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Recent Developments Pertaining to H. pylori Infection.
Howden, Colin W. MD, FACG 1; Graham, David Y. MD, MACG 2
doi : 10.14309/ajg.0000000000001031
January 2021 - Volume 116 - Issue 1 - p 1-3
Managing the Inevitable Surge of Post–COVID-19 Functional Gastrointestinal Disorders
Schmulson, Max; Ghoshal, Uday C.; Barbara, Giovanni
doi : 10.14309/ajg.0000000000001062
January 2021 - Volume 116 - Issue 1 - p 4-7
A Rare Case of Esophageal Hypomotility in a Middle-Aged Woman
Lin, Hung-En; Lu, Ching-Liang; Wang, Yen-Po
doi : 10.14309/ajg.0000000000000613
January 2021 - Volume 116 - Issue 1 - p 8
Multifocal Intramucosal Gastric Adenocarcinoma Arising in Fundic Gland Polyposis Due to Gastric Adenocarcinoma and Proximal Polyposis of the Stomach
Powers, Jacquelyn; Sande, Christopher M.; Fortuna, Danielle; Katona, Bryson W.
doi : 10.14309/ajg.0000000000000625
January 2021 - Volume 116 - Issue 1 - p 9
Where Did the Colon Cancer Go?
Marques-de-S?, Inês; Pita, Inês; Coimbra, Nuno; Dinis-Ribeiro, M?rio
doi : 10.14309/ajg.0000000000000644
January 2021 - Volume 116 - Issue 1 - p 10
Multimodality Endotherapy of Esophageal-Pleural Fistula Using a Novel Stent-Anchoring Mechanism
Abdulla, Hamza M.; Crain, Rebecca; Gomez, Guillermo A.; Guturu, Praveen; Parupudi, Sreeram
doi : 10.14309/ajg.0000000000000642
January 2021 - Volume 116 - Issue 1 - p 11
Ring-Shaped Thread Counter Traction–Assisted Endoscopic Retrograde Cholangiopancreatography of a Huge Periampullary Diverticula
Ishikawa-Kakiya, Yuki; Maruyama, Hirotsugu; Yamamoto, Kei; Yamamura, Masafumi; Tanoue, Kojiro; Ominami, Masaki; Fukunaga, Shusei; Taira, Koichi; Nagami, Yasuaki; Watanabe, Toshio; Fujiwara, Yasuhiro
doi : 10.14309/ajg.0000000000000842
January 2021 - Volume 116 - Issue 1 - p 12
Continuing Medical Education Questions: January 2021
Friedenberg, Frank K.
doi : 10.14309/ajg.0000000000001120
January 2021 - Volume 116 - Issue 1 - p 15
Article Title: Assessing for Eating Disorders: A Primer for Gastroenterologists
Continuing Medical Education Questions: January 2021
Staller, Kyle D.
doi : 10.14309/ajg.0000000000001092
January 2021 - Volume 116 - Issue 1 - p 16
Article Title: ACG Clinical Guideline: Management of Irritable Bowel Syndrome
ACG Clinical Guideline: Management of Irritable Bowel Syndrome
Lacy, Brian E.; Pimentel, Mark; Brenner, Darren M.; Chey, William D.; Keefer, Laurie A.; Long, Millie D.; Moshiree, Baha
doi : 10.14309/ajg.0000000000001036
January 2021 - Volume 116 - Issue 1 - p 17-44
Irritable bowel syndrome (IBS) is a highly prevalent, chronic disorder that significantly reduces patients' quality of life. Advances in diagnostic testing and in therapeutic options for patients with IBS led to the development of this first-ever American College of Gastroenterology clinical guideline for the management of IBS using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Twenty-five clinically important questions were assessed after a comprehensive literature search; 9 questions focused on diagnostic testing; 16 questions focused on therapeutic options.
Biosimilars in Inflammatory Bowel Disease
Buchner, Anna M.; Schneider, Yecheskel; Lichtenstein, Gary R.
doi : 10.14309/ajg.0000000000000844
January 2021 - Volume 116 - Issue 1 - p 45-56
Over the past 2 decades, biological therapy with monoclonal antibodies targeting tumor necrosis factor-? has become a cornerstone of treatment of patients with inflammatory bowel disease. Although clinically effective, the biological therapies remain expensive, and their availability and utilization have been at times limited due to their high costs. Biosimilars are biological products similar to but not identical to the original biological agent or “reference biologic,” also called “originator biologic.”
