This website provides information on various topics within gastroenterology, including diagnosis and treatment of related diseases and conditions. Join discussion...

The video illustrates the Aer-O-Scope™, a colonoscopy system known for its miniaturized design, self-propelling and self-navigating action, 360° views, "including inside hard-to-see folds where polyps tend to grow." Not to be overlooked is the system's disposable camera. Join discussion...

One of the difficulties in determining a rational imaging strategy to evaluate jaundiced patients stems from the fact that jaundice is a clinical finding, not a single disease entity. The causes of nonhemolytic jaundice can be divided into two distinct categories: intrahepatic biliary stasis (hepatocellular jaundice) and mechanical biliary obstruction. Because imaging Join discussion...

Due to the high prevalence of benign focal hepatic lesions in adults, liver lesion characterization is an important objective of diagnostic imaging. For example, “incidental” liver masses discovered in healthy adults as well as liver lesions detected during staging of a known malignancy often need to be characterized. Common benign liver masses include cysts and hemangiomas, and common malignant tumors are metastases and hepatocellular carcinoma (HCC). Less common liver tumors include focal n Join discussion...

In the United States, metastatic disease is the most common cause of malignancy in the liver and is 20 to 50 times more common than primary liver cancer. The colon, stomach, pancreas, and breast are the most common primary sites. The appearance of a new lesion in the liver in a patient with a history of cancer strongly suggests hepatic metastasis. On the other hand, most small (1-1.5 cm) liver lesions, even in patients with known malignancy, are not malignant, especially if there are fewer than Join discussion...

The widespread availability and use of serum blood chemistries for screening both symptomatic and asymptomatic patients has resulted in a dramatic increase in the number of normal and abnormal liver chemistry tests that must be interpreted by physicians. Therefore, a rational approach for the appropriate evaluation of serum liver chemistries is essential for providing high-quality, cost-effective health care. Although there are no controlled clinical trials examining the optimal approach for eva Join discussion...

Since licensure in 1995 of a hepatitis A vaccine, the Centers for Disease Control and Prevention and the American Academy of Pediatrics have been implementing an incremental hepatitis A immunization strategy for children. In 1996, children living in populations with the highest rates of disease were targeted for immunization, and in 1999 the program was expanded to immunization of children 2 years and older living in states and counties with rates of hepatitis A that historically have been highe Join discussion...

Helicobacter pylori (H. pylori) remains a prevalent, worldwide, chronic infection. Though the prevalence of this infection appears to be decreasing in many parts of the world, H. pylori remains an important factor linked to the development of peptic ulcer disease, gastric malignanc and dyspeptic symptoms. Whether to test for H. pylori in patients with functional dyspepsia, gastroesophageal reflux disease (GERD), patients taking nonsteroidal antiinflammatory drugs, with iron deficiency anemia, or who are at greater risk of developing gastric cancer remains controversial. H. pylori can be diagnosed by endoscopic or nonendoscopic methods. A variety of factors including the need for endoscopy, pretest probability of infection, local availability, and an understanding of the performance characteristics and cost of the individual tests influences choice of evaluation in a given patient. Testing to prove eradication should be performed in patients who receive treatment of H. pylori for peptic ulcer disease, individuals with persistent dyspeptic symptoms despite the test-and-treat strategy, those with H. pylori-associated MALT lymphoma, and individuals who have undergone resection of early gastric cancer. Recent studies suggest that eradication rates achieved by first-line treatment with a proton pump inhibitor (PPI), clarithromycin, and amoxicillin have decreased to 70–85%, in part due to increasing clarithromycin resistance. Eradication rates may also be lower with 7 versus 14-day regimens. Bismuth-containing quadruple regimens for 7–14 days are another first-line treatment option. Sequential therapy for 10 days has shown promise in Europe but requires validation in North America. The most commonly used salvage regimen in patients with persistent H. pylori is bismuth quadruple therapy. Recent data suggest that a PPI, levofloxacin, and amoxicillin for 10 days is more effective and better tolerated than bismuth quadruple Join discussion...

A previously healthy 12-year-old boy presented with abdominal pain, vomiting, and abdominal distention of 3 days' duration. On physical examination, hyperpigmented macules were seen on his lips (Panel A). A computed tomographic scan showed proximal jejunojejunal (Panel B, arrow) and ileocolic intussusceptions. Surgical exploration revealed dilatation of the small bowel and necrosis of the jejunal intussusceptum. Resection of this segment and a short ileal intussusceptum containing a large polyp was performed, followed by primary anastomosis. Pathological evaluation showed multiple hamartomatous polyps in the necrotic jejunum and an ileal polyp 3.5 cm in diameter. The diagnosis was Peutz–Jeghers syndrome, an autosomal Join discussion...

Scientists at the University of Bonn, together with colleagues from Romania, have discovered a gene variant that significantly increases the risk of developing gallstones (Hepatology No. 46, 11 July 2007, DOI 10.1002/hep.21847). It is estimated that one in ten Europeans has this variant in their hereditary disposition. For those affected, the likelihood of developing a gallstone in the course of their life is two to three times higher. The relevant gene contains the instructions for building a m Join discussion...