Management of Helicobacter Pylori in the United States: Results from a national survey of gastroenterology physicians.

BACKGROUND AND AIMS: We sought to determine current knowledge and practices among gastroenterology physicians and assess adherence to current guidelines for H. pylori management. METHODS: Online surveys were distributed in 2014 to practicing gastroenterology physicians for information related to the diagnosis and treatment of H. pylori infection. RESULTS: A total of 582 completed surveys were reviewed. The H. pylori screening test used "almost always" was gastric biopsy obtained during endoscopy (histology) (59%) followed by stool antigen test (20%). Standard triple therapy for 14days was commonly prescribed by 53% of respondents. The stool antigen test was most frequently chosen to confirm H. pylori eradication (51%), although only 58% of physicians checked for eradication in patients who underwent treatment. CONCLUSIONS: Adherence to current American College of Gastroenterology guidelines is low. Although more physicians treat patients with a positive H. pylori test, only half ensure eradication after treatment. Improving knowledge of the resistance patterns of H. pylori may be critical to ensure successful eradication.

New-Onset Collagenous Colitis in a Patient With Psoriatic Arthritis: Can It Be Secukinumab?

Collagenous colitis is a chronic inflammatory condition and one type of a bigger entity, microscopic colitis. Collagenous colitis is associated with autoimmune diseases, such as psoriatic arthritis, suggesting an immune mechanism involved in the pathogenesis of the disease. New onset and flares of inflammatory bowel disease have been associated with the use of secukinumab, but no cases of microscopic colitis have been reported yet. We present a case of a 41-year-old woman with psoriatic arthritis treated with secukinumab who developed chronic diarrhea and was found to have collagenous colitis.

More Than Just a Polyp: Diagnosis of Tuberculosis From a Screening Colonoscopy.

The diagnosis of tuberculosis (TB) is challenging to make due to the non-specific signs and symptoms that patients usually present with. Furthermore, the endoscopic appearance of colonic TB is not specific and can mimic other more common pathologies such as Crohn's disease and colonic malignancy. We report the case of a 66-year-old female who presented for a routine screening colonoscopy and was diagnosed with disseminated TB after histopathological examination of the discovered polyps.

The Missing Link: A Case of Plummer-Vinson Syndrome in a Young Pacific-Islander Woman With Helicobacter Pylori.

Plummer-Vinson syndrome (PVS), the triad of dysphagia, iron-deficiency anemia (IDA), and esophageal webs, is a relatively rare disease entity that is mostly observed in the Caucasian populations of Scandinavia and North America. As these regions have become more developed with improved nutrition, PVS is now more commonly seen in the developing regions of the world. We present the case of a 29-year-old Pacific-islander woman who presented with progressive dysphagia and IDA and was found to have an esophageal web and Helicobacter pylori (H. pylori) gastritis on upper endoscopy. She improved with dilation of the web in the esophagus and treatment of H. pylori. Identifying the possibility of this syndrome in clinical practice and the association between H. pylori and PVS, especially given recent changes in its epidemiology, is important given the patient population in Hawaii and the Pacific.

Poorly Differentiated Neuroendocrine Tumor of the Rectum Coexistent with Giant Rectal Villous Adenoma Presenting as McKittrick-Wheelock Syndrome.

McKittrick-Wheelock Syndrome is a rare disorder, noted for electrolyte and fluid depletion caused by secretory colorectal adenomas and carcinomas. We report here the first reported case of a 55-year-old man with a large rectal villous adenoma coexistent with a poorly differentiated neuroendocrine tumor of rectum presenting with McKittrick-Wheelock Syndrome. Palliative chemotherapy resulted in complete resolution of symptoms and improved quality of life.