GI Pearls and Diagnostic Errors
|
|
|
- Patience Barnett
- 6 years ago
- Views:
Transcription
1 GI Pearls and Diagnostic Errors David A. Johnson MD MACG FASGE FACP Professor of Medicine Chief of Gastroenterology Eastern VA Medical School Norfolk VA
2 Disclosures Editor: NEJM J Watch Gastro (esophageal) : WebMD/MedScape (Gastro) Consultant: Pfizer, Aries, CRH Medical
3 Helicobacter pylori testing 34 year old Hispanic epigastric pain 2 weeks -worse with eating -melena for the last 24 hrs Emergent upper endoscopy: 1 cm prepyloric ulcer -active bleed which is controlled by endoscopic therapy -antral biopsies: Helicobacter pylori PPI, clarithromycin, amoxicillin, metronidazole x 14 d - 8 week PPI Seen back in the office 10 weeks off all meds You recommend:
4 Next Test A H pylori serology (IgG) B H pylori serology (IgA) C Repeat endoscopy with biopsy D Stool for HP antigen E No further test- observation for recurrence
5 H.Pylori testing Appropriate testing document eradication - stool antigen for H.pylori - urea breath test - biopsy (only if endoscopy to be repeated) Repeat testing >4 weeks post completion Rx PPIs may affect sensitivity/specificity of nonserologic testing - hold PPI at least 1 week Am J Gastroenterol 2017; 112 (2),
6 H pylori Treatment Most patients will be better served first line Tx: -bismuth quadruple therapy or -concomitant therapy consisting of PPI, clarithromycin, amoxicillin, metronidazole
7 Next Test A H pylori serology (IgG) B H pylori serology (IgA) C Repeat endoscopy with biopsy D Stool for HP antigen E No further test- observation for recurrence
8 H. Pylori - Pearls 14 day treatment duration New treatments-quadruple based tx All treated patients- document eradication Serology testing not for eradication f/u
9 CRC Screening Fecal Blood Testing 52 yr old Caucasian male seen annual physical exam Initial screening colonoscopy (age 50) -mild diverticulosis and hemorrhoids -GI colonoscopist recommended repeat 10 yrs He reports his father recently diagnosed CRC age 86 What test would you recommend for CRC screening?
10 Next Test A Hemoccult testing x 3 (FOBT) B Fecal immunohistochemical test x1 (FIT) C Fecal DNA (Cologuard) D No test at present - repeat colonoscopy 10 yrs after first exam E EpiproColon (Septin 9 serum assay)
11 CRC Screening After high quality screening colonoscopy -no alternative screening if colonoscopy to be repeated FOBT no longer recommended (replaced by FIT) - Improves sensitivity/specificity - Any + FIT warrants colonoscopy Am J Gastroenterol 2017; Jul;112(7):
12 Next Test A Hemoccult testing x 3 (FOBT) B Fecal immunohistochemical test x1 (FIT) C Fecal DNA (Cologuard) D No test at present - repeat colonoscopy 10 yrs after first exam E EpiproColon (Septin 9 serum assay)
13 CRC Screening Pearls FIT replaces FOBT No interval sceen testing if 10 yr colonoscopy Family hx CRC >60 -First degree relative begin at 40 then q 10 Age to stop -USPTF 85 yr -MSTF- consider comorbidities (life <10 yrs)
14 Abdominal Pain Evaluation 24-year-old Caucasian woman RUQ pain - dull ache with intermittent stabbing severe pains - improved with recumbence - intermittent nocturnal awakening (rolled her right side) - no change with meals/ associated relief with BM - no radicular pain
15 Abdominal Pain Evaluation Onset: - backpacking hiking vacation trip to Europe - swinging backpack/carrying infant extended hiking Return home month ago but since - experienced it on two separate occasions - severe enough that she went to the emergency room - normal CAT/labs x2 PE: point tender RUQ over gallbladder area - more tender flexes abdominal muscles/raises off bed - no rebound/normal BS/no rashes
16 Next Test A CCK Hida (evaluation ejection fraction) B MRCP C ERCP D Referral for upper endoscopy E Local heat/analgesics
17 Abdominal Pain Evaluation Good history/classic physical finding -abdominal wall pain Carnett s sign -patient supine/ find exact point maximally tender -fold arms flex up -examiner kept fingers point of max tenderness Carnett s hypothesis Savings average $900 per case /avoidance testing Clin Translat Gastro 2016; 7: e136
18 Next Test A CCK Hida (evaluation ejection fraction) B MRCP C ERCP D Referral for upper endoscopy E Local heat/analgesics
19 Abdominal Pain Carnett s Pearls Local heat/nsaids/topical analgesics Look for causes - habitus/posture - take good history - look at back/posture/shoulders/pelvis tilt
20 Clostridium difficile Testing 75 yr old female acute diarrheal illness Recent tx amoxacillin for URI No prior history of diarrheal disease C difficele + glutamate dehydrogenase (GDH) - Rx flagyl 500 mg tid for 10 days Seen your office 2 weeks post treatment -resolution diarrhea now normal BM What is best recommendation for next test?
