American Journal of Gastroenterology




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ACG Presidential Address 2022.

Shah, Samir A. MD, FACG

doi : 10.14309/ajg.0000000000002119

Volume 118(1) pgs. 1-182 January 2023

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The Tailored Approach to Manometric Esophagogastric Junction Outflow Obstruction: Treat the Clinical Diagnosis, Not the Manometry Pattern.

Carlson, Dustin A. MD, MS 1; Yadlapati, Rena MD, MS 2; Pandolfino, John E. MD, MS 1

doi : 10.14309/ajg.0000000000001938

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The Ongoing Debate of Serum Ammonia Levels in Cirrhosis: the Good, the Bad, and the Ugly.

Deutsch-Link, Sasha MD 1; Moon, Andrew M. MD, MPH 1

doi : 10.14309/ajg.0000000000001966

AB Serum ammonia testing in hepatic encephalopathy (HE) has been long debated in the field of hepatology. Although central to the pathophysiology of HE, serum ammonia testing is fraught with complexities that can lead to challenges in laboratory collection and interpretation.

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Rectal Polyp on Extrinsic Compression Due to Prostatic Stromal Tumor.

Ochiai, Yorinari MD, PhD; Matsui, Akira MD, PhD; Kikuchi, Daisuke MD, PhD; Hoteya, Shu MD, PhD

doi : 10.14309/ajg.0000000000001975

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An Ulcerative Lesion in the Mid-Esophagus.

He, Long MM 1,*; Ye, Liansong MD 1,*; Mou, Yi MD 1,*; Hu, Bing MD 1

doi : 10.14309/ajg.0000000000001978

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Juvenile Polyposis of the Stomach.

Tanaka, Kyosuke MD, PhD; Umeda, Yuhei MD; Nakagawa, Hayato MD, PhD

doi : 10.14309/ajg.0000000000001990

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Esophageal Apoplexy: A Rare Complication of Foreign-Body Ingestion.

Goncalves, Margarida MD 1; Costa, Dalila MD 1,2,3; Rebelo, Ana MD 1

doi : 10.14309/ajg.0000000000001977

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Pleomorphic Hyalinizing Angiectatic Tumor in the Upper Abdomen.

Su, Chaoyun MM 1,*; Zhang, Junwei MD 2,*; Chen, Xiaoxue MM 3; Xu, Yiyao MD 2; Lu, Xin MD 2

doi : 10.14309/ajg.0000000000002007

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Peroral Endoscopic Myotomy for Infantile Esophageal Achalasia: The First Case Treated With an Ultrathin Endoscope.

Tomida, Hideomi MD, PhD 1; Ikeda, Yoshio MD, PhD 1; Tange, Kazuhiro MD 2; Yamamoto, Yasunori MD, PhD 1; Kawamoto, Atsushi MD 3; Eguchi, Mariko MD, PhD 3; Hamada, Taisuke MD 4; Kitamura, Sakiko MD 4; Takeshita, Eiji MD, PhD 2; Hiasa, Yoichi MD, PhD 5

doi : 10.14309/ajg.0000000000001982

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ACG Clinical Guideline: Diagnosis and Management of Gastrointestinal Subepithelial Lesions.

Dhindsa, Banreet MBBS

doi : 10.14309/ajg.0000000000002113

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ACG Guideline: Diagnosis and Management of Celiac Disease.

Chaudrey, Khadija H. MD

doi : 10.14309/ajg.0000000000002111

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Liver-Related Mortality in Hepatitis B Virus Core Antibody+/Hepatitis B Virus Surface Antigen- Patients: Occult Hepatitis B Virus, Hepatitis B Virus Reactivation, and Hepatocellular Carcinoma Development.

Jung, Janghan MD 1,2; Nguyen, Mindie H. MD, MAS 1,3

doi : 10.14309/ajg.0000000000002030

AB Although hepatitis B virus surface antigen (HBsAg) serum clearance is an important milestone in the natural history of chronic hepatitis B virus (HBV) infection, HBsAg-negative patients are at risk of liver cancer and liver-related death, especially when progressive fibrosis is present.

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Clinical Prediction Models for Pancreatic Cancer in General and At-Risk Populations: A Systematic Review.

Santos, Ralph PhD candidate 1; Coleman, Helen G. PhD 1,2; Cairnduff, Victoria PhD 1; Kunzmann, Andrew T. PhD 1

doi : 10.14309/ajg.0000000000002022

Identifying high-risk individuals using a risk prediction model could be a crucial first stage of screening pathways to improve the early detection of pancreatic cancer. A systematic review was conducted to critically evaluate the published primary literature on the development or validation of clinical risk prediction models for pancreatic cancer risk.

