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Medicine by the numbers

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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

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

Hemorrhoids: Diagnosis and Treatment Options - American Family Physician

Feb 1, 2018 - Many Americans between 45 and 65 years of age experience hemorrhoids. Hemorrhoidal size, thrombosis, and location (i.e., proximal or distal to the dentate line) determine the extent of pain or discomfort. The history and physical examination must assess for risk factors and clinical ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0201/p172.html

Flexible Sigmoidoscopy or Fecal Occult Blood Testing for Colorectal Cancer Screening in...

Aug 1, 2019 - This meta-analysis provides high-quality evidence that flexible sigmoidoscopy and fecal occult blood testing both reduce the risk of death from colorectal cancer. The study did not provide a clear answer regarding a superior screening modality, so the decision to choose one test over ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0801/od1.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

Acute Pancreatitis - American Family Physician

Nov 1, 2014 - Acute pancreatitis is most commonly caused by gallstones or chronic alcohol use, and accounts for more than 200,000 hospital admissions annually. Using the Atlanta criteria, acute pancreatitis is diagnosed when a patient presents with two of three findings, including abdominal pain ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1101/p632.html

Chewing Gum for Reducing Post-Cesarean Section Ileus - Medicine by the Numbers - ...

Sep 1, 2018 - Although the current body of literature suggests a need for higher-quality, more robust research, the simplicity, frugality, and safety of chewing gum makes it a viable option to offer women undergoing cesarean section.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0901/od2.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

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 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

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

Colorectal Cancer Screening and Surveillance in Individuals at Increased Risk - ...

Jan 15, 2018 - Individuals at increased risk of developing colorectal cancer include those with a personal or family history of advanced adenomas or colorectal cancer, a personal history of inflammatory bowel disease, or genetic polyposis syndromes. In general, these persons should undergo more ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0115/p111.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

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

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

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

Efficacy of Direct-Acting Antivirals Compared with Older Agents for Hepatitis C - ...

Jun 1, 2017 - Although they help patients achieve sustained viralogic response, expensive direct-acting antivirals have yet to show that they can succeed in meeting top-priority treatment goals.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0601/od1.html

Diagnostic Imaging of Acute Abdominal Pain in Adults - American Family Physician

Apr 1, 2015 - Acute abdominal pain is a common presentation in the outpatient setting and can represent conditions ranging from benign to life-threatening. If the patient history, physical examination, and laboratory testing do not identify an underlying cause of pain and if serious pathology remains...

American Family Physician : Article

https://www.aafp.org/afp/2015/0401/p452.html

Gastroenteritis and Diarrhea in Children - American Family Physician

Mar 1, 2019 - This collection features AFP content on gastroenteritis and diarrhea in children and related issues, including dehydration, foodborne illnesses, probiotics, and rotavirus vaccination. This collection features AFP content on gastroenteritis and diarrhea in children and related issues, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=9

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

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

Hepatitis (and Other Liver Diseases) - American Family Physician

Aug 15, 2019 - This collection features AFP content on hepatitis and other liver disease, including cirrhosis, chronic liver failure, hemochromatosis, hepatitis A, hepatitis B, hepatitis C, jaundice, and nonalcoholic fatty liver disease. This collection features AFP content on hepatitis and other ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=38

Common Questions About Clostridium difficile Infection - American Family Physician

Mar 15, 2014 - Clostridium difficile infection is a common cause of antibiotic-associated diarrhea. It causes no symptoms in more than one-half of infected patients, but can also cause a wide spectrum of illnesses and death. The incidence and severity have increased in recent years. The most important...

American Family Physician : Article

https://www.aafp.org/afp/2014/0315/p437.html

Effectiveness of Selective Serotonin Reuptake Inhibitors for Irritable Bowel Syndrome -...

