Technology Talk
  • Patients suffering from symptoms suggestive of gastroparesis and chronic constipation frequently present with vague, nonspecific, and overlapping symptoms, often making it a challenge to provide a unifying diagnosis.
    VOLUME: 7:1
  • For confirming the diagnosis of gastroesophageal reflux disease (GERD) in patients suffering from upper gastrointestinal symptoms, objective testing is always recommended prior to surgical intervention.1 However, in selected patients, such testing is increasingly being employed to assess the efficacy of treatment with a proton pump inhibitor (PPI).
    VOLUME: 6:2
  • Due to its ability to detect disease activity in the small bowel, capsule endoscopy (CE) can play an essential role in ensuring that patients with Crohn’s disease (CD) are receiving adequate treatment. Mucosal healing can be confirmed by this technology by verifying that inflammation is managed throughout areas of potential involvement.
    VOLUME: 6:1
  • For the diagnosis and staging of gastrointestinal tract malignancies, the relative roles of fine needle aspiration (FNA) and fine needle biopsy (FNB) are being reevaluated. In endoscopic ultrasound (EUS)-guided acquisition of tissues, including esophageal, gastric, pancreaticobiliary, and rectal tissues among others, use of FNA remains a gold standard.
    VOLUME: 5:2
  • The prevalence of esophageal adenocarcinoma is increasing in the United States, presenting a major concern for gastroenterologists and fellows tasked with evaluating and managing patients who may have this malignancy. Higher cancer rates have driven researchers to further study Barrett’s esophagus (BE), a known precursor to esophageal adenocarcinoma, and the efficacy of BE interventions including radiofrequency ablation (RFA).
    VOLUME: 5:1
  • Colonoscopy has been demonstrated to be effective for colorectal cancer (CRC) screening and identification and removal of polyps when successfully performed. Complete visualization of the colon including the cecum is the goal of the procedure and necessary to ensure its benefits are achieved, benefits including early CRC detection and reduced patient mortality.1 Therefore, the risk of not meeting that goal—incomplete or failed colonoscopy—always is a concern for both experienced gastroenterology clinicians and fellows alike.
    VOLUME: 4:2
  • For more than a decade, capsule endoscopy (CE) has become the standard procedure for small bowel visualization,2 common enough that clinical fellows often are required to master CE during their training and effective enough to be considered a first-line diagnostic tool for conditions like obscure gastrointestinal (GI) bleeding. More recently, double balloon enteroscopy (DBE) also has offered complete small bowel visualization, but with control and treatment capabilities beyond CE. Although typically considered separately, using CE and DBE in tandem may provide particular benefit for GI clinicians and fellows seeking to confirm difficult diagnoses, as noted by several prominent gastroenterologists.
    VOLUME: 4:1
  • How Performance Guidelines Might Affect Care and Patient Outcomes
    The disease progression and chronicity of Crohn’s disease and ulcerative colitis can complicate the delivery of high-quality care. Practice guidelines are available, yet quality remains highly variable. Thus, similar to conditions like colorectal cancer, a quality-of-care movement is being established for inflammatory bowel disease (IBD).
    VOLUME: 3:2
  • While the use of anorectal manometry to evaluate bowel function is well-established, the evolution of high-resolution and 3D devices has increased the detail these tools can uncover about functional abnormalities. For gastroenterology fellows learning these techniques, the emerging question is whether training should still be performed using the conventional method.
    VOLUME: 3:1
  • For patients with suspected or known Crohn’s disease (CD), capsule endoscopy (CE) offers a patient-friendly tool to visualize the small bowel. An estimated 75% of CD cases involve the small bowel and 30% present only in the small bowel, so CE represents an effective imaging option for this difficult-to-access region.
    VOLUME: 2:2
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