גסטרו

18:12 Friday, 7 June 2019
-
-
Familial polyposis Polyposis Coli

-
5 APC -
25 -
40 -
Gardner's syndrome -
retinal pigment epithelium

desmoid
ampulla
CNS Turcot's syndrome -
-
NSAIDs
colectomy
-
35 sigmoidoscopy
Lynch syndrome HNPCC

-
microsatellite instability missmatch repair proteins hMLH1 hMSH2 -
-
3 colorectal cancer
2
50
-
10-15 50
poorly differentiated mucinous
pancriato-biliary GU -
HNPCC -
40 25
US
Quick Notes 2 Page 1

CRC 50% -
-
10%
20-30%
13 CRC -
77 CRC screening
50 -
10
5
virtual colonoscopy
-
-
-

CRC screening
18:13 Friday, 7 June 2019

10:48 Sunday, 25 November 2018

-
-
1:1000 FNA EUS
0.5-5%
10-15% PEG -
ERCP -
ERCP
30% 5% 

1%

20:55 Tuesday, 2 June 2020
LGIB 1.3 UGIB -

UGIB -
3% GI -
-
GI -
Overt -
melena hematochezia coffee grounds hematemesis
Occult -
-
UGIB
LGIB
Obscure GIB
- UGIB
50% PUD 1
visible vessel, active bleeding high risk ulcer 20% -
1/3
IV PPI
IV PPI
clean base Lower risk ulcers -
oral PPI
10-50% -
5% rebleeding H. Pylory
NSAIDs
1-7
PPI COX2 inhibitor NSAIDS

7 PPI NSAIDs
42%
10-15% Erosions 2
-
-
NSAIDS 50% NSAIDs
2-40% Varices 3
20-30% -
1/3 -
12 HVPG (Hepatic venous pressure gradient) -
EVL -
ABC -
90% Endoscopic Variceal Ligation 12 -
2-5 terlipressin somatostatin, octreotide IV Vasoconstricting agents -
-
TIPS -
child C

child C
TIPS blakemore/minnesota tube -

-
high rebleeding rate EVL
glue tissue adhesive
TIPS
EVL -
portal hypertensive gastropathy -
2-10% Mallory Weiss tears 4

retching -
GEJ -
0-10% 80-90% -
-
non bleeding visible vessel mallory weiss tear -
Stress induced gastric mucosal injury 5

1/3 -
-
-
H2 PPI -
blockers
6
-
aorto-enteric fistula -
Osler weber rendu -
GAVE -
Dieulafoy's lesion -
hemosccus pancreaticus -
obscure 75% GIB 5-10%

40
Vascular ectasia -
45% rebleeding
last resort thalidomide octreotide
GIST -
NSAIDs induced -
40
-
-
small intestine Meckel's diverticulum -
-
Diverticula -
Painless
15-40% 80-90%

Vascular ectasia -
70
aortic stenosis Vascular ectasia Heyde's syndrome
-
radiation IBD Colitis -
Post-polypectomy bleeding -
NSAIDs -
Solitary rectal ulcer -
-
-
-
juvenile polyposis IBD -
GIB
LGIB UGIB
Hematemesis -
14 Melena -
90%
10%
maroon Hematochezia -
UGIB LGIB 85%
UGIB presenting symptom o
volume depletion BUN UGIB -
-
15-20% o
20% o
40% o
-
72 o
people bleed whole blood
chronic GIB o
-
UGIB 15% - o
50% UGIB o
o
GIB

-
-
-
70 0-2 0-1 Glasgow Blatchford scale -

0.5% 1% -
UGIB
IV PPI -
terlipressin octreotide
uptodate -
7
o
8
9
UGIB 24 -
o
o
o
12 -
urgent endoscopy

urgent endoscopy
70
5-10% rebleeding -

Coaptive coagulation 
PPI -
LGIB

315
urgent colonoscopy -
yield -
-
GIB of obscure origin

overt
-
CT 
-
25% upper + lower endoscopy -
-
small bowel barium push enteroscopy o
o
CT enterography o
-
CT enterography o
Double or single balloon or spiral endoscopy Deep enteroscopy o
o
Tc-pertechnetate Meckel s diverticulum

CT angio o
o
Occult GIB
-
-
-
-
30% -
colorectal cancer 10% -
-
-
-
mucosal vascular ectasia 50-70% -
MR enterography CT -
Deep enteroscopy -
0.1 -
0.1-0.3 CTA -
0.5 -

20:11 Thursday, 26 July 2018
200 -
Acute -
2-4 Persistent -
4 Chronic -
-
IBS Pseudodiarrhea
Fecal incontinence
fecal impaction Overflow diarrhea -
90% -
norovirus Giardia E COLI
Vibrio A E COLI O157:H7

