GI

Core IM podcast: 5 Pearls on Iron Deficiency Anemia

November 15, 2017

Listen to 5 Pearls segment of Iron Deficiency Anemia! By Dr. Cary Blum MD, Marty Fried MD and Shreya P. Trivedi MD; Illustration by Mike Natter MD

Time Stamps:

  1.  Should patients be screened for iron deficiency? If so, who and how often? (1:40)
  2.  What are the indications for diagnostic endoscopy in iron deficient patients? (3:23)
  3. How should you advice patients to take oral iron? What is optimal dosing? (5:53)
  4.  In which patients would you consider IV iron? What are the risks? (11:41)
  5.  Throwback Question: What is a medication overuse HA? (14:44)

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Spotlight: Hepatic Encephalopathy and TIPS: A Clinical Vignette

April 26, 2017
Spotlight: Hepatic Encephalopathy and TIPS: A Clinical Vignette

By Samantha Kass Newman, MD

Peer Reviewed

Today marks the first publication of the new Spotlight series in Clinical Correlations. This series uses case vignettes to explore diagnosis, pathophysiology, and management of a wide variety of diseases seen in the outpatient and inpatient settings.  Articles in the Spotlight section contain clinical pearls that will be highlighted in the case discussion.  While the occasional zebra may appear, the goal of the series is to provide clinically relevant information, and each case has been selected specifically for …

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PTH versus PTHrP — Small Differences, Big Implications

March 3, 2016
PTH versus PTHrP — Small Differences, Big Implications

Samantha Kass Newman, MD

Peer Reviewed 

A 48-year-old depressed male smoker with a bit of an alcohol problem presents to the emergency department with worsening fatigue, severe lower back pain, constipation, abdominal pain, and 4 days of coffee ground emesis.

This could be anything. Viral gastroenteritis? Perhaps. Food poisoning? Probably not. Upper GI bleed? Likely, given his alcohol use. You send off routine labs, and then are called for a critical value: his calcium is 13.8 mg/dL. The albumin is normal. Next, you check the …

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Are We Overusing Proton Pump Inhibitors?

November 13, 2015
Are We Overusing Proton Pump Inhibitors?

By Shimwoo Lee
Peer Reviewed
Case: A 31-year-old man with poorly controlled type 2 diabetes was hospitalized for community-acquired pneumonia. His home medications included esomeprazole. When asked why he was receiving this medication, the patient said it was first started during his prior hospitalization for “ulcer prevention” eight months ago and that he had continued to take it since. He denied any history of upper gastrointestinal symptoms. Esomeprazole was tapered off during this admission. When being discharged after successful treatment of his pneumonia, he was …

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Proton Pump Inhibitors: Acid Suppression with a Nutritional Cost

June 13, 2014
Proton Pump Inhibitors: Acid Suppression with a Nutritional Cost

By Dana Zalkin

Peer Reviewed

In the late 1970s evidence began to emerge that a newly discovered pump, a H+/K+ ATPase in the gastric mucosa, was the final step in the process of acid secretion . With this discovery, further research demonstrated the ability to reduce gastric acid secretion by inhibiting these proton pumps . We now have drugs that do just that: the proton pump inhibitors (PPIs). Proton pump inhibitors have been used since 1989 to treat acid-related gastrointestinal disorders as well as in …

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Proton Pump Inhibitors and Clostridium Difficile Infection

March 20, 2014
Proton Pump Inhibitors and Clostridium Difficile Infection

By Aaron Smith, MD

Peer Reviewed

First introduced in the late 1980s, proton pump inhibitors (PPIs) have revolutionized the treatment of gastric acid-related disorders and have been described as a miracle drug by patients and physicians alike. As is often the case with miracle drugs, however, long-term use of PPIs has led to unforeseen adverse effects. Chief among the purported side effects of PPI use is an association with Clostridium difficile infection (CDI). CDI, an enterocolitis that leads to voluminous and potentially fatal diarrhea, was …

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Can Young Patients Get Diverticular Disease?

January 23, 2014
Can Young Patients Get Diverticular Disease?

By Aaron Smith, MD

Peer Reviewed

Case: A 35 year-old, overweight female presents to the emergency room with five days of left lower quadrant abdominal pain. The pain is 10/10 in severity and accompanied by nausea, bloating, and loss of appetite.

Diverticulosis, the presence of small colonic outpouchings thought to occur secondary to high pressure within the colon, is an extremely common condition in elderly patients. Recent data suggests that up to 50% of people over the age of 60 have colonic diverticula. When a …

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The Prevention of Post-ERCP Pancreatitis

January 10, 2014
The Prevention of Post-ERCP Pancreatitis

By Shivani K Patel, MD

Peer reviewed

A 61-year old male with chronic epigastric discomfort presented to the emergency room with severe abdominal pain radiating to his back. He had similarly presented and been hospitalized two weeks prior to this admission at an outside hospital, where he underwent endoscopic retrograde cholangiopancreatography (ERCP) with placement of a pancreatic duct stent. His pain initially improved, but quickly recurred after discharge. Admission labs showed only mild leukocytosis with slight elevation in serum lipase. Computed tomography (CT) of the …

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