21 Next Test A C. difficile glutamate dehydrogenase (GDH) B CDI Nucleic Acid Amplification Gene Testing C EIA detection toxin A+B toxin D No CDI test at present E Immune deficiency evaluation
22 Clostridium difficile Testing 50% responded to treatment -asymptomatically can shed C difficile spores 6 weeks After successful treatment -stool assays often remain + for months -indicating ongoing colonization w/o clinical disease JAMA Intern Med 2015 ;175(11): Am J Gastroenterol 2013; 108: ; Clin Infect Dis. 2018; doi: /cid/cix1085
23 Clostridium difficile Testing Repeated demonstration stool + by laboratory assays - repeated stool test of cure not recommended - even more so patients not have ongoing diarrhea JAMA Intern Med 2015 ;175(11): Am J Gastroenterol 2013; 108: ; Clin Infect Dis. 2018; doi: /cid/cix1085
24 Next Test A C. difficile glutamate dehydrogenase (GDH) B CDI Nucleic Acid Amplification Gene Testing C EIA detection toxin A+B toxin D No CDI test at present E Immune deficiency evaluation
25 C diff. Pearls No test if not diarrhea Toilet hygiene discussion Prophylaxis for high risk patients FMT treatment option - high risk - recurrence
26 BELL RINGERS
27 Be Thoughtful and.. Careful with Change
Treatment of Helicobacter pylori Infection
Treatment of Helicobacter pylori Infection Epidemiology of H. pylori infection (North America) Which are the high risk groups? Epidemiology of H. pylori infection (North America) Which are the high risk
9/18/2018. Clostridium Difficile: Updates on Diagnosis and Treatment. Clostridium difficile Infection (CDI) Clostridium difficile Infection (CDI)
Clostridium Difficile: Updates on Diagnosis and Treatment Elizabeth Hudson, DO, MPH 9/25/18 Antibiotic-associated diarrhea and colitis were well established soon after widespread use of antibiotics In
I. Kalfus MD, D. Riff MD, R. Fathi PhD, D. Graham MD
A Randomized Double Blind Placebo Controlled Phase III Study to Assess the Safety and Efficacy of Rifabutin Triple Therapy (RHB-105) for Helicobacter pylori (H. pylori) Infection in Dyspepsia Patients
CHAPTER 18. PEPTIC ULCER DISEASE, SELF-ASSESSMENT QUESTIONS. 1. Which of the following is not a common cause of peptic ulcer disease (PUD)?
CHAPTER 18. PEPTIC ULCER DISEASE, SELF-ASSESSMENT QUESTIONS 1. Which of the following is not a common cause of peptic ulcer disease (PUD)? A. Chronic alcohol ingestion B. Nonsteroidal antiinflammatory
Treating H. pylori in 2016
Treating H. pylori in 2016 William D. Chey, MD, FACG Professor of Medicine University of Michigan The Case: A 38 yo Russian man presents with recurrent epigastric pain which occurs after meals and sometimes
Case 1. Which of the following would be next appropriate investigation/s regarding the pts diarrhoea?
Case 1 21 yr old HIV +ve, Cd4-100 HAART naïve Profuse diarrhoea for 3/52. Stool MC&S ve Which of the following would be next appropriate investigation/s regarding the pts diarrhoea? Repeat stool MC&S Stool
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) MANAGEMENT OF DYSPEPSIA
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) MANAGEMENT OF DYSPEPSIA o Patients of any age with ALARM signs should be referred through the 2-week referral system o Routine endoscopic investigation
Proton Pump Inhibitors Drug Class Prior Authorization Protocol
Proton Pump Inhibitors Drug Class Prior Authorization Protocol Line of Business: Medi-Cal P&T Approval Date: November 15, 2017 Effective Date: January 1, 2018 This policy has been developed through review
Helicobacter 2008;13:1-6. Am J Gastroent 2007;102: Am J of Med 2004;117:31-35.
