INTRODUCTION Liver biopsy (LB) remains essential for the diagnosis and staging of parenchymal liver diseases. Endoscopic ultrasound-guided LB (EUS-LB) has emerged as an attractive alternative to percutaneous and transjugular routes. We aimed at comparing the adequacy of samples obtained by EUS-LB with percutaneous LB. METHODS A single-center, randomized, controlled clinical trial was designed. Patients

Bowel urgency, the sudden or immediate need for a bowel movement, is one of the most common and disruptive symptoms experienced by patients with ulcerative colitis. Distinct from the separate symptom of increased stool frequency, bowel urgency has a substantial negative impact on quality of life and psychosocial functioning. Among patients with ulcerative colitis, bowel urgency is one of the top reasons

OBJECTIVES Recent pilot trials in acute pancreatitis (AP) found that Lactated Ringers (LR) usage may result in decreased risk of moderately severe/severe AP compared with Normal Saline, but their small sample sizes limit statistical power. We investigated if LR usage is associated with improved outcomes in AP in an international, multi-center, prospective study. METHODS Subjects directly admitted with

ObjectivesObesity is a global epidemic. Its clinical impact on symptoms of fecal incontinence (FI) and/or constipation and underlying anorectal pathophysiology remains uncertain.MethodsCross-sectional study of consecutive patients meeting Rome IV criteria for FI and/or functional constipation, with data on body mass index (BMI), attending a tertiary center for investigation between 2017-2021. Clinical

Background We used New Hampshire Colonoscopy Registry (NHCR) data to examine the association between Post-colonoscopy colorectal cancer (PCCRC) and sessile serrated detection rates (SSLDR). Methods We included patients with either a colonoscopy or a CRC diagnosis in the NH State Cancer Registry. PCCRC, was any CRC diagnosed >/= 6 months after index exam. Results Of 26,901 patients, 162 were diagnosed

BACKGROUND AIMS To evaluate the effect of three-dimensional (3D) imaging device on polyp and adenoma detection during colonoscopy. METHODS In a single-blind, randomized controlled trial, participants aged 18-70 years who underwent diagnostic or screening colonoscopy were consecutively enrolled between August 2019 to May 2022. Each participant was randomized in 1:1 ratio to undergo either 2D-3D colonoscopy

INTRODUCTION Artificial intelligence chatbots could serve as an information resource for patients and a tool for clinicians. Their ability to respond appropriately to questions regarding gastroesophageal reflux disease (GERD) is unknown. METHODS Twenty-three prompts regarding GERD management were submitted to ChatGPT, and responses were rated by three gastroenterologists and eight patients. RESULTS

IntroductionOlder adults with IBD are at higher risk for postoperative complications as compared to their younger counterparts, however factors contributing to this are unknown. We assessed risk factors associated with adverse IBD-related surgical outcomes, evaluated trends in emergency surgery, and explored differential risks by age.MethodsUsing the American College of Surgeons National Surgical Quality

INTRODUCTION The pathoetiology and treatment of levator ani syndrome (LAS) remains unclear. METHODS We evaluated pathophysiology using translumbosacral motor evoked potentials (MEP), and anorectal manometry in LAS patients and compared with healthy controls. A cohort underwent Translumbosacral Neuromodulation Therapy (TNT). RESULTS Lumbar and sacral MEP latencies were prolonged in 32 LAS patients compared

BACKGROUND Surgical management of Crohn's disease (CD) is common. Postoperative complications include anastomotic stricturing (AS). The natural history and risk factors for AS has not been elucidated. METHODS A retrospective cohort study of patients with CD who underwent ileocolonic resection (ICR) with ≥1 postoperative ileocolonoscopy between 2009-2020. Postoperative ileocolonoscopies with corresponding

OBJECTIVES There is growing interest in the pre-diagnostic phase of inflammatory bowel disease (IBD) and in the overlap of IBD with other diseases. We described and compared use of any prescription medication between individuals with and without IBD in a ten-year period preceding diagnosis. METHODS Based on cross-linked nationwide registers, we identified 29,219 individuals diagnosed with IBD in Denmark

BACKGROUND AIMS Esophageal food bolus impactions (FBIs) are a common gastrointestinal emergency. Appropriate management includes not only index endoscopy for disimpaction, but also medical follow-up and treatment for the underlying esophageal pathology. We evaluated the appropriateness of post-endoscopy care for patients with FBIs, and assessed patient-, physician- and system-related factors that may