Cryptosporidium microsporida CMV 
vibrio 
cryptosporidium giardia rota virus
C. Difficile
-
Yersinia
reactive arthritis Yersinia
HUS E COLI
Postinfectious IBS
-
NSAIDS
sparing 50 Ischemic colitis
Graft versus host disease

IBD
-
Profuse diarrhea
38.5
48
50
70
C difficile -
CT -
IBD
-
loperamide moderate-severe -
bismuth encephalopathy -
febrile dysentery moderate-severe -
3-5 500
7 250 giardia
-
Recent vascular graft
4 -
-
3 -
1
2
3

-
Stool Osmotic gap 290- 2x (fecal sodium + fecal potassium)

- Stool osmotic gap >50 = osmotic diarrhea
- Stool osmotic gap <50 = secretory diarrhea
1 -
Stimulant laxatives painless -
-
sprue like entropathy Olmesartan Osmotic gap<50 -
2
carcinoid syndrome primary bronchial carcinoid Metastatic carcinoid tumor
flushing
10% 1/3 gastrinoma
20 VIP VIPoma
pancreatic cholera
pellagra like
calcitonin Medullary carcinoma of thyroid
urticaria pigmentosa Systemic mastocytosis
NSAIDS Large colorectal villous adenoma
Bile acid diarrhea 3
C4 FGF-19
lactase deficiency 1 -
GI 75% Osmotic gap 50 -
2
3
Fermentable Oligo-, Di-, Mono-saccharides And Polyols FODMAP Intolerance 4
1 -
pancreatic duct CF ADEK -
Bacterial overgrowth -
B12 7 -
billiary obstruction 14
2 15-25
32
Giardia Micobacterium avium intracellulare tropical sprue

Abetalipoproteinemia
MMF
3
IBD - -
Lymphocytic collitis, collagenous collitis - WBC -
Ischemic colitis - calprotectin -
Radiation enteritis - protein losing enteropathy -
-
charcot Leyden crystals 50-75% Eosinophilic gastroenteritis - colorectal cancer -
-
rifaximine 5HT3 IBS -

-
Diabetic diarrhea -
-
Poatvagotomy -
- Factitial
-
-

10:22 Wednesday, 20 March 2019

prolonged defecation time straining 3 -
90% -
-
TSH -
-
Melanosis coli -
-
Colon tranist time
balloon expulsion
defection proctography Rectoanal angle measurment
-
chloride channel activatior Lubiprostone
guanylate cyclase C agonist Linaclotide

20:55 Thursday, 21 March 2019
-
pyloric obstruction gastroparesis
rumination syndrome
gastric obstruction
Zenker's
-
pyloric obstruction gastroparesis Succussion splash
-
-
CT -
-
-
-
C labelled gastric emptying breath test
pseudo-obstruction -

pseudo-obstruction -
rumination syndrome PH\impedance -
-
-
-
-

18:06 Sunday, 7 October 2018
hearburn, pyrosis -
GERD
retching -
rumination retching
GERD -
-
30%
oropharyngeal dysphagia
pill\infectious esophagitis -
GERD
Water brush -
barret metaplasia
Contrast radiography -
22-95% reflux esophagitis
13
TE Fistula
Zenker's cricopharyngeaous
video fluoroscopic rapid sequence
EUS -
barret
staging

impedance
24-96h ph monitoring -
GERD 5% 4 ph
GERD
impedance
Hiatal hernia
esophageal hiatus
sliding hernia Type I -
95
GE hiatus paraesophageal
gastric cardia junction
wear and tear
GERD
Paraesophageal hernia -
sliding hernia II III Type II& III

gastric volvulus
Type IV
Rings and webs

Plummer vinson syndrome -
proximal esophageal webs
B ring -
squamocolumnar mucosal junction
10-15%
Schatzki ring 13
steakhouse syndrome
Diverticula
False diverticula -
Hypopharyngeal (Zenker's)
UES stenotic crycopharyngeaous muscle 
Killian triangle

crycopharyngeal myotomy diverticulectomy 
marsupialization
Epiphrenic
Midesophageal True diverticula -
esophageal candidiasis Diffuse intramural esophageal pseudodiverticulosis -

15:48 2016 29
100,000 4.4 100,000 4.5

10
SCC shift -
Barret's
-
HPV SCC -
left recurrent
laryngeal

-
oropharyngeal dysphagia -
Esophageal dysphagia -

19:03 2016 25
myenteric plexus NO -
100,000 1-3 -
25-60 -
LES -
LES + sigmoid espohagus -
HSV1 -
-
-
-
squeezing
chest pain equivalent
-
-
DD
DES -
Chaga's disease -
kissing bug protozoa T. Cruzi
5% Pseudo-achalasia -
-



anti-neuronal ab.
-
beak like esophagus
epiphrenic diverticulum
sigmoid configuration
-
impaired LES relaxation + absent peristalsis

impaired LES relaxation + absent peristalsis
pseudo-achalasia -
EUS CT
LES -
-
-
1
3-4
32-98%
0.5-5%
Laparoscopic Heller myotomy 2
Heller myotomy
62-100%
5 90% RCT
POEM - Per Oral Esophageal Myotomy LES myotomy
LES
-
CCB
LES

