GI

Have a Cow? How Recent Studies on Red Meat Consumption Apply to Clinical Practice

April 12, 2013
Have a Cow? How Recent Studies on Red Meat Consumption Apply to Clinical Practice

By Tyler R. McClintock

Faculty Peer Reviewed

“Red Meat Kills.” “Red Meat a Ticket to Early Grave.” “A Hot Dog a Day Raises Risk of Dying.” Such were the headlines circulating in popular press last year when the Annals of Internal Medicine released details of an upcoming article out of Frank Hu’s research group at the Harvard School of Public Health . Analyzing long-term prospective data from two large cohort studies, researchers found that individuals who ate a serving of unprocessed red meat each day…

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The Effect of Bariatric Surgery on Incretin Hormones and Glucose Homeostasis

April 4, 2013
The Effect of Bariatric Surgery on Incretin Hormones and Glucose Homeostasis

By Michael Crist

Faculty Peer Reviewed

Until recently, little thought was given to the important role played by the duodenum, jejunum, and ileum in glucose homeostasis. The involvement of the gut in glucose regulation is mediated by the enteroinsular axis, which refers to the neural and hormonal signaling pathways that connect the gastrointestinal (GI) tract with pancreatic beta cells. These pathways are largely responsible for the increase in insulin that occurs during the postprandial period. In 1964 McIntyre and colleagues first reported the phenomenon…

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Anal cancer screening – A case for screening anal paps

January 24, 2013
Anal cancer screening – A case for screening anal paps

 By Nelson Sanchez, MD

Faculty Peer Reviewed

Case:

A 56 year-old homosexual male presents to your clinic to ask whether or not he should have an anal Pap smear. The patient is HIV positive, has been on HAART for five years, and has no history of opportunistic infections. He denies any anal pain, bleeding or masses.

While efforts to improve knowledge about colorectal cancer in various communities continues to grow, awareness of and misconceptions about anal cancer remain. Over the past couple of years there…

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Promising New Hepatitis C Medications Raise Hopes, Questions

January 17, 2013
Promising New Hepatitis C Medications Raise Hopes, Questions

By Carl M. Gay, MD

Faculty Peer Reviewed

A healthy 61-year old man with a history of chronic genotype 1b hepatitis C virus infection of unknown duration arrives for his semiannual appointment in the Hepatology Clinic. The patient has previously been offered treatment with pegylated interferon and ribavirin, which he has declined on the basis of potential side effects and poor reported efficacy. He states that he has read that new treatment options for hepatitis C have recently become available…

Hepatitis C virus (HCV), first…

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From The Archives: The Role of Serologic Testing in the Diagnosis of Celiac Disease

August 23, 2012
From The Archives: The Role of Serologic Testing in the Diagnosis of Celiac Disease

Please enjoy this post from the archives dated, August 18, 2010

By Todd Cutler

Faculty Peer Reviewed

A 31-year-old woman presents to the clinic with chronic fatigue. She was diagnosed with iron  deficiency anemia when she was 25 years old and has since taken oral contraceptives to limit bleeding during menstruation which she describes as minimal. She has a family history significant for an older brother with celiac disease. She is thin and her exam is significant for conjunctival pallor. Her laboratory findings are…

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Should I Consider Antibiotics in My Patient with Irritable Bowel Syndrome?

July 26, 2012
Should I Consider Antibiotics in My Patient with Irritable Bowel Syndrome?

By Jason Chalifoux

Faculty Peer Review

The story of a patient with multiple office visits due to uncontrolled abdominal pain, bloating and diarrhea/constipation is common among primary care doctors and gastroenterologists. The workup is often extensive and rules out many etiologies. After discovering no metabolic, inflammatory, or anatomic pathology, physicians use the Rome III criteria to diagnose irritable bowel syndrome (IBS). IBS is a functional bowel disorder that is diagnosed by symptoms of recurrent abdominal pain or discomfort for at least 3 days per month…

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A New Era of Therapy for Hepatitis C

November 4, 2011
A New Era of Therapy for Hepatitis C

By Alexander Jow, MD

Faculty Peer Reviewed

Hepatitis C virus (HCV) is a major public health issue, representing the leading cause of chronic liver disease, death from liver disease, and a principal indication for liver transplantation in the US. It is estimated that 3-4 million people in the world are infected with HCV each year. Globally, 130-170 million people are chronically infected with HCV and more than 350,000 people die from HCV-related liver disease each year. Although the natural history of HCV infection…

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Should You Eradicate Helicobacter Pylori Prior to Chronic NSAID Treatment?

January 19, 2011
Should You Eradicate Helicobacter Pylori Prior to Chronic NSAID Treatment?

By Joshua Smith, MD

Faculty Peer Reviewed

 CASE:  A 54-year-old Asian female with no significant past medical history presents to her primary care physician with the complaint of several weeks of pain in her fingers bilaterally along with pronounced, worsening morning stiffness.  She is subsequently diagnosed with rheumatoid arthritis (RA), and the decision is made to start her on long-term, high-dose non-steroidal anti-inflammatory drugs (NSAIDs).  Given the link between NSAIDs and peptic ulcer disease (PUD), should this patient first…

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Is a Low Vitamin D Level a Risk Factor for Colon Cancer?

December 16, 2010
Is a Low Vitamin D Level a Risk Factor for Colon Cancer?

By Nelson Sanchez, MD and Fritz Francois, MD, MS

Faculty Peer Reviewed

Case: A 45-year-old woman presents to your office for an annual check-up.  She states that her grandmother was recently diagnosed with colon cancer at the age of 90, and she wants to know what she can do to reduce her own risk for the disease.  She recently read an article about the benefits of vitamin D and wants to know if they extend to protecting against colon…

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Proton Pump Inhibitors 2.0

November 26, 2010
Proton Pump Inhibitors 2.0

By Mary C. Whitman, MD

Faculty Peer Reviewed

Proton pump inhibitors (PPIs) are generally considered “safe” medications and are prescribed to over 100 million patients per year for a variety of indications, often for long durations. Recently, new data has emerged that suggests that we should be more judicious in prescribing PPIs.

In a recent development, the FDA announced that it will require new labeling of PPIs indicating that their use at high dosage and for prolonged…

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The Role of Serologic Testing in the Diagnosis of Celiac Disease

August 18, 2010
The Role of Serologic Testing in the Diagnosis of Celiac Disease

By Todd Cutler

Faculty Peer Reviewed

A 31-year-old woman presents to the clinic with chronic fatigue. She was diagnosed with iron  deficiency anemia when she was 25 years old and has since taken oral contraceptives to limit bleeding during menstruation which she describes as minimal. She has a family history significant for an older brother with celiac disease. She is thin and her exam is significant for conjunctival pallor. Her laboratory findings are significant for a hemoglobin of 9.7…

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Does Dietary Modification Help GERD?

June 18, 2010
Does Dietary Modification Help GERD?

By Ramya Srinivasan, MD

Faculty Peer Reviewed

 The patient is a 29 year old overweight male presenting to clinic with complaints of reflux symptoms. He says that spicy foods aggravate these symptoms. In addition to weight loss counseling, he is given a prescription for esomeprazole along with a patient handout containing recommendations on foods to avoid and other behavior modifications that may ameliorate his symptoms.

 Gastroesophageal reflux disease (GERD) is defined as the abnormal reflux of gastric contents into the esophagus…

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