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Section snippets Understanding Distinctions Between De-intensification, De-escalation, and Cessation of TherapyReduction of therapeutic intensity should be tailored to the specific clinical context and previous therapies. In this context, “de-intensification” serves as an overarching term that encompasses any reduction in therapy intensity, whether or not the patient initially underwent escalation

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Background and AimsCurrently, patients with hepatocellular carcinoma (HCC) in the United States are assigned a uniform score relative to the median MELD at transplant (MMaT-3) after a minimum 6-month waiting period. Here, we develop a risk stratification model for patients with HCC, using the available and objective variables at time of listing. MethodsWe identified adult liver transplant candidates

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Section snippets What Is a GI Dietitian?GI dietitians are registered dietitian nutritionists (RDNs) working with individuals exhibiting symptoms of, or diagnosed with, GI conditions in a variety of settings. RDNs must hold a master’s degree, complete 1000 hours of supervised clinical practice, and pass a national credentialing examination, in addition to completing 75 hours of continuing education

Section snippets Case HistoryThe patient is a 54-year-old man with history of cirrhosis related to metabolic dysfunction-associated steatotic liver disease who is being followed in the hepatology clinic. His cirrhosis has been complicated by ascites and hepatic encephalopathy, which is well-controlled on spironolactone 100 mg/d, furosemide 20 mg twice per day, and lactulose. He has been listed for

Background & AimsERBB2-pathway activation, through amplification or activating mutations, represents a new target for colon cancer (CC) treatment. We compared molecular methods to the gold-standard for assessing ERBB2 status and determined the prognostic value of ERBB2 amplification, mutations, and expression using data from two phase III trials involving nearly 3,000 stage III CC patients. MethodsIn

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BackgroundPrior studies have shown that individuals with fecal hemoglobin (f-Hb) concentrations just below the positivity cut-off have an increased colorectal cancer (CRC) risk compared to those with no or low f-Hb. Understanding the dose-response association between f-Hb in prior screening round and the detection of colorectal neoplasia is crucial for tailoring risk-based screening recommendations

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Crohn’s perianal fistula (CPF) is an aggressive phenotype of Crohn’s disease (CD) that remains challenging to diagnose and treat, with profound effects on quality of life (QOL). CPF affects approximately 25% of the 780,000 people in the United States living with CD.1 Patients with CPF, only one-third of whom attain long-term remission,2 have higher rates of hospitalizations, surgical intervention,

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BACKGROUND & AIMSHepatitis E virus (HEV) constitutes a substantial public health burden with ∼20 million human infections annually, including 3.3 million symptomatic cases. Appropriate treatment options for, in particular, HEV-infected immunocompromised patients and pregnant women are lacking, underscoring the urgent need for potent and safe antiviral drugs. METHODSHEV subgenomic replicon systems were

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Background & AimsGemcitabine combined with albumin-paclitaxel (AG) is a crucial therapeutic option for pancreatic ductal adenocarcinoma (PDAC). However, the response to chemotherapy is relatively poor, with rapid development of resistance. The aim of this study was to explore the mechanism of resistance to AG and to develop strategies that can sensitize the AG regimen. MethodsWe utilized organoid models

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Background & AimsThis American Gastroenterological Association (AGA) living guideline is intended to support practitioners in the pharmacological management of moderate-to-severe ulcerative colitis (UC). MethodsA multidisciplinary panel of content experts and guideline methodologists used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to prioritize clinical

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Section snippets CME/MOC CreditsThe AGA Institute is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The AGA Institute designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity

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DescriptionNonampullary duodenal polyps are found in up to 5% of all upper endoscopies; the vast majority are identified incidentally in asymptomatic patients. Although most are benign, adenomas are estimated to account for 10%–20% of these lesions. Most international guidelines recommend that all duodenal adenomas should be considered for endoscopic resection; this may be associated with a near 15%

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DescriptionThe purpose of this American Gastroenterological Association (AGA) Clinical Practice Update is to facilitate understanding and improve the clinical practice of endoscopic enteral access. MethodsThis expert commentary was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance

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BackgroundIn Crohn’s disease (CD) wrapping of mesenteric fat around the bowel wall, so called ‘creeping fat’, is highly associated with strictures. The strongest contributor to luminal narrowing in strictures is a thickening of the human intestinal muscularis propria (MP). We hence investigated creeping fat derived factors and their effect on mechanisms of human intestinal MP smooth muscle cell (HIMC)

Background and aimsHepatocellular carcinoma (HCC) risk stratification is an urgent unmet need for cost-effective HCC screening and early detection in patients with cirrhosis to improve poor HCC prognosis. MethodsMolecular (Prognostic Liver Secretome signature with alpha-fetoprotein) and clinical (aMAP score) variable-based scores were integrated to develop PAaM, which was subsequently validated in

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