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Introduction: Gastric manifestations of SARS-CoV-2 infection are not uncommon and may even precede respiratory symptoms. Common gastrointestinal symptoms include loss of appetite, diarrhea, nausea, vomiting and abdominal pain. Here, we describe a case of a 74 year old-old male with acute COVID-19 infection with acute gastroparesis and hypomotility in the large intestine, which to our knowledge has not been previously described. Case Description/Methods: A 74 year-old male with a past medical history of Dementia, Parkinson's Disease, Controlled Type 2 Diabetes Mellitus was admitted with worsening dyspnea found to be COVID-19 positive. Vitals on presentation: 84 beats/min heart rate, 151/95 mmHg blood arterial pressure, 98.1 F temperature, 18 breaths/min, and 89% O2 saturation. On examination, he was oriented to person, place, but not time. Breath sounds were coarse bilaterally, and the abdomen was soft, mildly distended, active bowel sounds. Initial lab work was unremarkable. He was admitted and started on dexamethasone, remdesevir, and supplemental oxygen via nasal cannula. The following day, the patient had increasing abdominal distention and nausea. An abdominal film was obtained which revealed a gas-distended stomach with concern for gastric outlet obstruction. CT showed similar gastric distention, progression of oral contrast, and dilated sigmoid colon. The patient was made NPO and nasogastric (NG) tube was placed with removal of 1L of bilious content, a bedside rectal tube was placed, and IV metoclopramide was started. Over the next several days, the patient had a gradual improvement in NG output and abdominal distention with close monitoring. Follow up abdominal plain films showed complete resolution of gastric and colonic distention, tubes were removed, and diet was advanced. Diet was advanced and oxygen was weaned off, and he was discharged in stable condition. Discussion: Our case describes an uncommon manifestation of acute gastroparesis and colonic dysmotility in the setting of acute COVID-19 as opposed to the classic diarrhea, nausea, abdominal pain. It remains unclear whether his symptoms were a direct result of the COVID-19 infection or a manifestation of his acute illness or undiagnosed condition. Nevertheless, bringing awareness to this transient manifestations of COVID-19 is clinically relevant and highlights our management strategy. Our patient improved gradually with supportive care including gastric and colonic decompression, electrolyte optimization, bowel rest, and time.. more...

Colorectal cancer in African Americans has an increased incidence and mortality relative to Whites. The mean age of CRC development in African Americans is younger than that of Whites. There is also evidence for a more proximal colonic distribution of cancers and adenomas in African Americans. African Americans are less likely to have undergone diagnostic testing and screening for colorectal cancer. Special efforts are needed to improve colorectal cancer screening participation rates in African Americans. Clinical gastroenterologists should play an active role in educating the public and primary care physicians about special issues surrounding colorectal cancer in African Americans. Community healthcare groups and gastrointestinal specialists should develop culturally sensitive health education programs for African Americans regarding colorectal cancer. The high incidence and younger age at presentation of colorectal cancer in African Americans warrant initiation of colorectal cancer screening at the age 45 yr rather than 50 yr. more...

Copyright: © 2015 Chen P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. *Corresponding author: Sangeeta Agrawal, Associate Professor of Medicine, Dept. of Internal Medicine, Division of Gastroenterology, Wright State University, Dayton VA Medical Center, USA, Tel: 937-268-6511, ext 2698; Fax: 937-262-2154; E-mail: Sangeeta.Agrawal@va.gov more...

Recipients of renal transplants are known to have an increased incidence of cancer, which is believed to be related to the use of immunosuppressive drugs used to prevent rejection. Although the risks of lymphoma and Kaposi's sarcoma are clearly increased in this setting, the association with colon cancer is controversial. We report a 44-yr-old woman, 20 yr post-renal transplant, and with no family history of colorectal cancer or polyps, who was found to have synchronous, poorly differentiated colon cancers associated with extensive abdominal lymph node, bone marrow, and bone (skull) metastasis. The long term immunosuppressive drugs that she had received may have been an important factor in her tumor development and/or progression. Our case and literature review suggest a possible mild, increased risk of colon cancer development in patients after renal transplantation. more...