An Update on Helicobacter pylori and Its Treatment Trenika Mitchell, PharmD, BCPS Clinical Assistant Professor University of Kentucky College of Pharmacy October 18, 2008 Objectives Review the epidemiology
GASTROENTEROLOGY ESSENTIALS
GASTROENTEROLOGY ESSENTIALS Practical Gastroenterology 8/25/2018 Jahnavi Koppala, MBBS Abdullah Abdussalam, MD A 48-year-old male was evaluated for noncardiac chest pain. Treatment with PPI twice daily
University Medical Center at Brackenridge. Gastroenterology Clinic Worksheet
Gastroenterology Clinic Worksheet 1. GI Bleeding (occult or symptomatic) a. CBC b. Iron, Ferritin b. Medication history 2. Iron Deficiency Anemia and no evident source (if no iron deficiency consider hematological
Peptic Ulcer Disease Update
Peptic Ulcer Disease Update Col Pat Storms RAM 2005 Disclosure Information 84th Annual AsMA Scientific Meeting Col Patrick Storms I have no financial relationships to disclose. I will discuss the following
Clostridium difficile Infection: Diagnosis and Management
Clostridium difficile Infection: Diagnosis and Management Brian Viviano D.O. Case study 42 year old female with history of essential hypertension and COPD presents to ED complaining of 24 hours of intractable,
Clostridium difficile Infection (CDI) Management Guideline
Clostridium difficile Infection (CDI) Management Guideline Do not test all patients with loose or watery stools for CDI o CDI is responsible for
What is the status of Sequential Therapy Versus Standard Triple- Drug Therapy in peptic ulcer disease in eradicating H pylori?
What is the status of Sequential Therapy Versus Standard Triple- Drug Therapy in peptic ulcer disease in eradicating H pylori? Sequential Therapy Versus Standard Triple- Drug Therapy for Helicobacter pylori
PEPTIC ULCER DISEASE JOHN R SALTZMAN, MD. Director of Endoscopy Brigham and Women s Hospital Professor of Medicine Harvard Medical School
PEPTIC ULCER DISEASE JOHN R SALTZMAN, MD Director of Endoscopy Brigham and Women s Hospital Professor of Medicine Harvard Medical School No disclosures Disclosures Overview Causes of peptic ulcer disease
Helicobacter Pylori Testing HELICOBACTER PYLORI TESTING HS-131. Policy Number: HS-131. Original Effective Date: 9/17/2009
Easy Choice Health Plan, Inc. Harmony Health Plan of Illinois, Inc. Missouri Care, Inc. Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc. WellCare Health Insurance of Illinois,
A Trip Through the GI Tract: Common GI Diseases and Complaints. Jennifer Curtis, MD
A Trip Through the GI Tract: Common GI Diseases and Complaints Jennifer Curtis, MD Colon Cancer How does it develop? Most cancers arise from polyps Over time these can turn into cancer Combination of genetic
Dr David Rowbotham. The Leeds Teaching Hospitals NHS Trust NHS
Dr David Rowbotham The Leeds Teaching Hospitals NHS Trust NHS Useful Titbits from the World of Gastroenterology David Rowbotham Clinical Director & Consultant Gastroenterologist Dept of Gastroenterology
Management of Dyspepsia
MPharm Programme Management of Dyspepsia Slide 1 of 28 Learning Objectives Understand the principles and wider implications underpinning evidence based therapeutics in the key clinical specialities Objectively
ACG Clinical Guideline: Treatment of Helicobacter pylori Infection
ACG Clinical Guideline: Treatment of Helicobacter pylori Infection William D. Chey, MD, FACG 1, Grigorios I. Leontiadis, MD, PhD 2, Colin W. Howden, MD, FACG 3 and Steven F. Moss, MD, FACG 4 1 Division
MANAGEMENT OF DYSPEPSIA AND GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD)
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) MANAGEMENT OF DYSPEPSIA AND GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD) Routine endoscopic investigation of patients of any age, presenting with dyspepsia
Clostridium DifficileInfection & Readmissions: An ounce of prevention is worth a pound of cure
Clostridium DifficileInfection & Readmissions: An ounce of prevention is worth a pound of cure Brian S. Zuckerbraun, MD, FACS Henry T. Bahnson Professor of Surgery University of Pittsburgh Chief, Trauma
ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Clostridium difficile Infections
ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Clostridium difficile Infections Christina M. Surawicz, MD 1, Lawrence J. Brandt, MD 2, David G. Binion, MD 3, Ashwin N. Ananthakrishnan,
Management of dyspepsia and of Helicobacter pylori infection
Management of dyspepsia and of Helicobacter pylori infection The University of Nottingham John Atherton Wolfson Digestive Diseases Centre University of Nottingham, UK Community management of dyspepsia
Stony Brook Adult Clostridium difficile Management Guidelines. Discontinue all unnecessary antibiotics
