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Overcoming the Challenges and Mitigating the Disparities in Our LGBTQI+ Patients
Paul, Sonali MD, MS1
doi : 10.14309/ajg.0000000000001359
September 2021 - Volume 116 - Issue 9 - p 1815-1818
Skip, Stop, Switch, and Spare: Steroid Therapy in Inflammatory Bowel Disease
Harrison, Nicole MD1,2; Humes, Ross MD2,3; Singla, Manish MD, FACG4
doi : 10.14309/ajg.0000000000001380
September 2021 - Volume 116 - Issue 9 - p 1819-1821
Retrograde Colonic Intussusception Caused by a Pedunculated Adenoma
Sudo, Gota MD1,2; Takagi, Hideyasu MD, PhD1; Goto, Akira MD, PhD1; Nakahara, Seiya MD, PhD1; Hinoda, Yuji MD, PhD1; Nakase, Hiroshi MD, PhD2
doi : 10.14309/ajg.0000000000001173
September 2021 - Volume 116 - Issue 9 - p 1822
Localized Vasculitis of the Gastrointestinal Tract
Kamboj, Amrit K. MD1,2; Benanzer, Tessa M. MD1; Sweetser, Seth MD1,2
doi : 10.14309/ajg.0000000000001169
September 2021 - Volume 116 - Issue 9 - p 1823
A Case of Large Duodenal Lymphangioma as Struggled to Diagnose Because of Well Localized Morphology
Masunaga, Teppei MD1; Nakayama, Atsushi MD, PhD1; Kato, Motohiko MD, PhD1
doi : 10.14309/ajg.0000000000001178
September 2021 - Volume 116 - Issue 9 - p 1824
Recurrent Lower Gastrointestinal Bleeding due to a Cholecystocolonic Fistula
Kraft, Cary MD1; Kim, Rebecca Greaves MD1; Kathpalia, Priya MD1
doi : 10.14309/ajg.0000000000001209
September 2021 - Volume 116 - Issue 9 - p 1825
Endoscopic Vacuum-Assisted Wound Closure of a Rectal Perforation in the Setting of Active Ulcerative Colitis
Slater, Nicholas R. MD1; Loomes, Dustin E. MD1
doi : 10.14309/ajg.0000000000001208
September 2021 - Volume 116 - Issue 9 - p 1826
Endoscopic Mucosal Resection With Double Band Ligation for Small Rectal Neuroendocrine Tumors
He, Long MM1; Wen, Wu MM2; Ye, Liansong MD1; Liao, Ke MS1; Hu, Bing MD1
doi : 10.14309/ajg.0000000000001302
September 2021 - Volume 116 - Issue 9 - p 1827-1828
CME Information
doi : 10.14309/ajg.0000000000001123
September 2021 - Volume 116 - Issue 9 - p 1829-1830
Continuing Medical Education Questions: September 2021
Aytaman, Ayse MD, FACG
doi : 10.14309/ajg.0000000000001418
September 2021 - Volume 116 - Issue 9 - p 1831
After this activity, the participant will be able to understand the initial evaluation of a patient with chronic hepatitis B infection and identify factors that impact surveillance and follow up of patients with chronic hepatitis B infection.
Continuing Medical Education Questions: September 2021
Park, James S. MD
doi : 10.14309/ajg.0000000000001419
September 2021 - Volume 116 - Issue 9 - p 1832
Identify the factors associated with increased in-hospital mortality and indications for early liver transplant evaluation in patients of Budd-Chiari Syndrome.
