Risk Factors for Serrated Polyps: Results From a Large, Multicenter Colonoscopy-Based Study
December 2024
Dr. Millie Long
Co-Editor-in-Chief Millie Long, MD, MPH, FACG interviews author and AJG Associate Editor Seth D. Crockett, MD, MPH on his recently published article, "Risk Factors for Serrated Polyps: Results From a Large, Multicenter Colonoscopy-Based Study." (18:20)
Natural History of Indeterminate Liver Nodules in Patients With Advanced Liver Disease: A Multicenter Retrospective Cohort Study
November 2024
Dr. Jasmohan S. Bajaj
Jasmohan S. Bajaj, MD, MS, FACG interviews Amit G. Singal, MD, MS about his recently published article "Natural History of Indeterminate Liver Nodules in Patients With Advanced Liver Disease: A Multicenter Retrospective Cohort Study." (11:56)
Patients With Inflammatory Bowel Disease Are at Increased Risk of Hospitalization Due to Respiratory Syncytial Virus
August 2024
Dr. Millie Long
Co-Editor-in-Chief Millie Long, MD, MPH, FACG interviews Freddy Caldera, DO, MS, FACG about his recent article "Patients With Inflammatory Bowel Disease Are at Increased Risk of Hospitalization Due to Respiratory Syncytial Virus," published in the August issue of AJG.(9:35)
Effect of Glucagon-Like Peptide-1 Receptor Agonists on Bowel Preparation for Colonoscopy
July 2024
Dr. Millie Long
Co-Editor-in-Chief Millie Long, MD, MPH, FACG interviews Eric J. Vargas, MD, MS about his recently published article "Effect of Glucagon-Like Peptide-1 Receptor Agonists on Bowel Preparation for Colonoscopy."(9:41)
ACG Clinical Guideline: Focal Liver Lesions
July 2024
Dr. Jasmohan S. Bajaj
Co-Editor-in-Chief Jasmohan S. Bajaj, MD, MS, FACG interviews Anjana Pillai, MD, FACG about the recently published ACG Guideline on the diagnosis and management of focal liver lesions.
Antibiotics With or Without Rifaximin for Acute Hepatic Encephalopathy in Critically Ill Patients With Cirrhosis: A Double-Blind, Randomized Controlled (ARiE) Trial
May 2024
Dr. Jasmohan S. Bajaj
Co-Editor-in-Chief Jasmohan S. Bajaj, MD, MS, FACG interviews Anand V. Kulkarni, MD, DM about the ARiE Trial, an RCT published in the May 2024 issue. (12:40)
Risk of Esophageal Cancer in Achalasia: A Matched Cohort Study Using the Nationwide Veterans Affairs Achalasia Cohort
April 2024
Dr. Millie Long
Co-Editor-in-Chief Dr. Millie Long interviews Dr. Eric E. Low on his recently published article discussing the risk of achalasia in esophageal cancer. (16:10)
Thirty-Day Readmissions Are Largely Not Preventable in Patients With Cirrhosis
March 2024
Dr. Millie Long
Co-Editor-in-Chief Dr. Millie Long interviews Dr. Eric S. Orman on his recently published article discussing the incidence, causes, and risk factors for preventable readmission in cirrhosis patients.(10:47)
ACG Clinical Guideline - Management of Acute Pancreatitis
March 2024
Dr. Jasmohan S. Bajaj
Co-Editor-in-Chief Jasmohan S. Bajaj, MD, MS, FACG interviews Scott Tenner, MD, MPH, JD, FACG about the recently published ACG Guideline on the management of acute pancreatitis. (18:47)
ACG Clinical Guideline: Alcohol-Associated Liver Disease
January 2024
Dr. Vijay H. Shah
Co-Editor-in-Chief Jasmohan S. Bajaj, MD, MS, FACG interviews Vijay H. Shah, MD, FACG about the recently published ACG Guideline on the management of alcohol-associated liver disease.
Postendoscopy Care for Patients Presenting With Esophageal Food Bolus Impaction
October 2023
Co-Editor-in-Chief Dr Millie Long interviews Dr Christopher Ma of the Cumming School of Medicine at the University of Calgary (Canada) on the most recent population-based multicenter cohort study on postendoscopy care for patients with food bolus impactions (8:41).
ACG-AGA Clinical Guideline: Pharmacological Management of Chronic Idiopathic Constipation
August 2023
Dr. Millie Long
Co-Editor-in-Chief Millie Long, MD, MPH, FACG interviews William D. Chey, MD, FACG about the updated AGA-ACG Guideline on the management of chronic idiopathic constipation.
ACG Clinical Guideline: Acute Liver Failure
July 2023
Dr. Jasmohan S. Bajaj
Co-Editor-in-Chief Jasmohan S. Bajaj, MD, MS, FACG interviews Alexandra Shingina, MD, MSc about the recently published ACG Guideline on the diagnosis and management of acute liver failure. (18:20)
ACG Clinical Guideline: Diagnosis and Management of Celiac Disease
March 2023
Dr. Millie Long
Co-Editor-in-Chief Millie Long, MD, MPH, FACG interviews Alberto Rubio-Tapia, MD about the updated ACG Guideline on the diagnosis and management of celiac disease. (10:46)
ACG Clinical Guideline: Diagnosis and Management of Biliary Strictures
March 2023
Dr. Jasmohan Bajaj
Co-Editor-in-Chief Jasmohan Bajaj, MD, MS, FACG interviews Joseph B. Elmunzer, MD, MSc on the recently published ACG Clinical Guideline on the diagnosis and management of biliary strictures (15:39).
Management of Patients With Acute Lower Gastrointestinal Bleeding: An Updated ACG Guideline
February 2023
Dr. Millie Long
Co-Editor-in-Chief Dr Millie Long interviews Dr. Neil Sengupta about the updated ACG Guideline on the management of patients with acute lower gastrointestinal bleeding. (14:57)
ACG Clinical Guideline: Gastrointestinal Subepithelial Lesions
January 2023
Dr. Brian C. Jacobson
Co-Editor-in-Chief Jasmohan Bajaj, MD, MS, FACG interviews Brian C. Jacobson, MD, MPH, FACG on the recently published ACG Clinical Guideline for the diagnosis and management of gastrointestinal subepithelial lesions (17:50).
