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Mildly Elevated Liver Transaminase Levels: Causes and Evaluation - American Family ...

Dec 1, 2017 - Mild, asymptomatic elevations (less than five times the upper limit of normal) of alanine transaminase and aspartate transaminase levels are common in primary care. It is estimated that approximately 10% of the U.S. population has elevated transaminase levels. An approach based on the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p709.html

Abdominal Wall Pain: Clinical Evaluation, Differential Diagnosis, and Treatment - ...

Oct 1, 2018 - Abdominal wall pain is often mistaken for intra-abdominal visceral pain, resulting in expensive and unnecessary laboratory tests, imaging studies, consultations, and invasive procedures. Those evaluations generally are nondiagnostic, and lingering pain can become frustrating to the ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p429.html

Management of Constipation in Older Adults - American Family Physician

Sep 15, 2015 - Chronic constipation is common in adults older than 60 years, and symptoms occur in up to 50% of nursing home residents. Primary constipation is also referred to as functional constipation. Secondary constipation is associated with chronic disease processes, medication use, and ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0915/p500.html

Acute Diarrhea in Adults - American Family Physician

Feb 1, 2014 - Acute diarrhea in adults is a common problem encountered by family physicians. The most common etiology is viral gastroenteritis, a self-limited disease. Increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea. A history and ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0201/p180.html

Surgical and Nonsurgical Management of Gallstones - American Family Physician

May 15, 2014 - Cholelithiasis, or gallstones, is one of the most common and costly of all the gastrointestinal diseases. The incidence of gallstones increases with age. At-risk populations include persons with diabetes mellitus, persons who are obese, women, rapid weight cyclers, and patients on ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0515/p795.html

Crohn's Disease: Diagnosis and Management - American Family Physician

Dec 1, 2018 - Crohn’s disease is a chronic inflammatory condition that affects the gastrointestinal tract. It can cause lesions from mouth to anus and may result in extraintestinal complications. The prevalence of Crohn’s disease is increasing in adults and children. Genetic predispositions to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1201/p661.html

Diagnosis and Management of Acute Diverticulitis - American Family Physician

May 1, 2013 - Uncomplicated diverticulitis is localized diverticular inflammation, whereas complicated diverticulitis is diverticular inflammation associated with an abscess, phlegmon, fistula, obstruction, bleeding, or perforation. Patients with acute diverticulitis may present with left lower ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0501/p612.html

Colorectal Cancer Screening and Surveillance - American Family Physician

Jan 15, 2015 - Colorectal cancer is the third most common cancer in men and women. The incidence and mortality rate of the disease have been declining over the past two decades because of early detection and treatment. Screening in persons at average risk should begin at 50 years of age; the U.S. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0115/p93.html

Gas, Bloating, and Belching: Approach to Evaluation and Management - American Family ...

Mar 1, 2019 - Gas, bloating, and belching are associated with a variety of conditions but are most commonly caused by functional gastrointestinal disorders. These disorders are characterized by disordered motility and visceral hypersensitivity that are often worsened by psychological distress. An ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p301.html

Recurrent Abdominal Pain in Children - American Family Physician

Jun 15, 2018 - Recurrent abdominal pain (RAP) in children is defined as at least three episodes of pain that occur over at least three months and affect the child’s ability to perform normal activities. RAP is most often considered functional (nonorganic) abdominal pain, but an organic cause is found ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0615/p785.html

Evaluation of Jaundice in Adults - American Family Physician

Feb 1, 2017 - Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p164.html

Intestinal Obstruction: Evaluation and Management - American Family Physician

Sep 15, 2018 - Acute intestinal obstruction occurs when the forward flow of intestinal contents is interrupted or impaired by a mechanical cause. It is most commonly induced by intra-abdominal adhesions, malignancy, and herniation. The clinical presentation generally includes nausea, emesis, colicky ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0915/p362.html

Evaluation and Treatment of Constipation in Children and Adolescents - American Family ...

Jul 15, 2014 - Childhood constipation is common and almost always functional without an organic etiology. Stool retention can lead to fecal incontinence in some patients. Often, a medical history and physical examination are sufficient to diagnose functional constipation. Further evaluation for ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0715/p82.html

Acute Abdominal Pain in Children - American Family Physician

May 15, 2016 - Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0515/p830.html

Causes and Evaluation of Mildly Elevated Liver Transaminase Levels - American Family ...