66% 
-
stasis esophagitis
17 Squamous cell esophageal cancer

Diffuse esophageal spasm
2016 25 19:26
normal LES relaxation
DES
short latency -
pseudo-diverticula rosary bead esophagus Corkscrew esophagus -

-
CCB -
anxiolytic -
-

GERD
15:29 Saturday, 11 May 2019
20 2-6 -
10-15% -
-
Barret's esophagus -
GERD -
-
LES 1
LES hypotention 2
GEJ 3

50% ZES 
-
-
-
-
-













GERD -
-
-
-
GEJ Erosive esophagitis
1/3
-
peptic stricture erosive esophaitis
PPI
Barret metaplasia -
PPI
Barret's screening 50 5
Barret metaplasia
GE Junction 
columnar metaplasia 

low and high grade 0.1-0.3%
dysplasia


6 
barret PPI
endoscopic mucosal ablation high grade dysplasia 

3-10% 
2
PPI 3
H2 Receptor antagonist
PPI
interstital nephritis 

B12 
Clostridium difficile infection 
PPI
PPI Laparoscopic Nissen fundoplication 4

PPI Laparoscopic Nissen fundoplication 4

22:28 2016 21
CMV -
200 CD4<100 AIDS -
seroconversion
HAART
HSV - -
-
co oral trush - - -
infection - candida albicans
-
100-200 200-400 PO
14-21 -
voriconazole, posconazole -
IV Echinocandin
- - HSV 1\2 - Herpetic

7-10 5x 200 punched out
- VZV -
14-21 5x 400 -
1 valcyclovir 3x 500 famciclovir ground glass
Cowdry A
8 5 IV
7-14 PCR -
900 Valgancyclovir PO 12 5 IV Gancyclovir - - - CMV

12
3-6 -
relapse - -
yield
-
CMV
Pill esophagitis
-
mid esophagus -
-
Doxycycline
Tetracycline
NSAIDs
Bisphosphonates
Phenytoin
Quinidine
Potassium phosphate
Ferrous sulfate
-
-
CT -
-
PPI
-
schatzki ring -

schatzki ring -
1 IV -
-
impaction -
Eosinophilic Esophagitis
100,000 4-6 -
30-40 -
GERD EoE -
-
HPF 15 food impaction -
PPI food aversion
50% -
-
-
Narrow caliber esophagus

Food impaction
-
PPI 30-50% GERD PPI
Elimination Diet
budesonide Fluticasone propionate
fibrostenosis

17:51 2016 02
40/50/55 -
40 -
5 GERD
Test and treat
-

PUD
10% 12% -
-
90% -
-
5 -
-
OR 3.7
OR 3.3 NSAIDs
NSAIDS 50-70% - 95% - 6-15% -

- 3 90% - -
duodenal bulb - 1 -
3-6 -
-
eosinophilic necrosis -
-
NSAIDS 30-60% - - -
-
- - -
- -
1
2
3 3 antral gastritis
4
NSAIDS -
chemical
gastropathy
Helicobacter Pylori
-
PUD
gastric MALT lymphoma
S shaped -
dormant cocoid -
CagA Vac A CO2 urease -
LPS -

20-50% 20 80% -
-
fecal-oral oral-oral -
-
-
10-15% -
30-60% 50-70% -
-
body
NSAIDs
50-60% -
15-30% PUD -
1.5% -
4-5% -
80% -
75 NSAIDs -
-
NSAIDs
NSAIDS

NSAIDs
-
-
O -
-
-
-
-
-
A1 antitrypsin def. -
Systemic mastocytosis -
CAD -
3-
NSAIDS 87% -

hunger pain -
3 90
3
2/3
coffee ground
20% -
succusion splash -
15-25% GI 1
NSAIDS 60
30 2.5-10%
50%
7% 2
NSAIDS
20% 30
2/3
GU DU
Gatro-colic fistula
IV PPI
1-2% 3
pylorospasm
7-10 PPI
DD
NUD Non Ulcer Dyspepsia -
essential dyspepsia
EPS epigastric pain syndrome PDS postprandial distress syndrome

