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The Time Is Now to Understand and Address Sex-Related Disparities in Gastroenterology and Hepatology
Shaukat, Aasma MD, MPH1; Oxentenko, Amy S. MD2
doi : 10.14309/ajg.0000000000001185
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 441-443
Many gastrointestinal disorders, autoimmune diseases, and pregnancy-related conditions preferentially impact women. This issue of The American Journal of Gastroenterology focuses on women's health in the context of gastrointestinal and liver disease. This editorial highlights the current issue's contents and seeks to spark the conversations to bring awareness to the many issues faced by women as both patients and practitioners.
Donald O. Castell (1935-2021): A Life Dedicated to Investigation, Mentoring, and Education
DeVault, Ken MD, FACG1; Katz, Philip MD, MACG2; Richter, Joel MD, MACG3
doi : 10.14309/ajg.0000000000001190
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 444
Interviewing for Two
Feld, Lauren D. MD
doi : 10.14309/ajg.0000000000001101
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 445-446
Intramural Biliary Stricture From Metastatic Breast Cancer
Fejleh, M. Phillip MD1; Paredes, Harold MD1; Muthusamy, V. Raman MD, MAS1
doi : 10.14309/ajg.0000000000000945
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 447
Ectopic Thyroid Tissue in Duodenum—A Rare Case in a Young Woman
Liu, Yen-Tze MD, MPH1,2,3,4; Chen, Ko-Chin MD5; Chen, Mu-Kuan MD, MS, PhD6; Yang, Chia?Wei MD7
doi : 10.14309/ajg.0000000000001040
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 448
A Dermoid Cyst Presenting as a Hypoechoic Pancreatic Mass
Holmes, Ian MD1,2; Ha, Nghiem B. MD1,2; Peng, Yue MD PhD3; Kaltenbach, Tonya MD, MS2
doi : 10.14309/ajg.0000000000000702
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 449
Stridor From Tracheal Compression Caused by Esophageal Stent
Paleti, Swathi MD1; Rustagi, Tarun MD1
doi : 10.14309/ajg.0000000000000738
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 450
Intussusception due to Incarceration of Hard Stool With the Ileocecal Valve as the Leading Point: A Case Study
Ochiai, Yasutoshi MD, PhD1; Hara, Masaki MD, PhD1; Nakajima, Takashi MD1; Ito, Fumio MD, PhD2
doi : 10.14309/ajg.0000000000000745
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 451
Underwater Ischemic Polypectomy for Multiple Small Bowel Polyps in a Patient With Peutz-Jeghers Syndrome
Suwa, Tetsuya MD, PhD1; Imai, Kenichiro MD1; Hotta, Kinichi MD1; Ito, Sayo MD1; Kishida, Yoshihiro MD, PhD1; Ono, Hiroyuki MD, PhD1
doi : 10.14309/ajg.0000000000001162
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 452
CME Information
doi : 10.14309/ajg.0000000000001123
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 453-454
Continuing Medical Education Questions: March 2021: ACG Clinical Guideline: Colorectal Cancer Screening 2020
Hachem, Christine Y. MD, FACG
doi : 10.14309/ajg.0000000000001189
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 455
Continuing Medical Education Questions: March 2021: Irritable Bowel Syndrome in Pregnancy
Bushyhead, Daniel W. MD
doi : 10.14309/ajg.0000000000001187
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 456
Continuing Medical Education Questions: March 2021: Pregnancy Outcomes after Liver Transplantation: A Systematic Review and Meta-Analysis
Park, James S. MD
doi : 10.14309/ajg.0000000000001188
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 457
ACG Clinical Guidelines: Colorectal Cancer Screening 2021
Shaukat, Aasma MD, MPH, FACG1,2; Kahi, Charles J. MD, MSc, FACG3,7; Burke, Carol A. MD, FACG4; Rabeneck, Linda MD, MPH, MACG5; Sauer, Bryan G. MD, MSc, FACG (GRADE Methodologist)6; Rex, Douglas K. MD, MACG3
doi : 10.14309/ajg.0000000000001122
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 458-479
Colorectal cancer (CRC) is the third most common cancer in men and women in the United States. CRC screening efforts are directed toward removal of adenomas and sessile serrated lesions and detection of early-stage CRC. The purpose of this article is to update the 2009 American College of Gastroenterology CRC screening guidelines. The guideline is framed around several key questions. We conducted a comprehensive literature search to include studies through October 2020. The inclusion criteria were studies of any design with men and women age 40 years and older. Detailed recommendations for CRC screening in average-risk individuals and those with a family history of CRC are discussed. We also provide recommendations on the role of aspirin for chemoprevention, quality indicators for colonoscopy, approaches to organized CRC screening and improving adherence to CRC screening. CRC screening must be optimized to allow effective and sustained reduction of CRC incidence and mortality. This can be accomplished by achieving high rates of adherence, quality monitoring and improvement, following evidence-based guidelines, and removing barriers through the spectrum of care from noninvasive screening tests to screening and diagnostic colonoscopy. The development of cost-effective, highly accurate, noninvasive modalities associated with improved overall adherence to the screening process is also a desirable goal.
