Background:
- Amebiasis is a large intestine infection caused by a microscopic protozoan parasite called Entamoeba histolytica, which is spread through human feces. The infection is distributed worldwide, particularly in tropic/subtropic areas with poor sanitation.
- Aka intestinal amebiasis, amebic dysentary, and amebic colitis.
- Transmission occurs through the fecal-oral route, either by direct person-to-person contact or through consumption of fecally contaminated food or water.

Symptoms:
- Often there are no symptoms, but, sometimes it causes localized GI symptoms including abdominal pain, amoebic dysentery (blood, mucus in stool), nausea, fever, and weight loss. Possible systemic symptoms can occur from inflammatory disseminated disease.
- Illness occurs gradually, over a period of days or weeks after infection.

Complications:
- Can erode the colon, access portal circulation, and progress to liver abscess.
- Creates colonic “teardrop” ulcers.
- Can cause perforated diaphragm and sub-phrenic abscesses in widely disseminated disease.
- Elderly, pregnant, and immunocompromised are at risk for severe disease.

Diagnosis:
- Infection is diagnosed by the detection of Entamoeba histolytica.
- Microscopic examination of a stool or tissue biopsy may identify trophozoites or cysts, but it cannot differentiate between E. histolytica and nonpathogenic Entamoeba species.
- If possible, E. histolytica should be definitively identified in a stool or biopsy sample using 1 of the following:
1.) antigen detection testing
2.) culture in special media, followed by isoenzyme analysis (technically difficult and typically not done in current practice)
3.) detection of DNA by polymerase chain reaction (PCR) (PCR is mostly used in research settings)
- Secondary amebic liver abscess is done via imaging studies, positive serology, and if needed, fluid aspiration for microscopy, antigen testing, or PCR.

Treatment:
- Treat asx infection with an intraluminal amebicide to reduce transmission and progression to disease, with preferred regimens including: paromomycin, diloxanide, or Iodoquinol.
- Treat intestinal infection or extraintestinal disease with tissue amebicides followed by intraluminal amebicides.
- Saccharomyces boulardii is helpful.

Background:
- Malignant neoplasm of anal canal that begins at anorectal junction at upper portion of pelvic floor, passes through anal ring, and ends at merging of skin and anal margin.
- Aka anal canal cancer, anal carcinoma, anal squamous carcinoma, cancer of the anal canal, squamous cancer of anal canal, carcinoma of anal canal.

Background:
- Candida, aka intestinal fungal overgrowth, is when yeast species in the intestines grow to pathogenic levels. It commonly happens when a person is on antimicrobials because Candida can be quite opportunistic.

Risk Factors:
- Hx of proton pump inhibitors (PPIs)
- Hx of antibiotic use
- Diabetes
- Dysmotility
- Immunocompromised
- Elderly

Symptoms:
- Eructations (belching)
- Bloating
- Indigestion
- Nausea
- Diarrhea
- Constipation
- Flatulence
- Brain Fog

Intro:
Crohn’s disease is a type of inflammatory bowel disease (IBD) that can affect tissue anywhere from the mouth to the anus within the gastrointestinal tract.

Pathology:
- Develop “skip” lesions and cobblestoning of ileum mucosa leading to strictures, adhesions, and fistulas. Lymphocyte infiltration into GI tract is a sign of Crohn’s.- May lead to colonic adenocarcinoma

Cause(s) and/or Risk Factors:
- Smoking
- Auto-immune disease
- Vitamin D deficiency
- Celiac Disease

Symptoms:
- Most patients with Crohn’s disease experience diarrhea, bloating, abdominal pain, and weight loss.

It can also be associated with the following conditions manifesting outside the gastrointestinal tract:
-Atrophic glossitis
-Dermatitis herpetiformis
-Osteoporosis
-Iron deficiency anemia
-Hyposplenism
-Ataxia
-Epilepsy
-Headaches
-Peripheral neuropathy
-Anxiety
-Depression
-Idiopathic urticaria

Diagnosis:
- Biopsy taken via endoscopy or colonoscopy is the gold standard.
- Might see elevation in WBC, fever

Treatment:
- Often subdue any current Crohn flare as quickly as possible with medications.
- Once stable, work on adjusting diet (anti-inflammatory), supplements (L-glutamine, aloe, DGL, Slippery Elm, Curcumin, Boswellia, Fish Oi), and identify aggravating factors (food sensitivity testing)
- Replenish nutrient deficiencies such as Vitamin D
- Consider rectal Butyrate, castor oil packs to abdomen

Dysphagia, a condition characterized by swallowing difficulties, can affect one in six adults, according to the Dysphagia Research Society.

Eosinophilic esophagitis (EOE) is a chronic allergic inflammatory disease experienced by around 1 in 2,000 individuals.

Cancer of the esophagus ranks within the top 10 most commonly diagnosed cancers across the globe. Certain esophageal cancers are associated to lifestyle factors, like the use of tobacco and alcohol consumption, while others are associated with continuous acid reflux in individuals who have GERD.

As indicated by the American College of Gastroenterology, gastroesophageal reflux disease (GERD) impacts one-fifth of the nation's population.

- www.siboinfo.com - Dr. Allison Siebecker has made an entire website dedicated to everything SIBO. She offers information and news about SIBO to empower people in their health.

Anxiety disorders impact over 40 million adults in the United States, and rates of anxiety and depression have spiked by more than 25% over the course of the ongoing CV19 pandemic, and existing treatment options do not consider nor target the underlying role of the gut microbiome despite promising research.