Stephan Miehlke, Danila Guagnozzi, Yamile Zabana, Gian E Tontini, Anne-Marie Kanstrup Fiehn, Signe Wildt, Johan Bohr, Ole Bonderup, Gerd Bouma, Mauro D'Amato, Peter J Heiberg Engel, Fernando Fernandez-Banares, Gilles Macaigne, Henrik Hjortswang, Elisabeth Hultgren-Hörnquist, Anastasios Koulaouzidis, Jouzas Kupcinskas, Stefania Landolfi, Giovanni Latella, Alfredo Lucendo, Ivan Lyutakov, Ahmed Madisch, Fernando Magro, Wojciech Marlicz, Emese Mihaly, Lars K Munck, Ann-Elisabeth Ostvik, Árpád V Patai, Plamen Penchev, Karolina Skonieczna-Żydecka, Bas Verhaegh, Andreas Münch
INTRODUCTION: Microscopic colitis is a chronic inflammatory bowel disease characterised by normal or almost normal endoscopic appearance of the colon, chronic watery, nonbloody diarrhoea and distinct histological abnormalities, which identify three histological subtypes, the collagenous colitis, the lymphocytic colitis and the incomplete microscopic colitis. With ongoing uncertainties and new developments in the clinical management of microscopic colitis, there is a need for evidence-based guidelines to improve the medical care of patients suffering from this disorder...
February 22, 2021: United European Gastroenterology Journal
Tonya Kaltenbach, Andrew Gawron, Craig S Meyer, Samir Gupta, Amandeep Shergill, Jason A Dominitz, Roy M Soetikno, Tiffany Nguyen-Vu, Mary Whooley, Charles Kahi
BACKGROUND: Adenoma detection rate (ADR) is a key measure of colonoscopy quality. However, its efficient measurement can be challenging because many colonoscopies are performed for non-screening purposes. Measuring ADR without being restricted to screening indication may likely facilitate more widespread implementation of quality monitoring. We hypothesized that the ADR for all colonoscopies, irrespective of the indication, would be equivalent to the ADR for screening colonoscopies. METHODS: We reviewed consecutive colonoscopies at two Veterans Affairs centers performed by 21 endoscopists over 6 months in 2015...
February 19, 2021: Clinical Gastroenterology and Hepatology
Yong Lv, Wei Bai, Kai Li, Zhengyu Wang, Wengang Guo, Bohan Luo, Jianhong Wang, Qiuhe Wang, Enxin Wang, Dongdong Xia, Xiaomei Li, Jie Yuan, Na Han, Jing Niu, Zhanxin Yin, Daiming Fan, Guohong Han
INTRODUCTION: Current guidelines recommend anticoagulation as the mainstay of portal vein thrombosis (PVT) treatment in cirrhosis. However, because of the heterogeneity of PVT, anticoagulation alone does not always achieve satisfactory results. This study aimed to prospectively evaluate an individualized management algorithm using a wait-and-see strategy (i.e., no treatment), anticoagulation, and transjugular intrahepatic portosystemic shunt (TIPS) to treat PVT in cirrhosis. METHODS: Between February 2014 and June 2018, 396 consecutive patients with cirrhosis with nonmalignant PVT were prospectively included in a tertiary care center, of which 48 patients (12...
February 25, 2021: American Journal of Gastroenterology
Kara Wegermann
No abstract text is available yet for this article.
February 22, 2021: Clinical Gastroenterology and Hepatology
Peter S Liang, Aasma Shaukat, Seth D Crockett
DESCRIPTION: The purpose of this expert review is to describe the role of medications for the chemoprevention of colorectal neoplasia. Neoplasia is defined as precancerous lesions (e.g., adenoma and sessile serrated lesion) or cancer. The scope of this review excludes dietary factors and high-risk individuals with hereditary syndromes or inflammatory bowel disease. METHODS: The best practice advice statements are based on a review of the literature to provide practical advice...
February 10, 2021: Clinical Gastroenterology and Hepatology
Stacy A Markwell, Katherine S Garman, Iris L Vance, Ami Patel, Melissa Teitelman
BACKGROUND AND AIMS: The prevalence and burden of ergonomic related musculoskeletal injury is well established in the literature, though there is a paucity of data on techniques that can be used to avoid injury. This pilot study aimed to develop a new method of endoscopist wellness assessment. This technique presented here is an intervention by a physical therapist assessing ergonomic position and posturing during endoscopy to create an individualized wellness plan. METHODS: Volunteer endoscopists were identified in a single ambulatory surgical center...
