Computer-assisted classification of the squamocolumnar junction.

Background And Aims: An irregular Z-line is characterized by a squamocolumnar junction (SCJ) that extends proximally above the gastroesophageal junction by <1 cm, whereas Barrett's esophagus is defined as a columnar-lined esophagus (CLE) that extends proximally by ≥1 cm with the presence of specialized intestinal metaplasia on biopsy sampling. Measurement of the CLE is most accurate for lengths ≥1 cm, and, as such, guidelines do not recommend biopsy sampling of an irregular Z-line when seen on endoscopy. However, a CLE is often estimated by visual inspection rather than direct measurement, making this characterization imprecise.

Results of Anorectal Physiological Testing in Patients with Limited English Proficiency.

Background: Patients with limited English proficiency (LEP) experience barriers to healthcare. These include language barriers and difficulty accessing medical subspecialties. Consequently, patients with LEP may be underrepresented, and may be more likely to have abnormal results, among individuals referred for anorectal testing.

Retrospective evaluation of operator bias in the performance of high-resolution anorectal manometry.

Background: Measurements obtained during high-resolution anorectal manometry (HRM) are subject to operator-patient interactions. For example, standardized enhanced instruction delivered by a single operator in a test-retest fashion did not consistently increase pressures generated during dynamic maneuvers. It is probable that factors other than verbal instruction effect communication during the procedure.