Curbside Consultation of the Colon: 49 Clinical Questions

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Brooks D. Cash
SLACK Incorporated, 2008 - Medical - 189 pages
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Are you looking for concise, practical answers to questions that are often left unanswered by traditional medical searches? Are you seeking brief, evidence-based advice for complicated cases or complications? Curbside Consultation of the Colon: 49 Clinical Questions provides quick and direct answers to the thorny questions commonly posed during a “curbside consultation” between colleagues.

Dr. Brooks D. Cash has designed this unique reference, which offers expert advice, preferences, and opinions on tough clinical questions commonly associated with the colon. The unique Q&A format provides quick access to current information related to the colon with the simplicity of a conversation between two colleagues. Numerous images, diagrams, and references are included to enhance the text and to illustrate the treatment of the colon.

Curbside Consultation of the Colon: 49 Clinical Questions provides information basic enough for residents while also incorporating expert advice that even high-volume clinicians will appreciate. Gastroenterologists, fellows and residents in training, surgical attendings, and surgical residents will benefit from the user-friendly and casual format and the expert advice contained within.

Some of the questions that are answered:

• What is the appropriate evaluation for fecal incontinence?
• What colonic infections are associated with AIDS?
• What are the current colorectal cancer screening and surveillance recommendations?
• What is the best way to manage chronic constipation?
• Where do probiotics fit into the management of IBS?
• How should diverticulitis be managed?
• What is colonic pseudo-obstruction and how is it managed?

 

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Contents

A 46YearOld African American Man Who Has No Alarm Features or Symptoms Requests a Screening Colonoscopy Is This Appropriate?
3
What Pathologic Analysis Do I Need to Pursue in a 38YearOld Man With Cecal Cancer Whose Family History Is Suspicious for Hereditary N on pol...
7
How Do You Respond to Patients Wanting to Take Aspirin Calcium or Other Medications as Prophylaxis for Colorectal Cancer? Is There Any Evide...
11
My Patient Had a 3cm Sessile Tubulovillous Adenoma on the Sigmoid That I Removed Piecemeal The Pathology Lab Cant Verify Clear Margin Wha...
15
The Board of Directors of My Hospital Wants to Know the Current Colorectal Cancer Screening Options and Will Go With Whatever I Recommend ...
19
My Patient Had a 13mm Tubular Adenoma Removed From Her Colon What Kind of Surveillance Do I Need To Recommend? Would It Change Thi...
23
I Have a Patient Whose Brother Mother and Maternal Uncle All Had Colon Cancer Diagnosed Before the Age of 45 Does My Patient Have Hereditar...
27
What Do I Need to Tell My Inflammatory Bowel Disease Patients About Their Risk for Colon Cancer and How Should I Perform Surveillance Colon...
31
Want to Use Alosetron for a Woman With IBSD What Do I Need to Tell Her About the Risks and Outcomes Assooated With Ischemic Colitis and Th...
101
For Patients Who Report Persistent Diarrhea What Is Considered Chronic When Do I Need to Begin a Workup and What Does That Workup Involve?
105
My Patient With Collagenous Colitis Developed a Black Tongue With Bismuth What Other Therapeutic Options Do I Have?
109
PERIANAL DISORDERS
113
What Are the Treatment Options for a Patient With Metastatic Colon Cancer Who Has a Malignant Sigmoid Stricture?
115
What Should I Be Doing With My Patients Who Have Anal Fissures?
119
What Is Pruritus Ani and How Is It Managed?
123
What Is Proctalgia Fugax and How Is It Managed?
127

