Gastroenterology Archives - Page 3 of 5 - The Emergency Medical Minute

Gastroenterology

Podcast # 427: Cookie Dough is Delicious

Author: Eric Miller, MD Educational Pearls: Recent CDC statement warns against consumption of cookie dough Two common ingredients can pose risk: eggs and flour Flour in dough is a raw agricultural product not treated to kill E. coli A 2016 E. coli outbreak was linked to flour   References: https://www.cdc.gov/features/no-raw-dough/index.html https://www.cdc.gov/ecoli/2016/o121-06-16/index.html Summarized by Travis Barlock,…

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Podcast #399: Hunting for pancreatitis

Author: Michael Hunt, MD Educational Pearls: Alcohol and gallstones are most common causes of pancreatitis Diagnosis is not simply based on lipase alone – must have at least two the the three criteria: Elevated lipase (greater than 3x upper limit of reference range) Typical pain (epigastric pain, radiating to back, etc.) Radiographic findings suggestive of…

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Podcast #388: Antibiotics for Appendicitis

Author:  Aaron Lessen, MD Educational Pearls: 5-year follow up study on antibiotic treatment for uncomplicated appendicitis showed 39.1% recurrence rate requiring appendectomy by 5 years Nearly 60% chance then of preventing an appendectomy by using antibiotics only for uncomplicated appendicitis   Editor’s note: not surprisingly, complications were much higher in the group receiving surgery, which…

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Podcast #385: Probiotics

Author:  John Winkler, MD Educational Pearls: Probiotics are bacteria that are ingested to promote gut health but recent research casts doubt on their effectiveness. Recent study suggests that most probiotics that are ingested are killed by stomach acid. Those that remain are not very healthy and are outcompeted by the normal gut flora. Probiotics should…

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Podcast # 348: Steakhouse Syndrome

Author: Don Stader, MD Educational Pearls: Steakhouse syndrome is an impacted esophageal food bolus. Occurs because they have an esophageal stricture (schatzki ring, scarring, esophagitis). Classic treatments have consisted of effervescents, glucagon, and/or sublingual nitroglycerin (NTG). Recent case series has shown oral 400mcg tablet of NTG dissolved in 10cc tap water was 100% successful. Complications…

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Podcast # 331: Oral Rehydration Therapy (ORT)

Author: Nick Hatch, MD Educational Pearls: The sodium-glucose cotransporter in the gut is essential for rehydration. Oral rehydration therapies require an equimolar concentration of glucose and sodium to be effective. ORT has saved millions of lives globally. Consider using ORT in patients with dehydration. Especially useful in resource limited settings. References: Victora CG, Bryce J,…

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Podcast # 327: No More Hemoccults

Author: Don Stader, MD Educational Pearls:   The use of fecal occult blood tests is falling out of favor in emergency departments These tests have strong evidence suggesting their efficacy in colon cancer screening but clinical significance in ED is limited They have relatively high false positive and false negative rates Small/microscopic bleeding are often…

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Podcast #307: Guillain-Barre Syndrome

Author: Peter Bakes, M.D. Educational Pearls: Rare disease with 1-2 patients out of 100,000. About 60% of patients report a preceding diarrheal illness and classically presents with an ascending motor weakness. Pathophysiology is likely due to molecular mimicry where the immune system creates antibodies against a pathogen (C. jejuni ) which appears similar to the…

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Podcast #301: Biliary Pathology

Author: Don Stader, M.D. Educational Pearls Common pathologies include cholecystitis, choledocholithiasis, and in concerningly ascending cholangitis. Cholecystitis is obstruction at the cystic duct leading to inflammation of gallbladder wall, while choledocholithiasis is a distal obstruction of the biliary tree, and ascending cholangitis is an ascending infection of the biliary tree secondary to obstruction. Risk factors…

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Podcast #289: Cannabinoid Hyperemesis

Author: Dylan Luyten, M.D. Educational Pearls Cannabinoid Hyperemesis syndrome is a relatively new diagnosis that presents with vomiting and abdominal pain without a clear etiology in the setting of daily marijuana use. The pathophysiology is not well-understood well, but may involve cannabinoid receptors in the gut. Treatment is abstinence from marijuana, fluids, dextrose, and antiemetics…

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