Nov 1, 2011 - Mild elevations in levels of the liver enzymes alanine transaminase and aspartate transaminase are commonly discovered in asymptomatic patients in primary care. Evidence to guide the diagnostic workup is limited. If the history and physical examination do not suggest a cause, a stepwise...

American Family Physician : Article

https://www.aafp.org/afp/2011/1101/p1003.html

Chronic Pancreatitis: Diagnosis and Treatment - American Family Physician

Mar 15, 2018 - Chronic pancreatitis is an irreversible and progressive disorder of the pancreas characterized by inflammation, fibrosis, and scarring. Exocrine and endocrine functions are lost, often leading to chronic pain. The etiology is multifactorial, although alcoholism is the most significant ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p385.html

Evaluation of Chronic Diarrhea - American Family Physician

Nov 15, 2011 - Chronic diarrhea, defined as a decrease in stool consistency for more than four weeks, is a common but challenging clinical scenario. It can be divided into three basic categories: watery, fatty (malabsorption), and inflammatory. Watery diarrhea may be subdivided into osmotic, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1115/p1119.html

Evaluation and Mangement of Intestinal Obstruction - American Family Physician

Jan 15, 2011 - Acute intestinal obstruction occurs when there is an interruption in the forward flow of intes- tinal contents. This interruption can occur at any point along the length of the gastrointestinal tract, and clinical symptoms often vary based on the level of obstruction. Intestinal ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0115/p159.html

Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children - American ...

Oct 15, 2015 - Gastroesophageal reflux is defined as the passage of stomach contents into the esophagus with or without accompanied regurgitation (spitting up) and vomiting. It is a normal physiologic process that occurs throughout the day in infants and less often in children and adolescents. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1015/p705.html

Esophageal Cancer - American Family Physician

Jan 1, 2017 - Esophageal cancer has a poor prognosis and high mortality rate, with an estimated 16,910 new cases and 15,910 deaths projected in 2016 in the United States. Squamous cell carcinoma and adenocarcinoma account for more than 95% of esophageal cancers. Squamous cell carcinoma is more common...

American Family Physician : Article

https://www.aafp.org/afp/2017/0101/p22.html

Diabetes Mellitus: Management of Gastrointestinal Complications - American Family ...

Dec 15, 2016 - Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1215/p980.html

Nausea and Vomiting of Pregnancy - American Family Physician

Jun 15, 2014 - Nausea and vomiting of pregnancy affects nearly 75% of pregnant women. The exact cause is unknown. In most cases, it is a mild, self-limited condition that can be controlled with conservative measures and has no adverse fetal sequelae. About 1% of women develop hyperemesis gravidarum, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0615/p965.html

Diagnosis and Management of Hepatitis C - American Family Physician

Jun 15, 2015 - Hepatitis C virus (HCV) infection, a major cause of chronic liver disease and cirrhosis, is predominantly transmitted by exposure to blood or body fluids. The infection progresses to a chronic state in 80% of patients, whereas the virus clears completely after the acute infection in 20%...

American Family Physician : Article

https://www.aafp.org/afp/2015/0615/p835.html

Celiac Disease: Diagnosis and Management - American Family Physician

Jan 15, 2014 - Celiac disease is an autoimmune disorder of the gastrointestinal tract. It is triggered by exposure to dietary gluten in genetically susceptible individuals. Gluten is a storage protein in wheat, rye, and barley, which are staples in many American diets. Celiac disease is characterized ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0115/p99.html

Evaluation of Acute Abdominal Pain in Adults - American Family Physician

Apr 1, 2008 - Acute abdominal pain can represent a spectrum of conditions from benign and self-limited disease to surgical emergencies. Evaluating abdominal pain requires an approach that relies on the likelihood of disease, patient history, physical examination, laboratory tests, and imaging ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0401/p971.html

Diagnosis and Management of Upper Gastrointestinal Bleeding - American Family Physician

Mar 1, 2012 - Upper gastrointestinal bleeding causes significant morbidity and mortality in the United States, and has been associated with increasing nonsteroidal anti-inflammatory drug use and the high prevalence of Helicobacter pylori infection in patients with peptic ulcer bleeding. Rapid ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0301/p469.html