Gravity and the Gut: A Hypothesis of IrritableBowel Syndrome
December 2022
Brennan Spiegel, MD, MSHS, FACG
Co-Editor-in-Chief Dr Millie Long interviews Dr Brennan Spiegel of Cedars-Sinai Medical Center in Los Angeles on his new hypothesis that seeks to accommodate the manifold theories, clinical symptoms, somatic comorbidities, neuropsychological features, and treatment outcomes of IBS by describing the syndrome in relation to a principal force of human evolution: gravity. (20:33)
Impact of Obesity on Risk of Hospitalization, Surgery and Serious Infection in Biologic-treated Patients with IBD
November 2022
Dr Phillip Gu
AJG Co-Editor-in-Chief Millie Long and Dr Phillip Gu from Cedars-Sinai Medical System in Los Angeles, California discuss a new study on whether or not obesity is associated with an increased risk of unplanned healthcare utilization and serious infections.(09:04)
A Randomized, Dose-Finding, Proof of Concept Study of Berberine Ursodeoxycholate in Patients with Primary Sclerosing Cholangitis
November 2022
Kris V. Kowdley
Co-Editor-in-Chief Jasmohan Bajaj, MD, MS, FACG interviews Kris Kowdley, MD on the recent Rapid RCT "A Randomized, Dose-Finding, Proof of Concept Study of Berberine Ursodeoxycholate in Patients with Primary Sclerosing Cholangitis," published in the November 2022 issue of AJG. (17:35)
ACG Clinical Guideline: Gastroparesis
October 2022
Dr. Michael Camilleri
Michael Camilleri, DSc, MRCP (UK), MACG and co-Editor-in-Chief Millie Long, MD, MPH, FACG discuss the new ACG Clinical Guideline on Gastroparesis. Increasingly seen in clinical practice, Gastroparesis is characterized by symptoms suggesting retention of food in the stomach with objective evidence of delayed gastric emptying in the absence of mechanical obstruction in the gastric outflow. Camilleri summarizes risk factors, diagnosis, and management of gastroparesis in adults. (16:41)
Randomized Controlled Trial Investigating Cold Snare and Forceps Polypectomy Among Small POLYPs in Rates of Complete Resection: The TINYPOLYP Trial
October 2022
Dr. Mike Wei
Author Mike T. Wei, MD and Co-Editor-in-Chief Millie Long, MD, MPH, FACG discuss the largest randomized clinical trial to date evaluating cold forceps and cold snare removal of nonpedunculated polyps ≤3 mm. (7:56)
A Smartphone Application Using Artificial Intelligence Is Superior To Subject Self-Reporting When Assessing Stool Form
August 2022
Dr. Mark Pimentel
Mark Pimentel, MD, FACG, discusses a smartphone application that uses artificial intelligence to help subjects self-report stool form. A novel smartphone application can determine BSS and other visual stool characteristics with high accuracy compared with the 2 expert gastroenterologists. Moreover, trained AI was superior to subject self-reporting of BSS. AI assessments could provide more objective outcome measures for stool characterization in gastroenterology. (10:49)
Pickle Juice Intervention for Cirrhotic Cramps Reduction: The PICCLES Randomized Controlled Trial
June 2022
Dr. Elliot Tapper
Elliot B. Tapper, MD from the Division of Gastroenterology and Hepatology, University of Michigan joins co-Editor-in-Chief Millie Long, MD, MPH, FACG to discuss the new randomized controlled trial on pickle juice to reduce cirrhotic cramps. The RCT is published in the June 2022 issue of the American Journal of Gastroenterology. (10:54)
Diagnosis and Management of Barrett's Esophagus
May 2022
Nicholas Shaheen, MD, MPH
Co-Editor-in-Chief Millie Long, MD, MPH, FACG interviews Nicholas Shaheen, MD, MPH discuss the recently updated ACG Guideline on the Diagnosis and Management of Barrett's Esophagus. Dr. Shaheen highlights changes in the new guideline including broadening of acceptable screening modalities for BE to include nonendoscopic methods, liberalized intervals for surveillance of short-segment BE, and volume criteria for endoscopic therapy centers for BE. (19:44)
Analysis From the GIQuIC Registry: Adenoma Detection Rates in 45–49-Year-Old Persons Undergoing Screening Colonoscopy
May 2022
Aasma Shaukat, MD, MPH, FACG
Co-Editor-in-Chief of AJG, Jasmohan Bajaj, MD, FACG, and author Aasma Shaukat, MD, MPH, FACG, discuss the new study using the GI Quality Improvement Consortium registry from 2014 to 2020 among individuals aged 45–75 years on the on the endoscopist adenoma detection rate. (11:38)
ACG-CAG Clinical Practice Guideline: Management of Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Periendoscopic Period
March 2022
Dr. Neena S. Abraham
Co-Editor-in-Chief Millie Long, MD, MPH, FACG interviews Neena S. Abraham, MD, MSc (Epi), FACG of the Mayo Clinic on the new guideline "Management of Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Periendoscopic Period," co-published between the American College of Gastroenterology and the Canadian Association of Gastroenterology. The authors also wrote a clinical practice guideline dissemination tool for practicing clinicians to understand the guideline through common scenarios encountered during endoscopic practice. (24:35)
Read the Clinical Practice Guideline Dissemination Tool, published as a Red Section piece in the April 2022 issue of the journal.Development of the AI-Cirrhosis-ECG Score: An Electrocardiogram-Based Deep Learning Model in Cirrhosis
March 2022
Douglas A. Simonetto, MD
Co-Editor-in-Chief Jasmohan Bajaj, MD, FACG and Douglas A. Simonetto, MD discuss the newly published article "Development of the AI-Cirrhosis-ECG Score: An Electrocardiogram-Based Deep Learning Model in Cirrhosis." This study aimed to develop a proof-of-concept deep learning-based artificial intelligence model that could detect cirrhosis-related signals on ECG and generate an AI-Cirrhosis-ECG, or ACE, score to correlate with disease severity. (12:59)
ACG Clinical Guideline: Diagnosis and Management of GERD
February 2022
Philip O. Katz, MD, MACG
Co-Editor-in-Chief Jasmohan Bajaj and Dr Philip Katz of Weill Cornell Medicine discuss the recently published ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. First author Dr. Katz discusses how PPIs remain the medical treatment of choice for GERD even though multiple publications question potential adverse events. The guideline addresses key issues in PPI management and adverse events, so clinicians will have a comprehensive, go-to source in the guideline. (16:43)
Acute-on-Chronic Liver Failure Clinical Guidelines
February 2022
Jasmohan Bajaj
Jasmohan S. Bajaj, MD, MS, FACG and co-Editor-in-Chief Millie Long, MD, MPH, FACG discuss the 2022 ACG Acute-on-Chronic Liver Failure guideline (18:52).
Comparative Safety of Endoscopic vs Radiological Gastrostomy Tube Placement
December 2021
Dr Divyanshoo Kohli
Divyanshoo R. Kohli, MD of the Kansas City VA Medical Center in Missouri, discusses his publication of a retrospective analysis and comparison of outcomes of PEG and IRG using an integrated nationwide database. (19:29)
ACG Clinical Guidelines: Management of Benign Anorectal Disorders
November 2021
Arnold Wald, MD, MACG
Co-Editor-in-Chief Brennan Spiegel, MD, MSHS, FACG interviews Arnold Wald, MD, MACG to discuss highlights from the ACG Clinical Guideline Management of Benign Anorectal Disorders, published in the October 2021 issue of the American Journal of Gastroenterology.
Download slides summarizing key concepts and treatment recommendations for proctalgia syndromes, chronic anal fissures, and hemorrhoids to follow along with this podcast. (31:18)Ursodeoxycholic Acid Response Is Associated With Reduced Mortality in Primary Biliary Cholangitis With Compensated Cirrhosis
September 2021
Binu V. John, MD, MPH
Binu V. John, MD, MPH joins Co-Editor-in-Chief Brian Lacy, MD, PhD, FACG to discuss the retrospective study conducted through the US Veterans Administration which examined the association of ursodeoxycholic acid liver-related death, hepatic decompensation, and hepatocellular carcinoma in patients with primary biliary cirrhosis. (23:28)
Controversies in Gastroparesis: Discussing the Sticky Points
August 2021
Brian Lacy, MD, PhD, FACG
Co-Editor-in-Chief Dr Brennan Spiegel interviews his Co-Editor-in-Chief Dr Brian Lacy on the recent Red Section article "Controversies in Gastroparesis: Discussing the Sticky Points." Listen for a discussion on the 10 controversies in gastroparesis, including the uncommonness of abdominal pain in patients with gastroparesis, endoscopic pyloric therapy, and timing of emptying during scans that could lead to an incorrect diagnosis. (22:56)
Cholangiopathy After Severe COVID-19
July 2021
Dr. Ira Jacobson
Ira Jacobson, MD, FACG joins Co-Editor-in-Chief Brian Lacy to discuss the recently published article on the clinical features and prognostic implication of cholangiopathy after severe COVID-19. (29:49)
ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile
July 2021
Dr. Colleen Kelly
Colleen Kelly, MD, FACG joins Co-Editor-in-Chief Brian Lacy, MD, PhD, FACG to discuss the preferred approach to the management of adults with C. difficile infection taken from the ACG Clinical Guideline. (21:48)
Exploratory Comparative Effectiveness Trial of Green Kiwifruit, Psyllium, or Prunes in US Patients With Chronic Constipation
June 2021
Dr. Shanti Eswaran
Shanti Eswaran, MD and Co-Editor-in-Chief Brennan Spiegel, MD discuss the new study on how kiwifruit can improve symptoms in patients with chronic constipation. (15:58)
ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding
May 2021
Dr. Loren Laine
Loren Laine MD, FACG joins Co-Editor-in-Chief Brennan Spiegel, MD, MSHS, FACG to discuss the ACG Clinical Guideline "Upper Gastrointestinal and Ulcer Bleeding." Dr. Laine discusses risk assessment in the emergency department in order to identify very-low-risk patients who may be discharged, as well as the recommendation for high-dose PPI therapy after endoscopic hemostatsis. (25:55)
ACG Clinical Guideline: Diagnosis and Management of Idiosyncratic Drug-Induced Liver Injury
May 2021
Dr. K. Rajender Reddy
K. Rajender Reddy MD, FACG speaks with Co-Editor-in-Chief Brian Lacy, MD on the new ACG Guideline Diagnosis and Management of Idiosyncratic Drug-Induced Liver Injury. Dr. Reddy offers clinical pearls of wisdom for diagnosing drug-induced liver injury in patients and reviews the new recommendations. (24:17)
Off-Label Use of Multitarget Stool DNA Testing in Primary Care
April 2021
Dr. Amol Agarwal
Amol Agarwal, MD talks with Co-Editor-in-Chief Brennan Speigel, MD on whether or not the use of mt-sDNA testing in the primary care setting is an appropriate diagnostic tool for colorectal cancer screening. (16:40)
Gender Disparities in Food Security, Dietary Intake, and Nutritional Health in the United States
March 2021
Dr. Christpher Ma
Join author Christopher Ma, MD, MPH and Co-Editor-in-Chief Dr. Brennan Spiegel as they discuss the newly published article on gender and food insecurities. Food insecurity represents a substantial public health challenge in the United States that differentially affects women compared with men. Alternative strategies may be required to meet the nutritional requirements for food insecure women. (17:16)
ACG Clinical Guideline: Colorectal Cancer Screening 2021
March 2021
Dr. Aasma Shaukat
Aasma Shaukat, MD, MPH, FACG talks with Co-Editor in Chief Dr. Brian Lacy about the new ACG Guideline Colorectal Cancer Screening 2021. She discusses the new screening recommendation for average-risk individuals as young as 45 to reduce incidence of advanced adenoma, CRC, and mortality from CRC. (22:22)
Evidence of Duodenal Epithelial Barrier Impairment and Increased Pyroptosis in Patients With Functional Dyspepsia
February 2021
Dr. William D. Chey
William D. Chey, MD, discusses the first report of duodenal confocal laser endomicroscopy abnormalities in patients with functional dyspepsia. (22:45)
Companion Article: View the recent commentary Paradigm Shift: Functional Dyspepsia—A “Leaky Gut” Disorder? by Tack et al published in the February 2021 issue.
