Should my patient stop taking PPIs?
Of the 2 types of these polyps, the sporadic type is linked to proton pump inhibitor use, whereas the syndromic type occurs on a background of familial adenomatous polyposis—a key distinction.
- Colovesical fistula in men with chronic urinary tract infection: A diagnostic challenge
Most cases are in older men with diverticular disease, Crohn disease, cancer, or iatrogenic injury. Suspect it especially in these patients with UTI symptoms refractory to conventional treatments.
- Evaluation and management of gastroesophageal reflux disease: A brief look at the updated guidelines
Updated guidelines from the American College of Gastroenterology address the evaluation and management of reflux disease, consequences of long-term PPI therapy, and emerging therapies.
- When should antithrombotic therapy be resumed after gastrointestinal bleeding?
The timing should be individualized after considering factors related to the bleeding event, thromboembolic risk, and patient comorbidities.
- Scaly plaques in a malnourished patient
A markedly low serum zinc level and the characteristic location of the rash in a patient with long-standing alcohol use disorder and cirrhosis led to the correct diagnosis.
- Mucinous ascites: Pseudomyxoma peritonei
A 59-year-old man presented with progressive abdominal distention that limited daily activities and oral intake. The ascitic fluid was markedly viscous and jelly-like.
Cirrhotic coagulopathy: A rebalanced hemostasisCirrhosis affects all 3 phases of coagulation, leading to a delicate new equilibrium, easily disturbed and tipped toward either bleeding or thrombosis by acute events such as infection, renal failure, and invasive procedures.
- Which ICU patients need stress ulcer prophylaxis?
An examination of the controversy surrounding stress ulcer prophylaxis in critically ill patients, with guidance for its appropriate use in this setting.
- A clinical trial and another clinical practice bites the dust, or should there not be an appendix?
Studies over the past 2 decades have assessed an alternative approach to acute appendicitis: treatment with systemic antibiotics and observation.
- Appendicitis management: Is it time for a change?
Antibiotic therapy has been a successful alternative to surgery for more than 60 years, but surgery is still the primary treatment.