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Gastrointestinal Disorders

An internal hernia causes abdominal pain and small bowel obstruction

Lisa Vieira, DHS, PA-C, Sona James, RN, MA, ACNP-BC, CCRN January 09, 2012

This case of a woman with an internal hernia caused by a small bowel obstruction illustrates a relatively rare condition. Clinician awareness and suspicion are key to a good outcome—left untreated, bowel strangulation is fatal more than 50% of the time.

Is rifaximin an effective treatment option for irritable bowel syndrome?

Rachel E. Smith, BSN, Wilson Crone, MD, PhD December 22, 2011

Research suggests that rifaximin could offer symptom relief to IBS patients who have not had success with traditional medications and lifestyle modifications.

An unusual presentation in an elderly man

Lara M. West, RPA-C November 23, 2011

Nocturnal abdominal and right-sided shoulder pain signal a life-threatening condition in a patient whose history revealed tell-tale clues.

Acute cholecystitis and ischemic colitis

Dawn Colomb-Lippa, MHS, PA-C, Peter Sandor, MHS, PA-C, RRT November 09, 2011

This month's review focuses on inflammation and its effect in two locations—the gallbladder and the colon.

Abdominal pain in an elderly patient with an extensive surgical history

Lisa Vieira, DHS, PA-C, Sonia James, RN, MA, ACNP-BC, CCRN October 10, 2011

One of the first steps to diagnosis was ruling out ischemia due to an earlier surgical procedure. CT with and without contrast helped confirm the cause of this man's worsening discomfort.

Wireless capsule endoscopy in the  diagnosis of Crohn disease

Crista R. Berry, Michael D. Sarap, MD, FACS; Jennifer Childers, MS, PA-C May 23, 2011

In evaluating possible Crohn disease, capsule endoscopy is effective at showing the entire small bowel and tracking the progression of healing.

An atypical case of ARB-associated angioedema of the small intestine

Brennan Bowker, MHS, PA-C, Dawn Colomb-Lippa, MHS, PA-C May 09, 2011

A patient with a history of hypertension and myasthenia gravis reports worsening bouts of nausea, vomiting, and diarrhea.

Ciliary injection: A differential diagnosis for the patient with acute red eye

Samuel Powdrill, MPhil, PA-C  December 02, 2010

A case report helps demonstrate how to make an accurate diagnosis in patients presenting with this challenging ocular manifestation.

Small bowel necrosis in association with jejunal tube feeding

Andrea N. Sarap, PA-C; Michael D. Sarap, MD, FACS; Jennifer Childers, PA-C November 15, 2010

Despite successful gastrojejunostomy reconstruction and jejunal feeding tube placement, this patient died from a rare complication.

Irritable bowel syndrome: Relieving the symptoms, and the frustration

Laura C. Blesse, MPAS, PA-C November 02, 2010

IBS is not life-threatening, but its symptoms are life long. Finding an effective treatment can be a frustrating process for PAs and patients.

Left upper-quadrant abdominal pain in a geriatric female

Willard R. Baker, Jr, MS, PA-C October 07, 2010

Sudden onset of left upper-quadrant abdominal pain creates confusion in an elderly woman.

Stress management: Helping patients to find effective coping strategies

Denise Rizzolo, PA-C, PhD, Mona Sedrak, PA-C, PhD September 01, 2010

The impact of stress on physical and mental health illustrates the need for a variety of effective coping techniques.

Heartburn and abdominal pain in a patient with a history of reflux disease

Corri Wolf, PA-C, MS, RD July 30, 2010

Recurring symptoms prompt an important and potentially lifesaving evaluation when a patient runs out of medication.

Acute pancreatitis and croup

Dawn Colomb-Lippa, MHS, PA-C, Amy M. Klingler, MS, PA-C July 22, 2010

The general features, diagnostic criteria, and treatment modalities for acute pancreatitis and croup are reviewed.

Collis-Nissen fundoplication for a symptomatic paraesophageal hernia

Ashley L. Racette, PA-C, MPAS; Richard T. Miller, MD July 12, 2010

A laparoscopic approach leads to relief of the patient's gastroesophageal reflux, uneventful surgery, and a smooth recovery.

Helicobacter pylori infection: An update on diagnosis and management

John E. Lopes Jr, DHSc, PA-C, DFAAPA July 06, 2010

Sequelae of infection are causative factors in gastric cancer. Eradication of the bacteria, however, can be difficult.

Vomiting and apparent discomfort in an 11-month-old girl

Michelle Jacobs, RPA-C April 26, 2010

The baby's physical reaction to her symptoms led to the diagnostic imaging that identified the problem.

What could be causing this woman's abdominal pain and constipation?

Corri Wolf, PA-C, MS, RD January 26, 2010

Imaging studies and key laboratory test results help identify the cause of this patient's GI pain and altered bowel habits.

The title sums up celiac disease: common and often overlooked

January 22, 2010

Common signs and symptoms, and a diagnosis that is often overlooked

Bettie Coplan, MPAS, PA-C December 14, 2009

Celiac disease should be considered in anyone who presents with suspicious gastrointestinal symptoms or with associated conditions.

An uncommon cause of mechanical small bowel obstruction

Joel Hill, PA-C November 09, 2009

An otherwise active and healthy, older man experiences a recurrence of GI symptoms that occur after eating.

Anatomical variant found during catheter insertion

Gina Luckianow, PA-C; Deborah Cole, PA-C, MMSC; Lewis J. Kaplan, MD, FACS, FCCM, FCCP September 28, 2009

Catheter placement to address bleeding following repair of a duodenal ulcer leads to the discovery of a congenital cardiac anomaly in a 62-year-old woman.

FAP: Recognizing the importance of family history and genetic testing

Mike Deeter, PA-C September 14, 2009

A young woman with a family history of abdominal scars presents with hematochezia, diffuse abdominal pain, and anemia.

A complaint of hourly diarrhea and severe abdominal pain

Lt. Stefan C. Hamelin, PA-C, MPAS April 01, 2007

The patient is a 63-year-old woman who arrived at the emergency department complaining of a 5-day history of diarrhea and increasing abdominal pain.

The pathophysiology, diagnosis, and treatment of IBS

Lauren Kolfenbach, MPAS, PA-C January 01, 2007

A thorough history and examination, with appropriate testing, are vital to establish rapport with the patient, identify any comorbid conditions, and exclude organic causes of symptoms.

Diagnosis and management of chronic constipation

Jennifer Drost, MMSc, PA-C; Lucinda A. Harris, MS, MD November 01, 2006

Diagnosis is a challenge because patients and clinicians often define constipation differently. The history, physical examination, and appropriate diagnostic procedures are key.

Detecting celiac disease in adult patients

Pamela Early, PA-C October 01, 2005

Your differential diagnosis should include celiac disease if the patient has symptoms as diverse as diarrhea, constipation, malabsorption, indigestion, pain, fatigue, and anemia.

Case report: For facial swelling, look below the belt

Kristopher M. Murphy, PA-C; Brent Savelli, MD; Karen Newell, PA-C October 01, 2005

An atypical presentation of a patient with a ruptured diverticulum highlights a concern of corticosteroid use—and demonstrates once again how in medicine, things arent always what they're supposed to be.

Laryngopharyngeal reflux—It's not GERD

Linda Diamond, PA-C August 01, 2005

Laryngopharyngeal reflux--It's not GERD - Before you can alleviate symptoms in patients with LPR and ensure healing of the laryngopharynx, you must understand the differences between LPR and GERD.