[Pa27] Follow up from class yesterday

[Gerstner, Laura R.]

See below from Dr. Fisher...

Laura R. Gerstner, DHSc, MHA, PA-C
Chair & Program Director
Campbell University Physician Assistant Program
Mailing Address: P.O. Box 1090, Buies Creek, NC 27506
Physical Address: 4150 U.S. 421 S., Lillington, NC 27546
*: 910.893-1252 |*: gerstnerl at campbell.edu<mailto:gerstnerl at campbell.edu>
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From: Fisher, Susan <Susan.Fisher at pfeiffer.edu>
Sent: Thursday, January 22, 2026 12:45 PM
To: Gerstner, Laura R. <reedl at campbell.edu>
Subject: EXTERNAL EMAIL: Follow up from class yesterday

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Greetings,
Below is some follow up from class yesterday. Here is the link to a short Medscape article on the use of antibiotics for appendicitis. It looks like we initially started using antibiotics over surgery for some patients about 10 years ago. This article looks at the incidence of a second bout of appendicitis and notes that antibiotic treatment of appendicitis is acceptable.

Antibiotics for Uncomplicated Acute Appendicitis Still Acceptable at 10 Years | MedPage Today<https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/119514>

I also looked at GLP1 medications and the risk of gallbladder disease. GLP1 receptor agonist use does increase the risk of cholelithiasis and cholecystitis by a number of mechanisms. Gallbladder disease arises at a median of ~180 days of use, but has occurred as early as 7 days of use.
Some of the mechanisms are:
Alteration of bile composition by increasing the cholesterol secretion into bile; this can increase the saturation of bile with cholesterol which can promote the formation of cholesterol stones
Rapid weight loss which can occur with GLP1 RA use also increases the risk of gallbladder disease.  The rapid weight loss can again result in supersaturation of cholesterol in bile, other metabolic disturbances and other alterations in bile composition.
Further, rapid weight loss decreases the secretion of cholecystokinin. This decreases gallbladder motility and delays gallbladder emptying which can lead to the formation of cholesterol crystals and cholelithiasis.
GLP1 also inhibits the release of cholecystokinin leading to the altered motility and delayed emptying.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12279493/
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2790392

Sincerely,
Greer Fisher

S. Greer Fisher, DSc, PA-C

Master of Science in Physician Assistant Studies
Center for Health Sciences
P.O. Box 960   |   48380 US Hwy 52
Misenheimer, NC  28109
Office  704-463-3723   |   Fax  704-463-1363
https://www.pfeiffer.edu/program/master-of-science-in-physician-assistant-studies/
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