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Risk Factors for Bile Aspiration and its Impact on Clinical Outcomes
Rosen, Rachel MD, MPH1; Lurie, Margot BA1; Kane, Madeline BS1; DiFilippo, Courtney BS1; Cohen, Alexandra BA1; Freiberger, Dawn RN2; Boyer, Debra MD2; Visner, Gary DO2; Narvaez-Rivas, Monica PhD3; Liu, Enju PhD4; Setchell, Kenneth PhD3
doi : 10.14309/ctg.0000000000000434
December 2021 - Volume 12 - Issue 12 - p e00434
Bile reflux may cause for lung allograft rejection, yet there are no studies that determine (i) the relationship between gastric and lung bile concentrations, (ii) whether bile is present in lungs of nontransplant patients, (iii) the relationship between gastric dysmotility and lung bile, (iv) the impact of reflux therapies on lung bile, and (v) whether lung bile worsens outcomes in nontransplant patients. This study will address these gaps in the literature.
A Coached Digital Cognitive Behavioral Intervention Reduces Anxiety and Depression in Adults With Functional Gastrointestinal Disorders
Szigethy, Eva MD, PhD1,2; Tansel, Aylin MD, MPH2; Pavlick, Alexa N. BA1; Marroquin, Maria A. BA1; Serio, Catherine D. PhD3; Silfee, Valerie BA3; Wallace, Meredith L. PhD1; Kingsley, Michael J. MD2; Levinthal, David J. MD, PhD2
doi : 10.14309/ctg.0000000000000436
December 2021 - Volume 12 - Issue 12 - p e00436
Traditional cognitive behavioral interventions (CBIs) improve mood and gastrointestinal symptom severity in patients with functional gastrointestinal disorders (FGIDs) but face substantial barriers to implementation. Integrating behavioral health technology into medical clinic workflows could overcome these barriers. We evaluated the feasibility and impact of a coached digital CBI (dCBI) as a first-line intervention in a prospective cohort of emotionally distressed patients with FGID.
Lack of Effect of Gluten Challenge on Fecal Microbiome in Patients With Celiac Disease and Non-Celiac Gluten Sensitivity
Nobel, Yael R. MD1; Rozenberg, Felix BA2; Park, Heekuk PhD2; Freedberg, Daniel E. MD, MS1; Blaser, Martin J. MD3; Green, Peter H.R. MD1,4; Uhlemann, Anne-Catrin MD, PhD2,5; Lebwohl, Benjamin MD, MS1,4
doi : 10.14309/ctg.0000000000000441
December 2021 - Volume 12 - Issue 12 - p e00441
Celiac disease (CD) may be associated with gut microbial dysbiosis. Whether discrete gluten exposure in subjects with well-controlled disease on a gluten-free diet impacts the gut microbiome is unknown and may have implications for understanding disease activity and symptoms. We conducted a prospective study to evaluate the impact of gluten exposure on the gut microbiome in patients with CD and nonceliac gluten sensitivity (NCGS).
Role of Wide-Area Transepithelial Sampling With 3D Computer-Assisted Analysis in the Diagnosis and Management of Barrett's Esophagus
Odze, Robert D. MD, FRCPc1; Goldblum, John MD2; Kaul, Vivek MD, FACG3
doi : 10.14309/ctg.0000000000000422
December 2021 - Volume 12 - Issue 12 - p e00422
Barrett's esophagus (BE) is a premalignant condition in which cancer prevention is performed by endoscopic surveillance combined with Seattle protocol mucosal biopsies. The Seattle protocol has significant limitations, including a high rate of sampling error due to the focality of dysplasia/carcinoma, low endoscopist adherence to the protocol, and a high degree of variability in pathologic interpretation. These factors all contribute to a high incidence of cancers missed within 1 year of surveillance endoscopy. Wide-area transepithelial sampling with computer-assisted three-dimensional analysis (WATS3D) is a relatively new technique that minimizes sampling error by using a brush biopsy device that extensively samples “at risk” mucosa and helps pathologists diagnose dysplasia/neoplasia by generating three-dimensional images of whole crypts using a neural network-based software program. Several large prospective trials (involving both academic and community practices) have shown significantly increased rates of detection of dysplasia and intestinal metaplasia in both screening and surveillance in patients with BE when used as an adjunct to Seattle protocol-based forceps biopsies. The WATS3D diagnostic platform was included in the most recent American Society for Gastrointestinal Endoscopy Barrett's guideline as an adjunct to forceps biopsies (conditional recommendation and low quality of evidence). This review summarizes the scientific and pathologic basis of WATS3D technology, its potential impact on BE surveillance and management, and its limitations and future directions.
Modifying Crohn's Colitis Recurrence Through Surgery? The Jury Is Still Out
Sang, Adam MD1; Shmidt, Eugenia MD2; Melton, Genevieve B. MD, PhD1
doi : 10.14309/ctg.0000000000000421
December 2021 - Volume 12 - Issue 12 - p e00421
Data suggesting that the mesentery plays an important pathophysiologic role in Crohn's disease and recurrence make the mesentery an attractive therapeutic target during surgical management of Crohn's disease. A new study by Zhu et al. demonstrates that patients with Crohn's colitis who undergo a more extensive mesenteric resection may have a lower rate of needing subsequent operations. We discuss some of the reasons why these data, although much needed by the inflammatory bowel disease community, do not yet sway standard surgical practice for Crohn's colitis.
