Evidence-Based GI: An ACG Publication and Podcast

Epizode

• Acute Myeloid Leukemia and Myelodysplastic Syndrome with IBD and Thiopurines Impact on Risk 07.10.2021 13min

  Associate Editor Ravy K. Vajravelu, MD, MSCE and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss Incidence of Acute Myeloid Leukemia and Myelodysplastic Syndrome in Patients with Inflammatory Bowel Disease and the Impact of Thiopurines on Their Risk by Kahn et al., published in The American Journal of Gastroenterology [2021; 116: 741-47]. www.doi.org/10.14309/ajg.0000000000001058
• Screening Colonoscopy Decreases Colorectal Cancer Incidence and Related Mortality in Healthy Patients Over 75 14.10.2021 15min

  Associate Editor Jeffrey Lee, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss Association of Screening Lower Endoscopy with Colorectal Cancer Incidence and Mortality in Adults Older than 75 Years by Ma et al, published in .JAMA Oncology [2021;7(7):985-992]. https://doi.org/10.1001/jamaoncol.2021.1364
• Once-Weekly Semaglutide in Adults with Overweight or Obesity 21.10.2021 15min

  Associate Editor Sonali Paul, MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss Semaglutide Treatment Effect in People with Obesity (STEP) Investigators. Once-Weekly Semaglutide in Adults with Overweight or Obesity by Wilding et al, published in the New England Journal of Medicine [2021; 384: 989-1002. https://www.nejm.org/doi/10.1056/NEJMoa2032183
• Piecemeal Cold Snare Polypectomy of Large SSP: Cold Is the New Hot 28.10.2021 14min

  Associate Editor Swati Patel, MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss Piecemeal cold snare polypectomy versus conventional endoscopic mucosal resection for large sessile serrated lesions: a retrospective comparison across two successive periods bt Van Hattem WA, published in Gut [2021;70:1691-97]. https://doi.org/10.1136/gutjnl-2020-321753
• Computer-aided Detection Systems increase detection of non-advanced adenomas, but is it ready for prime-time? 04.11.2021 13min

  Shria Kumar, MD, MSCE discusses a 2020 article in Gastroenterology, “Efficacy of Real-Time Computer-Aided Detection of Colorectal Neoplasia in a Randomized Trial.” GI-Genius™, a new computer-aided adenoma detection tool, is FDA-approved, integrates into existing endoscopic systems, and overlays a detection box around a potential polyp. In a well-designed RCT, adenoma detection was significantly higher with GI-Genius™. Endoscopists will need to consider a variety of factors to determine whether to integrate this tool into their endoscopy practice.
• Inching Closer to a NASH Cure: Daily Semaglutide Achieves Resolution of NASH but Not Fibrosis after 72 Weeks 11.11.2021 12min

  Sonali Paul, MD, MS discusses “A Placebo-Controlled Trial of Subcutaneous Semaglutide,” published in NEJM in May 2021. Semaglutide, a GLP-1 receptor agonist for type II diabetes mellitus and weight loss, shows potential as a treatment for NASH in a well-designed, placebo-controlled RCT. May need longer trials to see if it can resolve fibrosis, which is a key treatment goal. Will anxiously await results from ongoing study of weekly high-dose semaglutide in NASH patients.
• A New “Pill Prep” for Colonoscopy: An Effective Alternative for Individuals Who Won’t Drink GoLytely® 18.11.2021 14min

  Philip N. Okafor, MD, MPH discusses the recent AJG article “A Safety and Efficacy Comparison of a New Sulfate-Based Tablet Bowel Preparation Versus a PEG and Ascorbate Comparator in Adult Subjects Undergoing Colonoscopy.” This RCT compares SUTAB®, a sodium sulfate tablet bowel preparation, to MoviPrep®. Since it is a hyperosmolar prep, be cautious when using it in patients with congestive heart failure, renal insufficiency, or electrolyte abnormalities.
• Treating All the Symptoms of IBS-C: Linaclotide Significantly Decreases Abdominal Pain, Bloating, and Discomfort 06.01.2022 17min

  Associate Editor Jill Deutsch, MD and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss “Efficacy of Linaclotide in Reducing Abdominal Symptoms of Bloating, Discomfort, and Pain: A Phase 3B Trial Using a Novel Abdominal Scoring System” by Chang et al, published in American Journal of Gastroenterology [2021;116: 1929-37]. https://pubmed.ncbi.nlm.nih.gov/34465695/
• Hereditary Syndrome Risk Assessment in all Colorectal Cancer Patients: Keep it Simple! 13.01.2022 14min

  Associate Editor Swati Patel, MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss “Prospective Statewide Study of Universal Screening for Hereditary Colorectal Cancer: The Ohio Colorectal Cancer Prevention Initiative” by Pearlman et al, published in JCO Precision Oncology [2021;5:779-91]. https://pubmed.ncbi.nlm.nih.gov/34250417/
• Drainage for Infected Pancreatic Necrosis – Earlier Is Not Better 20.01.2022 16min

