Debates

This is half of a two-part debate — read the opposing argument. The opinions expressed here are that of the author and do not represent the position of AGA. The past decade has witnessed numerous technical and technological advances in the field of colonoscopy. One of the most important developments, however, has been the realization […]

Debates

The last decade has witnessed significant expansion in our understanding of inflammatory bowel disease (IBD) therapies and their pharmacological characteristics. This improved knowledge, along with the paradigm shift in IBD management — evolving from merely symptom control to blocking disease progression and preventing bowel damage — has resulted in the emergence of several treatment concepts […]

Debates

In almost all areas of medicine, we accept a role for therapeutic drug monitoring. Whether we consider digoxin levels or vancomycin and cyclosporine troughs, the principles remain the same — there is a range wherein the drug is effective and also one in which there is toxicity. For the purposes of this treatise, we posit […]

Debates

Roughly one-fifth of all human cancers arise in the gastrointestinal tract. Worldwide, over 3.5 million patients are newly diagnosed with GI tract cancer each year, of whom 310,000 are in the U.S. alone. These malignancies show marked gender, racial and socioeconomic differences in incidence. For instance, esophageal and gastric adenocarcinomas occur more frequently in U.S. […]

Debates

Most Crohn’s disease patients who undergo an intestinal resection will have postoperative recurrence. The most effective way to prevent recurrence is to initiate an anti-TNF within four weeks of surgery. It has been my practice that patients at high risk for postoperative Crohn’s disease recurrence initiate anti-TNF shortly after they are discharged from the hospital. […]

Debates

A surgical resection for a patient with Crohn’s disease is a major milestone in the natural history of their condition. It is without a doubt that patients who require surgery will make avoiding further surgery a priority and accordingly many patients will consider any possible preventive measure. I explain to patients that surgery is usually […]