• • Night time diarrhea is a red flag symptom - usually suggests secretory diarrhea.
  • Those s/p Whipple may be more at risk for Small intestinal Bacterial Overgrowth (SIBO) - Labs usually show Low B12, High Folate
    • Dx- Hydrogen breath test 
  
  

  Posted 08/16/16 09:50:16 AM by Adam Faye

• Celiac Disease- IgA TTG (Check IgA level as well, can have false negative if IgA deficiency)
  • Most sensitive and most specific
  • HLA DQ2/DQ8
  • Once patient off gluten for 6-12 months, may see normal TTG levels 
  • Suspect in any nationality/region - new data shows high prevalence in Northern India
  • Untreated Celiac- can lead to intestinal lymphoma, small bowel adenocarcinoma, Fe def. anemia, Osteoporosis etc. 
  
  

  Posted 08/16/16 10:02:36 AM by Adam Faye

• Tropical Sprue:
  • Chronic diarrhea illness in people who live/visited areas where it is common (tropics)
  • Possibly infectious in origin (malabsorption of Folate/B12)
  • Endoscopy will show scalloping/flattening of duodenal folds --> blunted vili with elongated crypts and lymphocytes
  • Rx- Tetracyline 250mg qid + Folate 5mg/day for 3-6 months
  
  

  Posted 08/16/16 10:10:20 AM by Adam Faye

• Most common causes of pancreatitis:
  • ETOH, Gallstones
  • Post-op can have structural causes
  
  

  Posted 08/16/16 10:12:59 AM by Adam Faye

• Celiac Disease NEJM case
  Acute Infectious Diarrhea
  
  

  Posted 08/16/16 10:16:33 AM by Adam Faye

Created by Christopher Kelly

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