Dr. Michael Chew @mchew85
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GrepMed Gastroenterology-Hepatology Editor, Academic Hospitalist UC Davis Medical Center Internal Medicine, Yale Gastroenterology Fellow '22
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Irritable Bowel Syndrome (IBS) - Pathophysiology, Diagnosis and Management Algorithm
Risk factors: Previous acute enteric infection, Female
Irritable Bowel ... Syndrome (IBS) - ... functional somatic syndromes ... Pregabalin #IBS #Irritable ... #Bowel #Syndrome
Causes of Small Bowel Bleeding - Differential Diagnosis
Common Causes:
 • Under age 40 years: Inflammatory Bowel
Bowel Bleeding - Differential ... Plummer-Vinson syndrome ... Ehlers-Danlos syndrome ... , Inherited syndromes ... SmallBowel #Bleeding #Differential
Trichuris dysentery syndrome on sigmoidoscopy (whipworms)

An 8y child was referred for sigmoidoscopy from a pediatric unit.
Trichuris dysentery syndrome ... paed unit for endoscopy ... Trichuris #dysentery #syndrome
Gallstone Diseases
1. Asymptomatic Stones 75%
2. Biliary Pain 20%
3. Acute Cholecystitis 10%
4. Mirizzi's Syndrome < 0.1%
5. Cholangitis/
Mirizzi's Syndrome ... Fistula/Bouveret's Syndrome ... Gallstone #Diseases #differential
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
disease (Budd-Chiari syndrome ... #Diagnosis #Differential
Gastrointestinal Causes of Iron Deficiency Anemia
 • Mass lesions: Carcinoma, Large polyps
 • Inflammatory: Reflux esophagitis,
rubber bleb nevus syndrome ... Anemia #Causes #differential
Boerhaave Syndrome on Endoscopy 

Boerhaave Syndrome with complete left wall dehiscence. This one went to surgery
Boerhaave Syndrome ... on Endoscopy ... Boerhaave Syndrome ... #Boerhaave #Syndrome ... #clinical #endoscopy
Causes of Low Vitamin B12 Levels
Low vitamin B12 intake - Vegetarianism, chronic alcoholism and older people
Autoimmune
and Sjögren's syndrome ... low #cobalamin #differential
Rome IV Criteria for the Irritable Bowel Syndrome.

#Diagnosis #PrimaryCare #IBS #IrritableBowelSyndrome #RomeIV #Criteria
Criteria for the Irritable ... Bowel Syndrome.
Abnormal liver function tests algorithm.
 This figure details the initial response to abnormal liver blood tests.
presence of metabolic syndrome ... Liver #Enzymes #Differential