Gastrointestinal case studies
Crohn's disease - ANS-Chronic diarrhea, abdominal pain, fever, anorexia, weight loss,
perianal fistulas
TX: anticholinergics (Atrovent)
Tests: colonoscopy, barium contrast studies, genetic markers
Gastroesophageal Reflux Disease - ANS-Upper abdominal pain wrose after meals,
bending, and lying down
TX: dietary changes and proton-pump inhibitors (Nexium)
Tests: endoscopy
HBV - ANS-Loss of appetite, myalgia, nausea, low-grade fever, RUQ pain
TX: anti-virals (tyzeka)
Tests: positive HBsAg, anti HBc, elevated AST -ALT
Constipation predominant IBS - ANS-Colicky abdominal pain relieved by BM, clear or
white mucous in stool, bloating, flatulence, nausea, dyspepsia, symptoms worse after
eating.
TX: anti spasmodias, dietary changes, psychotherapy
Tests: history, physical exam, proctosigoidoscopy
Duodenal Ulcer - ANS-Epigastric pain lessens with meals and reappears 2-3 hours after
meals, pain that awakens at night, weight gain
Tests: endoscopy
TX: proton pump inhibitors + triple therapy
Chronic Pancreatitis - ANS-Alcoholism, recurrent attacks of epigastric pain, weight loss,
glucose intolerance
Tests: abdominal x-ray or CT
TX: supportive therapy only
Celiac Sprue - ANS-Lassitude, weakness, anorexia, intermittent diarrhea, steatorrhea,
weight loss, rash
TX: gluten-free diet
Tests: small bowel biopsy, serological markers (AGA, EMA)
Gastric Carcinoma - ANS-Anorexia and early satiety, dysphagia, weight loss, vomiting,
epigastric pain