ACG Clinical Guideline: Management of Irritable Bowel Syndrome
January 2021
Dr. Mark Pimentel
Mark Pimentel, MD, FACG, discusses the newly published ACG Guideline for Management of Irritable Bowel Syndrome. (27:59)
Assessing for Eating Disorders: A Primer for Gastroenterologists
January 2021
Dr. Monia E. Werlang
Monia E. Werlang, MD of the University of South Carolina School of Medicine Greenville discusses how unidentified eating disorders can interfere with effective management of GI disease and its symptoms. (17:52)
Environmental Impact of Endoscopy: “Scope” of the Problem
December 2020
Dr. Swapna Gayam
Swapna Gayam, MD discusses her Red Section article on the carbon footprint of endoscopy procedures and methods that can help reduce this environmental impact, including reducing plastic wastage and energy consumption. (22:20)
Linked article: Visit the Practice Management Toolbox to read Rabia de Latour's article Improving Your Endoscopy Unit's Carbon Footprint
An Analysis of the GIquIC Nationwide Quality Registry Reveals Unnecessary Surveillance Endoscopies in Patients with Normal and Irregular Z-Lines
November 2020
Dr. Sachin Wani
Sachin Wani, MD discusses the recent study published in AJG that examines endoscopic surveillance practices using data from the GI Quality Improvement Consortium Registry. (20:38)
Impact of Famotidine Use on Clinical Outcomes of Hospitalized Patients With COVID-19
October 2020
Dr. Jeffrey Mather and Dr. Raymond McKay
Jeffrey Mather MS, and Raymond G. McKay, MD discuss their study examining outcomes on famotidine treatment for patients hospitalized with COVID-19. (17:05)
ACG Clinical Guideline: Clinical Use of Esophageal Physiologic Testing
September 2020
Dr. C. Prakash Gyawali
C. Prakash Gyawali, MD, MRCP, FACG, discusses the new ACG Clinical Guideline on Esophageal Testing (21:13)
ACG Clinical Guideline: Achalasia
September 2020
Dr. Rena Yadlapati
Rena Yadlapati, MD, MHS summarizes the new ACG Clinical Guideline on Achalasia.
ACG Clinical Guideline: Achalasia
September 2020
Rena Yadlapati, MD, MHS summarizes the new ACG Clinical Guideline on Achalasia.
COVID-19 and the Digestive System
June 2020
Dr. Brian Lacy
Dr. Brian Lacy interviews Dr. Brennan Spiegel about a recent review article published in AJG: COVID-19 and the Digestive System by Ma; Cong; and Zhang. (17:41)
ACG Clinical Guideline: Chronic Pancreatitis
February 2020
Dr. Timothy B. Gardner
Timothy B. Gardner, MD, FACG, summarizes the new clinical guideline on diagnosis, etiology, and treatment of chronic pancreatitis. (25:13)
ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth
February 2020
Dr. Mark Pimentel
Mark Pimentel, MD, FACG, summarizes the new clinical guideline on small intestinal bacterial overgrowth.
ACG Clinical Guideline: Disorders of the Hepatic and Mesenteric Circulation
January 2020
Dr. Patrick S. Kamath
Patrick Kamath, MD, summarizes the new clinical guideline on vascular liver disorders.
Lactulose Breath Testing as a Predictor of Response to Rifaximin in Patients With IBS-D
January 2020
Dr. Ali Rezaie
Ali Rezaie, MD, advises how to assess IBS-D patients for possible response to rifaximin using lactulose breath tests.
Women With NAFLD Lose Protection Against Cardiovascular Disease
December 2019
Dr. Alina Allen
Alina Allen, MD, discusses the negative impact of NAFLD on cardiovascular disease risk in women.
