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Am J Gastroenterol 2019 Apr 17. Epub 2019 Apr 17.

IRCCS San Raffaele Scientific Institute, Milan, Italy.

Am J Gastroenterol 2019 Apr 17. Epub 2019 Apr 17.

VA San Diego Healthcare System, and University of California San Diego, San Diego, California, USA.

Two persistent problems confront anyone wishing to gauge the public-health cost and impact of hemorrhoids. First, there is the slipperiness of the term "hemorrhoids," which both patients and physicians use with imprecision. Second, there is endoscopic over-diagnosis of prominent anal cushions as internal hemorrhoids. Read More

Am J Gastroenterol 2019 Apr 17. Epub 2019 Apr 17.

Department of Internal Medicine, Universidad de La Sabana, Bogotá DC, Colombia.

Am J Gastroenterol 2019 Apr 17. Epub 2019 Apr 17.

Department of Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tübingen, Germany.

Objectives: Accumulating evidence indicates that the gut microbiota communicates with the central nervous system, possibly through neural, endocrine, and immune pathways, and influences brain function. B. longum 1714™ has previously been shown to attenuate cortisol output and stress responses in healthy subjects exposed to an acute stressor. Read More

Am J Gastroenterol 2019 Apr 11. Epub 2019 Apr 11.

Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Am J Gastroenterol 2019 Apr 11. Epub 2019 Apr 11.

Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Am J Gastroenterol 2019 Apr 12. Epub 2019 Apr 12.

Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

HIV and hepatitis B virus (HBV) share routes of transmission, and coinfection is associated with higher levels of HBV DNA, accelerated fibrosis progression, and increased liver-related events compared with those with HBV alone. The full spectrum of hepatic histology has not been recently addressed, in part because of the decreasing use of liver biopsy in clinical practice. The current study provides a modern "snapshot" of biopsy data from 114 HIV/HBV coinfected individuals, elucidating the degree of liver fibrosis years into the effective antiretroviral era and also revealing that hepatic steatosis was a frequent finding. Read More

Am J Gastroenterol 2019 Apr 12. Epub 2019 Apr 12.

The Ohio State University Inflammatory Bowel Disease Center, Columbus, Ohio, USA.

The growing need for transitional care is quickly becoming apparent in the medical community because children with chronic illnesses are surviving into adulthood. Transitional care is the coordinated movement of young adults with chronic conditions from the pediatric to adult health care setting. This transition period is associated with poorer health outcomes due to differences in pediatric and adult health care models, reluctance to change providers, and transfer of disease ownership. Read More

Am J Gastroenterol 2019 Apr;114(4):556-559

Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom.

Nonalcoholic fatty liver disease and hypertension are closely related but there has been little genetic evidence to link them. In this issue, Musso et al. provide evidence that a common variant in AGTR1 (A1166C) is associated with both incident hypertension and nonalcoholic fatty liver disease, as well as nonalcoholic steatohepatitis, fibrosis, dyslipidemia, and insulin resistance. Read More

Am J Gastroenterol 2019 Apr;114(4):550

Department of Gastroenterology, Thumbay Hospital, Al Qusais, Dubai, United Arab Emirates.

Am J Gastroenterol 2019 Apr;114(4):552

Case Western Reserve University/Cleveland VAMC, Cleveland, OH.

To receive CME/MOC credit for this activity, please go to: http://acgjournalcme.gi.org/Article Title: Diagnosis and Treatment of Rumination Syndrome: A Critical Review. Read More

Am J Gastroenterol 2019 Apr;114(4):551

Johns Hopkins Bayview Medical Center, Baltimore, MD.

Article Title: The Clinician's Guide to Suspected Small Bowel Bleeding. Read More

Am J Gastroenterol 2019 Apr 4. Epub 2019 Apr 4.

Eastern Virginia Medical School, Norfolk, Virginia.

Am J Gastroenterol 2019 Apr 4. Epub 2019 Apr 4.

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

Am J Gastroenterol 2019 Apr 4. Epub 2019 Apr 4.

Section of Gastroenterology, Boston University Medical Center, Boston, Massachusetts, USA.

Objectives: Several single-nucleotide polymorphisms (SNPs) have been associated with Barrett's esophagus (BE) risk. In addition, environmental factors including smoking, alcohol consumption, and heartburn increase BE risk. However, data on potential interactions between these genetic and environmental factors on BE risk are scant. Read More

Am J Gastroenterol 2019 Apr 3. Epub 2019 Apr 3.

