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Combination direct-acting antiviral (DAA) therapy of eight to 24 weeks for the treatment of chronic hepatitis C is highly effective. Current guidelines do not encourage treatment for less than 12 weeks. However, mounting evidence indicates that many patients can achieve sustained virologic response (SVR) with only eight weeks of treatment. Thus, treatment for shorter durations […]

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Acute alcoholic hepatitis is a clinical syndrome characterized by sudden onset of jaundice, malaise, anorexia and occasionally abdominal pain associated with fever, tachycardia, leukocytosis and other evidence of a systemic inflammatory response in an individual who has been drinking heavily within the preceding eight weeks. By definition, serum bilirubin is elevated with modest elevation in […]

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With the recent approvals of infliximab biosimilars, CT-P13 and SB2, and adalimumab biosimilar, ABP 501, by the U.S. FDA, the landscape of available anti-tumor necrosis factor (TNF) therapies for the treatment of inflammatory bowel disease (IBD) is changing right before our eyes. To understand the implications of this change, it is important to consider several […]

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One of the most common clinical challenges that endoscopists encounter is how to properly manage antithrombotic agents in patients undergoing endoscopic procedures. Optimal management requires strategies individualized to specific patients. Physicians must consider the bleeding risk of the endoscopic procedure being performed, the underlying patient condition necessitating the antithrombotic therapy and the specific characteristics of […]

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The advent of direct acting antivirals (DAAs) in the treatment of chronic hepatitis C infection has been revolutionary in that they have drastically mitigated the side effects of therapy while enhancing efficacy relative to interferon-based therapy. DAAs are broadly categorized into the NS3/4A protease inhibitors, NS5A inhibitors, and the non-nucleoside and nucleotide NS5B inhibitors. Ribavirin, […]

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This commentary describes the current status of the multi-target stool DNA test (mt-sDNA) (Cologuard®, Exact Sciences, Madison, WI) and of stool-based markers for GI diseases. Approved by both the U.S. Food and Drug Administration and the Center for Medicare and Medicaid Services in August 2014, the mt-sDNA test is a non-invasive screening test for colorectal […]

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Acute pancreatitis (AP) is one of the most common causes of hospitalization for a gastrointestinal condition, and its incidence continues to increase in the U.S. and across the world.1 With improvements in general clinical care, the overall mortality of AP in the U.S. is now less than 2 percent. Despite this seemingly low mortality, all clinicians […]

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1. Why do I need to know about defecatory disorders?  Defecation requires increased rectal pressure coordinated with relaxation of the anal sphincter and pelvic floor. Some patients with chronic constipation have defecatory disorders (DDs). In contrast to normal or isolated slow transit constipation, these should be treated with pelvic floor biofeedback therapy rather than laxatives.1,2 […]

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The link between chronic inflammatory bowel disease (IBD) and colon cancer is well established. Colorectal cancer (CRC) is increased in patients with IBD involving at least one-third of the colon, and it is important to remember that it is the same for Crohn’s disease and ulcerative colitis. Classically, the risk of CRC was estimated to […]

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Evidence from a few randomized trials and multiple observational studies supports performing a liver ultrasound every six months as part of hepatocellular carcinoma (HCC) surveillance in patients with hepatitis C virus-related cirrhosis (HCVc). Although the possibility of using other technical modalities is tempting, there are concerns regarding radiation exposure and cost. Use of multiphase computed […]