Nov 1, 2015 - Studies show that 1 in 4 had improved bloating and stool consistency, and less interference with daily life, while only 1 in 9 experiences medication related adverse effects. Want to know more?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/1101/od1.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

Ondansetron for Gastroenteritis in Children and Adolescents - Medicine by the Numbers -...

Apr 1, 2015 - Studies show vomiting stopped in 1 in 5 patients and diarrhea was a consistent adverse effect. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0401/od3.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

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

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

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

Hepatitis B: Diagnosis and Treatment - American Family Physician

Apr 15, 2010 - Although an estimated 1 million persons in the United States are chronically infected with hepatitis B virus, the prevalence of hepatitis B has declined since the implementation of a national vaccination program. Hepatitis B virus is transmitted in blood and secretions. Acute infection ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0415/p965.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

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

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

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

Special Considerations in Interpreting Liver Function Tests - American Family Physician

Apr 15, 1999 - A number of pitfalls can be encountered in the interpretation of common blood liver function tests. These tests can be normal in patients with chronic hepatitis or cirrhosis. The normal range for aminotransferase levels is slightly higher in males, nonwhites and obese persons. Severe ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0415/p2223.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

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

Practical Selection of Antiemetics - American Family Physician

Mar 1, 2004 - An understanding of the pathophysiology of nausea and the mechanisms of antiemetics can help family physicians improve the cost-effectiveness and efficacy of therapy. Nausea and vomiting are mediated primarily by visceral stimulation through dopamine and serotonin, by vestibular and ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0301/p1169.html

Laxatives for the Management of Childhood Constipation - Cochrane for Clinicians - ...

Oct 1, 2017 - Polyethylene glycol (PEG) is superior to placebo (mean difference [MD] = 2.61 more stools per week; 95% confidence interval [CI], 1.15 to 4.08), lactulose (MD = 0.70; 95% CI, 0.10 to 1.31), and milk of magnesia (MD = 0.69; 95% CI, 0.48 to 0.89) at increasing the number of bowel ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/1001/p433.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

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

Diagnosis of Acute Abdominal Pain in Older Patients - American Family Physician

Nov 1, 2006 - Acute abdominal pain is a common presenting complaint in older patients. Presentation may differ from that of the younger patient and is often complicated by coexistent disease, delays in presentation, and physical and social barriers. The physical examination can be misleadingly ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1101/p1537.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

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

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

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

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

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

Feed Thickener for Newborn Infants with Gastroesophageal Reflux - Cochrane for ...

Sep 1, 2018 - Feed thickeners decrease the number of reflux episodes in full-term formula-fed infants. Additionally, full-term formula-fed infants with GER who are given thickeners are more than twice as likely to be asymptomatic compared with infants not receiving thickeners at one to eight weeks of...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0901/p275.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

Should Screening Techniques for Colorectal Cancer All Have an 'A' Recommendation? No: ...

May 15, 2017 - The AAFP will continue to evaluate different screening tests as more research becomes available, but currently can endorse only those options that have the strongest evidence that benefits exceed harms.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2017/0515/p618.html

Treatment of Irritable Bowel Syndrome - American Family Physician

Dec 15, 2005 - Irritable bowel syndrome affects 10 to 15 percent of the U.S. population to some degree. This condition is defined as abdominal pain and discomfort with altered bowel habits in the absence of any other mechanical, inflammatory, or biochemical explanation for these symptoms. Irritable ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1215/p2501.html

Esophageal Cancer: A Review and Update - American Family Physician

Jun 15, 2006 - Although significant advancements have been made in the treatment of esophageal cancer, this aggressive malignancy commonly presents as locally advanced disease with a poor prognosis. Despite improvements in the detection of premalignant pathology, newer preventative strategies, and the...