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Abdominophrenic Dyssynergia: A Narrative Review.

Damianos, John A. MD 1; Tomar, Sanjeevani K. MD 2; Azpiroz, Fernando MD, PhD 3; Barba, Elizabeth MD, PhD 4

doi : 10.14309/ajg.0000000000002044

AB Chronic bloating and abdominal distension are common and highly bothersome gastrointestinal symptoms. Although the differential diagnoses for bloating and distension are broad, these symptoms are frequently associated with disorders of the gut-brain interaction.

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ACG Clinical Guideline: Diagnosis and Management of Gastrointestinal Subepithelial Lesions.

Jacobson, Brian C. MD, MPH, FACG 1; Bhatt, Amit MD 2; Greer, Katarina B. MD, MS 3; Lee, Linda S. MD 4; Park, Walter G. MD, MS 5; Sauer, Bryan G. MD, MSc, FACG 6; Shami, Vanessa M. MD, FACG 6

doi : 10.14309/ajg.0000000000002100

AB Subepithelial lesions (SEL) of the GI tract represent a mix of benign and potentially malignant entities including tumors, cysts, or extraluminal structures causing extrinsic compression of the gastrointestinal wall.

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American College of Gastroenterology Guidelines Update: Diagnosis and Management of Celiac Disease.

Rubio-Tapia, Alberto MD 1; Hill, Ivor D. MD 2; Semrad, Carol MD 3; Kelly, Ciaran P. MD 4; Lebwohl, Benjamin MD, MS 5

doi : 10.14309/ajg.0000000000002075

AB This guideline presents an update to the 2013 American College of Gastroenterology Guideline on the Diagnosis and Management of Celiac Disease with updated recommendations for the evaluation and management of patients with celiac disease (CD).

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Functional Lumen Imaging Probe Panometry Helps Identify Clinically Relevant Esophagogastric Junction Outflow Obstruction per Chicago Classification v4.0

Carlson, Dustin A. MD, MS 1; Schauer, Jacob M. PhD 2; Kou, Wenjun PhD 1; Kahrilas, Peter J. MD 1; Pandolfino, John E. MD, MS 1

doi : 10.14309/ajg.0000000000001980

Esophagogastric junction (EGJ) outflow obstruction (EGJOO) per Chicago Classification v4.0 (CCv4.0) represents a high-resolution manometry (HRM) diagnosis with uncertain clinical significance.

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Sleep Disturbances, Bowel Movement Kinetics, and Travel Interruption With Bowel Preparation: A Bowel CLEANsing National Initiative Substudy.

Tse, Carmen MD 1; Barkun, Alan MD 2; Martel, Myriam MSc 3; Nugent, Zoann PhD 1; Epstein, Ian MD 4; Sey, Michael MD 5; Richard, Sultanian MD 6; von Renteln, Daniel MD 7; Singh, Harminder MD, MPH 1

doi : 10.14309/ajg.0000000000002026

We investigated sleep disturbances, bowel movement (BM) kinetics, and travel experience with different bowel preparation regimens in a substudy of patients enrolled in a randomized multicenter Canadian clinical trial.

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Isolated Hepatitis B Core Antibody Positivity and Long-Term Liver-Related Mortality in Korea: A Cohort Study.

Sohn, Won MD, PhD 1,*; Chang, Yoosoo MD, PhD 2,3,4,*; Cho, Yong Kyun MD, PhD 1,4; Hong, Yun Soo MD, PhD 5; Ryu, Seungho MD, PhD 2,3,4

doi : 10.14309/ajg.0000000000001994

Whether isolated hepatitis B core antibody (anti-HBc) positivity is a risk factor for long-term liver-related outcomes in hepatitis B virus (HBV)-endemic areas remains unclear.

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Evaluating the Role of Antibiotics in Patients Admitted to Hospital With Decompensated Cirrhosis: Lessons From the ATTIRE Trial.

Kutmutia, Rishen BSc 1,*; Tittanegro, Thais MSc 1,*; China, Louise MD, PhD 1; Forrest, Ewan MD 2; Kallis, Yiannis MD, PhD 3; Ryder, Stephen D. DM 4; Wright, Gavin MD, PhD 5; Freemantle, Nick PhD 6; O'Brien, Alastair MD, PhD 1,6

doi : 10.14309/ajg.0000000000001937

Hospital-acquired infections (HAI) are common in cirrhosis with antibiotics frequently used to prevent infections, but their efficacy for this role is unknown. To investigate this, we used Albumin to Prevent Infection in Chronic Liver Failure (ATTIRE) data to evaluate whether antibiotic use in patients without infection prevented HAI.