A Clinician's Guide to Celiac Disease HLA Genetics
December 2019
Dr. Sonia Kupfer
Sonia Kupfer, MD, discusses the use and best practices of HLA genetic testing for celiac patients. (21:32)
A Practical Path to Transitioning From Pediatric to Adult IBD Care
September 2019
Dr. Anita Afzali
Anita Afzali, MD, MPH, FACG, discusses how to successfully transition a patient from pediatric to adult IBD care. (22:25)
Endoscopic Bariatric Therapy: A Guide to the Intragastric Balloon
August 2019
Dr. Barham Abu Dayyeh
Barham K. Abu Dayyeh, MD, MPH, FASGE, summarizes the current state of intragastric balloons for treatment of class I and II obesity. (25:02)
ACG Clinical Guideline: Hereditary Hemochromatosis
August 2019
Dr. Kris Kowdley
Kris Kowdley, MD, FACG, summarizes highlights from the new ACG Clinical Guidelines on hereditary hemochromatosis. (20:09)
Fecal Microbiota Transplant for Patients With Primary Sclerosing Cholangitis
July 2019
Dr. Jessica Allegretti
Jessica Allegretti, MD, MPH, discusses the relationship between primary sclerosing cholangitis and inflammatory bowel disease, the biologic plausibility of fecal microbiota transplant for this condition, and the design of this pilot clinical trial. (18:57)
Cannabinoid Use in Patients With Gastroparesis and Related Disorders
June 2019
Dr. Henry Parkman
Henry Parkman, MD, FACG, discusses current treatment options for gastroparesis, reasons why those treatments may fall short, and how cannabis may improve symptoms for these patients. (18:49)
Detection of Gluten in Gluten-Free Labeled Restaurant Food: Analysis of Crowd-Sourced Data
May 2019
Dr. Benjamin Lebwohl
Benjamin Lebwohl, MD, MS, discusses results from a study analyzing presence of gluten in "gluten-free" restaurant food, based on data from users of the Nima gluten detection device. (19:30)
ACG Clinical Guideline: Ulcerative Colitis in Adults
March 2019
Dr. Millie Long
Millie Long, MD, MPH, FACG, summarizes highlights from the new ACG Clinical Guidelines on ulcerative colitis in adult patients. (21:11)
A Randomized Controlled Trial of TELEmedicine for Patients with IBD (TELE-IBD)
March 2019
Dr. Raymond Cross
Raymond Cross, MD, MS, explains what TELEmedicine is, how it can be useful for gastroenterologists, and how this study found improved quality of life for IBD patients using this service. (15:07)
Influence of Dietary Restriction on Irritable Bowel Syndrome
February 2019
Dr. Mark Pimentel
Mark Pimentel, MD, FACG, discusses non-pharmaceutical management approaches for IBS, including gluten-free diet, dairy-free diet, low FODMAP diet, and fiber. (21:55)
Diagnosis and Management of Primary Biliary Cholangitis
January 2019
Dr. Zobair Younossi
Zobair Younossi, MD, MPH, FACG, explains the definition, pathophysiology, diagnosis, and treatment of primary biliary cholangitis. (18:26)
Pros and Cons of CRC Screening for Adults Aged 45-49 Years
December 2018
Dr. Jewel Samadder
Jewel Samadder, MD, debates the pros and cons of changing the screening age for colorectal cancer to 45 years. (32:23)
Vedolizumab for Ulcerative Colitis: Treatment Outcomes from the VICTORY Consortium
September 2018
Dr. Parambir Dulai
Parambir Dulai, MD, describes how vedoluzimab works, the design of the VICTORY study, and provides tips for using this agent for ulcerative colitis patients. (11:24)
Complications of Antireflux Surgery
August 2018
Dr. Rena Yadlapati
Rena Yadlapati, MD, discusses which patients are candidates for antireflux surgery, as well as the preparation, technique, and potential complications of this procedure. (13:09)
ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts
April 2018
Dr. Grace Elta
Grace Elta, MD, FACG, discusses why pancreatic cysts are identified more and more frequently, the best imaging modalities for diagnosis and following pancreatic cysts, and common biomarkers used to diagnose malignancy. Dr. Elta also walks through her algorithm for cyst classification. (17:00)
ACG Clinical Guideline: Management of Crohn’s Disease in Adults
April 2018
Dr. Gary Lichtenstein
Gary Lichtenstein, MD, FACG, discusses highlights from the comprehensive new guideline about the diagnosis, treatment, and management of Crohn’s disease. (32:15)
ACG Clinical Guideline: Alcoholic Liver Disease
February 2018
Dr. Vijay Shah
Vijay Shah, MD, FACG, discusses definition of alcohol use disorder, diagnostic tests for suspected cirrhosis and alcoholic hepatitis, and current treatment modalities, including when to refer for transplant. (16:45)
Bezafibrate Plus Ursodeoxycholic Acid for Treatment of Pruritus in Primary Biliary Cholangitis
January 2018
Dr. Albert Pares
Albert Pares, MD, PhD, discusses the symptoms, causes, and diagnostic approaches to primary biliary cholangitis. Dr. Pares also describes the results of his study, which combines bezafibrate with ursodeoxycholic acid (UDCA) to treat severe pruritus, the cardinal symptom of primary biliary cholangitis. (17:33)
Low-Dose Linaclotide (72 μg) for Chronic Idiopathic Constipation
January 2018
Dr. Philip Schoenfeld
Philip Schoenfeld, MD, discusses results from a double-blind, randomized controlled trial of low-dose linaclotide for patients with chronic idiopathic constipation. (28:21)
When and How to Stop Surveillance Colonoscopy in Older Adults
January 2018
Dr. Sameer Saini
Sameer Saini, MD, MS, discusses the five rules of thumb for stopping screening colonoscopy in older adults: know the data, get a full history, individualize benefits and harms, engage the patient, and work with primary care colleagues. (21:42)
Bariatric Surgery Complications: What to Expect in Your GI Practice
November 2017
Dr. Allison Schulman
Allison Schulman, MD, MPH, discusses the growing popularity and evolution of bariatric surgery as a weight-loss solution for morbidly obese patients and describes the most commonly performed bariatric procedures. She provides a thorough review of the most frequent complications for each procedure, including Roux-en-Y gastric bypass, sleeve gastrectomy, and intragastric balloons. (20:00)
Living on Liquids: A GI Dietitian’s Experience on EEN
October 2017
Kelly Issokson, MS, RD, CNSC
Kelly Issokson, a GI dietitian, discusses how she underwent an exclusive enteral nutrition (EEN) trial for 30 days in order to better understand her patients’ experience. She describes the physical and psychological effects of living exclusively on liquid formula for an extended period of time, and provides tips for physicians prescribing EEN for patients. (18:38)
ACG and the 80% by 2018 Colorectal Cancer Initiative
September 2017
Dr. Jordan Karlitz
Jordan Karlitz, MD, reviews the dedicated contributions of the National Colorectal Cancer Roundtable and various ACG committees to the 80% by 2018 initiative, which aims to screen 80% of eligible U.S. adults for colorectal cancer by 2018. (17:59)
Bloating and Abdominal Distension: Old Misconceptions and Current Knowledge
August 2017
Dr. Juan Malagelada
Juan R. Malagelada, MD, explains the definitions and mechanisms of bloating and distension, how visceral hypersensitivity heightens patient sensation of bloating, and what treatments work best for persistent gas and bloating. (17:58)
ACG and CAG Clinical Guideline: Management of Dyspepsia
July 2017
Dr. Paul Moayyedi
Paul Moayyedi, MB, ChB, PhD, MPH, FACG, co-author of new guidelines on management of dyspepsia, discusses the evolving definition and diagnosis of dyspepsia, when and when not to use endoscopy, and how H. pylori factors into dyspepsia treatment. (30:14)
Early Aggressive Hydration Hastens Clinical Improvement in Mild Acute Pancreatitis
May 2017
Dr. James Buxbaum
James L. Buxbaum, MD, discusses the controversies surrounding aggressive fluid hydration in acute pancreatitis, why lactated ringer’s solution may be superior to normal saline, and how a weight-based fluid infusion approach can help prevent fluid overload during hydration. (14:08)
Do Primary Care Provider Strategies Improve Patient Participation in CRC Screening?
April 2017
Dr. Nancy Baxter
Nancy N. Baxter MD, PhD, author of research on primary care provider (PCP) strategies to increase colorectal cancer screening participation, discusses the various strategies reported by PCPs in this study, and why combining multiple strategies led to highest participation. (19:34)
Aspiration Therapy for Weight Loss: Is the Squeeze Worth the Juice?