Nonalcoholic Fatty Liver Disease: Diagnosis and Management - American Family Physician

Jul 1, 2013 - Nonalcoholic fatty liver disease is characterized by excessive fat accumulation in the liver (hepatic steatosis). Nonalcoholic steatohepatitis is characterized by steatosis, liver cell injury, and inflammation. The mechanism of nonalcoholic fatty liver disease is unknown but involves ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0701/p35.html

Cirrhosis: Diagnosis, Management, and Prevention - American Family Physician

Dec 15, 2011 - Cirrhosis is the 12th leading cause of death in the United States. It accounted for 29,165 deaths in 2007, with a mortality rate of 9.7 per 100,000 persons. Alcohol abuse and viral hepatitis are the most common causes of cirrhosis, although nonalcoholic fatty liver disease is emerging ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1215/p1353.html

Diagnosis and Management of IBS in Adults - American Family Physician

Sep 1, 2012 - Irritable bowel syndrome is defined as abdominal discomfort or pain associated with altered bowel habits for at least three days per month in the previous three months, with the absence of organic disease. In North America, the prevalence of irritable bowel syndrome is 5 to 10 percent ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0901/p419.html

Diagnostic Approach to Chronic Constipation in Adults - American Family Physician

Aug 1, 2011 - Constipation is traditionally defined as three or fewer bowel movements per week. Risk factors for constipation include female sex, older age, inactivity, low caloric intake, low-fiber diet, low income, low educational level, and taking a large number of medications. Chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0801/p299.html

Complications of Adjustable Gastric Banding Surgery for Obesity - American Family ...

May 15, 2014 - Laparoscopic adjustable gastric banding procedures have a favorable risk-benefit profile and are increasingly important as part of the overall management of obesity. These procedures are effective at inducing weight loss and improving comorbid conditions, including diabetes mellitus, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0515/p813.html

Evaluation of Nausea and Vomiting: A Case-Based Approach - American Family Physician

Sep 15, 2013 - In the absence of acute abdominal pain, significant headache, or recent initiation of certain medications, acute nausea and vomiting is usually the result of self-limited gastrointestinal infections. Nausea and vomiting is also a common adverse effect of radiation therapy, chemotherapy,...

American Family Physician : Article

https://www.aafp.org/afp/2013/0915/p371.html

Evaluation of Occult Gastrointestinal Bleeding - American Family Physician

Mar 15, 2013 - Occult gastrointestinal bleeding is defined as gastrointestinal bleeding that is not visible to the patient or physician, resulting in either a positive fecal occult blood test, or iron deficiency anemia with or without a positive fecal occult blood test. A stepwise evaluation will ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0315/p430.html

Diagnosis and Management of Pancreatic Cancer - American Family Physician

Apr 15, 2014 - Pancreatic cancer remains the fourth leading cause of cancer-related deaths in the United States. Risk factors include family history, smoking, chronic pancreatitis, obesity, diabetes mellitus, heavy alcohol use, and possible dietary factors. Because more than two-thirds of ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0415/p626.html

Common Questions About Barrett Esophagus - American Family Physician

Jan 15, 2014 - Barrett esophagus is a precancerous metaplasia of the esophagus that is more common in patients with chronic reflux symptoms, although it also occurs in patients without symptomatic reflux. Other risk factors include smoking, male sex, obesity, white race, hiatal hernia, and increasing ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0115/p92.html

Considerations for Safe Use of Statins: Liver Enzyme Abnormalities and Muscle Toxicitiy...

Mar 15, 2011 - Statins play an important role in the care of patients with cardiovascular disease and have a good safety record in clinical practice. The risk of hepatic injury caused by statins is estimated to be about 1 percent, similar to that of patients taking a placebo. Patients with ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0315/p711.html

Diverticular Bleeding - American Family Physician

Nov 1, 2009 - Diverticular bleeding is a common cause of lower gastrointestinal hemorrhage. Patients typically present with massive and painless rectal hemorrhage. If bleeding is severe, initial resuscitative measures should include airway maintenance and oxygen supplementation, followed by ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1101/p977.html

