April 2016 Vol XL Issue 4

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Introduction to a New Series Colorectal Cancer Real Progress in Diagnosis and Treatment

Melvin Schapiro

We present the evolution of our Colorectal Cancer Series, Colorectal Cancer: Real Progress in Diagnosis and Treatment. Experts in the field, many of whom have generously participated in the series over the past 25 years, will contribute.


A Practical Approach for Colorectal Cancer Screening

Jeffrey K. Lee, Dan Li, Theodore R. Levin

Although randomized controlled trials have demonstrated that screening reduces colorectal cancer incidence and mortality, a large proportion of Americans remain unscreened. National efforts are underway to help increase our colorectal cancer screening rates to 80% by 2018. In this article, we will review several practical strategies for improving colorectal cancer screening in the average-risk population such as including patient preferences, promoting fecal immunochemical test as a screening option, and implementing an organized screening program. In addition, we will discuss practical approaches for colorectal cancer prevention in the increased or high-risk population.


Photodynamic Therapy for Perihilar Cholangiocarcinoma

Haroon Shahid, David Loren

The current standard of care in the United States for patients affected by cholangiocarcinoma of the biliary hilum is chemotherapy with gemcitabine and cisplatin that offers a survival benefit just in excess of three months. Endoscopic ablation with photodynamic therapy (PDT) has been used effectively to palliate patients and is considered the standard of care in some European countries. PDT has been demonstrated to resolve jaundice, improve quality of life, and prolong life with favorable outcomes when compared to other treatment options. This has led to other novel applications and a multicenter trial is currently being performed to study the role of PDT compared to chemotherapy for perihilar cholangiocarcinoma.


Enhanced Recovery After Surgery: If You Are Not Implementing it, Why Not?

Aditya J. Nanavati, Subramaniam Prabhakar

The basic premise of Enhanced Recovery After Surgery (ERAS) is that the impact of surgery on the metabolic and endocrine response is reduced leading to earlier recovery. Implementation leads to reduced length of hospital stay and earlier return to productivity. It has also been shown to actually reduce complications without a rise in re-admissions. Beginning with colorectal surgery, the scope of ERAS has gradually been expanded to other surgical sub-specialties. Implementation at an institutional level needs the constitution of a multi-disciplinary team with representatives from all specialties involved in patient care. Nutrition plays a central role in ERAS, with almost all interventions related to it either directly or indirectly.


Hypermobility Syndrome and Gastric Emptying Disorders

Richard W. McCallum, Gehan Botrus, Omar Baker, Erica Borrego

Joint hyper mobility syndrome (JHS) is a common hereditary non inflammatory connective tissue disorder associated with a variation of clinical presentations. While JHS has been primarily a rheumatological disorder, recent research and literature suggest that there is a strong correlation between JHS and Gastrointestinal disorders. The purpose of this review article is to evaluate the existing research and literature regarding the associations between JHS and gastroparesis and to raise awareness of JHS as the reason behind chronic unexplained symptoms suggesting a gastric motility disorder as well as present the current standard tests used to identify suspected JHS cases.


Not All Gastric Ulcers are Peptic Ulcer Disease: Unusual Case of Gastric Metastases

Abdul Haseeb, Erinn Downs-Kelly, Kathryn Peterson, Iliana Doycheva


Infliximab-Induced Interstitial Pneumonitis in a Pediatric Patient with Ulcerative Colitis

Tanaz Farzan Danialifar, Hillel Naon, Shengmei Zhou


Unusual Causes of Abdominal Pain

Malorie Simons, Sean Fine

Departments Section

Book Reviews

Review of Hepatitis C: A Complete Guide for Patients and Families

A Johns Hopkins Press Review Book, this book is a comprehensive overview of the current workup and diagnosis of hepatitis C for curious patients and families.

Critical Evaluation of Current Concepts and Moving to New Horizons in the Management of IBD: Falk Symposium 196 (2015)

Critical Evaluation of Current Concepts and Moving to New Horizons in the Management of IBD summarizes the proceedings of an international symposium held in Germany in March 2015 which covered emerging concepts in the pathogenesis, diagnosis and treatment of in ammatory bowel disease (IBD).

Pediatric Nutrition in Practice (World Review of Nutrition and Dietetics, Vol. 113), 2nd Edition

This book was written by an international panel of pediatric nutrition experts and is formatted into short and tightly constructed chapters on all aspects of pediatric nutrition. For readers in the United States, it provides an important world view of aspects of nutrition that need to be discussed but are rarely seen in this country, such as HIV/AIDS and malnutrition with chronic diarrhea. This book has something for anyone at various levels of practice.

