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It was great to be with all of my friends at @ACPinternists today at #ACP2021! I gave the #UpdatesInGI talk, so want to summarize the 7 papers here! These are what YOU, my #GITwitter and #MedTwitter friends, helped identify as the top papers for the last year....
Paper 1:
Not all “GERD” = #GERD. @AGA_CGH
Who may benefit from PPIs most?
Esophagitis
Barrett’s
Heartburn w/ or w/o esophagitis
Regurg w/ or w/o esophagitis
Chest pain w/objective GERD
Cough w/objective GERD
The rest
or 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960363/
Not all “GERD” = #GERD. @AGA_CGH
Who may benefit from PPIs most?
EsophagitisBarrett’sHeartburn w/ or w/o esophagitisRegurg w/ or w/o esophagitisChest pain w/objective GERDCough w/objective GERDThe rest
or https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960363/
Paper 2:
PPIs for persistent throat sxs?
In R-DB-PCT trial:
346 pts w/persistent throat sxs
Lansoprazole 30 BID x16 wks vs placebo
Outcome: rsp at 16 wks w/reflux sx index (RSI)
FINDING: No statistical difference in RSI b/t the groups.
https://www.bmj.com/content/bmj/372/bmj.m4903.full.pdf
PPIs for persistent throat sxs?
In R-DB-PCT trial:
346 pts w/persistent throat sxs Lansoprazole 30 BID x16 wks vs placeboOutcome: rsp at 16 wks w/reflux sx index (RSI)FINDING: No statistical difference in RSI b/t the groups.
https://www.bmj.com/content/bmj/372/bmj.m4903.full.pdf
Paper 3:
New @AmCollegeGastro #ColorectalCancerScreening Guidelines
A few key points:
CRC screening to start at age 45 for average-risk
Colonoscopy and FIT recommended as primary modalities
Quality metrics of endoscopists part of guidelines!
https://journals.lww.com/ajg/fulltext/2021/03000/acg_clinical_guidelines__colorectal_cancer.14.aspx
New @AmCollegeGastro #ColorectalCancerScreening Guidelines
A few key points:
CRC screening to start at age 45 for average-riskColonoscopy and FIT recommended as primary modalitiesQuality metrics of endoscopists part of guidelines!https://journals.lww.com/ajg/fulltext/2021/03000/acg_clinical_guidelines__colorectal_cancer.14.aspx
Paper 4:
Now that colonoscopy done, polyps found, what next?
USMSTF has updated recs for f/u after polypectomy!
Take-home points:
First ensure high quality colonoscopy (complete, prep ok, skilled endoscopists
1-2 adenomas < 10 mm = 7-10 yrs!
https://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2819%2941479-0
Now that colonoscopy done, polyps found, what next?
USMSTF has updated recs for f/u after polypectomy!
Take-home points:
First ensure high quality colonoscopy (complete, prep ok, skilled endoscopists1-2 adenomas < 10 mm = 7-10 yrs! https://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2819%2941479-0
Paper 5:
PIANO
study looking at pregnancy and neonatal outcomes in women with #IBD on #Biologics and #Thiopurines
No increase in:
Congenital malformations
Spontaneous abortions
Preterm birth
Low birth weight
Milestones
https://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2820%2935441-X
PIANO
study looking at pregnancy and neonatal outcomes in women with #IBD on #Biologics and #ThiopurinesNo increase in:
Congenital malformations Spontaneous abortionsPreterm birthLow birth weightMilestoneshttps://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2820%2935441-X
