Pancreatitis (acute and chronic)

Pancreatitis is an inflammation of the pancreas which involves activation of the pancreatic enzymes (that normally digest food) inside the pancreas (ie: it is an inflammatory process in which pancreatic enzymes autodigest the gland). It may be acute or chronic according to the cause, treatment regimen, and the prognosis.   Acute pancreatitis Presentation: The cardinal symptom of… Read more »

Indications for Colonoscopy Screening

General population: every 10 yrs for patients over 50, colonoscopy is superior to occult blood testing or sigmoidoscopy. Single family member with colon cancer. Start at age 40, or 10 years earlier than the family member’s diagnosis (which ever is earlier). In patients with multiple benign polyps observed and removed on initial examination, a follow-up colonoscopy should… Read more »

Whipple disease

Whipple disease is a systemic disease most likely caused by a gram-positive bacterium, Tropheryma whippelii.   It is a rare disorder which classically presents with arthralgia, abdominal pain, diarrhea, progressive weight loss. Microscopically, dilated lacteals are seen in the bowel wall leading to impaired intestinal absorption which may manifest as steatorrhea. 80% can have guaiac… Read more »

Wilson Disease

Wilson disease is a rare autosomal recessive inherited disorder of copper metabolism in which excessive amounts of copper accumulate in the body.  The buildup of copper leads to damage in the liver, brain, and eyes.  Although copper accumulation begins at birth, symptoms of the disorder only appear later in life.   Presentation Clinical symptoms vary significantly, but… Read more »

Hepatitis C

Hepatitis C virus (HCV) is a small, enveloped, single-stranded, positive-sense RNA virus that causes an infection of the liver which is considered the most common cause for liver cirrhosis. . . which may lead to liver cell failure, liver cancer, or life threatening esophageal varices. The World Health Organization (WHO) estimates that 3% of the… Read more »

Stomach (Gastric) Cancer

Gastric neoplasms are predominantly malignant, and nearly 90 to 95% of these tumors are adenocarcinomas. Far less frequently seen malignancies include lymphomas, particularly non-Hodgkin’s lymphoma, and sarcomas such as leiomyosarcoma. Benign gastric neoplasms include leiomyomas, carcinoid tumors, and lipomas. Gastric cancer is the 15th most common cancer in the US. Gastric adenocarcinoma was the most frequently… Read more »

Primary Sclerosing Cholangitis

Primary Sclerosing Cholangitis is an idiopathic, progressive, inflammatory, sclerosing, and obliterative process affecting extrahepatic and often intrahepatic bile ducts. The underlying cause of the inflammation is believed to be autoimmune related. The condition may lead to cirrhosis of the liver with portal hypertension. Very high alkaline phosphatase compared to AST and ALT. High Copper levels… Read more »

Hepatitis B Serology Interpretation

The serology interpretation for Hep B is fairly easy (once you get your arms around it). The antigen measurement (HBs-Ag) can be made as soon as one week after infection, and its persistence beyond six months indicates a chronic carrier or chronic infection. Remember that IgM comes before IgG (opposite alphabetical order) so the antibody… Read more »

Autoimmune chronic hepatitis

Chronic disorder with continuing hepatocellular necrosis and inflammation, usually with fibrosis and tendency to progress to cirrhosis and liver failure Autoimmune hepatitis is believed to be caused by autoimmune reactions against normal hepatocytes in genetically predisposed persons or patients exposed to triggers of an autoimmune process against liver antigens. Humoral immunity plays a role in… Read more »

Irritable bowel syndrome

Diagnostic criteria for irritable bowel syndrome: At least 3 months of continuous or recurrent symptoms of abdominal pain or discomfort that is (a) Improvement with defecation (b) Associated with change in frequency or (c) Consistency of stool; and Two or more of the following (no less than ¼ of days): (a) Altered stool frequency (<3… Read more »