Carbohydrate intolerance is a poorly understood and potentially overlooked cause of unexplained gastrointestinal symptoms, particularly among patients with disorders of gut-brain interaction. Symptoms related to carbohydrate intolerance arise from bacterial fermentation of unabsorbed carbohydrates leading to increased gases and osmotic load within the gastrointestinal tract. This mechanism is shared

BACKGROUND AIMS Patients with type 2 diabetes mellitus (T2DM) are at increased risk for metabolic dysfunction-associated steatotic liver disease (MASLD), advanced liver fibrosis, and metabolic dysfunction-associated steatohepatitis (MASH). We evaluated the prevalence and severity of MASLD among patients with T2DM at their first referral to diabetes clinics, and assessed the effectiveness of the 2-tier

OBJECTIVES Recent data suggest emerging rural-urban disparities in hepatocellular carcinoma (HCC) burden in the US. We aimed to assess (1) trends in rural vs urban HCC-related mortality and (2) differences in underlying chronic liver disease etiologies contributing to HCC-related deaths. METHODS We utilized the National Vital Statistics System to examine crude and age-adjusted HCC death rates overall

INTRODUCTION We used New Hampshire Colonoscopy Registry (NHCR) data to examine the association between post-colonoscopy colorectal cancer (PCCRC) risk and an adenoma detection rate (ADR) which was calculated using exams with all indications, as compared to ADR restricted to only screening exams. METHODS Our cohort study included NHCR patients with an index exam and at least one follow-up event, either

BACKGROUND AND AIMS Fluoroquinolones (FQ) have a favorable safety profile, but the risk of drug-induced liver injury (DILI) is well described. The aim of this study was to identify clinical features and HLA genetic variants associated with FQ-DILI in a large national registry. METHODS Analysis of FQ-DILI cases enrolled in DILIN between 2004-2022. HLA class I and II alleles were sequenced by the Illumina

BACKGROUND The term 'laryngopharyngeal reflux' ('LPR') is frequently applied to aerodigestive symptoms despite lack of objective reflux evidence. This initiative aimed to develop a modern care paradigm for LPR supported by otolaryngology and gastroenterology disciplines. METHODS A 28-member international inter-disciplinary working group developed practical statements within the following domains:

BACKGROUND Multitarget stool DNA (MT-sDNA) tests (i.e., Cologuard®) serve as screening tests for colorectal cancer (CRC) and are recommended by the USPSTF every 1-3 years. Here, in a primary care setting, our aim was to evaluate the diagnostic performance of MT-sDNA testing and colonoscopy findings following a positive MT-sDNA testing result. METHODS This was retrospective cohort study of electronic

BACKGROUND Cannabinoids are being explored as potential treatments for gastroparesis due to their anti-emetic, gastric motility modulation, appetite stimulation, and analgesic properties coupled with their increasing use due to legalization in many states. While these theoretical benefits are promising, clinical evidence remains limited. This study aimed to evaluate the effects of cannabis use on clinical

INTRODUCTION We aimed to explore the prevalence of carbohydrate (lactose and fructose) intolerance in patients with disorders of gut-brain interaction (DGBI), and to characterize those patients in terms of gastrointestinal and non-gastrointestinal symptoms. METHODS DGBI patients who were referred to the Physiology Unit of our Hospital between May 2022 and December 2023 for lactose (25g) and fructose

Patient-reported outcome (PRO) measures are essential tools for assessing a patient's subjective experience related to disease and health. PROs measure symptom severity and evaluate treatment efficacy across a range of conditions at a particular point in time. While PROs focusing on esophageal symptoms and esophageal hypervigilance exist, disease-specific PROs for commonly encountered benign esophageal

OBJECTIVES A subcutaneous formulation of infliximab was recently approved for maintenance therapy of inflammatory bowel disease (IBD). However, limited clinical experience, particularly with patients on escalated intravenous infliximab regimens, poses challenges for the transition to subcutaneous therapy. We investigated the pharmacokinetics and pharmacodynamics of subcutaneous infliximab to identify

METHODS After the QI initiative, we developed an "urgent care toolkit" for sites to implement. We measured patient- and provider-reported outcomes at clinical visits. RESULTS Improvements in ED utilization and hospitalization were sustained for over 3 years following completion of the initiative. CONCLUSIONS Efforts to sustain improvements after a QI initiative can result in long-term improvement in

