We all have gas, and we let loose about a liter a day.<p> Get the inside story: Everything you’ve been dying to know about ‘air biscuits’- their cause, composition, and cure.<p>
A belch is but a gentle wind <p>That cometh from the heart, <p>But when it takes a downward turn<p> It then becomes a fart.
Your staff needs an attitude adjustment, or you have a really cranky, non-compliant patient. You know you should step up to the plate and say something, or the behavior will continue.
So why don’t you?
Because you’re like most of us… you’d rather set your hair on fire than face a confrontation.
In this presentation you will learn techniques to use to approach confrontation with an open heart and an inquiring mind, and will find that the difficult conversations are interesting, fun, and yield results.
Give examples of confrontations that you have avoided in the past, and the deleterious effect of non-confrontation
Describe confrontations that you have embraced, that lead to better than expected outcomes
Exercise techniques and skills to embrace confrontation in your practice
Create your culture of friendly confrontation for your office and develop an implementation strategy
Belly Buttons Not Just About Innies, Outies, Or PiercingsPatricia Raymond
The document summarizes various cultural, religious, medical, and social aspects related to the human belly button or navel. It discusses different terms used to describe the navel across cultures. It also explores the navel's significance in Greek mythology, Hinduism, Christianity and other religions. Medically, it examines the navel's embryological development and use as a diagnostic indicator. Socially, it mentions portrayals of the navel in media and body modifications like piercings.
This document provides an overview of a presentation on traveling through the gastrointestinal tract. It outlines the objectives to cover the anatomy, pathology, testing capabilities, and questions for each segment of the GI tract. Sections are devoted to the oropharynx, esophagus, stomach, liver, gallbladder, pancreas, small intestine, and colon. Various coding examples and tests for each area are also mentioned such as endoscopy, biopsy, pH studies, and imaging. The presentation aims to educate attendees on the details of the GI tract using an analogy of traveling within it.
The document discusses the visual examination of the belly and navel from anatomical, historical, social, and medical perspectives. Anatomically, the navel is located at the midpoint of the body and develops from the umbilical cord that nourishes the fetus. Historically, many religions and cultures have ascribed spiritual or theological significance to the navel. Medically, examination of the navel can provide clues to intra-abdominal diseases and conditions. Variations in navel appearance like outies can occur normally or indicate issues like hernias.
Nocturnal GERD may be more important than daytime GERD in the development of severe GERD-related complications; and up to 80% of refluxers describe nocturnal symptoms. Nighttime reflux is associated with a 11x risk of esophageal adenocarcinoma, as well as sleep disturbance and respiratory symptoms.
Perhaps you don’t need to know the details of nocturnal GERD… but ask yourself-
“Do you feel lucky?”
Hospitals have become unfriendly places for patients to be in…rushed, harried staff simply doesn’t have the time to provide the personal touch anymore…or can we? Delighted patients refer their friends and return for repeat procedures.
The ‘Spa Hospital’ addresses our patients’ needs with low or no cost techniques adapted from those used at spas. Attention will also be given to reception and departure from unit, patient privacy concerns, and their lasting impression with reviews of medical literature supporting these techniques.
Your staff needs an attitude adjustment, or you have a really cranky, non-compliant patient. You know you should step up to the plate and say something, or the behavior will continue.
So why don’t you?
Because you’re like most of us… you’d rather set your hair on fire than face a confrontation.
In this presentation you will learn techniques to use to approach confrontation with an open heart and an inquiring mind, and will find that the difficult conversations are interesting, fun, and yield results.
Give examples of confrontations that you have avoided in the past, and the deleterious effect of non-confrontation
Describe confrontations that you have embraced, that lead to better than expected outcomes
Exercise techniques and skills to embrace confrontation in your practice
Create your culture of friendly confrontation for your office and develop an implementation strategy
Belly Buttons Not Just About Innies, Outies, Or PiercingsPatricia Raymond
The document summarizes various cultural, religious, medical, and social aspects related to the human belly button or navel. It discusses different terms used to describe the navel across cultures. It also explores the navel's significance in Greek mythology, Hinduism, Christianity and other religions. Medically, it examines the navel's embryological development and use as a diagnostic indicator. Socially, it mentions portrayals of the navel in media and body modifications like piercings.