Stony Brook Adult Clostridium difficile Management Guidelines Summary: Use of the C Diff Infection (CDI) PowerPlan (Adult) Required Patient with clinical findings suggestive of Clostridium difficile infection
Clostridium Difficile Infection: Applying New Treatment Guidelines and Strategies to Reduce Recurrence Rate
Clostridium Difficile Infection: Applying New Treatment Guidelines and Strategies to Reduce Recurrence Rate Objectives Summarize the changing epidemiology and demographics of patients at risk for Clostridium
Objectives. Definitions. Colorectal Cancer Screening 5/8/2018. Payam Afshar, MS, MD Kaiser Permanente, San Diego. Colorectal cancer background
Colorectal Cancer Screening Payam Afshar, MS, MD Kaiser Permanente, San Diego Objectives Colorectal cancer background Colorectal cancer screening populations Colorectal cancer screening modalities Colonoscopy
Chapter 14: Training in Radiology. DDSEP Chapter 1: Question 12
DDSEP Chapter 1: Question 12 A 52-year-old white male presents for evaluation of sudden onset of abdominal pain and shoulder pain. His past medical history is notable for a history of coronary artery disease,
Updates in Evaluation and Management of Dyspepsia and H. Pylori Infection
Updates in Evaluation and Management of Dyspepsia and H. Pylori Infection Isabel Lee, MD Associate Professor of Health Sciences UCSF Department of Family and Community Medicine Disclosures None 2 Session
6/25/ % 20% 50% 19% Functional Dyspepsia Peptic Ulcer GERD Cancer Other
Peptic Ulcer Disease and Dyspepsia John M. Inadomi, MD Professor of Medicine UCSF Chief, Clinical Gastroenterology San Francisco General Hospital Case History 49 y/o woman complains of several months of
! MQ is a 44 year old woman that I first saw in Sept ! In MVA in Jan 2003 requiring spinal surgery
Case MQ is a 44 year old woman that I first saw in Sept 2006 UPDATE ON CLOSTRIDIUM DIFFICILE DISEASE Richard A. Jacobs, M.D.,PhD In MVA in Jan 2003 requiring spinal surgery Subsequently developed fecal
Outline. GI-Bleeding. Initial intervention
Internal Medicine Board Review 2016: GI-Bleeding Stephan Goebel, M.D. Assistant Professor Division of Digestive Diseases Management UGI-Bleeding (80%) Ulcers Varices others LGI-Bleeding (20%) Outline Initial
GASTROINTESTINAL AND ANTIEMETIC DRUGS. Submitted by: Shaema M. Ali
GASTROINTESTINAL AND ANTIEMETIC DRUGS Submitted by: Shaema M. Ali GASTROINTESTINAL AND ANTIEMETIC DRUGS by: Shaema M. Ali There are four common medical conditions involving the GI system 1) peptic ulcers
The incubation period is unknown. However; the onset of clinical disease is typically 5-10 days after initiation of antimicrobial treatment.
C. DIFFICILE Case definition CONFIRMED CASE A patient is defined as a case if they are one year of age or older AND have one of the following requirements: A laboratory confirmation of a positive toxin
ACP Aaron Fieker, D.O
ACP 2016 Aaron Fieker, D.O Colorectal cancer (CRC) Update on screening strategies and tools Irritable Bowel Syndrome (IBS) New therapeutic options C-difficile Updates on treating recurrent disease CRC
Updates in Colorectal Cancer Screening & Prevention
Updates in Colorectal Cancer Screening & Prevention Swati G. Patel, MD MS Assistant Professor of Medicine Division of Gastroenterology & Hepatology Gastrointestinal Cancer Risk and Prevention Clinic University
Gut Microbiota Transplant Pro Position. Christina Surawicz, MD, MACG Professor of Medicine University of Washington Seattle WA
Gut Microbiota Transplant Pro Position Christina Surawicz, MD, MACG Professor of Medicine University of Washington Seattle WA My Focus Recurrent Clostridium difficile infection No uniformly successful
Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer
Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer Douglas K. Rex, MD, MACG 1, C. Richard Boland, MD 2, Jason A. Dominitz,
Modern approach to Clostridium Difficile Infection
Modern approach to Clostridium Difficile Infection Pseudomembranous Colitis: Principles for diagnosis and treatment Aggelos Stefos Internist, Infectious diseases Specialist Department of Medicine and Research
Colon Cancer Screening Past, Present & Future
Colon Cancer Screening Past, Present & Future Steve Lanspa, MD August 25, 2018 Dr. Lanspa has listed no financial interest/arrangement that would be considered a conflict of interest. Learning Objectives
Peptic ulcer disease Disorders of the esophagus
Peptic ulcer disease Disorders of the esophagus Peptic ulcer disease Burning epigastric pain Exacerbated by fasting Improved with meals Ulcer: disruption of mucosal integrity >5 mm in size, with depth
What Is Peptic Ulcer Disease?
