Stomodeum to Proctodeum: Email Narratives on Clinical Problem Solving in Gastroenterology

Stomodeum to Proctodeum: Email Narratives on Clinical Problem Solving in Gastroenterology

Paramartha Bhattacharya (Consultant Physician, India), Amar Puri Asanga (Yoga consultant, Nepal) and Rakesh Biswas (People’s College of Medical Sciences, India)
DOI: 10.4018/978-1-4666-2770-3.ch054

Abstract

This chapter contains physician and patient perspectives of their gastrointestinal system problem solving experiences beginning from one anatomical end, stomodeum and continuing toward the other end proctodeum of the gastrointestinal tube. These experiences reflect user driven health care to the extent that they have been largely shared and developed over a web interface through email narratives and illustrate conversational learning in a patient centered manner.
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Stomodeum: The Journey Begins

Sometime around April 2002 author RB saw this patient in his clinic in a teaching hospital in Nepal and posted the patient’s picture along with the clinical query on to the www.jiscmail.ac.uk/lists/evidence-based-health list serv.

Figure 1.

A middle aged white lady has persistent angular cheilitis and stomatitis since the last 4 months

She is a yoga teacher on a strict vegetarian diet and has taken all possible vitamins and essential nutrients available along with various antibiotic creams (partly self medication). What are the possible causes and what further line of management would benefit the patient? Rakesh Biswas, Asst Prof, Pokhara, Nepal

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