This document provides an overview of a presentation on traveling through the gastrointestinal tract. It outlines the objectives to cover the anatomy, pathology, testing capabilities, and questions for each segment of the GI tract. Sections are devoted to the oropharynx, esophagus, stomach, liver, gallbladder, pancreas, small intestine, and colon. Various coding examples and tests for each area are also mentioned such as endoscopy, biopsy, pH studies, and imaging. The presentation aims to educate attendees on the details of the GI tract using an analogy of traveling within it.
The document discusses the visual examination of the belly and navel from anatomical, historical, social, and medical perspectives. Anatomically, the navel is located at the midpoint of the body and develops from the umbilical cord that nourishes the fetus. Historically, many religions and cultures have ascribed spiritual or theological significance to the navel. Medically, examination of the navel can provide clues to intra-abdominal diseases and conditions. Variations in navel appearance like outies can occur normally or indicate issues like hernias.
Nocturnal GERD may be more important than daytime GERD in the development of severe GERD-related complications; and up to 80% of refluxers describe nocturnal symptoms. Nighttime reflux is associated with a 11x risk of esophageal adenocarcinoma, as well as sleep disturbance and respiratory symptoms.
Perhaps you don’t need to know the details of nocturnal GERD… but ask yourself-
“Do you feel lucky?”
Hospitals have become unfriendly places for patients to be in…rushed, harried staff simply doesn’t have the time to provide the personal touch anymore…or can we? Delighted patients refer their friends and return for repeat procedures.
The ‘Spa Hospital’ addresses our patients’ needs with low or no cost techniques adapted from those used at spas. Attention will also be given to reception and departure from unit, patient privacy concerns, and their lasting impression with reviews of medical literature supporting these techniques.
Holistic Management as an Adjunct in IBD: Encourage your patient to own the...Patricia Raymond
The document discusses the potential for holistic management approaches as adjunct treatments for inflammatory bowel disease (IBD). It provides information on several ways patients can self-monitor their disease activity through indices like CDAI, UCDAI, and P-SCCAI. It also reviews evidence on the role of vitamin D supplementation, dietary changes, cannabis use, and lifestyle factors like exercise and meditation in managing IBD symptoms. While some studies found improvements in outcomes from these approaches, the evidence has limitations and their long-term impact requires more research.
Hash It Out: The Role of Medical Marijuana in GIPatricia Raymond
Marijuana's side effect of Cannabinoid Hyperemesis Syndrome is well known to us, as is use of Marinol to enhance appetite in the chronically ill, but are there other high points in the use of medical marijuana? What about the possible use of CBD oil for chronic pancreatitis or intractable abdominal pain?
Studies have shown cannabis' effect on GI motility, inflammation and immunity, intestinal and gastric acid secretion, nociception and emesis pathways, and appetite. Let's weed through the available data on the medical use and side effects of medicinal cannabis in gastroenterology.
Celiac Disease: Beyond Bowes, Bone, & Blood Rev 2019Patricia Raymond
Celiac disease can cause iron deficiency anemia, osteoporosis, and malabsorption…but is that all? Nope. There are a huge number of other disease associations with celiac disease beyond just bowels, bone, and blood. Join us for this classic presentation of celiac comorbidities that may alert you to the presence of this woefully under-diagnosed condition.
Diverticulitis: Popular Misconceptions & New Management rev 2019Patricia Raymond
As presented at RMSGNA 2019: Of course, it's not about just avoiding nuts and seeds. However, do you know how many attacks you can endure before suggesting a resection? How to manage young or immunosuppressed patients with diverticulitis? How Eastern (asian)diverticulitis differs? The role of mesalamine in treatment? It's time to re-explore a disease that you thought you knew!
Evolving diets in GI Disease 2019 Raymond/GallagherPatricia Raymond
As presented 09/2019 at RMSGNA: In the 50's , doctors recommended smoking for your health. More recently gastroenterologists told patients with ulcers to drink milk and eat bread to heal.
Are you using new science based dietary information for your patients? It's time to update your timeworn dietary strategies and handouts. Join us and review the science on recent advances in dietary management for gastrointestinal disorders: Fatty liver, IBS, IBD, Gastroparesis, Post gastric bypass, Diverticulosis, Cirrhosis, and more!