Irritable Bowel Syndrome in Pregnancy
Moosavi, Sarvee MD1; Pimentel, Mark MD2,3,4; Wong, Melissa S. MD5; Rezaie, Ali MD, MSc2,3,4
doi : 10.14309/ajg.0000000000001124
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 480-490
Irritable bowel syndrome (IBS) affects a significant percentage of the general population and is more common in women. A large proportion of women affected with IBS are of childbearing age; however, there is a paucity of studies and guidelines to specifically address the epidemiology, course, maternal/fetal prognosis, or management of IBS in pregnancy. This scarcity of literature on IBS and pregnancy poses significant challenges to healthcare providers in counseling and managing patients. In this comprehensive review, we summarize the current literature and knowledge gaps regarding the effects of pregnancy on IBS and vice versa, along with the efficacy and safety profiles of commonly used IBS diets and medications in pregnancy. The management of pregnant women with IBS should be multidisciplinary, with emphasis on education and judicious use of dietary modifications and pharmacologic options that are deemed relatively safe during pregnancy.
Pregnancy Outcomes After Liver Transplantation: A Systematic Review and Meta-Analysis
Valentin, Nelson MD, MSc1; Guerrido, Isabel MD2; Rozenshteyn, Frederick MD2; Pinotti, Rachel MLIS3; Wu, Yi Chia MD2; Collins, Kelsey MD2; Shah, Michelle MD2; Hershman, Melissa MD2; Weisberg, Ilan MD, MSc2
doi : 10.14309/ajg.0000000000001105
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 491-504
Liver transplantation (LT) remains the gold standard for treatment of end-stage liver disease. Given the increasing number of liver transplantation in females of reproductive age, our aim was to conduct a systematic review and meta-analysis evaluating pregnancy outcomes after LT.
Baby Steps in the Right Direction: Toward a Parental Leave Policy for Gastroenterology Fellows
Feld, Lauren Deborah MD1
doi : 10.14309/ajg.0000000000001145
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 505-508
The American Board of Medical Specialties announced in July 2020 the adoption of a parental leave policy for residents and fellows allows for a minimum of 6 weeks of leave. This policy includes caveats: vacation and/or sick leave can be applied toward these 6 weeks, this leave can only be utilized once during training (whether for parental, caregiver, or medical leave), and this policy only applies to training programs of 2 or more years' duration. Although the new existence of a parental leave policy is a step in the right direction, trainees are in need of a more robust and evidence-based policy. There are particular challenges to be addressed in the male-dominated and procedural field of gastroenterology, in which women are underrepresented and female gastroenterology trainees are more likely to have career decisions limited around the availability of parental leave. This article reviews the evidence supporting the creation of a parental leave policy for gastroenterology fellows, with potential benefits to individual trainees as well as the field, in order to promote equity, recruitment, retention, and advancement of women in gastroenterology.
Screening Women for Anal Cancers: Guidance for Health Care Professionals
Vegunta, Suneela MD1; Shah, Amit A. MD2; Whited, M. Helen MD2; Long, Margaret E. MD3
doi : 10.14309/ajg.0000000000001186
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 509-516
Anal cancer is rare in the general population but is steadily increasing in incidence over the past decade especially in women. Identification and screening of women with high risk facilitates detection of anal precancer and early-stage cancer, improves survival, and potentially uses less invasive therapies compared with the conventional chemoradiation treatments used for advanced cancers. No recently published guidelines currently describe details about screening women for anal squamous cell cancer (ASCC). The available evidence supports the existence of groups of women with higher prevalence of ASCC (e.g., women with human immunodeficiency virus, immune suppression, or previous lower-genital high-grade lesion or cancer) who would likely benefit from screening with some combination of anal cytology and human papillomavirus testing. Additional research is needed to establish the cost-effectiveness and the influence of screening on ASCC mortality rates.
