Primary sclerosing cholangitis (PSC) is a progressive liver disease with no effective medical treatment. Jayant A. Talwalkar, M.D., discusses diagnosis, complications, liver transplantation, and Mayo Clinic's role in developing new diagnostic tests and PSC therapies.

Education about diet, exercise and bowel techniques should be considered a first line treatment for chronic constipation in older patients, says a Mayo Clinic specialist.

Autoimmune pancreatitis is notoriously difficult to distinguish from pancreatic cancer, and different diagnostic criteria in the East and West once compounded the problem. Now, new international consensus criteria should improve diagnosis and aid the search for better long-term treatments.

Todd H. Baron Sr., M.D., describes new techniques for managing post-surgical leaks and chronic fistulous tracts, including fibrin-type glues, fully covered expandable stents and a novel over-the-scope clip device on YouTube. Also discussed is the effect of leaks and fistulas on quality of life.

IBD pipeline drugs take aim at diverse targets
Emerging therapies and new applications of existing ones seek to expand treatment options for inflammatory bowel disease by targeting a range of pathways. Whether some or all will hit the mark remains to be seen.

pCLE improves dysplasia detection in Barrett's esophagus
In an international, multicenter trial, probe-based confocal laser endomicroscopy (pCLE) significantly improved the detection of dysplasia in patients with Barrett's esophagus. The technology may increase the efficiency of surveillance endoscopy and help orient patient management in real time.

Mayo Clinic investigators are participating in a multinational study that seeks to develop an activity index to assess the symptoms and biological activity of eosinophilic esophagitis (EoE). Until now, this inflammatory condition of the esophagus has been relatively unstudied.

9th Annual EUS Course 2012
Principles and Pearls in Pancreatology
Aug. 1-4, 2012, in Rochester, Minn.
This course offers health care providers at all levels of expertise a comprehensive, multidisciplinary review of endoscopic ultrasound. The one-day pancreatology course covers appropriate use of diagnostic and therapeutic modalities in the management of pancreatic diseases.

Sept. 6-9, 2012, in Chicago
This course simulates board examinations in gastroenterology. Topics include pathology, endoscopy, radiology and nutrition.

See all Gastroenterology Continuous Professional Development courses

Sunanda V. Kane, M.D., addresses fertility, the effect of pregnancy on inflammatory bowel disease, and management of IBD during pregnancy.

Patrick S. Kamath, M.D., discusses approaches to different manifestations of liver and heart disease, including cardiac manifestations of liver disease, hepatic manifestations of heart disease, and conditions for the liver and heart involved by the same disease.

New Grand Rounds presentations are available online

• Mayo Clinic in Arizona
  866-629-6362 (toll-free)
• Mayo Clinic in Florida
  800-634-1417 (toll-free)
• Mayo Clinic in Minnesota
  Gastroenterology and Hepatology
  800-533-1564 (toll-free)
• Online Referrals

• Physician Update Video Blog
• Clinical Trials at Mayo Clinic
• Mayo School of Continuous Professional Development