BACKGROUND AND AIMS Post-endoscopic sphincterotomy (EST) bleeding presents challenges for endoscopists using side-viewing duodenoscopes. Recently, polysaccharide hemostatic powder (PHP) has shown promising results in managing gastrointestinal hemorrhage. Given the established efficacy of endoscopic clips in addressing post-EST bleeding, we aim to evaluate the efficacy of PHP and its non-inferiority

BACKGROUND Best practices for removal of <1 cm colon polyps exist, but adherence to this guidance is uncertain. METHODS Using GI Quality Improvement Consortium (GIQuIC) Registry data, colonoscopies with polyps <1cm were analyzed for polypectomy technique used, and differences in practices according to patient, procedure, and provider characteristics. RESULTS Among 1,830,067 colonoscopies, cold forceps

OBJECTIVES Current treatment guidelines do not address the unique health risks or life priorities of the aging population with inflammatory bowel diseases (IBD). Patient priority-directed care approaches can facilitate better clinical management for this population. We aimed to explore the experiences of older adults with IBD in relation to medical and surgical treatments by investigating the factors

INTRODUCTION Advances in medical and surgical therapy have improved the outlook for those affected with Crohn's disease and ulcerative colitis; however, it is unclear whether Americans from marginalized racial and ethnic backgrounds have adequate and equitable access to care for inflammatory bowel disease (IBD). We evaluated the association between race and ethnicity and healthcare utilization in patients

INTRODUCTION Recent guidelines for Lynch Syndrome recommend starting a colonoscopy at 30-35 years for path_MSH6 carriers. This study aimed to measure the rate of advanced neoplasia (AN) in these carriers up to age 35. METHODS A multicenter retrospective analysis of endoscopic and pathological data for path_MSH6 carriers who underwent endoscopic surveillance at specialized high-risk clinics. Advanced

INTRODUCTION The effects of metabolic syndrome (MetS), its individual components, and baseline liver histology, on the rates of progression and regression of nonalcoholic fatty liver disease (NAFLD) were evaluated. METHODS We conducted a post-hoc analysis of a multi-center prospective cohort study using the non-interventional registry of the nonalcoholic steatohepatitis (NASH) Clinical Research Network

BACKGROUND The liver supplement market is rapidly expanding, yet the efficacy and safety of these products remain largely unsubstantiated. This study aimed to analyze the best-selling liver "cleansing" supplements on Amazon®, the leading online retailer in the United States. METHODS We identified the top 20 liver cleanse supplements on Amazon® using specific search criteria. Product composition, marketing

BACKGROUND AND AIMS The aim of this long-term progression study was to evaluate the clinical and pathologic features of gastric type dysplasia in Barrett's esophagus (BE). METHODS Baseline biopsies from 208 BE patients from the Seattle prospective cohort were evaluated for the type and grade of dysplasia (gastric or intestinal). Twenty-seven patients progressed to cancer and 181 did not over the long

OBJECTIVE Swallowed topical corticosteroids (STC) are effective in treating patients with eosinophilic esophagitis (EoE). However, real-world data about loss of response to STC are limited and whether patients with off-label STC (olSTC) failure may achieve histologic remission after a switch to budesonide orodispersible tablets (BOT), is unknown. METHODS We analyzed prospectively collected data between

OBJECTIVES To evaluate the risks of colorectal endoscopic submucosal dissection (ESD) in older adult patients, given the increasing number of ESD in an aging population. METHODS We conducted a retrospective cohort study using the Japanese nationwide database from 2012 to 2023. Patients aged ≥60 who underwent colorectal ESD were included. The primary outcome was overall adverse events (AEs), including

BACKGROUND Current guidelines recommend endoscopic surveillance of Barrett's esophagus (BE), but do not account for competing mortality unrelated to esophageal cancer (EC). We conducted a systematic review and meta-analysis to estimate EC and non-EC mortality risk in BE patients. METHOD We searched multiple databases for studies reporting mortality in BE. We included population-based studies providing

