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.
