Gastrointestinal Illnesses Archives - Page 15 of 16 - Clinical Advisor

Gastrointestinal Illnesses

Elevated liver enzymes and fatty liver

After all other potential causes have been ruled out, I attribute elevated liver enzymes (aspartate aminotransferase and alanine aminotransferase) to a fatty liver. This, of course, is usually noted on ultrasound or CT scan. How often should the enzymes be checked as part of routine monitoring? When should additional tests be ordered if the enzyme…

Fatty liver treatment

I am seeing fatty liver more frequently as an incidental finding in patients undergoing abdominal ultrasound for GI complaints without a history of alcohol abuse or liver disease (particularly in middle-aged, slightly obese women). Does this progress to a more serious problem if not treated? What is the proper treatment?—Jean Marsalla, ANP, Tucson, Ariz. Nonalcoholic…

Cheers for Murphy’s sign

Even though Murphy’s sign is nonspecific, I use it to aid in diagnosing gallbladder disease in patients with a history of fatty meals leading to abdominal pain. If a hand placed in the medial aspect of the upper right quadrant and a command to take a deep breath elicits pain, I do a hepato-iminodiacetic acid…

INCREASED PRACTITIONER INTERACTION MAY IMPROVE RELIEF IN IBS PATIENTS

Level 2: Mid-level evidence A randomized trial evaluated the impact of increased practitioner interaction in 262 patients (mean age 39 years) with irritable bowel syndrome (IBS) (BMJ. 2008;336:999-1003; full-text available online free of charge at: www.bmj.com/cgi/content/full/336/7651/999; accessed August 13, 2008). Patients were randomized to one of three groups for three weeks: waiting-list control vs. placebo…

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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