Prevalence of Barrett's Esophagus in Female Patients With Scleroderma
Snyder, Diana L. MD1; Crowell, Michael D. PhD1; Kahn, Allon MD1; Griffing, W. Leroy MD2; Umar, Sarah MD1; Ramirez, Francisco C. MD1
doi : 10.14309/ajg.0000000000001109
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 517-521
Systemic sclerosis or scleroderma (SSc) is a chronic autoimmune disease that renders the esophagus prone to significant gastroesophageal reflux due to impaired esophageal clearance and reduced lower esophageal sphincter pressure. The reported prevalence of Barrett's esophagus (BE) in women with SSc varies from 2% to 37% and is derived from older studies with small sample sizes. We aimed to assess the prevalence of BE in a large cohort of women with SSc.
Circulating Sex Hormones Are Associated With Gastric and Colorectal Cancers but Not Esophageal Adenocarcinoma in the UK Biobank
McMenamin, ?na C. PhD1; Liu, Peipei MSc1; Kunzmann, Andrew T. PhD1; Cook, Michael B. PhD2; Coleman, Helen G. PhD1,3; Johnston, Brian T. PhD4; Cantwell, Marie M. PhD5; Cardwell, Chris R. PhD1
doi : 10.14309/ajg.0000000000001045
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 522-529
Gastrointestinal cancers show an unexplained male predominance, but few prospective studies have investigated sex hormones and gastrointestinal cancer risk. This study aimed to determine the impact of circulating sex hormones on risk of esophageal, gastric, and colorectal cancers in men and women.
Are All Endoscopy-Related Musculoskeletal Injuries Created Equal? Results of a National Gender-Based Survey
Pawa, Swati MD1,2; Banerjee, Promila MD3; Kothari, Shivangi MD4; D'Souza, Sharlene L. MD5; Martindale, Sarah L. PhD6,7; Gaidos, Jill K. J. MD8; Oxentenko, Amy S. MD9; Burke, Carol A. MD10, on behalf of the Women in Gastroenterology Committee of the American College of Gastroenterology
doi : 10.14309/ajg.0000000000001136
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 530-538
Endoscopy-related injury (ERI) is common in gastroenterologists (GI). The study aim was to assess the prevalence of self-reported ERI, patterns of injury, and endoscopist knowledge of preventative strategies in a nationally representative sample.
Gender-Specific Factors Influencing Gastroenterologists to Pursue Careers in Advanced Endoscopy: Perceptions vs Reality
David, Yakira N. MD1; Dixon, Rebekah E. BS1; Kakked, Gaurav MD2; Rabinowitz, Loren G. MD1; Grinspan, Lauren T. MD, PhD1; Anandasabapathy, Sharmila MD3; Greenwald, David A. MD1; Kim, Michelle K. MD, PhD1; Sethi, Amrita MD4; Kumta, Nikhil A. MD, MS1
doi : 10.14309/ajg.0000000000001112
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 539-550
In 2020, only 19% of 63 matched advanced endoscopy (AE) fellows were women. This study evaluates the gender-specific factors that influence gastroenterologists to pursue careers in AE.
Excess Mortality After Liver Transplantation in Young Women With Alcohol-Associated Liver Disease
Lee, Brian P. MD, MAS1; Dodge, Jennifer L. MPH1,2; Terrault, Norah A. MD, MPH1
doi : 10.14309/ajg.0000000000001007
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 551-559
Young adults with alcohol-associated liver disease (ALD) are the fastest increasing demographic contributing to liver-related deaths; their outcomes after liver transplantation (LT) are understudied.
Pregnancy in Liver Transplantation Recipients Is Associated With Increased Complications and Healthcare Utilization
Sobotka, Lindsay A. DO1; Mumtaz, Khalid MBBS, MSc1; Hinton, Alice PhD2; Conteh, Lanla F. MD, MPH1
doi : 10.14309/ajg.0000000000001135
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 560-567
Given the increased rates of pregnancy in liver transplant recipients, evaluating the safety of pregnancy is crucial. We aim to evaluate pregnancy-related complications and outcomes in liver transplant recipients.
Burden of Future Liver Abnormalities in Patients With Intrahepatic Cholestasis of Pregnancy
Monrose, Erica MD1; Bui, Anthony MD1; Rosenbluth, Emma BA1; Dickstein, Daniel MD1; Acheampong, Derrick MD1; Sigel, Keith MD, PhD2; Ferrara, Lauren MD3; Kushner, Tatyana MD, MSCE3,4
doi : 10.14309/ajg.0000000000001132
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 568-575
There are limited data on the incidence, predictors, and time to future liver abnormalities in patients with intrahepatic cholestasis of pregnancy (ICP).