GI -
GERD -
-
-
billiary colic -
-
30% -
80% -
40 -
-
0.5 80-90%

NSAIDS

-
14 NSAIDS
H2 Blocker PPI 4-6
6 -
Urea Breath Test monoclonal stool antigen test
PPI
1% Reinfection
-
-
8-12
70%
-
90%
8 12
NSAIDS
ZES
secretin stimulation test
High dose PPI 8 90
30-60 40
Eosinophilic gastroenteritis
TB CMV
NSAIDs HP -
-
Antacids -
PUD
CKD 1
CKD 2
milk alkali syndrome 3
4
H2 -
4 nizatidine famotidine ranitidine cimetidine
Abx 4-6
Cimetidine
CYP450
PPI H2
PPI -
H+K+ATPase
95% 72-96
18 2-5

PPI
H2
1-2
ketoconazole
reinfection 2.5 74% C diff CAP
IF B12
40%
diazepam CYP P450

atazanavir
CYP2C9
DAPT PPI pantoprazole
PPI H2 PPI
12
Interstitial nephritis
65
PPI
Tentoprazole PPI -
benzimidazole imidazopyridine
GERD
P-CABs -
venoprazan revaprazan potassium competitive acid pump antagonist
Cytoprotective Agents -
Sucralfate
sulfate aluminium hydroxyl
bezoar
flushing
misoprostol
HP
-
-
10-20% 70% 60%
documented PUD 1
NSAIDS
PUD
MALToma 2
60-90%
NSAIDs 3
PUD
PPI
4
15% 158
subtotal resection
Pan-gastritis, body-predominant

ITP 6
7
85-90% -
-
14 -
4-6 H2/PPI 14 -
sequential -
-
3-4 -
-
GI -
-
1-2% Pseudomembranous colitis
-
80% 30% -
1-2% 15%
-
-
15-20% -
in vitro -
-
-
-
-
14 2 PPI 1
500 2 clarithromycin
3 500 1 3 based
Prevac
10-14 4 PPI 1
2 Bismuth
500 3 quadruple
250-500 4 Helidac
5 2 PPI 1
1 2 Concomitant
10-14 500 3
500 Tinidazole 4
10-14 2 PPI 5-7 1 sequential

tinidazole PPI 5-7 2
14 2 1 PPI 71 Hybrid
nitroimidazole PPI 72
10-14 2 PPI 5-7 1 Levofloxacin
nitoimidazole PPI 5-7 2 sequential
7-10 250 1 LOAD
PPI 2
500 Nitazoxanide 3
100 4
-
Rifabutin/Furazolidone/Levofloxacin+amoxi+PPI -

N-acetylcystein -
-
saccharomyces Lactubacillus -
-
NSAIDS related injury
NSAIDS -
NSAIDS PPI -
NSAIDS -
NSAIDS
naproxen, ibuprofen GI NSAIDS -
-
PPI -
200 misoprostol 40 H2 -
Selective COX2 -
COX2 100 rofecoxib clecoxib -
COX2 Inhibitors CLASS -
COX2 Inhibitors
NSAIDS -
NSAIDS combination pills -

90
gastroduodenostomy\jejunostomy 1
Highly selective vagotomy 2
partial jejunostomy Billroth II gastroduodenostomy Billroth I Vagotomy with anterectomy 3

gastrectomy with Roux en Y
highly selective vagotomy
Bilroth I antrectomy 1
Roun-en-Y GEJ subtotal gastrectomy 2
ZES o
o
NSAIDS o
retained gastric antrum o
sham feeding gastric acid analysis
50% cephalic
sham feeding pancreatic polypeptide
PPI 70-90 H2
2 Afferent loop syndrome -

afferent Bacterial overgrowth o
loop B12
20-60 o
afferent loop
1% Billroth 50% Dumping syndrome -
15-30 1
volume contraction shift
VIP GI
3 90 2

2
6
acrabose guar
1-2 truncal vagotomy 10% Post vagotomy diarrhea -
cholestyramine diphenoxylate loperamide
Bile reflux gastropathy -

cholestyramine
alkaline challenge test sucralfate
3 10% 60% -
intake
bacterial overogrowth B12 o

IF
2 o
o
25% D o
ALP
o
20-25 5-7 gastric stump -
screening

ZES
15:51 Saturday, 15 June 2019
non beta cells -

severe peptic ulcer diathesis < -
0.1-3 0.1-1% PUD 

MEN1 80% 30-50 

90% o
75% o
o
50% 60% 


ECL o
o
PUD 
90% o
o
NSAIDs H pylory
2/3 
50% 
MEN1
20-25% 





5 6% 
pernicious anemia

pernicious anemia o
PPI o
H. Pylory o
Retained gastric antrum o
G cell hyperplasia o
o
o
o
RA o
o
o
ZES o
MEN1 o
-
PPI -
12 PPI -
150 pg\ml -
PH 2
3 PH -
3 PH -
3
PPI -
90% ZES 15 120 pg\ml -
-
4
50% -
Ga-DOTATATE PET CT octreoscan MRI CT -
SSTR2 Sub type 2
US EUS -
selective arterial secretin injection -
EUS
PPI 
o
5 10 Basal Acid Output BAO o
PPI 
lanreotide octreotide o
o
90% 5-10 

