Gastroenterology

Esophageal Pathology

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GERD

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PUD

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IBD

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IBS

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Diarrhea

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• Dx: For chronic diarrhea, send stool microscopy, electrolytes, and fat content.
• Tx: For acute viral gastroenteritis. Diet recommendation is to resume normal eating without excessive sugars

Celiac Sprue

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UGIB

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LGIB

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• Dx: Angiodysplasias (e.g. AVMs) are associated with AS, vWD, and ESRD. Workup for hematochezia is colonoscopy if HDS, resuscitate, ± surgery/IR consult, EGD if HDUS.
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Pancreatitis

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• Dx: Thiazide diuretics and most loop diuretics are in important cause of drug-induced pancreatitis.
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Approach to LFTs

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• Dx: GGT measurement helps differentiate if elevated alk phos is from liver (elevated) or bone (normal)
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Gallstone Disease

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• Dx: Cholestatic pattern of elevated bilirubin and alk phos, Charcot triad for ascending cholangitis includes RUQ pain, fever, jaundice.
• Tx: For acute/ascending cholangitis, treat with ERCP within 24-48 hrs

Viral and Non-viral Hepatitis

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Cirrhosis and Ascites

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Acetaminophen Toxicity

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Heredity Hemochromatosis

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Wilson Disease

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α1-Antitrypsin Disease

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Autoimmune Hepatitis

• H&P: Young to middle-aged women. Painless hepatomegaly.
• Dx: Elevated AST and ALT, normal ALK and TBili. ANA and anti smooth muscle antibodies are positive.
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PBC

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PSC

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Missed Concepts

• Food protein-induced allergic proctocolitis shows up at 1-4 weeks of age with blood and mucus streaked stools. Treat by eliminating dairy from the maternal diet. It is benign and self-limited.