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The hepatic artery provides ~33% of the blood supply to the liver but 50% (𝘰𝘳 𝘮𝘰𝘳𝘦) of the oxygen. The hepatic artery is the 𝘰𝘯𝘭𝘺 blood supply to the bile ducts.

The top 3 risk factors for Crohn’s disease recurrence following surgery are: 1. Ongoing tobacco use 2. Younger age at diagnosis 3. Prior surgery for Crohn’s

Veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), causes sinusoidal dilation & liver congestion due to nonthrombotic obstruction of central hepatic venules Risk factors: 🦴Bone marrow transplant (usually <21 days) ☣️Chemotherapy 💊Azathioprine

TERMINAL ILEITIS DDX: 🔹Actinomycosis 🔹Amyloidosis 🔹Anisakiasis 🔹Ankylosing spondylitis 🔹Backwash ileitis in UC 🔹Behçet’s syndrome 🔹Cryptosporidiosis 🔹Crohn’s disease 🔹Endometriosis 🔹Eosinophilic enteritis 🔹Neoplasm 🔹NSAIDs 🔹Radiation enteritis 🔹Reactive arthritis

What foods are 𝒎𝒐𝒔𝒕 𝒍𝒊𝒌𝒆𝒍𝒚 to cause symptoms in lactose intolerance? 1. Animal milk 2. Ice cream 3. Soft cheese (ie ricotta or cream cheese) 4. Buttermilk 5. Yogurt (variable depending on type) 6. Heavy cream 7. Sour cream 8. Aged hard cheese (ie parmesan) 9. Butter

H pylori infection affects ~40% of the world! Interestingly, H pylori alters the gastric environment where it can be protective against esophageal adenocarcinoma. Why then do we check for & treat it? Because H pylori infection is associated w/ a host of other conditions!

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Just finished a talk on physician recruitment from an early career perspective! Thank you Andy Tau, MD and ACG for the invitation!

Clarithromycin antibiotic resistance is 15% (or more!!) in the US Treat H pylori infection with bismuth based quadruple therapy initially And remember, always test for H pylori eradication at least one month after finishing treatment and off PPI (stool Ag or breath test)

The adenoma miss rate during colonoscopy was ~22% in one study, not including harder-to-spot sessile serrated lesions. An adequate ADR is not enough. 15% of endoscopists with adequate ADRs were also low detectors for SSLs. Use the data to improve. Let’s be exceptional!

In patients with bleeding from H pylori related PUD who require ongoing ASA for 2° cardiac ppx, recurrent ulcer bleeding at 12 months was substantially lower in those taking PPI (only 1.6%) vs placebo (14.8%)

Major breakthrough treatment option for patients with MSI-H / dMMR metastatic CRC Worth noting MSI-H / dMMR represents only ~15% of CRC cases (and only ~5% metastatic CRC cases)

IgA deficiency is the most common immunodeficiency. Common variable immunodeficiency (CVID) is second most common.

Fast food consumption would drastically reduce if more cities banned drive through windows. People choose convenience over food quality. So why not make it more inconvenient?

Polypharmacy is too common. I can’t tell you how many times I’ve “fixed” someone’s diarrhea or abnormal liver tests simply by stopping a medication they didn’t need anyway.

I had the opportunity to be featured on CA Central Coast news station KSBY to discuss colorectal cancer screening

I am a board certified gastroenterologist!

My thoughts on ‘Dry January’