radiolabeled somatostatin analogue o
20 5 o

6% MEN1 o
o
o

o

Shorter disease duration o
10,000 o
3 o
o
o
o

Stress related mucosal injury
Sunday, 18 November 2018 11:54
Stress related mucosal injury
Cushing s ulcer Curling s ulcer
insult 48-72 40% GI
PPI
5% PPI
-
-
Multi organ failure -
-
IV PPI
superficial gsastritis=> atrophic gastritis => gastric atrophy

Menetrier s disease
Sunday, 18 November 2018 11:55
Menetrier s disease
sparing
40-60
CMV ZES
familial polyposis syndrome PPI
massive foveolar hyperplasia
CMV
20-100% GI
protein losing gastropathy
snare technique
CBC -
-
CMV -
PH -
EGFR pathway
EGF Cetuximab

IBD
-
IBD 0.6% -
-
African American -
-
2-4 1
UC 7-9 2
5-10% -
o
o
36% IBD 10% IBD -
IBD 2.9 -
IBD -
6 -
100 0-20.2 100 0-19.2

0.34-1.65 0.5-1.58
Non gender
specific
HR 2.82
13-26% Appendectomy
concordance 38-58% concordance 6-18%
concordance 4% concordance 0-2%
2-3 C DIFF
- -
- -
sparing -
skip areas -
30-40% 40-50% -

30-40% o 40-50% -
40-55% o 30-40% -
15-25% o total colitis 20% -
90% - 2-3 10-20%
1/3 - backwash ileitis
-
stellate - Sandpaper
Cobblestone inflammatory polyps
appearance
- toxic megacolon -
-
Creeping fat -
- -
crypt abcess - -
- -
UC -
skip areas -
1
bifid
2
Crypt Cryptitis 3
abscesses
-
Fibrostenotic obstructing pattern 1 -
Penetrating fistulous pattern 2 -
-
- -
-
Ileo-colitis
10-20% -
-
- -
-
- PR -
o toxic megacolon hepatic tympany -
enterocutaneus o
fecaluria pneumaturia entero-vesical o -
foul-smelling dyspareunia enterovaginal o
String sign - CRP
Jejuno-ileitis Fecal Lactoferrin -

- Fecal calprotectin -
pouchitis
bacterial overgrowth - IBS -
intact colon -
ADEK Pellagra B12 - -
Colitis & perianal disease CDT ova

-
1-2% UC - acute flare
short duration disease toxic megacolon -
4-16% -
-
o
o
rectovaginal fistula 10% o
-
1/3 o
o
o
-
bulb -
-
30% -
-
IBS lactoferrin calprotectin -

-
4 -
10% o
-
MRE CTE o
o
5% 1% Capsule retention o
patency capsule o
30
MRE CT -
o
CTE MRE o
1-2% 1 UC 15% -
10-30% 2 1% 1
- -
CT - 24-48 6-8 -
-
- 5% Toxic megacolon 2
40% 3 6 -
4
5 -
6 50% -
-
15%
Toxic colitis -
5-10% 3
-
-
93% 55% ASCA - pANCA -
IPAA
indeterminate
colitis
-
40 -
-

-
STD o
o
TB o
CMV CMV o
o
HIV o
-
Ischemic colitis -
o
AAA o
o
o
Radiation colitis -
IBD 1-2 o
o
Solitary rectal ulcer syndrome -
o
puborectalis muscle o
anal verge o
o
-
-
IBD NSAIDS o
anti CTLA-4 Ipilimumab o
TNF 3
1/3 MMF o
Etanercept o
Atypical colitis -
Lymphocytic colitis Collagenous colitis

1:1 - 9 -
6-7 - 6-7 -
NSAIDS - NSAIDS -
- -
PPI - PPI -
Sertaline - -
27% - -
1
2

2
collagenous budesonide 5-ASA
Diversion colitis o
SCFA
IBD 1/3 -
-
- o
UC 10% 15%
o
UC 1-12%
IV
neutrophilic dermatosis sweet syndrome o
o
5-10% o
80% perianal skin tags o
o
-
15-20% o
10% Ankylosing spondylitis o
TNF
HLA B27 2/3
Sacroileitis o
UC
AS

