Audio Summaries

Issue 10

Time to Increase Adenoma Detection Rate Benchmarks for Screening Colonoscopies 
Jeffrey Lee, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Association of Physician Adenoma Detection Rates With Postcolonoscopy Colorectal Cancer,” by Schottinger JE, Jensen CD, Ghai NR, et al, published in JAMA [2022 Jun 7;327(21):2114-2122].

Continue Thiopurines and Anti-TNF Agents If Your IBD Patient Becomes Pregnant
Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discusses “Pregnancy and Neonatal Outcomes After Fetal Exposure to Biologics and Thiopurines Among Women With Inflammatory Bowel Disease,” by Mahadevan U, Long MD, Kane SV, et al, published in Gastroenterology [2021 Mar;160(4):1131-1139].

Achieve IBD Remission Before Pregnancy: PIANO Registry Data Shows Adverse Perinatal Outcomes For Infants Associated with IBD Flares and Steroid Use

Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discusses “Exposure to Corticosteroids in Pregnancy Is Associated with Adverse Perinatal Outcomes Among Infants of Mothers with Inflammatory Bowel Disease,” by Odufalu FD, Long MD, Lin K, Mahadaven U for PIANO Investigators, published in GUT [2022; 71: 1766-72].

ICYMI-Pantoprazole Prophylaxis Does Not Reduce 90-day Mortality and Clinically Significant Adverse Events in ICU Patients
Philip Okafor, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Pantoprazole in Patients at Risk for Gastrointestinal for Gastrointestinal Bleeding in the ICU,” by Krag M, Marker S, Perner A et al, published in NEJM [379; 23: 2018].

Issue 9

ADR Isn’t the Only Game in Town: Proximal Serrated Lesion Detection Rates Are Inversely Associated with Post-Colonoscopy Cancer Risk

Swati Patel, MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Serrated polyp detection and risk of interval post-colonoscopy colorectal cancer: a population-based study,” by van Toledo et al, published in Lancet Gastroenterol Hepatol [2022 Aug;7(8):747-754]. https://pubmed.ncbi.nlm.nih.gov/35550250/

Tiny Polyps-It’s OK to Remove Polyps < 3mm with Large Biopsy Forceps

Shria Kumar, MD, MSCE and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Randomized Controlled Trial Investigating Cold Snare and Forceps Polypectomy Among Small POLYPs in Rates of Complete Resection: The TINYPOLYP Trial,” by Wei et al, published in Am J Gastroenterol [2022 Aug 1;117(8):1305-1310]. https://pubmed.ncbi.nlm.nih.gov/35467557/

Prophylactic Rifaximin Decreases Post-TIPS Hepatic Encephalopathy 

Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discusses “The Use of Rifaximin in the Prevention of Overt Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt : A Randomized Controlled Trial,” by Bureau et al, published in Ann Intern Med [2021 May;174(5):633-640].https://pubmed.ncbi.nlm.nih.gov/33524293/

Issue 8

Treating H.pylori Infection with Vonoprazan, a Potassium-Competitive Acid Blocker: A New Paradigm

Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discusses “Vonoprazan Triple and Dual Therapy for Helicobacter pylori Infection in the US and Europe: A Randomized Controlled Trial,” by Chey, et al, published in Gastroenterology [2022; In Press]. https://pubmed.ncbi.nlm.nih.gov/35679950/

In Case You Missed It: Peroral Endoscopic Myotomy (POEM) for Achalasia: At Least As Good as Laparoscopic Heller’s Myotomy

Jennifer Kolb, MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Endoscopic or Surgical Myotomy in Patients with Idiopathic Achalasia,” by Werner et al, published in N Engl J Med [2019;381:2219-2229]. https://pubmed.ncbi.nlm.nih.gov/31800987/

Does Choice of Anticoagulant Influence Risk of Gastrointestinal Bleeding? 

Ravy K. Vaajravelu, MD, MSCE and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Rivaroxaban Is Associated With Higher Rates of Gastrointestinal Bleeding Than Other Direct Oral Anticoagulants : A Nationwide Propensity Score-Weighted Study,” by Ingason et al, published in Ann Intern Med [2021 Nov;174(11):1493-1502]. https://pubmed.ncbi.nlm.nih.gov/34633836/

Adenoma Detection Rate in 45-49 Year Olds is Lower Compared to 50-54 Year Olds, but Still Higher than 25% Benchmark

Philip Okafor, MD and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Adenoma Detection Rates in 45-49-Year-Old Persons Undergoing Screening Colonoscopy: Analysis From the GIQuIC Registry,” by Bilal et al, published in Am J Gastroenterol [2022 May 1;117(5):806-808]. https://pubmed.ncbi.nlm.nih.gov/35169107/

Issue 7

SER-109, an Oral Microbiome Therapy, Decreases Recurrent Clostridiodes difficile Infection 

Jessica Allegretti, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “SER-109, an Oral Microbiome Therapy for Recurrent Clostridioides difficile Infection” by Feuerstadt et al, published in N Engl J Med [2022;386(3):220-229]. https://pubmed.ncbi.nlm.nih.gov/35045228/

When Is Routine Prophylactic Clipping Indicated Post-Polypectomy?

