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ASGE Journal Scan | Stomach and Small Bowel

Does Ranitidine Use Increase Cancer Risk?

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Stomach and Small Bowel

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Pancreas

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Colon

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,

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ASGE Journal Scan | Colon

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.

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ASGE Journal Scan | Pancreas

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Pancreas

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

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ASGE Journal Scan | Stomach and Small Bowel

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.

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ASGE Journal Scan | Stomach and Small Bowel

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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).

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ASGE Journal Scan | Stomach and Small Bowel

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

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ASGE Journal Scan | Pancreas

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Stomach and Small Bowel

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Pancreas

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

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ASGE Journal Scan | Colon

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)

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Pancreas

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Stomach and Small Bowel

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Pancreatobiliary System and Liver

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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.

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Pancreas

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

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ASGE Journal Scan | Colon

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,

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Pancreas

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

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ASGE Journal Scan | Colon

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

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IBD

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

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ASGE Journal Scan | Stomach and Small Bowel

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Pancreatobiliary System and Liver

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.

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ASGE Journal Scan | PANCREATOBILIARY | Pancreas

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

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ASGE Journal Scan | Colon

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).

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Stomach and Small Bowel

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | PANCREATOBILIARY

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Stomach and Small Bowel

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,

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Colon

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.

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Stomach and Small Bowel

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | EUS

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | PANCREATOBILIARY

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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:

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ASGE Journal Scan | PANCREATOBILIARY | Pancreas

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

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ASGE Journal Scan | Stomach and Small Bowel

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;

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | PANCREATOBILIARY

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | PANCREATOBILIARY

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

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ASGE Journal Scan | Colon

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).

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | COVID-19

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,

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ASGE Journal Scan | COVID-19

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

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ASGE Journal Scan | General Endoscopy

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | General Endoscopy

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

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ASGE Journal Scan | COVID-19

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

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ASGE Journal Scan | COVID-19

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

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ASGE Journal Scan | COVID-19

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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)

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ASGE Journal Scan | COVID-19

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

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ASGE Journal Scan | General Endoscopy

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

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ASGE Journal Scan | General Endoscopy

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,

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ASGE Journal Scan | General Endoscopy

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | General Endoscopy

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.

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ASGE Journal Scan | General Endoscopy

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | Esophagus

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | PANCREATOBILIARY

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.

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Stomach and Small Bowel

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

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ASGE Journal Scan | IBD

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Colon

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

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ASGE Journal Scan | Esophagus

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,

BEITRAG LESEN

ASGE Journal Scan | Colon

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 | Colon

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 | Colon

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 | Stomach and Small Bowel

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 | Stomach and Small Bowel

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 | Esophagus

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 | PANCREATOBILIARY

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Esophagus

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 | Colon

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 | Colon

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 | PANCREATOBILIARY

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 | PANCREATOBILIARY

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 | Colon

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 | Stomach and Small Bowel

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 | Colon

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 | Esophagus

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Esophagus

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 | Esophagus

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 | Colon

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 | Colon

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 | Colon

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 | Stomach and Small Bowel

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 | Colon

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 | 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

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ASGE Journal Scan | Stomach and Small Bowel

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 | Colon

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 | Colon

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 | Stomach and Small Bowel

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Esophagus

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Colon

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 | Esophagus

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 | Stomach and Small Bowel

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 | Colon

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 | Colon

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 | Esophagus

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 | Colon

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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