Posts filtered by tags: Gastroenterology[x]


 

How should salespeople sell to doctors?

Two device salesmen recently came unannounced to our small private gastroenterology practice. They were hawking a product that could quickly and non-invasively determine how much scar tissue had formed in a patient’s liver, a useful tool for assessing patients with hepatitis and many other liver conditions. We are physicians, not entrepreneurs. We do not regard […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Practice Management, Physician, Gastroenterology, PA NP, CRNA


Using probiotics in children: a pediatrician’s take

The over-the-counter sale of probiotics is a huge industry. They are heavily promoted on social media as a cure-all for a wide variety of ills. Probiotics are live cultures of what are often called “good bacteria,” and there are solid physiological reasons for recommending them. But, and this is a huge but, actual clinical data […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Pediatrics, Gastroenterology, Meds, PA NP, CRNA


MKSAP: 55-year-old man with mild nausea and dyspepsia

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated in the emergency department for a 2-day history of mild nausea and dyspepsia that is worse with fasting and improved with eating. He has also had a 24-hour history of frequent black stools and fatigue. He […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, American College of Physicians, Conditions, Gastroenterology, PA NP, CRNA


Physician gives in to police pressure to conduct a forced invasive rectal exam

Recently, news broke about a disturbing act of medical battery carried out by doctors at St. Joe’s Medical Center in Syracuse, New York. The case began when police officers conducted a pretext stop and elected to harass their victim about a small amount of marijuana. As the situation escalated, the cops took the man to […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Syracuse New York, Physician, Gastroenterology, PA NP, Hospital-Based Medicine, CRNA, St Joe 's Medical Center


Seasoned medical professionals prescribe new medicines sparingly

I prescribe heartburn medicines every day. There’s a gaggle of them now — Prilosec, Nexium, Prevacid, Protonix — to name a few. As far as experts know, their primary effect is to reduce the production of stomach acid. This is why they are so effective at putting out your heartburn fire. In simple terms: no […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Gastroenterology, Meds, PA NP, CRNA, Prilosec Nexium Prevacid Protonix


A clinician’s guide to microbiome testing

The intestinal microbiota, also commonly known as the ‘‘gut microbiome’’ is integral to human physiology and has wide-ranging effects on the development and function of the immune system, energy metabolism and even nervous system activity. There is a lot of excitement around the potential of targeting the microbiome therapeutically to promote health and to prevent […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Conditions, Gastroenterology, PA NP, CRNA


Before undergoing a test, ask whether it will make a difference in your care

Recently, a physician asked my opinion if a patient needed a colonoscopy. My partner was already on the case and I was covering over the weekend. The facts suggested that a colonoscopy was warranted. The patient had a low blood count and had received blood transfusions. Certainly, a bleeding site in the colon, such as […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Conditions, Gastroenterology, PA NP, CRNA


MKSAP: 58-year-old woman with left lower abdominal discomfort

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 58-year-old woman is evaluated in the emergency department for a 2-day history of left lower abdominal discomfort. The pain began insidiously and has gradually progressed. She has felt warm but has not had shaking chills, urinary symptoms such as dysuria […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, American College of Physicians, Conditions, Gastroenterology, PA NP, CRNA


Beware the hazards of over-the-counter (OTC) pain medications

A 30-year old male patient was recently admitted to my service via the emergency department. He came in complaining of abdominal pain and dark tarry stools. He mentioned a recent fall resulting in knee pain for which he had been taking 400 mg ibuprofen four times daily. He underwent upper GI endoscopy and was diagnosed […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Gastroenterology, Meds, PA NP, CRNA


It’s time to talk about private equity in gastroenterology

Well, they are calling it the golden age of rectums! The trends are simple and straightforward. First, Baby Boomers and beyond are aging and staying alive longer. The gut, a hidden culprit behind many ailments, requires continuous maintenance. Colonoscopies, EGDs and ERCPs. These require services of gastroenterologists (GIs) who are always in short supply (14,000 […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Physician, Gastroenterology, PA NP, CRNA


MKSAP: 64-year-old man seen after an intraoperative liver biopsy

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old man is evaluated in follow-up after recent abnormal findings on intraoperative liver biopsy. Two days ago he underwent right colon resection for a large villous adenoma with high-grade dysplasia. At the time of surgery, an abnormal-appearing liver was noted […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. ...
Tags: Health, Diabetes, American College of Physicians, Conditions, Gastroenterology, PA NP, CRNA


Beware of food sensitivity tests on Facebook

Facebook. Where else could I stumble on a video of a baby hippo taking a bath, or Toto’s Africa performed on solo Harp? But among the shares and silliness and talent, there’s a dark side to Facebook. It’s become a fast way for quacks to push their scams and empty your wallet. Just today in my feed […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Facebook, Africa, Conditions, Gastroenterology, PA NP, CRNA


