Gastrointestinal disorders - Clinical challenges for the primary care clinician

Gastrointestinal (GI) associated symptoms are among the most common medical concerns resulting in visits to primary and specialty care. Especially challenging is the wide range of causative disorders and exposures associated with symptoms ranging from mild to life threatening - from within the GI tract as well as extra-gastrointestinal. Some of these are well described, and common, including infections, while others are newly emerging, such as cannabinoid hyperemesis syndrome. Others are well known but clinical success can remain elusive, such as food associated GI disorders - lactose intolerance and related. Although entire references have been written to address gastrointestinal diseases, in this edition of Disease a Month we will address some of the more challenging GI disorders; some of which are common but often difficult to control - food associated for example, and emerging GI illnesses such as radiation or cannabinoid hyperemesis, that lead patients to the Emergency Department, primary care clinician or specialty referral. What follows is a discussion of diverse but clinically important GI disorders, and the newer therapeutic strategies to help patients better manage their symptoms, and improve their quality of life.