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ASGE Journal Scan | Kolon

Expanding Cold EMR to Large Laterally Spreading Lesions

Douglas K. Rex, MD, FASGE, reviewing Mangira D, et al. Gastrointest Endosc 2020 Jan 15. In 5 Australian academic hospitals, cold EMR was performed on

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ASGE Journal Scan | Kolon

High Definition Is Still the Only Way to Go

Douglas K. Rex, MD, FASGE, reviewing Tziatzios G, et al. Gastrointest Endosc 2020 Jan 15. Previous meta-analyses have suggested that the use of high-definition (HD)

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ASGE Journal Scan | Kolon

Artificial Intelligence for the Other Half of Detection at Colonoscopy

Douglas K. Rex, MD, FASGE, reviewing Thakkar S, et al. Gastroenterology 2020 Jan 13. Assuming that a colonoscopist knows what precancerous lesions look like, high-level

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ASGE Journal Scan | Magen und Dünndarm

Reduction in IBS Rates Using Rome IV Criteria

Vanessa M. Shami, MD, FASGE, reviewing Olafur S, et al. Gastroenterology 2020 Jan 6.  Functional bowel disorders (FBDs) are common, and the diagnosis is clinical.

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ASGE Journal Scan | Magen und Dünndarm

Gastrostomy Site Metastasis: How Common Is It?

Vanessa M. Shami, MD, FASGE, reviewing Siu J, et al. Gastrointest Endosc 2020 Jan 8. More than half of individuals with upper aerodigestive tract (UADT)

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ASGE Journal Scan | IBD

Mediterranean Diet May Reduce the Risk of Crohn’s Disease Onset in Middle-Aged or Older Adults

Monika Fischer, MD, reviewing Khalili H, et al. Gut 2019 Jan 3. A large prospective cohort study from Sweden (N=83,147; age range, 45-79 years; mean

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ASGE Journal Scan | IBD

Higher Infliximab Trough Concentrations Needed for Mucosal Healing in Crohn’s Disease Than Previously Suggested

Monika Fischer, MD, reviewing Dreesen E, et al. Clin Gastroenterol Hepatol 2020 Jan 16. The previously published TAILORIX study failed to show benefits from proactive therapeutic drug

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ASGE Journal Scan | Ösophagus

Physician and Patient Education Can Lead to Reduction in Inappropriate PPI Use

Prateek Sharma, MD, FASGE, reviewing Lin D, et al. Clin Gastroenterol Hepatol 2019 Dec 27. The use of proton pump inhibitors (PPIs) for the treatment

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ASGE Journal Scan | Bauchspeicheldrüse

Time Is of the Essence for Moderate to Severe Ascending Cholangitis

Bret T. Petersen, MD, FASGE, reviewing Iqbal U, et al. Gastrointest Endosc 2019 Oct 16. While most patients with acute cholangitis respond to initial antibiotics

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ASGE Journal Scan | IBD

Microscopic Colitis Increases the Risk of Late-Onset IBD

Monika Fischer, MD, reviewing Khalili H, et al. Gastroenterology 2020 Jan 8. In a nationwide Swedish cohort study, the diagnosis of microscopic colitis (N=14,000) was

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ASGE Journal Scan | IBD

Inpatient Fecal Microbiota Transplantation Program Decreases C difficile-Related Mortality and Colectomy

Monika Fischer, MD, reviewing Cheng YW, et al. Clin Gastroenterol Hepatol 2020 Jan 7. Severe and fulminant forms of C difficile infection (CDI) are often refractory to

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ASGE Journal Scan | IBD

Crohn’s Disease Patients with HLA-DQA1*05 Allele at Increased Risk of Antidrug Antibody Development

Monika Fischer, MD, reviewing Sazonovs A, et al. Gastroenterology 2020 Jan.  In this genome-wide association study, 1240 patients with biologic-naive Crohn’s disease were treated with

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ASGE Journal Scan | Kolon

Cancer After Colonoscopy in UK Study Associated With, Well, Some Very Poor-Quality Colonoscopy

Douglas K. Rex, MD, FASGE, reviewing Anderson R, et al. Gastroenterology 2020 Jan 8.  Interval cancer, or postcolonoscopy cancer, is one of the dreaded outcomes

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ASGE Journal Scan | Kolon

End-Stage Renal Disease Still Risk Factor for Colonoscopy Complications

Douglas K. Rex, MD, FASGE, reviewing Yang SC, et al. J Gastroenterol Hepatol 2020 Jan 3. End-stage renal disease (ESRD) has been considered a risk

