April 2012 Vol XXXVI Issue 4

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Introduction to a New Series

Practical Approaches to the Diagnosis and Treatment of Colorectal Cancer

Melvin Schapiro

Practical Approaches to the Diagnosis and Treatment of Colorectal Cancer, Series #1

Hereditary Colorectal Cancer Syndromes: Understanding Genetics

Jordan Hoffman, Gary H. Hoffman

The physician on the front lines should be able to appreciate the molecular and genetic patterns of hereditary polyposis and non-polyposis colorectal cancers and how these patterns contribute to diagnosis, prognosis and cure. This review will discuss both the framework for inherited genes and how a clinician may take advantage of this framework to secure a diagnosis of inherited colorectal cancer.

Hepatitis c: A New Era of Treatment, Series #4

Hepatitis C Patient Management Issues in the Era of Protease Inhibitor Based Triple Therapy

Melissa Palmer

With the addition of a protease inhibitor (PI) [either Telaprevir (TVR) or Boceprevir (BOC)] to pegylated interferon (PIFN) plus ribavirin (RBV), the percentage of G1 Hepatitis C patients capable of achieving a sustained virologic response (SVR) has dramatically improved. However, the incidence and severity of side effects including rash, anemia, anorectal problems and dysgeusia, has made patient management increasingly complex. Here we review the most commonly encountered side effects associated with BOC or TVR plus PIFN/RBV (triple therapy) and outline strategies for successful management.

Inflammatory Bowel Disease: A Practical Approach, Series #75

Primary Care Considerations in the Management of Inflammatory Bowel Disease Patients

Emory Manten, Jesse A. Green, Catherine Bartholomew

Multiple pharmacologic interactions are noted between current Inflammatory Bowel Disease (IBD) medications and drugs used to treat more common diseases. In an effort to evaluate these important, clinically significant side-effects, the Lexi-Comp and Epocrates databases were used to analyze interactions between IBD medications and those of several common conditions (hypertension, diabetes, asthma, dyslipidemia, and chronic pain). Additionally, Pub Med Searches were performed to evaluaterecent literature discussing the relationship between IBD and these co-morbidities.

Nutrition Issues in Gastroenterology, Series #104

Nutrition in Pediatric Inflammatory Bowel Disease

Bhaskar Gurram, Rebecca Joeckel, Michael Stephens

Approximately 25% of patients with inflammatory bowel disease (IBD) have the onset of their disease within the first 2 decades of life. Malnutrition is frequent in patients with IBD, especially those with Crohn?s Disease (CD). Various micronutrient deficiencies also contribute to morbidity in these patients. Liquid nutrition is frequently utilized to manage the group of patients with malnutrition. In pediatric CD, there is considerable evidence to support the use of polymeric formula as exclusive nutrition to induce remission in newly diagnosed patients, as well as in those with relapses. Exclusive enteral nutrition is an attractive alternative to corticosteroids in patients with CD. There is no evidence for using exclusive enteral nutrition for inducing or maintaining remission in patients with UC. We review the nutritional aspects of patients with IBD and the use of liquid enteralnutrition for remission induction in pediatric patients with IBD.

Fellows Corner

Case Presentation

Arieda Gjikopulli, Ritu Walia, David Tuchman

A 16 year-old male patient presented with an eight-month history of chronic constipation, and hematochezia. There was no history of abdominal pain, tenesmus, decreased appetite, weight loss or diarrhea.

Departments Section

Book Reviews

Endoscopic Ultrasound: An Introductory Manual and Atlas, 2nd Edition

This is the second edition of a comprehensive textbook on endoscopic ultrasound (EUS). The book uses up to date, evidence-based information with contributions from experts in the field to convey to the readers the technical and clinical spectrum in which EUS is utilized today. A DVD is conveniently included which is essential for mastering the concepts, techniques, and clinical applications of endoscopic ultrasound. Captions are included throughout to inform the reader which videos correspond with each section. Each chapter is also accompanied by a plethora of labeled images and illustrations (1280 in total) which are invaluable to understanding the discourse surrounding this discipline.

Diarrhea: Diagnostic and Therapeutic Advances

The book "Diarrhea: Diagnostic and Therapeutic Advances" is a concise yet comprehensive look into diarrheal illnesses. This clinically oriented volume has a broad enough base to be useful to practitioners at all levels from novice to sub-specialist taking care of patients of all ages. The concept of diarrhea is concisely introduced in the first chapter approaching it from a general, pathophysiologic perspective, providing readers with the framework on how to clinically classify an unknown diarrheal illness.

GI Emergencies: A Quick Reference Guide

GI Emergencies: A Quick Reference Guide is ideally suited for gastroenterology fellows but is also valuable for residents, students, and staff who may care for patients in the midst of a GI emergency and need efficient access to clinical guidance, such as members of an inpatient primary or consult service as well as in learning the differential diagnosis of gastrointestinal lesions and understanding the role of EUS in assessing their distinguishing features.

Medical Bulletin Board


IBS is a chronic condition affecting between 15 and 20 percent of all adults in the Western world. However, IBS is difficult to identify due to the numerous symptoms associated with it. Almost 40 percent of IBS sufferers report symptoms severe and frequent enough to disrupt their daily lives, making it is a serious issue.

TapeRelief™ Replaces Multiple Products Used for Ostomy, Wound Care and Skin Protection

TapeRelief™, a new topical cream that provides a soothing and effective barrier between human skin and medical tape and adhesives, can replace multiple products commonly used for wound care and skin protection. Regular use of TapeRelief™ has proven to greatly reduce or prevent numerous ailments arising from medical purpose adhesives intended to protect the patient.