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patients with ASUC.
CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to AGA CLINICAL PRACTICE UPDATE ON MANAGEMENT OF BLEEDING Management of bleeding gastric varices (GV) presents a unique challenge for patients with portal hypertension. Despite over thirty years of diagnostic and treatment advances standardized practices for bleeding GV are lacking and unsupported by adequate evidence. There are no definitive natural history studies to help with risk assessment or prospective clinical trials to guide clinical CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGYHOMEHEPATOCELLULAR CARCINOMAVIRAL HEPATITISBARRETT'S ESOPHAGUSMICROBIOME This special issue of CGH focuses on the clinical management of several hepatic disorders including common conditions such as nonalcoholic fatty liver disease (NAFLD) and viral hepatitis, and uncommon but difficult disorders such as autoimmune hepatitis and primary sclerosing cholangitis (PSC). INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA1 The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to TOFACITINIB FOR BIOLOGIC-EXPERIENCED HOSPITALIZED PATIENTS Despite rescue therapy, more than 30% of patients with acute severe ulcerative colitis (ASUC) require colectomy. Tofacitinib is a rapidly acting JAK inhibitor with proven efficacy in ulcerative colitis. Tofacitinib may provide additional means for preventing colectomy inpatients with ASUC.
CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to AGA CLINICAL PRACTICE UPDATE ON MANAGEMENT OF BLEEDING Management of bleeding gastric varices (GV) presents a unique challenge for patients with portal hypertension. Despite over thirty years of diagnostic and treatment advances standardized practices for bleeding GV are lacking and unsupported by adequate evidence. There are no definitive natural history studies to help with risk assessment or prospective clinical trials to guide clinical CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. AGA CLINICAL PRACTICE UPDATE ON MANAGEMENT OF BLEEDING Management of bleeding gastric varices (GV) presents a unique challenge for patients with portal hypertension. Despite over thirty years of diagnostic and treatment advances standardized practices for bleeding GV are lacking and unsupported by adequate evidence. There are no definitive natural history studies to help with risk assessment or prospective clinical trials to guide clinical MANAGEMENT OF AUTOIMMUNE PANCREATITIS Autoimmune pancreatitis (AIP) is a chronic, steroid-responsive fibroinflammatory disease of the pancreas. The incidence and prevalence of AIP remain largely unknown, but they are increasingly being identified. One study from Japan reported an incidence of 1 per 100,000, whereas the prevalence was estimated to be 5%–6% of all patients with chronic pancreatitis.1 AIP often mimics pancreatic INFLIXIMAB VS ADALIMUMAB FOR UC: IS THERE A DIFFERENCE Anti–tumor necrosis factor (anti-TNF) therapy has been transformational for the treatment of inflammatory bowel disease (IBD), beginning with Crohn’s disease (CD) in 19981 and extending to ulcerative colitis (UC) in 2005.2 Since their initial approval we have learned a great deal about these drugs for the treatment of IBD, some of which has differed from their use in other diseases. SERRATED POLYPOSIS SYNDROME Colorectal serrated polyps (SPs) are a pathologically diverse group of lesions that include hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), and sessile serrated polyps (SSPs). Although the majority of sporadic colorectal cancers (CRCs) arise from adenomatous polyps, SSPs are believed to be the precursor in up to 30% of cases. Serrated polyposis syndrome (SPS), formerly called ACTIVITY-BASED COSTING AND MANAGEMENT IN A HOSPITAL-BASED Over the last 2 decades, a number of attempts have been made to slow the rise in healthcare costs. Among them were Health Maintenance Organizations, which lowered costs through capitation. In most cases, this resulted in quality being sacrificed for cost and ultimately, many patients rejected the Health Maintenance Organization concept due to the lack of choice and access.1–3 The PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND HEPATOLOGY Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to FOLLOW-UP TESTING AFTER TREATMENT OF HELICOBACTER PYLORI Before the seriousness of H. pylori infections was fully appreciated and when it was still believed that H. pylori eradication therapy could routinely cure more than 90% of patients, confirmation of cure testing was not routinely recommended. Although confirmation for cure testing is currently considered the standard of care, preferably with noninvasive tests such as the stool antigen or a FOOD HYPERSENSITIVITY AS A CAUSE OF RECTAL BLEEDING IN Rectal bleeding and lymphonodular hyperplasia (LNH) in children can be caused by food hypersensitivity (FH). Our aim was to verify whether similar clinical and endoscopy presentations in adults can be due toFH.
NATURAL HISTORY AND DISEASE IMPACT OF ROME IV VS ROME III Natural History and Disease Impact of Rome IV Vs Rome III Q1 Irritable Bowel Syndrome: A Longitudinal Follow-Up Study Q20 Vivek C. Goodoory,*,‡ Lesley A. Houghton,* Yan Yiannakou,§ Christopher J. Black,*,‡,b and Alexander C. Ford*,‡,b Q3Q4 *Leeds Institute of Medical Research, ‡Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds, United ORAL BISACODYL IS EFFECTIVE AND WELL-TOLERATED IN PATIENTS Oral Bisacodyl Is Effective and Well-Tolerated in Patients With Chronic Constipation MICHAEL A. KAMM,*,‡ STEFAN MUELLER–LISSNER,§ ARNOLD WALD, ERIKA RICHTER,¶ ROS SWALLOW,# and ULRIKA GESSNER** *St. Vincent’s Hospital and University of Melbourne, Melbourne, Australia; ‡Imperial College, London, UK; §Park-Klinik, Weissensee, Charité-Universitätsmedizin HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGYHOMEHEPATOCELLULAR CARCINOMAVIRAL HEPATITISBARRETT'S ESOPHAGUSMICROBIOME This special issue of CGH focuses on the clinical management of several hepatic disorders including common conditions such as nonalcoholic fatty liver disease (NAFLD) and viral hepatitis, and uncommon but difficult disorders such as autoimmune hepatitis and primary sclerosing cholangitis (PSC). INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA1 The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to TOFACITINIB FOR BIOLOGIC-EXPERIENCED HOSPITALIZED PATIENTS Despite rescue therapy, more than 30% of patients with acute severe ulcerative colitis (ASUC) require colectomy. Tofacitinib is a rapidly acting JAK inhibitor with proven efficacy in ulcerative colitis. Tofacitinib may provide additional means for preventing colectomy inpatients with ASUC.
AGA CLINICAL PRACTICE UPDATE ON MANAGEMENT OF BLEEDING Management of bleeding gastric varices (GV) presents a unique challenge for patients with portal hypertension. Despite over thirty years of diagnostic and treatment advances standardized practices for bleeding GV are lacking and unsupported by adequate evidence. There are no definitive natural history studies to help with risk assessment or prospective clinical trials to guide clinical CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGYHOMEHEPATOCELLULAR CARCINOMAVIRAL HEPATITISBARRETT'S ESOPHAGUSMICROBIOME This special issue of CGH focuses on the clinical management of several hepatic disorders including common conditions such as nonalcoholic fatty liver disease (NAFLD) and viral hepatitis, and uncommon but difficult disorders such as autoimmune hepatitis and primary sclerosing cholangitis (PSC). INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA1 The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to TOFACITINIB FOR BIOLOGIC-EXPERIENCED HOSPITALIZED PATIENTS Despite rescue therapy, more than 30% of patients with acute severe ulcerative colitis (ASUC) require colectomy. Tofacitinib is a rapidly acting JAK inhibitor with proven efficacy in ulcerative colitis. Tofacitinib may provide additional means for preventing colectomy inpatients with ASUC.