Be the honest doctor instead of the confident one

This is an article about certainty, or maybe lack of certainty? It is about the need for confidence, without having overconfidence. Doctor! Don’t be arrogant — listen to your patient — they are telling you the answer. So believe them, but be a skeptic! Better yet, figure out the diagnosis, but then don’t believe yourself. Try […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Physician, Gastroenterology, PA NP, CRNA


MKSAP: 30-year-old woman is evaluated for a 2-month history of diarrhea

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated for a 2-month history of diarrhea with three to five loose stools per day. She has mild abdominal cramps, bloating, intermittent nausea, and mild anorexia that has resulted in the loss of 2.3 kg (5.0 lb). She has had no fever or blood in the stool. She works in a day care center and has not traveled recently or had exposure to antibiotics. She is otherwi...
Tags: Health, Infectious Disease, American College of Physicians, Conditions, Gastroenterology


A vow to never become a robot doctor

Before coming to medical school, I made a promise to myself: I will not become a robot doctor. Time and again, I visited what I call robot doctors: those physicians unable to empathize with me and seemingly unable to compute moments when I said something unscripted. For example, I once made an appointment with a doctor to discuss what might have been irritable bowel syndrome (IBS). While describing my symptoms and discomfort, I cried. The doctor stared at me, blankly, and offered, “I can also re...
Tags: Health, Education, Time, Medical School, Gastroenterology


When diagnosing colon cancer isn’t in a patient’s best interest

So much of life depends upon timing. Sure, we plan, but we know how much of our life’s events are unplanned and unexpected. So often, our jobs and our mates — two of our most defining accomplishments — are the result of a chance encounter or a random act. Life does not reliably proceed in an orderly manner. This is often true in the medical profession. Here, physicians in our quest to seek out and squelch disease, often discover what would should have been left alone. For example, is discovering...
Tags: Health, Conditions, Gastroenterology, Oncology/Hematology


MKSAP: 36-year-old woman with refractory constipation

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old woman is evaluated for a 12-year history of refractory constipation. Her symptoms began after a difficult childbirth. She has constipation marked by straining, bloating, and a constant sensation of incomplete emptying. She sometimes has 4 or more days between bowel movements. When she does have a bowel movement, the stool is soft-formed. Trials of several fiber supplements...
Tags: Health, American College of Physicians, Conditions, Gastroenterology


With rising obesity, microbiomes tip the scale

Human beings have grappled with obesity for thousands of years. Greek philosopher and physician Galen described “bad humors” as the cause of obesity and prescribed low-calorie foods, massages, baths, greens and garlic to his patients to help them slim down. In the 18th century, William Banting successfully lost weight following a low-carb diet and spread his mantra to the public in a pamphlet called a “Letter on Corpulence,” which sold faster than chocolates. In June 2013, the American Medical A...
Tags: Health, American Medical Association, Galen, Conditions, Gastroenterology, William Banting


Will artificial intelligence ever replace doctors?

Increasingly, we see functions executed by machines that were formerly performed by living breathing human beings. Examples range from the mundane to the preternatural. Order food and drink from an iPad. No server needed. Driverless auto travel. This may lead to a resurgence in prayer. Pilotless air travel. Hard times ahead for the Airline Pilots Association. Making precision tools from 3D printers. Gourmet meals created with a voice-activated command. Theater and film productions starring faux...
Tags: Health, Tech, Gastroenterology, Airline Pilots Association Making


Happy National Grateful Patient Day!

One day I found out that it was National Limerick Day. I didn’t even know there was a National Limerick Day. I investigated other “days” and found out that September 7th was National Grateful Patient Day. So, this grateful patient will start her post with a limerick: There was a patient in a flimsy gown, Who was also wearing a frown. She was getting a bad cold, And feeling cold and old, She wanted another garb, truly, hands down. Now for the grateful patient part. This patient is grateful for co...
Tags: Health, Patients, Patient, Gastroenterology


MKSAP: 48-year-old man with a 4-week history of heartburn

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 48-year-old man is evaluated for a 4-week history of heartburn that awakens him at night. The symptoms occur about three times per week. He has been taking over-the-counter antacids with incomplete relief. Food triggers include coffee and spicy foods. He has not had unintentional weight loss or difficulty swallowing. Physical examination and laboratory studies are normal. Which of the...
Tags: Health, American College of Physicians, Conditions, Gastroenterology


