Ranitidine is a widely used H2-receptor antagonist used to treat reflux and peptic ulcer disease. Recently, the U.S. Food and Drug Association (FDA) discontinued sales
ASGE Journal Scan
ASGE Journal Scan
Does Ranitidine Use Increase Cancer Risk?
Lower Back, Neck, and Left Thumb Injuries Most Common Types of Injuries Among Colonoscopists
In a survey of primarily UK endoscopists (72% of all respondents) that included endoscopists from 45 countries and had an overall 20.2% response rate, the
Diverticulitis Not Associated With Constipation
In this study, researchers evaluated the Nurses’ Health Study (NHS) and Health Professional Follow-up Study (HPFS) databases to examine the association of diverticulitis with bowel
Risks of Recurrence and Mortality After Local Endoscopic Resection of T1 Colorectal Cancer
In a meta-analysis of 71 studies involving 5167 endoscopically treated T1 colorectal cancers (CRCs), the cumulative recurrence rate was 3.3%, the local recurrence rate was
Yes, Early Onset Colorectal Adenocarcinoma Rates Are Increasing, But Rectal Carcinoid Rates Are Increasing Faster
There is now widespread recognition that there are increasing rates of colorectal cancer in persons under age 50 (early-onset colorectal cancer), that most of the
Depressed Lesions Are Different at a Histologic and Molecular Level
In a study from Japan, T1 colorectal cancers and adenomas were classified as “depressed,” “flat,” or “protruded” subtypes. Depressed lesions constituted only 1.2% of all
Can We Decrease Lesion Recurrence After Duodenal Endoscopic Mucosal Resection?
Laterally spreading lesions (LSLs) of the duodenum are increasingly being diagnosed and treated endoscopically. Although endoscopic resection of the thin and vascular duodenal wall is
Recurrence of Intestinal Metaplasia in the Cardia After Barrett’s Endoscopic Therapy: What To Do?
In patients undergoing Barrett’s endoscopic therapy (BET), complete eradication of intestinal metaplasia (CE-IM) is the final goal. However, studies have reported recurrence of IM, specifically
Predicting Complete Closure of EMR Sites
Clip closure of endoscopic mucosal resection (EMR) defects ≥20 mm located proximal to the splenic flexure and removed by electrocautery is associated with a reduction
Patients With Multifocal Cancer: Evidence for Intraluminal Spread of Tumor
In various series, 2% to 7% of patients with colorectal cancer (CRC) have either synchronous or metachronous second cancer. Second CRCs have generally been considered
Hydrogen Peroxide, One Way or Another, Appears Beneficial During Endoscopic Necrosectomy
Management of walled-off pancreatic necrosis often benefits from direct transmural endoscopic necrosectomy. This retrospective chart review assessed the utility of hydrogen peroxide (H2O2) lavage as
Hot Snare Polypectomy of 5-9 mm Polyps Leads To More Next-Day Abdominal Pain
Cold snare polypectomy is widely considered to be comparably effective and safer than hot snare polypectomy for colorectal polyps <10 mm. In a randomized trial
New Expert Review From the American Gastroenterological Association on Managing Colonic Diverticulitis
The American Gastroenterological Association has issued a clinical practice update on the management of colonic diverticulitis. The recommendations are as follows: Physicians should order a
Positive Incidental Colorectal PET/CT: Sometimes Serious Lesions, Sometimes Not
There is general agreement that when positron emission tomography (PET) incidentally lights up the colon, there is a substantial positive predictive value for cancer and
Reflux Monitoring Can Reduce the Inappropriate Use of Proton Pump Inhibitors in Patients With GERD
Proton pump inhibitors (PPIs) are the main treatment for gastroesophageal reflux disease (GERD). However, 30% to 50% of patients with GERD fail to achieve adequate
Diaphragmatic Breathing Can Help Reduce GERD
Upright gastroesophageal reflux disease (GERD), also known as upright reflux, is thought to be a result of increased intragastric pressure. In turn, increases in intragastric
Appendicitis Treatments: Large Randomized Controlled Trial Compares Antibiotics With Appendectomy
Antibiotic treatment is now widely recognized as an option for appendicitis therapy. In a nonblinded randomized trial of 1552 adults, including 414 with an appendicolith,
When Is Clip Closure of EMR Defects Cost-Effective?
Randomized controlled trials demonstrate that prophylactic clip closure of endoscopic mucosal resection (EMR) defects of large (≥20 mm) nonpedunculated colorectal lesions effectively prevents delayed hemorrhage.
Best Conformation for Hilar Self-Expanding Metal Stents Remains Undefined
Bilateral placement of metal stents for malignant hilar strictures (MHS) can be challenging. Two approaches have been used, each with potential benefits and challenges. In
Multi-Society Task Force Issues Malignant Polyp Management Recommendations
The U.S. Multi-Society Task Force on Colorectal Cancer, which consists of experts from the 3 luminal GI societies, has issued recommendations on the management of
Oral Sulfate Tablets for Bowel Preparation Are Effective and Safe
This study compared a new formulation of oral sulfate in tablet form to polyethylene glycol with ascorbate (PEG-EA). Both types of preparation were given in
Updated Criteria for Prediction of Choledocholithiasis Add Specificity
A variety of recommendations have been proposed for predicting choledocholithiasis based upon presenting signs, symptoms, initial laboratory studies, and imaging. In this retrospective study, the
Endoscopic Management of Gastroduodenal Obstruction
Gastric outlet obstruction (GOO) can result in significant morbidity. Symptoms include early satiety, nausea, vomiting, and abdominal pain, which are frequently associated with weight loss.