Sex Differences in Extrahepatic Outcomes After Antiviral Treatment for Hepatitis C
Li, Jia PhD1; Gordon, Stuart C. MD2,3; Zhou, Yueren MS1; Boscarino, Joseph A. MD, PhD4; Schmidt, Mark A. PhD5; Daida, Yihe G. PhD6; Rupp, Loralee B. MS, MBA7; Trudeau, Sheri MPH1; Lu, Mei PhD1; for the CHeCS Investigators
doi : 10.14309/ajg.0000000000001095
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 576-583
Despite recognized differences in the rates of cardiovascular and renal disease between men and women in the general population, studies of the downstream effects of antiviral treatment for hepatitis C (HCV) have not investigated differences in outcomes based on sex. We analyzed sex differences in risk of acute coronary syndrome (ACS), end-stage renal disease (ESRD), and ischemic stroke by treatment and response in a large US-based multisite cohort of HCV patients.
Gender Disparities in Food Security, Dietary Intake, and Nutritional Health in the United States
Ma, Christopher MD, MPH1,2; Ho, Stephanie K.M.3; Singh, Siddharth MD, MSc4; Choi, May Y. MD5
doi : 10.14309/ajg.0000000000001118
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 584-592
Food insecurity is associated with negative nutritional outcomes and is experienced differently by women vs men. We evaluated the effects of gender on food insecurity and dietary intake in the United States.
Reproductive Characteristics and Pregnancy Outcomes in Hidden Celiac Disease Autoimmunity
Celdir, Melis G. MD1,2; Choung, Rok Seon MD1; Rostamkolaei, Shahryar K. PharmD1; Jansson-Knodell, Claire L. MD3; King, Katherine S. BS4; Larson, Joseph J. BS4; Absah, Imad MD5; Murray, Joseph A. MD1
doi : 10.14309/ajg.0000000000001148
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 593-599
Untreated symptomatic celiac disease (CD) adversely affects female reproduction; however, the effect of hidden CD autoimmunity is uncertain.
Clinical Course of Chronic Pancreatitis During Pregnancy and its Effect on Maternal and Fetal Outcomes
Mahapatra, Soumya Jagannath MD, DM1; Midha, Shallu PhD1; Teja, Gadella Varun MD, DM1; Vajpai, Tanmay MD, DM1; Singh, Nilanchali MD2; Sahoo, Sushree Monika MD2; Pandey, Shivam PhD3; Elhence, Anshuman MD, DM1; Sethia, Rahul MD, DM1; Garg, Pramod Kumar MD, DM1
doi : 10.14309/ajg.0000000000001076
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 600-608
There are limited data on the effect of chronic pancreatitis (CP) on pregnancy outcomes and vice versa. Our aim was to evaluate the clinical trajectory of CP during pregnancy and its effect on pregnancy outcomes.
Impact of Recreational Cannabis Legalization on Hospitalizations for Hyperemesis
Nemer, Laura MD1; Lara, Luis F. MD1; Hinton, Alice PhD2; Conwell, Darwin L. MD, MS1; Krishna, Somashekar G. MD, MPH1; Balasubramanian, Gokulakrishnan MD1
doi : 10.14309/ajg.0000000000001182
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 609-612
Chronic cannabis use had been associated with hyperemesis. We sought to determine whether cannabis liberalization contributed to increased hospitalizations for hyperemesis.
Equal Opportunity: Women Representation on Editorial Boards and Authorship of Editorials in Gastroenterology and Hepatology Journals
Subramaniam, Mythri MD1; Azad, Nabila MD1; Wasan, Sharmeel K. MD2; Long, Michelle T. MD, MSc2
doi : 10.14309/ajg.0000000000001183
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 613-616
The proportion of women editorial board members and authors of editorials in major gastroenterology journals is not known.
Hepatocellular Carcinoma in Women: Could Tobacco Matter More than Sex?
Braillon, Alain MD, PhD1
doi : 10.14309/ajg.0000000000001131
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 617
Response to Braillon
Phipps, Meaghan MD1; Wattacheril, Julia MD, MPH2, on behalf of co-authors
doi : 10.14309/ajg.0000000000001180
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 617-618
Empagliflozin Eliminates Refractory Ascites and Hepatic Hydrothorax in a Patient With Primary Biliary Cirrhosis
Kalambokis, Georgios N. PhD1; Tsiakas, Ilias MD1; Filippas-Ntekuan, Sebastien MD1; Christaki, Maria MD1; Despotis, Grigorios MD1; Milionis, Haralampos MD, PhD1
doi : 10.14309/ajg.0000000000000995
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 618-619
Calendar of Courses, Symposiums and Conferences
doi : 10.14309/ajg.0000000000001184
The American Journal of Gastroenterology: March 2021 - Volume 116 - Issue 3 - p 620