Fibrosis-4 Index vs Nonalcoholic Fatty Liver Disease Fibrosis Score in Identifying Advanced Fibrosis in Subjects With Nonalcoholic Fatty Liver Disease: A Meta-Analysis
Castellana, Marco MD1; Donghia, Rossella BSc1; Guerra, Vito BSc1; Procino, Filippo PhD1; Castellana, Fabio BSc1; Zupo, Roberta BSc1; Lampignano, Luisa BSc1; Sardone, Rodolfo PhD1; De Pergola, Giovanni PhD1,2; Romanelli, Francesco PhD3; Trimboli, Pierpaolo MD4,5; Giannelli, Gianluigi MD6
doi : 10.14309/ajg.0000000000001337
September 2021 - Volume 116 - Issue 9 - p 1833-1841
In subjects with nonalcoholic fatty liver disease (NAFLD), advanced fibrosis (AF) carries the highest risk of adverse liver-related events. To reduce the number of unnecessary biopsies, several noninvasive tools (NITs) for the risk stratification of fibrosis have been developed. We conducted this meta-analysis to assess the performance of the fibrosis-4 index (FIB-4) and NAFLD fibrosis scores (NFS), the 2 most common NITs, for the appropriate selection of subjects with AF for biopsy.
A Deep Ravine Rather Than a Shallow Gap: Many More Bridges Needed to Improve Care of Chronic Hepatitis B in the United States
Schaefer, Esperance A. K. MD, MPH1
doi : 10.14309/ajg.0000000000001364
September 2021 - Volume 116 - Issue 9 - p 1842-1843
In the United States, improved screening of those who are at highest risk of chronic hepatitis B (CHB) has been a major focus of public health efforts, as has facilitating access to care for those with chronic infection. Despite this, data suggest that less than half of those at risk are tested, and another minority of those who harbor chronic infection receive longitudinal care for the disease. In this study by Tran et al., the authors find that even among those being treated for CHB, a vast minority receive basic testing and screening for staging and complications of CHB.
Population Attributable Risks of Subtypes of Esophageal and Gastric Cancers in the United States
Wang, Shao-Ming PhD1,2; Katki, Hormuzd A. PhD3; Graubard, Barry I. PhD3; Kahle, Lisa L. BS4; Chaturvedi, Anil PhD5; Matthews, Charles E. PhD2; Freedman, Neal D. PhD2; Abnet, Christian C. PhD2
doi : 10.14309/ajg.0000000000001355
September 2021 - Volume 116 - Issue 9 - p 1844-1852
To help target preventive strategies, we estimated US population attributable risks (PARs) of demographic and potentially modifiable risk factors for esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), gastric cardia adenocarcinoma (GCA), and gastric noncardia adenocarcinoma (GNCA).
Cap-Assisted Endoscopic Septotomy of Zenker's Diverticulum: Early and Long-Term Outcomes
Repici, Alessandro MD1,2; Cappello, Annalisa MD1,2; Spadaccini, Marco MD1,2; Nicoletti, Rosangela MD1; Carrara, Silvia MD1; Fugazza, Alessandro MD1; Galtieri, Piera Alessia MD1; Lamonaca, Laura MD1,2; Romana, Chiara MD1,2; Badalamenti, Matteo MD2; Di Leo, Milena MD1; Pellegatta, Gaia MD1; Ferrara, Elisa Chiara MD1; Anderloni, Andrea MD, PhD1; Maselli, Roberta MD, PhD1
doi : 10.14309/ajg.0000000000001356
September 2021 - Volume 116 - Issue 9 - p 1853-1858
Multiple therapeutic modalities including surgery and rigid and flexible endoscopy have been adopted to manage Zenker's diverticulum (ZD). Minimally invasive flexible endoscopic septotomy (FES) techniques have been increasingly favored over the past 20 years; however, long-term data are still scanty. The aim of this study is to evaluate early and long-term outcomes of FES for naive ZD in a single-center setting.
