Managing Complex Cases in Gastroenterology

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.

Features Medical College of Wisconsin experts' pearls to management of gastrointestinal disorders Streamlined to pinpoint common questions from the point of view of the practicing gastroenterologist A useful everyday tool that for those taking care of patients with gastrointestinal disorders

Auteur

W. Harley Sobin MD

Assistant Professor of Medicine

Medical College of Wisconsin

Milwaukee, WI

USA

Kia Saeian MD

Konrad H Soergel MD and Walter J Hogan MD Endowed Professor of Medicine

Medical College of Wisconsin

Milwaukee, WI

USA

Patrick Sanvanson MD

Associate Professor of Medicine

Medical College of Wisconsin

Milwaukee, WI

USA

Contenu

Part I: General GI.- Chapter 1: Introduction.- Chapter 2: Eosinophilic esophagitis.- Chapter 3: Oropharyngeal dysphagia.- Chapter 4: Achalasia.- Chapter 5: Other motility disorders of the esophagus and achalasia.- Chapter 6: GERD.- Chapter 7: Refractory GERD.- Chapter 8: Surgery for GERD.- Chapter 9: Barrett's esophagus.- Chapter 10: PEG Tubes.- Chapter 11: Autoimmune metaplastic atrophic gastritis.- Chapter 12: Subepithelial lesions and NETs.- Chapter 13: Viewpoints on managing common clinical GI disorders from a practitioner with over 50 Years of Real-World experience.- Chapter 14: Small intestinal bacterial overgrowth.- Chapter 15: Unusual causes of abdominal pain and controversies in diagnosis.- Chapter 16: Vascular disorders of the intestine.- Chapter 17: Polypectomy.- Chapter 18: Rectal incontinence.- Chapter 19: Diverticulitis.- Chapter 20: Pancreatic cysts and recurrent pancreatitis.- Chapter 21: Chronic pancreatitis.- Chapter 22: GI oncology.- Chapter 23: Issues in therapeutic endoscopy.- Chapter 24: GI pharmacology.- Part II: IBD Compendium.- Chapter 25: Introduction.- Chapter 26: Crohn's ileitis.- Chapter 27: Ulcerative colitis refractory to mesalamine.- Chapter 28: Managing Crohn's in a patient with prior MI.- Chapter 29: Managing post-op Crohn's.- Chapter 30: Managing pseudopolyps.- Chapter 31: Ulcerative colitis refractory to anti-TNFs.- Chapter 32: Severe ulcerative colitis.- Chapter 33: Resistant/refractory proctitis.- Chapter 34: Vaccinations in newly diagnosed IBD.- Chapter 35: Ustekinumab vs risankizumab in Crohn's.- Chapter 36: Use of vedolizumab in UC.- Chapter 37: Functional diarrhea in IBD.- Chapter 38: When to postpone infusions.- Chapter 39: Musculoskeletal complaints in a patient on anti-TNFs.- Chapter 40: Use of immune modulators in patients being started on anti-TNFs.-Chapter 41: Pyoderma gangrenosum.- Chapter 42: UC in a patient who failed mesalamine and anti-TNF.- Chapter 43: Patients with IBD who are squeamish about rectal meds and self-injection.- Chapter 44: Colon stricture in UC.- Chapter 45: Nonspecific ileal ulcers.- Chapter 46: Concern about Pneumocystis jirovecii.- Chapter 47: Bloating in Crohn's.- Chapter 48: Severe diarrhea in a patient on chemotherapy.- Chapter 49: Microscopic colitis.- Chapter 50: Miscellaneous questions.- Part III: Disorders of the Gut-Brain Interaction.- Chapter 51: Introduction.- Chapter 52: IBS-D.- Chapter 53: IBS-C.- Chapter 54: Functional dyspepsia.- Chapter 55: Bloating.- Part IV: Hepatology Compendium.- Chapter 56: Introduction.- Chapter 57: Liver enzyme elevation-negative work-up.- Chapter 58: Increased LFTs with increased iron.- Chapter 59: Increased LFTs with low ceruloplasmin.- Chap^ALT.- Chapter 64: Marked hyperbilirubinemia.- Chapter 65: Suspected NAFLD.- Chapter 66: Treatment of NAFLD.- Chapter 67: Treatment of MASLD.- Chapter 68: Alcohol and liver disease in women.- Chapter 69: Alcoholic hepatitis.- Chapter 70: Fatty Liver on ultrasound with normal liver enzymes.- Chapter 71: Evaluation for liver damage from chronic alcohol use.- Chapter 72: Ascites in a patient without obvious cirrhosis.- Chapter 73: Ascites in a patient with cirrhosis of unclear etiology with increased mononuclear cells.- Chapter 74: Low SAAG ascites.- Chapter 75: Banding esophageal varices.- Chapter 76: Gastric varices.- Chapter 77: Increased ascites in a stable cirrhotic.- Chapter 78: Complications related to managing ascites.- Chapter 79: Portal vein thrombosis as a complication of cirrhosis.- Chapter 80: Portal vein thrombosis and Budd-Chiari in a patient with ulcerative colitis.- Chapter 81: HCC management, solitary lesion in a Child's A cirrhotic.- Chapter 82: Management of Unresectable HCC in a Cirrhotic.- Chapter 83: HCC in NAFLD without Cirrhosis.- Chapter 84: Managing primary biliary cholangitis.- Chapter 85: Advanced PBC.- Chapter 86: Autoimmune hepatitis.- Chapter 87: Autoimmune hepatitis.- Chapter 88: Primary sclerosing cholangitis.- Chapter 89: PBC-AIH overlap.- Chapter 90: Immune-tolerant chronic HBV.- Chapter 91: Immune-active chronic HBV.- Chapter 92: HBV treatment discontinuation.- Chapter 93: Differentiating acute HBV from an acute exacerbation of chronic HBV.- Chapter 94: Acute HBV and risk of HBV reactivation.- Chapter 95: Complicated HCV.- Chapter 96: Acute liver failure.- Chapter 97: Delayed presentation of Tylenol overdose.- Chapter 98: Candidates for liver transplant?.- Chapter 99: Frustrations with waiting for a liver transplant.- Chapter 100: Complications post liver transplant.