February 2009 Vol XXXIII Issue 2

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Life After SONIC

Amar R. Deshpande, Maria T. Abru

What does the Study of Immunomodulator Naive Patients in Crohn's Disease (SONIC) trial tell us? It tells us that in patients with moderate to severe Crohn's disease who are naÔve to therapy, combination therapy is better than monotherapy up front. The real question is, what to do long-term once remission has been achieved.


Iron: Not Too Much And Not Too Little

Kevin Dasher, Mark T. Worthington

This article reviews iron disorders commonly seen in GI practice and describes clinical tools for diagnosis and treatment.


A Comparison of the Effect of Regular Eno® and Placebo on Intragastric pH

Steven M. Johnson, Jacqueline Suralik

A randomized, open, crossover study in healthy individuals to determine the time required for regular Eno to induce a significant acid neutralization effect compared to placebo.


Gastric Antral Vascular Ectasia: An Uncommon Cause of GI Bleeding

L. Pasumarthy, J. Srour

Gastric antral vascular ectasia (GAVES) is an uncommon cause of GI bleeding. It is more common in females and the elderly. The authors advise that it is important to accurately diagnose and differentiate GAVES from portal hypertensive gastropathy since the treatment and outcome vary significantly.

Departments Section

Article Reprints

Evidence in ServiceóAn Evidence-based Literature Review of Service and Satisfaction in Health Care

Evidence-based medicine has been a household word in training programs for about 20 years. Many large organizations have been evaluating the interaction of patients and physicians with tools that have not met the same standards. Cornish and Dukette have reviewed the literature and have put together a very readable softbound book about this important issue.

Excrement in the Late Middle Ages: Sacred Filth and Chaucer's Fecopoetics

This is a fascinating book that has little to do with gastrointestinal pathophysiology but provides a historical insight of Western civilization's interest in fecal material. Dr. Morrison is a medievalist who specializes in medieval literature.

Curbside Consultation of the Colon: 49 Clinical Questions

This first edition of Curbside Consultation of the Colon, part of the Curbside Consultations series, addresses various issues encountered by general physicians and gastroenterologists alike. Leading gastroenterologists review the latest evidence to answer 49 clinically relevant questions that have been divided into five main sections: Colon Cancer Screening, Constipation, Diarrhea, Perianal Disorders, and Colon Potpourri.

From the Pediatric Gastroenterology Literature

Predictors of Severe Crohn's Disease in Children

Pediatric Crohn's disease (CD) often can have a more aggressive clinical course which suggests that a genetic predisposition may explain disease progression. Children with CD were recruited using retrospective data obtained from three pediatric CD research alliances (21 clinical sites).

Is Ursodeoxycholic acid a Reasonable Treatment for a1-Antitrypsin Deficiency?

The presentation of a1-antitrypsin deficiency (AAT) in children is associated with the ZZ phenotype can present as cholestatic jaundice leading to cirrhosis and liver transplantation. There is no recommended medical therapy for AAT, and the investigators in this study evaluated the possibility of using ursodeoxycholic acid as treatment for AAT.

Medical Bulletin Board

ACG Releases Evidence-Based Systematic Review on Management of Irritable Bowel Syndrome

New Graded Recommendations Clarify the Clinical Options for Physicians and Patients. The American College of Gastroenterology has published a new evidence-based systematic review on the management of Irritable Bowel Syndrome as a supplement to the January 2009 issue of The American Journal of Gastroenterology.

New Recommendations on Diagnostic Testing in IBS

Because of the low likelihood of uncovering organic diseases, routine diagnostic testing with complete blood count, serum chemistries, thyroid function studies, stool for ova and parasites, and abdominal imaging should not be routinely performed in patients with typical IBS symptoms and no alarm features.

Cellvizio Announces That University of Colorado Physicians Treat First U.S. Patients in Large Study to Confirm if Live, Microscopic Imaging Enhances a Physician's Ability to Differentiate Cancerous Lesions in the Bile and Pancreatic Ducts

Doctors at the University of Colorado Hospital in Aurora have treated the first patients in a study to confirm whether using Cellvizio®, the world's smallest microscope, with a standard diagnostic procedure will help physicians identify and differentiate pre-cancerous and cancerous lesions in the bile and pancreatic ducts more effectively than the standard method alone.

Risk of Colorectal Cancer Screening Low Five Years After a Normal Colonoscopy Screening

A study in a late issue of the New England Journal of Medicine shows that among individualss with no colorectal neoplasia on initial screening colonoscopy, the five-year risk of colorectal cancer is extremely low. The data provides support for rescreening at an interval of five years or longer after a normal colonoscopic examination.