American Journal of Gastroenterology

Background and rationale. Digestive diseases are common and lead to significant morbidity, mortality, and health care utilization. We used national survey and claims databases to expand on earlier findings and investigate current trends in the digestive disease burden in the United States. Methods. The National Ambulatory Medical Care Survey, Nationwide Emergency Department Sample, National Inpatient Sample, Vital Statistics of the U.S., Surveillance, Epidemiology, and End Results Program, Optum...

Background and AimsEmergency admission with foreign body in the oesophagus (FBO) commonly requires endoscopic removal. Oesophageal food bolus obstruction is often due to eosinophilic oesophagitis (EoE). Patients with food bolus obstruction should undergo endoscopy and multilevel oesophageal biopsies to exclude EoE. This national retrospective study examined the management, including endoscopy and follow-up, of patients presenting as an emergency with FBO. MethodsThe Hospital Episode Statistics ...

BackgroundBarretts Esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), and guidelines exist for screening, surveillance, and treatment. However, historically most high-risk individuals have not been reliably screened, likely due to a combination of factors associated with patient/physician awareness and use of upper endoscopy (UE) as the traditional screening test. EsoGuard(R) (EG) is a DNA biomarker assay, and EsoCheck(R) (EC) is a non-invasive, swallowable capsule de...

Introduction Vonoprazan, a new oral potassium-competitive acid blocker (PCAB), has shown promise in terms of superior acid suppression when compared to Proton pump inhibitors (PPIs). We evaluated the efficacy of PCABs versus PPIs in preventing rebleeding in high-risk peptic ulcer patients after endoscopic hemostasis. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines, we conducted a comprehensive search for relevant studies across Medline...

BackgroundChronic nausea and vomiting syndromes (CNVS), gastroparesis and functional dyspepsia (FD) are complex disorders. Body Surface Gastric Mapping (BSGM), a new test of gastric function, using Gastric Alimetry(Alimetry, New Zealand) may be useful for de-escalating healthcare utilisation. This study aimed to define healthcare costs and estimate health economic impacts of implementing this test in patients with chronic gastroduodenal symptoms. MethodsConsecutive patients at a tertiary referr...

BackgroundGastric cancer remains a major cause of cancer mortality worldwide, including in intermediate-risk countries. While endoscopic screening has proven effective in high-risk populations, its impact and economic value in intermediate-risk settings remain uncertain. ObjectiveThis systematic review and meta-analysis aimed to evaluate the effectiveness and cost-effectiveness of endoscopic screening for gastric cancer in these countries. DesignA systematic review and meta-analysis was conduc...

Background/ObjectiveThere is a paucity of data on the management of gastrointestinal (GI) bleeding in patients with COVID-19 amid concerns about the risk of transmission during endoscopic procedures. We aimed to study the outcomes of conservative treatment for GI bleeding in patients with COVID-19. MethodsIn this retrospective analysis, 24 of 1342 (1.8%) patients with COVID-19, presenting with GI bleeding from 22 April to 22 July 2020, were included. ResultsThe mean age of patients was 45.8{+/...

Background and AimsThere is a high unmet need for the treatment of gastroparesis and studies of NK1-R antagonists suggest potential benefit in reducing the symptoms of nausea and vomiting. We hypothesized that tradipitant, an NK1-R antagonist, would be effective in treating patients with idiopathic or diabetic gastroparesis. MethodsIn a randomized, double-blind, placebo-controlled study across 47 U.S. sites, 152 gastroparesis patients were randomized to receive oral 85mg BID tradipitant (n=77) ...

ObjectivesGastric cancer (GC) is a leading cause of cancer mortality in the United States (U.S.), yet no routine screening strategy exists. Opportunistic upper endoscopy (EGD) performed during screening colonoscopy (EGD-SC) may provide a practical early detection approach. We evaluated the feasibility, acceptability, patient perspectives, and diagnostic yield of EGD-SC. MethodsThis single-center, open-label, single-arm prospective trial enrolled adults aged 45-80 years scheduled for colonoscopy...

ObjectiveTo analyze presentation, management and outcomes of large ([≥] 20 mm) polyps (LPs) detected in a colorectal cancer (CRC) screening program using a fecal immunochemical test (FIT). DesignRetrospective population-based study of all LPs detected in patients aged 50-74 years between 2015 and 2019 during FIT-positive colonoscopies within the screening program organized in Alsace (France). ResultsAmong 13,633 FIT-positive colonoscopies, 1256 LPs (8.5% malignant and 51.8% non- pedunculate...