BD 2014: Thinking Out of the Box

This is a proceedings monograph: a collection of articles/lectures from the international symposium IBD 2014: Thinking Outside the Box, held in Paris from May 30-31, 2014.

From the Literature

Frequency of Esophageal Adenocarcinoma After Radiofrequency Ablation in Barrett's Esophagus

To assess the incidence of esophageal adenocarcinoma (EAC) after radiofrequency ablation (RFA) utilized in treatment of Barrett’s esophagus (BE), and to evaluate the factors associated with the development of EAC and EAC-speci c and all cause mortality who underwent RFA for BE from July 2007 to July 2011 from US Multicenter RFA Patient Registry, data was collected.

Withdrawal of Long-Term Therapy in IBD

A systematic search of the literature was carried out to identify studies reporting after de-escalation (drug cessation or dose reduction), of anti-TNF agents and/or immunomodulators in patients in remission from IBD.

Acute Pancreatitis and Diabetes Mellitus

To assess the incidence of diabetes in acute pancreatitis (AP) survivors compared with matched controls, a study cohort drawn from Taiwan National Health Insurance claims data included 2966 first attack AP patients and 11,864 non-AP general controls individually matched on age and sex with an AP/non-AP ratio of 1:4.

Prognostic Laboratory Tests in Acute Pancreatitis

To compare admission BUN, hematocrit and creatinine as well as changes in their levels over 24 hours, aiming to determine the most accurate laboratory tests for predicting persistent organ failure and pancreatic necrosis in severe acute pancreatitis (AP), study of clinical data of 1612 AP patients was carried out.

Heredity in Hepatic Fibrosis and Steatosis

A cross-sectional analysis of a cohort of well- characterized twins residing in Southern California was carried out to include 60 pairs (42 monozygotic and 18 dizygotic); average age 45.7 and average BMI 26.4. Data was collected on medical history, physical examinations, fasting laboratory test results, and liver health.

Treatment of CHB During Pregnancy

A systematic review and meta-analysis to synthesize the evidence on the ef cacy and maternal and fetal safety of antiviral therapy during pregnancy was carried out and a protocol was developed by the AASD Guidelines Writing Committee.

Hepatic Fibrosis Present in Diabetes and Steatosis

To investigate the relationships, prevalence of and factors associated with liver fibrosis in the general population, a well-characterized cohort was evaluated by means of transient elastography (TE).

HCV Treatment With Mixed Cryoglobulinemia

A case series of patients with HCV-associated mixed cryoglobulinemia syndrome (HCV-MCS), who were treated with sofosbuvir-based regimens and historic controls treated with pegylated Interferon and ribavirin in a single healthcare network was carried out.

Statin Use With Hepatitis C-Related Compensated Cirrhosis

Statins decrease portal pressure in patients with cirrhosis and increase survival times of patients who have bled from varices. To determine whether long-term statin use will be beneficial or detrimental for patients with cirrhosis, the effects of statins on decompensation and survival times in patients with compensated cirrhosis was carried out in a retrospective cohort, using the Veteran Affairs Clinical Case Registry with nationwide data from veterans infected with HCV.

From the Pediatric Gastroenterology Literature

Hepatitis B Infection in Children in the United States and Canada

The disease burden of chronic Hepatitis B virus (HBV) infection in children in the United States and Canada is not well understood, especially in the pediatric immigrant population. This study involved a large, cross-sectional analysis of children infected with HBV in the United States and Canada.

Medical Bulletin Board


MARLBOROUGH, MA - Boston Scientific Corporation (NYSE: BSX) announced the launch of the AXIOS™ Stent and Electrocautery Enhanced Delivery System to help physicians manage two serious complications from pancreatitis using a minimally invasive endoscopic approach.


GARDEN CITY, NY - For more than 11 million children and adults, summer camp provides an escape from every day life- a chance to enjoy the outdoors, meet new people, and participate in fun and exciting activities.


SAN JOSE, CA - Avantis Medical Systems, Inc., a technology leader in developing novel digital imaging devices, announced that it has submitted a 510(k) to the U.S. Food & Drug Administration (FDA) that would allow its Third Eye® Panoramic™ device to be used as a resposable product for colonoscopies.

Meetings Calendar

Digestive Disease Week (DDW) - May 21-24, 2016
Mastering Clinical Challenges and Emerging Therapies in IBD - July 23, 2016