Examine historical misinformation in dietary management of gastrointestinal disorders
Describe the emerging evidence supporting the primary role of dietary therapies in digestive disease including Irritable Bowel Syndrome, Inflammatory Bowel Disease, Small Intestinal Bacterial Overgrowth, Non-Alcoholic Fatty Liver Disease, Gastroparesis, Pancreatitis, Post-Gastric Bypass, and Diverticulitis.
Identify the role of the Registered Dietitian and the importance of a multi-disciplinary approach to the management of digestives diseases
Know GI Inside & Out? Recognizing Skin Lesions of GI DisordersPatricia Raymond
Skin lesions seen with disorders of the digestive tract are not rare; would you recognize and correctly correlate erythema nodosum, dermatitis herpetiformis, pyoderma gangrenosum? Those were easy-- how about pyoderma vegetans, pyostomatitis vegetans, sweet’s syndrome, xanthomas, tripe palms, palmoplantar keratoderma, or trichilemmomas? Stumped?
Join us and learn the art of GI diagnosis without resorting to our endoscopes.
Fun Functional Gallbladder Disorders: Update on Hypo and Hyperkinetic Gallbla...Patricia Raymond
Functional gallbladder disorder is biliary pain from motility disturbance in the absence of gallstones, sludge, or microcrystal disease. In patients with biliary-type pain and a normal US, the prevalence is 8% men and 21% women. We will review the clinical manifestations, diagnosis, and management of patients with suspected functional gallbladder disorder, and also address current evaluation and management of sphincter of Oddi dysfunction.
Cyst Assist: Pancreatic Cyst Evaluation & ManagementPatricia Raymond
This document provides an overview of pancreatic cyst evaluation and management. It discusses the prevalence of incidentally detected pancreatic cysts on imaging and categorizes cysts as benign, pseudocysts, or one of four subtypes of pancreatic cystic neoplasms (PCNs): serous cystic tumors, mucinous cystic neoplasms, intraductal papillary mucinous neoplasms, and solid pseudopapillary neoplasms. For each PCN subtype, it describes characteristics such as patient demographics, location, risk of malignancy, and management guidelines. It also reviews guidelines for managing pseudocysts and outlines the endoscopic, percutaneous, and surgical drainage options with expected outcomes. In summary,
Kudos To You: Learning your Kudo Pit Patterns and Paris Polyp ClassificationsPatricia Raymond
We've told patients that we won't know about their polyps until after the pathology report is back; turns out that's not precisely true. Today's excellence in optics provides an accurate instantaneous assessment of the histology of colon polyps which may help in decision making during colonoscopy.
Did you know that if a polyp has a type 5 Kudo pit pattern, 50% were invasive cancers to the submucosal layer? What is it about that scary polyp that raises your hackles? Join us in this highly interactive session where we'll learn Kudo pit patterns as well as Paris polyp classifications to elevate your GI procedure reporting and your patient care.
Describe the emerging evidence supporting the primary role of Kudo Pit Patterns in visual inspection of in situ polyps, and demonstrate your ability to identify the patterns
Authentication of Kudo Pits
Pits and their risks
Images of Kudo pits
Quiz of Kudo Pits
Discuss the potential and shortcomings of the Paris Polyp Classification, and demonstrate an ability to classify the polyp shape
Polyp shapes and and their risks (pedunculated, elevated, depressed)
Images of polyps for Paris classification
Polyps and their risks
Quiz of polyp shapes
Concerns regarding interobserver variability
Familial Adenomatous Polyposis affects 1 in 10,000 to 30,000 Americans who experience 100% risk of colon cancer, and FAP doesn't end with a total colectomy for removal of their hundreds of polyps.
Follow this journey of two real FAP patients through pancreatitis from symptomatic ampulla polyps, surgical resection of giant small bowel polyps, bowel obstruction from abdominal desmoid tumors, and Wilm's tumor of the kidney. How do we diagnose, monitor and support our FAP patients? Can pharmacotherapy reduce risk of polyp growth in FAP? What are the extracolonic manifestations of the APC gene mutation? Our responsibility doesn't end when the colon does.
Bored with Barretts: Diagnosing Gastric Intestinal Metaplasia, Meckels, & Pa...Patricia Raymond
We all know what to do with the border disorder that is Barretts, but what about other mucosal heterotopia: intestinal mucosa in the stomach, stomach mucosa in the intestine, pancreas mucosa in the stomach...what's going on with all this meandering mucosa? Join us for a discussion about how to diagnose and manage various misplaced gastrointestinal mucosa.