Evaluation of Nausea and Vomiting - American Family Physician

Jul 1, 2007 - A comprehensive history and physical examination can often reveal the cause of nausea and vomiting, making further evaluation unnecessary. Acute symptoms generally are the result of infectious, inflammatory, or iatrogenic causes. Most infections are self-limiting and require minimal ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0701/p76.html

Jaundice in the Adult Patient - American Family Physician

Jan 15, 2004 - Jaundice in an adult patient can be caused by a wide variety of benign or life-threatening disorders. Organizing the differential diagnosis by prehepatic, intrahepatic, and posthepatic causes may help make the work-up more manageable. Prehepatic causes of jaundice include hemolysis and ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0115/p299.html

Mildly Elevated Liver Transaminase Levels in the Asymptomatic Patient - American Family...

Mar 15, 2005 - Mild elevations in liver chemistry tests such as alanine transaminase and aspartate transaminase can reveal serious underlying conditions or have transient and benign etiologies. Potential causes of liver transaminase elevations include viral hepatitis, alcohol use, medication use, ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0315/p1105.html

Update on the Evaluation and Management of Functional Dyspepsia - American Family ...

Mar 1, 2011 - Dyspepsia affects up to 40 percent of adults each year and is often diagnosed as functional (nonulcer) dyspepsia. The defining symptoms are postprandial fullness, early satiation, or epigastric pain or burning in the absence of causative structural disease. These symptoms may coexist ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0301/p547.html

Iron Deficiency Anemia - American Family Physician

Mar 1, 2007 - The prevalence of iron deficiency anemia is 2 percent in adult men, 9 to 12 percent in non-Hispanic white women, and nearly 20 percent in black and Mexican-American women. Nine percent of patients older than 65 years with iron deficiency anemia have a gastrointestinal cancer when ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0301/p671.html

Peptic Ulcer Disease - American Family Physician

Oct 1, 2007 - Peptic ulcer disease usually occurs in the stomach and proximal duodenum. The predominant causes in the United States are infection with Helicobacter pylori and use of nonsteroidal anti-inflammatory drugs. Symptoms of peptic ulcer disease include epigastric discomfort (specifically, ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1001/p1005.html

Nonalcoholic Fatty Liver Disease - American Family Physician

Jun 1, 2006 - Nonalcoholic fatty liver disease is a common condition associated with metabolic syndrome. It is the most common cause of elevated liver enzymes in U.S. adults, and is diagnosed after ruling out other causes of steatosis (fatty infiltration of liver), particularly infectious hepatitis ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0601/p1961.html

Traveler's Diarrhea - American Family Physician

Jun 1, 2005 - Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella, and Shigella...

American Family Physician : Article

https://www.aafp.org/afp/2005/0601/p2095.html

Treatment of Constipation in Older Adults - American Family Physician

Dec 1, 2005 - Constipation is a common complaint in older adults. Although constipation is not a physiologic consequence of normal aging, decreased mobility and other comorbid medical conditions may contribute to its increased prevalence in older adults. Functional constipation is diagnosed when no ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1201/p2277.html

Celiac Disease - American Family Physician

Dec 15, 2007 - As many as one in every 100 to 200 persons in the United States has celiac disease, a condition resulting from an inappropriate immune response to the dietary protein gluten. The manifestations of celiac disease range from no symptoms to overt malabsorption with involvement of multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1215/p1795.html

Acute Pancreatitis: Diagnosis, Prognosis, and Treatment - American Family Physician

May 15, 2007 - Mild acute pancreatitis has a low mortality rate, but patients with severe acute pancreatitis are more likely to develop complications and have a much higher death rate. Although serum amylase and lipase levels remain the most widely used diagnostic assays for acute pancreatitis, other ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0515/p1513.html

Evaluation and Treatment of Constipation in Infants and Children - American Family ...

Feb 1, 2006 - Constipation in children usually is functional and the result of stool retention. However, family physicians must be alert for red flags that may indicate the presence of an uncommon but serious organic cause of constipation, such as Hirschsprung's disease (congenital aganglionic ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0201/p469.html

Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - American Family...

Sep 1, 2006 - Cirrhosis and chronic liver failure are leading causes of morbidity and mortality in the United States, with the majority of preventable cases attributed to excessive alcohol consumption, viral hepatitis, or nonalcoholic fatty liver disease. Cirrhosis often is an indolent disease; most ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0901/p756.html

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