American Family Physician : Article

https://www.aafp.org/afp/2006/0615/p2187.html

Pancreatic Cancer: Diagnosis and Management - American Family Physician

Feb 1, 2006 - Although only 32,000 new cases of adenocarcinoma of the pancreas occur in the United States each year, it is the fourth leading cause of cancer deaths in this country. The overall five-year survival rate is 4 percent, and localized, resectable disease has only a 17 percent survival ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0201/p485.html

Update on Helicobacter pylori Treatment - American Family Physician

Feb 1, 2007 - One half of the world's population has Helicobacter pylori infection, with an estimated prevalence of 30 percent in North America. Although it is unclear whether eradication of H. pylori improves symptoms in patients with nonulcer dyspepsia, there is strong evidence that eradication of ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0201/p351.html

Dietary Interventions for Recurrent Abdominal Pain in Childhood - Cochrane for ...

Jan 1, 2018 - Probiotics relieve pain in children with recurrent abdominal pain in the short term (number needed to treat [NNT] = 8). There is no convincing evidence that fiber supplements improve pain in children with recurrent abdominal pain.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0101/p19.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

Clostridium difficile-Associated Diarrhea - American Family Physician

Mar 1, 2005 - Clostridium difficile infection is responsible for approximately 3 million cases of diarrhea and colitis annually in the United States. The mortality rate is 1 to 2.5 percent. Early diagnosis and prompt aggressive treatment are critical in managing C. difficile-associated diarrhea. ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0301/p921.html

Atypical Presentations of Gastroesophageal Reflux Disease - American Family Physician

Aug 15, 2008 - Gastroesophageal reflux disease typically manifests as heartburn and regurgitation, but it may also present with atypical or extraesophageal symptoms, including asthma, chronic cough, laryngitis, hoarseness, chronic sore throat, dental erosions, and noncardiac chest pain. Diagnosing ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0815/p483.html

Lactose Intolerance - American Family Physician

May 1, 2002 - Persons with lactose intolerance are unable to digest significant amounts of lactose because of a genetically inadequate amount of the enzyme lactase. Common symptoms include abdominal pain and bloating, excessive flatus, and watery stool following the ingestion of foods containing ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0501/p1845.html

Diagnosing the Patient with Abdominal Pain and Altered Bowel Habits: Is it Irritable ...

May 15, 2003 - Diagnosing a patient who presents with abdominal pain and altered bowel habits can be challenging. Although serious organic illnesses can cause these symptoms, irritable bowel syndrome is commonly responsible. It can be difficult to properly evaluate these patients without overusing ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0515/p2157.html

Gastroesophageal Reflux in Infants and Children - American Family Physician

Dec 1, 2001 - Gastroesophageal reflux is a common, self-limited process in infants that usually resolves by six to 12 months of age. Effective, conservative management involves thickened feedings, positional treatment, and parental reassurance. Gastroesophageal reflux disease (GERD) is a less common,...

American Family Physician : Article

https://www.aafp.org/afp/2001/1201/p1853.html

Gastric Cancer: Diagnosis and Treatment Options - American Family Physician

Mar 1, 2004 - Although the overall incidence of gastric cancer has steadily declined in the United States, it is estimated that more than 12,000 persons died from gastric cancer in 2003. The incidence of distal stomach tumors has greatly declined, but reported cases of proximal gastric carcinomas, ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0301/p1133.html

Echinococosis-An Emerging Parasite in the Immigrant Population - American Family Physician

Sep 1, 2002 - Echinococcus tapeworms are parasites that infect dog species worldwide and occasionally are transmitted to humans. Infection occurs most commonly in persons who raise sheep or cattle, and who have contact with dogs. The tapeworm eggs are typically ingested during play with dogs or ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0901/p817.html

H. pylori Screening Before Initiation of Long-term NSAIDs - FPIN's Clinical Inquiries -...

Jun 15, 2019 - Physicians should perform laboratory screening for and eradicate H. pylori before initiating long-term NSAID therapy in NSAID-naive patients to reduce the risk of peptic ulcer disease.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0615/p783.html

Liver Disease in Pregnancy - American Family Physician

Feb 15, 1999 - Acute viral hepatitis is the most common cause of jaundice in pregnancy. The course of acute hepatitis is unaffected by pregnancy, except in patients with hepatitis E and disseminated herpes simplex infections, in which maternal and fetal mortality rates are significantly increased. ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0215/p829.html

Caring for Patients After Bariatric Surgery - American Family Physician

Apr 15, 2006 - Bariatric surgery leads to sustainable long-term weight loss and may be curative for such obesity-related comorbidities as diabetes and obstructive sleep apnea in severely obese patients. The Roux-en-Y gastric bypass has become the most common procedure for patients undergoing bariatric...