  Associate Editor Shria Kumar, MD, MSCE and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss “Immediate versus Postponed Intervention for Infected Necrotizing Pancreatitis” by Boxhoorn et al, published in NEJM. [2021;15:1372-1381]. https://pubmed.ncbi.nlm.nih.gov/34614330/
• Slow Down to Speed Up Quality: Longer Withdrawal Time of 9 Versus 6 Minutes Increases Adenoma Detection Rate 27.01.2022 20min

  Associate Editor Jennifer M. Kolb MD, MSCS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi, FACG discuss “Impact of 9-Minute Withdrawal Time on the Adenoma Detection Rate: A Multicenter Randomized Controlled Trial” by Zhao et al, published in Clinical Gastroenterology and Hepatology [2020;20:31553-6]. https://pubmed.ncbi.nlm.nih.gov/33220526/
• Family Matters: Increased Risk of Colorectal Cancer among Individuals with Family History of Polyps 03.02.2022 21min

  Associate Editor Ravy K. Vajravelu, MD, MSCE and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Risk of colorectal cancer in first degree relatives of patients with colorectal polyps: nationwide case-control study in Sweden” by Song et al, published in BMJ [2021;373:n877]. https://pubmed.ncbi.nlm.nih.gov/33947661/
• Effectiveness of Intermittent Fasting for Weight Loss: It’s Not Just When You Eat, but What You Eat, Too! 10.02.2022 17min

  Associate Editor Sonali Paul, MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men with Overweight and Obesity. The TREAT Randomized Clinical Trial” by Lowe et al, published in JAMA [2021; 181(6):883]. https://pubmed.ncbi.nlm.nih.gov/32986097/
• It’s a Bad “Prep” Even Though the Patient Took It Correctly: Consider 15 mg Bisacodyl plus 4-Liter PEG Split Prep Before Next Colonoscopy 17.02.2022 13min

  Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discusses “A Multicenter Randomized Controlled Trial Comparing Bowel Cleansing Regimens for Colonoscopy After Failed Bowel Preparation” by Sey at al, published in Clinical Gastroenterology and Hepatology [2022;In Press]. https://pubmed.ncbi.nlm.nih.gov/34256147
• Increased Risk of Metachronous Neoplasia After Incomplete Polyp Resection – Time to CARE About Polypectomy Technique! 24.02.2022 17min

  Associate Editor Jeffrey Lee, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Recurrence of Colorectal Neoplastic Polyps After Incomplete Resection” by Pohl et al, published in Annals of Internal Medicine. [2021;174(10):1377-1384]. https://pubmed.ncbi.nlm.nih.gov/34370514/
• Endoscopic Eradication Therapy for Neoplastic Barrett’s Esophagus Demonstrates 94% Treatment Success and Long-term Durability 07.04.2022 17min

  Associate Editor Jennifer M Kolb MD, MS and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Long-term Outcomes after Endoscopic Treatment for Barrett’s Neoplasia with Radiofrequency Ablation ± Endoscopic Resection: Results from the National Dutch Database in a 10-year Period” by Munster et al, published in Gut [2022;71:265-76]. https://pubmed.ncbi.nlm.nih.gov/33753417/
• Therapeutic Drug Monitoring of Maintenance Infliximab Is Beneficial for Patients with Immunemediated Inflammatory Diseases 14.04.2022 11min

  Associate Editor Jessica R. Allegretti, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Effect of Therapeutic Drug Monitoring vs Standard Therapy During Maintenance Infliximab Therapy on Disease Control in Patients With Immune-Mediated Inflammatory Diseases: A Randomized Clinical Trial” by Syversen et al, published in JAMA [2021; 326(23):2375-2384]. https://pubmed.ncbi.nlm.nih.gov/34932077/
• Low Grade Dysplasia in Barrett’s Esophagus – Get Two Expert GI Pathologist Reviews and Repeat EGD After PPI Treatment 05.05.2022 15min

  Associate Editor Shria Kumar, MD, MSCE and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Discordance Among Pathologists in the United States and Europe in Diagnosis of Low-Grade Dysplasia for Patients With Barrett’s Esophagus” by Vennalaganti et al, published in Gastroenterology [2017 Feb;152(3):564-570.e4]. https://pubmed.ncbi.nlm.nih.gov/27818167/
• Tenapanor (IBSRELA) for Treatment of IBS-C: Effective over 26 Weeks 02.06.2022 11min

  Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discusses “Efficacy of Tenapanor in Treating Patients With Irritable Bowel Syndrome with Constipation: A 26-Week, Placebo-Controlled Phase 3 Trial (T3MPO-2)” by Chey et al, published in Am J Gastroenterol [2021;116: 1294-1303]. https://pubmed.ncbi.nlm.nih.gov/33337659/
• When Is Routine Prophylactic Clipping Indicated Post-Polypectomy? 09.06.2022 13min

  Associate Editor Jeffrey Lee, MD, MPH and Editor-in-Chief Philip Schoenfeld, MD, MSEd, MScEpi FACG discuss “Effect of prophylactic endoscopic clip placement on clinically significant post-endoscopic mucosal resection bleeding in the right colon: a single-centre, randomised controlled trial” by Gupta et al, published in Lancet Gastroenterol Hepatol [2022;7(2):152-160]. https://pubmed.ncbi.nlm.nih.gov/34801133/