Background & Aims Portal hypertension (PH) is the strongest predictor of hepatic decompensation and death in patients with cirrhosis. However, its discriminatory accuracy in patients with non-alcoholic fatty liver disease (NAFLD) has been challenged as hepatic vein catheterization may not reflect the real portal vein pressure as accurately as in patients with other etiologies. We aimed to evaluate

Background and Aims Prolonged colon transit times may increase contact time between potential carcinogens in the stool and the colonic mucosa. Nonetheless, previous studies have yielded conflicting results connecting chronic constipation with risk of CRC. We examined the association between chronic constipation and later CRC. Methods In this nationwide case-control study, we identified 41,299 CRC cases

Background and Aims Several endoscopic methods have been proposed for treatment of large biliary stones. We assessed the comparative efficacy of these treatments through a network meta-analysis. Methods 19 randomized controlled trials (2752 patients) comparing different treatments for management of large bile stones (>10 mm) (endoscopic sphincterotomy, balloon sphincteroplasty, sphincterotomy followed

Background & Aims Missed or inappropriate referrals of potential candidates for liver transplantation (LT) are common and traditional referral methods (tRs) do not allow for efficient triage. We investigated the effects on these issues of a website developed for electronic oupatient referral to LT (eRW-LT) Methods We prospectively collected data on all consecutive outpatient referrals to two Italian

Background Coffee is associated with a reduced risk of liver disease. This association is limited by important sources of confounding such as recall bias, healthy-user bias, and indirect measures of liver outcomes or health. We aimed to examine the impact of coffee consumption with liver fibrosis and steatosis in a nationally representative sample. Methods We evaluated 4,510 subjects >20 years old

Background and Aims In addition to gastric sensorimotor dysfunctions, functional dyspepsia (FD) is also variably associated with duodenal micro-inflammation and epithelial barrier dysfunction, the pathogenesis and clinical significance of which are unknown. Our hypothesis was that miRNAs and/or inflammation degrade epithelial barrier proteins resulting in increased duodenal mucosal permeability in

Background & aims While the association between fatty pancreas and metabolic syndrome has been suggested in retrospective studies, long-term prospective data on the effect of fatty pancreas on various metabolic outcomes is lacking. We aimed to prospectively investigate the association between fatty pancreas and development of major metabolic outcomes. Methods 631 subjects from a population study using

INTRODUCTION Chronic pancreatitis (CP) is associated with osteopathy (osteoporosis or osteopenia). However, existing literature is mostly limited to retrospective or administrative studies that have not clearly defined the prevalence and risk factors. Our aim was to identify patient- and disease-related associations with osteopathy in a prospective cohort study of CP. METHODS We studied 282 subjects

Background Cancer cachexia is a wasting syndrome associated with functional impairment and reduced survival that impacts up to 50% of patients with gastrointestinal cancers. However, data are limited on the prevalence and clinical significance of cachexia in patients with hepatocellular carcinoma (HCC). Methods We performed a retrospective cohort study of patients diagnosed with HCC at two U.S. health

Eosinophilic esophagitis (EoE) is an immune-mediated condition characterized by symptoms of esophageal dysfunction and an eosinophilic inflammation of the esophagus.1 Swallowed topical steroids represent one of the possible strategies for inducing and maintaining remission in EoE.2 To date, a validated maintenance strategy has yet to be defined, especially in children. The available evidence suggests

Prior studies have reported the prevalence of colorectal cancer (CRC) in average-risk screening population ages 50-75 to be 0.7%-1.0%.1,2 However, no estimates from studies enrolling individuals undergoing screening colonoscopy have been reported. The experience of ongoing studies enrolling average-risk individuals is that the prevalence rates are substantially lower. A 2020 study from a community-based

Background and Aims The aims of this study were to: 1) assess the performance of the pancreatitis activity scoring system (PASS) in a large intercontinental AP cohort, 2) investigate whether a modified PASS, yields a similar predictive accuracy and produces distinct early trajectories between severity subgroups. Methods Data was prospectively collected through the APPRENTICE consortium (2015-2018)

BACKGROUND AND AIMS Artificial intelligence-based computer aided polyp detection (CADe) systems are intended to address the issue of missed polyps during colonoscopy. The effect of CADe during screening and surveillance colonoscopy has not previously been studied in a United States population. METHODS We conducted a prospective, multi-center, single-blind randomized tandem colonoscopy study to evaluate

Background Celiac disease (CD) affects around 1% of the population worldwide. Data on work disability in celiac patients remain scarce. We estimated work loss in celiac patients including its temporal relationship to diagnosis. Methods Through biopsy reports from Sweden’s 28 pathology departments, we identified 16,005 working-aged patients with prevalent CD (villus atrophy) as of January 1, 2015, and

Background and Aims Detailed information on the immune response after second vaccination of cirrhotic patients and liver transplant (LT) recipients against SARS-CoV-2 is largely missing. We aimed at comparing the vaccine-induced humoral and T-cell responses of these vulnerable patient groups. Methods In this prospective cohort study, anti-SARS-CoV-2 spike-protein titers were determined using the DiaSorin

Aims To compare polyethylene glycol (PEG) high-volume to PEG low-volume with bisacodyl split-dosing regimens. Methods Adult outpatients in 10 Canadian tertiary hospitals were randomized, stratified by morning or afternoon colonoscopy, to PEG high-volume split-dose (2+2L) (High-SD) or low volume (1L+1L) + bisacodyl (15mg) (Low-SD) with a second randomization to liquid or low-residue diets. The primary

BACKGROUND & AIMS Antiviral treatment from hepatitis B envelope antigen (HBeAg)-positive status may attenuate the integration of hepatitis B virus DNA into the host genome causing hepatocellular carcinoma (HCC). We investigated the impact of HBeAg status at the onset of antiviral treatment on the risk of HCC. METHODS The incidence of HCC was evaluated in Korean chronic hepatitis B (CHB) patients who

Introduction Laboratory studies have demonstrated that antibiotic use in conjunction with bowel purgatives causes alterations to the gut microbiota. Because gut microbiota changes may be a trigger for the development of irritable bowel syndrome (IBS), we sought to assess whether individuals who undergo bowel cleansing for colonoscopy and have concurrent antibiotic exposure develop IBS at higher rates

Background Despite the rising numbers of older adults with inflammatory bowel diseases (IBD), there are few studies regarding safety and effectiveness of IBD treatments in older adults. Aims To compare the safety and effectiveness of anti-tumor necrosis factor (TNF)-α agents and vedolizumab in older adults with IBD. Methods We conducted a retrospective cohort study using an active comparator, new user

Background and Aims Inflammatory bowel disease (IBD) care and outcomes exhibit substantial variability, suggesting quality gaps. We aimed to identify interventions to narrow these gaps. Methods We performed a systematic review of Medline, Embase and Web of Science through May 2021 to find manuscripts and abstracts reporting quality improvement (QI) interventions in IBD. We included studies with interventions

Background & Aims Post-ERCP Pancreatitis (PEP) is the most common adverse event following ERCP; responsible for substantial morbidity and healthcare expenditures of at least $200 million. Therapies for PEP prevention include pancreatic stent placement (PSP), rectal indomethacin, sublingual nitrates, and aggressive Lactated Ringer’s (LR) hydration. Our objective was to determine which PEP prophylactic

Celiac disease (CD) is an autoimmune disorder mediated by an immune response to dietary gluten that affects the small intestine and leads to inflammation, malabsorption, and systemic consequences.1 The only established therapy is strict adherence to a gluten-free diet.2,3 Recently there has been growth in the development of novel non-dietary therapies for patients with CD,4 which are driven by dissatisfaction