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ASGE Journal Scan | Kolon

For Left-Sided Colon Lesions up to 25 mm and Right-Sided Colon Lesions up to 20 mm, Piecemeal EMR Is as Good as en Bloc Resection

Douglas K. Rex, MD, FASGE reviewing Tate DJ, et al. Gastrointest Endosc 2019 Dec 27. Advanced endoscopists are often tempted to remove laterally spreading lesions

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ASGE Journal Scan | Kolon

Observations on FIT-Fecal DNA Testing in Clinical Practice

Douglas K. Rex, MD, FASGE reviewing Vakil N, et al. Gastrointest Endosc 2020 Jan 2. The commercially available FIT (fecal immunochemical test)-fecal DNA test is

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ASGE Journal Scan | Kolon

Small Left-Sided Polyps Seen During Colonoscope Insertion: Remove Them When You See Them

Douglas K. Rex, MD, FASGE reviewing Teramoto A, et al. Gastrointest Endosc 2019 Dec 23. Experienced colonoscopists know that when a small polyp is encountered

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ASGE Journal Scan | Kolon

How Do We Get to 80% Screening?

Douglas K. Rex, MD, FASGE reviewing Inadomi JM, et al. Clin Gastroenterol Hepatol 2019 Dec 27. The National Colorectal Cancer Roundtable set a goal of

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ASGE Journal Scan | Kolon

Brits Shake Up Postpolypectomy Surveillance

Douglas K. Rex, MD, FASGE reviewing Rutter MD, et al. Gut 2019 Nov 27. British societies have always had their own postpolypectomy guidelines. Previous recommendations

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ASGE Journal Scan | Kolon

Review and Meta-analysis Finds FIT CRC Sensitivity Lower in Stage I and T1

Douglas K. Rex, MD, FASGE reviewing Niedermaier T, et al. Am J Gastroenterol 2019 Dec 10. Fecal immunochemical test (FIT) sensitivity for colorectal cancer (CRC)

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ASGE Journal Scan | Kolon

Polygenic Risk Score Has Predictive Value for Early Onset Colorectal Cancer

Douglas K. Rex, MD, FASGE reviewing Archambault AN, et al. Gastroenterology 2019 Dec 19. Everyone wants to understand the underlying drivers for why early-onset colorectal

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ASGE Journal Scan | Kolon

Not Asking Enough Questions: Low Rates of Recommending and Receiving Genetic Testing in U.S. in Those at Risk for Lynch Syndrome

Douglas K. Rex, MD, FASGE reviewing Faust N, et al. Gastroenterology 2019 Dec 6. The National Health Interview Survey is conducted every 5 years and

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ASGE Journal Scan | Ösophagus

POEM Versus Surgery for Achalasia Treatment: Which One To Select?

Prateek Sharma, MD, FASGE reviewing Werner YB, et al. N Engl J Med 2019 Dec 5. Both peroral endoscopic myotomy (POEM) and surgical laparoscopic Heller’s

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ASGE Journal Scan | Kolon

New ASGE Guideline on Endoscopy and Management of ACPO and Colonic Volvulus

Douglas K. Rex, MD, FASGE reviewing Naveed M, et al. Gastrointest Endosc 2019 Nov 29. Some of the key and/or interesting findings in the new

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ASGE Journal Scan | Kolon

Endoscopic Resection Effective for SSPs ≥10 mm in Meta-analysis; Cold EMR May Be Best

Douglas K. Rex, MD, FASGE reviewing Chandrasekar VT, et al. Clin Gastroenterol Hepatol 2019 Nov 28. This systematic review and meta-analysis identified 911 patients with

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ASGE Journal Scan | Bauchspeicheldrüse

Cholangioscopy for Indeterminate Strictures: Is the Juice Worth the Squeeze? Probably

Bret T. Petersen, MD, FASGE reviewing Gerges C, et al. Gastrointest Endosc 2019 Nov 25. Biliary strictures are often hard to characterize using standard brush

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ASGE Journal Scan | Bauchspeicheldrüse

Cancer in IPMN? Don’t Stop Looking!