Discuss the natural history of Gastric Intestinal Metaplasia and construct proper endoscopic surveillance and mapping guidelines
Epidemiology and risk factors
Complete and incomplete, types I-III based on mucin expression
Risk of progression to cancer
Proper surveillance and endoscopic mapping
Management
35 min
Meckels
Describe the presumed anatomical development of Meckel's Diverticulum, summarize the 'Rule Of Twos', formulate management of a Meckel's associated cryptic bleed
Who was Meckel
Epidemiology and risk factors
Rule of twos
Risk of bleed
Management
10 min
Pancreatic Rests
Discuss the natural history of Gastric Intestinal Metaplasia and construct proper endoscopic surveillance and mapping guidelines
Review the endoscopic appearance of the Pancreatic Rest, discuss rare symptoms attributable to the finding and current endoscopic evaluation and management
Endoscopic appearance
Anatomic development
Risks for pancreatitis, cancer, obstruction
Endoscopic and surgical management
10 min
Do You Believe in Reflux: Idiopathic Pulmonary FibrosisPatricia Raymond
Recent studies suggest that if you have IPF (idiopathic pulmonary fibrosis), that you may not perceive the GERD (reflux) that you have, and that this acid reflux may cause the fibrosis to progress. Ask for proper testing and treatment to see if you are one of the almost 80% of IPF patients who have reflux, often silent reflux.
This document summarizes key points from a presentation on restoring hospitality to hospital care. It emphasizes treating the whole person, not just the disease, and using a patient-centered approach. This involves greeting patients with courtesy, making them feel comfortable, clearly explaining their treatment plan, and finding ways to bring joy to difficult situations. The goal is to win by treating the person, not just curing the disease.
Diverticulitis: Popular Misconceptions and New ManagementPatricia Raymond
Of course, it's not about just avoiding nuts and seeds. However, do you know how many attacks you can endure before suggesting a resection? How to manage young or immunosuppressed patients with diverticulitis? How Eastern (asian)diverticulitis differs? The role of mesalamine in treatment? It's time to re-explore a disease that you thought you knew!
This document contains information from a gastroenterologist on various gastrointestinal conditions including secretory diarrhea, Giardia infection, celiac disease, lactose intolerance, protein-losing enteropathy, small bowel bacterial overgrowth, irritable bowel syndrome, mesenteric ischemia, and Whipple's disease. It includes diagnostic criteria, clinical features, diagnostic tests, treatment recommendations, and prevalence statistics for each condition.
What Their Poo Can Tell You: How FIT (iFOBT) Fits Your Colorectal Cancer Algo...Patricia Raymond
Everyone needs a colonoscopy at 50 for colorectal cancer prevention, but what if…they simply refuse? They can’t afford it due to insurance issues? We seem to have forgotten that the updated ACG guidelines of 2009 for first time recommend use of annual stool FIT testing as “the preferred cancer detection test” if colonoscopy was not available or refused. How does FIT differ from our venerable stool guaiac testing? And is it finally time to discard gFOBT (AKA guaiac testing) as an insensitive and nonspecific diagnostic tool? Join our conversation and see how FIT testing fits our current screening guidelines, your patients’ financial limitations, and your excellent medical care.
Kiss Your Hemorrhoids Goodbye: Surgical and Non-Surgical Management OptionsPatricia Raymond
Kiss Your Hemorrhoids Goodbye: Surgical and Non-Surgical Management Options
Patricia L. Raymond MD FACG, Rx For Sanity
There seem to be many options to manage our patients' hemorrhoids: hemorrhoidectomy, banding, sclerotherapy, laser photocoagulation, topical medications. Which option is the best for your patient? The physiology and management of the bitter end of the gastrointestinal tract.
Objectives: The participant will…
Distinguish between internal and external hemorrhoids, review the anorectal anatomy and understand the grading system for internal hemorrhoids.
Categorize the differential diagnosis of hemorrhoids, including proctalgia fugax, anal fissure, perianal crohns disease, anal cancer, condyloma, skin tags and rectal prolapse
Examine specific medical, endoscopic, office, and surgical treatment options for hemorrhoids and their stated efficacy
What are the correct probiotics to advise your ill patients to take? Should your well patients be on probiotic supplements? What doses are appropriate? Can they cause harm?
