Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated for a 6-year history of typical gastroesophageal reflux symptoms treated on an as-needed basis with a proton pump inhibitor. However, the frequency of his reflux symptoms has recently increased and his episodes do not respond to treatment as completely as in the past. An upper endoscopy is ...

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I walked into room 30 to find two eager sets of eyes awaiting me. One set belonged to a young man, late-twenties, muscular and imposing, sitting in a chair in the corner of the room. His eyes were hazel brown, big and inviting, relieved at seeing my entry into their sheltered world. The other set of eyes, darker brown and magnified by her gold-stemmed glasses, belonged to my patient, a ...

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The mortality from colorectal cancer has decreased substantially in the U.S. during the past decade. While some of the improvement is due to better cancer treatment and reduced risk factors, the largest proportion is thought due to screening. The concept that early detection saves lives has now become well recognized. The harms of screening -- particularly among individuals with limited life expectancy -- are less well appreciated. Royce et al. recently published a ...

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medpagetodayFrom MedPage Today:

  1. Surgery Fails to Show Superiority in Shoulder Fractures. The trend of increased surgery for patients with displaced fractures of the proximal humerus may be inappropriate.
  2. Restricting Fructose Cuts Liver Fat in Kids. In just 10 days, restricting the amount of fructose children consumed through sugary drinks and juices resulted ...

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A 75-year-old woman with progressive constipation. An 82-year-old man with unexplained anemia. A 39-year-old mother of two with intermittent blood in her stool. These are three of my patients. And sadly, they are three of nearly 150,000 Americans diagnosed with colorectal cancer every year. March is National Colorectal Cancer Awareness Month for good reason. In the United States, colorectal cancer is the third most commonly diagnosed cancer. It is also the ...

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medpagetodayFrom MedPage Today:

  1. Trends in Teen, Young Adult Suicide Differ by Gender. Patterns of suicides among adolescents and young adults changed dramatically from 1994 to 2012, with major gender differences in these 19-year trends.
  2. Early Hot Flashes May Predict Heart Disease. Early-onset and frequent hot flashes and night sweats in women were ...

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March is colon cancer awareness month.  We have made tremendous strides in the fight against cancer especially colon cancer. Between 1991 and 2011, U.S. cancer death rate decreased by 22 percent (1.5 million lives saved), and colon cancer death rate decreased by almost 50 percent. This decrease coincides with widespread adoption of colorectal cancer screening particularly colonoscopy. Despite this progress, colon cancer is still the 2nd leading cause of cancer death in ...

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I was glad she never asked if I had done this before. My first nasogastric tube was placed on an elderly woman with chronic liver disease. As her illness worsened, it gradually turned her skin yellow, her abdomen swollen, and her mind foggy. One day, we realized that she was at too high a choking risk to swallow her medications herself. She would need a plastic tube to do it for ...

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Fecal microbiota transplantation (FMT) has emerged as an increasingly common treatment for patients with refractory Clostridium difficile infection (CDI). Unlike standard antibiotic approaches, which only exacerbate dysbiosis and may perpetuate CDI recurrence, FMT restores normal gut microbial community structure and function of the gastrointestinal tract. However, a number of challenges need to be overcome before this procedure is widely accepted in mainstream clinical practice.

Before I jump into highlighting ...

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Whenever I am asked this question, I can't help but think of the punchline to a joke that was once supposed to be funny but would now be considered beyond the pale in all respects, so I won't repeat it. The punch line is: “Just lucky, I guess.” That's the short answer to why we gastroenterologists work in our field. Despite the distasteful aspect of human waste and the perverse ...

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