Is Gastric Electric Stimulation Cost-Effective in Patients With Refractory Vomiting?
Medication-refractory nausea and vomiting, which is often due to gastric dysmotility, is a challenging problem. High-frequency gastric electrical stimulation (GES), which was approved by the
Non-White Race and Low Socioeconomic Status Associated With Longer Wait for Treatment After Colorectal Cancer Diagnosis
The time between diagnosis of colorectal cancer (CRC) and initiation of treatment is associated with mortality. In this study of 330,988 CRC cases in the
Sessile Serrated Lesions That Are 10 mm or Larger: No Need To Inject
Cold resection of sessile serrated lesions (SSLs) ≥10 mm in size is increasingly accepted as effective and, compared to electrocautery, is safer. Many experts prefer
Poor Compliance With Antithrombotic Guidelines Associated With Bad Outcomes
Rates of polypectomy in colonoscopy are high for all indications; therefore, clinicians usually stop antiplatelet and antithrombotic agents other than aspirin prior to colonoscopy and
Lynch Syndrome Colonoscopy: Quality Matters
In the U.S., colonoscopy is usually performed at 1- to 2-year intervals in Lynch syndrome. This multicenter study evaluated the relationship of adenoma detection and
Colonoscopy Performance Produces Force Levels and Durations of Force Elevation That Are Associated With Upper Extremity Injury
Musculoskeletal injuries are common in endoscopists. This study used surface electromyography of wrist flexors and extensors as well as pressure transducers on the thumbs to
Colon Capsule Endoscopy Scorches CT Colonography in Fecal Immunochemical Test-Positive Trial
Comparative trials in patients with prior incomplete colonoscopy suggest that colon capsule endoscopy (CCE) detects polyps with higher sensitivity than CT colonography (CTC). In the
Postcolorectal Endoscopic Mucosal Resection Follow-up Is Essential
There is a well-known risk of adenoma recurrence after piecemeal endoscopic mucosal resection (EMR). In a single-center study of 2411 nonpedunculated lesions ≥20 mm in
Polish Study Calls for Using Adenoma Detection Rate to Stratify Screening and Surveillance Recommendations
In this study, the risk of interval cancer was compared between doctors with high (≥20%) versus low (<20%) adenoma detection rates (ADRs) in the Polish
Achalasia Patients at Increased Risk for Esophageal Cancer
Achalasia can cause food retention, leading to bacterial overgrowth, irritation, and chronic inflammation, a proposed pathophysiological process that may lead to squamous cell carcinoma (SCC).
Should We Be Treating Postsurgical Leaks Endoscopically?
Postoperative leaks are difficult to treat; however, the evolution of therapeutic endoscopy has allowed less-invasive repair techniques in an attempt to avoid repeat surgery. This
Further Evidence Supporting Early, Primary Use of Precut Sphincterotomy for Duct Access
Deep access to the bile duct or the pancreatic duct is required in order to complete all subsequent therapeutic ERCP maneuvers. Precut sphincterotomy (PCS) refers
Cryoballoon Ablation Can Be Used for Barrett’s Esophagus Endoscopic Therapy
Cryotherapy involves the application of a cryogen by way of spraying liquid nitrogen to the esophageal mucosa or by surface contact with a nitrous oxide-filled
Anesthesia and Pathology Charges Lead to Surprise Billing in Commercially Insured Colonoscopy
This study reviewed colonoscopies identified in a claims database from a large national insurer in the United States. The database was queried for commercially insured
Kaiser Achieved Greater Than 80% Screening Adherence; How Did They Do It?
Organized screening, in which a nation or health care system systematically offers colorectal cancer screening for eligible patients, usually by fecal immunochemical testing (FIT), is
Symptoms are Common After Total Proctocolectomy With Ileal Pouch Creation in Patients With Familial Adenomatous Polyposis
Pouch symptoms are typically considered to occur less frequently after total proctocolectomy and ileal pouch-anal anastomosis (IPAA) for familial adenomatous polyposis (FAP) compared to after
New Clinical Model Predicts Need for Screening Colonoscopy
A risk-stratified approach to colorectal cancer screening within the average-risk population is seldom used. In this approach, patients whose prescreening predicted prevalence of advanced neoplasia
Which Rectal Neuroendocrine Tumors are Dangerous?
In this study of 309 rectal neuroendocrine tumors (NETs), often called rectal carcinoids in the past, endoscopic factors were studied to understand their association with
How Safe Is Endoscopic Gastrostomy Tube Placement?
The invasive nature of the endoscopic placement of a gastrostomy tube is associated with higher morbidity and mortality compared to other routine endoscopic procedures. Alternative
Negative Colonoscopy for FIT-Positive Patients: Should We Keep Doing FIT?
In this study from Taiwan, patients with a negative colonoscopy after a positive fecal immunochemical test (FIT) during the interval 2004 through 2009 were followed
Chemoprevention for Colorectal Cancer: What Works and What Doesn’t?