Role of Locoregional Therapies in Patients With Hepatocellular Cancer Awaiting Liver Transplantation
Thuluvath, Paul J.; To, Chau; Amjad, Waseem
doi : 10.14309/ajg.0000000000000999
January 2021 - Volume 116 - Issue 1 - p 57-67
Hepatocellular cancer (HCC) is the fifth most common cancer in the world and the third most common cause of cancer-related deaths. The United Network for Organ Sharing has its own staging criteria for organ allocation, which is a modification of tumor-node-metastasis staging of American Joint Committee on Cancer. For the purpose of clarity, United Network for Organ Sharing staging will be described as uT1, uT2 (Milan criteria), and uT3 (eligible for downstaging) in this review. For those with unresectable HCC or those with advanced liver disease and HCC but within the Milan criteria, liver transplantation is the treatment of choice.
Assessing for Eating Disorders: A Primer for Gastroenterologists
Werlang, Monia E.; Sim, Leslie A.; Lebow, Jocelyn R.; Lacy, Brian E.
doi : 10.14309/ajg.0000000000001029
January 2021 - Volume 116 - Issue 1 - p 68-76
Eating disorders involve irregularities in eating behavior that may cause gastrointestinal (GI) symptoms. Consequently, many patients with eating disorders seek gastroenterological healthcare at some point in their illness, with many seeking this care even before they seek treatment for and/or diagnosed with their eating disorder. As such, the gastroenterology provider is in a unique position to identify, manage, and facilitate treatment for an eating disorder early in the course of the illness.
Keratin-18: Diagnostic, Prognostic, and Theragnostic for Alcohol-Associated Hepatitis
McClain, Craig J.; Vatsalya, Vatsalya; Mitchell, Mack C.
doi : 10.14309/ajg.0000000000001042
January 2021 - Volume 116 - Issue 1 - p 77-79
It is still sometimes difficult to differentiate alcohol-associated hepatitis (AH) from other liver problems. In this edition of AJG, Atkinson et al. showed that keratin-18 (intermediate filament protein) is a promising biomarker for predicting histological severity of AH, defining the type of hepatocyte death (necrosis vs apoptosis), predicting 90-day mortality, and predicting the response to corticosteroid therapy in severe AH. The authors conclude that K18 is diagnostic, prognostic, and may be a theragnostic marker for prednisolone therapy and note that “serum K18 estimation should be adopted into routine clinical practice.” We agree.
Translumbosacral Neuromodulation Therapy Is a Promising Option for Fecal Incontinence
Bharucha, Adil E.; Oblizajek, Nicholas R.
doi : 10.14309/ajg.0000000000001069
January 2021 - Volume 116 - Issue 1 - p 80-81
Fecal incontinence is a common symptom that can significantly impair quality of life. The treatment options range from conservative measures (e.g., Kegel exercises, pelvic floor biofeedback therapy, fiber supplementation, or medications) to noninvasive nerve stimulation (e.g., posterior tibial nerve stimulation and transcutaneous tibial nerve stimulation), implanted neurostimulation (i.e., sacral nerve stimulation), perianal injection of dextranomer, and anal sphincteroplasty. In this issue of the journal, a promising, uncontrolled study suggests that noninvasive, repetitive magnetic stimulation of the lumbosacral nerves significantly improved symptoms, increased anal squeeze pressure, and increased rectal compliance in patients with fecal continence. Sham-controlled studies are necessary to confirm these findings.
“ASKing” the Right Questions About Screening for Celiac Disease
Forbes, Geoffrey M.
doi : 10.14309/ajg.0000000000001026
January 2021 - Volume 116 - Issue 1 - p 82-83
Make a distinction between investigating symptoms and screening for disease. Understand the performance characteristics of a test for those with symptoms and for screening those without symptoms, whether at elevated risk or average risk of disease. Positive test results require patient education and follow-up. Importantly, screening should be advantageous to an individual, and disease treatment should be in their interest. The practical application of these principles in relation to population-based Celiac disease screening may be difficult, as a large Colorado study has found.
