GI

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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From The Archives: Myths and Realities: Colon Cleansing: Healthful or just a load of @$%!

January 26, 2012
From The Archives: Myths and Realities: Colon Cleansing: Healthful or just a load of @$%!

Please enjoy this post from the archives on July 16, 2009

By Chau Che MD

Faculty Peer Reviewed

You’ll have increased energy, radiant skin, reduced joint pain, improved asthma symptoms, and best of all…you will lose weight. These are some of the purported benefits of removing “toxins” (otherwise known as undigested material) from the colon through cleansing. As with fashion, music, and art, what’s old has a way of becoming trendy again…especially when celebrities such as Beyonce talk about it on the Oprah Winfrey show.…

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Is There Really Any Role For Steroids In Acute Alcoholic Hepatitis?

December 8, 2011
Is There Really Any Role For Steroids In Acute Alcoholic Hepatitis?

By Keri Herzog, MD

Faculty Peer Reviewed

The patient is a 48-year-old male with a history of heavy alcohol use (he drinks about 1 pint of vodka daily) who presented to the hospital when he noticed that he had become increasingly jaundiced. The patient was hemodynamically stable on admission and afebrile, with jaundice and scleral icterus on exam. Laboratory data was significant for a total bilirubin of 6.6, an INR of 2.3, AST of 83, ALT 72, and a Maddrey’s discriminant function (MDF) that was…

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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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The Treatment For Clostridium Difficile? Transplant!

July 29, 2011
The Treatment For Clostridium Difficile? Transplant!

By Andrea Mignatti , MD

Faculty Peer Reviewed

Among all the new medical therapies, this one will probably not be the most elegant or refined that you will read about. But it just may be one of the most unconventional ones you will come across.

From our experiences working on busy hospital wards, we know that Clostridium difficile colitis is an extremely serious infection that is becoming more prevalent due to the development of new hyper-virulent strains (toxinotype III BI/NAP1/027). It has been…

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Hepatocellular Carcinoma Screening Guidelines and Bellevue’s High-Risk Population

June 22, 2011
Hepatocellular Carcinoma Screening Guidelines and Bellevue’s High-Risk Population

By Ramoncito David

Faculty Peer Reviewed

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death in the world.  The prevalence of this fatal disease greatly varies among different nations, due to the fact that almost 80% of cases are secondary to hepatitis B or C.

The implementation of an effective vaccine against the hepatitis B virus (HBV) has reduced the prevalence of HBV carriers in North America to 0.1-2%; however, hepatitis B remains a global public health problem due its high…

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The Myth of the Helminth: Can Worms be the Next Therapeutic Breakthrough for IBD Patients?

March 16, 2011
The Myth of the Helminth: Can Worms be the Next Therapeutic Breakthrough for IBD Patients?

By Michael Guss, Class of  2012

Faculty Peer Reviewed

Helminths–parasitic worms that have co-evolved with humans and colonized our gastrointestinal (GI) tract for millennia–have developed the ability to modulate our inflammatory responses and evade our immune systems to survive . Until the 1930s, the helminth colonization of humans was almost universal, owing to poor sanitation conditions and an impure food supply . This changed as the economic development of the last century created improved sanitary conditions: clean running water,…

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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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Branched Chain Amino Acid Supplementation for Patients with Cirrhosis

December 3, 2010
Branched Chain Amino Acid Supplementation for Patients with Cirrhosis

By Nicole Leigh Aaronson,MD,  Loren Wissner Greene, MD, and  Denise Pate, MD

Faculty Peer Reviewed

Introduction:

Whereas there are specially designed diets for patients with hypertension, diabetes, and renal failure, NYU Medical Center, like most medical centers, does not have a specific diet for patients with cirrhosis. In considering what dietary modifications might benefit these patients, it is useful to first examine the nutritional status of the cirrhotic patient. Cirrhosis is a disease characterized by progressive liver…

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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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How do you Manage the Adult with Perinatally Acquired Hepatitis B?

October 22, 2010
How do you Manage the Adult with Perinatally Acquired Hepatitis B?

Nathaniel Rosso Smilowitz, MD

Faculty Peer Reviewed

Hepatitis B virus is a DNA hepadnavirus affecting 1.25 million people in the United States and nearly 400 million worldwide.  The virus is transmitted perinatally, sexually, and percutaneously, and is endemic in many countries in South East Asia, Central Asia, and Africa.  When exposure occurs early in life, the likelihood of chronic infection is high; up to 90% of cases of vertical transmission result in the persistence of the viral envelope protein,…

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