AS
1-10% -
anterior uveitis o
UC
3-4% Episcleritis o
-
o
IBD 50%
o
10-35%
Granulomatous hepatitis o
Hepatic amyloidosis o
PSC o
IBD PSC 50-75% PSC UC 5%
pANCA UC
IBD
ERCP GS
MRCP
5-10
1 US lifetime risk 10-15% 1

2
PSC small duct PSC
-
10-20% o
o
ileal-bladder o
-
40% o
o
TPN budesonide MTX
60
1% o
o
MRI
-
o
o
o
o
-
o
5ASA o
o

IBD
11:25 Saturday, 1 June 2019
5ASA - -
15 o
30 o
Sulfasalazine o -
2-4 - budesonide o
- o
o
acute severe colitis o -
- o
o
acute severe colitis Cyclosporine -
5ASA - AZA, 6MP, MTX -

MTX AZA 6MP - o
TNF - TNF -
IV infiliximab IV infiliximab o
Adalimumab Adalimumab o
SIMPOMNI Golimumab CIMZIA Certolizumab o
ENTYVIO vedolizumab Anti integrin - ENTYVIO vedolizumab Anti integrin -

bbb alpha4beta7 bbb alpha4beta7 o
XELJANZ Tofacitinib - JAK inhibitor - STELARA Ustekinumab Anti IL12\IL23 -
-
SONIC -
Acute severe colitis

5 -
IV infliximab -
infliximab o
toxic megacolon -
5-ASA
UC -
-
-
Sulfasalazine
-
G6PD -
-
30% -
o
o
-
o
o
o
hypersensitivity pneumonitis o
o
o
o
folic acid -
5-ASA
-
-
-
-

UC -
-
Budesonide -
o
fast metabolism o
5-ASA -
IPAA UC 20-50% UC -
-
o
disulfiram like-reaction o
o
-
tendon rupture tendinitis o
Azathioprine 6-Mercaptopurine
-
thioinosinic acid -
-
-
4-6 3-4 -
-
-
3-4% o
o
o
o
dose related
TMPT
CBC -
MTX
IL-1 DNA -
-
IM\SC -
-
-
o
PO o
o
o
o
IL-2 calcineurin inhibitor -

acute severe colitis -
82% -
150-350 IV 2-4 -
15% -
o
o
120 o
o
o
o

o
PCP o
-
AZA\6MP PO IV -
infliximab infliximab CsA -
100 -
integrity -
UC CD -
moderate-severe CD and UC -
AZA\MTX Top-down therapy -
o
o
TNF
infliximab -
o
IV o
adalimumab -
o
o
acute severe colitis o
infliximab o
o
cerolizumab pegol -
o
Fab2 o
o
o
human IgG 1 anti TNF Golimumab -
o
o
UC o
adalimumab o
anti TNF
-
serum sickness infusion reaction o
o
8
MTX 6MP AZA
o
TNF Secondary failure
Primary failure
NHL -
2:10,000 CD o
4:10,000 6MP AZA o
65 o
thiopurine TNF o
TNF adjustment o
Hepatosplenic T Cell lymphoma -
o
5% -
o
TNF o
Ustekinumab o
-

-
o
thiopurines TNF BCC Non melanoma skin cancer o
o
IBD
thiopurines TNF 2
-
65 o
PPD TB o
o
B o
CNS -
NYHA III-IV -
Drug induced lupus -
Anti integrins
Natalizumab -
maintanance alpha4 integrin IgG o
11:1000 PML o
50-55% JC Virus 1
2
3
seroconversion 1-2% JC virus o
o
Vedolizumab -
gut selective immunosuppression alpha4beta7 o
TNF o
JC Virus TNF CD UC o
anti IL12\IL23 Ustekinumab

IL23 IL12 p40 IgG monoclonal antibody -
-
-
-
-
Tofacitinib
2 JAK1,3 -
signaling -
UC -
Biosimilars
-
-
infliximab -
RCT -
Ozanimod
sphingosine-1-phosphate receptor subtypes 1,5 -
GI tract -
UC -
-
TPN bowel rest o
o
TPN EEN o
UC -
-
10 UC 50%

10 UC 50% o
20-40% o
IPPA o
10%
permanent ileostomy 5-10%
6-10
30-50%
urgency 
CD 

3-5% 

-
o
o
o
80%

strictureplasties 


50%

IPAA 

-
o
o
o
sulfasalazine o
IPAA o
-
conception o
o
6 o
IPAA o
-
Sulfasalazine 5-ASA o
o
AZA 6-MP o
o
MTX o
o
TNF o
Certolizumab
Infliximab, adalimumab
TNF
-
o
50% Total colectomy o
IBD
1.5-2 UC -
-
-
o
o
o
PSC