This was a systematic review of 80 meta-analyses of colorectal cancer prevention with medications, vitamins, supplements, and dietary factors. Of the factors found to be
Endoscopic Approaches to Drainage for Acute Cholecystitis Are Optimal in Nonoperative Patients
Gallbladder removal or drainage is a key component of treatment for acute cholecystitis. When the risk of urgent cholecystectomy is considered prohibitive, the optimal alternative
Even Expert Pathologists Have Only Moderate Agreement Regarding Differentiating Sessile Serrated Lesions From Hyperplastic Polyps
Current recommendations for measurement of the adenoma detection rate (ADR) recommend that sessile serrated lesions (SSLs; also called sessile serrated adenomas and sessile serrated polyps)
Artificial Intelligence System Outperforms Guideline Predictive Criteria for Lymph Node Metastasis in T1 Cancers
In a study from 7 centers in Japan, a deep learning artificial intelligence (AI) program trained on 3134 T1 colorectal cancers (CRCs) from 6 Japanese
Relapse in Eosinophilic Esophagitis Occurs Despite Treatment With Swallowed Topical Corticosteroids
Swallowed topical corticosteroids (STC) are effective as initial treatment in patients with eosinophilic esophagitis (EoE) and in achieving histological remission. However, their role in the
First Single-Use Duodenoscope Measures up in Direct Comparison for Low-Complexity Procedures
The development of single-use (disposable) endoscopes is one approach to eliminating infection transmission between sequential patients during endoscopy. This single-center study randomized patients undergoing endoscopic
Neoplasia Detection Rate in Barrett’s Esophagus: A Measure of High-Quality Upper Endoscopy
Studies have reported that up to 25% of esophageal adenocarcinomas (EACs) are detected within 1 year of index endoscopy (missed cancer), emphasizing the need for
ESGE Issues Comprehensive Training Curriculum on Optical Diagnosis
The extent to which optical diagnosis is used in routine endoscopy in the United States to improve treatment decisions in endoscopy is virtually unknown. The
More Evidence That Negative Screening Colonoscopy Can Be Followed by Intervals of More Than 10 Years
This study compared the incidence of advanced neoplasms in 2456 German screening colonoscopy patients who had a previous colonoscopy without polyps to the results from
Computerized Imaging of Vessels in EMR Defects Predicts Postprocedural Bleeding
Recent studies indicate that prophylactic clip closure of postendoscopic mucosal resection defects from colonic lesions >20 mm in size and proximal to the splenic flexure
Monoallelic NTHL1 Loss of Function Not Associated With Colorectal Cancer
NTHL1 encodes endonuclease III-like protein 1, an enzyme involved in base-excision repair that identifies and removes oxidized pyrimidines. Biallelic loss-of-function mutations of base-excision repair genes, such
Optical Character Recognition Combined With Natural Language Processing to Improve Extraction of Quality Parameters From Colonoscopy Reports
Measurement and improvement of colonoscopy quality measures, such as the adenoma detection rate (ADR), are critical to optimizing colorectal cancer prevention by colonoscopy. The process
Is Endoscopic Sleeve Gastroplasty the Solution?
The prevalence of obesity in the United States has reached an epidemic level and is associated with conditions such as insulin resistance (IR) and nonalcoholic
Ileal and Rectal Ulcers Heal Slower and May Be More Refractory to Therapy Than Colonic Lesions in Crohn’s Disease
Researchers performed a post hoc analysis of endoscopic outcomes in participants of the pivotal SONIC trial that compared the efficacy of azathioprine, infliximab, and the
Budesonide Can Be Used for Maintaining Long-Term Remission in Eosinophilic Esophagitis
Eosinophilic esophagitis (EoE) is a chronic antigen-mediated immunological disorder that has a high relapse rate of >80% with cessation of therapy. Although corticosteroids (both topical
Discovering Adverse Events By Phone – the Sweet Spot is 7 Days After ERCP
Identification of adverse events following gastrointestinal endoscopy can be challenging due to patient reticence to present for mild to moderate problems and dispersed follow-up among
Most Primary Care Physicians Not Following the American Cancer Society’s Recommendation to Screen at Age 45
The American Cancer Society (ACS) recommended in 2018 that all Americans should undergo colorectal cancer (CRC) screening beginning at age 45. Thus far, other major
American Gastroenterological Association Issues Guidelines on GI Evaluation of Iron Deficiency Anemia
The American Gastroenterological Association (AGA) has issued the following recommendations regarding GI evaluation of iron deficiency anemia (IDA): In patients with anemia, IDA should be
Implementing a Standardized Protocol Helps to Increase Diagnosis of Eosinophilic Esophagitis
The incidence of eosinophilic esophagitis (EoE), a condition characterized by esophageal eosinophilia and dysfunction, has been reported in about 5 to 10 per 100,000 individuals.
What Are Cold Snare Protrusions and Are They a Bad Thing?
During cold snare polypectomy, removal of larger lesions and/or larger specimens sometimes results in a cold snare protrusion (CSP), appearing as a white cord in
Large-Caliber Dilation Without Sphincterotomy Is Efficacious and Safe for Stones >10 mm
Endoscopic biliary sphincterotomy (ES) is the standard prelude to duct stone removal; however, it carries moderate risk for both pancreatitis and bleeding and can be
Hemostasis Peptide Reduces Need for Electrocoagulation of Bleeding Points During ESD
Bleeding is common during endoscopic submucosal dissection (ESD). It can obscure dissection planes and often requires electrocoagulation that could injure the muscularis propria. PuraStat (3D-Matrix,
Risk of Death From Colonoscopy in the Italian FIT Screening Program
Organized fecal immunochemical test (FIT)-based screening programs offer the opportunity to prospectively assess adverse events of colonoscopy. A recent large study from the Netherlands found
All That Time That Cannot Be Billed
Previous data found that primary care physicians and some specialists spend about an hour on electronic health records (EHRs) for each hour they are scheduled
Motility Disorders Can Exist in Patients With Eosinophilic Esophagitis, Specifically in Those Not Responding to Therapy
Eosinophilic esophagitis (EoE) is characterized by the presence of esophageal dysfunction along with histological evidence of ≥15 eosinophils per high-power field from esophageal biopsies. Recent
Pancreatic Extracorporeal Shock Wave Lithotripsy: Efficient and Effective in Gastroenterologists’ Hands
Extracorporeal shock wave lithotripsy (ESWL) has become the dominant therapy for the treatment of symptomatic pancreatic duct stone obstruction in chronic calcific pancreatitis. In the
Risk of Death From Colonoscopy in a FIT-Positive Program
In any screening program, it is important to know the benefits and harms of screening. Patients who have a positive fecal immunochemical test (FIT) result
Low Incidence of Colorectal Cancer After Endoscopic Dysplasia Resection in Patients With IBD
Given the paucity of high-quality outcome data, the optimal management of polypoid and/or nonpolypoid colonic lesions in IBD is an ongoing debate. Guidelines recommend that
Should Asian Americans Be Routinely Screened for Gastric Cancer With Endoscopy?
