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Chronic Diarrhea in Adults: Evaluation and Differential Diagnosis - American Family ...

Apr 15, 2020 - Chronic diarrhea is defined as a predominantly loose stool lasting longer than four weeks. A patient history and physical examination with a complete blood count, C-reactive protein, anti-tissue transglutaminase immunoglobulin A (IgA), total IgA, and a basic metabolic panel are useful ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0415/p472.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

Hepatitis B: Screening, Prevention, Diagnosis, and Treatment - American Family Physician

Mar 1, 2019 - Hepatitis B virus (HBV) is a partly double-stranded DNA virus that causes acute and chronic liver infection. Screening for hepatitis B is recommended in pregnant women at their first prenatal visit and in adolescents and adults at high risk of chronic infection. Hepatitis B vaccination ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p314.html

Gastroenteritis in Children - American Family Physician

Feb 1, 2019 - Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each year. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p159.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

Colorectal Cancer Screening and Prevention - American Family Physician

May 15, 2018 - Colorectal cancer is a common cause of morbidity and mortality in the United States. Most colorectal cancers arise from preexisting adenomatous or serrated polyps. The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p658.html

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

Probiotics for Gastrointestinal Conditions: A Summary of the Evidence - American Family...

Aug 1, 2017 - Probiotics contain microorganisms, most of which are bacteria similar to the beneficial bacteria that occur naturally in the human gut. Probiotics have been widely studied in a variety of gastrointestinal diseases. The most-studied species include Lactobacillus, Bifidobacterium, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p170.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

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

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

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

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

Common Questions About the Management of Gastroesophageal Reflux Disease - American ...

May 15, 2015 - Common questions that arise regarding treatment of gastroesophageal reflux disease (GERD) include which medications are most effective, when surgery may be indicated, which patients should be screened for Barrett esophagus and Helicobacter pylori infection, and which adverse effects ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0515/p692.html

Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection - American ...

Feb 15, 2015 - The most common causes of peptic ulcer disease (PUD) are Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). The test-and-treat strategy for detecting H. pylori is appropriate in situations where the risk of gastric cancer is low based on age younger ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0215/p236.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

Prevention and Treatment of Motion Sickness - American Family Physician

Jul 1, 2014 - Motion sickness is a common syndrome that occurs upon exposure to certain types of motion. It is thought to be caused by conflict between the vestibular, visual, and other proprioceptive systems. Although nausea is the hallmark symptom, it is often preceded by stomach awareness, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p41.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

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

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

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

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

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

Hepatitis A - American Family Physician

Dec 1, 2012 - Hepatitis A is a common viral illness worldwide, although the incidence in the United States has diminished in recent years as a result of extended immunization practices. Hepatitis A virus is transmitted through fecal-oral contamination, and there are occasional outbreaks through food ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1201/p1027.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

Reducing Adverse Effects of Proton Pump Inhibitors - American Family Physician

Jul 1, 2012 - Proton pump inhibitors effectively treat gastroesophageal reflux disease, erosive esophagitis, duodenal ulcers, and pathologic hypersecretory conditions. Proton pump inhibitors cause few adverse effects with short-term use; however, long-term use has been scrutinized for ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0701/p66.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 Crohn's Disease - American Family Physician

Dec 15, 2011 - Crohn’s disease is a chronic inflammatory condition affecting the gastrointestinal tract at any point from the mouth to the rectum. Patients may experience diarrhea, abdominal pain, fever, weight loss, abdominal masses, and anemia. Extraintestinal manifestations of Crohn’s disease ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1215/p1365.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

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

Hemorrhoids - American Family Physician

Jul 15, 2011 - Most patients with hemorrhoids experience only mild symptoms that can be treated with nonprescription topical preparations. Patients usually seek treatment when symptoms increase. Internal hemorrhoids typically present with prolapse or painless rectal bleeding. External hemorrhoids also...

American Family Physician : Article

https://www.aafp.org/afp/2011/0715/p204.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

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

Hepatitis C: Diagnosis and Treatment - American Family Physician

Jun 1, 2010 - Hepatitis C, a common chronic bloodborne infection, is found in approximately 2 percent of adults in the United States. Chronic infection is associated with serious morbidity and mortality (e.g., cirrhosis, hepatocellular carcinoma). Testing for hepatitis C is recommended for at-risk ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0601/p1351.html

Colorectal Cancer: A Summary of the Evidence for Screening and Prevention - American ...

Dec 15, 2008 - Colorectal cancer causes significant morbidity and mortality in the United States. The incidence of colorectal cancer can be reduced with increasing efforts directed at mass screening of average-risk adults 50 years and older. Currently, fecal occult blood test and flexible ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1215/p1385.html

Gastrointestinal Complications of Diabetes - American Family Physician

Jun 15, 2008 - Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0615/p1697.html

Colonoscopy Surveillance After Polypectomy and Colorectal Cancer Resection - American ...

Apr 1, 2008 - This article describes a joint update of guidelines by the American Cancer Society and the U.S. Multi-Society Task Force on Colorectal Cancer delineating evidence-based surveillance recommendations for patients after polypectomy and colorectal cancer resection. Although there are some ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0401/p995.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

Chronic Pancreatitis - American Family Physician

Dec 1, 2007 - Chronic pancreatitis is the progressive and permanent destruction of the pancreas resulting in exocrine and endocrine insufficiency and, often, chronic disabling pain. The etiology is multifactorial. Alcoholism plays a significant role in adults, whereas genetic and structural defects ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1201/p1679.html

Ulcerative Colitis: Diagnosis and Treatment - American Family Physician

Nov 1, 2007 - Ulcerative colitis is a chronic disease with recurrent symptoms and significant morbidity. The precise etiology is still unknown. As many as 25 percent of patients with ulcerative colitis have extraintestinal manifestations. The diagnosis is made endoscopically. Tests such as ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1101/p1323.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

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

Oct 15, 2006 - Hirschsprung's disease (congenital megacolon) is caused by the failed migration of colonic ganglion cells during gestation. Varying lengths of the distal colon are unable to relax, causing functional colonic obstruction. Hirschsprung's disease most commonly involves the rectosigmoid ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1015/p1319.html

Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - American ...

Sep 1, 2006 - Major complications of cirrhosis include ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, portal hypertension, variceal bleeding, and hepatorenal syndrome. Diagnostic studies on ascitic fluid should include a differential leukocyte count, total protein level, a ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0901/p767.html

Hepatitis A - American Family Physician

Jun 15, 2006 - The introduction of hepatitis A vaccines in 1995 led to a drop in the number of reported cases of hepatitis A and a shift to a higher percentage of cases occurring in older age groups. The hepatitis A virus survives for extended periods in the environment. Transmission primarily is ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0615/p2162.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

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

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

Diverticular Disease: Diagnosis and Treatment - American Family Physician

Oct 1, 2005 - Diverticular disease refers to symptomatic and asymptomatic disease with an underlying pathology of colonic diverticula. Predisposing factors for the formation of diverticula include a low-fiber diet and physical inactivity. Approximately 85 percent of patients with diverticula are ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1001/p1229.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

Barrett's Esophagus - American Family Physician

May 1, 2004 - Gastroesophageal reflux disease (GERD) is a condition commonly managed in the primary care setting. Patients with GERD may develop reflux esophagitis as the esophagus repeatedly is exposed to acidic gastric contents. Over time, untreated reflux esophagitis may lead to chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0501/p2113.html

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