PSC o
o
o
-
8-10 1/3 o
12-15 1/3 Proctosigmoiditis o
PSC o
o
chromoendoscopy o
10 4-6 o
UC CD o
UC
impassable strictures
-
high grade dysplasia o
UC
segemtal resection
low grade dysplasia o
-
NHL o
o
MDS o
SCC o
o

IBS
80% -
45 -
post infectious IBS -
IBS
shigella salmonella
crampy
200
-
Upper GI symptoms -
25-50%

-
48
200-300
40
IBS-D


microscopic colitis 
trial Lactose hydrogen breath test 
bacterial lactulose hydrogen breath test 

overgrowth
US RUQ
UGI
-
Reassurance
IBS-D -
anti-diarrheals Anti-spasmosdics
Bile acid binders
5HT3 Alosetron Serotonin receptor modulators

5HT3 Alosetron Serotonin receptor modulators
IBS-C -
Fibers
Lubiprostone Chloride channel opener
Linaclotide Guanylate Cyclase C agonist
-
Low FODAMP diet
Rifaximine
-
TCA

22:14 Sunday, 10 February 2019
-
-
-
Atypical celiac disease -
Silent celiac disease -
-
-
-
steatorrhea -
GI -
Steatorrhea -
brush border Secondary lactase deficiency -
-
crypt hyperplasia -
gliadin -
IgA -
Anti tTG
90-95% Anti Endomysial
Antigliadin
-
10%
HLA-DQ8 HLA-DQ2
HLA
DQ2\DQ8
DH dapsone Dermatitis herpetiformis -

DH
1 -
IgA Deficiency -
Down syndrome -
Turner's syndrome -
tTG -

1
Proximal to distal intestinal distribution
intra-epithelial lymphocytes -
villous atrophy crypt hyperplasia villi -
Cuboidal appearance -
lamina propria -
eosinophilic
bacterial overgrowth milk intolerance enteritis
2
-
-
rechallange -
-
-
-
90% -
Refractory celiac disease -
-
Intestinal T cell lymphoma
Intestinal ulceration -
BM collagen like material Collagenous spure -

22:50 Sunday, 10 February 2019
-
-
B12
ALK-P ADKE
-
72 gold standard
Sudan III
Urinary D xylose test -

MRE CTE enteroclysis small bowel series -
-
Tropical sprue
Short bowel syndrome
-
-
Intergrity -
-
-
-
6-12
bacterial overgrowth intestinal transit time

intestinal failure
SCFA
Lactose intolerance
PPI steatorrhea Gastric hypersecretion
enteric hyperoxaluria intact colon Renal calcium oxalate stones -
cholestyramine
Cholestrol gallstones -
bacterial overgrowth 1.2 B12 -

bacterial overgrowth 1.2 B12 -
-
-
MCTs -
bacterial overgrowth -
steatorrhea PPI -
B12 zinc fat soluble vitamins -
teduglutide GLP-2 -
Bacterial Overgrowth syndromes
Functional stasis -
afferent loop Anatomic stasis -
ileocolonic resection -
B12 -
unconjugated Steaorrhea -
steatorrhea -
B12 -
jejunum -
Hydrogen breath test -
-
anatomic blind loop -

jejunal diverticula -
3
rifaximin
Whipple's Disease
PAS steatorrhea GI -
Migratory arthropathy -
-
CNS -
-
-
T. Whipplei

-
CNS -
PAS positive macrophages
M. Avium
-
-
-
BBB

Pseudo-divericula -
muscularis propria
vasa recta
dysbiosis -
70% left sigmoid colon -
60 60% -
20% -
Westerenized societies -
-
-
60 -
20% -
NSAIDS
-
-
25%
RBC CT
80% coil embolization
sub-total colectomy segmental resection 24 6
LLQ pain -
25% LLQ -
-
CT -
4
Complicated diverticulitis -
-
30
Uncomplicated -
75%
Bowel rest
3 

3 

Tazocin 
7-10 

5 
Complicated -
low surgical risk
6 -
-
review
Rifaximin

30% 

- non- - 75% SMA embolism - - Arterio-

- remitting Recent MI - occlusive
- thumbprinting SMA - mesenteric
pneumatosis Progrssive thrombosis - - ischemia
intestinalis -
CT - - 2
-
gold angiography - -
standard
PPV SMA duplex -
80%
- CT - - - - Non-occlusive
- - - mesenteric
- ischemic colitis - - ischemia
Cardiogenic \septic -
shock
Cocaine overdose -
IV - CT - - - Mesenteric
- SMV - Protein C\S - venous
- deficiency thrombosis
Anti thrombin III -
deficiency
Polycythemia vera -
-
- - Intestinal angina - - Chronic
- intestinal
GS - ischemia
- MRA -
80%

Ileus
ileus
IV -
-
-
mu receptor antagonist -
colonic pseudo obstruction Ogilvie's

