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Pearls from the AGA Clinical Congress

AGA recently concluded our annual Clinical Congress of Gastroenterology and Hepatology: Clinical Practice Skills in a Changing World in Miami, Fla.

Course Director Gary Falk, M.D., shares the top clinical take-away points from the meeting:

• For esophageal eosinophilia, exclude proton pump inhibitor (PPI) responsive esophageal eosinophilia (PPI-REE) first.

• Think medications in addition to opiates in patients with suspected gastroparesis:

Oral hypoglycemics, tramadol.

Tacrolimus in organ transplant patients.

• Remember IgG anti-DGP moving forward in equivocal celiac disease testing.

• Evidence accumulating for fecal transplant in C. difficile infection.

• Be proactive in IBD management – ongoing disease activity problematic for recurrence:

Mucosal healing is important.

Risk stratify for prevention of postoperative recurrence.

TNF response correlates to trough levels.

• Beware right-sided colon lesions:

Mucus cap.

Decreased vascular markings.

Utilize image enhancement:

• Chromoendoscopy.

• Narrow-band imaging.

• Resect and discard may be coming:

NICE criteria for adenomas versus hyperplastic polyps:

• Color.

• Vessels.

• Pit pattern.

• Management of pancreatic cystic lesions best done by consulting 2012 guidelines.

• Acute pancreatitis may be triaged for severity by systematic inflammatory response syndrome:

Early infections typically extrapancreatic.

Think step-up therapy for pancreatic necrosis.

• New HCV clinical trials have remarkable results with greater than 90 percent sustained virologic response.

• NAFLD is not NASH:

Weight loss and exercise reduces steatosis.

[email protected]

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AGA recently concluded our annual Clinical Congress of Gastroenterology and Hepatology: Clinical Practice Skills in a Changing World in Miami, Fla.

Course Director Gary Falk, M.D., shares the top clinical take-away points from the meeting:

• For esophageal eosinophilia, exclude proton pump inhibitor (PPI) responsive esophageal eosinophilia (PPI-REE) first.

• Think medications in addition to opiates in patients with suspected gastroparesis:

Oral hypoglycemics, tramadol.

Tacrolimus in organ transplant patients.

• Remember IgG anti-DGP moving forward in equivocal celiac disease testing.

• Evidence accumulating for fecal transplant in C. difficile infection.

• Be proactive in IBD management – ongoing disease activity problematic for recurrence:

Mucosal healing is important.

Risk stratify for prevention of postoperative recurrence.

TNF response correlates to trough levels.

• Beware right-sided colon lesions:

Mucus cap.

Decreased vascular markings.

Utilize image enhancement:

• Chromoendoscopy.

• Narrow-band imaging.

• Resect and discard may be coming:

NICE criteria for adenomas versus hyperplastic polyps:

• Color.

• Vessels.

• Pit pattern.

• Management of pancreatic cystic lesions best done by consulting 2012 guidelines.

• Acute pancreatitis may be triaged for severity by systematic inflammatory response syndrome:

Early infections typically extrapancreatic.

Think step-up therapy for pancreatic necrosis.

• New HCV clinical trials have remarkable results with greater than 90 percent sustained virologic response.

• NAFLD is not NASH:

Weight loss and exercise reduces steatosis.

[email protected]

AGA recently concluded our annual Clinical Congress of Gastroenterology and Hepatology: Clinical Practice Skills in a Changing World in Miami, Fla.

Course Director Gary Falk, M.D., shares the top clinical take-away points from the meeting:

• For esophageal eosinophilia, exclude proton pump inhibitor (PPI) responsive esophageal eosinophilia (PPI-REE) first.

• Think medications in addition to opiates in patients with suspected gastroparesis:

Oral hypoglycemics, tramadol.

Tacrolimus in organ transplant patients.

• Remember IgG anti-DGP moving forward in equivocal celiac disease testing.

• Evidence accumulating for fecal transplant in C. difficile infection.

• Be proactive in IBD management – ongoing disease activity problematic for recurrence:

Mucosal healing is important.

Risk stratify for prevention of postoperative recurrence.

TNF response correlates to trough levels.

• Beware right-sided colon lesions:

Mucus cap.

Decreased vascular markings.

Utilize image enhancement:

• Chromoendoscopy.

• Narrow-band imaging.

• Resect and discard may be coming:

NICE criteria for adenomas versus hyperplastic polyps:

• Color.

• Vessels.

• Pit pattern.

• Management of pancreatic cystic lesions best done by consulting 2012 guidelines.

• Acute pancreatitis may be triaged for severity by systematic inflammatory response syndrome:

Early infections typically extrapancreatic.

Think step-up therapy for pancreatic necrosis.

• New HCV clinical trials have remarkable results with greater than 90 percent sustained virologic response.

• NAFLD is not NASH:

Weight loss and exercise reduces steatosis.

[email protected]

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Pearls from the AGA Clinical Congress
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Pearls from the AGA Clinical Congress
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