AGA CLINICAL PRACTICE UPDATE ON MANAGEMENT OF BLEEDING Management of bleeding gastric varices (GV) presents a unique challenge for patients with portal hypertension. Despite over thirty years of diagnostic and treatment advances standardized practices for bleeding GV are lacking and unsupported by adequate evidence. There are no definitive natural history studies to help with risk assessment or prospective clinical trials to guide clinical CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. AGA CLINICAL PRACTICE UPDATE ON MANAGEMENT OF BLEEDING Management of bleeding gastric varices (GV) presents a unique challenge for patients with portal hypertension. Despite over thirty years of diagnostic and treatment advances standardized practices for bleeding GV are lacking and unsupported by adequate evidence. There are no definitive natural history studies to help with risk assessment or prospective clinical trials to guide clinical MANAGEMENT OF AUTOIMMUNE PANCREATITIS Autoimmune pancreatitis (AIP) is a chronic, steroid-responsive fibroinflammatory disease of the pancreas. The incidence and prevalence of AIP remain largely unknown, but they are increasingly being identified. One study from Japan reported an incidence of 1 per 100,000, whereas the prevalence was estimated to be 5%–6% of all patients with chronic pancreatitis.1 AIP often mimics pancreatic INFLIXIMAB VS ADALIMUMAB FOR UC: IS THERE A DIFFERENCE Anti–tumor necrosis factor (anti-TNF) therapy has been transformational for the treatment of inflammatory bowel disease (IBD), beginning with Crohn’s disease (CD) in 19981 and extending to ulcerative colitis (UC) in 2005.2 Since their initial approval we have learned a great deal about these drugs for the treatment of IBD, some of which has differed from their use in other diseases. SERRATED POLYPOSIS SYNDROME Colorectal serrated polyps (SPs) are a pathologically diverse group of lesions that include hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), and sessile serrated polyps (SSPs). Although the majority of sporadic colorectal cancers (CRCs) arise from adenomatous polyps, SSPs are believed to be the precursor in up to 30% of cases. Serrated polyposis syndrome (SPS), formerly called ACTIVITY-BASED COSTING AND MANAGEMENT IN A HOSPITAL-BASED Over the last 2 decades, a number of attempts have been made to slow the rise in healthcare costs. Among them were Health Maintenance Organizations, which lowered costs through capitation. In most cases, this resulted in quality being sacrificed for cost and ultimately, many patients rejected the Health Maintenance Organization concept due to the lack of choice and access.1–3 The PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND HEPATOLOGY Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to FOLLOW-UP TESTING AFTER TREATMENT OF HELICOBACTER PYLORI Before the seriousness of H. pylori infections was fully appreciated and when it was still believed that H. pylori eradication therapy could routinely cure more than 90% of patients, confirmation of cure testing was not routinely recommended. Although confirmation for cure testing is currently considered the standard of care, preferably with noninvasive tests such as the stool antigen or a FOOD HYPERSENSITIVITY AS A CAUSE OF RECTAL BLEEDING IN Rectal bleeding and lymphonodular hyperplasia (LNH) in children can be caused by food hypersensitivity (FH). Our aim was to verify whether similar clinical and endoscopy presentations in adults can be due toFH.
NATURAL HISTORY AND DISEASE IMPACT OF ROME IV VS ROME III Natural History and Disease Impact of Rome IV Vs Rome III Q1 Irritable Bowel Syndrome: A Longitudinal Follow-Up Study Q20 Vivek C. Goodoory,*,‡ Lesley A. Houghton,* Yan Yiannakou,§ Christopher J. Black,*,‡,b and Alexander C. Ford*,‡,b Q3Q4 *Leeds Institute of Medical Research, ‡Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds, United ORAL BISACODYL IS EFFECTIVE AND WELL-TOLERATED IN PATIENTS Oral Bisacodyl Is Effective and Well-Tolerated in Patients With Chronic Constipation MICHAEL A. KAMM,*,‡ STEFAN MUELLER–LISSNER,§ ARNOLD WALD, ERIKA RICHTER,¶ ROS SWALLOW,# and ULRIKA GESSNER** *St. Vincent’s Hospital and University of Melbourne, Melbourne, Australia; ‡Imperial College, London, UK; §Park-Klinik, Weissensee, Charité-Universitätsmedizin WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT3 As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 WORKUP AND MANAGEMENT OF BLOATING Bloating is a common presenting complaint to health care providers, but is often difficult to evaluate and manage. Bloating is defined as a sensation of increased abdominal pressure that may or may not be accompanied by visible abdominal distention.1 In fact, objective abdominal distention occurs only in half the patients with bloating.2 Although bloating affects 16%–19% of the general MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. INFLIXIMAB VS ADALIMUMAB FOR UC: IS THERE A DIFFERENCE Anti–tumor necrosis factor (anti-TNF) therapy has been transformational for the treatment of inflammatory bowel disease (IBD), beginning with Crohn’s disease (CD) in 19981 and extending to ulcerative colitis (UC) in 2005.2 Since their initial approval we have learned a great deal about these drugs for the treatment of IBD, some of which has differed from their use in other diseases. PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND … Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to ORAL BISACODYL IS EFFECTIVE AND WELL-TOLERATED IN PATIENTS Oral Bisacodyl Is Effective and Well-Tolerated in Patients With Chronic Constipation MICHAEL A. KAMM,*,‡ STEFAN MUELLER–LISSNER,§ ARNOLD WALD, ERIKA RICHTER,¶ ROS SWALLOW,# and ULRIKA GESSNER** *St. Vincent’s Hospital and University of Melbourne, Melbourne, Australia; ‡Imperial College, London, UK; §Park-Klinik, Weissensee, Charité-Universitätsmedizin WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT3 As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 WORKUP AND MANAGEMENT OF BLOATING Bloating is a common presenting complaint to health care providers, but is often difficult to evaluate and manage. Bloating is defined as a sensation of increased abdominal pressure that may or may not be accompanied by visible abdominal distention.1 In fact, objective abdominal distention occurs only in half the patients with bloating.2 Although bloating affects 16%–19% of the general MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. INFLIXIMAB VS ADALIMUMAB FOR UC: IS THERE A DIFFERENCE Anti–tumor necrosis factor (anti-TNF) therapy has been transformational for the treatment of inflammatory bowel disease (IBD), beginning with Crohn’s disease (CD) in 19981 and extending to ulcerative colitis (UC) in 2005.2 Since their initial approval we have learned a great deal about these drugs for the treatment of IBD, some of which has differed from their use in other diseases. PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND … Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to ORAL BISACODYL IS EFFECTIVE AND WELL-TOLERATED IN PATIENTS Oral Bisacodyl Is Effective and Well-Tolerated in Patients With Chronic Constipation MICHAEL A. KAMM,*,‡ STEFAN MUELLER–LISSNER,§ ARNOLD WALD, ERIKA RICHTER,¶ ROS SWALLOW,# and ULRIKA GESSNER** *St. Vincent’s Hospital and University of Melbourne, Melbourne, Australia; ‡Imperial College, London, UK; §Park-Klinik, Weissensee, Charité-Universitätsmedizin HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGY This special issue of CGH focuses on the clinical management of several hepatic disorders including common conditions such as nonalcoholic fatty liver disease (NAFLD) and viral hepatitis, and uncommon but difficult disorders such as autoimmune hepatitis and primary sclerosing cholangitis (PSC). CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 INFLIXIMAB VS ADALIMUMAB FOR UC: IS THERE A DIFFERENCE Anti–tumor necrosis factor (anti-TNF) therapy has been transformational for the treatment of inflammatory bowel disease (IBD), beginning with Crohn’s disease (CD) in 19981 and extending to ulcerative colitis (UC) in 2005.2 Since their initial approval we have learned a great deal about these drugs for the treatment of IBD, some of which has differed from their use in other diseases. FEATURES AND TREATMENT OF DAPSONE-INDUCED HEPATITIS, BASED We identified 44 cases of DIH among 850 patients with DILI, constituting 5.2% of all cases. The clinical, demographic, and laboratory characteristics at presentation are summarized in Table 1.The mean treatment duration before the onset of liver injury was 34 days (range, 8–150 d). ACTIVITY-BASED COSTING AND MANAGEMENT IN A HOSPITAL-BASED Over the last 2 decades, a number of attempts have been made to slow the rise in healthcare costs. Among them were Health Maintenance Organizations, which lowered costs through capitation. In most cases, this resulted in quality being sacrificed for cost and ultimately, many patients rejected the Health Maintenance Organization concept due to the lack of choice and access.1–3 The WORKUP AND MANAGEMENT OF BLOATING Bloating is a common presenting complaint to health care providers, but is often difficult to evaluate and manage. Bloating is defined as a sensation of increased abdominal pressure that may or may not be accompanied by visible abdominal distention.1 In fact, objective abdominal distention occurs only in half the patients with bloating.2 Although bloating affects 16%–19% of the general FOOD HYPERSENSITIVITY AS A CAUSE OF RECTAL BLEEDING IN Rectal bleeding and lymphonodular hyperplasia (LNH) in children can be caused by food hypersensitivity (FH). Our aim was to verify whether similar clinical and endoscopy presentations in adults can be due toFH.