There are no current guidelines in the United States for gastric cancer screening, even with a high population of immigrants from Asian-Pacific countries. Studies have
Early Colorectal Cancer Screening in African Americans: High Uptake and High Yield
Recommendations from GI societies to screen African Americans for colorectal cancer (CRC) starting at age 45 were based largely on age-related incidence and mortality data
Granular Laterally Spreading Tumors With Nodule: Rectal Location and at Least 4-cm Size Warrant en Bloc Resection
Granular laterally spreading tumors (G-LST) in the colorectum are more common than nongranular lesions, less likely to have cancer, and in general, easier to remove
Dysphagia Is Common After Bariatric Surgery
Symptoms of dysphagia due to obstruction (mechanical or functional) can be caused by a noncompliant gastric pouch after bariatric surgery and, theoretically, could lead to
When Draining Walled-Off Pancreatic Necrosis, Attention to Disconnected Pancreatic Duct Syndrome Guides Terminal Steps in Therap
Internal drainage using large-caliber lumen-apposing metal stents (LAMS) is now a dominant therapy for acute fluid collections and walled-off pancreatic necrosis associated with acute pancreatitis.
Video Auditing of Duodenoscope Reprocessing Contributes to High Performance in a Tertiary Care Center
Lapses in reprocessing of flexible endoscopes have been demonstrated in many environments and are thought to contribute to the transmission of infection between patients. The
Acetic Acid and Blue Light Highlight Sessile Serrated Lesions
This case study demonstrates how acetic acid in combination with blue-light imaging (BLI), a relatively new mode of chromoendoscopy technology, highlights sessile serrated lesions (SSLs).
Nonendoscopic Screening for Barrett’s Esophagus: Are We There?
Upper endoscopy (EGD) with biopsy remains the gold standard for the diagnosis of Barrett’s esophagus (BE). Several nonendoscopic techniques (sponge, capsule) have utilized biomarkers, such
Hope for Those Suffering From Gastroparesis?
Gastroparesis is a chronic medical condition that can cause unpleasant and refractory symptoms that adversely affect quality of life. Unfortunately, metoclopramide, which can cause serious
Peroral Endoscopic Myotomy Can Be Safe and Effective for Persistent Symptoms After Heller Myotomy
Persistent and recurrent symptoms have been reported in up to 20% of patients with achalasia after surgical treatment with Heller myotomy. The aim of this
Recycled Precolectomy Anti-Tumor Necrosis Factor Does Not Work for Chronic Pouchitis
Following total proctocolectomy with restorative ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC), about one-third of patients develop chronic pouchitis. Treatment of antibiotic-refractory and Crohn’s
Delayed Start Times Associated With Reduced Adenoma Detection
Previous studies have shown that the adenoma detection rate (ADR) is sometimes lower in colonoscopies performed in the afternoon versus the morning, though the results
Surgery Not Needed After Complete Endoscopic Resection of Intramucosal Colorectal Cancer
Intramucosal cancer (IMC) refers to dysplasia in the lamina propria of the mucosa with or without invasion of the muscularis mucosa. Such lesions are usually
Initial Experience With EndoRotor Tissue Resection Device
The EndoRotor nonthermal powered endoscopic debridement (PED) instrument (Interscope, Inc., Whitinsville, Mass) is a new tissue resection device that can be passed through endoscopes. There
Fully Covered Metal Stents Provide Respectable Efficacy for Posttransplant Strictures
Biliary leaks and strictures are among the most common adverse events after liver transplantation. Anastomotic strictures are generally managed using endoscopic balloon dilation and stenting
Is Barrett’s Esophagus Thickness a Marker for Response to Radiofrequency Ablation Therapy?
Radiofrequency ablation (RFA) is a widely used modality for treating flat Barrett’s esophagus (BE) dysplasia, with the goal of achieving complete eradication of intestinal metaplasia
Relapse Half as Likely With Ulcerative Colitis in Clinical and Endoscopic Remission Than Clinical Remission with Mild Endoscopic Disease Activity
The current treatment target in ulcerative colitis (UC) is clinical and endoscopic remission, defined by patient-reported outcomes and a Mayo endoscopic subscore of 0 or
ESGE Expands the Postpolypectomy Cohort With No Recommended Surveillance
The European Society of Gastrointestinal Endoscopy (ESGE) has issued its first update of postpolypectomy surveillance recommendations since 2013. Key recommendations include the following: Patients with
Adding Time for Inspection During Colonoscope Insertion Does Not Work
There remain occasional advocates of dedicated time during colonoscope insertion to look for polyps as a way of increasing detection. In this analysis of 7
Endoscopic Submucosal Dissection Outcomes for Early Gastric Lesions in North America
There are sufficient data in Asia to demonstrate that endoscopic submucosal dissection (ESD) has equivalent outcomes to surgical intervention for early gastric cancer (EGC). Moreover,
Is Obesity a Risk Factor for Barrett’s Esophagus?