OBJECTIVES To assess the safety of early versus late biologic switch in patients with inflammatory bowel disease (IBD). METHODS In this retrospective study we included patients with IBD who underwent biological switch between Jan 2014 and July 2022 at a tertiary center. The primary outcome was any infection by 6 months. RESULTS There was no statistically significant difference between patients who

INTRODUCTION Objective evidence of small intestinal dysmotility is a key criterion for the diagnosis of pediatric intestinal pseudo-obstruction (PIPO). Small bowel scintigraphy (SBS) allows for objective measurement of small bowel transit (SBT), but limited data are available in children. We aimed to evaluate the utility of SBS in children suspected of gastrointestinal dysmotility. METHODS Patients

INTRODUCTION Chronic idiopathic constipation (CIC) and opioid-induced constipation (OIC) are disorders that negatively affect quality of life. We sought to assess the prevalence, symptom severity, and medication use among people with Rome IV CIC, OIC, and opioid-exacerbated constipation (OEC) using a nationally representative data set with nearly 89,000 people in the United States. METHODS From May

BACKGROUND Sleeve gastrectomy (SG) results in persistent or de novo reflux more often than Roux-en-Y gastric bypass (RYGB). We investigated pressurization patterns in the proximal stomach on high resolution manometry (HRM) to determine associations with reflux following SG. METHODS Patients undergoing HRM and ambulatory pH-impedance monitoring following SG and RYGB over a 2-year period (2019-20) were

INTRODUCTION We assessed the prevalence and clinical outcomes of segmental colitis associated with diverticulosis (SCAD) in patients with newly diagnosed diverticulosis. METHODS A 3-year international, multicenter, prospective cohort study was conducted involving 2,215 patients. RESULTS SCAD diagnosis was posed in 44 patients (30 male patients; median age: 64.5 years; prevalence of 1.99%, 95% confidence

INTRODUCTION Diagnosis of drug-induced liver injury (DILI) is difficult. We reviewed cases in the DILI Network prospective study that were adjudicated to have liver injury due to other causes to discover pearls for improved diagnostic accuracy. METHODS Cases were adjudicated by expert opinion and scored from 1 (definite DILI) to 5 (unlikely DILI). Confirmed cases (1-3) were compared with unlikely cases

INTRODUCTION The role of inhaled and swallowed aeroallergens in treatment outcomes of adult patients with eosinophilic esophagitis (EoE) is unclear. We hypothesized that the pollen season contributes to the failure of the 6-food elimination diet (SFED) in EoE. METHODS We compared outcomes of patients with EoE who underwent SFED during vs outside of the pollen season. Consecutive adult patients with

INTRODUCTION Low-grade dysplasia (LGD) in Barrett's esophagus (BE) is associated with an increased risk of progression to high-grade dysplasia or esophageal adenocarcinoma. However, because of substantial interobserver variability in the diagnosis of LGD, a patient's management plan and health outcome depend largely on which pathologist reviews their case. This study evaluated the ability of a tissue

INTRODUCTION We aimed to determine whether the intensity of alanine aminotransferase (ALT) flares during antiviral therapy is associated with the level of hepatitis B surface antigen (HBsAg) decline. METHODS Quantitative HBsAg was determined during tenofovir monotherapy or tenofovir plus peginterferon alfa-2a in 201 participants with hepatitis B e antigen-positive or -negative chronic hepatitis B.

INTRODUCTION Hiatus hernia is characterized by axial separation between the lower esophageal sphincter and the crural diaphragm, and higher reflux burden. Impact on reflux is unclear if such separation is intermittent rather than persistent. METHODS Reflux burden off antisecretory therapy was compared between no hernia (n = 357), intermittent hernia (n = 42), and persistent hernia (n = 155) after review

INTRODUCTION Data are scarce regarding the virologic impact and safety of immune checkpoint inhibitors (ICI) in patients with chronic hepatitis C virus (HCV) infection. We examined the virologic impact of ICI in HCV-infected patients with solid tumors and their safety. METHODS HCV-infected patients with solid tumor treated with ICI at our institution between April 26, 2016, and January 5, 2022, were

