Gastroenterology Commons^™

Management Of Patient With Impaction Secondary To Undigested Sunflower Seed Bezoar: A Case Report, Sufia Ahmed, Anthony Adetomiwa

Research Day

Introduction: Bezoars are aggregates of undigested plant fibers, hair, or seeds that may impact in any portion of the GI tract. These bezoars if left can lead to significant complications, including perforation and peritonitis.

Methods: We report a case of a 4-year-old female patient who presented to the emergency department with constipation and severe lower abdominal pain following unsupervised consumption of a large unknown volume of sunflower seeds. Initial radiograph revealed an undigested bezoar of seeds in the sigmoid colon and rectum. The patient was managed with mineral oil enema and manual disimpaction under conscious sedation. Subsequent radiographs revealed a …

Colonic Stenosis In An Elderly Female, Tiffany R. Pittman, Kylie A. Parrish, Grace M. Perry, Oyindamola C. Orekoya, Shiv Dhiman, Savita Arya

Research Day

Introduction

Colonic stenosis is commonly caused by chronic inflammation and is a known side effect of inflammatory conditions, such as diverticulitis and irritable bowel syndrome. Diverticulosis is a common condition where parts of the colon wall become weakened, forming outpouches. These outpouchings may become inflamed, leading to diverticulitis. This chronic inflammation can cause scarring and fibrosis of the colon, resulting in colonic stenosis. Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, may also result in scarring and colonic stenosis. The incidence rate of patients developing colonic stenosis is 8-13.5% for Crohn's disease and 1-11% for ulcerative colitis. Patients …

Early Colonoscopy In Hospitalized Patients With Acute Lower Gastrointestinal Bleeding: A Nationwide Analysis., Kuldeepsinh P Atodaria, Samyak Dhruv, Joseph M Bruno, Brisha Bhikadiya, Shravya R Ginnaram, Shreeja Shah

Internal Medicine Resident Research

Background: Performing colonoscopy within 24 h of presentation to the hospital is the accepted standard of care for patients with an acute lower gastrointestinal bleed (LGIB). Previous studies have failed to demonstrate the benefit of early colonoscopy (EC) on mortality. In this study, we wanted to see if there was a change in inpatient deaths (primary outcome), length of stay (LOS), and hospitalization charges (TOTCHG) (secondary outcomes) with EC compared to previous studies.

Methods: Adults diagnosed with LGIB were identified using the International Classification of Disease 10th Revision codes from the National Inpatient Sample database for 2016 to 2019. EC …

Does Preprandial Oral Lactase Supplement Reduce Abdominal Pain In Lactose-Intolerant Adult Patients After A Lactose-Containing Meal?, Margaryta Tolchynska

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not preprandial oral lactase supplement reduces abdominal pain in lactose-intolerant adult patients after a lactose-containing meal.

STUDY DESIGN: A systematic review of three randomized, blinded, controlled primary research studies published between the years of 2010 and 2018.

DATA SOURCES: One randomized controlled trial (RCT), one randomized comparative study, and one randomized crossover study evaluating the efficacy of 9,000 units of preprandial oral lactase supplement in reducing abdominal pain due to lactose intolerance (LI). All studies were published in peer-reviewed journals and found via the use of PubMed, …

Does The Use Of Prophylactic Probiotics Prevent Antibiotic-Associated Diarrhea In Adults Using One Or More Antibiotics?, David E. Castillo

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective Evidence Based Medicine (EBM) review is to determine if the use of probiotics can prevent the incidence of antibiotic-associated diarrhea (AAD) in adults using one or more antibiotics.

STUDY DESIGN: Systematic review of three randomized, double-blind, placebo controlled trials in the English language published between 2013 and 2014.

DATA SOURCES: Data sources obtained for this review were articles published in peerreviewed journals found using PubMed and Cochrane databases.

OUTCOME MEASURED: All three studies defined diarrhea as the passage of three or more loose stools in a 24-hour period. All the studies used the Bristol …

Is Oral Aloe Vera Effective In Reducing Symptoms In Adults With Irritable Bowel Syndrome (Ibs)?, Chelsey J. Gebhardt

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this EBM review is to determine whether or not “Is oral aloe vera effective in reducing symptoms in adults with Irritable Bowel Syndrome (IBS) symptoms?”

Study Design: Systematic review of three English, randomized, controlled, double-blind studies, including one cross-over study, were selected based on their relevance to the clinical question. The studies were published in 2006, 2011, and 2015.

Data Sources: Three RCTs analyzing the effects on IBS symptoms of drinking aloe vera daily compared to a placebo drink were found using PubMed.

