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Although there is a downward trend of patients with Crohn’s disease undergoing surgical management, surgery remains an important treatment option for Crohn’s disease. In fact, no guidelines or specific evidence base exists that directs the optimal timing of surgery for Crohn’s disease. It is the experience of the gastroenterologist that guides him or her on […]

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In the hospital setting, upper gastrointestinal (GI) bleeding remains the most common reason for consulting a gastroenterologist. The care of patients with upper GI bleeding has recently changed, including the approach to initial management, timing of endoscopy, use of blood products, and available techniques for endoscopic therapy. I am going to provide an overview of […]

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The term autoimmune pancreatitis (AIP) is used for two rare, steroid-responsive pancreatitides that present most commonly with a pancreatic mass and occasionally with acute pancreatitis. They are the only pancreatic diseases with a potential cure through effective medical therapies. Although their increased recognition has led to the avoidance of unnecessary surgery in numerous patients, it […]

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Significant advances in antiviral therapy with direct acting antivirals (DAAs) have transformed hepatitis C virus (HCV) treatment over the past four years (Table). We have achieved nearly every characteristic of an ideal regimen: pangenotypic, excellent safety and tolerability, high sustained virologic response (SVR), low pill burden, simplified dosing schedule, short treatment duration, and high genetic […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]