Does Size Really Matter?
Coelho-Prabhu, Nayantara; Kane, Sunanda
doi : 10.14309/ajg.0000000000001057
January 2021 - Volume 116 - Issue 1 - p 84-85
Ileocolonoscopy remains the mainstay of objective disease assessment in Crohn's Disease, and various validated indices are used to grade severity of the disease. The most commonly used indices are the Simple Endoscopic Score for Crohn's Disease (including the size of ulcers) and the Crohn's Disease Endoscopic Index of Severity (including the depth of ulcers). These measurements are highly subjective, especially the depth of an ulcer, and are based solely on the discretion of the endoscopist coupled with the imaging capabilities of the colonoscope and adequacy of the bowel prep. Narula et al.
Effects of Diaphragmatic Breathing on the Pathophysiology and Treatment of Upright Gastroesophageal Reflux: A Randomized Controlled Trial
Halland, Magnus; Bharucha, Adil E.; Crowell, Michael D.; Ravi, Karthik; Katzka, David A.
doi : 10.14309/ajg.0000000000000913
January 2021 - Volume 116 - Issue 1 - p 86-94
Uncontrolled results suggest that diaphragmatic breathing (DB) is effective in gastroesophageal reflux disease (GERD) but the mechanism of action and rigor of proof is lacking. This study aimed to determine the effects of DB on reflux, lower esophageal sphincter (LES), and gastric pressures in patients with upright GERD and controls.
Variation Over Time and Factors Associated With Detection Rates of Sessile Serrated Lesion Across the United States: Results Form a National Sample Using the GIQuIC Registry
Shaukat, Aasma; Holub, Jennifer; Greenwald, David; Eisen, Glenn; Schmitt, Colleen
doi : 10.14309/ajg.0000000000000824
January 2021 - Volume 116 - Issue 1 - p 95-99
Sessile serrated lesions (SSLs) are important precursor lesions for the CpG island–methylated pathway to colorectal cancer. The reported detection rates of SSL are highly variable, and national or population-based estimates are not available. Patient-, provider-, and procedure-level factors associated with the detection rates of SSL have not been well described. The aim of our study was to study the detection rates of SSL, variability of rates over time, and factors associated with detection rates of SSL in a national sample of patients undergoing colonoscopy using the GIQuIC registry.
Time Trend of the Radiation Exposure Dose in Endoscopic Retrograde Cholangiopancreatography Over an 8-Year Period: A Single-Center Retrospective Study
Hayashi, Shiro; Nishida, Tsutomu; Osugi, Naoto; Yamaoka, Sho; Sugimoto, Aya; Mukai, Kaori; Nakamatsu, Dai; Matsumoto, Kengo; Yamamoto, Masashi; Fukui, Koji; Takenaka, Mamoru; Hosono, Makoto; Inada, Masami
doi : 10.14309/ajg.0000000000000838
January 2021 - Volume 116 - Issue 1 - p 100-105
The global needs for a reduction in radiation exposure (RE) are increasing. Endoscopic retrograde cholangiopancreatography (ERCP) is a significant fluoroscopic procedure in the gastrointestinal field. However, the actual RE in ERCP and its annual trend are still unclear. Therefore, we examined the yearly trend of RE in ERCP.
Obesity, Diabetes, Coffee, Tea, and Cannabis Use Alter Risk for Alcohol-Related Cirrhosis in 2 Large Cohorts of High-Risk Drinkers
Whitfield, John B.; Masson, Steven; Liangpunsakul, Suthat; Mueller, Sebastian; Aithal, Guruprasad P.; Eyer, Florian; Gleeson, Dermot; Thompson, Andrew; Stickel, Felix; Soyka, Michael; Muellhaupt, Beat; Daly, Ann K.; Cordell, Heather J.; Foroud, Tatiana; Lumeng, Lawrence; Pirmohamed, Munir; Nalpas, Bertrand; Jacquet, Jean-Marc; Moirand, Romain; Nahon, Pierre; Naveau, Sylvie; Perney, Pascal; Haber, Paul S.; Seitz, Helmut K.; Day, Christopher P.; Mathurin, Philippe; Morgan, Timothy R.; Seth, Devanshi; for the GenomALC Consortium
doi : 10.14309/ajg.0000000000000833
January 2021 - Volume 116 - Issue 1 - p 106-115
Sustained high alcohol intake is necessary but not sufficient to produce alcohol-related cirrhosis. Identification of risk factors, apart from lifetime alcohol exposure, would assist in discovery of mechanisms and prediction of risk.