Outcomes Measured: Various patient-reported IBS symptom questionnaires were utilized …

Does Fecal Microbiota Transplantation Cause Clinical Remission In Patients With Ulcerative Colitis?, Amandeep Singh

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Does Fecal Microbiota Transplantation cause Clinical Remission in Patients with Ulcerative Colitis?”

Study Design: Review of three English language primary studies published in 2015.

Data Sources: Two randomized control trials and a cohort study determining if fecal microbiota transplantation does lead to clinical remission of Ulcerative Colitis were found by using PubMed and Cochrane databases.

Outcome(s) Measured: The outcomes measured in all three studies were patient oriented evidence that matters which is clinical remission. The outcomes in the Moayyedi et al. was …

Is Radiofrequency Ablation Effective In Treating Barrett’S Esophagus Patients With High-Grade Dysplasia?, Ariana S. Karnado

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of the selective EBM review is to determine whether or not “Is radiofrequency ablation effective in treating Barrett’s esophagus patients with high-grade dysplasia?”

Study Design: Review of two randomized controlled trials and one cohort study. All three studies were published in English in peer-reviewed journals after 2000.

Data Sources: Two randomized controlled trials and one cohort study found via PubMed.

Outcome(s) Measured: All three studies measured eradication of dysplasia via biopsy evaluation. Other outcomes measured included progression to high-grade dysplasia or adenocarcinoma based on histology findings, overall cancer risk based on observations of …

Is Radiofrequency Energy A Safe And Effective Treatment For Reducing Symptoms Of Gastroesophageal Reflux Disease In Patients 18 Years Or Older?, Kristen L. Schaffer

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not “Is radiofrequency energy a safe and effective treatment for reducing symptoms of gastroesophageal reflux disease in patients 18 years or older?”

STUDY DESIGN: Review of two double-blind, randomized control trials and one double-blind, randomized cross-over study published between 2003 and 2012. All studies were published in the English language in peer reviewed journals.

DATA SOURCES: Two randomized control trials and one randomized cross-over study were found using PubMed.

OUTCOMES MEASURED: The outcomes measured include changes in GERD symptom scores for …

Are Cams Safe And Effective In Improving Symptoms Of Adult Patients Over The Age Of 18 With Active Crohn Disease?, Amy Pellerito

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not complimentary and alternative medicines are safe and effective in improving symptoms of adult patients over the age of 18 with active Crohn disease.

Study design: A review of three published, randomized controlled trials (RCTs), one published in 2010, and the second and third in 2014. All English language.

Data source: All 3 RCT’s were found using PubMed.

Outcomes measured: All three studies measured improvement of Crohn disease symptoms through the Crohn Disease Activity Index (CDAI), Hamilton’s Depression Scale (HAMD), the Inflammatory Bowel …

In Adults With Acute Diarrhea, Which Treatment Is More Effective Between Loperamide And Racecadotril?, Lorena A. Castillo

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine which treatment is more effective between loperamide and racecadotril to treat acute diarrhea in adults.

STUDY DESIGN: Review of three English language primary randomized controlled studies published from 1999-2005.

DATA SOURCES: First study was a RCT that was double blinded, double placebo, parallel study group and second and third study was RCT single blinded, comparative parallel group that all compared efficacy of loperamide and racecadotril. These were all found by using PubMed, COCHRANE and NCBI.

OUTCOMES MEASURED: Each of the studies measured the efficacy of each …

Are Sodium Alginate Solutions Effective In Reducing Postprandial Symptoms In Adults With Gastroesophageal Reflux?, Kristi L. Hackman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not sodium alginate solutions are effective in reducing postprandial symptoms in adults with gastroesophageal reflux?

STUDY DESIGN: A review of three English language studies published from 2006-2011. Includes two randomized, double-blind, controlled trials and one controlled case series.

DATA SOURCES: Randomized, placebo-controlled studies evaluating the effectiveness and safety of sodium alginate solutions (Gaviscon) for managing gastroesophageal reflux disease (GERD) symptoms in adults were located using the PubMed, CINAHL, and Cochrane Library databases.

OUTCOMES MEASURED: The primary measures of effectiveness used were the Reflux Severity Index Questionnaire …

Is Laparoscopic Gastric Banding An Effective Treatment For Obesity In Adolescents And Adults As Measured By Physical Function?, Shawna Mccormick

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is laparoscopic gastric banding an effective treatment for obesity in adolescents and adults as measured by physical functioning?”

STUDY DESIGN: Review of all English language primary studies from 2009, 2010, and 2011.

DATA SOURCES: Two randomized control trials and one cohort study were found using PubMed, Medline, and OVID.

OUTCOMES MEASURED: There were multiple outcomes measured in the studies but the outcome of concern is quality of life post-operatively, specifically, physical functioning as measured by surveys including SF-36, Moorehead-Ardelt, BAROS, and CHQ CF-50. …