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A 45- year- old man underwent RYGB for severe obesity 2 months ago
Ineffective esophageal motility is characterized by more than 70% ineffective swallows (DCI 5 cm) or more than 50% failed swallows (DCI 30 mm Hg with isobaric contour tool) and 100% failed swallows Type III 20% spastic swallows (DL 1 L Continues with fasting Stool osmotic gap 1 deficiency) Examples: vitamin D, vitamin B12, iron, zinc, copper Evaluate for AIH, PBC, PSC Pruritic, papulovesicular, on extensor surfaces Functional, predisposed to encapsulated organisms Calcium or vitamin D loss or lactose avoidance Vitamin D deficiency, increased bone alkaline phosphatase level Similar to Sjgren syndrome Nonerosive, polyarticular, symmetrical, large joint From low levels of calcium, vitamin D, or magnesium Symmetrical, distal, small-fiber most common Cerebellar Bilateral parieto-occipital calcifications Female or male One-third of celiac patients Abbreviations: AIH, autoimmune hepatitis
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