American Family Physician : Article

https://www.aafp.org/afp/2006/0415/p1403.html

Rifaximin (Xifaxan) for Irritable Bowel Syndrome - STEPS - American Family Physician

Feb 15, 2017 - Rifaximin has good overall tolerability. A relatively short course of treatment results in sustained clinical benefit for at least 10 weeks, eliminating the need for continued therapy, with an NNT of 10. However, it is expensive and should be reserved for patients who cannot tolerate or...

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0215/p258.html

Which Probiotics Should I Take? A Practical Guide for Family Physicians - Editorials - ...

Aug 1, 2017 - Find out what requirements should be met to know that you are offering your patients the highest quality probiotics to help prevent and treat disease.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0801/p156.html

Management of Gastroesophageal Reflux Disease - American Family Physician

Oct 1, 2003 - The primary treatment goals in patients with gastroesophageal reflux disease are relief of symptoms, prevention of symptom relapse, healing of erosive esophagitis, and prevention of complications of esophagitis. In patients with reflux esophagitis, treatment is directed at acid ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1001/p1311.html

Clostridium difficile Infection: Prevention and Treatment - Implementing AHRQ Effective...

Feb 1, 2018 - How effective are interventions to prevent and treat Clostridium difficile infection?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2018/0201/p196.html

HELLP Syndrome: Recognition and Perinatal Management - American Family Physician

Sep 1, 1999 - HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the syndrome to be a variant of preeclampsia, but it may be a separate ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0901/p829.html

Should We Screen Patients for Barrett's Esophagus? No: The Case Against Screening - ...

May 15, 2011 - Although there is enthusiasm in some groups for screening patients for Barrett's esophagus, with the goal of reducing death from esophageal adenocarcinoma, review of the evidence does not show sufficient benefit to recommend such a program.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2011/0515/p1148.html

Management of Hepatitis C: Evaluating Suitability for Drug Therapy - American Family ...

Mar 15, 2004 - Chronic hepatitis C virus infection is a common and serious disease. Although an estimated 2.7 million persons in the United States have this disease, most have not yet been diagnosed. Recent advances in treatment provide successful cure in 50 to 80 percent of cases. Current drug ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0315/p1429.html

Diagnosis of Gastrointestinal Bleeding in Adults - American Family Physician

Apr 1, 2005 - The clinical evaluation of gastrointestinal bleeding depends on the hemodynamic status of the patient and the suspected source of the bleeding. Patients presenting with upper gastrointestinal or massive lower gastrointestinal bleeding, postural hypotension, or hemodynamic instability ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0401/p1339.html

Management of Acute Gastroenteritis in Children - American Family Physician

Dec 1, 1999 - Acute gastroenteritis is a common and costly clinical problem in children. It is a largely self-limited disease with many etiologies. The evaluation of the child with acute gastroenteritis requires a careful history and a complete physical examination to uncover other illnesses with ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1201/p2555.html

Failure to Pass Meconium: Diagnosing Neonatal Intestinal Obstruction - American Family ...

Nov 1, 1999 - Timely passage of the first stool is a hallmark of the well-being of the newborn infant. Failure of a full-term newborn to pass meconium in the first 24 hours may signal intestinal obstruction. Lower intestinal obstruction may be associated with disorders such as Hirschsprung's disease,...