Bret T. Petersen, MD, FASGE reviewing Oyama H, et al. Gastroenterology 2019 Aug 29. Pancreatic intraductal papillary mucinous neoplasia (IPMN) lesions pose a risk for

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ASGE Journal Scan | Kolon

Endocuff Vision Defeats Cap in Tandem Study

Douglas K. Rex, MD, FASGE reviewing Rameshshanker R, et al. Gastrointest Endosc 2019 Dec 10. Recent controlled trials comparing Endocuff Vision (EV) to cap-assisted colonoscopy

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ASGE Journal Scan | Magen und Dünndarm

Incorporate Histologic Subtyping of Gastric Intestinal Metaplasia Into Routine Practice

Vanessa M. Shami, MD, FASGE reviewing Shah SC, et al. Gastroenterology 2019 Dec 6. Gastric cancer is the third leading cause of cancer-related mortality worldwide,

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ASGE Journal Scan | Kolon

Colonoscopy in Inpatient Octogenarians: Beware

Douglas K. Rex, MD, FASGE reviewing Olaiya B, Adler DG. J Clin Gastroenterol 2019 Nov 22. Population-based studies have consistently shown that the risk of

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ASGE Journal Scan | Ösophagus

Does Prior Treatment Impact Outcomes of POEM in Patients With Achalasia?

Prateek Sharma, MD, FASGE reviewing Liu ZQ, et al. Endoscopy 2019 Apr. The major treatment options for achalasia include laparoscopic Heller myotomy, pneumatic balloon dilation,

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ASGE Journal Scan | Kolon

Pay Attention to Anal Cancer

Douglas K. Rex, MD, FASGE reviewing Deshmukh AA, et al. J Natl Cancer Inst 2019 Nov 19. In the period 2001 to 2015, squamous cell

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ASGE Journal Scan | Kolon

Endoscopic Mucosal Resection: First-Line Treatment for Laterally Spreading Lesions at Anorectal Junction

Douglas K. Rex, MD, FASGE reviewing Shahidi N, et al. Gut 2019 Nov 12. Laterally spreading lesions at the anorectal junction can be treated by

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ASGE Journal Scan | Kolon

ESGE Endorses Resect and Discard in Routine Practice

Douglas K. Rex, MD, FASGE reviewing Bisschops R, et al. Endoscopy 2019 Nov 11. The European Society of Gastrointestinal Endoscopy (ESGE) has issued an updated

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ASGE Journal Scan | Kolon

Another Study Supports Underwater Versus Conventional Endoscopic Mucosal Resection for Lesions ≥10 mm

Recent randomized controlled trials found that underwater endoscopic mucosal resection (UEMR) results in more en bloc resections and faster resection for flat and sessile colorectal

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ASGE Journal Scan | Kolon

Randomized Trial of Sequential Testing Versus Multiple Choices for CRC Screening

Many guidelines on colorectal cancer (CRC) screening advocate that the choice of screening tests should be based on a discussion between the provider and patient

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ASGE Journal Scan | Kolon

Ontario Physicians More Likely to Get Colonoscopy Than Their Patients

This study evaluated administrative health care data from Ontario, Canada, to determine colorectal cancer screening rates among physicians, aged 52 to 74 years, and their

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ASGE Journal Scan | Ösophagus

1% Lugol’s Iodine Solution Should Be Used for Esophageal Chromoendoscopy

Prateek Sharma, MD, FASGE reviewing Gotoda T, et al. Gastrointest Endosc 2019 Oct 25. Lugol’s iodine has been utilized for dye-spray chromoendoscopy to detect esophageal

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ASGE Journal Scan | Ösophagus

Medical Versus Surgical Treatment for Refractory Heartburn: What Should You Do?

Prateek Sharma, MD, FASGE reviewing Spechler SJ, et al. New Engl J Med 2019 Oct 17. Although proton pump inhibitors (PPIs) are widely utilized for

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ASGE Journal Scan | Kolon

Colon Capsule Doesn’t Help in FIT-Positive Patients

Douglas K. Rex, MD, FASGE reviewing Pecere S, et al. Gastrointest Endosc 2019 Oct 17. In some European countries with limited colonoscopy resources, capsule colonoscopy

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ASGE Journal Scan | Kolon

Biennial Surveillance Is the Right Interval in Lynch

Douglas K. Rex, MD, FASGE reviewing Peterese EFP, et al. Clin Gastroenterol Hepatol 2019 Oct 17. Universal screening of colorectal cancers (CRCs) for Lynch syndrome

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ASGE Journal Scan | Kolon

ACP Issues CRC Screening “Guidance Statement”; Declines to Endorse Either FIT-Fecal DNA or CT Colonography