What Is Peptic Ulcer Disease? Peptic ulcer disease is when painful sores form in the lining of the stomach, duodenum (start of the small intestine) or bowels. An ulcer can cause belly pain and, in some
Disclosures. Co-founder and Chief Science Officer, TechLab
H. pylori testing Disclosures Co-founder and Chief Science Officer, TechLab Learning Objectives Evaluate the appropriate testing methodology by balancing performance, economics, and workflow. Discuss the
Fecal Microbiota Transplantation in C. diff. colitis Benefits and Limitations
January 27th 2017, 8th Gastro Foundation Weekend for Fellows; Spier Hotel & Conference Centre, Stellenbosch Fecal Microbiota Transplantation in C. diff. colitis Benefits and Limitations Gerhard Rogler,
Colorectal Cancer Screening: Cost-Effectiveness and Adverse events October, 2005
Colorectal Cancer Screening: Cost-Effectiveness and Adverse events October, 2005 David Lieberman MD Chief, Division of Gastroenterology Oregon Health and Science University Portland VAMC Portland, Oregon
Helicobacter pylori: Diagnosis, treatment and risks of untreated infection
Helicobacter pylori: Diagnosis, treatment and risks of untreated infection Klaus Mönkemüller Department of Gastroenterology, Hepatology und Infectius Diseases Otto-von-Guericke University, Magdeburg bb
When to Refer for OGD and the Work Up of Upper GI Malignancies
When to Refer for OGD and the Work Up of Upper GI Malignancies Dr Hong Qiantai Registrar, Department of Surgery GP Forum 27 May 2017 38 year old female, non-smoker, BMI 29 Works as investment banker Presents
Fecoprevalence and determinants of Helicobacter pylor infection among asymptomatic children in Myanmar
International Journal of Gastroenterology, Hepatology, Transplant & Nutrition Original Article Fecoprevalence and determinants of Helicobacter pylor infection among asymptomatic children in Myanmar Hnin
The New Grade A: USPSTF Updated Colorectal Cancer Screening Guidelines, What does it all mean?
The New Grade A: USPSTF Updated Colorectal Cancer Screening Guidelines, What does it all mean? Robert A. Smith, PhD Cancer Control, Department of Prevention and Early Detection American Cancer Society
Diagnosis, Management, and Prevention of Clostridium difficile infection in Long-Term Care Facilities: A Review
Diagnosis, Management, and Prevention of Clostridium difficile infection in Long-Term Care Facilities: A Review October 18, 2010 James Kahn and Carolyn Kenney, MSIV Overview Burden of disease associated
-2002: Rectal blood loss, UC? (no definite diagnosis) rectal mesalazine. -June 2008: Recurrence of rectal blood loss and urgency
SD, male 40 yrs. old. (680718M467.) -2002: Rectal blood loss, UC? (no definite diagnosis) rectal mesalazine -June 2008: Recurrence of rectal blood loss and urgency Total colonoscopy: ulcerative rectitis,
The PPI Doesn t Work, Now What? PPI Non-responsive Dyspepsia. Disclosures
The PPI Doesn t Work, Now What? PPI Non-responsive Dyspepsia Lana Bistritz MD FRCPC Royal Alexandra Hospital GI Update 2016 Disclosures I have no relevant financial disclosures I will be discussing off
Zinplava. (bezlotoxumab) New Product Slideshow
Zinplava (bezlotoxumab) New Product Slideshow Introduction Brand name: Zinplava Generic name: Bezlotoxumab Pharmacological class: Human IgG1 monoclonal antibody Strength and Formulation: 25mg/mL; solution
C. difficile: When to Do Fecal Microbiota Transplant (FMT)
C. difficile: When to Do Fecal Microbiota Transplant (FMT) Lawrence J. Brandt, MD, MACG Emeritus Chief, Gastroenterology Montefiore Medical Center Professor of Medicine and Surgery Albert Einstein College
Improving Outcomes in Colorectal Cancer: The Science of Screening. Colorectal Cancer (CRC)
Improving Outcomes in Colorectal Cancer: The Science of Screening Tennessee Primary Care Association October 23, 2014 Durado Brooks, MD, MPH Director, Prostate and Colorectal Cancers Colorectal Cancer
Clostridium difficile: Can you smell the new updates?
