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Clinical Diagnostic Criteria of IgG4-Related Sclerosing Cholangitis (IgG4-SC)

Sclerosing cholangitis (SC) is defined as a condition with progressive stenosis and destruction of the bile ducts due to diffuse inflammation and fibrosis and currently includes three categories: primary sclerosing cholangitis (PSC), secondary cholangitis, and IgG4-related sclerosing cholangitis (IgG4-SC). SC categories share similar clinical features, such as cholestasis. Patients with SC present with cholestatic symptoms, including jaundice and pruritus, and blood tests reveal elevation of cholestatic enzymes. Continue reading “Clinical Diagnostic Criteria of IgG4-Related Sclerosing Cholangitis (IgG4-SC)”

Diagnosis of Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new concept proposed in 2020. Unlike non-alcoholic fatter liver disease (NAFLD), the diagnosis of MAFLD requires the presence any of the following 3 metabolic risks, including overweight/obesity, presence of diabetes mellitus, and evidence of metabolic dysregulation. Continue reading “Diagnosis of Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)”

Classification of Caustic-Induced Gastrointestinal Injuries

Caustic substances injure tissue by means of a chemical reaction on direct physical contact. Often thought of as acids or bases, caustics broadly include desiccants, vesicants, and protoplasmic poisons. The term “corrosive” is often used interchangeably with “caustic,” but corrosion implies a mechanical degradation, which does not always apply to caustics. Continue reading “Classification of Caustic-Induced Gastrointestinal Injuries”

Classification of Ulcer-Related Upper Gastrointestinal Bleeding

The Forrest classification is a widely used classification of ulcer-related upper gastrointestinal bleeding. It was initially developed to unify the description of ulcer bleeding for better communication amongst endoscopists. However, the Forrest Classification is now used as a tool to identify patients who are at an increased risk for bleeding, rebleeding and mortality. Continue reading “Classification of Ulcer-Related Upper Gastrointestinal Bleeding”

Ulcerative Colitis Activity Index

Ulcerative colitis (UC) is a chronic immune-mediated inflammatory condition of the large intestine that is frequently associated with inflammation of the rectum but often extends proximally to involve additional areas of the colon. Once a diagnosis of UC is made, determining the severity of disease becomes important. Continue reading “Ulcerative Colitis Activity Index”

Indications for Testing for Helicobacter pylori Infection

Testing for H. pylori is recommended in patients with peptic ulcer disease, gastric cancer, or gastric mucosa–associated lymphoid tissue lymphoma (MALToma). Other recommended indications for testing include dyspepsia, prolonged use of nonsteroidal antiinflammatory drugs or aspirin, unexplained iron-deficiency anemia, and immune thrombocytopenia. Continue reading “Indications for Testing for Helicobacter pylori Infection”

Approved Indications for Proton Pump Inhibitors (PPIs)

First introduced in 1989, proton pump inhibitors (PPIs) are among the most widely utilized medications worldwide, both in the ambulatory and inpatient clinical settings. The PPIs are currently approved by the US Food and Drug Administration (FDA) for the management of a variety of gastrointestinal disorders including symptomatic peptic ulcer disease, gastroesophageal reflux disease, and nonulcer dyspepsia as well as for prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy. Continue reading “Approved Indications for Proton Pump Inhibitors (PPIs)”

Helicobacter pylori Infection in Peptic Ulcer Disease

Endoscopy is the gold standard for diagnosis of peptic ulcer disease. Apart from  exclusion of malignant disease, detection of H pylori infection with histology or rapid urease tests is essential to the subsequent treatment plan.  Continue reading “Helicobacter pylori Infection in Peptic Ulcer Disease”

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