Introduction


Why a gastroenterology blog? 

A quick search of google will show about a thousand gastroenterology blogs.  However, if you look closer, about 99.8% of those “blogs” are really just advertisements for a doctor or a practice with titles like “when should I get a colonoscopy?” or “when should I contact a gastroenterologist about abdominal pain?” Most of them have only a few posts, and haven’t been updated in over a year.

I wanted to create a real gastroenterology blog, where I would share my real experiences, thoughts, emotions, and also more clinical matters such as information from studies, and case reports.  My goal for this site is to be interesting to both practicing clinicians and motivated patients.  Therefore, while most posts will be enjoyable by all, some articles here will be a bit more on the technical side.  I will try to define most terms and jargon when used, especially for the first time, however sometimes this becomes cumbersome (especially for more clinical entries) and I don’t want these posts to read like a dictionary.  Therefore, it may be helpful to use the search function on the page to look up any older articles that may be related for background information.

Like all fields, gastroenterology is becoming more and more data-driven, meaning that studies are being done giving us answers to specific questions that come up in our daily practice.  When a patient has an illness, much of what we recommend is based on past learning and experiences, however this knowledge base should always be evolving in the face of new information.  I find myself perusing multiple journals to keep up with the steady stream of information, which usually feels more like a river!

Clinicians see interesting or unusual problems every day.

To me, it doesn’t make sense to see an individual patient with a rare or unusual problem, look something up about the condition, and then apply that information only to that one patient.  If I took the time to do a little research in the first place, how much longer does it really take to post a little article here and share it with the world? What if I never see a case of the same disease again? Maybe someone else can find it and benefit from it.  Maybe more patients or clinicians with similar issues will recognize it and ideas can be exchanged.  I don’t know what the endpoint is, but without putting the information out there I will never know.

The internet and search engines have revolutionized the way information is obtained and shared.  Medical journals have the monopoly on reporting new information, but there are also many other places one can turn to for information.  Doing research and submitting articles to journals is time-consuming and not all practicing clinicians have the time, resources, and desire to do this.  I know that I don’t.  But with a blog and google I can still put some ideas “out there” and people can find them!

To be clear, the best place for original information is still peer-reviewed medical journals.  Most reputable journals have a very high level of quality and authority in what they produce.  World experts in the field, statisticians, and editors try to pick apart a study before it even gets printed.  Then after publication, anyone can challenge it by writing to the journal or the authors.  Obviously this site, being a one-man operation, will not approach anywhere near that level of stringency.  Instead, what I aim to do is to boil down a basic principle that I have applied to real patients and share it here in a more narrative format.  I hope it is both informative and interesting.

Something doesn’t have to be unusual to be interesting.

Medicine is inherently fascinating.  With so many complicated processes working together in the human body, it’s amazing that more things don’t go wrong more often.  Things that seem mundane and ordinary to a practicing doctor are still quite interesting if we take the time to stop and think about them.  Something as “routine” as a screening colonoscopy is actually an amazing feat of technology and science; we often forget that only 50 years ago colonoscopy was still an experimental technique and now expert practitioners can diagnose and prevent colon cancer with this fast, overall safe, and painless outpatient procedure.

When encountering common complaints, I often find myself reciting the same or similar advice many times during my day.  Knowledge that is basic to the practicing gastroenterologist may not be well known to other doctors in different specialties.  If nothing more, by writing this stuff down it will help to solidify my thought process and may be a resource to others.

It’s not all about GI and science.

Knowing what a study says is one thing, but applying that knowledge to a patient is another thing entirely.  Just getting a good history sometimes can be fraught with many pitfalls of communication.  Learning how to break bad news is a skill that is constantly being refined.  Navigating insurance issues, government mandates, and hospital systems can make my head spin.  If the title of this site “Retroflexions” makes you think of the word reflections it is not an accident.

I hope you enjoy your time here, and thank you for reading!

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