Pseudopyloric Metaplasia Is Not Associated With the Development of Gastric Cancer
Dilaghi, Emanuele MD1; Baldaro, Francesca MD1; Pilozzi, Emanuela MD2; Conti, Laura MD1; Palumbo, Antonio MD2; Esposito, Gianluca MD, PhD1; Annibale, Bruno MD1; Lahner, Edith MD, PhD1
doi : 10.14309/ajg.0000000000001390
September 2021 - Volume 116 - Issue 9 - p 1859-1867
Corpus atrophic gastritis (CAG) is associated with intestinal metaplasia (IM) and pseudopyloric metaplasia (PPM). Prospective data on corpus mucosa PPM and its link to the development of gastric cancer (GC) are lacking. This study aimed to investigate the relationship between the presence of corpus mucosa PPM at baseline and the development of GC at follow-up in patients with CAG.
Bleeding Risk and Mortality Associated With Uninterrupted Antithrombotic Therapy During Percutaneous Endoscopic Gastrostomy Tube Placement
Thosani, Nirav MD, MHA1; Rashtak, Shahrooz MD1; Kannadath, Bijun Sai MBBS, MS2; Munjal, Akhil MD1; Meriwether, Matthew MD1; Yoon, Eric D. MD1; Hermann, Andrew MD1; Ali, Sara MD1; Haddad, Paul G. MD1; Patil, Prithvi MS1; Ramireddy, Srinivas MD1; Badillo, Ricardo MD1; DaVee, R. Tomas MD1; Guha, Sushovan MD, PhD1
doi : 10.14309/ajg.0000000000001348
September 2021 - Volume 116 - Issue 9 - p 1868-1875
Antithrombotic therapy is often interrupted before the placement of a percutaneous endoscopic gastrostomy (PEG) tube because of potentially increased risk of hemorrhagic events. The aim of our study was to evaluate the risk of bleeding events and overall complication rates after PEG in patients on uninterrupted antiplatelet and anticoagulation therapy in a high-volume center.
Survey Finds Gender Disparities Impact Both Women Mentors and Mentees in Gastroenterology
Rabinowitz, Loren Galler MD1; Grinspan, Lauren Tal MD, PhD2; Zylberberg, Haley M. MD3; Dixon, Rebekah BA1; David, Yakira N. MD1; Aroniadis, Olga C. MD, MSc4; Chiang, Austin MD, MPH5; Christie, Jennifer MD, FASGE6; Fayad, Nabil F. MD, FACG7; Ha, Christina MD8; Harris, Lucinda A. MD9; Ko, Cynthia W. MD, MS10; Kolb, Jennifer MD11; Kwah, Joann MD12; Lee, Linda MD13; Lieberman, David MD14; Raffals, Laura E. MD15; Rex, Douglas K. MD7; Shah, Shailja C. MD, MPH16,17; Siddiqui, Uzma D. MD17; Smith, Michael S. MD, MBA3; Wallace, Michael MD19; Williams, Renee MD, MHPE12; Woods, Karen MD20; Crowe, Sheila E. MD21; Kumta, Nikhil A. MD, MS1; Kim, Michelle Kang MD, PhD1; Greenwald, David A. MD, FACG1
doi : 10.14309/ajg.0000000000001341
September 2021 - Volume 116 - Issue 9 - p 1876-1884
Gastroenterologists at all levels of practice benefit from formal mentoring. Much of the current literature on mentoring in gastroenterology is based on expert opinion rather than data. In this study, we aimed to identify gender-related barriers to successful mentoring relationships from the mentor and mentee perspectives.
Initial Evaluation, Long-Term Monitoring, and Hepatocellular Carcinoma Surveillance of Chronic Hepatitis B in Routine Practice: A Nationwide US Study
Tran, Sally BS1; Jeong, Donghak MS1; Henry, Linda PhD1; Cheung, Ramsey C. MD1,2; Nguyen, Mindie H. MD, MAS1
doi : 10.14309/ajg.0000000000001271
September 2021 - Volume 116 - Issue 9 - p 1885-1895
Previous studies, mostly small and single center, have shown gaps in the evaluation and monitoring of patients with chronic hepatitis B (CHB) virus infection. We aimed to examine the rates and predictors of adherence to guidelines for CHB care in a large nationwide cohort.