PATHOGENESIS, DIAGNOSIS, AND MANAGEMENT OF GASTRIC ISCHEMIA Pathogenesis, Diagnosis, and Management of Gastric Ischemia Shou–jiang Tang,* Sumanth R. Daram,* Ruonan Wu,* and Feriyl Bhaijee‡ *Division of Digestive Diseases, Department of Medicine, and ‡Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi AN ASSOCIATION BETWEEN MICROSCOPIC COLITIS AND CELIAC DISEASE An Association Between Microscopic Colitis and Celiac Disease PETER H. R. GREEN,* JUN YANG,* JIANFENG CHENG,§ ANNE R. LEE,* JASON W. HARPER,* and GOVIND BHAGAT‡ Departments of *Medicine and ‡Surgical Pathology, Columbia University College of Physicians and Surgeons, New York, New York, and §Department of Gastroenterology, Virginia Commonwealth University, Richmond, Virginia WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT3 As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to TOFACITINIB FOR BIOLOGIC-EXPERIENCED HOSPITALIZED PATIENTS Despite rescue therapy, more than 30% of patients with acute severe ulcerative colitis (ASUC) require colectomy. Tofacitinib is a rapidly acting JAK inhibitor with proven efficacy in ulcerative colitis. Tofacitinib may provide additional means for preventing colectomy inpatients with ASUC.
MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for WORKUP AND MANAGEMENT OF BLOATING Bloating is a common presenting complaint to health care providers, but is often difficult to evaluate and manage. Bloating is defined as a sensation of increased abdominal pressure that may or may not be accompanied by visible abdominal distention.1 In fact, objective abdominal distention occurs only in half the patients with bloating.2 Although bloating affects 16%–19% of the general MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND … Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to ORAL BISACODYL IS EFFECTIVE AND WELL-TOLERATED IN PATIENTS Oral Bisacodyl Is Effective and Well-Tolerated in Patients With Chronic Constipation MICHAEL A. KAMM,*,‡ STEFAN MUELLER–LISSNER,§ ARNOLD WALD, ERIKA RICHTER,¶ ROS SWALLOW,# and ULRIKA GESSNER** *St. Vincent’s Hospital and University of Melbourne, Melbourne, Australia; ‡Imperial College, London, UK; §Park-Klinik, Weissensee, Charité-Universitätsmedizin WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT3 As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to TOFACITINIB FOR BIOLOGIC-EXPERIENCED HOSPITALIZED PATIENTS Despite rescue therapy, more than 30% of patients with acute severe ulcerative colitis (ASUC) require colectomy. Tofacitinib is a rapidly acting JAK inhibitor with proven efficacy in ulcerative colitis. Tofacitinib may provide additional means for preventing colectomy inpatients with ASUC.
MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for WORKUP AND MANAGEMENT OF BLOATING Bloating is a common presenting complaint to health care providers, but is often difficult to evaluate and manage. Bloating is defined as a sensation of increased abdominal pressure that may or may not be accompanied by visible abdominal distention.1 In fact, objective abdominal distention occurs only in half the patients with bloating.2 Although bloating affects 16%–19% of the general MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND … Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to ORAL BISACODYL IS EFFECTIVE AND WELL-TOLERATED IN PATIENTS Oral Bisacodyl Is Effective and Well-Tolerated in Patients With Chronic Constipation MICHAEL A. KAMM,*,‡ STEFAN MUELLER–LISSNER,§ ARNOLD WALD, ERIKA RICHTER,¶ ROS SWALLOW,# and ULRIKA GESSNER** *St. Vincent’s Hospital and University of Melbourne, Melbourne, Australia; ‡Imperial College, London, UK; §Park-Klinik, Weissensee, Charité-Universitätsmedizin HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGY This special issue of CGH focuses on the clinical management of several hepatic disorders including common conditions such as nonalcoholic fatty liver disease (NAFLD) and viral hepatitis, and uncommon but difficult disorders such as autoimmune hepatitis and primary sclerosing cholangitis (PSC). CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 WORKUP AND MANAGEMENT OF BLOATING Bloating is a common presenting complaint to health care providers, but is often difficult to evaluate and manage. Bloating is defined as a sensation of increased abdominal pressure that may or may not be accompanied by visible abdominal distention.1 In fact, objective abdominal distention occurs only in half the patients with bloating.2 Although bloating affects 16%–19% of the general FEATURES AND TREATMENT OF DAPSONE-INDUCED HEPATITIS, BASED We identified 44 cases of DIH among 850 patients with DILI, constituting 5.2% of all cases. The clinical, demographic, and laboratory characteristics at presentation are summarized in Table 1.The mean treatment duration before the onset of liver injury was 34 days (range, 8–150 d). ACTIVITY-BASED COSTING AND MANAGEMENT IN A HOSPITAL-BASED Over the last 2 decades, a number of attempts have been made to slow the rise in healthcare costs. Among them were Health Maintenance Organizations, which lowered costs through capitation. In most cases, this resulted in quality being sacrificed for cost and ultimately, many patients rejected the Health Maintenance Organization concept due to the lack of choice and access.1–3 The HIGH RESOLUTION MANOMETRY IN SCLERODERMA PATIENTS We read with interest the article by Crowell et al1 regarding the prevalence and type of esophageal motor abnormalities in systemic scleroderma patients. In that study, which involved 200 patients and 102 controls, the distinctive features of scleroderma esophagus (hypotensive esophagogastric junction pressure with absent contractility) were detected in only one third of patients. FOOD HYPERSENSITIVITY AS A CAUSE OF RECTAL BLEEDING IN Rectal bleeding and lymphonodular hyperplasia (LNH) in children can be caused by food hypersensitivity (FH). Our aim was to verify whether similar clinical and endoscopy presentations in adults can be due toFH.
