An Approach to the Primary and Secondary Prevention of Gastric Cancer in the United States.

Background & Aims: Gastric cancer (GC) remains a leading cause of mortality among certain racial, ethnic, and immigrant groups in the United States (US). The majority of GCs are diagnosed at advanced stages, and overall survival remains poor. There exist no structured national strategies for GC prevention in the US.

Recommendations for follow-up interval after colonoscopy with inadequate bowel preparation in a national colonoscopy quality registry.

Background And Aims: Endoscopist recommendations regarding a repeat colonoscopy after inadequate bowel cleanliness have not been fully described. Our aim was to evaluate the timing of recommendations for repeat colonoscopy after inadequate bowel preparation using a large, national colonoscopy registry.

Methods: We performed a cross-sectional analysis of all outpatient screening and surveillance colonoscopies among adults ages 50 to 75 reported in the GI Quality Improvement Consortium from 2011 to 2018.

Survey Finds Gender Disparities Impact Both Women Mentors and Mentees in Gastroenterology.

Introduction: Gastroenterologists at all levels of practice benefit from formal mentoring. Much of the current literature on mentoring in gastroenterology is based on expert opinion rather than data. In this study, we aimed to identify gender-related barriers to successful mentoring relationships from the mentor and mentee perspectives.

Gender-Specific Factors Influencing Gastroenterologists to Pursue Careers in Advanced Endoscopy: Perceptions vs Reality.

Introduction: In 2020, only 19% of 63 matched advanced endoscopy (AE) fellows were women. This study evaluates the gender-specific factors that influence gastroenterologists to pursue careers in AE.

Methods: An anonymous survey was distributed to gastroenterology fellows and attendings through various gastroenterology society online forums.

Pancreatic Fungal Infection in Patients With Necrotizing Pancreatitis: A Systematic Review and Meta-analysis.

Goal: The goal of this study was to study the incidence of fungal infection in necrotizing pancreatitis (NP) and its impact on mortality.

Background: Infected pancreatic necrosis is a major contributor to morbidity and mortality in patients with NP. While pancreatic fungal infection (PFI) has frequently been identified in patients with NP, its effect on the clinical outcomes is unclear.

Upper Gastrointestinal Bleeding.

Upper gastrointestinal (GI) bleeding is a common reason for hospital admission in older adult patients and carries a high morbidity and mortality if not properly managed. Risk factors include advanced age, Helicobacter pylori infection, medication use, smoking, and history of liver disease. Patients with known or suspected liver disease and suspected variceal bleeding should also receive antibiotics and somatostatin analogues.

Gender dynamics in education and practice of gastroenterology.

Background And Aims: With an increasing number of women joining procedural fields, including gastroenterology, optimizing the work environment for learning, teaching, and clinical practice is essential to the well-being of both physicians and their patients. We queried female and male gastroenterologists on their beliefs toward the endoscopy suite environment, as well as their experiences in learning and teaching endoscopic skills.

Methods: We distributed a web-based survey to 403 gastroenterology fellows and practicing gastroenterologists at 12 academic institutions and 3 large private practices.

Yield and Practice Patterns of Surveillance Colonoscopy Among Older Adults: An Analysis of the GI Quality Improvement Consortium.

Objectives: There is little guidance regarding when to stop surveillance colonoscopy in individuals with a history of adenomas or colorectal cancer (CRC). We evaluated both yield and recommendations for follow-up colonoscopy in a large cohort of older individuals undergoing colonoscopy, using the GI Quality Improvement Consortium registry.

Methods: We analyzed the yield of colonoscopy in adults aged ≥75 years, comparing those who had an indication of surveillance as opposed to an indication of diagnostic or screening, stratified by 5-year age groups.

Prevention of Recurrent Lower Gastrointestinal Hemorrhage.

This article summarizes current knowledge regarding the incidence of and risk factors associated with recurrent lower gastrointestinal hemorrhage. The literature regarding medical, endoscopic, and surgical methods to prevent rebleeding from diverticulosis, angioectasia, and chronic hemorrhagic radiation proctopathy is reviewed. In addition, the evidence for endoscopic clipping as primary prophylaxis against postpolypectomy bleeding is explored.

Current Management of Benign Epithelial Gastric Polyps.

Purpose of review Benign epithelial gastric polyps, although typically asymptomatic, are identified incidentally on upper endoscopy in up to 23% of patients. These include fundic gland, hyperplastic, and adenomatous polyps. Their appropriate characterization is critical as some have malignant potential, may be indicative of a gastric mucosal field defect, or may be related to an underlying polyposis syndrome.

Managing antithrombotic agents during endoscopy.

Antithrombotic agents are used widely to reduce the risks of thromboembolic events in patients with a variety of cardiovascular and other conditions. This review focuses on the management of patients undergoing endoscopic procedures who are taking antithrombotic medications, and includes specific information and recommendations.

Non-pulmonary allergic diseases and inflammatory bowel disease: a qualitative review.

While the etiological underpinnings of inflammatory bowel disease (IBD) are highly complex, it has been noted that both clinical and pathophysiological similarities exist between IBD and both asthma and non-pulmonary allergic phenomena. In this review, several key points on common biomarkers, pathophysiology, clinical manifestations and nutritional and probiotic interventions for both IBD and non-pulmonary allergic diseases are discussed. Histamine and mast cell activity show common behaviors in both IBD and in certain allergic disorders.

Segmental increases in force application during colonoscope insertion: quantitative analysis using force monitoring technology.

Background: Colonoscopy is a frequently performed procedure that requires extensive training and a high skill level.

Objective: Quantification of forces applied to the external portion of the colonoscope insertion tube during the insertion phase of colonoscopy.

Design: Observational cohort study of 7 expert and 9 trainee endoscopists for analysis of colonic segment force application in 49 patients.

Peri-procedure pharmacotherapy, preparation, and infection control.

Minimizing endoscopic complications includes attention to the details about each patient's current medical condition before they undergo an invasive procedure. This article focuses on critical issues about proper preparation for endoscopic procedures and examines potential modifications to a patient's medical regimen near the time of an endoscopic procedure, highlighting recently published standards and guidelines. This article also reviews important issues related to infection control in endoscopy.

Aging, the gastrointestinal tract, and risk of acid-related disease.

It is estimated that by 2020, >16% of people in the United States will be > or =65 years of age and that nearly 20 million will be >85 years of age. Aging imparts a variety of physiologic changes in the oropharynx, esophagus, and stomach that increase the risk for esophageal and gastrointestinal disorders. Older individuals also tend to have a higher prevalence of comorbid factors, such as Helicobacter pylori infection, smoking, presence of other diseases, or use of medications (e.