Additional miscellaneous gastrointestinal notes

clinical management of shortcut syndrome

#1 control the diarrhea – dihpenoxylate, opioids, anticholinergics

#2 controlled diet small frequent meals low in sugar (osmolarity)

#3 nutrient replacement specifically magnesium calcium and micronutrients #number four total parenteral nutrition

Alpha-1 anti-trypsin clearance - clinical marker for protein malabsorption

Painless outlet bleeding

#1 diverticulosis approximately 30%

#2 hemorrhoids 15 to 20%

#3 malignancy 15 and 20%

#4 colitis

Thiamine deficiency seen after bariatric surgery so-called bariatric beriberi

1 quart of caffeine can deplete your entire same in stores

hyperemesis gravidarum check thiamine, they can be deficient

Clinical history hopping differentiate radiation enteritis versus radiation proctitis

  -enteritis is bloody outlet bleeding, proctitis is hematochezia and pain

Chromium is a micronutrient cofactor necessary for the action of insulin. Therefore in patients with hyperglycemia consider that chromium may be deficient. This is especially true in the setting of total parenteral nutrition because many formulations are lacking this micronutrient.

Manganese access the setting of total parenteral nutrition can present as paper dense deposits in the basal ganglia

Post polypectomy bleeding window of presentation is normally between 5– 7 days

electrocautery causes delayed bleeding

Subtle clinical clues for picking up zinc deficiency -abnormal taste, acrodermatitis enteropathica

Copper deficiency can present in the setting up gastrectomy or chelator therapy

Mantle cell lymphoma often presents in a colon polyp

Solid tissue biopsy report says "granulocytic sarcoma" - that is an acute myeloid leukemia in the tissue