Quick Hits

Endoscopic eradication therapies for Barrett’s esophagus (BE) have evolved and improved in the last 20 years. We excise nodular disease using endoscopic mucosal resection (EMR) and treat flat BE with radiofrequency ablation (RFA) based on accumulated, abundant and high-quality scientific evidence that shows pooled RFA eradication rates of 91 and 78 percent for dysplasia and […]

Quick Hits

The obesity epidemic is upon us. The most recent data from the Behavioral Risk Factors Surveillance System on self-reported rates of obesity show that, even in the “fittest” states in the country, obesity is reported in one in five individuals.1 The obesity epidemic has overwhelmed our practices, bariatric surgeons and health care systems. The direct […]

Quick Hits

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation. Damage to the upper gastrointestinal (GI) tract remains the most common serious adverse event (AE) related to NSAID use; however, small bowel and colonic injury also have clinical consequences. Cardiovascular (CV)-related AEs of these drugs have further complicated an approach to optimize clinical outcomes.1 Clinicians must estimate […]

Quick Hits

Chronic hepatitis C is the most common cause of hepatocellular carcinoma (HCC) in the United States and Europe. Antiviral therapy against hepatitis C virus (HCV) has long been regarded as one of the most effective chemopreventive strategies for HCC. Sustained viral response (SVR) in patients without cirrhosis can halt disease progression, thereby decreasing the risk […]

Quick Hits

A meaningful discussion on the relevance of proton pump inhibitor–responsive esophageal eosinophilia (PPI-REE) in 2018 should first consider this question: How did we ever end up with this cumbersome term? Well, it arose as an artifact of early confusion regarding the need to distinguish eosinophilic esophagitis (EoE) from gastroesophageal reflux disease (GERD). This confusion led […]

Quick Hits

Irritable bowel syndrome (IBS) is a complex, multifactorial disorder characterized by chronic or recurrent abdominal pain associated with altered bowel habits. My general approach is to identify the predominant or most bothersome symptoms and the most likely pathophysiologic mechanisms underlying these symptoms. Then I target treatment toward these predominant symptoms and mechanisms. Validating symptoms, building […]

Quick Hits

In 2018, there is substantial evidence that hepatitis C virus (HCV) infection is a systemic disease associated with adverse clinical, economic, and patient-reported outcomes (PROs). Specifically, the clinical consequences of HCV infection can lead to both hepatic and extrahepatic manifestations. In this context, HCV infection increases the risk of liver-related and overall mortality. Additionally, HCV […]

Quick Hits

By now, most of us have learned that human beings have co-existed with bugs since the beginning of time and that we bear trillions of microbes in our body (the “microbiome”) — mostly located in the gut. There, they appear to act as a digestive organ, a training tool for the immune system, and a guardian of dangerous infections — key roles in […]

Quick Hits

Making the diagnosis of eosinophilic esophagitis (EoE), a clinicopathologic disease, requires the integration of patient symptoms, histology and clinical data. As gastroenterologists, we are obliged to do the same when monitoring for a therapeutic response. Although there are several axes on which EoE treatments may be assessed, no single measure has been shown to be sufficient. Therefore, considering the subjective experience together […]