Discovery of Methylated DNA Biomarkers for Potential Non-Endoscopic Detection of Barrett's Esophagus and Esophageal Adenocarcinoma.

Background And Aims: We sought to develop a minimally-invasive, robust, accessible nonendoscopic strategy to diagnose Barrett's esophagus (BE), esophageal adenocarcinoma (EAC), and its immediate precursor lesion, high-grade dysplasia (HGD) based on methylated DNA biomarkers applied to a retrievable sponge-capsule device in a cohort representative of the BE population (i.e., mostly short-segment, non-dysplastic BE, NDBE).

The Role of the Gastrointestinal Hospitalist in Optimizing Endoscopic Operations.

The gastroenterology (GI) hospitalist model has improved endoscopic operations through improved interdisciplinary coordination, efficiencies introduced in endoscopy unit workflow, and increased patient access to both inpatient and outpatient GI care. The challenges and opportunities associated with a GI hospitalist model and supporting a GI hospitalist team are reviewed, especially in relation to advanced endoscopy. The roles of the GI hospitalist in endoscopy quality measurement and value-based care are also explored.

A patient-centered framework for health systems engineering in gastroenterology: improving inpatient colonoscopy bowel preparation.

Background: Inpatient colonoscopy bowel preparation (ICBP) is frequently inadequate and can lead to adverse events, delayed or repeated procedures, and negative patient outcomes. Guidelines to overcome the complex factors in this setting are not well established. Our aims were to use health systems engineering principles to comprehensively evaluate the ICBP process, create an ICBP protocol, increase adequate ICBP, and decrease length of stay.

Nutritional Considerations in the Hospital Setting.

Malnutrition and issues of nutrition are common in hospitalized patients. Identifying patients at nutritional risk can help to improve hospital-related outcomes. Specialized nutritional support in the form of oral nutritional supplementation, enteral nutrition, and parenteral nutrition is essential to meeting the nutritional needs of many patients.

The importance of anal cancer screening and high-resolution anoscopy to gastroenterology practice.

Purpose Of Review: Although human papillomavirus (HPV)-related anal squamous cell cancer (ASCC) is rare, its incidence has been rising and in high-risk populations exceeds the incidence of cancers for which screening programs are implemented. Therefore, targeted screening techniques are being evaluated with high-resolution anoscopy (HRA) as the current gold standard because of its ability to detect anal intraepithelial dysplasia (AIN) and premalignant high-grade squamous intraepithelial lesions (HSILs). However, a scarcity of trained providers presents a barrier to screening.

Continuing Medical Education Questions: October 2019.

Article Title: A Clinician's Guide to Celiac Disease HLA Genetics.

Endoscopy in the coagulopathic patient.

Purpose Of Review: The presence of coagulopathy in patients profoundly affects the performance of gastrointestinal endoscopy. However, the coagulopathy in chronic liver disease (CLD) and therapeutic anticoagulation to lower thromboembolic risk are different. In this review, we briefly discuss the hemostatic alterations in CLD leading to coagulopathy and the periprocedure management of antithrombotic medications in patients needing emergency or elective gastrointestinal endoscopy.

Same-Day vs Different-Day Elective Upper and Lower Endoscopic Procedures by Setting.

Importance: Performing elective upper and lower endoscopic procedures on the same day is a patient-centered and less costly approach than a 2-stage approach performed on different days, when clinically appropriate. Whether this practice pattern varies based on practice setting has not been studied.

Objectives: To estimate the rate of different-day upper and lower endoscopic procedures in 3 types of outpatient settings and investigate the factors associated with the performance of these procedures on different days.

Continuing Medical Education Questions: April 2019.

Article Title: The Clinician's Guide to Suspected Small Bowel Bleeding.

Race and colorectal cancer screening compliance among persons with a family history of cancer.

Aim: To determine compliance to colorectal cancer (CRC) screening guidelines among persons with a family history of any type of cancer and investigate racial differences in screening compliance.

Methods: We used the 2007 Health Information National Trends Survey and identified 1094 (27.4%) respondents (weighted population size = 21959672) without a family history of cancer and 3138 (72.

Evaluation of occult gastrointestinal bleeding.

Occult gastrointestinal bleeding is defined as gastrointestinal bleeding that is not visible to the patient or physician, resulting in either a positive fecal occult blood test, or iron deficiency anemia with or without a positive fecal occult blood test. A stepwise evaluation will identify the cause of bleeding in the majority of patients. Esophagogastroduodenoscopy (EGD) and colonoscopy will find the bleeding source in 48 to 71 percent of patients.