Gastroenterology Archives - Page 51 of 52 - Clinical Advisor


Photomicrograph shows fatty metamorphosis of a human liver. The clear vacuoles indicate fat droplets

What to do for fatty liver

How would you treat fatty liver in a middle-aged overweight woman with the following profile: liver function tests normal; HDL 70 mg/dL; LDL 160 mg/dL; and triglycerides 170 mg/dL. The patient uses alcohol occasionally, takes no medications, and complains of right upper-quadrant discomfort. One clinician recommends aggressive statin treatment. A second clinician says to treat…

Fatigue and dizziness in an iron-deficient patient

I am treating a 44-year-old Filipina who has iron deficiency anemia. Her RBC count, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and mean corpuscular volume are low and her hematocrit/hemoglobin is borderline low. Her ferritin rose from 2 to 3 ng/mL after two months of ferrous sulfate t.i.d. and vitamin C 500 mg daily. A…

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…

Speeding through history

Mr. B, a 34-year-old physician assistant, was having another frenetic day in the gastroenterology clinic, and he was not happy. When he had taken the job a year ago, he had hoped it would…

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:…

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