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Am J Gastroenterol 2020 Jun 29. Epub 2020 Jun 29.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.

Am J Gastroenterol 2020 Jun 23. Epub 2020 Jun 23.

Mayo Clinic, Jacksonville, Florida, USA.

Am J Gastroenterol 2020 Jun 23. Epub 2020 Jun 23.

Humamitas Huniversity, Pieve Emanuele (MI), Italy.

Am J Gastroenterol 2020 Jun 11. Epub 2020 Jun 11.

Division of Gastroenterology and Hepatology, Department of Medicine, Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Rochester, Minnesota, USA.

Bile acids (BAs) are the central signals in enterohepatic communication, and they also integrate microbiota-derived signals into enterohepatic signaling. The tissue distribution and signaling pathways activated by BAs through natural receptors, farsenoid X receptor and G protein-coupled BA receptor 1 (GPBAR1, also known as Takeda G-coupled receptor 5), have led to a greater understanding of the mechanisms and potential therapeutic agents. BA diarrhea is most commonly encountered in ileal resection or disease, in idiopathic disorders (with presentation similar to functional diarrhea or irritable bowel syndrome with diarrhea), and in association with malabsorption such as chronic pancreatitis or celiac disease. Read More

Am J Gastroenterol 2020 Jun 11. Epub 2020 Jun 11.

Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

Introduction: Esophageal dysmotility including features of achalasia may develop because of bariatric surgery. However, the prevalence of these complications is unknown. We sought to define the prevalence of dysphagia and major esophageal motility disorders including achalasia after bariatric surgery through a large retrospective database review. Read More

Am J Gastroenterol 2020 Jun 16. Epub 2020 Jun 16.

Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Am J Gastroenterol 2020 Jun 16. Epub 2020 Jun 16.

Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.

Objective: Diagnosed celiac disease (CD) is associated with lymphoproliferative malignancy and gastrointestinal cancer, but little is known about the long-term consequences of undiagnosed CD. We aimed to investigate long-term consequences of undiagnosed CD for mortality and incidence of cancer and other chronic diseases.

Methods: We screened biobank serum samples for immunoglobulin (Ig) A and IgG tissue transglutaminase (TTG) and IgG deamidated gliadin peptide in a study of 8 population-based cohort studies comprising 16,776 participants examined during 1976-2012 and followed with >99% complete follow-up in Danish nationwide registries until December 31, 2017, regarding vital status and incidence of diseases. Read More

Am J Gastroenterol 2020 Jun 16. Epub 2020 Jun 16.

University of Nevada, Reno School of Medicine, Reno, Nevada, USA.

Am J Gastroenterol 2020 Jun 15. Epub 2020 Jun 15.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester Minnesota, USA.

Introduction: Nonendoscopic Barrett's esophagus (BE) screening may help improve esophageal adenocarcinoma outcomes. We previously demonstrated promising accuracy of methylated DNA markers (MDMs) for the nonendoscopic diagnosis of BE using samples obtained from a capsule sponge-on-string (SOS) device. We aimed to assess the accuracy of these MDMs in an independent cohort using a commercial grade assay. Read More

Am J Gastroenterol 2020 Jun 15. Epub 2020 Jun 15.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA.

Am J Gastroenterol 2020 Jun 15. Epub 2020 Jun 15.

Division of Gastroenterology, Washington University School of Medicine, Barnes Jewish Hospital, St. Louis, Missouri, USA.

Am J Gastroenterol 2020 Jun 17. Epub 2020 Jun 17.

Department of Medicine, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, Virginia, USA.

Introduction: Numerous guidelines exist for the management of pancreatic cysts. We sought to compare the guideline-directed management strategies for pancreatic cysts by comparing 2 approaches (2017 International Consensus Guidelines and 2015 American Gastroenterological Association Guidelines) that differ significantly in their thresholds for imaging, surveillance, and surgery.

Methods: We developed a Monte Carlo model to evaluate the outcomes for a cohort of 10,000 patients managed per each guideline. Read More

Am J Gastroenterol 2020 Jun 9. Epub 2020 Jun 9.

Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA.

