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- 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
Posted 08/16/16 09:50:16 AM by Adam Faye
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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
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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
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Most common causes of pancreatitis:
- ETOH, Gallstones
- Post-op can have structural causes
Posted 08/16/16 10:12:59 AM by Adam Faye
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Posted 08/16/16 10:16:33 AM by Adam Faye
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