High Sustained Virologic Response Rates of Glecaprevir/Pibrentasvir in Patients With Dosing Interruption or Suboptimal Adherence
Zamor, Philippe J. MD1; Brown, Ashley MD2; Dylla, Douglas E. PhD3; Dillon, John F. MD4; Luetkemeyer, Anne F. MD5; Feld, Jordan J. MD6; Mutimer, David MD7; Ghalib, Reem MD8; Crown, Eric PhD3; Lovell, Sandra S. PhD3; Hu, Yiran PhD3; Moreno, Christophe MD9; Nelson, David R. MD10; Colombo, Massimo MD11; Papatheodoridis, Georgios MD, PhD12; Rockstroh, Juergen K. MD13; Skoien, Richard MBBS, PhD14; Lawitz, Eric MD15; Jacobson, Ira M. MD16
doi : 10.14309/ajg.0000000000001332
September 2021 - Volume 116 - Issue 9 - p 1896-1904
Pangenotypic, all-oral direct-acting antivirals, such as glecaprevir/pibrentasvir (G/P), are recommended for treatment of hepatitis C virus (HCV) infection. Concerns exist about the impact on efficacy in patients with suboptimal adherence, particularly with shorter treatment durations. These post hoc analyses evaluated adherence (based on pill count) in patients prescribed 8- or 12-week G/P, the impact of nonadherence on sustained virologic response at post-treatment week 12 (SVR12), factors associated with nonadherence, and efficacy in patients interrupting G/P treatment.
A Scoring Model to Predict In-Hospital Mortality in Patients With Budd–Chiari Syndrome
Thuluvath, Paul J. MD, FRCP1,2; Alukal, Joseph J. MD1; Zhang, Talan MS1
doi : 10.14309/ajg.0000000000001273
September 2021 - Volume 116 - Issue 9 - p 1905-1912
A model that can predict short-term mortality in patients with the Budd–Chiari syndrome (BCS) with a high degree of accuracy is currently lacking. The primary objective of our study was to develop an easy-to-use in-hospital mortality prediction model in patients with BCS using easily available clinical variables.
Ursodeoxycholic Acid Response Is Associated With Reduced Mortality in Primary Biliary Cholangitis With Compensated Cirrhosis
John, Binu V. MD, MPH1; Khakoo, Nidah S. MD2; Schwartz, Kaley B. BS1; Aitchenson, Gabriella MD2; Levy, Cynthia MD3; Dahman, Bassam PhD4; Deng, Yangyang MS4; Goldberg, David S. MD3; Martin, Paul MD3; Kaplan, David E. MD5,6; Taddei, Tamar H. MD7,8
doi : 10.14309/ajg.0000000000001280
September 2021 - Volume 116 - Issue 9 - p 1913-1923
Patients with cirrhosis and men have been under-represented in most studies examining the clinical benefit of response to ursodeoxycholic acid (UDCA) in primary biliary cholangitis (PBC). The aim of this study was to study the association of UDCA response and liver-related death or transplantation, hepatic decompensation, and hepatocellular carcinoma (HCC) in patients with PBC cirrhosis.
Ledipasvir/Sofosbuvir for 8, 12, or 24 Weeks in Hepatitis C Patients Undergoing Dialysis for End-Stage Renal Disease
Chuang, Wan-Long MD1; Hu, Tsung-Hui MD2; Buggisch, Peter MD3; Moreno, Christophe MD4; Su, Wei-Wen MD5; Biancone, Luigi MD6; Camargo, Marianne MD7; Hyland, Robert DPhil7; Lu, Sophia PhD7; Kirby, Brian J. PhD7; Dvory-Sobol, Hadas PhD7; Osinusi, Anu MD7; Gaggar, Anuj MD7; Peng, Cheng-Yuan MD8; Liu, Chen-Hua MD9; Sise, Meghan E. MD10; Mangia, Alessandra MD11
doi : 10.14309/ajg.0000000000001281
September 2021 - Volume 116 - Issue 9 - p 1924-1928
We evaluated 8, 12, or 24 weeks of ledipasvir/sofosbuvir in patients with hepatitis C virus and end-stage renal disease undergoing dialysis.
