The opinion magazine of the American Gastroenterological Association
Prevention of colorectal cancer through the endoscopic resection of pre-cancerous polyps is an important benefit of colonoscopy but is associated with a risk of serious adverse events, including bleeding. While immediate bleeding is usually managed at the time of the procedure, delayed post-polypectomy bleeding (after discharge from endoscopy unit, up to four weeks later) is […]
As we discuss the prophylactic value of hemostatic clips in colon polypectomy, it is important to begin by noting that there are some facts that are not up for “debate.” First, in the average-risk patient (i.e., no ongoing antiplatelet or anticoagulant agents), there is no data to support routine use of prophylactic clip closure after […]
Why inflammatory bowel disease? Inflammatory bowel disease (IBD) is a costly and chronic medical condition that disproportionately affects a young population demographic. IBD patients have unique behavioral, preventative and therapeutic health care needs.1 Due to care complexity, management is often fragmented amongst multiple providers, frequently across health care systems with the burden of coordination, communication […]
My clinical practice focuses on patients with gastrointestinal motility disorders and functional gastrointestinal disorders (FGID). I am frequently asked to see patients who report gastrointestinal (GI) symptoms after eating. These symptoms are non-specific and run the gamut from abdominal pain or discomfort, to epigastric fullness, postprandial nausea, bloating and diarrhea. Although quite common in the […]
“The greatest trick the Devil ever pulled was convincing the world he didn’t exist.” —Roger “Verbal” Kint, The Usual Suspects (1995 film) My fourth-year interventional endoscopy fellowship consisted of three-month rotations alternating between two different academic referral institutions. The endoscopic retrograde cholangiopancreatography (ERCP) practice at one institution utilized sphincter manometry to triage the need for […]
Prevention of colorectal cancer through the endoscopic resection of pre-cancerous polyps is an important benefit of colonoscopy but is associated with a risk of serious adverse events, including bleeding. While immediate bleeding is usually managed at the time of the procedure, delayed post-polypectomy bleeding (after discharge from endoscopy unit, up to four weeks later) is […]
As we discuss the prophylactic value of hemostatic clips in colon polypectomy, it is important to begin by noting that there are some facts that are not up for “debate.” First, in the average-risk patient (i.e., no ongoing antiplatelet or anticoagulant agents), there is no data to support routine use of prophylactic clip closure after […]
The application of clips during colonoscopy to prevent post-polypectomy bleeding is commonly performed, yet until recently not supported by high-quality evidence. New studies have shed some light, but controversies and areas of uncertainty remain. In this issue of AGA Perspectives, Dr. Fadi Antaki and Dr. Rajesh Keswani debate the benefits, limitations and appropriate clinical use […]
It is a reality that the practice of gastroenterology and medicine in general is subject to the public policy decisions made by Congress. The high importance that medical societies like AGA place on advocacy speaks to the impact that legislative and regulatory decisions have on clinical practices. The old adage “if you’re not at the […]
Like many of you, I see patients with a history of recurrent diverticulitis. These patients come to our clinic frustrated by their unpredictable recurrences and worried the next episode might be catastrophic. Many of these visits are about what the patient fears will happen more than any actual symptoms. They are afraid their pain will […]
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