Debates

Barrett’s esophagus is a metaplastic change of the esophageal epithelium which increases the risk of esophageal adenocarcinoma by 10 to 30 fold. It is thought to progress via the development of dysplasia to esophageal adenocarcinoma (EAC). EAC is a lethal malignancy with poor outcomes when diagnosed after the onset of symptoms despite recommendations for screening […]

Debates

Aspirin is a commonly prescribed drug and its prevention of both cardiovascular and vascular events is well established. Recently, the benefits of aspirin from a chemoprevention standpoint, particularly in gastrointestinal tract cancers, have emerged. Prevention of esophageal adenocarcinomas is particularly relevant for Barrett’s esophagus patients, a premalignant condition affecting 2 percent of the adult population. […]

Debates

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 […]

Debates

This is half of a two-part debate — read the opposing argument. Esophageal symptoms are common and affect at least a quarter of the population. There are a multitude of diagnostic tests available, but no true gold standard and each test is complementary.  Endoscopy allows direct visualization of the mucosa, biopsy acquisition and potential dilation […]

Debates

This is half of a two-part debate — read the opposing argument. Preamble to this article:  I did not volunteer to write this opinion paper, but was asked by the outgoing editor, Dr. Gary Falk. Why, I’m not sure, because I don’t have this technology in our Esophageal Center at the University of South Florida. […]

Debates

This is half of a two-part debate — read the opposing argument. Recurrent bleeding, along with advanced age and medical co-morbidities, is an independent predictor of mortality in patients with upper gastrointestinal (GI) hemorrhage. Although we as endoscopists cannot alter the patient’s age or their comorbidities, we may be able to reduce the risk of […]

Debates

This is half of a two-part debate — read the opposing argument. Why use Doppler endoscopic probe (DEP) in the management of severe non-variceal gastrointestinal hemorrhage (NVUGIH)? The fundamental reason is that DEP gives endoscopists a new dimension to help them treat patients: the ability to monitor arterial blood flow underneath stigmata of recent hemorrhage […]