March 2017
Dr. Patrick Okolo
Patrick Okolo, MD, author of an editorial commenting on recently published research into the AspireAssist device, discusses the difficulty faced by some obese patients losing weight through diet and exercise, the rise in bariatric surgery as a promising treatment for these patients, and the mechanisms of the AspireAssist device studied in the original article by Thompson, et al. (24:05)
ACG Clinical Guideline: Preventive Care in IBD
February 2017
Dr. Francis Farraye
Francis Farraye, MD, MSc, FACG, co-author of a recent ACG Clinical Guideline on preventive care in IBD, discusses the importance of collaboration between the gastroenterologist and the primary care team for IBD patients, the safety and timing of vaccinations, and recommendations for preventive screening for patients on immunosuppresants. (18:27)
ACG Clinical Guideline: Treatment of Helicobacter pylori Infection
February 2017
Dr. Bill Chey
Bill Chey, MD, FACG, co-author of a recent ACG Clinical Guideline on H. pylori infection, discusses the changing prevalence of H. pylori infection and its relationship to disorders beyond peptic ulcer disease. The complicated landscape of diagnosis and treatment are also discussed. (29:39)
ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries
January 2017
Dr. Paul Kwo
Paul Kwo, MD, FACG, FAASLD, co-author of a recent ACG Clinical Guideline on abnormal liver chemistries, discusses the change in terminology from “liver function tests,” the lowered upper limit of normal for ALT levels, and the importance of screening patients born between 1945 and 1965 for HCV. (20:13)
Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-D
December 2016
Dr. William Chey
William D. Chey, MD, FACG, co-author of new research comparing the effectiveness of the low FODMAP diet versus a modified NICE diet for IBS-D, speaks with AJG co-Editor in Chief Dr. Brennan Spiegel about improvements in bloating and abdominal pain found with the low FODMAP diet, the value of individual symptom response compared to an overall “adequate relief” end point, and practical advice for guiding patients through the low FODMAP diet process. (24:05)
Financial Incentives for Promoting Colorectal Cancer Screening
November 2016
Dr. Samir Gupta
Samir Gupta, MD, MSCS, co-author of recent study examining the impact of small financial incentives for completion of FIT testing, speaks with AJG co-Editor in Chief Dr. Brennan Spiegel about why use of financial incentives to encourage health behavior is not always effective, and the behavioral economics underlying this research. This article was published in the recent Negative Issue of AJG. (15:43)
Oropharyngeal pH Testing Does Not Predict Response to PPI Therapy in Patients with Laryngeal Symptoms
November 2016
Dr. John Pandfino
John Pandolfino, MD, MS, co-author of a recent study examining the effect of PPIs on laryngeal reflux symptoms, talks with AJG co-editor Dr. Brian Lacy about why laryngopharyngeal reflux symptoms are so difficult to diagnose and treat, whether PPIs are the correct approach, and how acid exposure and laryngeal pH factor into the equation. (18:16)
Prospective EUS-Based Approach to the Evaluation of Idiopathic Pancreatitis
September 2016
Dr. C. Mel Wilcox
C. Mel Wilcox, MD, MSPH, co-author of new research on the causes, response to therapy, and long-term outcome of idiopathic pancreatitis, speaks with AJG co-Editor in Chief Dr. Brian Lacy about the evolving definition of idiopathic pancreatitis, the role of EUS vs MRCP in its diagnosis, and when you should consider pancreas divisum or autoimmune disorders in your etiology. (12:35)
Harnessing the Hashtag: A Standard Approach to GI Dialogue on Social Media
August 2016
Dr. Austin Chiang
Austin Chiang, MD, co-author of a recent Red Section article on GI ontology in social media, speaks with AJG co-Editor in Chief Dr. Brian Lacy about the benefits and logistics of using social media, specifically Twitter, in a GI practice, how new users can best take the first steps. (11:22)
Clinical Features and Outcomes of CAM-Induced Acute Liver Failure and Injury
July 2016
Dr. William Lee
William Lee, MD, co-author of an new article comparing complementary and alternative medicine (CAM)-induced liver injury to that caused by prescription medications, speaks with AJG co-Editor in Chief Dr. Brian Lacy about the definition of CAM, the regulatory approval process (or lack thereof) for CAM compared to prescription medication, and the most frequent CAM and prescription offenders for drug-induced liver injury. Dr. Lee also provides advice for clinicians trying to diagnose and counsel patients with suspected CAM-induced liver injury. (15:50)
ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Acute Diarrheal Infections in Adults
May 2016
Dr. Mark S. Riddle
Mark S. Riddle, MD, DrPH, co-author of the new ACG Clinical Guideline, speaks with AJG co-Editor in Chief Dr. Brian Lacy about the public health threat of acute diarrheal infections, the most effective diagnostic tests, and the appropriateness of antibiotics. The role of oral rehydration, probiotics, and anti-diarrheal medication is also discussed. (19:51)
ACG Clinical Guideline: Management of Patients With Acute Lower GI Bleeding
April 2016
Dr. Lisa Strate
Lisa Strate, MD, MPH, FACG, co-author of the new ACG Clinical Guideline, speaks with AJG co-Editor in Chief Dr. Brennan Spiegel about the timing of endoscopy for management of lower GI bleeding, how to assess high-risk patients for whom colonoscopy should not be performed, and the important questions surrounding the topic that remain unanswered in the current literature. (18:22)
ACG Clinical Guideline: Nutrition Therapy in the Adult Hospitalized Patient
March 2016
Dr. Steve McClave
Steve McClave, MD, co-author of the new ACG Clinical Guideline, speaks with AJG co-Editor in Chief Dr. Brian Lacy about how to recognize nutritionally deficient patients, the most common deficiencies by condition, how to determine if a patient will tolerate enteral feeds, and the pros and cons of orgastric, nasogastric, and jejunal feeding. Dr. McClave dispels some common myths, provides advice on peripheral PN (Don’t do it!), and emphasizes the invaluable support GIs can provide for the nutritional team. (16:25)
Adverse Event and Complication Management in Gastrointestinal Endoscopy
March 2016
Dr. Andrew Feld
Andrew Feld, MD, JD, co-author of a recent editorial on endoscopic adverse events, speaks with AJG co-Editor in Chief Dr. Brian Lacy about the concept of informed consent, essential elements to any endoscopist’s consent forms, how to best communicate risk to patients, and how physicians can reduce their risk of litigation. The dos and don’ts of complication management are also covered. (17:37)
ACG Clinical Guideline: Liver Disease and Pregnancy
February 2016
Dr. Tram T. Tran
Tram T. Tran, MD, FACG, FAASLD, co-author of the new ACG Clinical Guideline on the management of liver diseases in pregnant women, speaks with AJG co-Editor in Chief Dr. Brennan Spiegel about the liver function tests that may be abnormal during pregnancy, which ones to be concerned about, and how to best pursue imaging or endoscopic follow-up in pregnant women. Advice for patients who are pregnant or who wish to become pregnant is also included. (21:18)
Food: The Main Course to Wellness and Illness in Patients with IBS
February 2016
Dr. William D. Chey
William D. Chey, MD, FACG, presenter of the 2015 David Sun Lecture and author of a recently published review of the same topic, speaks with AJG co-Editor-in-Chief Dr. Brennan Spiegel about the evolution of food from sustenance and medicine to entertainment and enjoyment and the gradual shift back toward food as medicine and therapy for disease. Learn more about the complex interplay between food and GI symptoms and the FODMAP diet as a promising treatment approach. The emerging academic focus on diet and nutrition in GI care and the essential role of dietitians in the lives of IBS patients are also discussed. (25:35)
ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus
January 2016
Dr. Nicholas Shaheen
Nicholas Shaheen, MD, MPH, FACG, co-author of the new ACG Clinical Guideline on the management of Barrett’s Esophagus (BE), speaks with AJG co-Editor in Chief Dr. Brian Lacy about the changing definition of BE and reasons for a new guideline. Learn more about biopsy strategies, which patients should be screened, and proper surveillance strategies once a diagnosis is made. Treatment and prevention strategies are also discussed. (16:20)
Diagnosis of Minimal Hepatic Encephalopathy Using Stroop EncephalApp
January 2016
Dr. Jasmohan S. Bajaj
Jasmohan S. Bajaj, MD, co-author of a multi-center study validating a new app to diagnose minimal hepatic encephalopathy (MHE), speaks with AJG co-Editor in Chief Dr. Brennan Spiegel about the difficulty diagnosing MHE in cirrhotic patients, and the importance of a valid, rapid, and accessible diagnostic tool for this disabling and dangerous condition. Dr. Bajaj also discusses the difficulty of creating validated, user-friendly apps that provide both accurate diagnostics for patients and their doctors as well as usable data for researchers. (22:33)
Which CRE Prevention Strategy for ERCP Endoscopes Is Most Cost-Effective?
December 2015
Dr. Christopher Almario
Christopher Almario, MD, MSHPM, co-author of a recent article examining the cost-effectiveness of various approaches for preventing transmission of carbapenem-resistant Enterobacteriaceae (CRE) through ERCP endoscopes, discusses the genesis of the study and the finding that newly issued FDA recommendations for endoscope reprocessing were most cost-effective compared to the other approaches studied. Dr. Almario explains why a “do nothing strategy” was not included in the model, and addresses other underlying assumptions of the analysis. (20:39)
IBD Patients Are at Increased Risk of Invasive Pneumococcal Disease
November 2015
Dr. Tine Jess
Tine Jess MD, MSc, co-author of a recent article about the risk of invasive pneumococcal disease (IPD) in IBD patients, talks with AJG Co-Editor Dr. Paul Moayyedi about the increased risk of IPD as long as 4 years prior to IBD diagnosis, the risk of IPD associated with various IBD drug therapies, including the lack of risk associated with biologic therapies and oral corticosteroids, and whether physicians should be routinely offering the pneumococcal vaccine to IBD patients. (16:28)
The Clinical Impact of Immediate On-Site Cytopathology Evaluation During EUS-FNA of Pancreatic Masses
October 2015
Dr. Sachin Wani
Sachin Wani MD, co-author of a recent article about on-site cytopathology evaluation during EUS-FNA for pancreatic masses, talks with AJG Co-Editor Dr. William Chey about why EUS has been come such an important part of evaluation for pancreatic masses and cancer, the benefits and limitations of on-site cytopathology, an presents advice on cost-minimization and quality indicator adherence. (18:21)
ACG Clinical Guideline: Small Bowel Bleeding
September 2015
Dr. Lauren Gerson
Lauren Gerson, MD, MSc, FACG, co-author of the new ACG Clinical Guideline on small bowel bleeding talks with AJG Co-Editor Dr. Paul Moayyedi about recommended diagnostic techniques, including second look endoscopy, capsule endoscopy, push enteroscopy, and double-balloon enteroscopy. Efficacy of hormonal therapies, somatostatin analogs, biologic therapy, and angiogenic therapy is discussed, as well as the role of anticoagulants in the management of patients with obscure bleeding. (20:28)
Should Chromoendoscopy Become the Standard of Care in IBD Surveillance?