Neostigmine IV -
IV 10

Gallstones 80-90% -
5 30-60% Gallstones
15-30%
100,000 5 
5-10% Post ERCP -
ERCP prophylactic pancreatic duct stent rectal NSAIDs
minor papilla sphinceterotomy 


post-ERCP pancreatitis 
60 
pancreatic duct 2 

1000 3.8% -
2% -
-
-
-
10-20%
Cullen's sign
Turner's sign
3 -
7-14 3-7

-
-
25% -
10% -
5-10% -
-
BUN Pre renal azotemia
Hemoconcentration
5-10%
-
3 2 -
1
3 2
3
Early phase<2 weeks -

48 persistent organ failure
48 CT
Late phase>2 weeks -
persistent organ failure
CT
US -
3-5 CT -
90-95% Interstitial pancreatitis
5-10% Necrotizing pancreatitis
peripancreatic necrosis 



3-7 self limited 85-90% -
NPO -
low fat solid diet
-
2-3 15-20
8 BUN bed side
3 BISAP 24 -
BUN>25
GCS<15
SIRS
60
Gallstone pancreatitits -
24-48 ERCP
4-6
-
-
organ failure
5-7
Sterile necrosis
step up approach necrosectomy pancreatic debridement Infected necrosis
Pseudo-cyst -
10% 6
Pancreatic duct disruption -
MRCP ERCP
90% 6 bridging pancreatic stent
Perivascular complicantions -
Splenic vein thrombosis
20% -
Recurrent pancreatitis
25% -
-
microlithiasis
2-4%
Pancreas divisum
CF

AIDS
MAC cryptosporidium CMV -

protease inhibitors pentamidine didanosine -

-
stellate cells -
-
-
-
CF -
25% -
15%

-
20%
-
-
severe pancreatic exocrine insufficency 100 fecal 1 elastase -
-
CT -
MRI
hormone stimulation test -
60%
FP EUS -
10 -
IgG4 AIP Autoimmune pancreatitis -

IDCP Idiopathic duct centric pancreatitis -

IDCP Idiopathic duct centric pancreatitis -
IgG GEL duct wall
AIP
IgG related disease -
IgG-associated cholangitis
UC RA
Mediastinal fibrosis and adenopathy
TIN
Chronic perioaortitis
Sialadenitis
Mikulicz's disease
-
2/3
-
2/3 IgG4
ALP
CT -
1/3 ERCP -
-
lymphoplasmacytic
Storiform fibrosis
IgG4
1 HISORt -
H
I
S
other organ involvment O
response R
-
tapering 4 40 
2-4 

2-4 
99%
30% relapse

Rituximab 6MP AZA relapse 

-
80-100,000
PPI
-
Pregabalin
dominant stricture

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18:12 Friday, 7 June 2019

Familial polyposis Polyposis Coli

retinal pigment epithelium

Lynch syndrome HNPCC

Quick Notes 2 Page 1

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LGIB 1.3 UGIB -

PPI COX2 inhibitor NSAIDS

Quick Notes 2 Page 6

TIPS blakemore/minnesota tube -

2-10% Mallory Weiss tears 4

Stress induced gastric mucosal injury 5

obscure 75% GIB 5-10%

Quick Notes 2 Page 7

aortic stenosis Vascular ectasia Heyde's syndrome

UGIB presenting symptom o

volume depletion BUN UGIB -

Quick Notes 2 Page 8

70 0-2 0-1 Glasgow Blatchford scale -

Quick Notes 2 Page 9

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GIB of obscure origin

Quick Notes 2 Page 11

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Graft versus host disease

Recent vascular graft

Quick Notes 2 Page 16

Stool Osmotic gap 290- 2x (fecal sodium + fecal potassium)

Bile acid diarrhea 3

Giardia Micobacterium avium intracellulare tropical sprue

rifaximine 5HT3 IBS -

Quick Notes 2 Page 17

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C labelled gastric emptying breath test

Quick Notes 2 Page 21

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sliding hernia II III Type II& III

Rings and webs

Midesophageal True diverticula -

esophageal candidiasis Diffuse intramural esophageal pseudodiverticulosis -

Quick Notes 2 Page 24

100,000 4.4 100,000 4.5

Quick Notes 2 Page 26

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kissing bug protozoa T. Cruzi

impaired LES relaxation + absent peristalsis

Quick Notes 2 Page 28

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normal LES relaxation

pseudo-diverticula rosary bead esophagus Corkscrew esophagus -

Quick Notes 2 Page 31

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endoscopic mucosal ablation high grade dysplasia 

Quick Notes 2 Page 33

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- - HSV 1\2 - Herpetic

900 Valgancyclovir PO 12 5 IV Gancyclovir - - - CMV

Quick Notes 2 Page 35