Effects of Statin Use on the Development and Progression of Nonalcoholic Fatty Liver Disease: A Nationwide Nested Case-Control Study
Lee, Jung Il; Lee, Hyun Woong; Lee, Kwan Sik; Lee, Hye Sun; Park, Ju-Young
doi : 10.14309/ajg.0000000000000845
January 2021 - Volume 116 - Issue 1 - p 116-124
The use of statins in nonalcoholic fatty liver disease (NAFLD) may reduce cardiovascular morbidity, although their effect on NAFLD itself is not well known. We aimed to investigate the role of statins on the development of de novo NAFLD and progression of significant liver fibrosis.
Cost-Effectiveness of 5-Aminosalicylate Therapy in Combination With Biologics or Tofacitinib in the Treatment of Ulcerative Colitis
Shaffer, Seth R.; Huang, Elbert; Patel, Shivani; Rubin, David T.
doi : 10.14309/ajg.0000000000000847
January 2021 - Volume 116 - Issue 1 - p 125-133
Medications are major cost drivers in the treatment of patients with inflammatory bowel disease. Recent analyses suggest that there is no added efficacy in continuing nor harm in stopping 5-aminosalicylate (ASA) therapy in patients with inflammatory bowel disease escalated to biological therapies or tofacitinib. We assessed the cost-effectiveness of discontinuing 5-ASA therapy in patients with ulcerative colitis on biological therapies or tofacitinib, compared with continuing 5-ASA therapy.
Location but Not Severity of Endoscopic Lesions Influences Endoscopic Remission Rates in Crohn's Disease: A Post Hoc Analysis of TAILORIX
Rivière, Pauline; D'Haens, Geert; Peyrin-Biroulet, Laurent; Baert, Filip; Lambrecht, Guy; Pariente, Benjamin; Bossuyt, Peter; Buisson, Anthony; Oldenburg, Bas; Vermeire, Séverine; Laharie, David
doi : 10.14309/ajg.0000000000000834
January 2021 - Volume 116 - Issue 1 - p 134-141
The impact of severity and location of Crohn's disease (CD) endoscopic ulcers on endoscopic remission in patients treated with antitumor necrosis factor is poorly known. We aimed to describe the endoscopic evolution of CD lesions in a prospective cohort of patients treated with infliximab (IFX) in combo therapy.
Constipation Predominant Irritable Bowel Syndrome and Functional Constipation Are Not Discrete Disorders: A Machine Learning Approach
Ruffle, James K.; Tinkler, Linda; Emmett, Christopher; Ford, Alexander C.; Nachev, Parashkev; Aziz, Qasim; Farmer, Adam D.; Yiannakou, Yan
doi : 10.14309/ajg.0000000000000816
January 2021 - Volume 116 - Issue 1 - p 142-151
Chronic constipation is classified into 2 main syndromes, irritable bowel syndrome with constipation (IBS-C) and functional constipation (FC), on the assumption that they differ along multiple clinical characteristics and are plausibly of distinct pathophysiology. Our aim was to test this assumption by applying machine learning to a large prospective cohort of comprehensively phenotyped patients with constipation.
Senna Versus Magnesium Oxide for the Treatment of Chronic Constipation: A Randomized, Placebo-Controlled Trial
Morishita, Daisuke; Tomita, Toshihiko; Mori, Sumire; Kimura, Takeshi; Oshima, Tadayuki; Fukui, Hirokazu; Miwa, Hiroto
doi : 10.14309/ajg.0000000000000942
January 2021 - Volume 116 - Issue 1 - p 152-161
This is the first prospective, double-blinded, randomized, placebo-controlled trial to evaluate the safety and efficacy of a stimulant laxative compared with an osmotic agent for the treatment of chronic idiopathic constipation.