INTRODUCTION In the treatment of upper GI endoscopy-negative patients with heartburn and epigastric pain or burning, antacids, antireflux agents, and mucosal protective agents are widely used, alone or as add-on treatment, to increase response to proton-pump inhibitors, which are not indicated in infancy and pregnancy and account for significant cost expenditure. METHODS In this randomized, controlled

OBJECTIVES Few large-scale studies have been published regarding the association between autoimmune hepatitis (AIH) and risk of osteoporotic fracture. This study aimed to determine the risk of developing an osteoporotic fracture in patients with AIH. METHODS We used claims data from the Korean National Health Insurance Service (NHIS) between 2007 and 2020. Patients with AIH (n = 7,062) were matched

BACKGROUND AND AIMS Cold snare polypectomy (CSP) is strongly recommended as the optimal technique for the complete removal of small polyps. Though significant variability in polypectomy technique and quality has been established, the learning curve and impact of targeted training on CSP are unknown. Video feedback has shown promise as an effective pedagogy to improve performance among surgical trainees

INTRODUCTION Patients with medically refractory ulcerative colitis who previously would have undergone surgery can now elect for subsequent medical therapy. METHODS In a commercially insured population, we evaluated the proportion of patients initiating second-line, third-line, or fourth-line treatment who underwent colectomy in the following 12 months. RESULTS Among 3,325 patients with ulcerative

Total abdominal proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) is associated with substantial complications despite the benefits of managing refractory and/or neoplasia-associated disease. For the purpose of this review, we focused on the diagnosis of some of the most common inflammatory and structural pouch disorders and their respective management. Pouchitis

INTRODUCTION Inflammatory bowel diseases (IBD) affect >3 million Americans and are associated with tremendous economic burden. Direct patient-level financial impacts, financial distress, and financial toxicity are less well understood. We aimed to summarize the literature on patient-level financial burden, distress, and toxicity associated with IBD in the United States. METHODS We conducted a literature

INTRODUCTION Chronic isolated terminal ileitis (TI) may be seen in Crohn's disease (CD) and intestinal tuberculosis (ITB) in addition to other etiologies that may be managed symptomatically. We developed a revised algorithm to distinguish patients with a specific etiology from a nonspecific etiology. METHODS Patients with chronic isolated TI followed up from 2007 to 2022 were retrospectively reviewed

INTRODUCTION Immune checkpoint inhibitor-mediated colitis (IMC) is commonly managed with steroids and biologics. We evaluated the efficacy of ustekinumab (UST) in treating IMC refractory to steroids plus infliximab and/or vedolizumab. RESULTS Nineteen patients were treated with UST for IMC refractory to steroids plus infliximab (57.9%) and/or vedolizumab (94.7%). Most of them had grade ≥3 diarrhea

INTRODUCTION We determined adverse events after 4 doses of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine in those with inflammatory bowel disease (IBD), associations between antibodies and injection site reactions (ISR), and risk of IBD flare. METHODS Individuals with IBD were interviewed for adverse events to SARS-CoV-2 vaccine. Multivariable linear regression assessed the association

INTRODUCTION Chat Generative Pretrained Transformer (ChatGPT) is a natural language processing model that generates human-like text. METHODS ChatGPT-3 and ChatGPT-4 were used to answer the 2022 and 2021 American College of Gastroenterology self-assessment tests. The exact questions were inputted in both versions of ChatGPT. A score of 70% or higher was required to pass the assessment. RESULTS Overall

INTRODUCTION In patients with inflammatory bowel diseases (IBDs), high visceral adipose tissue (VAT) burden is associated with a lower response to infliximab, potentially through alterations in volume distribution and/or clearance. Differences in VAT may also explain the heterogeneity in target trough levels of infliximab associated with favorable outcomes. The aim of this study was to assess whether

INTRODUCTION Corpus-restricted atrophic gastritis is a chronic inflammatory disorder leading to possible development of type 1 neuroendocrine tumors (T1gNET), intraepithelial neoplasia (IEN), and gastric cancer (GC). We aimed to assess occurrence and predictors of gastric neoplastic lesions in patients with corpus-restricted atrophic gastritis at long-term follow-up. METHODS A prospective single-center

Perianal Crohn's disease affects 25%-35% of patients with Crohn's disease and has proven to be one of the most difficult complications of the disease to treat. Patients with perianal Crohn's disease have lower health-related quality of life scores typically related to pain and fecal incontinence. In addition, patients with perianal Crohn's disease have higher rates of hospitalizations, surgeries, and