Efficacy of Linaclotide in Reducing Abdominal Symptoms of Bloating, Discomfort, and Pain: A Phase 3B Trial Using a Novel Abdominal Scoring System
Chang, Lin MD1; Lacy, Brian E. MD, PhD2; Moshiree, Baha MD, MSc3; Kassebaum, Amy PA-C, MMS, RD4; Abel, Jessica L. MPH5; Hanlon, Jennifer MPH6; Bartolini, Wilmin PhD7; Boinpally, Ramesh PhD5; Bochenek, Wieslaw MD8; Fox, Susan M. PhD5; Mallick, Madhuja PhD5; Tripp, Ken PhD6,9; Omniewski, Nicholas MPH7; Shea, Elizabeth PhD7; Borgstein, Niels MD6
doi : 10.14309/ajg.0000000000001334
September 2021 - Volume 116 - Issue 9 - p 1929-1937
Linaclotide improves abdominal pain and constipation in patients with constipation-predominant irritable bowel syndrome (IBS-C). Patients report additional bothersome abdominal symptoms of bloating and discomfort. The intention of this study was to evaluate linaclotide's efficacy in relieving IBS-C-related abdominal symptoms (bloating, discomfort, and pain) using a novel multi-item Abdominal Score (AS).
Postoperative Hospital Outcomes of Elective Surgery for Nonmalignant Colorectal Polyps: Does the Burden Justify the Indication?
doi : 10.14309/ajg.0000000000001374
September 2021 - Volume 116 - Issue 9 - p 1938-1945
Despite the increasing availability of advanced endoscopic resections and its favorable safety profile, surgery for nonmalignant colorectal polyps has continually increased. We sought to evaluate readmission rates and outcomes of elective surgery for nonmalignant colorectal polyps on a national level in the United States.
Benchmarking Adenoma Detection Rates for Colonoscopy: Results From a US-Based Registry
Shaukat, Aasma MD, MPH1,2; Holub, Jennifer MPH3; Pike, Irving M. MD4; Pochapin, Mark MD5; Greenwald, David MD6; Schmitt, Colleen MD, MHS7; Eisen, Glenn MD, MPH8
doi : 10.14309/ajg.0000000000001358
September 2021 - Volume 116 - Issue 9 - p 1946-1949
Adenoma detection rate (ADR) is highly variable across practices, and national or population-based estimates are not available. Our aim was to study the ADR, variability of rates over time, and factors associated with detection rates of ADR in a national sample of patients undergoing colonoscopy.
Hepatic Encephalopathy is Associated With Slow Speech on Objective Assessment
Bloom, Patricia P. MD1; Robin, Jessica PhD2; Xu, Mengdan MSc2; Arvind, Ashwini MBBS3; Daidone, Michael BA4; Gupta, Anoopum S. MD, PhD5; Chung, Raymond T. MD4
doi : 10.14309/ajg.0000000000001351
September 2021 - Volume 116 - Issue 9 - p 1950-1953
There are no available low-burden, point-of-care tests to diagnose, grade, and predict hepatic encephalopathy (HE).
Current Challenges in Fecal Microbiota Transplantation for Clostridioides difficile Infection in Children
Nicholson, Maribeth R. MD, MPH1; Hourigan, Suchitra K. MD2; Conrad, Maire MD3; Goyal, Alka MD4; Jensen, Kyle MD5; Kelsen, Judith MD3; Kennedy, Melissa MD3; Weatherly, Madison BA6; Kahn, Stacy A. MD6
doi : 10.14309/ajg.0000000000001350
September 2021 - Volume 116 - Issue 9 - p 1954-1956
The impact of the 2019 US Food and Drug Administration safety alert involving transmission of multidrug resistant organisms through fecal microbiota transplantation (FMT), and the COVID-19 pandemic on the use of FMT in children, is unknown.
