Examining linaclotide for the treatment of chronic idiopathic constipation.

Introduction: Chronic idiopathic constipation (CIC) is characterized by infrequent bowel movements and hard stools lasting for at least three months or longer. This disease affects 8-12% of the US population and 10-17% of the world population. Treatment and management involve identifying the primary cause, changing dietary habits, and adequate physical activity.

Current and emerging pharmacotherapy for the treatment of gastroparesis.

Introduction: Gastroparesis is a chronic disorder characterized by decreased gastric emptying and presents with nausea, vomiting, and abdominal pain which impacts patients' quality of life greatly. The treatment modalities available for gastroparesis have been expanding over the past 2 decades. Currently, there are multiple options available for gastroparesis, albeit with only one FDA-approved medication until June 2021.

The Association Between Non-Clinically Apparent Liver Fibrosis and Pulmonary Arterial Hypertension in Hispanic Patients.

Background: Pulmonary arterial hypertension (PAH) is a deadly cardiopulmonary disease with multi-organ involvement including impaired liver function. Liver dysfunction in PAH is poorly understood but significantly associated with morbidity and mortality. Hispanics have a significantly higher prevalence of non-alcoholic fatty liver disease (NAFLD) and evidence of more advanced disease in comparison to other ethnic groups.

Virtual Reality and Mindfulness Approaches in the Treatment of Rumination Syndrome.

Rumination syndrome (RS) is the repeated, effortless food regurgitation during or immediately after eating or drinking, which could be followed by rechewing, reswallowing, or spitting out of the regurgitant gastric contents. The mechanism by which RS ensues is because of the habitual contraction of the abdominal wall muscles leading to increased intra-abdominal pressure and regurgitation of gastric contents. Therefore, diaphragmatic breathing techniques and biofeedback are helpful in these patients to counteract the habitual abdominal contractions.

Frequency of GLP-1 receptor agonists use in diabetic patients diagnosed with delayed gastric emptying and their demographic profile.

Advances in the management of diabetes mellitus have come a long way in the 21st century. One of the most important developments in diabetes management has been the discovery of glucagon-like peptide-1 (GLP-1) receptor agonists. The most common side effects of GLP-1 receptor (GLP-1R) agonists are nausea and vomiting which have been attributed to delayed gastric emptying.

Vascular complications of pancreatitis.

More than 200000 hospital admissions happen per year for acute pancreatitis and more than 50000 for chronic pancreatitis in the United States of America. Necrotizing pancreatitis accounts for 20%-30% of the cases. One-quarter of the patients with pancreatitis develop vascular complications, which carries a high mortality.

A Rare Culprit of Methemoglobinemia.

Methemoglobinemia is a rare cause of hypoxia and can be a diagnostic challenge early in the disease course. The incidence of medication-induced methemoglobinemia is more common than congenital-related methemoglobinemia. The most common cause of methemoglobinemia is exposure to household detergents, illicit drugs, or medications with nitrate or sulfonamide chemical groups.

A Combined Factor V and Factor VIII Deficiency: A Case Report.

Factor V and VIII deficiency (F5F8D) is a rare coagulopathy; it's an autosomal recessive condition. This case report is about of 15-year-old unmarried Saudi female, who presented with a complaint of pain in the lower abdomen. Complete blood count and coagulation profile revealed low hemoglobin and prolongation of activated partial thromboplastin time (aPTT), prothrombin time (PT), and international normalized ratio (INR).

A Perfect Storm: Abdominal Pain and Ileus Explained by Acute Intermittent Porphyria Caused by Prehospitalization and Intrahospitalization Factors.

Acute intermittent porphyria (AIP) is a rare autosomal dominant inherited disease, predominantly seen in female patients, caused by mutations in the hydroxymethylbilane synthase gene. When impaired, elevated heme biosynthesis precursor levels accumulate in the liver, resulting in neurological symptoms, psychiatric disturbances, darkened urine color, abdominal pain, nausea, vomiting, and ileus. We present a 22-year-old Hispanic female with diffuse abdominal pain and no bowel movements for 8 days.

Colorectal Carcinoma in the Background of Pelvic Inflammatory Disease.

Colorectal carcinoma (CRC) is a common malignancy with steadily declining incidence rates and mortality, secondary to improved screening and lifestyle changes (eg, decreased smoking rates). The association between pelvic inflammatory disease (PID) and CRC has been unclear in the past. However, multiple studies showed a positive association between PID and underlying malignancy (gynecologic and pelvic primarily).

Post-cholecystectomy Mirizzi Syndrome.

Post-cholecystectomy Mirizzi syndrome (PCMS) is characterized by symptoms of recurrent abdominal pain, jaundice, and fever in patients who underwent cholecystectomy. Imaging is crucial in the diagnosis of PCMS and Mirizzi syndrome. Imaging modalities have evolved over the years with abdominal ultrasonography, computed tomography of the abdomen, and magnetic resonance cholangiopancreatography being used in the diagnosis of PCMS and Mirizzi syndrome.

Medical Management of Septic Arthritis of the Sternoclavicular Joint With Extended-Spectrum Beta-Lactamase-Producing Escherichia coli: A Case Report.

The sternoclavicular joint (SCJ) is an uncommon location for septic arthritis to occur in. Due to the rarity of the condition and the nonspecific symptoms, SCJ septic arthritis can be missed or mislabeled as osteoarthritis or muscle strain. Accurate history and physical examination is crucial for recognizing this condition.

When Worlds Collide: An Interesting Case of Rhinocerebral Mucormycosis Exacerbated by COVID-19 and Diabetic Ketoacidosis Complicated by Intraorbital Hematoma.

Mucormycosis is a devastating fungal infection seen in patients who are immunosuppressed or in severe inflammatory states. Mucormycosis has been increasingly seen in the setting of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. We describe a 68-year-old male with a past medical history of uncontrolled diabetes mellitus who presented with acute vision loss and was found to have concomitant diabetic ketoacidosis (DKA) and coronavirus disease 2019 (COVID-19) infection on presentation.

Abnormal liver enzymes: A review for clinicians.

Liver biochemical tests are some of the most commonly ordered routine tests in the inpatient and outpatient setting, especially with the automatization of testing in this technological era. These tests include aminotransferases, alkaline phosphatase, gamma-glutamyl transferase, bilirubin, albumin, prothrombin time and international normalized ratio (INR). Abnormal liver biochemical tests can be categorized based on the pattern and the magnitude of aminotransferases elevation.

Medication-Induced Gastroparesis: A Case Report.

Gastroparesis is a commonly diagnosed gastrointestinal disorder with a high prevalence globally and high disease burden to those afflicted with it. Etiologies are variable with idiopathic and diabetes being the most common causes of gastroparesis. Management of gastroparesis depends on the etiology, and accurate diagnosis is required for better targeted therapy.

Incidental Diagnosis of Duodenal Giardiasis.

 is a protozoan that results in the commonly diagnosed giardiasis. Due to its prevalence and incidence worldwide, it is essential to recognize the different presentations of giardiasis, routes of transmission, modalities of diagnosis, treatments, and complications. Diagnostic modalities have evolved over the years and can be achieved reliably through noninvasive stool testing.