News Feb 16, 2019 A closer look at sarcopenia and the role of exercise in liver transplant candidates Results from two multicenter studies help address the problem of progressive loss muscle mass and associated outcomes in liver transplant patients. Feb 16, 2019 Examining the role of gut microbial composition and function in weight loss Mayo Clinic researchers compared clinical characteristics and gut microbial composition and function in 26 adult study participants. Feb 16, 2019 Transoral endoscopic incisionless fundoplication Barham K. Abu Dayyeh, M.D., M.P.H., answers key questions about transoral incisionless fundoplication and provides an overview of recent research findings evaluating the efficacy of this approach. Feb 9, 2019 Nonpharmacological approaches to management of functional gastrointestinal disorders — Where are we now? Gastroenterologists discuss the Mayo Clinic experience and research in the use of dietary interventions and other nonpharmacological measures to manage irritable bowel syndrome and other functional gastrointestinal diso[...] Feb 9, 2019 Advanced imaging and endoscopic tools enhance diagnosis and treatment of PSC and cancer surveillance Mayo specialists employ highly specialized magnetic resonance cholangiopancreatography (MRCP) to diagnose and manage primary sclerosing cholangitis (PSC) in a large cohort of patients. Feb 9, 2019 Advances in the treatment of Crohn's disease and ulcerative colitis When used in a treat-to-target approach, therapies for mucosal healing may favorably modify the natural history of inflammatory bowel disease (IBD), reducing the need for steroids and risk of hospitalization. Oct 23, 2018 Updated IDSA guideline for treatment of Clostridium difficile infection Mayo Clinic gastroenterologists discuss new Clostridium difficile infection (CDI) treatment recommendations developed by the Infectious Diseases Society of America and Society for Healthcare Epidemiology of America, add[...] Oct 23, 2018 Evaluating the role of peroral endoscopic myotomy in the treatment of achalasia Available study data suggest that in the hands of a well-trained endoscopist, peroral endoscopic myotomy (POEM) can combine the performance of surgical myotomy with the safety profile of an endoscopic procedure. Oct 23, 2018 Esophageal cancers: Recent advances and challenges associated with early detection Because early diagnosis is associated with improved survival rates for both esophageal adenocarcinoma and squamous cell carcinoma, the search for accurate, cost-effective and widely accepted screening tools remains a pr[...] Oct 18, 2018 Endoscopic mucosal resection for management of large colorectal polyps Aug 18, 2018 Pancreatic cancer screening in high-risk individuals Because pancreatic cancer and precursor lesions detected early are potentially curable with surgery, there is growing interest in evaluating whether screening of high-risk individuals is effective. Aug 18, 2018 Tofacitinib is first oral medication approved for use in treating moderate to severe ulcerative colitis Tofacitinib, a Janus kinase (JAK) inhibitor, is the first oral medication approved for chronic use in this indication. Aug 18, 2018 ACS announces new guideline for colorectal cancer screening for adults at average risk In an announcement published in late May, the American Cancer Society released a new guideline recommending that regular screening for colorectal cancer should begin at age 45 for adults at average risk. Jun 13, 2018 Transoral outlet reduction with full thickness endoscopic suturing addresses weight regain after gastric bypass Transoral outlet reduction endoscopy (TORe) is a novel approach to reducing the stoma diameter that can be performed on an outpatient basis. Jun 12, 2018 Opioid-induced esophageal dysfunction Opioid-induced esophageal dysfunction is the subject of multiple studies conducted by Mayo Clinic researchers and colleagues. Jun 12, 2018 Inflammatory bowel disease biobank research update Researchers from Mayo Clinic's inflammatory bowel disease (IBD) biobank are hopeful that serologic and genetic markers will help them develop therapeutic approaches tailored to an individual's unique genetic or molecula[...] Apr 14, 2018 Laparoscopic gastrectomy for gastric cancer The minimally invasive procedure offers faster recovery, less blood loss and pain, and a return to eating and normal bowel function more quickly. The hospital stay is shorter and the patient is less likely to need a fee[...] Apr 13, 2018 Clip-assisted endoscopic full-thickness resection and biopsy techniques Clip-assisted endoscopic full-thickness resection (EFTR) and endoscopic full-thickness biopsy (EFTB) provide an alternative to surgery in the management of epithelial and subepithelial