Translumbosacral Neuromodulation Therapy for Fecal Incontinence: A Randomized Frequency Response Trial
Rao, Satish S.C.; Xiang, Xuelian; Sharma, Amol; Patcharatrakul, Tanisa; Yan, Yun; Parr, Rachael; Ayyala, Deepak; Hamdy, Shaheen
doi : 10.14309/ajg.0000000000000766
January 2021 - Volume 116 - Issue 1 - p 162-170
Treatments for fecal incontinence (FI) remain unsatisfactory because they do not remedy the underlying multifactorial dysfunction(s) including anorectal neuropathy. The aim of this study was to investigate the optimal dose frequency, clinical effects, and safety of a novel treatment, translumbosacral neuromodulation therapy (TNT), aimed at improving neuropathy.
Colonoscopy Outcomes in Average-Risk Screening Equivalent Young Adults: Data From the New Hampshire Colonoscopy Registry
Butterly, Lynn F.; Siegel, Rebecca L.; Fedewa, Stacey; Robinson, Christina M.; Jemal, Ahmedin; Anderson, Joseph C.
doi : 10.14309/ajg.0000000000000820
January 2021 - Volume 116 - Issue 1 - p 171-179
Data are needed to further inform the American Cancer Society recommendation to begin colorectal cancer (CRC) screening at age 45. We used the New Hampshire Colonoscopy Registry to compare the prevalence of advanced neoplasia (AN) in an “average-risk screening equivalent” group aged 45–49 years with patients aged 50–54 years and older receiving screening colonoscopy.
Mass Screening for Celiac Disease: The Autoimmunity Screening for Kids Study
Stahl, Marisa G.; Geno Rasmussen, Cristy; Dong, Fran; Waugh, Kathleen; Norris, Jill M.; Baxter, Judith; Yu, Liping; Steck, Andrea K.; Frohnert, Brigitte I.; Liu, Edwin; Rewers, Marian J.; the ASK Study Group
doi : 10.14309/ajg.0000000000000751
January 2021 - Volume 116 - Issue 1 - p 180-187
The Autoimmunity Screening for Kids (ASK) study is a large scale pediatric screening study in Colorado for celiac disease (CD) and type 1 diabetes. This is a report of the CD outcomes for the first 9,973 children screened through ASK.
Disease Course and Treatment Response of Eosinophilic Gastrointestinal Diseases in Children With Liver Transplantation: Long-Term Follow-Up
Ozdogan, Elif; Doganay, Latife; Can, Demet; Arikan, Cigdem
doi : 10.14309/ajg.0000000000000934
January 2021 - Volume 116 - Issue 1 - p 188-197
To describe the clinical and laboratory profile, natural course, treatment outcome, and risk factors of posttransplant esophageal and nonesophageal eosinophilic gastrointestinal disorders (EGIDs).
Risk Factor Profiles Can Distinguish Esophageal Adenocarcinoma From Barrett's Esophagus
Sawas, Tarek; Dilmaghani, Saam; Dhaliwal, Lovekirat; Wang, Kenneth K.; Iyer, Prasad G.; Katzka, David A.
doi : 10.14309/ajg.0000000000001001
January 2021 - Volume 116 - Issue 1 - p 198-201
It is assumed that screening risk factors for Barrett's esophagus (BE) and prevalent esophageal adenocarcinoma (EAC) are the same.
Aerosols Produced by Upper Gastrointestinal Endoscopy: A Quantitative Evaluation
Sagami, Ryota; Nishikiori, Hidefumi; Sato, Takao; Tsuji, Hiroaki; Ono, Masami; Togo, Kazumi; Fukuda, Kensuke; Okamoto, Kazuhisa; Ogawa, Ryo; Mizukami, Kazuhiro; Okimoto, Tadayoshi; Kodama, Masaaki; Amano, Yuji; Murakami, Kazunari
doi : 10.14309/ajg.0000000000000983
January 2021 - Volume 116 - Issue 1 - p 202-205
During the coronavirus disease 2019 pandemic, whether endoscopy generates aerosols needs to be determined.
Risk Factors for Delta Hepatitis in a North American Cohort: Who Should Be Screened?
