Current Issue September 2010, Vol. 8, No. 9

Editor's Essential Reading

Editorial

Benefit of Acid-Suppressive Therapy in Chronic Laryngitis: The Devil Is in the Details
Michael F. Vaezi
Gastroesophageal reflux disease is increasingly associated with ear, nose, and throat symptoms. The surge of referrals for presumed reflux-related throat symptoms in a group of patients who are not responsive to aggressive acid suppression has resulted in frustration in the gastroenterology community. This is in no small part owing to poor diagnostic or treatment options for this group of patients.

Issue Highlights

Review

Endoscopic Mucosal Resection in the Management of Esophageal Neoplasia: Current Status and Future Directions
Endoscopic mucosal resection has expanded the role of the gastroenterologist in the management of esophageal neoplasia from screening and diagnosis to staging and endoscopic treatment. Its rise to prominence is a reflection of the long-identified need to obtain histologic information regarding depth of invasion and neoplastic margins during therapy that previously could not be achieved with ablative techniques.

Endoscopy Corner

Low Incidence of Complications From Endoscopic Gastric Variceal Obturation With Butyl Cyanoacrylate
Endoscopic variceal obturation with tissue adhesive is used to control gastric variceal bleeding. We investigated the prevalence of serious complications from this therapy.

Brief Communication

Biofilm Demolition and Antibiotic Treatment to Eradicate Resistant Helicobacter pylori: A Clinical Trial
Helicobacter pylori attaches to gastric mucosa and grows as a biofilm. This constitutes protection from antimicrobial agents. We assessed the role of a pretreatment with n-acetylcysteine in destroying biofilm and overcoming H pylori antibiotic resistance.

Original Articles—Alimentary Tract

Rabeprazole Is Effective in Treating Laryngopharyngeal Reflux in a Randomized Placebo-Controlled Trial
There is controversy about the efficacy of treating patients with laryngopharyngeal reflux (LPR) using proton pump inhibitors (PPIs). We assessed the effects of high doses of the PPI rabeprazole in patients with LPR.

View Additional Issue Highlights

Skin Discoloration from Compulsive Bathing in a Patient with Hyperemesis Syndrome
02 September 2010
Daniel C. Sadowski
- PDF (562 KB)
A Splenic Artery Aneurysm that Mimics a Stromal Tumor and Causes Hematemesis
02 September 2010
Raymond S. Tang, Cristina S. Wiese, William Y. Go
- PDF (557 KB)
Do All Patients with Documented Infected Necrosis Require Necrosectomy/Drainage?
02 September 2010
Michael G. Sarr, Stefan Seewald
- PDF (163 KB)
Fulminant Hepatic Failure Due to Amanita Phalloides Toxicity
02 September 2010
Christina M. Cress, Aarati Malliah, Steven K. Herrine
- PDF (360 KB)
Gastrointestinal bleeding from Brunner's gland hamartoma
02 September 2010
Emad Qayed, Mohammad Wehbe, Robin Rutherford
Abstract: Brunner gland hamartomas (BGH) are rare benign tumors of the duodenum, and a size greater than 2 cm is extremely rare. We present a case of acute gastrointestinal bleeding secondary to a lar...
Neither Long Term Statin Use Nor Atherosclerotic Disease Is Associated With Risk Of Colorectal Cancer
02 September 2010
Douglas J. Robertson, Anders Hammerich Riis, Søren Friis, Lars Pedersen, John A. Baron, Henrik Toft Sørensen
Abstract: Background & Aims:: Statin use has been reported to reduce risk for colorectal cancer (CRC) whereas atherosclerotic disease has been reported to increase risk, but findings have been inc...
Norfloxacin Therapy for Hepatopulmonary Syndrome: A Pilot Randomized Controlled Trial
02 September 2010
Samir Gupta, Marie E. Faughnan, Les Lilly, Stuart Hutchison, Robert Fowler, Ahmed M. Bayoumi
Abstract: Background and Aims: The hepatopulmonary syndrome occurs in up to one third of patients with cirrhosis. Animal models of this disease suggest that endotoxemia may cause nitric oxide-mediated...
Exam 2: Incidence of Bleeding Following Invasive Procedures in Patients With Thrombocytopenia and Advanced Liver Disease
26 August 2010
Charles O. Elson
- PDF (198 KB)
Exam 1: A 27-Year-Old Woman With Constipation: Diagnosis and Treatment
26 August 2010
Joseph R. Bloomer
- PDF (211 KB)
Low-Dose Maintenance Therapy With Infliximab Prevents Postsurgical Recurrence of Crohn's Disease
23 August 2010
Gerald M. Fraser
- PDF (185 KB)

View More Articles in Press...

