If you pay close attention to medical education and training, you have surely read something like this as an goal or learning objective: “Manage inflammatory bowel disease and its complications.” However, this is not exactly what our goals should be. One push in the patient-centered care community has been changing the focus from managing the disease to managing the patient who has (or might have) the disease. The difference in wording is subtle, but it gets more ...

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As a resident of San Francisco (and with Los Angeles just a drive away), I cannot escape the food hate.  Whether it be a campaign against cooked provisions, farmed products or anything of solid consistency, I cannot help but wonder if any possible benefit of these diets outweigh the risk of missing out on amazing grub. But what about gluten-free diets? Gluten sensitivity Gluten, a protein found in foodstuffs such as wheat, barley ...

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The New York Times recently published two articles in a series about inflammatory bowel disease, or IBD, in hopes to destigmatize the disease, and to broadcast medical and surgical advancements that have worked to change how we conceptualize IBD. I applauded the Times for highlighting what can be a debilitating disease for the 1.4 million Americans who are afflicted with it, and thought: Finally! IBD is getting the attention it deserves. Albeit ...

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Cancer screening in those with metastatic disease“Your cancer has come back.” These are words no one treated for cancer wants to hear, yet they are words I have said far too often in my own career. In this case, I had said this to a patient I had cared for ever since her initial diagnosis. At that time, she had stage III breast cancer. After her surgery, ...

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The incidence of esophageal adenocarcinoma has increased more than five-fold over the past four decades in the U.S. While the rate of rise in incidence of esophageal cancer has slowed somewhat in recent years, this malignancy is still associated with a dismal prognosis. Barrett’s esophagus, the precursor lesion to esophageal cancer, is easily identifiable on routine upper endoscopy and can be monitored for the development of precancerous changes. We generally ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 51-year-old woman is evaluated for a 6-month history of diarrhea and bloating. She reports four to six loose stools per day, with occasional nocturnal stools. She has had a few episodes of incontinence secondary to urgency. She has not had melena or hematochezia but notes an occasional oily appearance to the ...

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From MedPage Today:

  1. SNRI Equal to Hormones for Hot Flush Tx. A low dose of the antidepressant venlafaxine (Effexor) appeared roughly as good as hormonal therapy to ease hot flushes in menopause.
  2. USPSTF Urges HBV Screening for High-Risk People. People at high risk for hepatitis B (HBV) should be screened for the virus, according to a new recommendation from the U.S. Preventive Services Task ...

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In the contest to get a creative name, few pathogens have done worse than hepatitis C. In the 1970s there were two known viruses that caused hepatitis: liver inflammation. You might have already guessed that these two viruses were called hepatitis A and hepatitis B. It was known at that time that people sometimes developed hepatitis after blood transfusions and that the majority of those patients tested negative for hepatitis ...

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Why does is seem that so much information given to us comes with disclaimers? The weight loss product ads on TV that promise more than they will deliver, are always accompanied by 5 nanosecond disclaimers in a font size that can’t be discerned by the human retina stating that the results are not typical. It seems deceptive to be advertising a product by showcasing a performance that the vendor admits is ...

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May marks Celiac Disease Awareness Month, with the goals of raising awareness of the disease and its potential health complications, and also to help elucidate which patients warrant diagnostic testing for the disease. A few days ago on Twitter, I noticed that #glutenfree was trending (again). It is fascinating to observe how gluten-free businesses are beyond booming as diseases and conditions such as celiac disease, wheat allergy, and non-celiac gluten intolerance ...

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