A simple technique to decrease the risk of developing colorectal cancer.

Of the cancers that both men and women can get, colon cancer is the second leading cause of cancer death in the Unites States.  Colonoscopy, when performed by an expert with an adequate adenoma detection rate, has been shown to reduce the risk of developing colorectal cancer.  For most people, routine screening colonoscopy is recommended starting at  … Read more

Do proton pump inhibitors cause heart attacks?

There has been concern for several years about commonly prescribed antacid drugs called proton pump inhibitors (PPIs) and the heart.  PPIs are used to treat gastroesophageal reflux disease (GERD), peptic ulcer disease, and other acid-related diseases.  Common drugs in the PPI class are omeprazole (Prilosec), esomeprazole (Nexium), pantoprazole (Protonix), lansoprazole (Prevacid), and dexlansoprazole (Dexilant), among  … Read more

An unusual case of duodenal perforation

Case: A 79-year-old man with a distant history of pulmonary embolism (PE) was admitted to the hospital with several days of vague right-sided lower abdominal pain.  There was no history of gastrointestinal bleeding, and the pain did not worsen with eating.  On physical exam, there was moderate right lower quadrant abdominal tenderness without rebound or  … Read more

“When can I go home?”

Most patients want to get out of the hospital as soon as possible.  No one wants to sleep in a loud hospital room with constant interruptions for rounding, vital sign checks, blood work, etc.  Hospitals are a place for people when they’re sick, and if you aren’t sick you shouldn’t be in a hospital. I  … Read more

Kissing duodenal ulcers.

These are “kissing” duodenal ulcers.  The ulcers are on opposite walls of the duodenal bulb, and are basically touching each other, hence the “kissing” description.  If you notice, the larger ulcer on the right has a flat dark spot in the middle…this is the former site of the large artery that was actively bleeding 24  … Read more

A family member has just been diagnosed with C. diff. Now what?

Clostridium difficile (C. difficile) has become the most commonly hospital acquired infection in the US, and also occasionally causes infection in people in the community without any traditional risk factors. C. difficile infects the colon and causes inflammation called colitis. The symptoms are usually diarrhea, abdominal pain, fever, and sometimes nausea and vomiting. C. difficile is treated with specific  … Read more

The little white one

“Are you still taking lasix?” I asked the patient. He was new to the office, here for a routine post-hospital follow up visit after recently being admitted for decompensated cirrhosis with ascites and fluid overload. His dose of lasix was resumed prior to discharge, and he was supposed to be taking 80 mg daily. “I  … Read more