Do you know how to choose and use a probiotic properly?
Marketing has gotten out of hand, and gastroenterology professionals need to understand the oftentimes scanty data that exists on probiotic usage. Join us and learn to use this age old tool made new again.
Holistic Management as an Adjunct in IBD: Encourage your patient to own the...Patricia Raymond
The document discusses the potential for holistic management approaches as adjunct treatments for inflammatory bowel disease (IBD). It provides information on several ways patients can self-monitor their disease activity through indices like CDAI, UCDAI, and P-SCCAI. It also reviews evidence on the role of vitamin D supplementation, dietary changes, cannabis use, and lifestyle factors like exercise and meditation in managing IBD symptoms. While some studies found improvements in outcomes from these approaches, the evidence has limitations and their long-term impact requires more research.
Hash It Out: The Role of Medical Marijuana in GIPatricia Raymond
Marijuana's side effect of Cannabinoid Hyperemesis Syndrome is well known to us, as is use of Marinol to enhance appetite in the chronically ill, but are there other high points in the use of medical marijuana? What about the possible use of CBD oil for chronic pancreatitis or intractable abdominal pain?
Studies have shown cannabis' effect on GI motility, inflammation and immunity, intestinal and gastric acid secretion, nociception and emesis pathways, and appetite. Let's weed through the available data on the medical use and side effects of medicinal cannabis in gastroenterology.
Celiac Disease: Beyond Bowes, Bone, & Blood Rev 2019Patricia Raymond
Celiac disease can cause iron deficiency anemia, osteoporosis, and malabsorption…but is that all? Nope. There are a huge number of other disease associations with celiac disease beyond just bowels, bone, and blood. Join us for this classic presentation of celiac comorbidities that may alert you to the presence of this woefully under-diagnosed condition.
Diverticulitis: Popular Misconceptions & New Management rev 2019Patricia Raymond
As presented at RMSGNA 2019: Of course, it's not about just avoiding nuts and seeds. However, do you know how many attacks you can endure before suggesting a resection? How to manage young or immunosuppressed patients with diverticulitis? How Eastern (asian)diverticulitis differs? The role of mesalamine in treatment? It's time to re-explore a disease that you thought you knew!
Evolving diets in GI Disease 2019 Raymond/GallagherPatricia Raymond
As presented 09/2019 at RMSGNA: In the 50's , doctors recommended smoking for your health. More recently gastroenterologists told patients with ulcers to drink milk and eat bread to heal.
Are you using new science based dietary information for your patients? It's time to update your timeworn dietary strategies and handouts. Join us and review the science on recent advances in dietary management for gastrointestinal disorders: Fatty liver, IBS, IBD, Gastroparesis, Post gastric bypass, Diverticulosis, Cirrhosis, and more!
Examine historical misinformation in dietary management of gastrointestinal disorders
Describe the emerging evidence supporting the primary role of dietary therapies in digestive disease including Irritable Bowel Syndrome, Inflammatory Bowel Disease, Small Intestinal Bacterial Overgrowth, Non-Alcoholic Fatty Liver Disease, Gastroparesis, Pancreatitis, Post-Gastric Bypass, and Diverticulitis.
Identify the role of the Registered Dietitian and the importance of a multi-disciplinary approach to the management of digestives diseases
Know GI Inside & Out? Recognizing Skin Lesions of GI DisordersPatricia Raymond
Skin lesions seen with disorders of the digestive tract are not rare; would you recognize and correctly correlate erythema nodosum, dermatitis herpetiformis, pyoderma gangrenosum? Those were easy-- how about pyoderma vegetans, pyostomatitis vegetans, sweet’s syndrome, xanthomas, tripe palms, palmoplantar keratoderma, or trichilemmomas? Stumped?
Join us and learn the art of GI diagnosis without resorting to our endoscopes.
Fun Functional Gallbladder Disorders: Update on Hypo and Hyperkinetic Gallbla...Patricia Raymond
Functional gallbladder disorder is biliary pain from motility disturbance in the absence of gallstones, sludge, or microcrystal disease. In patients with biliary-type pain and a normal US, the prevalence is 8% men and 21% women. We will review the clinical manifestations, diagnosis, and management of patients with suspected functional gallbladder disorder, and also address current evaluation and management of sphincter of Oddi dysfunction.
