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Etowah Gastroenterology Associates 1026 Goodyear Ave, Suite 201 Gadsden, AL 35904 Tel (256) 467-4477 Fax (256) 467-4830 Vipul Amin, M.D. Name: ______________________________________________________ Date of Birth: __________ Age_______ Referring Physician: ______________________________________________________________________________ CHIEF COMPLAINT (describe in your own words the main reason you are seeing the doctor today): _______________________ MARK ALL SYSTEMS OR CONDITIONS THAT YOU CURRENTLY HAVE GASTROINTESTINAL Mark all symptoms or conditions that you CURRENTLY have: Nausea Abdominal Swelling Vomiting Blood Belching Diarrhea Food / Milk Intolerance Abdominal Pain Black Stool Bloating Get Full Quickly at Meals Painful Swallowing Laxative Use Vomiting Change in Bowel Habits Difficulty Swallowing Blood in Stool Constipation Pain with Bowel Movement Gas / Flatulence Heartburn NONE Have you had any of these procedures? Colonoscopy: Yes Year: _________________ / Physician: ___________________ No Upper Endoscopy: Yes Year: _______________ / Physician: ___________________ No CT scan of abdomen (past 6 months): Yes No Ultrasound of abdomen (past 6 months): Yes NO MUSCULOSKELETAL RESPIRATORY GENERAL Physical Disability Chronic Cough Lack of Appetite Joint stiffness Difficulty Breathing Tiredness Back pain Wheezing Night Sweats NONE NONE Fever Weight loss (over 10lbs) CARDIOVASCULAR BREAST NONE Fainting/Blacking out Breast Pain Swelling of Hands or Feet Breast Mass HEENT Chest pain NONE Wear glasses Leg cramping Wear contacts Irregular heartbeats PYSHIATRIC Hoarseness NONE Suicidal Thoughts Decreased Hearing Anxiety Headache NEUROLOGICAL Depression NONE Dizziness Fainting OB/GYN GENITOURINARY Loss of Consciousness Menstrual abnormality Change in urinary stream Weakness in Extremities Are you currently pregnant? Blood in urine Seizure Yes No Difficulty urine Difficult Speech Last menstrual period Pelvic pain NONE date: ___________ NONE ENDOCRINOLOGY DERMATOLOGY/SKIN Cold Intolerance Rashes Excessive thirst Itching Heat intolerance NONE Change of appetite Frequent Urination NONE .

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2.04.26 Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Irritable Bowel Syndrome
MEDICAL POLICY – 2.04.26 Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Irritable Bowel Syndrome BCBSA Ref. Policy: 2.04.26 Effective Date: July 1, 2021 RELATED MEDICAL POLICIES: Last Revised: June 8, 2021 None Replaces: N/A Select a hyperlink below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE REVIEW | REFERENCES | HISTORY ∞ Clicking this icon returns you to the hyperlinks menu above. Introduction Intestinal dysbiosis is a condition that occurs when the microorganisms in the digestive tract are out of balance. This condition is believed to cause diseases of the digestive tract, including poor nutrient absorption, overgrowth of certain bacteria, and irritable bowel syndrome (IBS). Symptoms of these digestive problems are similar and may include: abdominal pain, excess gas, bloating, and changes in bowel movements (constipation or diarrhea, or both). One method of diagnosing digestive disorders is by testing a fecal sample. Using fecal analysis to diagnose intestinal dysbiosis, IBS, malabsorption, or small intestinal overgrowth of bacteria is unproven (investigational). More studies are needed to see if this testing improves health outcomes. Note: The Introduction section is for your general knowledge and is not to be taken as policy coverage criteria. The rest of the policy uses specific words and concepts familiar to medical professionals. It is intended for providers. A provider can be a person, such as a doctor, nurse, psychologist, or dentist. A provider also can be a place where medical care is given, like a hospital, clinic, or lab. This policy informs them about when a service may be covered.
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An Osteopathic Approach to Reduction of Readmissions for Neonatal Jaundice
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INFORMED CARING JAUNDICE Neonatal Jaundice BILIARY
1 INFORMED CARING Situations with Adults and Children with Gallbladder, Liver and Pancreatic Disorders 2 JAUNDICE ä Does NOT mean hepatitis ä Increased breakdown of RBCs ä Altered bilirubin breakdown ä Impeded flow through liver or bile duct ä First seen in sclera, then skin 3 Neonatal Jaundice ä Not liver failure ä RBC breakdown ä Phototherapy 4 BILIARY ATRESIA ä Jaundice 2-3 weeks after birth ä Easy bruising ä Stools putty like ä Tea colored urine ä Abdominal/organ distension 5 4 F’s of Gallbladder ä Fair ä Fat X size of person X amount in diet ä Fertile X BCP X Multiparity ä Forty 6 Cholelithiasis ä Calculi within the duct or gallbladder ä Severe colicky, cramp-like pain X radiates to shoulder blade X Murphy's sign ä Cholecystitis: inflammation X Can be caused by trauma, fasting, TPN or abdominal surgery 7 Diagnostic Studies ä Ultrasound of abdomen 1 X not for the obese ä HIDA scan X nuclear medicine ä Cholangiograms X endoscopic X transvenous X intraoperative 8 Post-op Care ä High abdominal incision X respiratory compromise ä T-tube X patients need to know how to empty it X may clamp it prior to removal X caution not dislodged with movements ä NO Morphine X spasms of sphincter of Oddi 9 Post-op Nutrition ä Limited fat in diet X can have rapid transit times ä Potential fat soluble vitamin deficit X A, D, E and K ä Weight loss diet 10 LIVER FAILURE ä Cirrhosis ä Drug toxicity X acetaminophen, anesthetics, HCTZ, chemotherapy ä Infection ä Cancer ä ETOH is single most linked cause 11 LIVER FAILURE S/S ä Don’t show up until 80-90% failed