Meet the editors of Diseases of the Esophagus

This year, professionals and researchers studying the esophagus will convene in Vienna for the 2018 World Congress of the International Society for Diseases of the Esophagus (ISDE 2018). Before the conference gets started, we’ve talked with Drs. Giovanni Zaninotto and Neil Gupta, co-editors-in-chief of the journal Diseases of the Esophagus, about their views on the field and the academic research in the journal.How did you get involved in Diseases of the Esophagus?Giovanni: I became a member of ...
Tags: Books, Featured, Cancer, Vienna, Cancer Research, Stephen, Editors, Q&a, Health & Medicine, Neil, Giovanni, Padova, Medical School, ISDE, Science & Medicine, GI


Why this gastroenterologist decided to treat hepatitis C patients

In a prior post, I shared my heretofore reluctance to prescribe medications for my hepatitis C (HCV) patients.  In summary, after consideration of the risks and benefits of the available options, I could not persuade myself — or my patients — to pull the trigger.  These patients were made aware of my conservative philosophy of medical practice. I offered every one of them an opportunity to consult with another specialist who had a different view on the value of HCV treatment. I do believe that t...
Tags: Health, Conditions, Gastroenterology


MKSAP: 38-year-old woman with endometrial cancer

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old woman is evaluated in follow-up after recent surgery for endometrial cancer. Her family history is significant for colon cancer in her sister (diagnosed at age 45 years) and her mother (diagnosed at age 65 years). Her maternal grandfather was diagnosed with rectal cancer at age 47 years. The patient has never had colon cancer screening with colonoscopy. Which of the follow...
Tags: Health, American College of Physicians, Conditions, Gastroenterology


MKSAP: 46-year-old man with intermittent rectal bleeding

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 46-year-old man is evaluated for intermittent rectal bleeding of 3 months’ duration. He is otherwise well and takes no medications. His father had a few polyps removed from the colon when he was 71 years old, but no other details are known about his father’s medical history. The patient and his wife have three children aged 8, 12, and 18 years. On physical examination, vital signs and...
Tags: Health, Genetics, American College of Physicians, Conditions, Gastroenterology


Why medical errors can never be completely eliminated

A patient with progressive neurologic disorder had a gastrojejunal tube placed for feeding. In a nursing home, the tube fell out and was replaced with a Foley catheter. He was sent to the hospital for placement of a new tube. When he arrived in the interventional radiology suite, the Foley catheter was not visible. A new gastrojejunal tube was successfully placed, and the patient was sent back to the nursing home. Below is a drawing showing where a gastrojejunal tube is placed. He returned to t...
Tags: Health, Google, Surgery, Foley, George Santayana, Healthcare Research and Quality, Physician, Gastroenterology


MKSAP: 70-year-old man with heartburn

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 70-year-old man is evaluated in follow-up for heartburn of 7 years’ duration. He has frequent nocturnal reflux but has not had odynophagia or dysphagia, and his weight has been stable. He was recently started on once-daily omeprazole with good control of his symptoms. He has a 30-pack-year history of cigarette smoking and continues to smoke. On physical examination, vital signs are no...
Tags: Health, Barrett, American College of Physicians, Conditions, Gastroenterology


A health insurer’s true motives

A patient came to see me with lower abdominal pain.  Was she interested in my medical opinion?  Not really.  She was advised to see me by her gynecologist who had advised that the patient undergo a hysterectomy.  Was this physician seeking my medical advice?  Not really.   Was this patient coming to see me as her day was boring and she was bored and needed an activity?  Not really. After the visit with me, was the patient planning to return for further discussion of her medical status?  Not real...
Tags: Health, Physician, OB/GYN, Gastroenterology


The freedom to admit someone because it was the right thing to do

The most high-powered rotation in my medical school was endocrinology. There, you got to see things most doctors never come close to diagnosing themselves. Uppsala University’s Akademiska Hospital served as a referral center for the Swedish population north of Uppsala, an area the size and shape of California. Back in the seventies, laboratory testing wasn’t as sophisticated as it is now. We didn’t have CT scanners even at the major hospitals, and MRIs weren’t in use yet. The endocrinology ward ...
Tags: Health, Sweden, California, Wilson, Uppsala, Bostrom, Uppsala University, Cushing, Physician, Gastroenterology, Hospital-Based Medicine, Akademiska Hospital


Which of these patients should get a liver transplant?

People with liver failure and cirrhosis die every year because there are not enough livers available. Who should receive the treasured life-saving organ? There is an organ allocation system in place, which has evolved over time, which ranks patients who need liver transplants. Without such a system, there would be confusion and chaos. How can we fairly determine who should receive the next available liver? What criteria should move a candidate toward the head of the line? Age? Medical diagnoses?...
Tags: Health, Conditions, Gastroenterology, Michael Kirsch