GI Pearls – November-December 2017 – Episode 13

Show Notes for November-December 2017 – Episode 13
  1. Long-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: a population-based study – GUT
  2. Association Between Use of Thiopurines or Tumor Necrosis Factor Antagonists Alone or in Combination and Risk of Lymphoma in Patients With IBD – JAMA
  3. Complications of Bariatric Surgery: What You Can Expect to See in Your GI Practice – Am Journal Gastro
  4. Oversuse of Repeat Upper Endoscopy in the Veterans Health Administration: A Retrospective Analysis – Am Journal Gastro
  5. Estrogen replacement reduces risk and increases survival time in of women with HCC – CGH
  6. Hepatitis C virus testing for case identification in persons born during 1945–1965: Results from three randomized controlled trials. –  Hepatology
  7. Population based paternity rate and partner birth outcomes among Utah men with IBD – Am J Gastro
  8. Agreement between home-based Measurement of stool calprotectin and ELISA Results for Monitoring Inflammatory Bowel Disease Activity – CGH
  9. Prevalence of Eosinophilic Gastroenteritis and Colitis in a Population-based Study – CGH
  10. Tongxie Formula Reduces Symptoms of Irritable Bowel Syndrome – CGH
  11. Chromoendoscopy for Surveillance in Ulcerative Colitis and Crohn’s Disease: A Systematic Review of Randomized Trials – CGH
  12. Long-Term Efficacy and Safety of Cyclosporine in a Cohort of Steroid-Refractory Acute Severe Ulcerative Colitis Patients from the ENEIDA Registry (1989–2013): A Nationwide Multicenter Study – Am J 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?