While the role of obesity in gastroesophageal reflux disease (GERD) and the role of GERD in Barrett’s esophagus (BE) are independently well established, there is
Prophylactic Clipping Ineffective for Polyps Less Than 20 mm in Size
Analyses of randomized trials indicate that prophylactic clipping of EMR sites ≥20 mm in size in the proximal colon reduces the risk of delayed hemorrhage.
Dutch Endoscopic Full-Thickness Resection Experience in Colorectum
This report summarizes a prospectively acquired experience using the endoscopic full-thickness resection device (FTRD) in the colorectum. Among 367 procedures performed between July 2015 and
Familial Adenomatous Polyposis: Should Routine Ampulla Biopsies Be Performed?
Duodenal and ampullary cancers are the most common causes of death in patients with familial adenomatous polyposis (FAP) who have undergone colectomy. Current guidelines recommend
Adenomas in the Young: What Do They Mean?
The incidence of colorectal cancer (CRC) is increasing in persons under age 50 in much of the world. Endoscopists commonly encounter sporadic adenomas when performing
Sarcopenia (Loss of Skeletal Muscle Mass) Associated With Metachronous Adenomas
Sarcopenia is a progressive loss of skeletal muscle mass in relation to aging. Sarcopenia is associated with metabolic syndrome, diabetes, and nonalcoholic steatohepatitis and has
Negative Colonoscopy Predicts Reduced Risk of Colon Cancer for 17 Years
Previous studies in symptomatic populations have found that a negative colonoscopy predicts a reduction in colorectal cancer (CRC) incidence for greater than 20 years. The
Malpractice Trends in Colon Cancer
This study identified 240 malpractice cases related to colorectal cancer (CRC) between 1988 and 2018 by using a legal database called VerdictSearch. This database is
Randomized Controlled Trial of Fellow Impact on Detection
There is widespread acceptance of a second-observer effect in improving adenoma detection in colonoscopy and general acceptance that this effect extends, in some regard, to
Lynch Syndrome Testing on Preoperative Biopsy Specimens Is Accurate
In this study, there were 96 patients with matched preoperative and postoperative immunohistochemistry (IHC) and microsatellite instability testing results for Lynch syndrome. The concordance of
Use of a Magnetically Assisted Capsule Device for Examining the Esophagus
The magnetically assisted capsule endoscopy (MACE) system (MicroCam Navi; IntroMedic) is a novel noninvasive technique for visualizing the upper GI tract. This device utilizes a
Postoperative Endoscopic Recurrence of Ileal Lesions, Not Anastomotic Lesions, More Likely to Predict Long-Term Outcomes in Crohn’s Disease
Early endoscopic recurrence of Crohn’s disease (CD) following ileocolonic resection predicts clinical recurrence, the need for therapy escalation, and repeat surgery. The significance of mild
ESD Versus EMR for Resecting Esophageal Neoplasia
Endoscopic submucosal dissection (ESD) is an effective method of resecting larger superficial esophageal lesions en bloc; however, it is fraught with advanced training needs, longer
Fecal Microbiota Transplantation Shows Promise for IBS in the Most Recent Randomized Controlled Trial
Alterations of the gut microbiota in irritable bowel syndrome (IBS) have been described. Observational studies on fecal microbiota transplantation (FMT) aiming to restore eubiosis have
High-Dose Vitamin D Does Not Prevent Postoperative Recurrence of Crohn’s Disease
The optimal vitamin D level for patients with IBD is highly debated. While a level >20 ng/L is sufficient for bone health even in high-risk
Pancreatic Cancer Screening: Who Should We Consider?
The incidence of pancreatic cancer continues to grow, and despite advances in oncologic treatment, the mortality rate continues to be high. The goal of screening
No Correlation Between Detection and Optical Diagnosis in Colon Polyps
This is a Dutch multicenter study involving 24 colonoscopists who performed at least 50 colonoscopies in a fecal immunochemical test-positive population. All were high-performing colonoscopists
No Benefit From Antibiotics for Uncomplicated Diverticulitis
A randomized, placebo-controlled, double-blinded trial showed no benefit from antibiotic therapy for the management of uncomplicated acute diverticulitis. Hospitalized patients (N=180) in New Zealand and
Prophylaxis for Post-ERCP Pancreatitis Appears Underutilized
Post-ERCP pancreatitis (PEP) remains an important adverse event. Indomethacin suppositories and pancreatic duct (PD) stents have both been demonstrated to reduce PEP in patients at
Artificial Intelligence Program Increases Adenoma Detection Rate in Randomized Controlled Trial by 14%
In a randomized controlled trial conducted at 3 Italian centers with 6 experienced endoscopists and 685 patients with a mix of screening, surveillance, and fecal
Meta-analysis Favors Low-Residue Diet Before Colonoscopy
This meta-analysis comparing a low-residue diet to a clear liquid diet the day before colonoscopy identified 20 relevant randomized controlled trials that were published between
Which Upper GI Findings During EGD Do Not Require Follow-Up?