July 2015
Dr. Peter Higgins
Peter Higgins, MD, PhD, co-author of a recent editorial regarding the use of chromoendoscopy surveillance in IBD and ulcerative colitis, talks with AJG Co-Editor Dr. William Chey about the relationship between chronic ulcerative colitis and dysplasia, the real rate of dysplasia development in these patients, and how frequently surveillance colonoscopy should be performed. Dr. Higgins also summarizes recent research on the use of chromoendoscopy for surveillance and weighs the costs and benefits of applying this procedure to IBD patients in clinical practice. (21:08)
ACG Clinical Guideline: Primary Sclerosing Cholangitis
May 2015
Dr. Keith D. Lindor
Keith D. Lindor, MD, FACG, co-author of the new ACG Clinical Guideline on primary sclerosing cholangitis talks with AJG Co-Editor Dr. Paul Moayyedi about recommended diagnostic techniques, symptom management strategies, and the role of liver transplantation. Recommendations for colon and cholangiocarcinoma surveillance are also discussed. (18:18)
Constipation and Fecal Incontinence During and After Pregnancy
April 2015
Dr. Ron Schey
Ron Schey, MD, FACG, co-author of a recent article reviewing common bowel changes for women during pregnancy and in the postpartum period, talks with AJG Co-Editor Dr. William Chey about the temporary and possibly permanent changes to pelvic floor anatomy and physiology during pregnancy and how preexisting functional GI disorders may change during and after pregnancy. The prevalence and risk factors constipation and fecal incontinence are discussed, as well as the safety and effectiveness of various treatments for both conditions. (21:34)
Gluten Avoidance in Non-Celiac Patients
March 2015
Dr. Joseph A. Murray
Joseph A. Murray, MD, co-author of a recent article on the racial/ethnic trends in celiac disease and gluten-free diets, talks with AJG Co-Editor Dr. William Chey about the racial differences in the prevalence of celiac disease, the startling increase in this prevalence over the last 20 years, and how physicians should consider celiac disease in the context of related disorders for at-risk populations. Dr. Murray also discusses the puzzling recent trend of non-celiac patients adhering to a gluten-free diet for “health” reasons not supported by science. (24:57)
Medical Marijuana: High Time to Prescribe?
February 2015
Dr. Mark E. Gerich
Mark E. Gerich, MD, co-author of a recent Red Section article on medical marijuana and digestive disorders, talks with AJG Co-Editor Dr. Paul Moayyedi about the controversies surrounding medical marijuana, the changing legal landscape, and the challenges of conducting clinical research on the drug’s effects. The specific pharmacological agents in marijuana and their potential treatment applications for a variety of digestive disease states and symptoms are also discussed. (18:32)
Epidemiology, Pathophysiology, and Treatment of Fecal Incontinence
January 2015
Dr. Adil Bharucha
Adil Bharucha, MBBS, MD, co-author of the NIDDK state of the science summary on fecal incontience, talks with AJG Co-Editor Dr. William D. Chey about the highly common but often taboo topic of fecal incontinence. Dr. Bharucha discusses the personal and economic costs of a disorder affecting up to 15% of community-dwelling adults, as well as some key risk factors, diagnostic tests, and treatments. Clinicians will hear valuable advice on how to broach this topic with patients and how to provide meaningful care for a condition with significant emotional consequences. (26:35)
New Quality Indicators for Colonoscopy and What They Mean for Your Practice
January 2015
Dr. Philip Schoenfeld
Philip Schoenfeld, MD, co-author of new Quality Indicators for Colonoscopy published on behalf of the ACG and ASGE, talks with AJG Co-Editor Dr. William D. Chey about the transition of screening colonoscopy practice from a fee-for-service model to a quality-based model. Dr. Schoenfeld explains pre-procedure, intra-procedure, and post-procedural quality indicators, performance targets for meeting those indicators, and impact of performance data on reimbursement rates from both CMS and third-party payers. Compliance dates and reporting systems such as GIQuIC are also discussed in this essential podcast for any practicing gastroenterologist. (30:11)
What Level of Bowel Prep Quality Requires Early Repeat Colonoscopy
November 2014
Dr. Loren Laine
Loren Laine, MD, co-author of a new systematic review of the impact of bowel prep quality on early repeat colonoscopy and adenoma detection rate (ADR), talks with AJG Co-Editor Dr. William D. Chey about the real-world differences in ADR during colonoscopies with high, intermediate, and poor quality bowel preps. Meta-analysis of high-quality studies found no significant difference in ADR between high and intermediate quality preps, suggesting that intermediate preps might be “good enough.” Dr. Laine also discusses the impact of withdrawal time, documentation of prep quality, and recommendations for repeat colonoscopies after intermediate or poor quality preps. (20:55)
ACG Monograph on the Management of IBS and Chronic Idiopathic Constipation
October 2014
Dr. Eamonn M. M. Quigley and Dr. Paul Moayyedi
Eamonn M. M. Quigley, MD, FACG and Paul Moayyedi, BSc, MB ChB, PhD, MPH, FACG, co-authors of the new ACG Monograph on the management of IBS and CIC, talk with AJG Co-Editor Dr. William D. Chey about the rapidly changing field of IBS and CIC treatments, the new relevance of products such as probiotics and antibiotics in altering the microbiome in IBS patients, recommendations for PEG and newer prosecretory agents in IBS-C and CIC, and the use of drugs such as alosetron and ondansetron for severe IBS-D. (22:44)
ACG Clinical Guideline: The Diagnosis and Management of Focal Liver Lesions
September 2014
Dr. Joseph Ahn
Joseph Ahn, MD, FACG, co-author of the new ACG Clinical Guideline on management of focal liver lesions talks with AJG Co-Editor Dr. William D. Chey about the epidemiology of focal liver lesions, use of imaging modalities and blood tests as diagnostic tools for this disorder, and treatment recommendations for different types of focal liver lesions, including hepatocellular carcinoma and adenoma, cholangiocarcinoma, hemangioma, nodular regenerative hyperplasia, and cystic liver lesions. (22:44)
ACG Clinical Guideline: Management of Benign Anorectal Disorders
August 2014
Dr. Arnold Wald
Arnold Wald, MD, MACG, co-author of the new ACG Clinical Guideline on management of benign anorectal disorders, talks with AJG Co-Editor Dr. Paul Moayyedi about the definitions and treatment of dyssynergic defecation disorders, proctalgia syndromes, and fecal incontinence. They discuss the importance of determining the causes of these disorders before pursuing treatment, and the overall merits of conservative treatments over more invasive measures. (26:44)
ACG Clinical Guideline: The Diagnosis and Management of Idiosyncratic Drug-Induced Liver Injury
July 2014
Dr. Naga P. Chalasani and Dr. Herbert L. Bonkovsky