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Use of a Cirrhosis Admission Order Set Improves Adherence to Quality Metrics and May Decrease Hospital Length of Stay.

Bhavsar-Burke, Indira MD, MHPE 1; Guardiola, John J. MD 1; Hamade, Nour MD 1; Gerke, Steven MD 2,3; Burke, Sean M. MD 2,3; Merrill, Katherine RN 4; Mulvey, Karalea D. PharmD 5; Orman, Eric S. MD 1; Fayad, Nabil MD 1,6

doi : 10.14309/ajg.0000000000001930

Quality metrics for inpatient cirrhosis management have been created to improve processes of care. We aimed to improve adherence to quality metrics by creating a novel clinical decision support (CDS) tool in the electronic health record (EHR).

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Long-Term Outcomes of Early vs Delayed Responders to Vedolizumab and Adalimumab: A Post Hoc Analysis of the VARSITY Study.

Narula, Neeraj MD, MPH, FRCPC 1; Wong, Emily C.L. BHSc 1; Marshall, John K. MD, MSc, FRCPC 1; Jairath, Vipul MD, PhD 2; Dulai, Parambir S. MD 3,*; Reinisch, Walter MD, PhD 4,*

doi : 10.14309/ajg.0000000000001987

It is uncertain whether patients with ulcerative colitis (UC) and delayed symptomatic response to therapy have as robust and durable a response as earlier responders to therapy.

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Humoral Immune Response and Safety of SARS-CoV-2 Vaccination in Pediatric Inflammatory Bowel Disease.

Kastl, Arthur J. MD 1; Weaver, Kimberly N. MD 2; Zhang, Xian PhD 3; Strople, Jennifer A. MD 4; Adler, Jeremy MD, MSc 5; Dubinsky, Marla C. MD 6; Bousvaros, Athos MD, MPH 7; Watkins, Runa MD 8; Dai, Xiangfeng PhD 2; Chen, Wenli MS 2; Cross, Raymond K. MD 9; Higgins, Peter D.R. MD, PhD 10; Ungaro, Ryan C. MD, MS 11; Bewtra, Meenakshi MD, PhD 12; Bellaguarda, Emanuelle A. MD 13; Farraye, Francis A. MD, MSc 14; Chun, Kelly Y. PhD 15; Zikry, Michael BS 15; Fernando, Manory MS 15; Bastidas, Monique PhD 15; Hernandez, Cristian G. BS 16; Craig, Riley G. BS 16; Boccieri, Margie E. BS 3; Firestine, Anne BS 3; Long, Millie D. MD, MPH 2,17; Kappelman, Michael D. MD, MPH 3,17

doi : 10.14309/ajg.0000000000002016

Children with inflammatory bowel disease (IBD) may respond differently to COVID-19 immunization as compared with healthy children or adults with IBD. Those younger than 12 years receive a lower vaccine dose than adults.

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Rapid and Sustained Symptom Relief in Patients With Ulcerative Colitis Treated With Filgotinib: Data From the Phase 2b/3 SELECTION Trial.

Danese, Silvio MD, PhD 1,2; Ferrante, Marc MD, PhD 3; Feagan, Brian G. MD 4,5; Peyrin-Biroulet, Laurent MD, PhD 6,7; Hibi, Toshifumi MD, PhD 8; Sandborn, William J. MD 9; Schreiber, Stefan MD, PhD 10; Ritter, Timothy MD 11; Loftus, Edward V. Jr MD 12; Rogler, Gerhard MD, PhD 13; Oortwijn, Alessandra MD, PhD 14; Yun, Chohee MD 15; Le Brun, Franck-Olivier MSc 16; Dinoso, Jason PhD 15; Hsieh, Jeremy MD, PhD 15; Vermeire, Severine MD, PhD 3

doi : 10.14309/ajg.0000000000001979

Patients with ulcerative colitis (UC) regard rapid onset of action among the most important aspects of their treatment. We used the partial Mayo Clinic Score (pMCS) and component patient-reported subscores to assess the rapidity and sustainability of response to filgotinib, a once-daily, oral Janus kinase 1 preferential inhibitor, in adults with moderately to severely active UC in the phase 2b/3 SELECTION trial

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The Risk of Metachronous Advanced Neoplasia After Colonoscopy in Patients Aged 40-49 Years Compared With That in Patients Aged 50-59 Years.