lesions and diagnosis of neuromusc[...] Apr 13, 2018 Transforming noninvasive liver disease detection by MRE: the hepatogram Mayo researchers recently studied the use of magnetic resonance elastography (MRE) to detect nonalcoholic steatohepatitis (NASH) in its earlier stages, before the onset of fibrosis. Apr 13, 2018 Assessing the risk of tumoremia after endoscopic ultrasound-guided fine-needle aspiration of pancreatic adenocarcinoma Although endoscopic ultrasound-guided fine-needle aspiration is thought to be safe, some experts question whether tumor manipulation during this procedure causes tumors to shed cells into the bloodstream. Feb 27, 2018 Role of novel DNA methylation markers in detection of advanced neoplasia in pancreatic cysts Researchers successfully identified and validated novel methylated DNA markers in pancreatic tissue that discriminate — more accurately than currently available cyst fluid markers — high-grade precursor lesi[...] Feb 27, 2018 Inherited cancers clinic seeks to advance understanding, diagnosis and management of hereditary colorectal cancers Use of a simple questionnaire of personal and family history of cancer in outpatient settings helps improve the identification of high-risk patients and families, detect cancers earlier, and formulate more-effective ind[...] Feb 27, 2018 Diagnosis and management of small bowel bleeding: Update on diagnostic and therapeutic tools Important issues to consider in the diagnosis and management of small bowel bleeding include appropriate selection of patients for evaluation, optimal selection and timing of tests, and an understanding of when a conser[...] Feb 20, 2018 Identifying diarrhea caused by bile acid malabsorption Bile acid malabsorption occurs in about one-third of patients diagnosed with irritable bowel syndrome with diarrhea. The serum 7αC4 test and the fecal bile acid excretion test help identify these patients so that [...] Feb 20, 2018 Targeted DNA next-generation sequencing aids the molecular assessment of pancreatic neuroendocrine tumors A recent Mayo Clinic study demonstrated that endoscopic ultrasound-acquired cytology-based tumor genotyping can reveal a spectrum of genetic variants, which may help guide biomarker-driven, individualized, targeted trea[...] Feb 20, 2018 NAFLD and NASH research update Mayo Clinic researchers are exploring several new treatment options for nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Feb 20, 2018 Understanding HCV and evolving treatment guidelines Hugo E. Vargas, M.D., a gastroenterologist and hepatologist specializing in viral hepatitis and liver transplantation at Mayo Clinic's campus in Arizona, answers several key questions about hepatitis C virus (HCV) infec[...] Nov 17, 2017 Use of dietary strategies in treating eosinophilic esophagitis Mayo Clinic gastroenterologist Jeffrey A. Alexander, M.D., explains current research findings and clinical experience related to the use of elimination diets in the treatment of eosinophilic esophagitis. Nov 17, 2017 Current and emerging pharmacological treatment options for irritable bowel syndrome A growing number of available and emerging pharmacological options for the treatment of irritable bowel syndrome (IBS) seek to alter the disease-modifying mechanisms leading to gut dysfunction or the long-term natural h[...] Nov 17, 2017 Mucosal healing in inflammatory bowel disease Many experts believe that incorporating endoscopy and other objective markers of mucosal healing into treatment algorithms for patients with inflammatory bowel disease (IBD) will help maximize quality of life and reduce[...] Sep 16, 2017 Placement of mesenchymal stem cell-coated matrix induces clinical healing and radiographic response in fistulas Results of a small study recently published by Mayo Clinic researchers show that using a synthetic, biodegradable matrix impregnated with stem cells may be an effective treatment for fistulizing perianal Crohn's disease[...] Sep 16, 2017 Current and emerging therapies for PBC Researchers exploring new treatments for primary biliary cholangitis (PBC) are hopeful that the 2016 FDA approval of obeticholic acid and novel therapeutic agents currently under investigation will yield new options for[...] Jul 17, 2017 Comparing the risk of gastrointestinal bleeding associated with direct oral anticoagulants This retrospective, propensity-matched study provides head-to-head comparisons of dabigatran, rivaroxaban and apixaban to help evaluate their risk of causing gastrointestinal (GI) bleeding. Jul 15, 2017 Surveillance of colorectal dysplasia and cancer in inflammatory bowel disease David H. Bruining, M.D., a gastroenterologist specializing in inflammatory bowel disease (IBD) and endoscopic imaging at Mayo Clinic's