PATHOGENESIS, DIAGNOSIS, AND MANAGEMENT OF GASTRIC ISCHEMIA Pathogenesis, Diagnosis, and Management of Gastric Ischemia Shou–jiang Tang,* Sumanth R. Daram,* Ruonan Wu,* and Feriyl Bhaijee‡ *Division of Digestive Diseases, Department of Medicine, and ‡Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi AN ASSOCIATION BETWEEN MICROSCOPIC COLITIS AND CELIAC DISEASE An Association Between Microscopic Colitis and Celiac Disease PETER H. R. GREEN,* JUN YANG,* JIANFENG CHENG,§ ANNE R. LEE,* JASON W. HARPER,* and GOVIND BHAGAT‡ Departments of *Medicine and ‡Surgical Pathology, Columbia University College of Physicians and Surgeons, New York, New York, and §Department of Gastroenterology, Virginia Commonwealth University, Richmond, Virginia HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGYHOMEHEPATOCELLULAR CARCINOMAVIRAL HEPATITISBARRETT'S ESOPHAGUSMICROBIOME This special issue serves as a go-to resource for practicing clinicians on the current understanding of the microbiome’s role in a variety of gastrointestinal diseases and provides a clinical context for translational and basic science researchers engaged in this topic. Ultimately, we hope it will facilitate further research that makes meaningful progress toward unraveling the mysteries of TOFACITINIB FOR BIOLOGIC-EXPERIENCED HOSPITALIZED PATIENTS Despite rescue therapy, more than 30% of patients with acute severe ulcerative colitis (ASUC) require colectomy. Tofacitinib is a rapidly acting JAK inhibitor with proven efficacy in ulcerative colitis. Tofacitinib may provide additional means for preventing colectomy inpatients with ASUC.
CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is MANAGEMENT OF AUTOIMMUNE PANCREATITIS Autoimmune pancreatitis (AIP) is a chronic, steroid-responsive fibroinflammatory disease of the pancreas. The incidence and prevalence of AIP remain largely unknown, but they are increasingly being identified. One study from Japan reported an incidence of 1 per 100,000, whereas the prevalence was estimated to be 5%–6% of all patients with chronic pancreatitis.1 AIP often mimics pancreatic INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE AND Metabolic Dysfunction-Associated Fatty Liver Disease and Incident Cardiovascular Disease Risk: A Nationwide Cohort Study Hokyou Lee,* Yong-ho Lee,‡,§ Seung Up Kim,‡,jj and Hyeon Chang Kim* *Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea; ‡Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; §Institute of Endocrine WHEN TO RESUME DIRECT ORAL ANTICOAGULANTS FOLLOWING EDITORIAL When to Resume Direct Oral Anticoagulants Following Gastrointestinal Bleeding For more than half a century, warfarin has been used as a highly effective oral anticoagulant. However, warfarin requires regular monitoring and has HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGYHOMEHEPATOCELLULAR CARCINOMAVIRAL HEPATITISBARRETT'S ESOPHAGUSMICROBIOME This special issue serves as a go-to resource for practicing clinicians on the current understanding of the microbiome’s role in a variety of gastrointestinal diseases and provides a clinical context for translational and basic science researchers engaged in this topic. Ultimately, we hope it will facilitate further research that makes meaningful progress toward unraveling the mysteries of TOFACITINIB FOR BIOLOGIC-EXPERIENCED HOSPITALIZED PATIENTS Despite rescue therapy, more than 30% of patients with acute severe ulcerative colitis (ASUC) require colectomy. Tofacitinib is a rapidly acting JAK inhibitor with proven efficacy in ulcerative colitis. Tofacitinib may provide additional means for preventing colectomy inpatients with ASUC.
CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is MANAGEMENT OF AUTOIMMUNE PANCREATITIS Autoimmune pancreatitis (AIP) is a chronic, steroid-responsive fibroinflammatory disease of the pancreas. The incidence and prevalence of AIP remain largely unknown, but they are increasingly being identified. One study from Japan reported an incidence of 1 per 100,000, whereas the prevalence was estimated to be 5%–6% of all patients with chronic pancreatitis.1 AIP often mimics pancreatic INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE AND Metabolic Dysfunction-Associated Fatty Liver Disease and Incident Cardiovascular Disease Risk: A Nationwide Cohort Study Hokyou Lee,* Yong-ho Lee,‡,§ Seung Up Kim,‡,jj and Hyeon Chang Kim* *Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea; ‡Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; §Institute of Endocrine WHEN TO RESUME DIRECT ORAL ANTICOAGULANTS FOLLOWING EDITORIAL When to Resume Direct Oral Anticoagulants Following Gastrointestinal Bleeding For more than half a century, warfarin has been used as a highly effective oral anticoagulant. However, warfarin requires regular monitoring and has HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGY This special issue serves as a go-to resource for practicing clinicians on the current understanding of the microbiome’s role in a variety of gastrointestinal diseases and provides a clinical context for translational and basic science researchers engaged in this topic. Ultimately, we hope it will facilitate further research that makes meaningful progress toward unraveling the mysteries of MANAGEMENT OF AUTOIMMUNE PANCREATITIS Autoimmune pancreatitis (AIP) is a chronic, steroid-responsive fibroinflammatory disease of the pancreas. The incidence and prevalence of AIP remain largely unknown, but they are increasingly being identified. One study from Japan reported an incidence of 1 per 100,000, whereas the prevalence was estimated to be 5%–6% of all patients with chronic pancreatitis.1 AIP often mimics pancreatic DIAPHRAGMATIC BREATHING REDUCES BELCHING AND PROTON PUMP In patients with gastroesophageal reflux disease (GERD) and excessive belching, most belches are supragastric, and can induce reflux episodes and worsen GERD. Supragastric belching (SGB) might be reduced with diaphragmatic breathing exercises. We investigated whether diaphragmatic breathing therapy is effective in reducing belching and proton pump inhibitor (PPI)-refractory ACTIVITY-BASED COSTING AND MANAGEMENT IN A HOSPITAL-BASED Over the last 2 decades, a number of attempts have been made to slow the rise in healthcare costs. Among them were Health Maintenance Organizations, which lowered costs through capitation. In most cases, this resulted in quality being sacrificed for cost and ultimately, many patients rejected the Health Maintenance Organization concept due to the lack of choice and access.1–3 The BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 SYSTEMATIC REVIEWS AND META-ANALYSES second-line (in patients with prior exposure to tumor necrosis factor -a antagonists) is a key knowl-edge gap. In the absence of head-to-head comparisons, FOLLOW-UP TESTING AFTER TREATMENT OF HELICOBACTER PYLORI Before the seriousness of H. pylori infections was fully appreciated and when it was still believed that H. pylori eradication therapy could routinely cure more than 90% of patients, confirmation of cure testing was not routinely recommended. Although confirmation for cure testing is currently considered the standard of care, preferably with noninvasive tests such as the stool antigen or a HIGH RESOLUTION MANOMETRY IN SCLERODERMA PATIENTS We read with interest the article by Crowell et al1 regarding the prevalence and type of esophageal motor abnormalities in systemic scleroderma patients. In that study, which involved 200 patients and 102 controls, the distinctive features of scleroderma esophagus (hypotensive esophagogastric junction pressure with absent contractility) were detected in only one third of patients. NATURAL HISTORY AND DISEASE IMPACT OF ROME IV VS ROME III Natural History and Disease Impact of Rome IV Vs Rome III Q1 Irritable Bowel Syndrome: A Longitudinal Follow-Up Study Q20 Vivek C. Goodoory,*,‡ Lesley A. Houghton,* Yan Yiannakou,§ Christopher J. Black,*,‡,b and Alexander C. Ford*,‡,b Q3Q4 *Leeds Institute of Medical Research, ‡Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds, United COAGULATION IN LIVER DISEASE: A GUIDE FOR THE CLINICIAN Coagulation in Liver Disease: A Guide for the Clinician PATRICK G. NORTHUP and STEPHEN H. CALDWELL Division of Gastroenterology and Hepatology, Center for the Study of Coagulation in Liver Disease, University of Virginia, Charlottesville, Virginia MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is ACTIVITY-BASED COSTING AND MANAGEMENT IN A HOSPITAL-BASED15 Over the last 2 decades, a number of attempts have been made to slow the rise in healthcare costs. Among them were Health Maintenance Organizations, which lowered costs through capitation. In most cases, this resulted in quality being sacrificed for cost and ultimately, many patients rejected the Health Maintenance Organization concept due to the lack of choice and access.1–3 The WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for SERRATED POLYPOSIS SYNDROME Colorectal serrated polyps (SPs) are a pathologically diverse group of lesions that include hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), and sessile serrated polyps (SSPs). Although the majority of sporadic colorectal cancers (CRCs) arise from adenomatous polyps, SSPs are believed to be the precursor in up to 30% of cases. Serrated polyposis syndrome (SPS), formerly called INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ().The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase deficiency porphyria (ADP), each of which is associated with a defect in a WORKUP AND MANAGEMENT OF BLOATING Bloating is a common presenting complaint to health care providers, but is often difficult to evaluate and manage. Bloating is defined as a sensation of increased abdominal pressure that may or may not be accompanied by visible abdominal distention.1 In fact, objective abdominal distention occurs only in half the patients with bloating.2 Although bloating affects 16%–19% of the general BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND … Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is ACTIVITY-BASED COSTING AND MANAGEMENT IN A HOSPITAL-BASED15 Over the last 2 decades, a number of attempts have been made to slow the rise in healthcare costs. Among them were Health Maintenance Organizations, which lowered costs through capitation. In most cases, this resulted in quality being sacrificed for cost and ultimately, many patients rejected the Health Maintenance Organization concept due to the lack of choice and access.1–3 The WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for SERRATED POLYPOSIS SYNDROME Colorectal serrated polyps (SPs) are a pathologically diverse group of lesions that include hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), and sessile serrated polyps (SSPs). Although the majority of sporadic colorectal cancers (CRCs) arise from adenomatous polyps, SSPs are believed to be the precursor in up to 30% of cases. Serrated polyposis syndrome (SPS), formerly called INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIA Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ().The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase deficiency porphyria (ADP), each of which is associated with a defect in a WORKUP AND MANAGEMENT OF BLOATING Bloating is a common presenting complaint to health care providers, but is often difficult to evaluate and manage. Bloating is defined as a sensation of increased abdominal pressure that may or may not be accompanied by visible abdominal distention.1 In fact, objective abdominal distention occurs only in half the patients with bloating.2 Although bloating affects 16%–19% of the general BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND … Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGY This special issue serves as a go-to resource for practicing clinicians on the current understanding of the microbiome’s role in a variety of gastrointestinal diseases and provides a clinical context for translational and basic science researchers engaged in this topic. Ultimately, we hope it will facilitate further research that makes meaningful progress toward unraveling the mysteries of MANAGEMENT OF AUTOIMMUNE PANCREATITIS Autoimmune pancreatitis (AIP) is a chronic, steroid-responsive fibroinflammatory disease of the pancreas. The incidence and prevalence of AIP remain largely unknown, but they are increasingly being identified. One study from Japan reported an incidence of 1 per 100,000, whereas the prevalence was estimated to be 5%–6% of all patients with chronic pancreatitis.1 AIP often mimics pancreatic WORKUP AND MANAGEMENT OF BLOATING Bloating is a common presenting complaint to health care providers, but is often difficult to evaluate and manage. Bloating is defined as a sensation of increased abdominal pressure that may or may not be accompanied by visible abdominal distention.1 In fact, objective abdominal distention occurs only in half the patients with bloating.2 Although bloating affects 16%–19% of the general ACTIVITY-BASED COSTING AND MANAGEMENT IN A HOSPITAL-BASED Over the last 2 decades, a number of attempts have been made to slow the rise in healthcare costs. Among them were Health Maintenance Organizations, which lowered costs through capitation. In most cases, this resulted in quality being sacrificed for cost and ultimately, many patients rejected the Health Maintenance Organization concept due to the lack of choice and access.1–3 The CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to DIAPHRAGMATIC BREATHING REDUCES BELCHING AND PROTON PUMP In patients with gastroesophageal reflux disease (GERD) and excessive belching, most belches are supragastric, and can induce reflux episodes and worsen GERD. Supragastric belching (SGB) might be reduced with diaphragmatic breathing exercises. We investigated whether diaphragmatic breathing therapy is effective in reducing belching and proton pump inhibitor (PPI)-refractory HIGH RESOLUTION MANOMETRY IN SCLERODERMA PATIENTS We read with interest the article by Crowell et al1 regarding the prevalence and type of esophageal motor abnormalities in systemic scleroderma patients. In that study, which involved 200 patients and 102 controls, the distinctive features of scleroderma esophagus (hypotensive esophagogastric junction pressure with absent contractility) were detected in only one third of patients. PATHOGENESIS, DIAGNOSIS, AND MANAGEMENT OF GASTRIC ISCHEMIA Pathogenesis, Diagnosis, and Management of Gastric Ischemia Shou–jiang Tang,* Sumanth R. Daram,* Ruonan Wu,* and Feriyl Bhaijee‡ *Division of Digestive Diseases, Department of Medicine, and ‡Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi FOLLOW-UP TESTING AFTER TREATMENT OF HELICOBACTER PYLORI Before the seriousness of H. pylori infections was fully appreciated and when it was still believed that H. pylori eradication therapy could routinely cure more than 90% of patients, confirmation of cure testing was not routinely recommended. Although confirmation for cure testing is currently considered the standard of care, preferably with noninvasive tests such as the stool antigen or a AN ASSOCIATION BETWEEN MICROSCOPIC COLITIS AND CELIAC DISEASE An Association Between Microscopic Colitis and Celiac Disease PETER H. R. GREEN,* JUN YANG,* JIANFENG CHENG,§ ANNE R. LEE,* JASON W. HARPER,* and GOVIND BHAGAT‡ Departments of *Medicine and ‡Surgical Pathology, Columbia University College of Physicians and Surgeons, New York, New York, and §Department of Gastroenterology, Virginia Commonwealth University, Richmond, Virginia WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT3 As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATINGCHRONIC ABDOMINAL DISTENSIONCHRONIC BLOATING AND DISTENTIONCAUSES OF ABDOMINAL