Cyst Assist: Pancreatic Cyst Evaluation & ManagementPatricia Raymond
This document provides an overview of pancreatic cyst evaluation and management. It discusses the prevalence of incidentally detected pancreatic cysts on imaging and categorizes cysts as benign, pseudocysts, or one of four subtypes of pancreatic cystic neoplasms (PCNs): serous cystic tumors, mucinous cystic neoplasms, intraductal papillary mucinous neoplasms, and solid pseudopapillary neoplasms. For each PCN subtype, it describes characteristics such as patient demographics, location, risk of malignancy, and management guidelines. It also reviews guidelines for managing pseudocysts and outlines the endoscopic, percutaneous, and surgical drainage options with expected outcomes. In summary,
Kudos To You: Learning your Kudo Pit Patterns and Paris Polyp ClassificationsPatricia Raymond
We've told patients that we won't know about their polyps until after the pathology report is back; turns out that's not precisely true. Today's excellence in optics provides an accurate instantaneous assessment of the histology of colon polyps which may help in decision making during colonoscopy.
Did you know that if a polyp has a type 5 Kudo pit pattern, 50% were invasive cancers to the submucosal layer? What is it about that scary polyp that raises your hackles? Join us in this highly interactive session where we'll learn Kudo pit patterns as well as Paris polyp classifications to elevate your GI procedure reporting and your patient care.
Describe the emerging evidence supporting the primary role of Kudo Pit Patterns in visual inspection of in situ polyps, and demonstrate your ability to identify the patterns
Authentication of Kudo Pits
Pits and their risks
Images of Kudo pits
Quiz of Kudo Pits
Discuss the potential and shortcomings of the Paris Polyp Classification, and demonstrate an ability to classify the polyp shape
Polyp shapes and and their risks (pedunculated, elevated, depressed)
Images of polyps for Paris classification
Polyps and their risks
Quiz of polyp shapes
Concerns regarding interobserver variability
Familial Adenomatous Polyposis affects 1 in 10,000 to 30,000 Americans who experience 100% risk of colon cancer, and FAP doesn't end with a total colectomy for removal of their hundreds of polyps.
Follow this journey of two real FAP patients through pancreatitis from symptomatic ampulla polyps, surgical resection of giant small bowel polyps, bowel obstruction from abdominal desmoid tumors, and Wilm's tumor of the kidney. How do we diagnose, monitor and support our FAP patients? Can pharmacotherapy reduce risk of polyp growth in FAP? What are the extracolonic manifestations of the APC gene mutation? Our responsibility doesn't end when the colon does.
Bored with Barretts: Diagnosing Gastric Intestinal Metaplasia, Meckels, & Pa...Patricia Raymond
We all know what to do with the border disorder that is Barretts, but what about other mucosal heterotopia: intestinal mucosa in the stomach, stomach mucosa in the intestine, pancreas mucosa in the stomach...what's going on with all this meandering mucosa? Join us for a discussion about how to diagnose and manage various misplaced gastrointestinal mucosa.
Discuss the natural history of Gastric Intestinal Metaplasia and construct proper endoscopic surveillance and mapping guidelines
Epidemiology and risk factors
Complete and incomplete, types I-III based on mucin expression
Risk of progression to cancer
Proper surveillance and endoscopic mapping
Management
35 min
Meckels
Describe the presumed anatomical development of Meckel's Diverticulum, summarize the 'Rule Of Twos', formulate management of a Meckel's associated cryptic bleed
Who was Meckel
Epidemiology and risk factors
Rule of twos
Risk of bleed
Management
10 min
Pancreatic Rests
Discuss the natural history of Gastric Intestinal Metaplasia and construct proper endoscopic surveillance and mapping guidelines
Review the endoscopic appearance of the Pancreatic Rest, discuss rare symptoms attributable to the finding and current endoscopic evaluation and management
Endoscopic appearance
Anatomic development
Risks for pancreatitis, cancer, obstruction
Endoscopic and surgical management
10 min
Do You Believe in Reflux: Idiopathic Pulmonary FibrosisPatricia Raymond
Recent studies suggest that if you have IPF (idiopathic pulmonary fibrosis), that you may not perceive the GERD (reflux) that you have, and that this acid reflux may cause the fibrosis to progress. Ask for proper testing and treatment to see if you are one of the almost 80% of IPF patients who have reflux, often silent reflux.
