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GI Pearls Episode 6 – First two weeks of July 2017 Gastroenterology Literature Review

Show Notes for 2017 First two weeks of July 006
  1. Treatment with Biologic Agents has not Reduced Surgeries among Patients with Crohn’s Disease with Short Bowel Syndrome – CGH
  2. Risk of colorectal cancer in chronic liver diseases: a systematic review and meta-analysis – GIE
  3. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection among Metabolically Healthy Obese Adults – JAMA Internal Medicine
  4. Urgent colonoscopy in patients with lower GI bleeding: a systematic review and meta-analysis – GIE
  5. Mobile phone in the stomach:call the emergency endoscopist! – GIE
  6. Impact of gum chewing on the quality of bowel preparation for colonoscopy: an endoscopist-blinded, randomized controlled trial – GIE
  7. Hepatitis B reactivation in Hepatitis B and C coinfected Patients treated with Antiviral Agents: A systematic Review and Meta-analysis. – Hepatology
  8. Gastostomies Preserve But Do Not Increease Quality of Life for Patients and Caregivers – CGH
  9. “Errare Humanum Est, Perseverare Autem Diabolicum” – Gastro
  10. Association of Changes in Diet Quality with Total and Cause-Specific Mortality – NEJM
  11. Association Between Proton Pump Inhibitor Use and Cognitive Function in Women – Gastro
  12. Increased Rate of Adenoma Detection Associates with Reduced Risk of Colorectal Cancer and Death – Gastro
  13. Risk Factors for 30-day Hospital Readmission for Diverticular Hemorrhage. – J of Clinical Gastro
2015 · Article · Case-Control

Unexpected reduction in polyp numbers in Chronic Inflammatory conditions of the Colon

Tubular_adenoma_4_low_magI have read this article back in July, and immediately found it interesting.  One reason is that it is (albeit a poor one) an example of the use of “Big Data” type analysis where a large database of patient biopsy specimens can be searched.

Second reason – is the actual clinical finding – less polyps than expected in those with microscopic colitis – prevalence of ALL types of polyps was reduced.

Summary:  130,000 patients with symptoms of diarrhea had a colonoscopy with biopsies.  Compared with 97,000 control cases.  So, in this CASE-CONTROL study for patients with workup of diarrhea – less polyps (Odds ratios = 0.46 for hyperplastic, 0.24for serrated adenomas, and 0.35 for tubular adenomas).

Criticism: It would have been nice if the authors have age-matched the cases one for one from the beginning, even though these were adjusted for. There is no duration of disease, so the mechanism would remain elusive. Although it would be interesting to have someone do a database review of patients whose clinical history is known. It can even be compared to the current study, if the data is available, i.e. authors had 14% of colons have polyps in normals, and 8.3% in microscopic colitis,  is there an influence of disease duration or is this an all or none phenomenon?