DISTENTIONABDOMINAL DISTENTION AND PAINTREATMENT FOR ABDOMINAL BLOATING DISTENTIONABDOMINAL DISTENTION MEANING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is SERRATED POLYPOSIS SYNDROME Colorectal serrated polyps (SPs) are a pathologically diverse group of lesions that include hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), and sessile serrated polyps (SSPs). Although the majority of sporadic colorectal cancers (CRCs) arise from adenomatous polyps, SSPs are believed to be the precursor in up to 30% of cases. Serrated polyposis syndrome (SPS), formerly called CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIANAUSEA AND LEUKEMIAWHAT CAN CAUSE LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for MANAGEMENT OF AUTOIMMUNE PANCREATITIS Autoimmune pancreatitis (AIP) is a chronic, steroid-responsive fibroinflammatory disease of the pancreas. The incidence and prevalence of AIP remain largely unknown, but they are increasingly being identified. One study from Japan reported an incidence of 1 per 100,000, whereas the prevalence was estimated to be 5%–6% of all patients with chronic pancreatitis.1 AIP often mimics pancreatic BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THEAUTOIMMUNE HEPATITIS WORKUPLIFE EXPECTANCY AUTOIMMUNE HEPATITISAUTOIMMUNE HEPATITIS TREATMENT GUIDELINESAUTOIMMUNE HEPATITIS UPTODATEENTOCORT FOR AUTOIMMUNE HEPATITISAUTOIMMUNE HEPATITIS STAGES OF DISEASE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIAACUTE NEUROLOGICAL PORPHYRIA The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND …JOURNAL OF CLINICAL GASTROENTEROLOGY AND HEP…CLINICAL GASTROENTEROLOGY AND HEPATOLOGY A…CLINICAL GASTROENTEROLOGY AND HEPATOLOGY E…GASTROENTEROLOGY AND HEPATOLOGY JOURNALGASTROENTEROLOGY AND HEPATOLOGY SPECIALISTSPEDIATRIC GASTROENTEROLOGY HEPATOLOGY Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to SYSTEMATIC REVIEWS AND META-ANALYSES SYSTEMATIC REVIEWS AND META-ANALYSES Fasiha Kanwal, Section Editor Effects of Antidepressants in Patients With Functional Esophageal Disorders or Gastroesophageal Reflux Disease: WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT3 As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATINGCHRONIC ABDOMINAL DISTENSIONCHRONIC BLOATING AND DISTENTIONCAUSES OF ABDOMINAL DISTENTIONABDOMINAL DISTENTION AND PAINTREATMENT FOR ABDOMINAL BLOATING DISTENTIONABDOMINAL DISTENTION MEANING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is SERRATED POLYPOSIS SYNDROME Colorectal serrated polyps (SPs) are a pathologically diverse group of lesions that include hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), and sessile serrated polyps (SSPs). Although the majority of sporadic colorectal cancers (CRCs) arise from adenomatous polyps, SSPs are believed to be the precursor in up to 30% of cases. Serrated polyposis syndrome (SPS), formerly called CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIANAUSEA AND LEUKEMIAWHAT CAN CAUSE LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for MANAGEMENT OF AUTOIMMUNE PANCREATITIS Autoimmune pancreatitis (AIP) is a chronic, steroid-responsive fibroinflammatory disease of the pancreas. The incidence and prevalence of AIP remain largely unknown, but they are increasingly being identified. One study from Japan reported an incidence of 1 per 100,000, whereas the prevalence was estimated to be 5%–6% of all patients with chronic pancreatitis.1 AIP often mimics pancreatic BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THEAUTOIMMUNE HEPATITIS WORKUPLIFE EXPECTANCY AUTOIMMUNE HEPATITISAUTOIMMUNE HEPATITIS TREATMENT GUIDELINESAUTOIMMUNE HEPATITIS UPTODATEENTOCORT FOR AUTOIMMUNE HEPATITISAUTOIMMUNE HEPATITIS STAGES OF DISEASE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIAACUTE NEUROLOGICAL PORPHYRIA The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND …JOURNAL OF CLINICAL GASTROENTEROLOGY AND HEP…CLINICAL GASTROENTEROLOGY AND HEPATOLOGY A…CLINICAL GASTROENTEROLOGY AND HEPATOLOGY E…GASTROENTEROLOGY AND HEPATOLOGY JOURNALGASTROENTEROLOGY AND HEPATOLOGY SPECIALISTSPEDIATRIC GASTROENTEROLOGY HEPATOLOGY Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to SYSTEMATIC REVIEWS AND META-ANALYSES SYSTEMATIC REVIEWS AND META-ANALYSES Fasiha Kanwal, Section Editor Effects of Antidepressants in Patients With Functional Esophageal Disorders or Gastroesophageal Reflux Disease: HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGY This special issue serves as a go-to resource for practicing clinicians on the current understanding of the microbiome’s role in a variety of gastrointestinal diseases and provides a clinical context for translational and basic science researchers engaged in this topic. Ultimately, we hope it will facilitate further research that makes meaningful progress toward unraveling the mysteries of DIAPHRAGMATIC BREATHING REDUCES BELCHING AND PROTON PUMP In patients with gastroesophageal reflux disease (GERD) and excessive belching, most belches are supragastric, and can induce reflux episodes and worsen GERD. Supragastric belching (SGB) might be reduced with diaphragmatic breathing exercises. We investigated whether diaphragmatic breathing therapy is effective in reducing belching and proton pump inhibitor (PPI)-refractory CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND HEPATOLOGY Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 SYSTEMATIC REVIEWS AND META-ANALYSES SYSTEMATIC REVIEWS AND META-ANALYSES Fasiha Kanwal, Section Editor Effects of Antidepressants in Patients With Functional Esophageal Disorders or Gastroesophageal Reflux Disease: HIGH RESOLUTION MANOMETRY IN SCLERODERMA PATIENTS We read with interest the article by Crowell et al1 regarding the prevalence and type of esophageal motor abnormalities in systemic scleroderma patients. In that study, which involved 200 patients and 102 controls, the distinctive features of scleroderma esophagus (hypotensive esophagogastric junction pressure with absent contractility) were detected in only one third of patients. FOLLOW-UP TESTING AFTER TREATMENT OF HELICOBACTER PYLORI Before the seriousness of H. pylori infections was fully appreciated and when it was still believed that H. pylori eradication therapy could routinely cure more than 90% of patients, confirmation of cure testing was not routinely recommended. Although confirmation for cure testing is currently considered the standard of care, preferably with noninvasive tests such as the stool antigen or a FIBROSIS PROGRESSION IN NONALCOHOLIC FATTY LIVER VS Little is known about differences in rates of fibrosis progression between patients with nonalcoholic fatty liver (NAFL) vs nonalcoholic steatohepatitis (NASH). We conducted a systematic review and meta-analysis of all studies that assessed paired liver biopsy specimens to estimate the rates of fibrosis progression in patients with nonalcoholic fatty liver disease (NAFLD) including NAFL and NASH. AN ASSOCIATION BETWEEN MICROSCOPIC COLITIS AND CELIAC DISEASE An Association Between Microscopic Colitis and Celiac Disease PETER H. R. GREEN,* JUN YANG,* JIANFENG CHENG,§ ANNE R. LEE,* JASON W. HARPER,* and GOVIND BHAGAT‡ Departments of *Medicine and ‡Surgical Pathology, Columbia University College of Physicians and Surgeons, New York, New York, and §Department of Gastroenterology, Virginia Commonwealth University, Richmond, Virginia WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT3 As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATINGCHRONIC ABDOMINAL DISTENSIONCHRONIC BLOATING AND DISTENTIONCAUSES OF ABDOMINAL DISTENTIONABDOMINAL DISTENTION AND PAINTREATMENT FOR ABDOMINAL BLOATING DISTENTIONABDOMINAL DISTENTION MEANING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is SERRATED POLYPOSIS SYNDROME Colorectal serrated polyps (SPs) are a pathologically diverse group of lesions that include hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), and