Ma, Gene MD 1; Anderson, Meredith MA 2; Liu, Liyan MD, MS 2; Li, Dan MD 2,3

doi : 10.14309/ajg.0000000000001946

This study investigated the risk of metachronous advanced neoplasia (AN) after colonoscopy in individuals aged 40-49 years compared with that in individuals aged 50-59 years.

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Derivation and External Validation of Machine Learning-Based Model for Detection of Pancreatic Cancer.

Chen, Wansu PhD 1; Zhou, Yichen MS 1; Xie, Fagen PhD 1; Butler, Rebecca K. ScM 1; Jeon, Christie Y. ScD 2; Luong, Tiffany Q. MPH 1; Zhou, Botao MS 1; Lin, Yu-Chen MPH 2; Lustigova, Eva MPH 1; Pisegna, Joseph R. MD 3,4; Kim, Sungjin MS 2; Wu, Bechien U. MD, MPH 5

doi : 10.14309/ajg.0000000000002050

There is currently no widely accepted approach to screening for pancreatic cancer (PC). We aimed to develop and validate a risk prediction model for pancreatic ductal adenocarcinoma (PDAC), the most common form of PC, across 2 health systems using electronic health records.

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Correction and Prevention of Hyponatremia in Patients With Cirrhosis and Ascites: Post Hoc Analysis of the ANSWER Study Database.

Zaccherini, Giacomo MD, PhD 1,*; Baldassarre, Maurizio PhD 1,2,*; Tufoni, Manuel MD 3; Nardelli, Silvia MD, PhD 4; Piano, Salvatore MD, PhD 5; Alessandria, Carlo MD 6; Neri, Sergio MD 7; Foschi, Francesco Giuseppe MD 8; Levantesi, Fabio MD 9; Bedogni, Giorgio MD 1,10; Domenicali, Marco MD, PhD 1,10; Bernardi, Mauro MD 1,**; Caraceni, Paolo MD 1,3,**; for the ANSWER Study Investigators

doi : 10.14309/ajg.0000000000001995

We assessed the impact of long-term albumin administration to hyponatremic patients with ascites enrolled in the ANSWER trial. METHODS: The normalization rate of baseline hyponatremia and the 18-month incidence rate of at least moderate hyponatremia were evaluated.

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Histologic Activity in an Endoscopically Normal-Appearing Pouch Predicts Future Risk of Pouchitis in Patients With Ulcerative Colitis.

Gupta, Akshita MD 1; Kizza, Jennifer F.N. MD 2; Ananthakrishnan, Ashwin N. MD, MPH 1,3

doi : 10.14309/ajg.0000000000002013

The impact of histologic inflammation on subsequent risk of acute pouchitis in patients with ulcerative colitis (UC) has not been robustly examined. METHODS: We examined the association between histologic inflammation in endoscopically normal-appearing ileal pouches in patients with UC with subsequent risk of antibiotic-responsive acute pouchitis.

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Much More Is Needed From Hepatitis B Core-Related Antigen to Predict Risk of Liver Cancer.

Singh, Satender Pal DM 1; Jindal, Ankur DM 1; Sharma, Manoj Kumar DM 1; Sarin, Shiv Kumar MD, DM 1

doi : 10.14309/ajg.0000000000001948

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Response to Singh et al.

Tseng, Tai-Chung MD, PhD 1,2,3; Hosaka, Tetsuya MD 4; Kao, Jia-Horng MD, PhD 1,2,3,5

doi : 10.14309/ajg.0000000000002061

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Cardiac Dysfunction in the Pathogenesis of Hepatorenal Syndrome.

Cailes, Benjamin MBBS (Hons), BMedSci (Hons) 1; Farouque, Omar MBBS (Hons), PhD 1; Majumdar, Avik MBBS (Hons), MPHTM, PhD 2; Koshy, Anoop N. MBBS (Hons), PhD 1

doi : 10.14309/ajg.0000000000002032

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Reply to Cailes et al.

Danielsen, Karen Vagner MD, PhD 1,2; Wiese, Signe MD, PhD 1; Hove, Jens Dahlgaard MD, PhD 2,3,4; Moller, Soren MD 2; Bentsen, Flemming MD 1,4

doi : 10.14309/ajg.0000000000002089

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Calendar of Courses, Symposiums and Conferences.

doi : 10.14309/ajg.0000000000002114

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