Da, Ben L.; Rahman, Farial; Lai, Walter C.; Kleiner, David E.; Heller, Theo; Koh, Christopher
doi : 10.14309/ajg.0000000000000954
January 2021 - Volume 116 - Issue 1 - p 206-209
The American Association for the Study of Liver Diseases recommends hepatitis D virus (HDV) screening in certain high-risk groups; however, the effectiveness is unknown.
An Increasing Incidence of Upper Gastrointestinal Disorders Over 23 Years: A Prospective Population-Based Study in Sweden
Andreasson, Anna; Talley, Nicholas J.; Walker, Marjorie M.; Jones, Michael P.; Platts, Loretta G.; Wallner, Bengt; Kjellstr?m, Lars; Hellstr?m, Per M.; Forsberg, Anna; Agréus, Lars
doi : 10.14309/ajg.0000000000000972
January 2021 - Volume 116 - Issue 1 - p 210-213
We hypothesized that the prevalence of functional dyspepsia and gastroesophageal reflux disease in the community may be increasing.
An Alternative Recommendation by Experienced Esophagologists
Richter, Joel E.; Vaezi, Michael F.
doi : 10.14309/ajg.0000000000000952
January 2021 - Volume 116 - Issue 1 - p 214
Response to Richter and Vaezi
Gyawali, C. Prakash; Baker, Jason R.; Moshiree, Baha; Rao, Satish; Neshatian, Leila; Nguyen, Linda; Chey, William D.; Saad, Richard; Garza, Jose M.; Waseem, Shamaila; Khan, Abraham R.; Pandolfino, John E.
doi : 10.14309/ajg.0000000000001021
January 2021 - Volume 116 - Issue 1 - p 214-215
Surrogate Markers for Antimitochondrial Antibody–Negative Primary Biliary Cholangitis
Granito, Alessandro; Muratori, Luigi; Tovoli, Francesco; Muratori, Paolo
doi : 10.14309/ajg.0000000000000928
January 2021 - Volume 116 - Issue 1 - p 215-217
Response to Granito et al.
Reig, Anna; Norman, Gary L.; Parés, Albert
doi : 10.14309/ajg.0000000000000980
January 2021 - Volume 116 - Issue 1 - p 217
A Novel Endoscopic Score for Postoperative Recurrence of Crohn's Disease: More Information Needed
Han?el, Jurij
doi : 10.14309/ajg.0000000000000918
January 2021 - Volume 116 - Issue 1 - p 217-218
Response to Hanzel
Hammoudi, Nassim; Allez, Matthieu
doi : 10.14309/ajg.0000000000000991
January 2021 - Volume 116 - Issue 1 - p 218
Sex-Based Disparities in Annual Compensation Among Academic Gastroenterologists
Bushyhead, Daniel; Strate, Lisa L.
doi : 10.14309/ajg.0000000000000804
January 2021 - Volume 116 - Issue 1 - p 219-220
Double Gastroscopy Resection Is a New Attempt to Treat Gastric Submucosal Tumors: A Case Report
Zhou, Haibin; Yang, Jianfeng; Zhang, Xiaofeng
doi : 10.14309/ajg.0000000000000818
January 2021 - Volume 116 - Issue 1 - p 220
A Ring in the Liver
Xu, Junjie; Liang, Xiao; Cai, Xiujun
doi : 10.14309/ajg.0000000000000837
January 2021 - Volume 116 - Issue 1 - p 220-222
Hepatic Abscess After Biodegradable Esophageal Stent Placement: A Rare Complication
Lopez-Tobaruela, Jose Maria; Valverde-Lopez, Francisco; Lopez de Hierro-Ruiz, Mercedes; Redondo-Cerezo, Eduardo
doi : 10.14309/ajg.0000000000000821
January 2021 - Volume 116 - Issue 1 - p 222-223
Personal Protective Equipment Works: A Letter From Portugal
Garrido, Isabel; Cardoso, Maria Jo?o; Guimar?es, Jo?o Tiago; Macedo, Guilherme
doi : 10.14309/ajg.0000000000000839
January 2021 - Volume 116 - Issue 1 - p 223
Calendar of Courses, Symposiums and Conferences
doi : 10.14309/ajg.0000000000001093
January 2021 - Volume 116 - Issue 1 - p 224