Clostridium difficile: Can you smell the new updates? Sunish Shah, Pharm.D. PGY-2 Infectious Disease Pharmacy Resident Yale-New Haven Hospital sshah1741@mail.usciences.edu Learning objectives Recognize
Drug Class Monograph
Drug Class Monograph Class: Proton Pump Inhibitors Drugs: Aciphex Sprinkle (rabeprazole), Dexilant (dexlansoprazole), Lansoprazole, Nexium (esomeprazole capsule, esomeprazole granules), Omeprazole, Pantoprazole,
CLOSTRIDIUM DIFICILE. Negin N Blattman Infectious Diseases Phoenix VA Healthcare System
CLOSTRIDIUM DIFICILE Negin N Blattman Infectious Diseases Phoenix VA Healthcare System ANTIBIOTIC ASSOCIATED DIARRHEA 1978: C diff first identified 1989-1992: Four large outbreaks in the US caused by J
Primary Sclerosing Cholangitis and Cholestatic liver diseases. Ahsan M Bhatti MD, FACP Bhatti Gastroenterology Consultants
Primary Sclerosing Cholangitis and Cholestatic liver diseases Ahsan M Bhatti MD, FACP Bhatti Gastroenterology Consultants I have nothing to disclose Educational Objectives What is PSC? Understand the cholestatic
concerned about his health and does not want to end up on medication, like his siblings
Volume: 802 Questions Question: 1 A 45-year-old male comes to your office for his first annual checkup in the last 10 years. On first impression, he appears overweight but is otherwise healthy and has
GI update. Common conditions and concerns my patients frequently asked about
GI update Common conditions and concerns my patients frequently asked about Specific conditions I ll try to cover today 1. Colon polyps, colorectal cancer and colonoscopy 2. Crohn s disease 3. Peptic ulcer
Epidemiology and Treatment of Colonic Angiodysplasia; a Population-Based Study. Naomi G. Diggs, MD Lisa L. Strate, MD MPH March 2, 2010
Epidemiology and Treatment of Colonic Angiodysplasia; a Population-Based Study. Naomi G. Diggs, MD Lisa L. Strate, MD MPH March 2, 2010 Background Angiodysplasia is an important cause of occult and acute
DISCLOSURE Relevant relationships with commercial entities Wyeth (received advisory board & speaker honoraria) Potential for conflicts of interest wit
GASTROENTERITIS DISCLOSURE Relevant relationships with commercial entities Wyeth (received advisory board & speaker honoraria) Potential for conflicts of interest within this presentation fidaxomicin (which
Colorectal Cancer Screening. Daniel C. Chung, MD GI Unit and GI Cancer Genetics Service Massachusetts General Hospital
Colorectal Cancer Screening Daniel C. Chung, MD GI Unit and GI Cancer Genetics Service Massachusetts General Hospital March, 2018 CRC Epidemiology 4th most common malignancy in US (136,000 cases/yr) 2nd
HELICOBACTER PYLORI UPDATE
HELICOBACTER PYLORI UPDATE PROF. TAWHEED MOWAFY DEAN OF AZAL FACULTY OF MEDICINE INTRODUCTION (H. pylori) is recognised as the most common chronic human bacterial infection,1 affecting up to 50% of the
Division of GIM Lecture Series Case Presentation David A. Erickson, M.D October 9th, 2013
Division of GIM Lecture Series Case Presentation David A. Erickson, M.D October 9th, 2013 Financial Disclosures No financial disclosures Objectives Review a case of recurrent Clostridium difficile infection
HEALTHCARE- ASSOCIATED INFECTIONS: A FOCUS ON Clostridium difficile
OBJECTIVES HEALTHCARE- ASSOCIATED INFECTIONS: A FOCUS ON Clostridium difficile Identify and describe the pathophysiology of C. diff. Identify and describe current therapies in treatment of C. diff Identify
Patient presentation
Update: Clostridium difficile Colitis David H. Kerman, MD Assistant Professor of Clinical Medicine Director, Fellowship Program Division of Gastroenterology University of Miami Miller School of Medicine
Managing Upper GI Tract Disease. Michael Herzlinger, MD Pediatric Gastroenterology 7/2018
Managing Upper GI Tract Disease Michael Herzlinger, MD Pediatric Gastroenterology 7/2018 Puke Happens Too Managing Upper GI Tract Disease Michael Herzlinger, MD Pediatric Gastroenterology 7/2018 Objectives
Urea Breath Test for Diagnosis of Helicobactor pylori. Original Policy Date 12:2013
MP 2.04.04 Urea Breath Test for Diagnosis of Helicobactor pylori Medical Policy Section Medicine Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date 12:2013 Return to Medical Policy Index
C. Difficile Testing Protocol
C. Difficile Testing Protocol Caroline Donovan, RN, BSN, ONC- Infection Control Practitioner Abegail Pangan, RN, MSN, CIC- Infection Control Practitioner U.S. NEWS & WORLD REPORT 2017 2018 RANKINGS Acute
Sphincter of Oddi dysfunction: SOD after EPISOD, Now what do we do?