Naga P. Chalasani, MD, FACG, and Herbert L. Bonkovsky, MD, FACG, co-authors of the new ACG Clinical Guideline on drug-induced liver injury (DILI) talks with AJG Co-Editor Dr. William D. Chey about the definition of DILI and its different subtypes, risk factors for the disorder, the drug classes that pose the greatest risk of liver injury, and the essentials of clinical work-up for DILI patients, including when to perform a liver biopsy. Special note is paid to herbal and dietary supplements, which are largely unregulated and have caused increasing harm to patients over the past few years. (32:17)
Synergistic Effects of Alcohol and Tobacco on the Risk of Esophageal Squamous Cell Carcinoma
June 2014
Dr. Joel H. Rubenstein
Joel H. Rubenstein, MD, MSc, co-author of new research on the synergistic effects of alcohol and tobacco consumption on the risk of esophageal squamous cell carcinoma talks with AJG Co-Editor Dr. Paul Moayyedi about the concept of synergy in epidemiological research, the potential confounding factors and variability of the studies included in the meta-analysis, and the explanations and implications of this synergistic effect of tobacco and alcohol on esophageal cancer. (16:10)
Novel Role of the Serine Protease Inhibitor Elafin in Gluten-Related Disorders
May 2014
Dr. Elena F. Verdu
Elena F. Verdu, MD, PhD, co-author of new research on the role of the serine protease inhibitor elafin in celiac disease published in the May 2014 issue of AJG, talks with AJG Co-Editor Dr. William D. Chey about the pathophysiology of celiac disease, the role of various serine proteases, including elafin, in the inflammatory processes of celiac disease, and the potential diagnostic and treatment implications of the study findings. (15:37)
Avoiding Burnout: Finding Balance Between Work and Everything Else
April 2014
Dr. Christina M. Surawicz
Christina M. Surawicz, MD, MACG, author and presenter of the J. Edward Berk Distinguished Lecture at ACG 2013, which was published in the April 2014 issue of AJG, talks with AJG Co-Editor Dr. Paul Moayyedi about physician burnout, which has been defined as “a state of mental exhaustion caused by one’s professional life.” She discusses the components of burnout (namely emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment), frequent contributing factors to burnout such as work-home conflicts, and suggestions for how to prevent and manage burnout if it occurs. (21:00)
Trends in Esophageal Adenocarcinoma Incidence and Lifestyle Factors Between the US, Spain, and The Netherlands
March 2014
Dr. Nicholas J. Shaheen
Nicholas J. Shaheen, MD, MPH, FACG, author of an editorial on a recent article on esophageal adenocarcinoma trends across three nations published in the March 2014 issue of AJG, talks with AJG Co-Editor Dr. William Chey about the rising incidence of esophageal adenocarcinoma, the most important and interesting conclusions drawn from this ecological study, and the role that GERD, Barrett’s esophagus, tobacco smoking, alcohol consumption, and obesity all play in the pathogenesis of this disease. (22:25)
Impact of Physical Complaints, Social Environment, and Psychological Functioning on IBS Patients’ Health Perceptions
February 2014
Dr. Jeffrey M. Lackner
Jeffrey M. Lackner, PsyD, co-author of new research on the correlation between self-ratings of health and IBS symptom severity published in the February 2014 issue of AJG, talks with AJG Co-Editor Dr. Paul Moayyedi about how fatigue, somatization, and negative social interactions might serve as key predictors for self-rated health in IBS, how IBS symptom severity has a surprisingly modest role in self-rated health, and how doctors can better consider the psychological experience of IBS and how that impacts treatment and patient response. (22:31)
Differential Effects of FODMAPs on Small and Large Intestinal Contents in Healthy Subjects Shown by MRI
January 2014
Dr. Robin C. Spiller
Robin C. Spiller, MD, FRCP, co-author of new research on the effect of FODMAPs such as fructose and fructans on irritable bowel syndrome (IBS) symptoms published in the January 2014 issue of AJG, talks with AJG Co-Editor Dr. William D. Chey about the dietary substances included in the FODMAP classification, the MRI imaging techniques used to measure FODMAP impact on colonic distention and gas production in this study, and how clinicians might consider FODMAPs along with gluten and lactose when recommending dietary interventions for IBS patients. (21:53)
Clinical and Endoscopic Characteristics Do Not Reliably Differentiate PPI-Responsive Esophageal Eosinophilia and Eosinophilic Esophagitis
December 2013
Dr. Evan S. Dellon
Evan S. Dellon, MD, MPH, co-author of new research on the distinguishing features of PPI-responsive esophageal eosinophilia and eosinophilic esophagitis (EoE) published in the December issue of AJG, talks with AJG Co-Editor Dr. Paul Moayyedi about the clinical features evaluated in the study, the lack of significant distinguishing association of these features to either disease, the role of PPIs in reducing eosinophils, and potential future studies worthy of pursuit in this area. (20:05)
Patient Assessments and Online Ratings of Quality Care
November 2013
Dr. David A. Johnson
David A. Johnson, MD, FACG, co-author of new research on the emerging impact of online patient evaluation websites (PEWs) published in the Red Section of the November issue of AJG, talks with AJG Co-Editor William D. Chey, MD, FACG, about the rating metrics used by these websites, the characteristics of typical users, and the potential ways in which physicians can interact with these sites to improve doctor-patient communication and manage their online reputation. (18:34)
Temporal Bacterial Community Dynamics Vary Among Ulcerative Colitis Patients After FMT
October 2013
Dr. Sieglinde Angelberger and Dr. David Berry
Sieglinde Angelberger, MD, and David Berry, PhD, co-authors of new research on the efficacy of fecal microbiota transplantation (FMT) in patients with ulcerative colitis published in the October issue of AJG, talk with AJG Co-Editor Dr. Paul Moayyedi about the highlights of their case series, including choice of stool donors, route and duration of administration, impact of FMT on these patients’ gut microbiota, and what the disappointing response to FMT in these ulcerative colitis cases suggests for further research into this practice. (16:20)
ACG Clinical Guideline: Diagnosis and Management of Achalasia
August 2013
Dr. Michael F. Vaezi, Dr. John E. Pandolfino and Dr. Marcelo F. Vela
Michael F. Vaezi, MD, FACG, John E. Pandolfino, MD, and Marcelo F. Vela, MD, co-authors of the ACG Clinical Guideline on the Diagnosis and Management of Achalasia published in the August issue of AJG, talk with Co-Editor Dr. Paul Moayyedi about the incidence, prevalence, and diagnosis of this disorder; the best treatment options—including myotomy, pneumatic dilatation, and botulinum toxin—according to achalasia subtype and patient age, gender, and preference; as well as the long-term outlook and risks for achalasia patients after successful therapy. (25:58)
The Acid Pocket: A Target for Treatment in Reflux Disease?