This document summarizes key points from a presentation on restoring hospitality to hospital care. It emphasizes treating the whole person, not just the disease, and using a patient-centered approach. This involves greeting patients with courtesy, making them feel comfortable, clearly explaining their treatment plan, and finding ways to bring joy to difficult situations. The goal is to win by treating the person, not just curing the disease.
Diverticulitis: Popular Misconceptions and New ManagementPatricia Raymond
Of course, it's not about just avoiding nuts and seeds. However, do you know how many attacks you can endure before suggesting a resection? How to manage young or immunosuppressed patients with diverticulitis? How Eastern (asian)diverticulitis differs? The role of mesalamine in treatment? It's time to re-explore a disease that you thought you knew!
This document contains information from a gastroenterologist on various gastrointestinal conditions including secretory diarrhea, Giardia infection, celiac disease, lactose intolerance, protein-losing enteropathy, small bowel bacterial overgrowth, irritable bowel syndrome, mesenteric ischemia, and Whipple's disease. It includes diagnostic criteria, clinical features, diagnostic tests, treatment recommendations, and prevalence statistics for each condition.
What Their Poo Can Tell You: How FIT (iFOBT) Fits Your Colorectal Cancer Algo...Patricia Raymond
Everyone needs a colonoscopy at 50 for colorectal cancer prevention, but what if…they simply refuse? They can’t afford it due to insurance issues? We seem to have forgotten that the updated ACG guidelines of 2009 for first time recommend use of annual stool FIT testing as “the preferred cancer detection test” if colonoscopy was not available or refused. How does FIT differ from our venerable stool guaiac testing? And is it finally time to discard gFOBT (AKA guaiac testing) as an insensitive and nonspecific diagnostic tool? Join our conversation and see how FIT testing fits our current screening guidelines, your patients’ financial limitations, and your excellent medical care.
Kiss Your Hemorrhoids Goodbye: Surgical and Non-Surgical Management OptionsPatricia Raymond
Kiss Your Hemorrhoids Goodbye: Surgical and Non-Surgical Management Options
Patricia L. Raymond MD FACG, Rx For Sanity
There seem to be many options to manage our patients' hemorrhoids: hemorrhoidectomy, banding, sclerotherapy, laser photocoagulation, topical medications. Which option is the best for your patient? The physiology and management of the bitter end of the gastrointestinal tract.
Objectives: The participant will…
Distinguish between internal and external hemorrhoids, review the anorectal anatomy and understand the grading system for internal hemorrhoids.
Categorize the differential diagnosis of hemorrhoids, including proctalgia fugax, anal fissure, perianal crohns disease, anal cancer, condyloma, skin tags and rectal prolapse
Examine specific medical, endoscopic, office, and surgical treatment options for hemorrhoids and their stated efficacy
What are the correct probiotics to advise your ill patients to take? Should your well patients be on probiotic supplements? What doses are appropriate? Can they cause harm?
Do you know how to choose and use a probiotic properly?
Marketing has gotten out of hand, and gastroenterology professionals need to understand the oftentimes scanty data that exists on probiotic usage. Join us and learn to use this age old tool made new again.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Intestinal gas raymond
1. Intestinal Gas:
Charting the course through a
perilous miasma
Patricia L Raymond MD FACP FACG
Rx for Sanity, Chesapeake VA
24 January 2009 1125-1215
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2. “If you jog in a jogging suit,
lounge in lounging pajamas,
and smoke in a smoking jacket,
WHY would anyone want to
wear a windbreaker??"
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6. The manly art of fart-burning.
Compression, ignition, combustion
and exhaust. ~Frank Zappa
Methane burns in oxygen forming water
and carbon dioxide often producing a blue
hue
CH4 + 2O2 → CO2 + 2H2O
Hydrogen sulfide also combusts
2H2S + 3O2 → 2SO2 + 2H2O
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7. How long would you need to
continuously pass flatus in
order to generate methane
gas with the energy of an
atomic bomb?
