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internal medicine and internal medicine subspecialty guidelines
ACG recommendations for C. Diff prevention, diagnosis, and treatment.
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Alignment of severity grading with the IDSA (non-severe, severe, fulminant)
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Recommend against using probiotics to prevent C. Diff while treating C. Diff (with antibiotics)
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Use highly sensitive and specific testing to distinguish colonization from active infection
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Metronidazole for initial non-severe infection
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PO vancomycin OR fidaxomicin for initial severe infection
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PO vancomycin + volume resuscitation for fulminant infection
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may consider adding IV metronidazole
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may consider vancomycin enemas if ileus is present
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USPSTF colorectal cancer screening recommendations.
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They agree with ACG recs to begin screening at age 45 (grade B)
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Colonoscopy follow-up must be done for any abnormal findings on non-colonoscopy modalities
The American College of Gastroenterology recs on colorectal cancer screening
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can start at age 45 for average risk individuals
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colonoscopy every 10 years of FIT testing every year are primary choices
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Flexible sigmoidoscopy and other modalities only if colonoscopy or FIT cannot be done
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Low-dose ASA is recommended to reduce CRC risk if 10-year ASCVD risk > 10% and low bleeding risk
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Also recs for colonoscopy quality indicators and improving adherence!
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