Am J Gastroenterol 2019 Apr 3. Epub 2019 Apr 3.

Gastroenterology Department, Álvaro Cunqueiro Hospital, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.

Am J Gastroenterol 2019 Apr;114(4):689-690

GI Division, Department of Medicine, Minneapolis, Minnesota, USA.

Am J Gastroenterol 2019 Mar 5. Epub 2019 Mar 5.

Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Medical School, Hebrew University Jerusalem, Israel.

Objectives: Despite encouraging data gathered in inflammatory bowel diseases (IBD) patients, Vedolizumabs' (VDZ) safety profile in pregnancy is not established.

Design: Data of 330 consecutive pregnancies with IBD was prospectively collected.

Results: Women with IBD were treated with: VDZ (n = 24), anti-tumor necrosis factors (n = 82) or conventional therapy (n = 224). Read More

Am J Gastroenterol 2019 Mar 26. Epub 2019 Mar 26.

College of Medicine, China Medical University, Taichung, Taiwan.

Am J Gastroenterol 2019 Apr;114(4):553-555

Division of Hepatology, Annette C. and Harold C. Simmons Transplant Institute, Baylor Scott & White All Saints Medical Center, Fort Worth, Texas, USA.

Spontaneous bacterial peritonitis (SBP) is associated with risk of acute on chronic liver failure (ACLF). Current guidelines recommend primary and secondary antibiotic prophylaxis for patients with cirrhosis and ascites who are at risk of a first episode and to prevent recurrence, respectively. Factors associated with prophylaxis failure leading to SBP, ACLF, and increased mortality are not well established. Read More

Am J Gastroenterol 2019 Mar 26. Epub 2019 Mar 26.

College of Medicine, China Medical University, Taichung, Taiwan.

Am J Gastroenterol 2019 Mar 26. Epub 2019 Mar 26.

Department of Medicine, Celiac Disease Center, Columbia University Medical Center, New York, NY, USA.

Introduction: Adherence to a gluten-free (GF) diet is the mainstay of therapy for celiac disease. Until now, those wishing to avoid gluten in restaurants had to rely on menu labels, word of mouth, intuition, and restaurant workers' advice, with a relative dearth of supporting data. We used crowd-sourced data from users of a portable gluten detection device to estimate rates of, and identify risk factors for, gluten contamination of supposed GF restaurant foods. Read More

Am J Gastroenterol 2019 Mar 27. Epub 2019 Mar 27.

Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Introduction: Surgery is advocated in hepatocellular adenomas (HCA) >5 cm that do not regress to <5 cm after 6-12 months. The aim of this study was to develop a model for these patients, estimating the probability of HCA regression to <5 cm at 1 and 2 years follow-up.

Methods: Data were derived from a multicenter retrospective cohort of female patients diagnosed with HCA >5 cm at first follow-up. Read More

Am J Gastroenterol 2019 Apr;114(4):607-619

Department of Medical Sciences, Città della salute, University of Turin, Turin, Italy.

Objectives: Hypertension has been linked to the presence and severity of nonalcoholic fatty liver disease (NAFLD) through unclear mechanisms. The gain-of-function rs5186 A1166C variant in angtiotensin receptor type 1 (AGTR1) gene has been linked to hypertension, cardiovascular disease and metabolic syndrome. We assessed the impact of AGTR1 A1166C variant on NAFLD incidence and severity and on glucose and lipid metabolism and explored the underlying mechanisms. Read More

Am J Gastroenterol 2019 Mar 12. Epub 2019 Mar 12.

Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, Virginia, USA.

Alteration of the normal gut-liver axis is important in primary sclerosing cholangitis (PSC). Lack of effective medical therapy for PSC makes microbiome restoration an alluring therapeutic target. Allegretti et al. Read More

Am J Gastroenterol 2019 Apr;114(4):560-561

Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Pancreatic cancer is a lethal disease that is commonly diagnosed at a late stage. Screening asymptomatic patients is necessary for early detection, but this is not currently recommended in the general population. As demonstrated in the current study, an important number of patients at increased risk can be diagnosed using either MRI/magnetic resonance cholangiopancreatography or endoscopic ultrasound. Read More

Am J Gastroenterol 2019 Mar 20. Epub 2019 Mar 20.