The European Society of Gastrointestinal Endoscopy (ESGE) has issued recommendations on conditions that do not require routine surveillance. Those related to upper GI endoscopy include:
Urgent Early Pancreatic Drainage Is Safe and Effective
Endoscopic decompression and drainage of immature pancreatic and peripancreatic fluid collections with incomplete encapsulation by a wall of surrounding tissue have generally been avoided out
EUS-Guided Biliary Drainage: Should Antiplatelet Agents and Anticoagulants Be Stopped?
Gastroenterologists are seeing an increasing number of patients taking antiplatelet agents and/or anticoagulants (APs/ACs). Discontinuation of these agents prior to therapeutic procedures is common practice;
Collagenous Colitis Is a Genetic Disease
Collagenous colitis (CC) produces a watery diarrhea syndrome, occurs mostly in older women, and is associated with several drug classes. Recent studies show that patients
Predicting CRC in Unscreened Populations by CBC
About one-third of the U.S. population is unscreened for colorectal cancer (CRC). One approach to early detection in this population is to screen health care
Some GI Doctors May Not Understand Significance of Intramucosal Adenocarcinoma in the Colon
Several studies have found that rates of surgery for benign colorectal polyps continue to be high, despite clear evidence that endoscopic resection is safer and
Meta-analysis for 6- to 9-mm Adenomas Shows Higher Risk of Subsequent Advanced Neoplasia Compared to 1 to 5 mm
Current surveillance recommendations classify patients with 1 or 2 tubular adenomas <10 mm in size and with low-grade dysplasia as low risk. Several studies have
Duodenoscope Sheath Protects High-Risk End of Instrument
The risk of transmission of microorganisms by contaminated duodenoscopes remains a pertinent concern for ERCP practices. This report describes microbial challenge studies in a single-use
Randomized Colorectal Cancer Screening Trial Includes Risk-Stratified Arm
Colorectal cancer (CRC) screening can be offered to patients as a menu of screening options; sequential testing (colonoscopy offered first with another testing option offered
Evidence for Routine Double Right-Sided Colon Examination
Double right-sided colon examination during colonoscopy is often recommended, and randomized controlled trials have compared a second examination of the right-sided colon in the forward
Is Cryoballoon Ablation Ready for Barrett’s Endoscopic Therapy?
The 90˚-swipe cryoballoon ablation system (CbSAS90) is a new technology incorporating cryotherapy that has been proposed to treat Barrett’s esophagus (BE) segments. This technology is
Risks of Colonoscopy: Not Just Bleeding and Perforation
This French study evaluated 4,088,799 patients undergoing a first-time colonoscopy during a 6-year interval. Patients with inflammatory bowel disease, colorectal cancer, or complicated diverticular disease
Reliable Biodegradable Pancreatic and Biliary Stents May Be on the Horizon
Biodegradable biliary and pancreatic stents with predictable performance would be tremendously cost-effective for many pathologies for which temporary stenting is used. In this prospective pilot
Quantitative Assignment of Ages to Start Screening Based on Family History
In a study from Sweden involving 12,829,251 persons who had family history information and were followed from 1958 to 2015, 173,796 developed colorectal cancer (CRC).
No Benefit of Endocuff Vision in Screening Flexible Sigmoidoscopy
Endocuff Vision (EV) has well-established benefits in colonoscopy, both for improved detection and faster withdrawal without reduced detection. EV has not been tested for its
Daily 81 mg of Aspirin OK in Patients With IBD
Monika Fischer, MD, reviewing Patel P, et al. Inflamm Bowel Dis 2020 Mar 27. Nonsteroidal anti-inflammatory medications are known to increase the risk of IBD
High-Volume Colonoscopy Predicts Higher Cecal Intubation Rates and Lower Perforation Risk, but Not Higher Detection or Cancer Prevention
Douglas K. Rex, MD, FASGE, reviewing Forbes N, et al. Clin Gastroenterol Hepatol 2020 Mar 20. In a systematic review and meta-analysis encompassing 27 studies
Endocuff Vision Improves Detection in High Performers
In meta-analyses, Endocuff Vision (ECV) typically increases adenoma detection rates (ADRs) by about 7%. However, one meta-analysis found that the benefit was primarily in doctors
Smartphone App for Bowel Prep Reduced Inadequate Preps and Improved ADR
Douglas K. Rex, MD, FASGE, reviewing Walter B, et al. Clin Gastroenterol Hepatol 2020 Mar 30. A variety of apps to assist in bowel preparation
What Therapy to Use for Patients With EoE: PPIs, Steroids, or Elimination Diets?
Prateek Sharma, MD, FASGE, reviewing Laserna-Mendieta EJ, et al. Clin Gastroenterol Hepatol 2020 Jan 25. Proton pump inhibitors (PPIs), steroids, elimination diets, and esophageal dilation
Achieving Deep Remission Early, No Matter How, Is Best Way to Decrease Crohn’s Disease Progression
Monika Fischer, MD, reviewing Ungaro RC, et al. Gastroenterology 2020 Mar 26. The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) program recommended deep remission
Fecal-Oral Route Does Not Appear to Be a Major Factor in COVID-19 Transmission
Klaus Mergener, MD, PhD, FASGE, reviewing Wölfel R. et al. Nature 2020 Apr 1. While a significant number of patients with COVID-19 experience GI symptoms,
SARS-CoV-2 Cannot Be Contained by Manual Contact Tracing Alone
Klaus Mergener, MD, PhD, FASGE, reviewing Ferretti L, et al. Science 2020 Mar 31. Because effective treatments for COVID-19 are not yet available, we rely
Minimal Staffing Requirements During Endoscopy
Vanessa M. Shami, MD, FASGE, reviewing Jamil LH, et al. Gastrointest Endosc 2020 Apr. We all strive to provide the best quality care for patients
Serum Biomarkers Predict Crohn’s Disease Diagnosis 5 Years in Advance, but Not Ulcerative Colitis
Monika Fischer, MD, reviewing Torres J, et al. Gastroenterology 2020 Mar 9. Early intervention appears to be the key to mitigating severe complications of Crohn’s
Shortening Ustekinumab Interval to Every 4 Weeks Associated With Increased Rates of Clinical and Biological Remission in Patients With Crohn’s Disease
Monika Fischer, MD, reviewing Ollech JE, et al. Clin Gastroenterol Hepatol 2020 Feb 25. This single-center retrospective study evaluated the outcomes of 110 patients with
DOACs Versus Warfarin: Is One Safer During Endoscopy?