American Family Physician : Article

https://www.aafp.org/afp/1999/1101/p2043.html

Evaluation and Management of Dyspepsia - American Family Physician

Oct 15, 1999 - Dyspepsia, often defined as chronic or recurrent discomfort centered in the upper abdomen, can be caused by a variety of conditions. Common etiologies include peptic ulcers and gastroesophageal reflux. Serious causes, such as gastric and pancreatic cancers, are rare but must also be ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1015/p1773.html

Evaluation and Management of Nonulcer Dyspepsia - American Family Physician

Jul 1, 2004 - When no organic cause for dyspepsia is found, the condition generally is considered to be functional, or idiopathic. Nonulcer dyspepsia can cause a variety of symptoms, including abdominal pain, bloating, nausea, and vomiting. Many patients with nonulcer dyspepsia have multiple somatic ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0701/p107.html

Gluten Is Not the Culprit in Many Patients’ Symptoms - POEMs - American Family Physician

May 1, 2016 - Gluten may not be the cause of gastrointestinal symptoms in many patients with nonceliac gluten sensitivity. Only one-third of patients on a gluten-free diet experienced symptoms and correctly identified when they were given gluten-containing flour. Almost one-half (49%) of patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0501/p788.html

Evaluation and Treatment of Swallowing Impairments - American Family Physician

Apr 15, 2000 - Swallowing disorders are common, especially in the elderly, and may cause dehydration, weight loss, aspiration pneumonia and airway obstruction. These disorders may affect the oral preparatory, oral propulsive, pharyngeal and/or esophageal phases of swallowing. Impaired swallowing, or ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0415/p2453.html

Hepatitis B - American Family Physician

Jan 1, 2004 - Hepatitis B causes significant morbidity and mortality worldwide. More than 400 million persons, including 1.25 million Americans, have chronic hepatitis B. In the United States, chronic hepatitis B virus infection is responsible for about 5,000 annual deaths from cirrhosis and ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0101/p75.html

Effect of Dietary Changes on IBS Symptoms - FPIN's Help Desk Answers - American Family ...

Sep 1, 2018 - A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FOD-MAPs) decreases IBS symptoms and improves quality of life compared with usual diet.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0901/od1.html

Treatment Guidelines for Primary Nonretentive Encopresis and Stool Toileting Refusal - ...

Apr 15, 1999 - Nonretentive encopresis refers to inappropriate soiling without evidence of fecal constipation and retention. This form of encopresis accounts for up to 20 percent of all cases. Characteristics include soiling accompanied by daily bowel movements that are normal in size and consistency....

American Family Physician : Article

https://www.aafp.org/afp/1999/0415/p2171.html

Constipation in the Elderly - American Family Physician

Sep 15, 1998 - Constipation affects as many as 26 percent of elderly men and 34 percent of elderly women and is a problem that has been related to diminished perception of quality of life. Constipation may be the sign of a serious problem such as a mass lesion, the manifestation of a systemic disorder...

American Family Physician : Article

https://www.aafp.org/afp/1998/0915/p907.html

Risk of GI Bleeding Highest with Rivaroxaban, Lower with Apixaban, and Lowest with PPI ...

May 15, 2019 - Among patients using oral anticoagulants alone, the risk of hospitalization for upper GI tract bleeding is highest with rivaroxaban (Xarelto) and lowest with apixaban (Eliquis).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od4.html

Preventive Strategies in Chronic Liver Disease: Part II. Cirrhosis - American Family ...

Nov 15, 2001 - Cirrhosis is a diffuse process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules. The modified Child-Pugh score, which ranks the severity of cirrhosis based on signs and liver function test results, has been shown to predict ...

American Family Physician : Article

https://www.aafp.org/afp/2001/1115/p1735.html

Should We Screen Patients for Barrett's Esophagus? Yes: Men with Long-standing Reflux ...