Jeffrey Lee, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Effect of prophylactic endoscopic clip placement on clinically significant post-endoscopic mucosal resection bleeding in the right colon: a single-centre, randomised controlled trial” by Gupta et al, published in Lancet Gastroenterol Hepatol [2022;7(2):152-160]. https://pubmed.ncbi.nlm.nih.gov/34801133/

Tenapanor (IBSRELA) for Treatment of IBS-C: Effective over 26 Weeks

Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discusses “Efficacy of Tenapanor in Treating Patients With Irritable Bowel Syndrome with Constipation: A 26-Week, Placebo-Controlled Phase 3 Trial (T3MPO-2)” by Chey et al, published in Am J Gastroenterol [2021;116: 1294-1303]. https://pubmed.ncbi.nlm.nih.gov/33337659/

Issue 6

Low Grade Dysplasia in Barrett’s Esophagus – Get Two Expert GI Pathologist Reviews and Repeat EGD After PPI Treatment

Shria Kumar, MD, MSCE and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Discordance Among Pathologists in the United States and Europe in Diagnosis of Low-Grade Dysplasia for Patients With Barrett’s Esophagus” by Vennalaganti et al, published in Gastroenterology [2017 Feb;152(3):564-570.e4]. https://pubmed.ncbi.nlm.nih.gov/27818167/

Issue 5

Therapeutic Drug Monitoring of Maintenance Infliximab Is Beneficial for Patients with Immunemediated Inflammatory Diseases

Jessica R. Allegretti, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Effect of Therapeutic Drug Monitoring vs Standard Therapy During Maintenance Infliximab Therapy on Disease Control in Patients With Immune-Mediated Inflammatory Diseases: A Randomized Clinical Trial” by Syversen et al, published in JAMA [2021; 326(23):2375-2384]. https://pubmed.ncbi.nlm.nih.gov/34932077/

Endoscopic Eradication Therapy for Neoplastic Barrett’s Esophagus Demonstrates 94% Treatment Success and Long-term Durability

Jennifer M Kolb MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Long-term Outcomes after Endoscopic Treatment for Barrett’s Neoplasia with Radiofrequency Ablation ± Endoscopic Resection: Results from the National Dutch Database in a 10-year Period” by Munster et al, published in Gut [2022;71:265-76]. https://pubmed.ncbi.nlm.nih.gov/33753417/

Issue 4

Increased Risk of Metachronous Neoplasia After Incomplete Polyp Resection – Time to CARE About Polypectomy Technique!

Jeffrey Lee, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Recurrence of Colorectal Neoplastic Polyps After Incomplete Resection” by Pohl et al, published in Annals of Internal Medicine. [2021;174(10):1377-1384]. https://pubmed.ncbi.nlm.nih.gov/34370514/

It’s a Bad “Prep” Even Though the Patient Took It Correctly: Consider 15 mg Bisacodyl plus 4-Liter PEG Split Prep Before Next Colonoscopy

Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discusses “A Multicenter Randomized Controlled Trial Comparing Bowel Cleansing Regimens for Colonoscopy After Failed Bowel Preparation” by Sey at al, published in Clinical Gastroenterology and Hepatology [2022;In Press]. https://pubmed.ncbi.nlm.nih.gov/34256147

Effectiveness of Intermittent Fasting for Weight Loss: It’s Not Just When You Eat, but What You Eat, Too!

Sonali Paul, MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men with Overweight and Obesity. The TREAT Randomized Clinical Trial” by Lowe et al, published in JAMA [2021; 181(6):883]. https://pubmed.ncbi.nlm.nih.gov/32986097/

Family Matters: Increased Risk of Colorectal Cancer among Individuals with Family History of Polyps

Ravy K. Vajravelu, MD, MSCE and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Risk of colorectal cancer in first degree relatives of patients with colorectal polyps: nationwide case-control study in Sweden” by Song et al, published in BMJ [2021;373:n877]. https://pubmed.ncbi.nlm.nih.gov/33947661/

Issue 3

Slow Down to Speed Up Quality: Longer Withdrawal Time of 9 Versus 6 Minutes Increases Adenoma Detection Rate

Jennifer M. Kolb MD, MSCS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss “Impact of 9-Minute Withdrawal Time on the Adenoma Detection Rate: A Multicenter Randomized Controlled Trial” by Zhao et al, published in Clinical Gastroenterology and Hepatology [2020;20:31553-6]. https://pubmed.ncbi.nlm.nih.gov/33220526/

Drainage for Infected Pancreatic Necrosis – Earlier Is Not Better

Shria Kumar, MD, MSCE and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss “Immediate versus Postponed Intervention for Infected Necrotizing Pancreatitis” by Boxhoorn et al, published in NEJM. [2021;15:1372-1381]. https://pubmed.ncbi.nlm.nih.gov/34614330/

Hereditary Syndrome Risk Assessment in all Colorectal Cancer Patients: Keep it Simple!