Objectives: The value of hepatocellular carcinoma (HCC) surveillance is defined by the balance of benefits, i.e., early tumor detection, and potential harms, related to false positive and indeterminate results. Read More

Am J Gastroenterol 2020 Jun 9. Epub 2020 Jun 9.

Yale School of Medicine, New Haven, Connecticut, USA.

Risk assessment tools for patients with gastrointestinal bleeding may be used for determining level of care and informing management decisions. Development of models that use data from electronic health records is an important step for future deployment of such tools in clinical practice. Furthermore, machine learning tools have the potential to outperform standard clinical risk assessment tools. Read More

Am J Gastroenterol 2020 Jun 9. Epub 2020 Jun 9.

Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA.

Am J Gastroenterol 2020 Jun 9. Epub 2020 Jun 9.

Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.

Am J Gastroenterol 2020 Jun 9. Epub 2020 Jun 9.

Department of Gastroenterology, Hepatology and Nutrition, the University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Am J Gastroenterol 2020 Jun 4. Epub 2020 Jun 4.

Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, China.

Am J Gastroenterol 2020 Jun 4. Epub 2020 Jun 4.

Division of Gastroenterology, Hepatology and Clinical Nutrition, Saint Peter's University Hospital, New Brunswick, New Jersey, USA.

Gastrointestinal symptoms are common and frequently reported in Coronavirus Disease-2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is unclear if SARS-CoV-2 is associated with increased risk of gastrointestinal bleeding (GIB). Nevertheless, GIB in COVID-19 patients poses unique challenges to patients due to high-risk of concomitant respiratory failure and to endoscopy personnel due to risk of airborne transmission during endoscopic procedures. Read More

Am J Gastroenterol 2020 Jun 8. Epub 2020 Jun 8.

University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, Illinois, USA.

Am J Gastroenterol 2020 Jun 8. Epub 2020 Jun 8.

Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India.

Introduction: Both transient elastography (TE)-based and non-TE-based criteria exist for detection of varices needing treatment (VNT) in patients with asymptomatic advanced chronic liver disease (CLD). However, their performance in clinical settings at different risk thresholds of detection of VNT and in regions where elastography is not widely available is unknown. We aimed to validate existing noninvasive criteria in our patients with CLD and identify best TE- and non-TE-based criteria for VNT screening at usual risk thresholds. Read More

Am J Gastroenterol 2020 Jun 8. Epub 2020 Jun 8.

Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, China.

Am J Gastroenterol 2020 06;115(6):942-946

Department of Internal Medicine, St. Joseph Mercy Health System, Ann Arbor, Michigan, USA.

Am J Gastroenterol 2020 Jun;115(6):934-940

Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.

Introduction: The benefit of indomethacin suppositories for prophylaxis against post-ERCP pancreatitis (PEP) in high-risk patients was established in a landmark trial published in 2012. The aims of this study were to measure the adoption of indomethacin prophylaxis in widespread clinical practice, evaluate concurrent trends in pancreatic duct (PD) stent utilization, and estimate the impact of these changes on PEP in a high-risk population.

Methods: Data were extracted from a commercial database (Explorys, IBM Watson Health, Somers, NY) that aggregates electronic health records from 26 US healthcare systems from 2009 to 2018. Read More

Am J Gastroenterol 2020 Jun 3. Epub 2020 Jun 3.

Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA.

Introduction: Higher levels of thyroid-stimulating hormone (TSH) in the euthyroid state can negatively affect the metabolic health, including nonalcoholic fatty liver disease (NAFLD). We studied the effect of TSH levels in the setting of normal levels of thyroid hormone on all-cause and cause-specific mortality stratified by NAFLD status.

Methods: The National Health and Nutrition Examination Survey (NHANES) III from 1988 to 1994 and NHANES III-linked mortality data through 2015 were used. Read More

Am J Gastroenterol 2020 Jun 3. Epub 2020 Jun 3.

Division of Gastroenterology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

Advanced adenomas represent a subset of colorectal polyps that are known to confer an increased risk of colorectal neoplasia to the affected individual and their first-degree relatives (FDRs). Accordingly, professional guidelines suggest earlier and more intensive screening for FDRs of those with advanced adenomas similar to FDRs of those with colorectal cancer (CRC). Although the risk to family members is less clear among patients with advanced serrated polyps, they are often considered in the same category. Read More

Am J Gastroenterol 2020 Jun 3. Epub 2020 Jun 3.

Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.

Am J Gastroenterol 2020 Jun 3. Epub 2020 Jun 3.

Harvard Medical School, Boston, Massachusetts, USA.

Introduction: Although coronavirus disease (COVID-19) has been associated with gastrointestinal manifestations, its effect on the pancreas remains unclear. We aimed to assess the frequency and characteristics of hyperlipasemia in patients with COVID-19.

Methods: A retrospective cohort study of hospitalized patients across 6 US centers with COVID-19. Read More

Am J Gastroenterol 2020 Jun;115(6):813

Article Title: Approach to the Post-Ablation Barrett's Esophagus Patient. Read More

Am J Gastroenterol 2020 Jun;115(6):812

Article Title: Effect of Lifestyle Factors on Outcomes in Patients with Inflammatory Bowel Diseases. Read More

Am J Gastroenterol 2020 May 28. Epub 2020 May 28.

Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC, USA.

Introduction: Limited data inform the current postpolypectomy surveillance guidelines, which suggest a shortened interval to third colonoscopy after a negative second examination if high-risk adenomas (HRA) were present on the initial screening colonoscopy. Therefore, we examined the risk of HRA at third colonoscopy stratified by findings on 2 previous examinations in a prospective screening colonoscopy cohort of US veterans.

Methods: We identified participants who had 3 or more colonoscopies from CSP#380. Read More

Am J Gastroenterol 2020 May 28. Epub 2020 May 28.

University of Washington, Seattle, Washington, USA.

Introduction: Health systems often emphasize technical skills to reduce iatrogenic injuries. Nontechnical skills such as clinical and communication skills are mostly overlooked or not readily retrievable from medical records. Our aim was to estimate the association of technical and nontechnical skills of endoscopists with indemnity payments to patients after endoscopic perforations. Read More

Am J Gastroenterol 2020 May 28. Epub 2020 May 28.

Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Introduction: Data on the associations between esophageal histological lesions and risk of esophageal squamous cell carcinoma (ESCC) in general populations are limited. We aimed to investigate these associations in a large Chinese general population to inform future Chinese ESCC screening guidelines.

Methods: We performed endoscopic screening of 21,111 participants aged 40-69 years from 3 high-risk areas of China in 2005-2009, and followed the cohort through 2016. Read More

Am J Gastroenterol 2020 May 28. Epub 2020 May 28.

Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri.

Am J Gastroenterol 2020 May 28. Epub 2020 May 28.

Division of Gastroenterology and Hepatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Am J Gastroenterol 2020 Jun 1. Epub 2020 Jun 1.

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Introduction: Elevated liver enzyme levels are observed in patients with coronavirus disease 2019 (COVID-19); however, these features have not been characterized.

Methods: Hospitalized patients with COVID-19 in Zhejiang Province, China, from January 17 to February 12, 2020, were enrolled. Liver enzyme level elevation was defined as alanine aminotransferase level >35 U/L for men and 25 U/L for women at admission. Read More

Am J Gastroenterol 2020 Jun 1. Epub 2020 Jun 1.

Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.

Every year approximately 750,000 cholecystectomies are performed in the United States, most of those are performed laparoscopically. Postcholecystectomy complications are not uncommon and lead to increased morbidity and financial burden. Some of the most commonly encountered complications with laparoscopic cholecystectomy include biliary injury (0. Read More

Am J Gastroenterol 2020 Jun 1. Epub 2020 Jun 1.

Division of Gastroenterology and Hepatology, New York University Langone Health, New York, New York, USA.

Chronic hepatitis B virus (HBV) infection represents a major global health problem, affecting an estimated 257-291 million persons worldwide and is associated with substantial morbidity and mortality because of clinical complications, such as liver cirrhosis and hepatocellular carcinoma. Despite existing resources for vaccination, screening, and treatment, the burden of chronic HBV remains significant within the United States (US). Both the World Health Organization (WHO) and US Department of Health and Human Services (DHHS) have articulated formal hepatitis elimination plans, although an updated assessment of the epidemiology and prevalence of chronic HBV is needed to inform these initiatives. Read More

Am J Gastroenterol 2020 May 27. Epub 2020 May 27.