campus in Rochester, Minnesota, answers several key questions about colorectal cance[...] Jul 15, 2017 Evaluating the efficacy of ESG as a minimally invasive nonsurgical endoscopic intervention for obesity Study results published in Clinical Gastroenterology and Hepatology and Obesity Surgery evaluate the procedure's durability and effects on body weight and gastrointestinal function. Jul 14, 2017 Technical advances have improved safety, efficacy of endoscopic submucosal dissection Endoscopic submucosal dissection (ESD) allows en bloc resection of pre-malignant and early-stage malignant lesions of the stomach, colorectum and esophagus with curative rates comparable to surgery. The technique is cha[...] Jul 14, 2017 Mayo Clinic streamlines hepatocellular carcinoma treatment Mayo Clinic's efficient, coordinated leads to superior outcomes in liver cancer and liver transplantation. Jun 21, 2017 Underused cancer test could improve treatment for thousands, Mayo Clinic study finds ROCHESTER, Minn. ? A simple blood test could improve treatment for more than 1 in 6 stage 2 colon cancer patients, suggests new Mayo Clinic research. The researchers also discovered that many patients who could benefit fro[...] May 19, 2017 Management of post-surgical complications involving the GI tract Careful assessment and avoiding an urge to use one approach for all or a "shotgun approach" are critical when planning the management of gastrointestinal defects and leaks. May 19, 2017 Frequently asked questions about complex polypectomies Polyp size, location and morphology determine the complexity of endoscopic excision and its risk of complications. In this article, Mayo Clinic gastroenterologists provide some answers to frequently asked questions abou[...] May 19, 2017 Association between gastric acid suppression and risk of primary C. diff infection In a meta-analysis of 16 studies involving 7,703 patients, Mayo researchers found evidence linking recurrent Clostridium difficile infections (CDIs) with use of these medications. Mar 28, 2017 The role of lifestyle-related treatments for IBS Therapeutic options for irritable bowel syndrome (IBS) focus on alleviating symptoms. This article addresses the role of diet, exercise and sleep modifications in the treatment of IBS. Mar 28, 2017 Treatment of Zenker's diverticulum Mayo Clinic experience and recently published data suggest that one or two treatments using a flexible endoscopic approach can provide a high rate of symptom relief and a low rate of diverticular recurrence or persisten[...] Mar 28, 2017 Biosimilars for IBD: What you need to know now Edward V. Loftus Jr., M.D., a gastroenterologist specializing in inflammatory bowel disease (IBD) at Mayo Clinic's campus in Rochester, Minnesota, addresses several key questions about biosimilars and their potential ro[...] Jan 14, 2017 Two drugs offer new options for IBD Ustekinumab was recently approved for patients with Crohn's disease who fail to respond to anti-TNF agents. Oral tofacitinib may be approved for ulcerative colitis by the end of 2017. Jan 14, 2017 Endoscopic fundoplication bridges gap in GERD management Many patients with gastroesophageal reflux disease (GERD) have a suboptimal response to proton pump inhibitors (PPIs). Long-term use is associated with a growing list of adverse events. Endoscopic fundoplication has eme[...] Jan 13, 2017 Chromoendoscopy better than random biopsies for IBD surveillance, but… In many studies, chromoendoscopy has proved superior to random biopsies for dysplasia detection in irritable bowel disease surveillance programs. But the technique remains a supplement to biopsy sampling, mainly due to [...] Dec 19, 2016 Colorectal cancer prevention: A proven benefit of nonsteroidal anti-inflammatory drugs ROCHESTER, Minn. ? Mayo Clinic researchers and a team of collaborating scientists from across the country have determined the comparative effectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin and several [...] Dec 8, 2016 Does donor stool affect FMT outcomes in kids? Current Mayo Clinic protocols require that children undergoing fecal microbial transplant for recurrent C. difficile infection supply fresh, familial donor stool. A new study is evaluating whether frozen stool from anon[...] Nov 12, 2016 Researchers identify FAH mutation without elevated succinylacetone Three siblings with classic symptoms of tyrosinemia type 1 but without elevated levels of succinylacetone were seen at Mayo Clinic in 2013. Their case led to the discovery of a novel FAH genetic variation. Nov 12, 2016 Still no optimal treatments for pediatric AP The incidence of pediatric acute pancreatitis (AP) has increased over the last two decades due to better recognition in children. Most kids recover