February 6, 2021: Gastrointestinal Endoscopy
Shailja C Shah, Prasad G Iyer, Steven F Moss
The purpose of this CPU Expert Review is to provide clinicians with guidance on the management of H. pylori after an initial attempt at eradication therapy fails, including best practice advice on specific regimen selection, and consideration of patient and systems factors that contribute to treatment efficacy. This Expert Review is not a formal systematic review, but is based upon a review of the literature to provide practical advice. No formal rating of the strength or quality of the evidence was carried out...
January 29, 2021: Gastroenterology
Zachary Henry, Kalpesh Patel, Heather Patton, Wael Saad
No abstract text is available yet for this article.
January 22, 2021: Clinical Gastroenterology and Hepatology
Lauren Deborah Feld
The American Board of Medical Specialties announced in July 2020 the adoption of a parental leave policy for residents and fellows allows for a minimum of 6 weeks of leave. This policy includes caveats: vacation and/or sick leave can be applied toward these 6 weeks, this leave can only be utilized once during training (whether for parental, caregiver, or medical leave), and this policy only applies to training programs of 2 or more years' duration. Although the new existence of a parental leave policy is a step in the right direction, trainees are in need of a more robust and evidence-based policy...
January 21, 2021: American Journal of Gastroenterology
Pabitra Sahu, Saurabh Kedia, Sudheer K Vuyyuru, Aditya Bajaj, Manasvini Markandey, Namrata Singh, Mukesh Singh, Bhaskar Kante, Peeyush Kumar, Mukesh Ranjan, Peush Sahni, Rajesh Panwar, Raju Sharma, Prasenjit Das, Govind Makharia, Simon P L Travis, Vineet Ahuja
BACKGROUND: Intravenous corticosteroids are the mainstay of therapy for acute severe ulcerative colitis (ASUC), but 30%-40% of patients fail to respond. AIM: To investigate the effectiveness of exclusive enteral nutrition (EEN) as adjunctive therapy to intravenous corticosteroids in patients with ASUC. METHODS: This was an open-label randomised controlled trial, in which patients who were admitted with ASUC between August 2018 and May 2020 were randomised 1:1 to EEN or standard of care (SOC)...
January 13, 2021: Alimentary Pharmacology & Therapeutics
Rena Yadlapati, John E Pandolfino, Mark R Fox, Albert J Bredenoord, Peter J Kahrilas
Since publication of Chicago Classification version 3.0 in 2015, the clinical and research applications of high-resolution manometry (HRM) have expanded. In order to update the Chicago Classification, an International HRM Working Group consisting of 52 diverse experts worked for two years and utilized formally validated methodologies. Compared with the prior iteration, there are four key modifications in Chicago Classification version 4.0 (CCv4.0). First, further manometric and non-manometric evaluation is required to arrive at a conclusive, actionable diagnosis of esophagogastric junction (EGJ) outflow obstruction (EGJOO)...
December 19, 2020: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Shengbing Zhao, Xia Yang, Shuling Wang, Qianqian Meng, Rundong Wang, Lumin Bo, Xin Chang, Peng Pan, Tian Xia, Fan Yang, Jun Yao, Jinghua Zheng, Jianqiu Sheng, Xiaojun Zhao, Shan Tang, Yali Wang, Yiping Wang, Aixia Gong, Weigang Chen, Jianwei Shen, Xian Zhu, Shaofeng Wang, Caiwen Yan, Youlin Yang, Yangbei Zhu, Rui-Jun Ma, Rong Wang, Yincai Ma, Zhaoshen Li, Yu Bai
BACKGROUND AND AIMS: Although current quality indicators of colonoscopy recommend 6 minutes as the minimum standard for withdrawal time (WT), the impact of a WT longer than 6 minutes on neoplasia detection is unclear. METHODS: A multicenter randomized controlled trial involving 1027 patients was conducted from January 2018 to July 2019. Participants were randomly divided into a 9-minute (n=514) and 6-minute (n=513) WT group, and a timer was used to adjust the withdrawal speed...
November 18, 2020: Clinical Gastroenterology and Hepatology
Natalie Tapaskar, Sandra A Ham, Dejan Micic, Neil Sengupta
BACKGROUND & AIMS: Limited data exist on the management of anticoagulation after hospitalization for gastrointestinal bleeding (GIB) and the risks of recurrent GIB and thromboembolism in patients who are prescribed warfarin vs direct oral anticoagulants (DOACs). The purpose of this study was to assess the risk of recurrent GIB and thromboembolism with resumption of anticoagulation after GIB. METHODS: This was a retrospective analysis of adults with atrial fibrillation prescribed warfarin or DOACs and subsequently hospitalized for GIB...
November 21, 2020: Clinical Gastroenterology and Hepatology
Puneeta Tandon, Anne Walling, Heather Patton, Tamar Taddei
Care with palliative care principles (aka Palliative Care, PC) is an approach to care that focuses on improving the quality of life of patients and their caregivers who are facing life-limiting illness. It encompasses the assessment and management of symptoms and changes in functional status, the provision of advance care planning and goals of care discussions, prognostication and caregiver support. PC is applicable across the spectrum of cirrhosis regardless of transplant eligibility. Although a common misconception, PC is not synonymous with hospice care...
