The opinion magazine of the American Gastroenterological Association
This is half of a two-part debate — read the opposing argument. For most individuals with gastroesophageal reflux, treatment with antisecretory medication yields excellent symptom relief. However, medical management fails in a subset of patients with more severe symptoms, and antireflux surgery should be considered. Traditionally the procedure of choice has been a 360° (Nissen) […]
This is half of a two-part debate — read the opposing argument. Gastroesophageal reflux disease (GERD) is one of the most common disorders in the U.S., affecting more than 25 million people. Despite the high prevalence of this disease, not much progress has been made in treating it in the last 30 to 70 years. Einstein […]
This is half of a two-part debate — read the opposing argument. Following the introduction of infliximab in 1998, two additional tumor necrosis factor antagonists (i.e., adalimumab, certolizumab pegol), the anti- integrin vedolizumab and ustekinumab (a monoclonal directed to interleukin 12 and 23) were approved for the management of inflammatory bowel disease. Biologics have greatly […]
This is half of a two-part debate — read the opposing argument. The safety and effectiveness of anti–tumor necrosis factor (TNF) therapy for the treatment of inflammatory bowel disease (IBD) has been well established for decades. Therefore, introducing anti-TNF biosimilars to the marketplace does not represent a new mode of treatment for patients with IBD, […]
This is half of a two-part debate — read the opposing argument. Even though this dialogue is constructed as a point–counterpoint, the reader will find that Dr. Shah and I have more in common than in conflict. First, we agree that severe alcoholic hepatitis is a terrible disease for which the currently available treatments are […]
This is half of a two-part debate — read the opposing argument. Innovation requires rigorous vetting for successful and sustained implementation. Such is the case for liver transplantation for alcoholic hepatitis. The seminal paper by Mathurin et al in 2011 stimulated debate regarding liver transplantation for patients with acute alcoholic hepatitis.1 This study showed that […]
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. Gastroparesis is a chronic and debilitating disorder with a complex pathophysiology yet to be fully understood. Unfortunately, the incidence of gastroparesis and the hospital stays associated […]
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. Despite what the title of this commentary may suggest, I want to state at the onset that I am not a Luddite. I trained in therapeutic […]
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 best treatments for achalasia disrupt the lower esophageal sphincter (LES) improving symptoms and esophageal emptying while preventing the progression to megaesophagus. The oldest of these treatments is brusque esophageal dilation, first […]
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. Achalasia is a chronic disorder and hence, treatment should be aimed at the long term. Generally, there are three different treatment options for achalasia that can provide a permanent effect: […]
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