Update on Colonoscopic Imaging and Projections for the Future
April 2010 (Vol. 8 | No. 4 | Pages 318-321)
Douglas K. Rex
Recently, a large number of articles on new colonoscopic imaging technologies has appeared, and this issue of Clinical Gastroenterology and Hepatology has 3 more such articles. This editorial reviews ...
Intramural Dissection of the Esophagus in a Young Man Presenting With Hematemesis
April 2010 (Vol. 8 | No. 4 | Page A18)
David Goldberg, Nuzhat A. Ahmad
A 19-year-old man presented to our hospital after an episode of hematemesis. The night before presentation the patient had a single episode of retching after dinner. The following morning he had an ep...
Risk and Reason in Barrett's Esophagus
March 2010 (Vol. 8 | No. 3 | Pages 233-234)
Nicholas J. Shaheen
What Are the Risks of General Surgical Abdominal Operations in Patients With Cirrhosis?
May 2010 (Vol. 8 | No. 5 | Pages 399-400)
J. Michael Henderson
The report in this issue from the Mount Sinai group on “Improved patient selection and operative outcome following abdominal operations in patients with advanced cirrhosis,” raises old, and new questi...
Fever and Upper Gastrointestinal Bleeding: Behçet's Disease
April 2010 (Vol. 8 | No. 4 | Pages e35-e36)
Hsu–Heng Yen, Maw–Soan Soon
A 40-year-old woman with polycystic kidney disease was admitted to our hospital for treatment of high fever for 1 week that was associated with diarrhea. Antibiotic treatment with ciprofloxacin had be...
The Role of Colonoscopy and Radiological Procedures in the Management of Acute Lower Intestinal Bleeding
April 2010 (Vol. 8 | No. 4 | Pages 333-343)
Lisa L. Strate, Christopher R. Naumann
There are multiple strategies for evaluating and treating lower intestinal bleeding (LIB). Colonoscopy has become the preferred initial test for most patients with LIB because of its diagnostic and th...
Cardiac Dysphagia
April 2010 (Vol. 8 | No. 4 | Pages e41-e42)
Klaus Mönkemüller, Klaus Feldmann, Ludger J. Ulbricht
An 82-year-old woman was admitted to the hospital because of failure to thrive and dysphagia to solids. The patient complained of decreased appetite and a 15-lb weight loss over a 10-month period. In ...
Endoscopy and Surgery for Appendiceal Adenoma
April 2010 (Vol. 8 | No. 4 | Page e39)
Erik Svensson, Philippa Newell, Tomas M. Heimann
A review of the literature shows that there have been fewer than 60 cases of appendiceal villous adenomas described. Appendiceal adenomas rarely are diagnosed preoperatively and usually are not associ...
Acute Pancreatitis Part I: Approach to Early Management
May 2010 (Vol. 8 | No. 5 | Pages 410-416)
Bechien U. Wu, Darwin L. Conwell
- Full Text
- PDF (1182 KB)
Risk of Esophageal Adenocarcinoma and Mortality in Patients With Barrett's Esophagus: A Systematic Review and Meta-analysis
March 2010 (Vol. 8 | No. 3 | Pages 235-244)
Marjolein Sikkema, Pieter J.F. de Jonge, Ewout W. Steyerberg, Ernst J. Kuipers
Background & Aims: As the risk of esophageal adenocarcinoma (EAC) and mortality in patients with Barrett's esophagus (BE) are important determinants of the potential yield and cost-effectiveness o...

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Image of the Week

Langerhans cell histiocytosis of the stomach mimicking early gastric cancer Upper GI endoscopy showing a superficially elevated reddish lesion, suggestive of early gastric cancer.

4 videos:

Dr. David A. Katzka discusses his manuscript "Variations in Presentations of Esophageal Involvement in Lichen Planus."

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Dr. Neal S. Leleiko discusses his manuscript "Factors That Determine Risk for Surgery in Pediatric Patients With Crohn's Disease."

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Dr. Victor L. Fox discusses his manuscript "Juvenile Polyps: Recurrence in Patients With Multiple and Solitary Polyps."

Video--flashvideo3cgh--http://www.youtube.com/v/bHLQx5xTfC4

Dr. Geoffrey C. Nguyen discusses his manuscript "Liver Cirrhosis Is Associated With Venous Thromboembolism Among Hospitalized Patients in a Nationwide US Study."

Video--flashvideo4cgh--http://www.youtube.com/v/Jqs5B1JQAxE

Education Practice

A 41-Year-Old Woman With Abdominal Complaints: Is It Food Allergy or Food Intolerance? How to Tell the Difference

A 41-year-old woman is referred to you for complaints of intermittent nonbloody diarrhea, abdominal cramping, and bloating. Her symptoms tend to occur shortly after eating, and she believes they might be triggered by dairy products. She also notes that soon after eating tomatoes she develops itching and swelling of her lips.

Practice Management

Value-Based Insurance Design: Implications for Gastroenterology

Despite the enactment of the Patient Protection and Affordable Care Act (PPACA), the tension between improved health care quality and escalating medical spending remains on public display. As the share of gross domestic product spent on health care passed 17% in 2009—the biggest 1-year jump in history—the fiscal impact of the new health care law is the critical bone of contention.

Letter to the Editor

Risk Factors for Colorectal Cancer After Negative Colonoscopy

In a recent issue, Rabeneck et al reported endoscopic specialty to be an important determinant of the effectiveness of screening colonoscopy but found no association between endoscopist colonoscopy volume and incident colorectal cancer (CRC).