Background and aims Previous studies show that mortality from chronic liver disease (CLD) and cirrhosis is increasing in the U.S. However, there are limited data on sex-specific mortality trends by age, race, and geographical location. The aim of this study was to conduct a comprehensive time-trend analysis of liver disease related mortality rates in the National-Center-of-Health-Statistics(NCHS) database

Description In this Clinical Practice Update (CPU), we provide guidance on the appropriate use of different polypectomy techniques. We focus on polyps <2 cm in size that are most commonly encountered by the practicing endoscopist, including use of classification systems to characterize polyps and various polypectomy methods. We review characteristics of polyps that require complex polypectomy techniques

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Background Acute enteric infections are well known to result in long-term gastrointestinal disorders. While COVID-19 is principally a respiratory illness, it demonstrates significant gastrointestinal tropism, possibly predisposing to prolonged gut manifestations. We aimed to examine the long-term gastrointestinal impact of hospitalization with COVID-19. Methods Nested within a large-scale observational

Background & Aims Histologic evaluation of mucosal healing in Crohn’s disease (CD) is an evolving treatment target. We evaluated histologic outcomes for mirikizumab efficacy and associations with endoscopic and 1-year outcomes. Methods Biopsies from 1 ileal and 4 colonic segments were evaluated at Weeks 0, 12, and 52 from each 170 SERENITY participants. Criteria for the Weeks 12 and 52 histologic response

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Background & Aims Villus height to crypt depth ratio (Vh:Cd) and intraepithelial lymphocytes (IEL) are key measures of histology of the small intestine in celiac disease (CeD). While the field of CeD has advanced, there remains no broadly accepted measure of mucosal injury. We assessed whether a composite Vh:Cd and IEL scale (named VCIEL) can improve accuracy and statistical precision for assessing

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DESCRIPTION The purpose of this American Gastroenterological Association (AGA) Institute Rapid Clinical Practice Update (CPU) Communication is to review the available evidence and provide expert advice regarding the evolving management of patients taking GLP-1 receptor agonists prior to endoscopy. METHODS This CPU was commissioned and approved by the AGA Institute Clinical Practice Updates Committee

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Background While both non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are used for analgesia in acute pancreatitis (AP), the analgesic of choice is not known. We compared buprenorphine, an opioid, and diclofenac, an NSAID, for analgesia in AP. Methods In a double-blind randomized controlled trial, AP patients were randomized to receive IV diclofenac or IV buprenorphine. Fentanyl was used

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The most recent US Multi Society Task Force (USMSTF) for Colorectal Cancer (CRC) post-polypectomy guidelines recommend surveillance intervals for sessile serrated lesions (SSLs) based on size, dysplasia, and number of index polyps.1 Large (>1 cm) hyperplastic polyps (HPs), which previously had a 10 year follow-up recommendation, now have a 3-5 year interval,2 However, most of the serrated polyp recommendations

Background & Aims Metoclopramide nasal spray (MNS) was developed as an alternative to oral metoclopramide. Prior phase 2 studies demonstrated efficacy in reducing symptoms in women, but not men with diabetic gastroparesis. The aim of this phase 3 study was to further determine the safety and efficacy of MNS compared to placebo in reducing symptoms of diabetic gastroparesis in women. Methods This US

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Background and Aims Prokinetics have limited effectiveness for treating symptoms of gastroparesis. Thus, alternative or adjunct therapies like gastroparesis diets or neuromodulators are often prescribed. Their therapeutic benefits alone or in combination remain unclear. Methods 129 patients with symptoms of gastroparesis underwent wireless motility capsule gastric emptying time (GET) and gastric emptying

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Background and aims Individuals with inflammatory bowel disease (IBD) are at increased risk of serious infections, but whether this risk varies by histological disease activity is unclear. Methods A national population-based study of 55,626 individuals diagnosed with IBD in 1990-2016 with longitudinal data on ileo-colorectal biopsies followed through 2016. Serious infections were defined as having

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Background and Aims The aim of this study was to characterize baseline morphologic features of crypts in non-dysplastic Barrett’s esophagus (NDBE) and correlate them with DNA content abnormalities and risk of progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC). Methods The morphologic features of non-dysplastic crypts in baseline biopsies from 212 BE patients (2956 biopsies)

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Background and Aims While gastroesophageal reflux disease (GERD) symptoms are an essential criterion for Barrett’s esophagus (BE) screening in most gastroenterology society guidelines, a significant proportion of BE and esophageal adenocarcinoma (EAC) cases do not endorse them. In a systematic review and meta-analysis (SRM), we aimed to study the prevalence of BE/EAC in those with and without GERD

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Celiac disease, non-celiac gluten sensitivity, and wheat allergy comprise three of the main conditions with wheat and gluten-containing foods as the symptom trigger. Distinguishing between these entities can be daunting. In this review we compare and contrast celiac disease, non-celiac gluten sensitivity, and wheat allergy to allow clinicians to determine which diagnosis fits their patient to facilitate

Value-based care focuses on improving the quality, effectiveness, and efficiency of healthcare while controlling costs. Low value care implies services or interventions that provide little or no benefit to patients, have the potential to cause harm, incur unnecessary cost to patients, or waste limited healthcare resources. In this review, we discuss common instances of low value care along the spectrum

Background & Aims We describe the experience of Lynch Syndrome (LS) diagnosis in the province of Manitoba, Canada over the last twenty years. Methods We performed a retrospective review of charts from the provincial Genetics clinic from January 1, 2000-May 31, 2023. We extracted data on individuals identified to carry a germline pathogenic or likely pathogenic LS gene variant, the mode of ascertainment

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Background & Aims Preoperative risk stratification may help guide prophylactic biologic utilization for the prevention of postoperative Crohn's disease (CD) recurrence; however, there is limited data exploring and validating proposed clinical risk factors. We aimed to explore preoperative clinical risk profiles, quantify individual risk factors, and assess the impact of biologic prophylaxis on postoperative

BACKGROUND AND AIMS Hepatitis B surface antigen (HBsAg) seroclearance is the goal of functional cure for hepatitis B virus (HBV) infection. However, the impact of metabolic dysfunction-associated steatotic liver disease (MASLD) on this favorable outcome remains unclear. METHODS Patients with chronic hepatitis B (CHB) were consecutively recruited. MASLD was defined by the newly proposed disease criteria

Background and Aims Thermal treatment of the defect margin after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal lesions reduces the recurrence rate. Both snare tip soft coagulation (STSC) and argon plasma coagulation (APC) have been used for thermal margin treatment, but there are few data directly comparing STSC to APC for this indication. Methods We performed a randomized

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