sessile serrated polyps (SSPs). Although the majority of sporadic colorectal cancers (CRCs) arise from adenomatous polyps, SSPs are believed to be the precursor in up to 30% of cases. Serrated polyposis syndrome (SPS), formerly called CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIANAUSEA AND LEUKEMIAWHAT CAN CAUSE LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for MANAGEMENT OF AUTOIMMUNE PANCREATITIS Autoimmune pancreatitis (AIP) is a chronic, steroid-responsive fibroinflammatory disease of the pancreas. The incidence and prevalence of AIP remain largely unknown, but they are increasingly being identified. One study from Japan reported an incidence of 1 per 100,000, whereas the prevalence was estimated to be 5%–6% of all patients with chronic pancreatitis.1 AIP often mimics pancreatic BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THEAUTOIMMUNE HEPATITIS WORKUPLIFE EXPECTANCY AUTOIMMUNE HEPATITISAUTOIMMUNE HEPATITIS TREATMENT GUIDELINESAUTOIMMUNE HEPATITIS UPTODATEENTOCORT FOR AUTOIMMUNE HEPATITISAUTOIMMUNE HEPATITIS STAGES OF DISEASE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIAACUTE NEUROLOGICAL PORPHYRIA The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND …JOURNAL OF CLINICAL GASTROENTEROLOGY AND HEP…CLINICAL GASTROENTEROLOGY AND HEPATOLOGY A…CLINICAL GASTROENTEROLOGY AND HEPATOLOGY E…GASTROENTEROLOGY AND HEPATOLOGY JOURNALGASTROENTEROLOGY AND HEPATOLOGY SPECIALISTSPEDIATRIC GASTROENTEROLOGY HEPATOLOGY Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to SYSTEMATIC REVIEWS AND META-ANALYSES SYSTEMATIC REVIEWS AND META-ANALYSES Fasiha Kanwal, Section Editor Effects of Antidepressants in Patients With Functional Esophageal Disorders or Gastroesophageal Reflux Disease: WHAT IS LYNCH-LIKE SYNDROME AND HOW SHOULD WE MANAGE IT3 As its name implies, Lynch-like syndrome looks like Lynch syndrome, but it is not. To understand what Lynch-like syndrome is requires that we acknowledge the interplay among a phenotype, its underlying mechanisms, our ability to recognize these mechanisms, and what we capture when we label something. Here, we must start with Lynch syndrome. A brief tour of the history of our ability to MANAGEMENT OF CHRONIC ABDOMINAL DISTENSION AND BLOATINGCHRONIC ABDOMINAL DISTENSIONCHRONIC BLOATING AND DISTENTIONCAUSES OF ABDOMINAL DISTENTIONABDOMINAL DISTENTION AND PAINTREATMENT FOR ABDOMINAL BLOATING DISTENTIONABDOMINAL DISTENTION MEANING with chronic bloating and distension. During this process the diaphragm contracts (descends) and the anterior abdominal wall muscles relax.28 This response is SERRATED POLYPOSIS SYNDROME Colorectal serrated polyps (SPs) are a pathologically diverse group of lesions that include hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), and sessile serrated polyps (SSPs). Although the majority of sporadic colorectal cancers (CRCs) arise from adenomatous polyps, SSPs are believed to be the precursor in up to 30% of cases. Serrated polyposis syndrome (SPS), formerly called CHRONIC DIARRHEA CAUSED BY CHRONIC LYMPHOCYTIC LEUKEMIANAUSEA AND LEUKEMIAWHAT CAN CAUSE LEUKEMIA A 65-year-old man with a history of hypogammaglobulinemia and recurrent sinusitis presented with worsening diarrhea and fecal urgency over 6 months. The diarrhea was associated with abdominal pain, early satiety, anorexia, fatigue, and weight loss. Laboratory investigations showed mild absolute lymphocytosis and a slight increase of β2 microglobulin levels. An extensive work-up for MANAGEMENT OF AUTOIMMUNE PANCREATITIS Autoimmune pancreatitis (AIP) is a chronic, steroid-responsive fibroinflammatory disease of the pancreas. The incidence and prevalence of AIP remain largely unknown, but they are increasingly being identified. One study from Japan reported an incidence of 1 per 100,000, whereas the prevalence was estimated to be 5%–6% of all patients with chronic pancreatitis.1 AIP often mimics pancreatic BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THEAUTOIMMUNE HEPATITIS WORKUPLIFE EXPECTANCY AUTOIMMUNE HEPATITISAUTOIMMUNE HEPATITIS TREATMENT GUIDELINESAUTOIMMUNE HEPATITIS UPTODATEENTOCORT FOR AUTOIMMUNE HEPATITISAUTOIMMUNE HEPATITIS STAGES OF DISEASE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 INTERMITTENT UNEXPLAINED ABDOMINAL PAIN: IS IT PORPHYRIAACUTE NEUROLOGICAL PORPHYRIA The Problem. Abdominal pain is the most common clinical manifestation of acute porphyria, occurring in 85%–95% of individuals with clinical expression of disease ( Table 1 ). The 4 types of acute porphyria are acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and aminolevulinate dehydratase MUSCLE CRAMPS IN LIVER DISEASE Muscle cramps are common in patients with liver disease and adversely influence quality of life. The exact mechanisms by which they occur remain unclear, although a number of pathophysiological events unique to liver disease may contribute. Clinical studies have identified alterations in 3 areas: nerve function, energy metabolism, and plasma volume/electrolytes. PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND …JOURNAL OF CLINICAL GASTROENTEROLOGY AND HEP…CLINICAL GASTROENTEROLOGY AND HEPATOLOGY A…CLINICAL GASTROENTEROLOGY AND HEPATOLOGY E…GASTROENTEROLOGY AND HEPATOLOGY JOURNALGASTROENTEROLOGY AND HEPATOLOGY SPECIALISTSPEDIATRIC GASTROENTEROLOGY HEPATOLOGY Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to SYSTEMATIC REVIEWS AND META-ANALYSES SYSTEMATIC REVIEWS AND META-ANALYSES Fasiha Kanwal, Section Editor Effects of Antidepressants in Patients With Functional Esophageal Disorders or Gastroesophageal Reflux Disease: HOME PAGE: CLINICAL GASTROENTEROLOGY AND HEPATOLOGY This special issue serves as a go-to resource for practicing clinicians on the current understanding of the microbiome’s role in a variety of gastrointestinal diseases and provides a clinical context for translational and basic science researchers engaged in this topic. Ultimately, we hope it will facilitate further research that makes meaningful progress toward unraveling the mysteries of DIAPHRAGMATIC BREATHING REDUCES BELCHING AND PROTON PUMP In patients with gastroesophageal reflux disease (GERD) and excessive belching, most belches are supragastric, and can induce reflux episodes and worsen GERD. Supragastric belching (SGB) might be reduced with diaphragmatic breathing exercises. We investigated whether diaphragmatic breathing therapy is effective in reducing belching and proton pump inhibitor (PPI)-refractory CURRENT AND FUTURE APPLICATIONS OF TELEMEDICINE TO Telemedicine is defined broadly by the World Health Organization as the delivery of health care services at a distance using electronic means for “the diagnosis of treatment, and prevention of disease and injuries, research and evaluation, education of health care providers”1 to improve health. Although no single accepted definition exists, telehealth often is used as the umbrella term to PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND HEPATOLOGY Hepatic cysts are more prevalent in women, and the average volume of hepatic cysts is higher in women (5.27 mL) versus men (1.94 mL).4,9 This difference in volume seems to BUDESONIDE IN AUTOIMMUNE HEPATITIS: THE RIGHT DRUG AT THE Autoimmune hepatitis (AIH) is a rare liver disease caused by an autoreactive immune response against the patient’s own liver. AIH may start with an episode of acute hepatitis but usually runs a chronic course. Untreated AIH may develop into liver cirrhosis and its complications. Most patients respond well to prednisolone with or without azathioprine, the so-called standard of care.1,2 SYSTEMATIC REVIEWS AND META-ANALYSES SYSTEMATIC REVIEWS AND META-ANALYSES Fasiha Kanwal, Section Editor Effects of Antidepressants in Patients With Functional Esophageal Disorders or Gastroesophageal Reflux Disease: HIGH RESOLUTION MANOMETRY IN SCLERODERMA PATIENTS We read with interest the article by Crowell