Beta-blockers in cirrhosis: friend or foe?

Part one of this topic can be found here. Nonselective beta-blockers (NSBBs) are often indicated for prevention of variceal bleeding in cirrhotic patients. However, there has been a large amount of data in the past several years that have raised serious concerns over the safety and utility of beta-blockers in patients with more advanced cirrhosis.  … Read more

Cirrhosis, varices, and beta-blockers: the basics.

Cirrhosis is the final common stage of most types of chronic liver disease, and appears as “scarring” of the liver tissue under the microscope. The liver becomes firm, and instead of blood flowing easily through the organ on the way back to the heart there is a high level of resistance to blood flow through  … Read more

Flat polyps, or the importance of a good bowel prep.

This is a flat polyp. It’s about the size of a dime or so. This was found on a routine colonoscopy in the ascending colon. The patient had an excellent bowel prep. Colonoscopy has been shown to prevent colon cancer by detecting and removing polyps which are known to be precancerous (known as adenomatous polyps).  … Read more

Infected endoscopes and CRE…what you need to know.

There have been a lot of reports surfacing recently regarding strange infections associated with endoscopy. At the time of publication of this article, there have been about 135 confirmed cases of infection with Carbepenem-resistant Enterobacteriaceae (CRE), which are mainly multi-drug resistant E. coli and Klebsialla species. These infections are relatively rare in general, and are very problematic  … Read more

The End

I must inform you that this is the end of the line.  To a gastroenterologist, seeing these images during a colonoscopy signifies that the end of the colon has been reached.  The more challenging portion of the procedure is over, and now the withdrawal phase begins, where the scope is slowly and methodically pulled back and  … Read more

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