Vanessa M. Shami, MD, FASGE, reviewing Tien A, et al. Gastrointest Endosc 2020 Feb 29. Gastroenterologists are seeing an increasing number of patients taking direct-acting
Gastroenterology Societies Issue Recommendations on the Use of Personal Protective Equipment
Klaus Mergener, MD, PhD, FASGE, reviewing joint gastroenterology society message on COVID-19 use of personal protective equipment. Gastrointest Endosc 2020 April 2. The GI societies
Decontamination Protocol for N95 Respirators May Help With PPE Shortage
Klaus Mergener, MD, PhD, FASGE, reviewing Schwartz A, et al. Appl Biosaf 2020 March 27. In an attempt to meet anticipated resource needs during the
Majority of SARS-CoV-2 Transmissions May Occur Prior to Day 2 of COVID-19 Illness
Klaus Mergener, MD, PhD, FASGE, reviewing Boehmer MM, et al. Lancet 2020 March 31. This report, co-authored by the scientist who developed the first SARS-CoV-2
Pocket Method Beats Conventional Colorectal Endoscopic Submucosal Dissection in Randomized Controlled Trial
Douglas K. Rex, MD, FASGE, reviewing Yamashina T, et al. Gastrointest Endosc 2020 Feb 28. The conventional method (CM) of endoscopic submucosal dissection (ESD) involves
Microprocessor-Controlled Endo Cut Versus Forced Coagulation: No Difference in Delayed Hemorrhage
Douglas K. Rex, MD, FASGE, reviewing Pohl H, et al. Gastroenterology 2020 Mar 12. Previous uncontrolled studies indicated that forced-coagulation (FC) current (the blue pedal)
Passive Antibody Therapy Against COVID-19 Holds Some Promise
Klaus Mergener, MD, PhD, FASGE, reviewing Shen C, et al. JAMA 2020 March 27. In this very small case series of 5 critically ill patients
Forty-Four Percent of SARS-CoV-2 Transmission May Occur Prior to Symptom Onset
Douglas K. Rex, MD, FASGE, reviewing He X, et al. medRXiv 2020 Mar 18. In a Chinese study of 77 infector-infectee pairs (clear viral transmission
SARS-CoV-2 Virus Shed in Stool
Douglas K. Rex, MD, FASGE, reviewing Xiao F, et al. Gastroenterology 2020 Mar 3. In a Chinese study of 73 patients with proven coronavirus infection,
Cytokine Storm May Be the Cause of Death in COVID-19
Douglas K. Rex, MD, FASGE, reviewing Mehta P, et al. Lancet 2020 Mar 16. In a letter to the Lancet, authors argued that secondary hemophagocytic lymphohistiocytosis
Bile Acid Sequestrants Demonstrate Significant Benefit As Adjunctive Therapy in Refractory GERD
Prateek Sharma, MD, FASGE, reviewing Vaezi MF, et al. Gastroenterology 2020 Feb 21. Proton pump inhibitor- (PPI) refractory GERD, accounting for about one-third of all
Healthy Lifestyle Recommended for General Public Associated With Significant Survival in Adult-Onset IBD
Monika Fischer, MD, reviewing Lo CH, et al. Clin Gastroenterol Hepatol 2020 Mar 3. Several studies in the non-IBD population have shown that a healthy
Helpful Perspective From Italy Regarding GI Endoscopy in Midst of COVID-19 Pandemic
Serious adherence to protection of patients and staff is now required as SARS-CoV-2 disseminates across the country.
GI Symptoms Common and Associated With Worse Outcomes in COVID-19
These results from China indicate that GI symptoms are common as the chief complaint in COVID-19, though most patients had simultaneous respiratory symptoms. GI symptoms
Molecular Markers Predict Prognosis in Colorectal Cancer
Douglas K. Rex, MD, FASGE, reviewing Phipps AI, et al. Gastroenterology 2020 Feb 20. Current recommendations from the U.S. Multi-Society Task Force recommend that all
Two From the Ascending Colon and Two From the Descending Colon: Biopsies From Microscopic Colitis Simplified
Douglas K. Rex, MD, FASGE, reviewing Virine, B, et al. Clin Gastroenterol Hepatol 2020 Feb 25. Guidelines recommend that clinicians perform 8 biopsies total from
Deciding on Surgery After Endoscopic Resection of T1-CRC? Repeat Colonoscopy and Biopsy Do Not Help
Douglas K. Rex, MD, FASGE, reviewing Gijsbers KM, et al. Gastrointest Endosc 2020 Feb 24. In general, when a flat or sessile T1 colorectal cancer
Patients With Barrett’s Esophagus and Indefinite Dysplasia: What To Do?
