GASTROENTEROLOGY INPATIENT CONSULTS
Residents should page the consult pager (x9894) the day before
the start of the rotation. The inpatient GI consult team consists of
two fellows and one attending. The team is typically in the 5th
floor endoscopy offices (take east elevators in CCD to 5) if not in
a procedure or rounding. The majority of procedures for inpatient
consult patients are in endoscopy room 1. Residents are expected
to assume full responsibility for their assigned patients, including
communicating recommendations to the primary team and are
encouraged to watch procedures.
CLINIC
• Residents will also be rotating through clinic during the rotation in addition to seeing inpatient consults.
CONFERENCES
• Monday: 5-6PM. Clinical Case Conference (M422)
• Friday: 12-1PM. Fellows Board Review (Conference room behind
DCAM 6B near staff elevators)
OVERVIEW
The gastroenterology rotation is a clinical service that provides residents an
opportunity to gain exposure to the pathophysiology, diagnosis and treatment
of various gastrointestinal disorders as well as indications for endoscopic
procedures.
LEARNING OBJECTIVES
The goal for each resident is to demonstrate proficiency in the evaluation,
diagnosis, and treatment of the common gastroenterologic disorders.
- Gastrointestinal Bleeding
- Understand the common etiologies for upper and lower GI
bleeding - Understand indications for endoscopic evaluation
- Understand the differences between
esophagogastroduodenoscopy, colonoscopy, video capsule
endoscopy and double balloon enteroscopy - Understand appropriate medical management of bleeding
- Indications for administration of proton pump inhibitors,
including duration and modality of therapy - Indications for administration of octreotide and need for
antibiotics in the setting of GI bleeding - Understand appropriate diagnostic imaging and indications for
angiography or referral to interventional radiology - Understand appropriate need for outpatient follow up including
indications for follow up endoscopy
- Esophageal disorders
- Demonstrate proficiency in the evaluation of dysphagia
- Differentiate between oropharyngeal versus esophageal
dysphagia - Identify and understand esophageal disorders such as GERD,
infectious and reflux esophagitis, Barrett’s esophagus, esophageal
motility disorders, and esophageal malignancy
- Stomach and Small bowel
- Understand evaluation of treatment of peptic ulcer disease
- Know risk factors including use of NSAIDs and H. pylori
infection - Understand appropriate diagnostic testing and treatment
plans for H. Pylori, including need for confirmation of
eradication - Understand risks and appropriate use of proton pump
inhibitors - Recognize common signs and symptoms of Celiac disease
- Understand diagnostic testing including appropriate
serology and need for intestinal biopsy
- Colon
- Understand the diagnostic workup and treatment for common
causes of diarrhea and irregular bowel habits
– Inflammatory bowel disease
– Irritable bowel syndrome
– Microscopic colitis
– Infectious causes - Know the appropriate age and intervals for colon cancer
screening based on family history and personal history of polyps - Be familiar with the hereditary colorectal cancer syndromes
such familial adenomatous polyposis (FAP) and hereditary
nonpolyposis colorectal cancer (HNPCC)
EVALUATION
Communication of expectations will occur at the beginning of the rotation and
a written evaluation will be provided based on reviews from the attendings and
fellows who worked directly with the resident.