6 years and 9 months
12 years and 3 months
25 years
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8. Flatulence in
America’s War on Terrorism
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10. Measurement of Gas
Techniques include plethmography, argon
washout technique, digitized KUB
Average amount only 200 ml,
range 115 ml to 1000 ml
14-23 average passage per day
(flatus + eructation)
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11. Composition of gas
99% nitrogen, oxygen,
carbon dioxide,
hydrogen, methane
Location, location,
location
– Stomach: high nitrogen,
oxygen (similar to
atmosphere)
– Colon: less oxygen,
more methane
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15. Sources of gas
Aerophagia
Rapid eating/drinking
Chewing gum
Carbonated beverages
Smoking or drinking
through straw
Poor fitting dentures
Nervous habit
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16. Intraluminal production
CO2: from digestion fat,
protein in upper SB,
bacterial fermentation of
malabsorbed foods, or
acid + bicarb
H2: mainly from colon,
may result from small
bowel bacterial overgrowth
(bacterial fermentation)
CH4: only from bacterial
metabolism
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17. Instilled or iatrogenic gas
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19. Sounds of intestinal gas
Joseph Pujol, 19th
century France
Vibration of anal orifice
Variations
– Tightness of sphincter
muscle
– Velocity of gas
– Other (TMI) moisture,
body fat
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20. Petomaine persists today
Italian movie 'Il Petomane',
contrasting his deep
longing for normalcy with
the condition of 'freak' to
which his act relegated
him.
Blazing Saddles (1974)
Mel Brooks plays the part
of "Governor William J. Le
Petomane".
Johnny Depp has
mentioned frequently in
interviews that he wishes
to portray Pujol in a film.
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22. Fart In A Jar Sells for $71 on eBay
In 2007 a fart in a jar
from a "hot girl" sold
for $71 on eBay.
It had 24 bids
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23. Diamonds are forever?
Janine Roberts' new book
"Glitter &
Greed: The Secret World
of the Diamond Cartel"
exposes the unromantic
side of diamonds.
– Roberts has seen scientists
"grow diamonds" using
methane and oxygen which
she says means diamonds
are nothing more than
"crystallized farts."
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24. Intestinal Gas: Sounds
Borborigmi
Term for noises
generated as gas &
fluid travel through the
gut
A normal sound when
rumbling/low, although
high pitched suggests
PSBO
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25. Herring Break Wind to
Communicate, Study Suggests
Ben Wilson, a marine biologist at the
Bamfield Marine Science Centre, British
Columbia, Canada U.K. science journal
Biology Letters, 2003
Atlantic and Pacific herring
Fast Repetitive Tick (FRT): high-frequency
nocturnal sound bursts up to 22 kilohertz,
accompanied by a fine stream of bubbles
from the anus.
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27. Foods that cause gas: Sugars
Raffinose
– Beans
– Smaller amounts in
cruciferous vegs and grains
Lactose
– Milk products & processed
foods
– Asian, AA, Native American
– Lactase drops with aging
Fructose
– Also soft drinks, onions,
artichokes, wheat
Sorbitol
– Fruits, dietetic foods, sugar
free foods, gum
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28. Gassy foods round-up
provided as a pre-lunch service by PLR
Beyond the beans…
Peas, lentils, soybeans
Broccoli, cabbage, cauliflower, cucumber,
green pepper, kolrabi, brussels sprouts,
onions, leeks, artichokes, and asparagus
Pears, apples, avocados, bananas, melon
and peaches , prunes and raisins
Whole grains, such as whole wheat and
bran.
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29. Starches, fiber & gas
Most starches produce gas
with breakdown in colon
(except rice)
– Potatoes, corn, pasta
Fiber
– Soluble fiber (dissolves in
H2O to gel) in oat bran,
fruits, beans, not broken
down until reaches colon.
digestion by bacteria
causes gas
– Insoluble fiber (wheat bran,
some vegs) passes
unchanged through bowel &
causes no gas
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37. Empiric therapy
Simethicone not very effective
(Phazyme, Mylicon, Gas-X, Mylanta
Gas)
– Changes the surface tension of gas
bubbles, enabling smaller bubbles to
join together into bigger bubbles.
Charcoal
– Tablets, briefs or pads
– May absorb other medications
– Theoretically adsorbs gas volume
Bismuth
– Said to reduce odor of HS gas
Probiotic therapy/antibiotic therapy
– Replace/reduce gas producing bacteria
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38. Never pass gas in a wetsuit.
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39. Thanks for letting me get this
presentation out of my system…
“Better out than in,
I always say.”
~Shrek (Mike Myers)
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41. Have a 239 bean day!
Anything more would be ‘too farty’
(240)!
~From a SGNA colleague who shall remain nameless
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