Swati Patel, MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss “Prospective Statewide Study of Universal Screening for Hereditary Colorectal Cancer: The Ohio Colorectal Cancer Prevention Initiative” by Pearlman et al, published in JCO Precision Oncology [2021;5:779-91]. https://pubmed.ncbi.nlm.nih.gov/34250417/

Treating All the Symptoms of IBS-C: Linaclotide Significantly Decreases Abdominal Pain, Bloating, and Discomfort

Jill Deutsch, MD and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss “Efficacy of Linaclotide in Reducing Abdominal Symptoms of Bloating, Discomfort, and Pain: A Phase 3B Trial Using a Novel Abdominal Scoring System” by Chang et al, published in American Journal of Gastroenterology [2021;116: 1929-37]. https://pubmed.ncbi.nlm.nih.gov/34465695/

Issue 2

A New “Pill Prep” for Colonoscopy: An Effective Alternative for Individuals Who Won’t Drink GoLytely®

Philip N. Okafor, MD, MPH discusses the recent AJG article “A Safety and Efficacy Comparison of a New Sulfate-Based Tablet Bowel Preparation Versus a PEG and Ascorbate Comparator in Adult Subjects Undergoing Colonoscopy.” This RCT compares SUTAB®, a sodium sulfate tablet bowel preparation, to MoviPrep®. Since it is a hyperosmolar prep, be cautious when using it in patients with congestive heart failure, renal insufficiency, or electrolyte abnormalities.

Inching Closer to a NASH Cure: Daily Semaglutide Achieves Resolution of NASH but Not Fibrosis after 72 Weeks

Sonali Paul, MD, MS discusses “A Placebo-Controlled Trial of Subcutaneous Semaglutide,” published in NEJM in May 2021. Semaglutide, a GLP-1 receptor agonist for type II diabetes mellitus and weight loss, shows potential as a treatment for NASH in a well-designed, placebo-controlled RCT. May need longer trials to see if it can resolve fibrosis, which is a key treatment goal. Will anxiously await results from ongoing study of weekly high-dose semaglutide in NASH patients.

Computer-aided Detection Systems increase detection of non-advanced adenomas, but is it ready for prime-time?

Shria Kumar, MD, MSCE discusses a 2020 article in Gastroenterology, “Efficacy of Real-Time Computer-Aided Detection of Colorectal Neoplasia in a Randomized Trial.” GI-Genius™, a new computer-aided adenoma detection tool, is FDA-approved, integrates into existing endoscopic systems, and overlays a detection box around a potential polyp. In a well-designed RCT, adenoma detection was significantly higher with GI-Genius™. Endoscopists will need to consider a variety of factors to determine whether to integrate this tool into their endoscopy practice.

Issue 1

Piecemeal Cold Snare Polypectomy of Large SSP: Cold Is the New Hot

Swati Patel, MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss Piecemeal cold snare polypectomy versus conventional endoscopic mucosal resection for large sessile serrated lesions: a retrospective comparison across two successive periods bt Van Hattem WA, published in Gut [2021;70:1691-97]. https://doi.org/10.1136/gutjnl-2020-321753

Once-Weekly Semaglutide in Adults with Overweight or Obesity

Sonali Paul, MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss Semaglutide Treatment Effect in People with Obesity (STEP) Investigators. Once-Weekly Semaglutide in Adults with Overweight or Obesity by Wilding et al, published in the New England Journal of Medicine [2021; 384: 989-1002. https://www.nejm.org/doi/10.1056/NEJMoa2032183

Screening Colonoscopy Decreases Colorectal Cancer Incidence and Related Mortality in Healthy Patients Over 75

Jeffrey Lee, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss Association of Screening Lower Endoscopy with Colorectal Cancer Incidence and Mortality in Adults Older than 75 Years by Ma et al, published in .JAMA Oncology [2021;7(7):985-992]. https://doi.org/10.1001/jamaoncol.2021.1364

Acute Myeloid Leukemia and Myelodysplastic Syndrome with IBD and Thiopurines Impact on Risk

Ravy K. Vajravelu, MD, MSCE and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss Incidence of Acute Myeloid Leukemia and Myelodysplastic Syndrome in Patients with Inflammatory Bowel Disease and the Impact of Thiopurines on Their Risk by Kahn et al., published in The American Journal of Gastroenterology [2021; 116: 741-47]. www.doi.org/10.14309/ajg.0000000000001058