IBS is no BS
Millions of people are diagnosed with irritable bowel syndrome (IBS) every year making it one of the most common gastrointestinal (GI) conditions. Despite its prevalence, there remain many misconceptions about IBS among both patients and doctors. Here we review some basic concepts in hopes of demystifying this nebulous syndrome.
What is IBS?
Irritable bowel syndrome is defined by a constellation of symptoms including abdominal pain and altered bowel habits (diarrhea or constipation) that persist for a prolonged period of time. There is no blood test, radiology study or endoscopic procedure that can definitively diagnose IB...
Source: Kevin, M.D. - Medical Weblog - February 14, 2015 Category: Journals (General) Authors: Steven Naymagon, MD Tags: Conditions GI Source Type: blogs
How NOT to have irritable bowel syndrome (IBS)
Irritable bowel syndrome, or IBS, affects 10-20% of the population. People struggle with unexplained bloating, abdominal discomfort, and inconvenient and embarrassing bowel urgency, having to empty their bowels unexpectedly. Some also struggle with intermittent constipation, as well. It turns something that should be subconscious, predictable, and serene into a nightmare.
The typical medical evaluation involves endoscopy and colonoscopy, since procedures, whether necessary or not, pay gastroenterologists well, performed under the guise of ruling out cancer. When they find nothing or only minor findings, such as mild gast...
Source: Wheat Belly Blog - January 11, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle gluten grains irritable bowel syndrome Source Type: blogs
Joan Rivers: What should the anesthesiologist have done?
New York Post reporter Susan Edelman revealed the name of the unfortunate anesthesiologist allegedly present on August 28 at Yorkville Endoscopy, during the throat procedure that led to the death of comedian Joan Rivers. She is reported to be Renuka Reddy Bankulla, MD, 47, a board-certified anesthesiologist from New Rochelle, NY.
Having her name made public will be a nightmare for Dr. Bankulla, as investigators will certainly target her role in Ms. Rivers’ sedation and the management — or mismanagement — of her resuscitation.
Continue reading ...
Your patients are rating you online: How to respond. Manage...
Source: Kevin, M.D. - Medical Weblog - January 8, 2015 Category: Journals (General) Authors: Karen S. Sibert, MD Tags: Physician Malpractice Surgery Source Type: blogs
The Anesthesiologist’s Story: New Details Emerge In the Joan Rivers Case
By KAREN SIBERT, MD New York Post reporter Susan Edelman revealed on January 4 the name of the unfortunate anesthesiologist allegedly present on August 28 at Yorkville Endoscopy, during the throat procedure that led to the death of comedian Joan Rivers. She is reported to be Renuka Reddy Bankulla, MD, 47, a board-certified anesthesiologist from New Rochelle, NY. Having […] (Source: The Health Care Blog)
Source: The Health Care Blog - January 4, 2015 Category: Consumer Health News Tags: THCB anesthesiology Joan Rivers Case Oxygen Saturation Propofol Yorkville Endoscopy Source Type: blogs
MKSAP: 50-year-old man with cirrhosis
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 50-year-old man is evaluated in follow-up for a recent diagnosis of cirrhosis secondary to nonalcoholic steatohepatitis. He has a history of asthma, type 2 diabetes mellitus, hyperlipidemia, and obesity. His current medications are inhaled fluticasone, montelukast, insulin glargine, insulin lispro, simvastatin, and lisinopril.
On physical examination, temperature is 37.5 °C (99.5 °F), blood pressure is 120/70 mm Hg, pulse rate is 80/min, and respiration rate is 16/min; BMI is 31. Abdominal examination reveal...
Source: Kevin, M.D. - Medical Weblog - December 13, 2014 Category: Journals (General) Authors: mksap Tags: Conditions GI Source Type: blogs
Gluten-free foods are NOT an argument against grain-free: a rebuttal to Consumer Reports
A recent Consumer Reports article has apparently raised skepticism that being gluten-free is really healthier. So let’s clear the air on this awful, awful report and expose it for the cheap shot it is.
First of all, those of you familiar with the Wheat Belly message understand: Wheat Belly is NOT about being gluten-free! Despite the popularity of the Wheat Belly message, I still have to remind critics and people in media of this fact.
Nonetheless, let’s go through the arguments that Consumers Reports makes and show why they drip thickly with misinformation, one by one:
1. Gluten-free isn’t more nutritious ...
Source: Wheat Belly Blog - December 8, 2014 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle barley corn gluten gluten-free grains rye Source Type: blogs
Research and Reviews in the Fastlane 059
This study looked at national survey data from 2009-2010 of patients >18 y/o presenting to the ED (n=44,448 visits) and found that cardiac enzyme testing was performed in 16.9% of visits, including in 8.2% of visits lacking ACS-related symptoms (which includes things like nausea, vomiting, abdominal pain, dyspnea, etc). This begs the question, why then, was a troponin (or ck-mb) ordered? It’s probably not changing management. In an era in which we’re discovering that there are harms to downstream testing, this study calls out just how trigger happy we may be. As more sensitive cardiac assays are used, this m...