INTRODUCTION Efforts to control health spending within the United States have led to reductions in physician reimbursement. This study aims to elucidate the effects of such efforts on physician behavior and care access. METHODS For all gastrointestinal procedures, public Medicare data sets were reviewed to extract variables of interest, leveraging a t test to assess significant change over time. RESULTS

INTRODUCTION Building on prior results, we hypothesized that an electrocardiogram (ECG)-enabled machine learning (ML) model could be used to detect advanced chronic liver disease (CLD). METHODS A cohort with CLD and 12-lead ECGs was matched with controls from electronic health records. A ML model was trained as a binary classifier. RESULTS There are 12,930 patients with CLD and 64,577 controls in the

INTRODUCTION The recent FDA-approval of resmetirom for treating metabolic dysfunction-associated steatohepatitis (MASH) in patients necessitates patient selection for significant fibrosis or higher (≥F2). No existing vibration-controlled transient elastography (VCTE) algorithm targets ≥F2. METHODS The ALADDIN study addressed this gap by introducing a machine-learning-based web calculator that estimates

OBJECTIVES Endoscopic retrograde appendicitis therapy (ERAT) is a new and non-invasive endoscopic technique originally developed by Liu in China for the management of acute appendicitis. While its safety and efficacy have been extensively validated in adult populations, evidence regarding its use in pediatric patients remains scarce. The aim of this study was to evaluate the clinical outcomes of ERAT

INTRODUCTION Colonoscopy is one of the most commonly performed endoscopic procedures and is generally considered low-risk. However, when adverse events (AEs) occur, they can present significant challenges in clinical practice. The aim of this study was to estimate the global incidence of colonoscopy-related AEs. METHODS We searched multiple databases for population-based studies reporting the incidence

OBJECTIVES Post-polypectomy colorectal cancers (PPCRCs) are diagnosed after a cancer-negative colonoscopy with polypectomy. Analyzing PPCRC characteristics informs prevention and early detection strategies. We investigated interval types and etiologies of PPCRCs using World Endoscopy Organization (WEO) guidelines. METHODS PPCRCs were identified in a retrospective cohort of U.S. Veterans who underwent

BACKGROUND We examined associations between pregnancy anti-tissue transglutaminase immunoglobulin A (tTG-IgA) seropositivity, a screening test for celiac disease, and celiac-related conditions in pregnancy and offspring health outcomes. We hypothesized that seropositivity would identify pregnant women and infants at risk of poor health. METHODS The Child Health and Development Studies enrolled pregnant

INTRODUCTION Women with inflammatory bowel disease (IBD) who have IBD surgery before pregnancy have an increased risk of adverse maternal and fetal outcomes. Very few studies have examined the risks of gastrointestinal complications during pregnancy in this group of women. METHODS Using the Danish national registries, we identified live born children of mothers with ulcerative colitis (UC) or Crohn's

INTRODUCTION Immune-modifying therapies in pediatric inflammatory bowel disease (IBD) increase infection risks, including varicella. METHODS Using Optum's deidentified Clinformatics Data Mart Database, a nationwide US commercial insurance claims database (2007-2022), we conducted a retrospective study of 5,368 patients with IBD aged 21 years or younger matched to a non-IBD cohort. The primary outcome

INTRODUCTION We evaluated the positive predictive value (PPV) of International Classification of Diseases, Tenth Revision ( ICD-10 ) codes used to identify organ failures in critically ill patients with cirrhosis. METHODS A cohort of 315 hospitalized cirrhosis patients was analyzed. PPVs were calculated using chart review as the reference standard. RESULTS Three hundred four patients had an ICD-10

INTRODUCTION Patients with ulcerative colitis (UC) experience disruptive symptoms that can impair quality of life (QoL). This study examined the effect of risankizumab (RZB) induction and maintenance treatment on symptom resolution and health-related QoL (HRQoL) outcomes. METHODS For the 12-week induction, patients were randomized to intravenous (IV) RZB 1,200 mg (RZB1200) or placebo (PBO). For the

OBJECTIVE Determine contemporary rates of early mucosal recovery in children with celiac disease (CeD). METHODS Multicenter retrospective cohort study in Canada and the United States. Children diagnosed with CeD between 2016 and 2021 who underwent a follow-up biopsy within 15 months of diagnosis were included. RESULTS Overall, 96/130 (74%) had mucosal recovery, including 48% (12/25) children who were