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This book was designed to help gastroenterologists take care of their patients with challenging problems. Every day in practice we face patients with issues that are not simple to master. Oftentimes we search out some guidance from “the experts,” and, if they are available, we will curbside them, either by phone or in person.
This text is written from the standpoint of a community gastroenterologist curbsiding his academic cohorts with his challenging cases. We present a patient with a difficult GI problem and ask the academic expert how he, or she, would manage the case. We have provided over a hundred examples of problem cases and asked the experts at the Medical College of Wisconsin (MCW) for help in their management. These cases run the gamut, including general GI, motility disorders, inflammatory bowel disease, advanced therapeutics, hepatology and functional GI disorders.
The main objective of this book is to compile the most clinically useful questions, present them to experts who frequently deal with these problems, and then wrap up their knowledge within one clinically useful text. If a community gastroenterologist had endless access to an academic panel of GI experts, these are the questions they might ask. There are hundreds of useful clinical pearls between the pages of this book which should help anyone taking care of patients with GI problems.
While the text may be targeted particularly toward practicing community gastroenterologists, it certainly can be of benefit to GI fellows in training, academic gastroenterologists, and general internists and surgeons with a strong interest in gastroenterology as well as APPs.
Pages i-xvii
Front Matter
Pages 1-1
Introduction to the General GI Section
Pages 3-6
Pages 7-14
Pages 15-16
Pages 17-24
Other Motility Disorders of the Esophagus and Achalasia
Pages 25-30
Pages 31-36
Pages 37-39
Pages 41-46
Pages 47-52
Pages 53-63
Autoimmune Metaplastic Atrophic Gastritis
Pages 65-67
Subepithelial Lesions and NETs
Pages 69-71
Pages 73-79
Small Intestinal Bacterial Overgrowth
Pages 81-86
Unusual Causes of Abdominal Pain and Controversies in Diagnosis
Pages 87-99
Vascular Disorders of the Intestine
Pages 101-108
Pages 109-120
Pages 121-127
Pages 129-137
Pancreatic Cysts and Recurrent Pancreatitis
Pages 139-144
Pages 145-149
Pages 151-158
Issues in Therapeutic Endoscopy
Pages 159-165
Pages 167-177
Front Matter
Pages 179-179
Introduction to the Inflammatory Bowel Disease Compendium
Pages 181-181
Pages 183-188
Ulcerative Colitis Refractory to Mesalamine
Pages 189-191
Managing Crohn’s in a Patient with Prior MI
Pages 193-196
Pages 197-198
Pages 199-200
Ulcerative Colitis Refractory to Anti-TNF
Pages 201-203
Acute Severe Ulcerative Colitis
Pages 205-206
Resistant/Refractory Proctitis
Pages 207-208
Vaccinations in Newly Diagnosed IBD
Pages 209-210
Ustekinumab vs Risankizumab in Crohn’s
Pages 211-213
Pages 215-217
Pages 219-220
Pages 221-221
Musculoskeletal Complaints in a Patient on Anti-TNFs
Pages 223-224
Use of Immune Modulators in Patients Being Started on Anti-TNFs
Pages 225-226
Pages 227-227
UC in a Patient Who Failed Mesalamine and Anti-TNF
Pages 229-230
Patients with IBD Who Are Squeamish About Rectal Meds and Self-Injection
Pages 231-232
Pages 233-234
Pages 235-236
Concern About Pneumocystis jirovecii
Pages 237-238
Pages 239-240
Severe Diarrhea in a Patient on Chemotherapy
Pages 241-242
Pages 243-244
Miscellaneous Questions About IBD
Pages 245-249
Front Matter
Pages 251-251
Introduction to Disorders of Gut-Brain Interaction
Pages 253-253
Pages 255-260
Pages 261-266
Pages 267-270
Pages 271-277
Front Matter
Pages 279-279
Introduction to the Hepatology Compendium
Pages 281-284
Liver Enzyme Elevation-negative Work-up
Pages 285-287
Increased LFTs with Increased Iron
Pages 289-290
Increased LFTs with Low Ceruloplasmin
Pages 291-292
Normal Ceruloplasmin-Suspected Wilson’s
Pages 293-293
Increased LFTs-Alpha 1 Antitrypsin Deficiency
Pages 295-295
Pages 297-298
Pages 299-300
Pages 301-302
Pages 303-306
Pages 307-308
Pages 309-318
Alcohol and Liver Disease in Women
Pages 319-321
Pages 323-324
Fatty Liver on Ultrasound with Normal LFTs
Pages 325-325
Evaluation for Liver Damage from Chronic ETOH Use
Pages 327-327
Ascites in a Patient Without Obvious Cirrhosis
Pages 329-330
Ascites in Cirrhosis of Unclear Etiology with Increased Mononuclear Cells
Pages 331-332
Pages 333-334
Pages 335-336
Pages 337-340
Increased Ascites in a Stable Cirrhotic
Pages 341-343
Complications Related to Managing Ascites
Pages 345-346
Portal Vein Thrombosis in Cirrhosis
Pages 347-349
PVT and Budd Chiari as a Complication of UC
Pages 351-352
HCC Management, Solitary Lesion in a Child’s A Cirrhosis
Pages 353-353
Management of Unresectable HCC in a Cirrhotic
Pages 355-356
HCC in NAFLD Without Cirrhosis
Pages 357-357
Managing Primary Biliary Cholangitis
Pages 359-364
Pages 365-367
Pages 369-370
Pages 371-374
Primary Sclerosing Cholangitis
Pages 375-377
Pages 379-380
Pages 381-383
Pages 385-389
Pages 391-393
Differentiating Acute HBV from an Acute Exacerbation of Chronic HBV
Pages 395-396
Acute HBV and Risk of HBV Reactivation
Pages 397-399
Pages 401-402
Pages 403-404
Delayed Presentation of Tylenol Overdose
Pages 405-406
Candidates for Liver Transplant?
Pages 407-409
Frustrations with Waiting for a Transplant
Pages 411-413
Pages 415-418
Pages 419-425
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