News from the AGA

Top AGA Community patient cases


 

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

In case you missed it, here are the most popular clinical discussions shared in the forum recently:

1. Biologic blood levels for pediatric IBD patient

An 11-year-old was experiencing right lower quadrant pain, a low-grade fever, painful red nodules in his legs, joint pain, moderate anemia, a peri-anal abscess and high fecal calprotectin. An MRI revealed signs of lower small bowel disease and moderate narrowing of the ileum. He was treated and showing no symptoms at about 20 weeks. The community discussed if the patient would benefit from adding adalimumab blood levels to his maintenance.

2. False positives in new DNA-based colon cancer tests

A discussion around some noninvasive colon cancer tests, such as Cologuard and liquid biopsy tests like Epi proColon, revealed community frustrations with false positives and dealing with an increased number of anxious patients awaiting colonoscopies.

3. Olmesartan-induced enteropathy

A female patient switched blood pressure medications and developed diarrhea, abdominal discomfort, and weight loss. She tested positive for celiac-type enteropathy and was placed on a gluten-free diet, with symptoms resolving a couple weeks later. She switched back to her original medication, and her GI had questions for the community regarding potential for a long-term condition, as well as celiac serology follow-up.

4. Inactive UC

A 49-year-old woman with a history of pancolitis hasn’t required therapy for over 10 years. Recent biopsies showed architectural distortion and atrophy consistent with inactive colitis, without any active colitis in the rectum, but the descending colon presented a polyp mucosa with chronic colitis, erosion, and regenerative hyperplasia. Given her history, the physician solicited advice on therapy and rescoping consistency going forward.

More clinical cases and discussions are at https://community.gastro.org/discussions.

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