Background: Large volume preparations that are polyethylene glycol based (such as GoLYTELY and MiraLAX) are the mainstay of bowel preparation regimens at many institutions. Studies have shown that patients prefer lower volume preparations compared to the standard 4 Liters of polyethylene glycol electrolyte solutions (PEG- ELS). Although data has been collected on low volume bowel [...]

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that affects at least 20% of the general population. There is a significant predominance of IBS in females, with a female: male ratio of 2:1, especially in western countries. In contrary Eastern countries, some studies report that men with IBS are 4 times more affected [...]

Background: Constipation is commonly encountered in patients admitted to the hospital, with a variety of possible treatments to choose from. Docusate is often prescribed to treat constipation, though evidence suggests it is ineffective. Utilizing an ineffective medication adds to patients’ pill burden, health care costs, and may delay the use of effective medications with downstream [...]

Background: Current guidelines and most experts recommend pharmacologic venous thromboembolism (VTE) prophylaxis for patients hospitalized with an acute inflammatory bowel disease (IBD) exacerbation.  Quality measures of physician performance further expand this mandate to include patients with a diagnosis of IBD who are hospitalized for any reason. We sought to assess the risk of VTE in [...]

Case Presentation: An 89 year-old woman was admitted for several days of severe constipation, abdominal bloating and absence of flatus. She had abdominal distention with minimal abdominal tenderness on exam. Initial CT imaging demonstrated significant stool burden with prominent colonic distension extending from the cecum to the transverse colon. She required nasogastric tube decompression. Several [...]

Case Presentation: A 94-year-old man with no significant past medical history presented to the Emergency Department with a two week history of progressively worsening constipation accompanied by nausea, vomiting, and abdominal pain. He denied any hematochezia, melena, change in stool caliber or unintentional weight loss. He had never undergone a colonoscopy. He had tried stool [...]

Case Presentation: A 54-year-old male with past medical history of ulcerative colitis not on active treatment and DM type II presented to his primary care provider (PCP) with right ear pain and swelling which began a week prior. His PCP added oral clindamycin, Cortisporin otic drops, and later prednisone when his pain and swelling did [...]

Case Presentation: A 33 year-old female presented to an outside facility with a few days of gradual onset abdominal pain with nausea and vomiting. On presentation, vital signs were notable for tachycardia. Examination showed periumbilical tenderness without rigidity or guarding. Labs were remarkable for leukocytosis and normocytic anemia but normal lipase. CT of the abdomen [...]

Case Presentation: This is a case of a 37-year-old female with a 9 month history of moderate ulcerative pancolitis (UC) who was admitted with worsening abdominal pain, a 30 lb weight loss, nausea, vomiting, and bloody diarrhea. She had been treated with mesalamine, vedolizumab, and infliximab with no improvement and refused corticosteroid therapy due to [...]

Case Presentation: A 47-year-old Caucasian woman presented with severe vomiting and abdominal pain for three days. Her past medical history revealed that she was diagnosed in 2010 with ulcerative colitis proctitis and was recently started on azathioprine. In the past, she had received a short course of steroids, but was complicated by an increase in [...]