In the News

Lack of follow-up common for rectal bleeding in primary care

A retrospective cohort study found that 22.3% of patients didn't get timely workup for rectal bleeding; among that cohort, 36% had no follow-up procedure ordered and 44% had one ordered but not scheduled or scheduled but not completed.

Concurrent cholinesterase inhibitors, NSAIDs linked to peptic ulcer risk

Risk of peptic ulcers increased ninefold when patients ages 65 years and older took cholinesterase inhibitors and NSAIDs concurrently, a Swedish study found, leading the authors to suggest that the combination be considered potentially inappropriate for older patients.

Fenofibrate may augment treatment for primary biliary cholangitis

Adding fenofibrate to ursodeoxycholic acid significantly increased the likelihood of biochemical response and normalization of alkaline phosphatase levels, a small trial in China found.

MKSAP Quiz: 6-month history of constipation

A 52-year-old man is evaluated for a 6-month history of constipation. He has bowel movements once every 5 days, low back pain after 2 days without a bowel movement, and straining during defecation. He reports no abdominal pain. After a physical exam and lab tests, what is the most appropriate management?

Spotlight on CRC screening in older adults

Age-based screening for colorectal cancer (CRC) results in underscreening of older, healthier patients, one study found, while a trial showed that personalized information about CRC risk from a primary care clinician led to more appropriate use of screening.

Higher fecal hemoglobin concentration on FIT may support shorter screening interval

Patients with a hemoglobin concentration on fecal immunochemical testing (FIT) in the range directly below the positive result cutoff had significantly increased risk of adenoma on follow-up screening compared to those with lower results, a new analysis from Germany found.

Endoscopy a potential option for acute cholecystitis with impacted stone

Two video cases demonstrate use of endoscopy as an alternative procedure in patients with acute cholecystitis and an impacted cystic duct stone.