et al1 regarding the prevalence and type of esophageal motor abnormalities in systemic scleroderma patients. In that study, which involved 200 patients and 102 controls, the distinctive features of scleroderma esophagus (hypotensive esophagogastric junction pressure with absent contractility) were detected in only one third of patients. FOLLOW-UP TESTING AFTER TREATMENT OF HELICOBACTER PYLORI Before the seriousness of H. pylori infections was fully appreciated and when it was still believed that H. pylori eradication therapy could routinely cure more than 90% of patients, confirmation of cure testing was not routinely recommended. Although confirmation for cure testing is currently considered the standard of care, preferably with noninvasive tests such as the stool antigen or a FIBROSIS PROGRESSION IN NONALCOHOLIC FATTY LIVER VS Little is known about differences in rates of fibrosis progression between patients with nonalcoholic fatty liver (NAFL) vs nonalcoholic steatohepatitis (NASH). We conducted a systematic review and meta-analysis of all studies that assessed paired liver biopsy specimens to estimate the rates of fibrosis progression in patients with nonalcoholic fatty liver disease (NAFLD) including NAFL and NASH. AN ASSOCIATION BETWEEN MICROSCOPIC COLITIS AND CELIAC DISEASE An Association Between Microscopic Colitis and Celiac Disease PETER H. R. GREEN,* JUN YANG,* JIANFENG CHENG,§ ANNE R. LEE,* JASON W. HARPER,* and GOVIND BHAGAT‡ Departments of *Medicine and ‡Surgical Pathology, Columbia University College of Physicians and Surgeons, New York, New York, and §Department of Gastroenterology, Virginia Commonwealth University, Richmond, Virginia Skip to Main Content__
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THE RISK OF EXTRAINTESTINAL CANCER IN INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF POPULATION-BASED COHORT STUDIES Systematic Reviews and Meta-Analyses RISK OF LATE POSTOPERATIVE RECURRENCE OF CROHN’S DISEASE IN PATIENTS IN ENDOSCOPIC REMISSION AFTER ILEOCECAL RESECTION, OVER 10 YEARS ATMULTIPLE CENTERS
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ILEAL OR COLONIC HISTOLOGIC ACTIVITY IS NOT ASSOCIATED WITH CLINICAL RELAPSE IN PATIENTS WITH CROHN’S DISEASE IN ENDOSCOPIC REMISSIONAlimentary Tract
MPORTANCE OF DISCONNECTED PANCREATIC DUCT SYNDROME IN RECURRENCE OF PANCREATIC FLUID COLLECTIONS INITIALLY DRAINED USING LUMEN-APPOSINGMETAL STENTS
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AGA CLINICAL PRACTICE UPDATE ON MANAGEMENT OF BLEEDING GASTRIC VARICES: EXPERT REVIEW Management of bleeding gastric varices (GV) presents a unique challenge for patients with portal hypertension. Despite over thirty years of diagnostic and treatment advances standardized practices for bleeding GV are lacking and unsupported by adequate evidence. -------------------------View Current Issue
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Therapeutic Drug Monitoring of Non-Anti-Tumor Necrosis FactorBiologics
Richa Shukla, Ashwin Ananthakrishnan DOI: https://doi.org/10.1016/j.cgh.2021.01.002 Vol. 19, Issue 6, p1108–1110Full-Text HTML
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Enhanced Liver Fibrosis Score Can Be Used to Predict Liver-Related Events in Patients With Nonalcoholic Steatohepatitis and CompensatedCirrhosis
Vijay S. Are, Raj Vuppalanchi, Eduardo Vilar-Gomez, Naga Chalasani DOI: https://doi.org/10.1016/j.cgh.2020.06.070 Vol. 19, Issue 6, p1292–1293.e3Full-Text HTML
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Physical Activity, Measured Objectively, Is Associated With Lower Mortality in Patients With Nonalcoholic Fatty Liver Disease Donghee Kim, Soumya Murag, George Cholankeril, Amanda Cheung, Stephen A. Harrison, Zobair M. Younossi, and others DOI: https://doi.org/10.1016/j.cgh.2020.07.023 Vol. 19, Issue 6, p1240–1247.e5Full-Text HTML
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CME Activities–Exam 1 DOI: https://doi.org/10.1016/j.cgh.2021.06.004 Publication stage: In Press Uncorrected ProofFull-Text HTML
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No durable impact of COVID-19 on intestinal disease activity insubjects with IBD
Dana Lukin, Gabriela Funez-dePagnier, Svetlana Lima, Daniel Lai, Lucia Duenas-Bianchi, Waseem Ahmed, and others DOI: https://doi.org/10.1016/j.cgh.2021.06.008 Publication stage: In Press Journal Pre-Proof*
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Early Dynamics of MELD Scores Predict Corticosteroid Responsiveness to Severe Acute-onset Autoimmune Hepatitis Fumie Noguchi, Po-sung Chu, Aya Yoshida, Nobuhito Taniki, Rei Morikawa, Yasushi Hasegawa, and others DOI: https://doi.org/10.1016/j.cgh.2021.06.006 Publication stage: In Press Journal Pre-Proof*
The placebo response in randomised trials in nonalcoholic steatohepatitis simply explained Ian A. Rowe, Richard Parker DOI: https://doi.org/10.1016/j.cgh.2021.05.059 Publication stage: In Press Journal Pre-Proof*
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DOI: https://doi.org/10.1016/j.cgh.2020.04.001 Clinical Gastroenterology and Hepatology, Vol. 18, Issue 8,p1663–1672
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AGA Clinical Practice Update on Management of Bleeding Gastric Varices: Expert Review Zachary Henry, Kalpesh Patel, Heather Patton, Wael Saad DOI: https://doi.org/10.1016/j.cgh.2021.01.027 Clinical Gastroenterology and Hepatology, Vol. 19, Issue 6,p1098–1107.e1
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Right Upper Quadrant Pain and a Normal Abdominal Ultrasound Furqaan Ahmed, Evan L. Fogel DOI: https://doi.org/10.1016/j.cgh.2008.06.020 Clinical Gastroenterology and Hepatology, Vol. 6, Issue 11,p1198–1201
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Food Hypersensitivity as a Cause of Rectal Bleeding in Adults Antonio Carroccio, Giuseppe Iacono, Lidia Di Prima, Alberto Ravelli, Giuseppe Pirrone, Angelo B. Cefalù, and others DOI: https://doi.org/10.1016/j.cgh.2008.07.029 Clinical Gastroenterology and Hepatology, Vol. 7, Issue 1, p120–122Full-Text HTML
2020 CITED ARTICLES
ISSN%281542-3565%29+AND+PUBYEAR+IS+2020+ ------------------------- * Clinical Features of COVID-19-Related Liver Functional Abnormality * Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management * Don't Overlook Digestive Symptoms in Patients With 2019 Novel Coronavirus Disease (COVID-19) * ACE2 Expression in Pancreas May Cause Pancreatic Damage After SARS-CoV-2 Infection * Burden of Gastric Cancer*
THE GUT MICROBIOME AND DIGESTIVE HEALTH – A NEW FRONTIER This special issue serves as a go-to resource for practicing clinicians on the current understanding of the microbiome’s role in a variety of gastrointestinal diseases. Read the issue.
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SPECIAL ISSUE ON THE ART AND SCIENCE OF MANAGING LIVER DISEASE This special issue of _CGH_ focuses on the clinical management of several hepatic disorders including common conditions such as nonalcoholic fatty liver disease (NAFLD) and viral hepatitis, and uncommon but difficult disorders such as autoimmune hepatitis and primary sclerosing cholangitis (PSC). RELATED PUBLICATIONSJune 2021
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SPECIAL ISSUE: THE GUT MICROBIOME AND DIGESTIVE HEALTH – A NEWFRONTIER
This special issue serves as a go-to resource for practicing clinicians on the current understanding of the microbiome’s role in a variety of gastrointestinal diseases and provides a clinical context for translational and basic science researchers engaged in this topic. Ultimately, we hope it will facilitate further research that makes meaningful progress toward unraveling the mysteries of some of our most complex diseases, and offers new therapeutic options that would allow us to safely and effectively improve patient outcomes.JOURNAL METRICS
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