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GI (Gastrointestinal)

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  • CA Colon
  • Diarrhea
  • Bloody diarrhea
  • Cryptosporidia
  • Traveler’s Diarrhea
  • Diverticulitis
  • Food Poisoning
  • Laxatives
  • Mucositis and Aphthae
  • Obesity
  • Ulcer

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    CA Colon


    Population test interval age to begin
    general occult blood annual 50
    sigmoidoscopy q3-5y 50
    1st degree relative with colorectal cancer (CRC) or adenomas > age 60 colonoscopy q5y 50 or 10 years younger than index case
    Two 1st degree relative with CRC/adenomas aged > 60 or 1 relative age < 60 colonoscopy q5y 40 or 10 years younger than index case
    chronic ulcerative colitis colonoscopy q1-2y 10 yrs after onset, 15 yrs after onset if left sided colitis only
    Crohn's disease colonoscopy q1-2y 10-15 yrs after onset
    Risk of familial adenomatous polyposis risk (FAP) sigmoidoscopy q1-2y age 10-12
    Risk of hereditary non-polyposis risk CRC colonoscopy q2y 25 yrs or 10 yrs younger than index case


    See also: Diarrhea, Ped

    Timing and Etiology

    Bloody diarrhea


    Traveler’s Diarrhea management (enterotoxic E. Coli)


    Food Poisoning

    Table sorted by time of onset.

    Organism/Toxin Onset Duration Characteristic Findings Other Findings Source Misc Treat
    Scombrotoxin (histamine) < 30 min < 30 min wheezing, flushing, mouth burning, N/V/D   tuna, sardines, mahi mahi, etc infrequent antihistamine
    Ciguatera ? days! oral numbness, tingling then N/V/D then paresthesias, twiching, vertigo, temp sensitivity, temperature sensory reversal   large predator fish: barracuda, grouper, red snapper infrequent supportive
    Bacillus cereus 30 min to 6 h 24 h N/V (like staph)   fried rice left out overnight   supportive
    6-15 h 24 h abd cramps, watery diarrhea   fish, meat, vegetables   supportive
    Botulin toxin
    (C. difficile)
    variable variable descending paralysis Mild cases have blurry vision, dysarthria flavored oils, honey in infants, home canning Like Guillain-Barre, but inverted. Facial paralysis, then resp failure CDC has botulin antitoxin. ICU.
    Staph 1-6 h <24h nausea & vomiting diarrhea 68% ham, poultry, pastries, egg salads   supportive
    C perfringes 6-24h <24h abdominal cramps, diarrhea vomiting & fever < 10% beef, poultry, gravy, Mexican food   supportive
    Norwalk Virus 16-72h 1-2d watery diarrhea, vomiting abd cramping & nausea, then myalgias with diarrhea/vomiting. Malaise, headache, low-grade fever. shellfish, salads, secondary contacts   Pepto-bismol
    Enterotoxic E Coli
    16-72h 3-4d watery diarrhea rare fever & vomiting travel "Traveler’s Diarrhea", can cause severe dehydration Cipro
    (S. enteritidis)
    10-72h 3-5d fever, tenesmus, bloody or watery diarrhea vomiting 35-80% eggs, poultry, beef, dairy positive leukocytes Cipro, but may prolong shedding. Many recommend no Rx unless at risk for dissemination.
    Enteroinvasive E Coli
    16-72h 3-5d fever, tenesmus, dyseneteric diarrhea vomiting 35-80% eggs, vegetables, dairy positive leukocytes none
    Shigella 16-72h 3-5d fever, tenesmus, bloody diarrhea vomiting 35-80% eggs, vegetables, dairy, direct contact positive leukocytes, very contagious Cipro
    (rare in US)
    16-72h 1d-4w fever, abdominal pain vomiting 25-40% milk, tofu, pork pos/neg leukocytes none?
    Campylobacter jejuni 2-5d 3-9d fever, tenesmus, dyseneteric diarrhea vomiting 15-25% poultry, unpasteurized milk, pets, beef positive leukocytes. 40% of all cases of Guillaine-Barre syndrome follow campylobacter infection. Cipro
    Enterohemorrhagic E Coli (EHEC)
    aka Shiga toxin-producing E. Coli (STEC) and E. coli O157:H7
    2-5d 1-12d bloody diarrhea serum leuk. beef, dairy, cider, water risk of HUS 2-14d post onset, 30% pos leuk. Can do serologic test for 0157 infections. Avoid antibiotics and antidarrheal agents.
    Listeriosis (food borne) ??   encephalitis/ meningitis Listeriosis Brie cheese, milk, hot dogs etc. risk for pregnant women (abortion) and immunocompromised Antibiotics. See Listeriosis.
    Toxoplasmosis ??   none usually, sometimes flu-like, adenopathy   Under cooked venison, lamb, pork risk for pregnant women and immunocompromised 50% disease food borne, 50% from cat feces


    GERD (gastroesophageal reflux)


    bulking, form stool

    soften stool/lubricant

    peristaltic agents, including combo

    Mucositis and Aphthous ulcers

    Recurrent and Complex Recurrent

    Single Large Aphthae

    Chronic non-microbial mucositis (Aphthous ulcers, apthae, canker sores)


    Body Mass Index (BMI)

    Adult Examples (CDC BMI Calculator)

    Height Weight Range BMI
    Weight Status
    5’ 9” 124 lbs or less Below 18.5 Underweight
    125 lbs to 168 lbs 18.5 to 24.9 Normal
    169 lbs to 202 lbs 25.0 to 29.9 Overweight
    203 lbs to 273 lbs 30 to 40 Obese
    273 lbs or more 40 or higher Bariatric surgery candidate

    The categories for children are based on percentiles on CDC growth charts. This makes no sense to me, so I'll just ignore it for now.

    Bariatric Surgery


    H Pylori and Duodenal Ulcer

    Author: John G. Faughnan.  The views and opinions expressed in this page are strictly those of the page author. Pages are updated on an irregular schedule; suggestions/fixes are welcome but they may take weeks to years to be incorporated. Anyone may freely link to anything on this site and print any page; no permission is needed for citing, linking,  printing, or distributing printed copies.