Source: Life in the Fast Lane - November 26, 2014 Category: Emergency Medicine Authors: Jeremy Fried Tags: R&R in the FASTLANE airway brain failure critical care Emergency Medicine General Surgery hypothermia Intensive Care prehospital recommendations Review Trauma Source Type: blogs
Assume Nothing
Patient with multiple medical problems (diabetes, COPD, hypertension, hyperlipidemia, headaches, arthritis; you know, your basic Baby Boomer) comes in with a new symptom: food gets stuck going down. It’s been going on for a while now and getting worse. Liquids are becoming problematic as well.
I’m worried. Esophageal cancer is the main concern here, so off he goes to endoscopy.
Good news is that there’s no cancer. Bad news is that brushings show infection with candida. It’s a yeast infection of the esophagus. Treatment begins, but now we have another problem: Why did this happen? Esophageal candidi...
Source: Musings of a Dinosaur - November 16, 2014 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
What Happened at Yorkville Endoscopy?
KAREN SIBERT, MD The ear, nose and throat specialist who treated comedian Joan Rivers on August 28 has been identified as Dr. Gwen Korovin, a prominent New York physician who is known as a voice doctor to many entertainers and Broadway stars including Hugh Jackman and Julie Andrews. With a physician who is an expert in airway anatomy at her […] (Source: The Health Care Blog)
Source: The Health Care Blog - September 23, 2014 Category: Consumer Health News Tags: THCB Accreditation Association For Ambulatory Health Care Ambulatory Surgery Center Class A Joan Rivers Laryngospam Office Based Surgery Law Propofol Succinycholine VIP Syndrome Yorkville Endoscopy Source Type: blogs
Healthcare Update Satellite — 09-15-2014
This study should be required reading in every emergency medicine residency in this country. In fact, the concepts in the studies should be tested on the emergency medicine board exams.
Now if the study only compared the type of a patient’s insurance with the likelihood of emergency department recidivism.
How else can the media try to tarnish this guy’s reputation? The doctor who oversaw Joan Rivers’ fatal endoscopy was once *sued* 10 years ago. Gasp.
The former patient’s attorneys are really trying to create their 15 minutes of fame. They alleged that 10 years ago the patient received no informed ...
Source: WhiteCoat's Call Room - September 15, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Anesthesiologist’s Review of the Facts in the Joan Rivers Case
By KAREN SIBERT, MD Since the death of comedian and talk-show host Joan Rivers, more information has surfaced about the events on the morning of August 28 at Yorkville Endoscopy. But key questions remain unanswered. News accounts agree that Ms. Rivers sought medical advice because her famous voice was becoming increasingly raspy. This could be caused […] (Source: The Health Care Blog)
Source: The Health Care Blog - September 15, 2014 Category: Consumer Health News Tags: THCB Airway Laryngospasm Larynx Polyp Propofol Tumor Yorkville Endoscopy Source Type: blogs
What Killed Joan Rivers? Piecing Together a Medical Mystery
KAREN SIBERT, MD There are minor operations and procedures, but there are no minor anesthetics. This could turn out to be the one lesson learned from the ongoing investigation into the death of comedian Joan Rivers. Ms. Rivers’ funeral was held yesterday, September 7. Like so many of her fans, I appreciated her quick wit as […] (Source: The Health Care Blog)
Source: The Health Care Blog - September 8, 2014 Category: Consumer Health News Tags: THCB Demerol Hypotension Joan Rivers Midazolam outpatient care Propofol Wellness Yorkville Endoscopy Source Type: blogs
Physician Payments Sunshine Act: Organizations Respond to CMS
September 2nd marked the last day for comments on CMS’ proposed rule to eliminate the accredited continuing medical education (CME) exemption from Sunshine Act reporting. In an overwhelming display of support for the exemption, over 800 comments were submitted encouraging the agency to either maintain or expand the current exclusion.
-Total comments supporting maintenance or expansion of the CME exemption: 820
-Total comments supporting elimination of the CME exemption: approximately 20
-Percentage of comments supporting the CME exemption: 98%
We have followed this issue closely, and recentl...
Source: Policy and Medicine - September 8, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs
How To Be A Bad Gastroenterologist
I am a regular reader of patient blogs, and I find myself frequently gasping at the mistreatment they experience at the hands of my peers. Yesterday I had the “pleasure” of being a patient myself, and found that my professional ties did not protect me from outrageously poor bedside manners. I suppose I’m writing this partly to vent, but also to remind healthcare professionals what not to do to patients waking up from anesthesia. I also think my experience may serve as a reminder that it’s ok to fire your doctor when conditions warrant.
I chose my gastroenterologist based on his credentials and the q...
Source: Better Health - July 10, 2014 Category: American Health Authors: Dr. Val Jones Tags: Opinion True Stories Bad Bedside Manner Bad Doctors Colonoscopy Compassion Empathy Gastroenterologist Lack Lack of Caring Source Type: blogs