Sphincter of Oddi dysfunction: SOD after EPISOD, Now what do we do? Priya A. Jamidar, M.D., FASGE Professor of Medicine, Director of Endoscopy Yale School Y A L E S CH OO L O F MEDIC IN E February in Connecticut
Updated Clostridium difficile Treatment Guidelines
Updated Clostridium difficile Treatment Guidelines Arielle Arnold, PharmD, BCPS Clinical Pharmacist Saint Alphonsus Regional Medical Center September 29 th, 2018 Disclosures Nothing to disclose Learning
QUICK QUERIES. Topical Questions, Sound Answers
QUICK QUERIES Topical Questions, Sound Answers Dyspepsia: An Evidence-Based Approach Alan B. R. Thomson, MD, PhD, FRCPC, FACP, FACG Presented at the University of Alberta s Medical Grand Rounds, University
Bezlotoxumab (Zinplava) as Adjunct Treatment for Clostridium difficile. Janel Liane Cala, RPh Medical Center Hospital
Bezlotoxumab (Zinplava) as Adjunct Treatment for Clostridium difficile Janel Liane Cala, RPh Medical Center Hospital Objectives Review pathophysiology, risk factors, prevention, and treatment options of
GASTROINTESTINAL SYSTEM MANAGEMENT OF DYSPEPSIA
GASTROINTESTINAL SYSTEM MANAGEMENT OF DYSPEPSIA MANAGEMENT Dyspepsia refers to a spectrum of usually intermittent upper gastrointestinal symptoms, including epigastric pain and heartburn. For the majority
Pediatric Gastroenterology Referral Guidelines
Suggested Pre-Referral Workup This is a general suggestion of possible testing to confirm a suspected diagnosis. Although referrals will be accepted without the suggested work up being complete, to ensure
Sequioa Education Systems, Inc. 1
Functional Diagnostic Medicine Training Program Module 2 The Functional Diagnostic Medicine Approach in the Treatment of Gastrointestinal Dysfunction and Disease Dr. Wayne L. Sodano, D.C., D.A.B.C.I. &
The significance of Helicobacter pylori in the approach of dyspepsia in primary care Arents, Nicolaas Lodevikus Augustinus
University of Groningen The significance of Helicobacter pylori in the approach of dyspepsia in primary care Arents, Nicolaas Lodevikus Augustinus IMPORTANT NOTE: You are advised to consult the publisher's
11/9/2015 OUTLINE. Quality Indicators for the Doctor Performing Screening Colonoscopy: What you should expect from your Endoscopist
Quality Indicators for the Doctor Performing Screening Colonoscopy: What you should expect from your Endoscopist Anil K Sharma MD FACP Professor of Clinical Medicine, University of Rochester Chief of Gastroenterology,
Corporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: helicobacter_pylori_testing 01/01/2019 N/A 01/01/2020 01/01/2019 Policy Effective April 1, 2019 Description
Clostridium Difficile Infection in Adults Treatment and Prevention
Clostridium Difficile Infection in Adults Treatment and Prevention Definition: Clostridium Difficile colonizes the human intestinal tract after the normal gut flora has been altered by antibiotic therapy
KK College of Nursing Peptic Ulcer Badil D ass Dass, Lecturer 25th July, 2011
KK College of Nursing Peptic Ulcer Badil Dass, Lecturer 25 th July, 2011 Objectives: By the end of this lecture, the students t will be able to: Define peptic pp ulcer Describe the etiology and pathology
2. Describe pros/cons of screening interventions (including colonoscopy, CT colography, fecal tests)
Learning Objectives 1. Review principles of colon adenoma/cancer biology that permit successful prevention regimes 2. Describe pros/cons of screening interventions (including colonoscopy, CT colography,
Clostridium difficile
Clostridium difficile Care Homes IPC Study Day Sue Barber Infection Prevention & Control Lead AV & Chiltern CCG s Clostridium difficile A spore forming Bacterium. Difficult to grow in the laboratory hence