Electro-Acupuncture vs Prucalopride for Severe Chronic Constipation: Aiming for Excellence in Mediocrity?
Philips, Cyriac Abby MD, DM1,2; Abraham, Libin MD2,3
doi : 10.14309/ajg.0000000000001361
September 2021 - Volume 116 - Issue 9 - p 1957
Response to Philips and Abraham
Sun, Yuanjie MD1; Liu, Zhishun MD, PhD1
doi : 10.14309/ajg.0000000000001383
September 2021 - Volume 116 - Issue 9 - p 1958-1959
5-ASAs Combined With a Biologic or Tofacitinib: Predetermined Cost-Effectiveness?
Tetangco, Eula Plana MD, MPH1; Hanauer, Stephen B. MD1
doi : 10.14309/ajg.0000000000001296
September 2021 - Volume 116 - Issue 9 - p 1958-1959
Response to Tetangco and Hanauer
Shaffer, Seth R. MD, MS1,2,3; Rubin, David T. MD1
doi : 10.14309/ajg.0000000000001330
September 2021 - Volume 116 - Issue 9 - p 1959-1960
Future Endoscopy-Related Injuries Will Be of Different Types and Gender-Equal
Marlicz, Wojciech MD, PhD, DSc1; Koulaouzidis, Anastasios MD, DM, PhD2; Koulaouzidis, George MD, PhD3
doi : 10.14309/ajg.0000000000001308
September 2021 - Volume 116 - Issue 9 - p 1960-1961
Response to Marlicz et al.
Pawa, Swati MD1,2; Oxentenko, Amy S. MD3; Burke, Carol A. MD4
doi : 10.14309/ajg.0000000000001360
September 2021 - Volume 116 - Issue 9 - p 1961-1963
Endoscopic-Refractory Bleeding From Radiation-Associated Gastrointestinal Vascular Injury Resolved With Bevacizumab
O'Grady, John MD, MRCPI1; Fennessy, Anne MB, MRCPI1; Abdelmoeti, Mahmoud MRCS2; O'Suilleabhain, Criostoir MD, FRCSI2; Buckley, Martin MB, FRCPI1
doi : 10.14309/ajg.0000000000001283
September 2021 - Volume 116 - Issue 9 - p 1961-1963
Elevated Liver Enzymes Secondary to Early Second Trimester HELLP Syndrome (Hemolysis, Elevated Liver Enzymes, Low Platelet Count)
Spartz, Ellen BS1; Sarwar, Raiya MD2; Jacobs, Katherine DO3; Thomson, Mary MD, MSc2
doi : 10.14309/ajg.0000000000001288
September 2021 - Volume 116 - Issue 9 - p 1963-1964
Greenspace in Childhood: A New Avenue to Prevent Inflammatory Bowel Disease?
Teich, Niels MD1,2; Stallmach, Andreas MD2,3; Bruns, Tony MD4
doi : 10.14309/ajg.0000000000001300
September 2021 - Volume 116 - Issue 9 - p 1964-1965
Calendar of Courses, Symposiums and Conferences
doi : 10.14309/ajg.0000000000001483
September 2021 - Volume 116 - Issue 9 - p 1966-1967
Correction to: Probiotics for Celiac Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Seiler, Caroline L. BSc1; Kiflen, Michel MSc2; Stefanolo, Juan Pablo MD3; Bai, Julio César MD3; Bercik, Premysl MD1; Kelly, Ciaran P. MD4; Verdu, Elena F. MD, PhD1; Moayyedi, Paul BSc, MB ChB, PhD, MPH, FRCP (London), FRCPC, FACG, AGAF1; Pinto-Sanchez, Maria Ines MD, MSc, CNSC1
doi : 10.14309/ajg.0000000000001371
September 2021 - Volume 116 - Issue 9 - p 1968