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

Objectives: Irritable bowel syndrome (IBS) is a common gastrointestinal condition with a heterogeneous pathophysiology. An altered gut microbiome has been identified in some IBS patients, and fecal microbiota transplantation (FMT) has been suggested to treat IBS. We performed meta-analyses and systematic review of available randomized controlled trials (RCTs) to evaluate the efficacy of FMT in IBS. Read More

Am J Gastroenterol 2019 Apr;114(4):692

Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.

Am J Gastroenterol 2019 Mar 22. Epub 2019 Mar 22.

Department of Hepato-Gastroenterology and Inserm U954, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France.

Objectives: In 2015, the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) program proposed shifting the therapeutic focus on ulcerative colitis (UC) toward altering the natural history of the disease course by regularly monitoring objective measurements of disease activity and tailoring treatment accordingly. The therapeutic paradigm shift was well received in the research community and is often cited. However, new evidence on optimal UC treatment targets continues to accumulate since the time of the STRIDE guidelines. Read More

Am J Gastroenterol 2019 Mar 15. Epub 2019 Mar 15.

Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China.

Objectives: To assess the safety and effectiveness of autologous skin-grafting surgery (ASGS) for preventing esophageal stenosis after complete circular endoscopic submucosal tunnel dissection (ccESTD) for superficial esophageal neoplasms.

Methods: Between October 2017 and March 2018, 8 patients who underwent ccESTD and ASGS were included. We assessed the occurrence of esophageal stenosis and adverse events. Read More

Am J Gastroenterol 2019 Mar 7. Epub 2019 Mar 7.

University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Introduction: Guidelines recommend that patients with non-dysplastic Barrett's esophagus (NDBE) undergo surveillance endoscopy every 3-5 years. Using a national registry, we assessed compliance to recommended surveillance intervals in patients with NDBE and identified factors associated with compliance.

Methods: We analyzed data from the GI Quality Improvement Consortium registry. Read More

Am J Gastroenterol 2019 Mar 7. Epub 2019 Mar 7.

Division of Gastroenterology and Hepatology, American Hospital, Istanbul, Turkey.

Am J Gastroenterol 2019 Mar 8. Epub 2019 Mar 8.

Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.

Objectives: Gastroparesis (Gp) can be a challenging disorder to manage due to the paucity of treatment options. We do not know how frequently patients with Gp symptoms resort to cannabinoids to address their symptoms. This study (i) determines the prevalence of cannabinoid use in patients with Gp symptoms, (ii) describes the patients with Gp symptoms using cannabinoids, and (iii) assesses the patients' perceived benefit of cannabinoids for Gp symptoms. Read More

Am J Gastroenterol 2019 Mar 8. Epub 2019 Mar 8.

Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain.

Involvement of the gastrointestinal (GI) tract is an infrequent extrathoracic presentation of sarcoidosis. We reviewed 305 cases of GI involvement reported in 238 patients, in whom GI sarcoidosis was the first sign of the disease in half the cases. The disease does not affect the GI tract uniformly, with a clear oral-anal gradient (80% of reported cases involved the esophagus, stomach, and duodenum). Read More

Am J Gastroenterol 2019 Mar 8. Epub 2019 Mar 8.

Unit of Lifestyle Medicine in Obesity and Diabetes, Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Objectives: We examined the dose-dependent association of habitual moderate-to-vigorous physical activity (MVPA) with the biochemical markers for nonalcoholic fatty liver disease (NAFLD) and whether this association changes with age and degree of impaired glucose metabolism. We also investigated whether the associations depend on the domain of MVPA.

Methods: In this study, using data from the population-based Lifelines cohort (N = 42,661), MVPA was self-reported on the short questionnaire to assess health-enhancing physical activity. Read More

Am J Gastroenterol 2019 Apr;114(4):630-639

Division of Gastroenterology, University of California San Diego, La Jolla, California, USA.

Introduction: We conducted a cohort study on the impact of obesity on disease activity and Patient-Reported Outcomes Measurement Information System (PROMIS) measures in the inflammatory bowel disease (IBD) Partners cohort.

Methods: We performed a cross-sectional and longitudinal study within IBD Partners, an internet-based cohort of >15,000 patients living with Crohn's disease (CD) and ulcerative colitis (UC). We included adult patients with IBD, with recorded body mass index (BMI), with at least 6 months of follow-up, excluding patients with BMI < 18. Read More

Am J Gastroenterol 2019 Mar 11. Epub 2019 Mar 11.

Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

Introduction: Split-dose bowel preparation leads to superior colon cleansing for colonoscopy. However, the magnitude of benefit in detecting colonic polyps is uncertain. We performed a systematic review to synthesize the data on whether using a split-dose bowel preparation regimen improves the detection of polyps when compared with other dosing methods or regimen products. Read More

Am J Gastroenterol 2019 Jan 17. Epub 2019 Jan 17.

APC Microbiome Ireland and Department of Medicine, University College Cork, National University of Ireland, Cork, Ireland.

The gut microbiota has emerged as an important consideration in clinical oncology. The role of the microbiome in cancer extends beyond causation and cancer risk. It is now known that the microbiome not only acts at a local epithelial level in the gut but also modifies immune responses within intestinal and extraintestinal tumors. Read More

Am J Gastroenterol 2019 Jan 17. Epub 2019 Jan 17.

Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Am J Gastroenterol 2019 Jan 17. Epub 2019 Jan 17.

Department of Internal Medicine, Northeastern Health System, Tahlequah, OK.

Am J Gastroenterol 2019 Apr;114(4):687

Division of Gastroenterology and Hepatology, University of Florida, Gainesville, Florida.

Am J Gastroenterol 2019 Jan 21. Epub 2019 Jan 21.

Laboratorio de Hígado, Páncreas y Motilidad (HIPAM), Unidad de Investigación en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autónoma de México (UNAM). Hospital General de México, Dr. Eduardo Liceaga. Gastroenterología y Endoscopía en PMG, Centro Médico ABC, Mexico City, Mexico.

Am J Gastroenterol 2019 Apr;114(4):544-547

Division of Gastroenterology, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, USA.

Am J Gastroenterol 2019 Apr;114(4):679-683

Division of Gastroenterology and Hepatology, University of Minnesota, Minneapolis, Minnesota, USA.

Objectives: To familiarize medical providers with the Food and Drug Administration approval process for antiobesity devices and to provide a brief overview of current and promising endoscopy-based bariatric devices.

Methods: Literature review of published scholarly articles.

Results: There has been a rapid development of novel endoscopic bariatric therapies in recent years, resulting in the approval of multiple devices. Read More

Am J Gastroenterol 2019 Jan 29. Epub 2019 Jan 29.

Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Introduction: The adenoma detection rate (ADR) is the best validated colonoscopy performance quality indicator. The ASGE/ACG Task Force on Colonoscopy Quality set an ADR benchmark of ≥25% in a mixed male/female population. We propose a novel means for defining locally relevant ADR benchmarks using data from the population of interest and for applying ADR benchmarks using 95% confidence intervals (CIs) of an endoscopist's ADR. Read More

Am J Gastroenterol 2019 Feb 18. Epub 2019 Feb 18.

Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.

Objectives: Diagnosis of covert hepatic encephalopathy (CHE) is challenging and often neglected in clinical practice. The aim of this study was to develop an easy-to-perform score to predict CHE in patients with cirrhosis.

Methods: For the development or validation cohort of the proposed clinical CHE score, 142 or 96 consecutive patients with cirrhosis were prospectively enrolled. Read More

Am J Gastroenterol 2019 Apr;114(4):684-685

Department of Gastroenterology, Juntendo University Urayasu Hospital, Urayasu-shi, Chiba, Japan.

Am J Gastroenterol 2019 Feb 26. Epub 2019 Feb 26.

Department of Surgery and Cancer, Imperial College London, London, United Kingdom.

Objectives: Accurate, real-time, endoscopic risk stratification of colorectal polyps would improve decision-making and optimize clinical efficiency. Technologies to manipulate endoscopic optical outputs can be used to predict polyp histology in vivo; however, it remains unclear how accuracy has progressed and whether it is sufficient for routine clinical implementation.

Methods: A meta-analysis was conducted by searching MEDLINE, Embase, and the Cochrane Library. Read More

Am J Gastroenterol 2019 Apr;114(4):640-647

Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Objectives: There is increased interest in measuring patient-reported outcomes (PROs) such as quality of life (QoL) among patients with inflammatory bowel disease (IBD). We aimed to create and validate a new measure of QoL to assess the psychosocial burden of IBD using publicly available assessment tools.

Methods: Using the Crohn's & Colitis Foundation's IBD Partners cohort, we performed several cross-sectional and longitudinal analyses to create a new PRO-based evaluation (PROBE) of QoL among patients with Crohn's disease (CD) and ulcerative colitis (UC). Read More