The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, USA.

Am J Gastroenterol 2020 May 27. Epub 2020 May 27.

Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University College of Medicine, Columbus, Ohio, USA.

Am J Gastroenterol 2020 May 27. Epub 2020 May 27.

Liver Unit, Hospital Clínic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.

Objectives: Antibodies to hexokinase 1 (HK1) and kelch-like 12 (KLHL12) have been identified as potential biomarkers in primary biliary cholangitis (PBC), and this study assesses changes of these antibodies over time and if they are associated with clinical outcomes.

Methods: Two hundred fifty-four PBC patients (93.3% female, 51 ± 12. Read More

Am J Gastroenterol 2020 May 27. Epub 2020 May 27.

Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, MI, USA.

Introduction: There is increasing recognition of the central role of muscle mass in predicting clinical outcomes in patients with liver disease. Muscle size can be extracted from computed tomography (CT) scans, but clinical implementation will require increased automation. We hypothesize that we can achieve this by using artificial intelligence. Read More

Am J Gastroenterol 2020 May 27. Epub 2020 May 27.

Equipe de Recherche en épidémiologie nutritionnelle (EREN), Université Paris 13, Inserm U1153, Inra U1125, Cnam, CRESS, Bobigny, France.

Introduction: This study aimed to assess the association between incident Crohn's disease (CD) or incident ulcerative colitis (UC) and dietary zinc intake.

Methods: NutriNet-Santé cohort's participants who completed at least three 24-hour dietary records were included and incident CD or UC cases were identified. Multivariable Poisson models were performed to assess associations between tertiles of zinc intake and CD or UC. Read More

Am J Gastroenterol 2020 May 27. Epub 2020 May 27.

Department of Gastroenterology, Daping Hospital, Army Medical University, Chongqing, China.

Am J Gastroenterol 2020 May 27. Epub 2020 May 27.

Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, U.O.C. Medicina Generale Emostasi e Trombosi, University of Milan, Milan, Italy.

Am J Gastroenterol 2020 May 27. Epub 2020 May 27.

Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.

Introduction: The risk of liver injury in patients with atrial fibrillation (AF) using nonvitamin K antagonist oral anticoagulants (NOACs) has not been previously examined using liver function tests as the primary outcome in the real-world setting. This study assessed the association between NOACs (dabigatran, rivaroxaban, and apixaban) and warfarin and the risk of liver injury, as defined by laboratory tests.

Methods: Patients newly diagnosed with AF and prescribed NOACs or warfarin between 2010 and 2016, identified using the Hong Kong Clinical Database and Reporting System, were matched on age, sex, health status scores, comorbidities, and medications by propensity score on a 1:1 ratio. Read More

Am J Gastroenterol 2020 May 21. Epub 2020 May 21.

Department of Hepatology, Institute of Liver & Biliary Sciences, New Delhi, India.

Objectives: Hepatic venous pressure gradient (HVPG) of ≥10 mm Hg predicts clinical decompensation (CD) in compensated cirrhosis. A proportion of cirrhotic patients at presentation have high HVPG (≥20 mm Hg) and are compensated. The natural history, spectrum of CD, and mortality in this group is largely unknown. Read More

Am J Gastroenterol 2020 May 21. Epub 2020 May 21.

Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), Heidelberg, Germany.

Introduction: Diabetes mellitus (DM) and colorectal cancer (CRC) share some risk factors, including lifestyle and metabolic disturbances. We aimed to provide in-depth information on the association of CRC risk, especially early-onset CRC, with DM, family history of CRC, and age at DM diagnosis.

Methods: A nationwide cohort study was conducted using Swedish family cancer data sets, inpatient, and outpatient registers (follow-up: 1964-2015), including all individuals born after 1931 and their parents (12,614,256 individuals; 559,375 diabetic patients; 162,226 CRC patients). Read More

Am J Gastroenterol 2020 May 21. Epub 2020 May 21.

Division of Gastroenterology, Mount Sinai Hospital, Chicago, Illinois, USA.

Am J Gastroenterol 2020 06;115(6):947-948

Division of Gastroenterology and Hepatology, William Beaumont Hospital, Royal Oak, Michigan, USA.