Gastroenterology Archives - Page 35 of 36 - Clinical Advisor

Gastroenterology

Antibiotic-induced diarrhea

To reduce the risk of antibiotic-associated diarrhea, I recommend yogurt with live cultures. The yogurt also helps settle diarrhea after a bout of gastroenteritis. I have my patients try the yogurt for one or two days before getting stool specimens.—Patricia L. Kress, MD, Eau Claire, Wis. (125-10)

H. pylori is a highly motile bacterium and has been linked with the formation of stomach ulcers.

H. pylori in the stool vs. the blood

Is there any difference in sensitivity or specificity when Helicobacter pylori is detected in the stool vs. the blood?—FELIX N. CHIEN, DO, Newport Beach, Calif. Many noninvasive tests diagnose H. pylori, including serology, polymerase chain reaction, stool antigen testing, and the urea breath test (UBT). The best choice for each patient is determined by the…

The majority of cases involving infection with salmonella (brown) do not require antibiotics

Salmonella symptoms with negative stool culture?

Can a patient exhibit signs of salmonella poisoning (e.g., nausea, vomiting, diarrhea, and elevated WBCs) and still have a negative stool culture?—Leslie Pryor, MSN, CRNP, Shamong, N.J. The short answer to this question is “Yes,” as there is no test that is 100% sensitive and specific. Stool testing is no exception. The real question is:…

Gallbladder wall polys (red) have been associated with abdominal pain and dyspeptic symptoms

Gallbladder wall polyp plus abdominal pain

A patient complaining of abdominal pain has normal liver enzymes and a gallbladder wall polyp (but no stones) on ultrasound. What further intervention do you recommend?—Cynthia Lewin, ARNP, Sioux City, Iowa Gallbladder wall polyps can act similar to gallstones and have been associated with abdominal pain and dyspeptic symptoms. Polyps can also be potentially precancerous,…

Biliary dyskinesia

A 44-year-old woman with a history of endometriosis who underwent total abdominal hysterectomy/bilateral salpingo-oophorectomy and appendectomy complains of intermittent right upper-quadrant pain of 3-4 on a 10-point scale for the past month. I suspect she has biliary dyskinesia, but she is able to sleep and has no nausea, vomiting, or diarrhea. A low-fat diet has…

In search of diarrhea relief

Celiac disease is diagnosed by upper endoscopy with duodenal biopsy, not colonoscopy as recommended in Item 103-3.—Judith Conway, APRN, Cromwell, Conn. You are correct. Unfortunately, I inadvertently left out a few key words in my response. Celiac disease is diagnosed with upper endoscopy, during which biopsies are obtained from the duodenum to assess for villous…

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