July 2013
Dr. Peter J. Kahrilas
Peter J. Kahrilas, MD, FACG, co-author of new research published in the July issue of AJG about the “acid pocket,” an area of unbuffered gastric acid that accumulates in the proximal stomach after meals, talks with AJG Co-Editor William D. Chey, MD, FACG, about the definition and genesis of the acid pocket concept; the relationship between this phenomenon and hiatal hernia, erosive esophagitis, and Barrett’s esophagus; as well as evolving methods to identify and target the acid pocket for the treatment of GERD. (21:50)
High Economic Burden of Caring for Patients with Suspected Extraesophageal Reflux
June 2013
Dr. Michael F. Vaezi and Dr. David O. Francis
Michael F. Vaezi, MD, FACG, and David O. Francis, MD, co-authors of new research on the high costs of caring for patients with extraesophageal reflux symptoms published in the June issue of AJG, talk with AJG Co-Editor Dr. Paul Moayyedi about the prevalence of various extraesophageal reflux symptoms, the costs of treating these symptoms, the impact of tertiary care centers in both patient improvement and health care costs, and whether the best treatment for extraesophageal reflux is perhaps no treatment at all. (26:44)
ACG Clinical Guideline: Diagnosis and Management of Celiac Disease
May 2013
Dr. Joseph A. Murray and Dr. Ciarán P. Kelly
Joseph A. Murray, MD, FACG, and Ciarán P. Kelly, MD, FACG, co-authors of the ACG Clinical Guideline on the Diagnosis and Management of Celiac Disease, talk with AJG Co-Editor William D. Chey, MD, FACG, about the key components of the guidelines, including the working definition of celiac disease, screening techniques such as small bowel biopsy and genetic testing, best practices for gluten challenge, as well as routine celiac patient monitoring and emerging treatments. (35:42)
ACG Clinical Guideline: Esophageal Eosinophilia and Eosinophilic Esophagitis
May 2013
Dr. David A. Katzka
David A. Katzka, MD, FACG, co-author of the ACG Clinical Guideline on the Diagnosis and Management of Esophageal Eosinophilia and Eosinophilic Esophagitis (EoE), talks with AJG Co-Editor Dr. Paul Moayyedi about the key components of the guidelines, including the epidemiology of the disease, the difficulty of diagnosis for EoE, the role of diet and pharmacological therapy for treatment of EoE, and the urgent need for more research into this disease. (40:38)
Nuevas Guías de Práctica sobre el Diagnóstico y Manejo de la Enfermedad Celíaca
May 2013
Dr. Alberto Rubio-Tapia
Alberto Rubio-Tapia, MD, co-autor de la American College of Gastroenterology Guía Clínica por el Diagnóstico y Manejo de la Enfermedad Celíaca, discute los elementos clave de las directrices con Editor Asociado Max Schmulson, MD. (28:00)
ACG Clinical Guideline: Clostridium difficile Infections
April 2013
Dr. Christina Surawicz
Christina M. Surawicz, MD, MACG, talks about the key components of the guideline, including the epidemiology of the disease, the criteria for diagnosis of severe C. difficile infection, and appropriate treatment regimens for both mild-to-moderate and severe disease, including fecal transplantation. (14:10)
ACG Clinical Guideline: Diagnosis and Management of Gastroesophageal Reflux Disease
March 2013
Dr. Philip O. Katz and Dr. Lauren B. Gerson
Philip O. Katz, MD, FACG and Lauren B. Gerson, MD, MSc, FACG, two authors of the ACG Clinical Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease (GERD), talk with AJG Co-Editor Paul Moayyedi, MD, FACG, about the key components of the guidelines, including the prevalence of GERD, the recommendations for the approach to diagnosis and management, and the potential adverse events associated with PPI therapy. (33:33)
The Role of Fecal Microbiota Transplant in Treating C. difficile
February 2013
Dr. Lawrence J. Brandt
William D. Chey, MD, FACG, talks with Lawrence J. Brandt, MD, MACG, on the efficacy of this potentially lifesaving procedure and how the FDA’s recent classification of stool as a “drug” could impact physicians who want to use FMT as a treatment option for their patients. A leading pioneer in the use of fecal microbiota transplantation (FMT) in treating C. difficile infection, Dr. Brandt gave the 2012 AJG Lecture that was also published in the February issue. (33:10)
ACG Clinical Guideline: Management of Gastroparesis
January 2013
Dr. Henry P. Parkman
Paul Moayyedi, MD, FACG, talks with Henry P. Parkman, MD, FACG, co-author of the ACG Clinical Guideline for the management of gastroparesis. Published in the January issue of AJG, the guideline addresses the definition, diagnosis, differential diagnosis, and treatment of gastroparesis, including nutritional supplementation, glycemic control, pharmacological, endoscopic, device, and surgical therapy. Dr. Parkman provides insight on the guideline’s key recommendations, including the scientifically-based evidence behind them. (25:43)
Non-Celiac Wheat Sensitivity: Distinct Clinical Condition?
December 2012
Dr. Joseph A. Murray
Recent research by Antonio Carroccio, MD, that suggests the existence of non-celiac wheat sensitivity as a distinct clinical condition is the basis for a discussion between AJG Co-Editor William D. Chey, MD, FACG, and Joseph A. Murray, MD, who is lead author of an upcoming clinical management guideline for celiac disease that will be published in the Red Journal. Dr. Murray helps define non-celiac gluten sensitivity, explores why gluten-free diets are unsatisfactory as a diagnostic tool, and explains the need for scientific advancement in this area. Dr. Carroccio’s paper was published in the December issue of The American Journal of Gastroenterology. (37:17)
Linaclotide for Irritable Bowel Syndrome (IBS)
November 2012
Dr. William D. Chey and Dr. Satish Rao
Dr. Paul Moayyedi talks with William D. Chey, MD, FACG and Satish Rao, MD, PhD, FACG about two randomized controlled trials on linaclotide in irritable bowel syndrome (IBS) published in the December issue of The American Journal of Gastroenterology. The phase 3 trials report that this new therapy significantly reduces constipation and abdominal pain associated with some kinds of IBS. (35:31)
Prevalence of Irritable Bowel Syndrome Symptoms in IBD
October 2012
Dr. Alexander C. Ford and Dr. Eamonn M. M. Quigley
Paul Moayyedi, MD, FACG, talks with Alexander C. Ford, MD, and Eamonn M. M. Quigley, MD, FACG, about the findings from the first systematic review of the literature of irritable bowel syndrome symptoms in inflammatory bowel disease. In the review, Dr. Ford and his co-investigator Stephen J. Halpin, MD, demonstrated that prevalence of symptoms compatible with IBS in patients with IBD is as high as 40%. This article and Dr. Quigley’s editorial “Irritable Bowel Symptoms in IBD: Diagnostic Uncertainty Meets Pathological Reality” were published in the October issue of the AJG. (23:08)
New Meta-Analysis Shows No Protective Effect of 5-ASA Against CRC in IBD
September 2012
Dr. Geoffrey C. Nguyen and Dr. Charles N. Bernstein
Findings from a new meta-analysis focusing on non-referral studies suggest that 5-Aminosalicylic Acid offers little, if any, protection against colorectal cancer in Inflammatory Bowel Disease. In a conversation with AJG Co-Editor Dr. Paul Moayyedi, co-investigators Geoffrey C. Nguyen, MD, PhD, FRCPC and Charles N. Bernstein, MD explain why their findings conflict with previous clinic-based population studies and why 5-ASA should not be prescribed to IBD patients solely for their putative effects against CRC. (32:30)
Gut Microbes: Role In GI Health & Disease
August 2012
Dr. Mark Pimentel
The importance of gut microflora in digestive health and disease is the topic of a July 2012 AJG Supplement. A podcast with Guest Editor Mark Pimentel, MD in conversation with Dr. Bill Chey covers post-infectious functional GI conditions, SIBO, IBS, and the role of methanogens, as well as an interesting perspective on probiotics in treating GI diseases. (20:36)
Evidence Shows Higher Risk of C. difficile Infection with PPIs
July 2012
Dr. Yoon K. Loke
Findings from a new meta-analysis portray a cautionary tale on the use of PPI therapy in patients at significant risk of C. difficile infection. In conversation with AJG Co-Editor, Dr. William D. Chey, MD, Dr. Yoon K. Loke discusses his research findings that suggest concurrent use of antibiotics with PPIs increases the risk of CDI; and a lower risk of CDI with use of H2RAs. (17:00)
Endotherapy for Barrett’s Esophagus
June 2012
Dr. Irving Waxman
Endotherapy for Barrett’s esophagus is the featured topic of the June 2012 Author Podcast featuring Dr. Irving Waxman of the University of Chicago. In conversation with Co-Editor of AJG, Dr. Paul Moayyedi, Dr. Waxman reviews Barrett’s surveillance and management strategies for patients with high grade dysplasia including a discussion of EMR and various ablative modalities. (27:10)
Food Choice as a Key Management Strategy for Functional Gut Symptoms
May 2012
Dr. Peter Gibson
Professor Peter Gibson reviews the quality of the evidence on diets high or low in poorly absorbed short-chain carbohydrates, known as FODMAPs (Fermentable Oligo-, Di- and Mono-saccharides and Polyols) and their impact on functional gastrointestinal symptoms. In a discussion with Co-Editor Dr. Bill Chey, Professor Gibson provides insights on implementing dietary approaches in the office and discusses the challenges of recognizing patients with non-celiac gluten sensitivity. (28:10)
PPIs vs. H2RAs for Preventing GI Bleeding in Critically Ill Patients
April 2012
Dr. Alan Barkun
Dr. Alan Barkun from McGill in Montreal, Canada is the author of a new systematic review and meta-analysis on PPIs vs. H2-receptor antagonists for stress related mucosal bleeding prophylaxis in critically ill patients. In a conversation with Dr. Paul Moayyedi, Professor Barkun reviews the evidence on the efficacy of PPIs vs. H2RAs in recurrent GI bleeding, ICU stay, mortality, and nosocomial pneumonia. (23:06)
Management of Patients with Ulcer Bleeding
March 2012
Dr. Loren Laine
A conversation with Dr. Loren Laine.