November 19, 2020: Clinical Gastroenterology and Hepatology
Terry L Jue, Andrew C Storm, Mariam Naveed, Douglas S Fishman, Bashar J Qumseya, Autumn J McRee, Mark J Truty, Mouen A Khashab, Deepak Agrawal, Mohammed Al-Haddad, Stuart K Amateau, James L Buxbaum, Audrey H Calderwood, John DeWitt, Christopher J DiMaio, Larissa L Fujii-Lau, Suryakanth R Gurudu, Laith H Jamil, Richard S Kwon, Joanna K Law, Jeffrey K Lee, Swati Pawa, Mandeep S Sawhney, Nirav C Thosani, Julie Yang, Sachin B Wani
This American Society for Gastrointestinal Endoscopy guideline provides evidence-based recommendations for the endoscopic management of gastric outlet obstruction (GOO). We applied the Grading of Recommendations, Assessment, Development and Evaluation methodology to address key clinical questions. These include the comparison of (1) surgical gastrojejunostomy to the placement of self-expandable metallic stents (SEMS) for malignant GOO, (2) covered versus uncovered SEMS for malignant GOO, and (3) endoscopic and surgical interventions for the management of benign GOO...
February 2021: Gastrointestinal Endoscopy
Yoshiaki Kimoto, Eiji Sakai, Rin Inamoto, Marie Kurebayashi, Syunya Takayanagi, Tomoya Hirata, Yuichiro Suzuki, Rindo Ishii, Takafumi Konishi, Keisuke Kanda, Ryoju Negishi, Maiko Takita, Kohei Ono, Yohei Minato, Takashi Muramoto, Ken Ohata
BACKGROUND & AIMS: Cold snare polypectomy (CSP) has become the standard resection method for small colorectal polyps (<10 mm). Sessile serrated lesions (SSL) have low prevalence of advanced histology irrespective of size, and thus could be amenable to CSP. In this study, we evaluated the safety and efficacy of CSP for SSLs ≥10 mm. METHODS: Between November 2018 and January 2020, we prospectively enrolled 300 consecutive patients who underwent CSP for 474 SSLs ≥10 mm...
November 2, 2020: Clinical Gastroenterology and Hepatology
Zachary L Smith, Raj Shah, B Joseph Elmunzer, Amitabh Chak
BACKGROUND: For years, the endoscopic management of the disorder formerly known as Type III Sphincter of Oddi Dysfunction (SOD) had been controversial. In 2013, the results of the Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction (EPISOD) trial demonstrated that there was no benefit associated with endoscopic sphincterotomy for patients with Type III SOD. We aimed to assess the utilization of endoscopic sphincterotomy for patients with SOD in a large population database from 2010-2019...
November 5, 2020: Clinical Gastroenterology and Hepatology
Michael Dougan, Yinghong Wang, Alberto Rubio-Tapia, Joseph K Lim
BACKGROUND & AIMS: Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape for oncology, leading to durable remissions in a subset of patients, but also a broad range of potentially life-threatening inflammatory toxicities, many of which involve the gastrointestinal (GI) tract and liver. The purpose of this expert review was to update gastroenterologists on the gastrointestinal and hepatic toxicities of ICIs and provide best practice advice on their diagnosis and management...
October 17, 2020: Gastroenterology
Christopher J Lee, Krishna C Vemulapalli, Douglas K Rex
BACKGROUND AND AIMS: Data are limited on safety and outcomes of colorectal EMR in octogenarians (≥80 years old). We sought to review outcome data for patients aged ≥80 in a prospectively collected database of patients referred for large polyp removal. METHODS: We retrospectively evaluated a database of patients referred for large (≥20 mm) nonpedunculated polyp removal. From 2000 to 2019, we compared the rates of follow-up, recurrence, adverse events, and synchronous neoplasia detection between younger patients and patients aged ≥80...
October 17, 2020: Gastrointestinal Endoscopy
Akshita Gupta, Amy Yu, Laurent Peyrin-Biroulet, Ashwin N Ananthakrishnan
BACKGROUND: Endoscopic remission is a recognized therapeutic endpoint in inflammatory bowel disease (IBD; Crohn's disease (CD), ulcerative colitis (UC)). The impact of persistent histologic activity on long-term outcomes is less clear and limited by small studies. METHODS: We performed a systematic search of PubMed and Embase to identify eligible studies examining the association between histologic activity and relapse in patients with CD or UC in endoscopic remission...
September 30, 2020: Clinical Gastroenterology and Hepatology
2020-10-16 20:15:10
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