Almost One-Third of Large Sessile Serrated Polyps Are Missed on CT Colonography.

Background: Nearly one-third of colorectal cancers (CRC) arise via the serrated pathway. CT colonography (CTC) is a CRC screening examination. Endoscopic detection of sessile serrated polyps (SSPs) varies widely; it is unknown whether CTC effectively detects SSPs.

Continuing Medical Education Questions: December 2019.

Article Title: Colonic Manifestations and Complications Are Relatively Under-reported in Systemic Sclerosis: A Systematic Review.

Levels of Vitamin D Are Low After Crohn's Disease Is Established But Not Before.

Background & Aims: Low serum levels of vitamin D have been associated with Crohn's disease (CD). However, it is unclear whether low vitamin D levels cause CD or CD reduces serum vitamin D.

Methods: United States military personnel with CD (n = 240) and randomly selected individuals without CD (controls, n = 240) were matched by age, sex, race, military branch, and geography.

Continuing Medical Education Questions: July 2019.

Article Title: The Gut Microbiome in Other Chronic Immune Disease: Lessons for Inflammatory Bowel Disease.

Continuing Medical Education Questions: March 2019.

To receive CME/MOC credit for this activity, please go to: http://acgjournalcme.gi.org/Article Title: ACG Clinical Guideline: Ulcerative Colitis in Adults.

The dose of omeprazole required to achieve adequate intraesophageal acid suppression in patients with gastroesophageal junction specialized intestinal metaplasia and Barrett's esophagus.

Background: The mainstay of medical therapy for Barrett's esophagus is normalization of esophageal acid exposure with proton pump inhibitors (PPIs). However, the optimal dose and whether once daily or twice daily is required for acid suppression is unknown.

Aim: The purpose of this study was to assess whether adequate intra-esophageal acid suppression could be achieved with once daily versus twice daily omeprazole in patients with gastroesophageal specialized intestinal metaplasia (GEJSIM), short-segment (SSBE) and long-segment Barrett's esophagus (LSBE).

Inflammatory bowel disease prevalence by age, gender, race, and geographic location in the U.S. military health care population.

Background: There is limited data examining the prevalence of inflammatory bowel disease (IBD) in a diverse North American population.

Methods: Using International Classification of Diseases, Ninth Revision codes, patients with Crohn's disease (CD) and ulcerative colitis (UC) seen within the military health care system (Tricare) from October 1, 2008 to September 30, 2009 were identified. This database comprised all active duty military, retirees, and dependents.

Randomized controlled trial comparing aerosolized swallowed fluticasone to esomeprazole for esophageal eosinophilia.

Objectives: Patients with clinical symptoms of esophageal dysfunction and dense eosinophilic infiltration of the esophageal mucosa are suspected to have eosinophilic esophagitis (EoE). Topical steroids are often used as first-line therapy for EoE, although some patients respond clinically to proton pump inhibitors (PPIs). The purpose of this study was to compare the histological and clinical response of patients with esophageal eosinophilia treated with aerosolized swallowed fluticasone propionate vs.

Probiotics for the treatment of inflammatory bowel disease.

Probiotics are organisms which provide a desired and beneficial effect on human health. With recent evidence implicating a disruption in the balance of the gastrointestinal microbiome and intestinal immunity as a potential trigger for inflammatory bowel disease (IBD), there has been growing interest in using probiotics as an adjunct to standard anti-inflammatory and immune suppressing therapy. Animal models describe potential and plausible mechanisms of action for probiotics to counter inflammation of colonic mucosa.

Esophageal motor disorders in adults with eosinophilic esophagitis.

Background: An association between eosinophilic esophagitis (EoE) and esophageal motility disorders has been described in small studies.

Aims: The aim of this study was to describe the prevalence of esophageal motor disorders in a large cohort of adults with EoE and examine whether an association exists between esophageal dysmotility and dysphagia.

Methods: A retrospective review of esophageal manometry studies in adult EoE patients was performed.

Extracolonic findings on CT colonography increases yield of colorectal cancer screening.

Objective: The purpose of this study is to evaluate the impact of extracolonic findings when screening is undertaken by CT colonography (CTC).

Materials And Methods: We performed a retrospective cohort study of patients completing a screening CTC from August 2003 to June 2006 at Walter Reed Army Medical Center. Extracolonic findings were categorized using a CTC reporting and data system that classifies findings as highly significant, likely significant, and insignificant.

Chronic proton pump inhibitor therapy associated with increased development of fundic gland polyps.

Background: Fundic gland polyps (FGP) have been implicated with long-term proton pump inhibitor (PPI) use.

Aims: We attempted to investigate the impact of length and dosage of PPI therapy on the development of FGP.

Methods: A retrospective cohort study of all patients who had gastric polyps removed during elective upper endoscopy between March and September 2007 as part of a prior prospective study protocol was carried out.

Eosinophilic esophagitis.

Eosinophilic esophagitis is a chronic inflammatory disorder characterized by dense eosinophilic infiltration of the esophageal mucosa. The pathogenesis is incompletely understood and food allergies and aeroallergens have been implicated. The most common clinical presentation in adults is dysphagia to solids.

Should computed tomographic colonography replace optical colonoscopy in screening for colorectal cancer?

Clinical evidence amassed over the last several decades indicates that routine colorectal cancer (CRC) screening, compared to no screening, detects CRC at an earlier stage, reduces the incidence of CRC or the progression early CRC through polypectomy, and reduces CRC mortality. Computed tomographic colonography (CTC) is a minimally invasive, structural evaluation of the entire colorectum that has recently been advocated by multiple American professional medical societies as an effective alternative for CRC screening. The potential advantages of CTC, including rapid image acquisition and processing, non-invasiveness, and decreased procedural risks of perforation, bleeding, and sedation complications may serve to improve the low rates of colorectal cancer screening that are currently observed in our society.