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Symptomatic Approach to Gas, Belching and Bloating 21
20 Osteopathic Family Physician (2019) 20 - 25 Osteopathic Family Physician | Volume 11, No. 2 | March/April, 2019 Gennaro, Larsen Symptomatic Approach to Gas, Belching and Bloating 21 Review ARTICLE to escape. This mechanism prevents the stomach from becoming IRRITABLE BOWEL SYNDROME (IBS) Symptomatic Approach to Gas, Belching and Bloating damaged by excessive dilation.2 IBS is abdominal pain or discomfort associated with altered with OMT Treatment Options Many patients with GERD report increased belching. Transient bowel habits. It is the most commonly diagnosed GI disorder lower esophageal sphincter (LES) relaxation is the major and accounts for about 30% of all GI referrals.7 Criteria for IBS is recurrent abdominal pain at least one day per week in the Carly Gennaro, DO1; Helaine Larsen, DO1 mechanism for both belching and GERD. Recent studies have shown that the number of belches is related to the number of last three months associated with at least two of the following: times someone swallows air. These studies have concluded that 1) association with defecation, 2) change in stool frequency, 1 Good Samaritan Hospital Medical Center, West Islip, NY patients with GERD swallow more air in response to heartburn and 3) change in stool form. Diagnosis should be made using these therefore belch more frequently.3 There is no specific treatment clinical criteria and limited testing. Common symptoms are for belching in GERD patients, so for now, physicians continue to abdominal pain, bloating, alternating diarrhea and constipation, treat GERD with proton pump inhibitors (PPIs) and histamine-2 and pain relief after defecation. Pain can be present anywhere receptor antagonists with the goal of suppressing heartburn and in the abdomen, but the lower abdomen is the most common KEYWORDS: ABSTRACT: Intestinal gas production is a normal physiologic progress.
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Patient Review of Systems Please Mark Any Condition with Which You Have Had Significant Problems in the Last 6 Months
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Standard of Care: Anorectal Disorders ICD 10 Codes
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Review of Systems
Review of Systems Name:_____________________________________ DOB:_________________ Date:___________________ Sex:___________ Age:_________________ General None Yes No Lymph_ None Yes No Pain ▢ ▢ Yes No Fever ▢ ▢ Discharge ▢ ▢ Tender nodes ▢ ▢ Chills ▢ ▢ Other:________________________ Enlargement ▢ ▢ Malaise ▢ ▢ Other:________________________ Fatigue ▢ ▢ Ears None Night sweats ▢ ▢ Yes No Endocrine None Weight changes ▢ ▢ Hearing loss ▢ ▢ Yes No Other:________________________ Pain ▢ ▢ Heat/cold intolerance ▢ ▢ Discharge ▢ ▢ Weight change ▢ ▢ Diet None Vertigo ▢ ▢ Increased thirst ▢ ▢ Yes No Ringing in the ears ▢ ▢ Increased urination ▢ ▢ Appetite ▢ ▢ Other:________________________ Hair changes ▢ ▢ Restrictions ▢ ▢ Other:________________________ Vitamins ▢ ▢ Nose None Supplements ▢ ▢ Yes No Female None Other:________________________ Congestion ▢ ▢ Yes No Nose bleeds ▢ ▢ Changes in menses ▢ ▢ Skin, Hair & Nails None Postnasal drip ▢ ▢ Pain with intercourse ▢ ▢ Yes No Changes in smell ▢ ▢ New partners ▢ ▢ Rash ▢ ▢ Other:________________________ Changes in contraception ▢ ▢ Eruptions ▢ ▢ Menopausal symptoms ▢ ▢ Itching ▢ ▢ Throat & Mouth None LMP________________________ Pigment changes ▢ ▢ Yes No Other:________________________ Hair loss/changes ▢ ▢ Hoarseness ▢ ▢ New moles ▢ ▢ Sore throat ▢ ▢ Male None Lesions /sores ▢ ▢ Bleeding gums ▢ ▢ Yes No Other:________________________ Ulcers ▢ ▢ Puberty onset ▢ ▢ Tooth problems ▢ ▢ Erections ▢ ▢ Head & Neck None Difficulty swallowing ▢ ▢ Testicular pain ▢ ▢ Yes No Changes in voice ▢ ▢ Libido ▢ ▢ Headaches
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In the Clinic
in the clinic Irritable Bowel Syndrome Diagnosis page ITC7-2 Treatment page ITC7-8 Practice Improvement page ITC7-14 Patient Information Page page ITC7-15 CME Questions page ITC7-16 Section Editors The content of In the Clinic is drawn from the clinical information and Christine Laine, MD, MPH education resources of the American College of Physicians (ACP), including David Goldmann, MD PIER (Physicians’ Information and Education Resource) and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine Science Writer editors develop In the Clinic from these primary sources in collaboration with Jennifer F. Wilson the ACP’s Medical Education and Publishing Division and with the assistance of science writers and physician writers. Editorial consultants from PIER and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://pier.acponline.org and other resources referenced in each issue of In the Clinic. The information contained herein should never be used as a substitute for clinical judgment. © 2007 American College of Physicians Downloaded From: http://annals.org/ by McGill University, Teresa Rudkin on 04/08/2016 in the clinic rritable bowel syndrome (IBS) is a common but poorly understood dis- order that interferes with normal colon function, resulting in abdominal I pain, bloating, constipation, and diarrhea. No specific biological bio- marker, physiologic abnormality, or anatomical defect has been discovered. Psychosocial stress may exacerbate symptoms. IBS is 1 of 28 adult and 17 pediatric functional gastrointestinal disorders. These disorders are symptom-based and not explained by other pathologically defined diseases.
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