GASTROENTEROLOGY ARTICLE OF THE WEEK
August 26, 2010
ASGE Guidelines: The role of endoscopy in the management of patient with diarrhea. Gastrointest Endosc 2010;71:887-892.
1. The preferred evaluation for a patient with diarrhea suspected to be related to graft-vs-host disease is
a. EGD with duodenal biopsies
b. Colonoscopy with ileal biopsies
c. Sigmoidoscopy with rectal biopsies
d. Stool testing for occult blood
True or False
2. Left sided colon biopsies should be sufficient to exclude the diagnosis of microscopic colitis
3. In the evaluation of patients with diarrhea, ileal biopsies of normal looking mucosa should always be performed as they have a high yield
4. Most patients with acute diarrhea should undergo flexible sigmoidoscopy
5. CMV is the most common cause of diarrhea in HIV if the work up is negative for other common etiologies
6. Chronic diarrhea is defined as diarrhea that has persisted over 4 weeks
7. Sodium phosphate preps and use of NSAID can cause changes in the bowel mucosa that mimic IBD.
8. For suspected small bowel disease as the cause of diarrhea, at least 4 biopsies from the duodenum should be obtained, even if the mucosa looks normal.