Douglas K. Rex, MD, FASGE reviewing Qaseem A, et al. Ann Intern Med 2019 Nov 5. The American College of Physicians (ACP) has issued a

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ASGE Journal Scan | Magen und Dünndarm

Selective Research Summary From the World Summit on Gut Microbiota for Health

Vanessa M. Shami, MD, FASGE reviewing Fuhler GM, et al. Gastroenterology 2019 Sep 6. The 2019 Gut Microbiota for Health World Summit focused on microbiota

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ASGE Journal Scan | Kolon

More on Bad Outcomes After Surgery for Benign Colon Polyps

Douglas K. Rex, MD, FASGE reviewing Ma C, et al. Am J Gastroenterol 2019 Oct 11.  Recent studies have established that surgery for benign colon

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ASGE Journal Scan | Kolon

Seven Percent Are “One-and-Done” Colonoscopists

Douglas K. Rex, MD, FASGE reviewing Fedewa SA, et al. Endosc Int Open 2019 Nov. “One and done” in colonoscopy refers to endoscopists who find

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ASGE Journal Scan | Magen und Dünndarm

Artificial Intelligence Could Help Early Discharge of Patients With UGI Bleeding

Prateek Sharma, MD, FASGE reviewing Shung DL, et al. Gastroenterology 2019 Sep 25. A number of clinical scoring systems (eg, the Glasgow-Blatchford, Rockall, and AIMS65)

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ASGE Journal Scan | Kolon

Dual Antiplatelet Therapy Judged Safe for Cold Snare Polypectomy ≤10 mm

Douglas K. Rex, MD, FASGE reviewing Won D, et al. Clin Transl Gastroenterol 2019 Oct 10.  Patients on both aspirin and a second antiplatelet agent

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ASGE Journal Scan | Kolon

Endocuff Vision Made Polypectomy Faster

Douglas K. Rex, MD, FASGE reviewing von Figura G, et al. Endoscopy 2019 Oct 15. Endocuff Vision (EV) has been shown in randomized controlled trials

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ASGE Journal Scan | Magen und Dünndarm

Use of Artificial Intelligence for Blind Spots During Sedated Versus Unsedated Upper Endoscopies

Vanessa M. Shami, MD, FASGE reviewing Chen D, et al. Gastrointest Endosc 2019 Sep 18.  High-resolution esophagogastroduodenoscopy (EGD) is commonly used in diagnosis and treatment

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ASGE Journal Scan | IBD

Proactive Versus Reactive Monitoring of Anti-TNF Drug Levels: A Randomized Controlled Trial

Kenneth R. McQuaid, MD, FASGE reviewing Assa A, et al. Gastroenterology 2019 Oct. In IBD, loss of response to anti-TNF therapy is more likely with

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ASGE Journal Scan | Kolon

Modeling Study Shows Current Surveillance Colonoscopy Paradigms Are Cost-Effective

Douglas K. Rex, MD, FASGE reviewing Meester RGS, et al. Ann Intern Med 2019 Sep 24. Some modeling studies suggest that surveillance colonoscopy in patients

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ASGE Journal Scan | Kolon

Follow Pyogenic Liver Abscess With Colonoscopy

Douglas K. Rex, MD, FASGE reviewing Mohan BP, et al. Dig Liver Dis 2019 Oct 7.  Researchers examined results from 12 previous studies including a

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ASGE Journal Scan | Kolon

Younger Physicians Are Better Detectors at Colonoscopy

Douglas K. Rex, MD, FASGE reviewing Shaukat A, et al. Clin Gastroenterol Hepatol 2019 Sep 10. A previous study showed that female endoscopists had higher

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ASGE Journal Scan | IBD

Vedolizumab Is More Efficacious Than Adalimumab for UC in a Head-to-Head Trial

Monika Fischer, MD, FASGE reviewing Sands BE, et al. N Engl J Med 2019 Sep 26. A head-to-head phase 3 trial involving patients with moderately

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ASGE Journal Scan | Kolon

Meta-analysis Confirms Two Observers Better Than One for Polyp Detection

Douglas K. Rex, MD, FASGE reviewing Aziz M, et al. Clin Gastroenterol Hepatol 2019 Oct 4. Among 5 randomized controlled trials, 2 observers increased the