Prateek Sharma, MD, FASGE, reviewing Krishnamoorthi R, et al. Gastrointest Endosc 2020 Jan. The risk of progression in Barrett’s esophagus (BE) with low-grade dysplasia has
First Selective Oral Jak1 Inhibitor Induces Remission in Ulcerative Colitis
Monika Fischer, MD, reviewing Sandborn WJ, et al. Gastroenterology 2020 Feb 21. Upadacitinib, a selective Janus kinase 1 (Jak1) inhibitor (60-fold selective for Jak1 over
Anti-Tumor Necrosis Factor Should Be Considered for Ulcerative Proctitis Refractory to Conventional Therapy
Monika Fischer, MD, reviewing Pineton de Chambrun G, et al. Clin Gastroenterol Hepatol 2020 Mar. Treatment of ulcerative proctitis that is unresponsive to mesalamine and
The Battle Zone of Barrett’s Endoscopic Therapy: The Gastric Cardia
Prateek Sharma, MD, FASGE, reviewing Eluri S, et al. Clin Gastroenterol Hepatol 2020 Jan. Long-term durability of complete eradication of intestinal metaplasia (CE-IM) is the
Primary Care Physicians Order 88% of FIT-Fecal DNA Tests
Douglas K. Rex, MD, FASGE, reviewing Weiser E, et al. J Med Screen 2020 Feb 13. This industry-sponsored study examined adherence rates to the fecal
Improving ADR Shown Again to Save Lives
Douglas K. Rex, MD, FASGE, reviewing Lam AY, et al. Gastrointest Endosc 2020 Feb 21. A 2017 study from the Polish screening colonoscopy program showed
Single-Use Duodenoscope Functionality Excellent in Early Studies
Bret T. Petersen, MD, FASGE, reviewing Muthusamy VR, et al. Clin Gastroenterol Hepatol 2019 Nov 6 and Ross A, et al. Gastrointest Endosc 2020 Feb.
Radiographic Studies Unreliable for Polyp Detection in Patients With Incomplete Colonoscopy
Douglas K. Rex, MD, FASGE, reviewing Parsa N, et al. Gastrointest Endosc 2020 Feb 4. In a single U.S. center with a large experience performing
Meta-analysis Associates Helicobacter pylori Infection With Colorectal Neoplasia
Douglas K. Rex, MD, FASGE, reviewing Choi DS, et al. Clin Transl Gastroenterol 2020 Feb. Helicobacter pylori (H. pylori) infection has been previously associated with colorectal
Antibiotics Are Not Necessary to Prevent Pancreatic Cyst Infection After Endoscopic Ultrasound-Guided Fine-Needle Aspiration
Vanessa M. Shami, MD, FASGE, reviewing Hernández JC, et al. Gastroenterology 2020 Jan 20. The European Society of Gastrointestinal Endoscopy recommends routine antibiotic prophylaxis for
Predictors of Colectomy at 1 Year in Severe Ulcerative Colitis
Monika Fischer, MD, reviewing Le Baut G, et al. Clin Gastroenterol Hepatol 2020 Jan 9. A French IBD consortium studied 270 hospitalized patients with severe
Calculating Effect of Surveillance Colonoscopy on Colon Cancer Prevention
he U.S. Multi-Society Task Force on Colorectal Cancer recently presented new postpolypectomy surveillance recommendations. Perhaps the most impactful new recommendation is that patients with 1
New Evidence Supports Surveillance Colonoscopy for Patients With Stage I Colon Cancer
Gastroenterologists may be surprised to learn that some guideline groups do not endorse surveillance colonoscopy after resection of stage I colon cancer because of a
Vitamin D Supplementation Did Not Prevent Adenomas or Serrated Lesions
Douglas K. Rex, MD, FASGE, reviewing Song M, et al. Clin Gastroenterol Hepatol 2020 Feb 13. There is an association between vitamin D levels and
Updated Postpolypectomy Surveillance Recommendations of the Multi-Society Task Force
Douglas K. Rex, MD, FASGE, reviewing Gupta S, et al. Gastroenterology 2020 Feb 7. The U.S. Multi-Society Task Force on Colorectal Cancer has updated its
Considering Endoscopy in Iron Deficiency Anemia? Don’t Rely on Fecal Blood Testing to Decide
Douglas K. Rex, MD, FASGE, reviewing Lee MW, et al. Am J Gastroenterol 2020 Jan 10. Fecal blood testing is approved as a colorectal cancer
Berberine Reduces Metachronous Colorectal Adenomas in Randomized Trial
Douglas K. Rex, MD, FASGE, reviewing Chen YX, et al. Lancet Gastroenterol Hepatol 2020 Jan 8. Berberine is a Chinese herbal extract used to treat
Improving the Message of Mailed Outreach Improves CRC Screening Adherence
Douglas K. Rex, MD, FASGE, reviewing Bakr O, et al. Clin Transl Gastroenterol 2020 Jan. Mailed outreach, in which a fecal immunochemical test (FIT) kit
Dupilumab: A New Treatment Option for Patients With Eosinophilic Esophagitis
Prateek Sharma, MD, FASGE, reviewing Hirano I, et al. Gastroenterology 2020 Jan. Medical treatment options for patients with eosinophilic esophagitis (EoE) include proton pump inhibitors,
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
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)
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
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.
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)
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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)
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
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
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
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
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
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
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
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
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,
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
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,
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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)
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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