May 15, 2011 - Although screening and surveillance for Barrett's esophagus is controversial, the latest evidence supports this approach to decrease morbidity and mortality. Carefully evaluating patients with reflux symptoms and stratifying them based on known risk factors has the potential to result ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2011/0515/p1140.html

Diagnosis and Managment of Acute Pancreatitis - American Family Physician

Jul 1, 2000 - Acute pancreatitis usually occurs as a result of alcohol abuse or bile duct obstruction. A careful review of the patient's history and appropriate laboratory studies can help the physician identify the etiology of the condition and guide management. Serum amylase and lipase levels are ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0701/p164.html

Hepatitis C: Part I. Routine Serologic Testing and Diagnosis - American Family Physician

Jan 1, 1999 - Hepatitis C, which is caused by the hepatitis C virus (HCV), is a major public health problem in the United States. HCV is most efficiently transmitted through large or repeated percutaneous exposures to blood. Most patients with acute HCV infection develop persistent infection, and 70 ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0101/p79.html

Update on Colorectal Cancer - American Family Physician

Mar 15, 2000 - An estimated 129,400 new cases of colorectal cancer occurred in the United States during 1999. The lifetime risk of developing this cancer is 2.5 to 5 percent in the general population but two to three times higher in persons who have a first-degree relative with colon cancer or an ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0315/p1759.html

Virtual Endoscopy: A Promising New Technology - American Family Physician

Jul 1, 2002 - Growing evidence shows that early detection of cancer can substantially reduce mortality, necessitating screening programs that encourage patient compliance. Radiology is already established as a screening tool, as in mammography for breast cancer and ultrasonography for congenital ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0701/p107.html

Managing Chronic Gastroesophageal Reflux Disease - Implementing AHRQ Effective Health ...

Oct 1, 2012 - What are the effectiveness, benefits, and harms of therapies used to address symptoms and prevent adverse long-term outcomes in adults with gastroesophageal reflux disease (GERD)?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2012/1001/p617.html

Preventive Strategies in Chronic Liver Disease: Part I. Alcohol, Vaccines, Toxic ...

Nov 1, 2001 - Chronic liver disease is the 10th leading cause of death in the United States. Hepatitis C virus infection is the most frequent cause of chronic liver disease and the most common indication for liver transplantation. Preventive care can significantly reduce the progression of liver ...

American Family Physician : Article

https://www.aafp.org/afp/2001/1101/p1555.html

Fidaxomicin (Dificid) for Clostridium difficile Infection - STEPS - American Family ...

Feb 1, 2013 - Fidaxomicin is effective for the treatment of C. difficile infection, but it is much more expensive than traditional therapy. Until it is known that the benefits outweigh the significant cost, metronidazole or oral vancomycin is the preferred treatment for most patients.

American Family Physician : STEPS

https://www.aafp.org/afp/2013/0201/p211.html

NIH Consensus Statement on Management of Hepatitis B - Practice Guidelines - American ...

Oct 15, 2009 - The National Institutes of Health (NIH) Consensus Development Panel has produced a report on the management of hepatitis B virus (HBV) created by independent panels of health professionals and public representatives using a systematic literature review.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2009/1015/p884.html

Antidepressants and Psychological Therapies Are Effective for IBS - POEMs - American ...

Jan 15, 2015 - Antidepressants and psychological therapies are effective in treating the symptoms of IBS. This study, an update of a similar systematic review and meta-analysis completed five years ago, found the same level of effectiveness for both treatment approaches as the previous analysis, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0115/p134.html

Appetite Suppressants as Adjuncts for Weight Loss - FPIN's Clinical Inquiries - ...

Apr 1, 2011 - Phentermine and diethylpropion are appetite suppressants approved for use in the United States as adjuncts in the treatment of obesity. These agents demonstrate a modest weight loss benefit when combined with dietary modifications and exercise.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2011/0401/od1.html

Routine Aspirin or Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of ...

Jul 1, 2007 - This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on routine aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) for the primary prevention of colorectal cancer and the supporting scientific evidence.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2007/0701/p109.html

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