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ASGE Journal Scan | Kolon

Cancer Incidence and Mortality in Adenoma Cohorts in Northern California Kaiser

Douglas K. Rex, MD, FASGE reviewing Lee JK, et al. Gastroenterology 2019 Oct 4. Databases developed from colonoscopies performed in the Kaiser Permanente Northern California

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ASGE Journal Scan | IBD

Ustekinumab Is Efficacious for Induction and Maintenance of UC

Monika Fischer, MD, FASGE reviewing Sands BE, et al. N Engl J Med 2019 Sep 26. Ustekinumab, an antagonist of the p40 subunit of interleukin-12

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ASGE Journal Scan | Ösophagus

How to Manage PPI-Refractory Regurgitation

Prateek Sharma, MD, FASGE reviewing Bell R, et al. Clin Gastroenterol Hepatol 2019 Sep 10. Magnetic sphincter augmentation (MSA) uses a series of titanium beads

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ASGE Journal Scan | Kolon

Large RCT Shows No Benefit of Early Colonoscopy in Patients With Acute LGIB

A benefit of early colonoscopy (in the first 24 hours) after hospitalization for acute lower-GI bleeding (LGIB) remains uncertain. In a large, randomized, controlled trial

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ASGE Journal Scan | Kolon

One Positive FIT and One Negative? Still Do Colonoscopy

Most fecal immunochemical testing as a screen for colon cancer is done with one sample. However, patients with a positive test sometimes request a second

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ASGE Journal Scan | Kolon

Acute Diverticulitis Still an Indication for Colonoscopy

Acute diverticulitis is generally considered an indication for colonoscopy, but the results of studies have been mixed with regard to the risk of colorectal cancer

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ASGE Journal Scan | Kolon

6- to 9-mm Adenomas Again Shown to Predict Advanced Neoplasia Versus Diminutive Adenomas

Current postpolypectomy surveillance guidelines lump adenomas 1 to 9 mm in size together in a category of low-risk adenomas. Advanced adenomas are defined as those

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ASGE Journal Scan | IBD

Subcutaneous Vedolizumab Is as Effective as Intravenous Formulation for Maintenance of Remission in Patients With Ulcerative Colitis

Vedolizumab is a highly effective and safe treatment option for patients with moderately severe and severe ulcerative colitis, with over 40% of patients achieving clinical

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ASGE Journal Scan | Kolon

What’s the Best Way to Examine Lynch Colons?

Because of the more rapid transformation of adenomas to cancer in Lynch syndrome, one often sees recommendations that colonoscopists performing Lynch examinations should be proven

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ASGE Journal Scan | Ösophagus

Patients With Eosinophilic Esophagitis Need Long-Term Treatment

Although it is known that eosinophilic esophagitis (EoE) is a chronic disease and recurs if treatment is discontinued, the rates of recurrence and the impact

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ASGE Journal Scan | Kolon

Rising Rates of CRC in Young People: Not Unique to U.S.

It is now widely recognized that colorectal cancer (CRC) rates have been increasing in the U.S. in persons under age 50, while simultaneously decreasing in

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ASGE Journal Scan | Kolon

Screening Rates Still Behind in Blacks

Blacks have higher colorectal cancer (CRC) incidence and mortality rates, develop CRC at a younger age, and are screened for CRC less often than whites

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ASGE Journal Scan | IBD

Therapeutic Drug Monitoring of Vedolizumab: Should Trough Levels Be Measured…and When?

In IBD patients treated with anti-TNF agents, therapeutic drug monitoring (TDM) is commonly used to optimize therapy, reduce risk of antibody formation, and determine mechanisms

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ASGE Journal Scan | Magen und Dünndarm

Safety and Efficacy of Peppermint Oil Treatment for IBS Tested

Peppermint oil is commonly prescribed to treat irritable bowel syndrome (IBS) without any evidence from high-quality controlled trials. This double-blind study (NCT02716285) evaluated the safety

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ASGE Journal Scan | Ösophagus

Are Potassium-Competitive Acid Blockers Superior to PPIs for GERD Treatment?

Proton pump inhibitors (PPIs) are widely used for the treatment of GERD, including healing erosive esophagitis. Since several PPIs have a slow, cumulative onset of

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ASGE Journal Scan | Kolon

When Colonoscopy for a Positive Cologuard Is Negative, STOP the Workup

The Cologuard test from Exact Sciences looks for hemoglobin and abnormal DNA in the stool. Because abnormal DNA can be shed from the GI tract

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