What Do I Tell the Surgeons Who Insist on Annual Colonoscopies for Patients With Cured Colon Cancer Even for Those 5 to 10 Years Past Therapy?
35
The Pathologists Keep Sending Me Reports About Serrated Adenomas What Is a Serrated Adenoma and What Do I Tell My Patients in Terms of Foll...
39
My Patient Was Found to Have About 50 Hyperplastic Polyps Ranging From 5 to 15 mm What Condition Do I Need to Fhink About and How Shoul...
45
CONSTIPATION
49
What Should I Suspect When I See Melanosis Coli and What Is Its Clinical Relevance?
51
What Should Be the Sequence of Investigations for a Patient Who Is Being Considered for Colectomy Due to Chronic Constipation?
55
What Do I Tell My Primary Care Colleagues About Chronic Constipation and the Risk of Colorectal Cancer?
57
What Diagnostic Tests Are Recommended for the Evaluation of Chronic Constipation and What Is Their Yield?
59
How Efficacious Are the Therapies for Chronic Constipation? I Have Heard About Several New Drugs for Constipation Have They Been Shown to ...
63
When Should a Patient Complaining of Chronic Constipation Be Sent for Anorectal Manometry?
67
A Patient Asks About Biofeedback Therapy for Her Constipation Symptoms and Wants to Know What Is Involved What Do I Tell Her?
69
What Are the Emerging Therapeutic Agents for Constipation and How Do They Modulate Colonic Motility?
71
What Do I Tell My Colleagues Who Are Concerned About Neuropathic Changes From Laxative Use?
77
DIARRHEA
81
What Colonic Infections Are Associated With AIDS?
83
We See Many Patients With Bone Marrow Transplants How Do We Recognize and Treat Gratt Versus Host Disease in the Colon? How Do We Make ...
85
Many of My Patients Want To Go With Natural Therapies Where Do Probiotics Tit in the Management of Irritable Bowel Syndrome?
87
What Is the Evidence for Antibiotics as a Therapy for Irritable Bowel Syndrome?
91
A Patient in the Midst of an Inflammatory Bowel Disease Flare Also Was Positive for Clostridium difficile How Often Does This Happen and Whats t...
95
The Nursing Staff Doesnt Know What to Do for a 72Hour Stool Collection as Part of a Diarrhea Workup What Do I Need to Tell Them to Get the A...
99
What Types of Procedures and Therapies Can I Use on Hemorrhoids Before Sending a Patient to the Surgeon?
129
What Tips Can I Give My Surgical Colleagues Who Are Seeing Patients With Pouchitis?
133
A 74YearOld Man Who Is Status Post External Radiation Therapy for Prostate Cancer Now Presents With Hematochezia What Should I Do Next? Ca...
137
What Should Be the Sequence of Investigations for a Patient With Rectal Adenocarcinoma?
141
What Is Solitary Rectal Ulcer Syndrome?
143
What Is Rectal Prolapse?
147
COLON POTPOURRI
149
The Emergency Room Is Calling About a Patient With Pneumatosis Coli What Do I Need To Do?
151
What Is the Appropriate Evaluation for Fecal Incontinence?
155
The Admitting Housestatf Cant Figure Out Where to Admit Patients With Diverticulitis What Can I Tell Them About This Condition?
159
What Should Be My Response to Patients Who Ask About Antibiotic Prophylaxis for Their Colonoscopies? If They Are Persistent and Do Not Have ...
163
The Diabetes Clinic Wants a Lecture on the Effects of Diabetes on Colonic Motility What Can I Tell Them in 5 Minutes or Less?
167
What Are the Adverse Effects of Nonsteroidal AntiInflammatory Drugs on the Colon and How Can They Be Mitigated?
169
When Do I Need to Refer a Patient With Diverticular Bleeding for a Colectomy and What Tests Should Be Done Before This Happens?
171
What Do I Tell a Patient Who I Just Diagnosed With Stage IIB Colon Cancer Regarding Treatment and Prognosis?
175
The Ward Team Has a Patient With a Distended Abdomen and Increasing GasFilled Loops of Bowel on XRay How Can I Help Them Recognize and ...
177
What Are the Various Manifestations of E coli Infection of the Colon and How Should It Be Treated?
181
Index
183
Copyright

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About the author (2008)

\Brooks D. Cash, MD, FACP, FACG is the Chief of Gastroenterology and the Colon Health Initiative at the National Naval Medical Center in Bethesda, Maryland. Dr. Cash received his medical degree from the Uniformed Services University of Medicine (USUHS) in Bethesda, and completed his internal medicine residency and gastroenterology fellowship training at the National Naval Medical Center. Board certified in gastroenterology, he currently serves as an Associate Professor of Medicine at USUHS. Active in research, his main areas of interest are wide ranging and consist primarily of functional gastrointestinal disorders, acid peptic disorders, and colorectal cancer screening. He currently oversees multiple ongoing protocols in all of these areas and, as a leader in the field of CT colonography, he currently oversees multiple studies designed to clarify and expand the practice of this new technology. He is the author of numerous book chapters, review articles, and peer-reviewed manuscripts; is actively involved in committee work for various gastroenterology professional societies; and serves on the editorial boards of multiple professional journals.

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