2017 NEEDS ASSESSMENT SURVEY
2017 NEEDS ASSESSMENT SURVEY Quick Overview: Educational Topic Findings The online 2017 Needs Assessment survey was programmed through SurveyMonkey and a personalized request to complete the questionnaire
Common Gastrointestinal Problems in the Elderly
Common Gastrointestinal Problems in the Elderly Brian Viviano, D.O. Objectives Understand the pathophysiology, clinical manifestations, diagnosis and management of GI diseases of the elderly. Differentiate
Bloating, Flatulence, and
A 45-Year-Old Man With Recurrent Abdominal Pain, Bloating, Flatulence, and Intermittent Loose Stools Anthony J. Lembo, MD Associate Professor of Medicine Harvard Medical School Director, GI Motility Laboratory
When to Scope in Lower GI Bleeding: It Must Be Done Now. Lisa L. Strate, MD, MPH Assistant Professor of Medicine University of Washington, Seattle, WA
When to Scope in Lower GI Bleeding: It Must Be Done Now Lisa L. Strate, MD, MPH Assistant Professor of Medicine University of Washington, Seattle, WA Outline Epidemiology Overview of available tests Urgent
Acid-Peptic Diseases of the Stomach and Duodenum Including Helicobacter pylori and NSAIDs Prof. Sheila Crowe
Acid-Peptic Diseases of the Stomach and Duodenum Including Helicobacter pylori and NSAIDs 1 Division of Gastroenterology UC San Diego School of Medicine Clinical presentations of Helicobacter pylori infection
Clostridium difficile Asymptomatic Carriers The Hidden Part of the Iceberg?
Clostridium difficile Asymptomatic Carriers The Hidden Part of the Iceberg? Disclosures Merck Canada, BD Diagnostics, AMD Medical, Canadian Institute for Health Research Merck Canada, Pfizer OBJECTIVES
Clostridium difficile Infection (CDI) Guideline Update:
Clostridium difficile Infection (CDI) Guideline Update: Understanding the Data Behind the Recommendations Erik R. Dubberke, MD, MSPH A Webinar for HealthTrust Members Professor of Medicine September 24,
EDUCATION PRACTICE. Persistent Helicobacter pylori Infection After a Course of Antimicrobial Therapy What s Next? Clinical Scenario.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2008;6:1086 1090 EDUCATION PRACTICE Persistent Helicobacter pylori Infection After a Course of Antimicrobial Therapy What s Next? RICHARD J. SAAD* and WILLIAM D.
Bleeding in the Digestive Tract
Bleeding in the Digestive Tract National Digestive Diseases Information Clearinghouse National Institute of Diabetes and Digestive and Kidney Diseases NATIONAL INSTITUTES OF HEALTH U.S. Department of Health
Efficacy of standard triple therapy versus bismuth-based quadruple therapy for eradication of Helicobacter Pylori infection
Efficacy of standard triple therapy versus bismuth-based quadruple therapy for eradication of Helicobacter Pylori infection Ramin Talaie Modarress Hospital, Shahid Beheshti University of Medical Sciences,
Managing Clostridium Difficile: An Old Bug With
932 The Red Section see related editorial on page x Managing Clostridium Difficile: An Old Bug With New Tricks Stephen M. Vindigni, MD, MPH 1,2 and Christina M. Surawicz, MD 1 Am J Gastroenterol (2018)
Peptic ulcer disease. Nomin-Erdene. D SOM-531
Peptic ulcer disease Nomin-Erdene. D SOM-531 Learning objectives Stomach gross anatomy PUD Epidemiology Pathogenesis Clinical manifestation Diagnosing Treatment Complicated ulcer disease Surgical procedures
American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection
American Journal of Gastroenterology ISSN 0002-9270 C 2007 by Am. Coll. of Gastroenterology doi: 10.1111/j.1572-0241.2007.01393.x Published by Blackwell Publishing American College of Gastroenterology