BackgroundUnderwater endoscopic mucosal resection (UEMR) is an emerging alternative to conventional endoscopic mucosal resection (CEMR). We intended to compare both techniques for colorectal polyp resection. MethodsA comprehensive search of several databases to identify studies published until November 2021 was performed. Inclusion criteria included studies comparing UEMR to CEMR in adult patients. The calculation was done by standard meta-analysis methodology, and heterogeneity was assessed us...

BackgroundChronic gastroduodenal disorders including chronic nausea and vomiting syndrome, gastroparesis, and functional dyspepsia, are challenging to diagnose and manage. The diagnostic and treatment pathways for these disorders are complex, costly and overlap substantially; however, experiences of this pathway have not been thoroughly investigated. This study therefore aimed to explore clinician and patient perspectives on the current clinical pathway. MethodsSemi-structured interviews were c...

ObjectiveTo identify independent risk factors for early ([≤]7-day) re-bleeding after peptic ulcer bleeding (PUB) and to compare the predictive performance of Forrest classification, Complete Rockall Score (CRS), and Glasgow-Blatchford Score (GBS). MethodsWe retrospectively analyzed adults with endoscopy-confirmed peptic ulcer bleeding from 2015-2020. Early re-bleeding was defined as [≤]7 days after index hemostasis. We applied univariable and multivariable logistic regression and assessed...

ObjectivesCurcumin has been claimed to have gastrointestinal benefits, including dyspepsia, a common disorder that could be managed in a primary care setting with behavioral and dietary modifications as well as over-the-counter medications. This study aimed to compare the efficacy of curcumin versus omeprazole in improving patient-reported outcomes. DesignPatients with functional dyspepsia were randomized to curcumin alone (C), omeprazole alone (O), or curcumin plus omeprazole (C+O). Patients i...

ObjectiveTo ascertain the diagnostic performance of faecal immunochemical test (FIT) in symptomatic primary care patients, to provide objective data on which to base referral guidelines. DesignStool samples from routine primary care practice in Oxfordshire, UK were analysed using the HM-JACKarc FIT method between March 2017 to March 2020. Clinical details described on the test request were recorded. Patients were followed up for up-to 36 months in linked hospital records for evidence of benign ...

Background and AimsHigh quality colonoscopy remains the cornerstone of colon cancer prevention. Studies have shown that generational advances in colonoscopes result in more favorable clinical outcomes. Performance of various endoscopes is determined using objective quality measures. The aim of this study was to compare these measures between two colonoscope platforms. MethodsThis study is a single center retrospective study of 3,761 patients undergoing initial screening colonoscopy between Nove...

Background and AimGastric emptying scintigraphy (GES) is the reference standard test for diagnosing gastroparesis. Body surface gastric mapping (BSGM) via Gastric Alimetry(R) is a new test of gastric function that combines non-invasive assessment of gastric electrophysiology and validated symptom profiling. This randomized, prospective pilot study evaluated the impact of GES vs BSGM test results on clinical decision-making. MethodsPatients with chronic gastroduodenal symptoms from a tertiary ce...

BackgroundObesity has been established as a risk factor for several gastrointestinal diseases, whether the associations are causal is uncertain. In addition, the associations of obesity-related factors with gastrointestinal diseases have been scarcely explored. This Mendelian randomization aimed to investigate the associations of birth weight, childhood body mass index (BMI), adulthood BMI and waist-hip ratio, and body composition with the risk of 24 gastrointestinal diseases. MethodsIndependen...

BackgroundLuminal application of 5-HT4 receptor agonists can increase peristalsis in the guinea pig, mouse, rat and rabbit colon. Our aim in the present study was to test the effects of intraluminal prucalopride on motor patterns in the human colon. MethodsColonic motor patterns were studied in vivo in a healthy volunteer using High-Resolution Colonic Manometry (HRCM) with an 84-sensor water perfused catheter with 1cm spacing. 5-HT and 5-HT4 receptor immunohistochemistry was performed on human ...

Background and AimsBarretts Esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC). We aimed to assess performance, safety, and tolerability of the EsoGuard (EG) assay on samples collected non-endoscopically with the EsoCheck (EC) device (EG/EC) for BE detection in the intended-use population, meeting American College of Gastroenterology (ACG) guideline criteria (chronic gastroesophageal reflux disease (GERD) and 3+ additional risk factors). MethodsWe performed a prospective, multic...