quickly with supportive care. But those with recurrent AP may experienc[...] Nov 12, 2016 Food sensitivities may affect gut barrier function Despite growing evidence implicating dietary factors in dysregulated gut barrier function, much about these interactions isn't clear, especially in the absence of food sensitivity biomarkers and validated assays for int[...] Sep 17, 2016 Study demonstrates efficacy of EUS-guided stent placement In experienced centers, EUS-guided duct drainage has a relatively high success rate. But the procedure is among the most technically challenging for endoscopists and carries potentially serious risks. Sep 13, 2016 Endoscopic management of post-transplant biliary strictures Endoscopic interventions for biliary strictures after liver transplantation have a high success rate and are the preferred approach in patients with duct-to-duct anastomoses. Sep 13, 2016 Healthy Living Program offers new approach to functional GI disorders Mayo Clinic's Healthy Living Program offers wellness plans for fundamentally healthy people wanting to maximize fitness, lose weight and manage stress. The same approach may help patients with functional bowel disorders[...] Sep 13, 2016 Linking patients with effective weight management strategies A broad spectrum of nutritional, behavioral, pharmacological, endoscopic and surgical therapies is essential for managing obesity, its complications and comorbidities. Jul 16, 2016 Multidisciplinary treatment in rectal cancer Despite improvements in preoperative tumor staging and outcomes, evaluation and management of locally advanced rectal cancer presents ongoing challenges for physicians and patients, highlighting the need for multidiscip[...] Jul 15, 2016 Laparoscopic proctectomy not ready for prime time Despite positive results in other trials and against expectations, laparoscopic surgery for rectal cancer did not prove equivalent to open resection in the 2015 ACOSOG trial. Jul 15, 2016 Aspirin a potential chemopreventive agent for cholangiocarcinoma Building on a long history of aspirin research, Mayo investigators find an association between aspirin use and a significant reduction in the three subtypes of cholangiocarcinoma. Jul 15, 2016 Stool DNA has potential for multiple cancer screenings Methylated DNA may not only provide an affordable, noninvasive method for pancreatic cancer screening but also represent a first step toward a universal cancer screening test. May 13, 2016 If it's not celiac disease, what is it? The role of gluten and FODMAPs in patients presenting with IBS-symptoms remains unclear. Persuasive studies exist on all sides of the debate. May 13, 2016 Genetic risk profile predicts early CD surgery Clinicians generally have no way of knowing which patients with newly diagnosed Crohn's disease will experience rapid disease progression and early surgery. Three new genetic risk profiles may change that. May 13, 2016 Innovations improve achalasia diagnosis, management In the last decade, high-resolution manometry, esophageal bolus transit assessment by intraluminal impedance and distensibility assessment with the EndoFlip probe have significantly improved treatment and management of [...] May 13, 2016 Hemorrhoidal disease: Diagnosis and management Rubber band ligation has been shown to be a safe, effective and painless therapy for grade I and grade II hemorrhoids. Although less durable than surgical excision, it is also less costly, has fewer complications and ze[...] May 7, 2016 Studies rebut common theories about pediatric celiac disease Children with celiac disease may not have the same fat-soluble vitamin deficiencies observed in adults but may take longer for complete mucosal healing than once thought, according to two recent studies. Apr 8, 2016 Intragastric balloon safe and effective in total weight management program The intragastric balloon procedure represents an intermediate option — between lifestyle change and bariatric surgery — for patients with a BMI of 30 to 40 kg/m2. Mar 19, 2016 Proton beam therapy reduces toxicity, increases survival in some GI cancers Proton beam therapy can create dose distributions that conform to tumor targets with significant sparing of normal tissue. This may make it a superior modality for some gastrointestinal cancers. Mar 18, 2016 Managing refractory IBD A majority of patients with IBD fail to respond to standard medical treatment or lose response over time. Managing these patients requires an understanding of the available medications and appropriate diagnostic tests a[...] Mar 18, 2016 More data needed to guide pancreatic cyst management Current guidelines for management of pancreatic cysts provide conflicting recommendations that confuse both physicians and patients. A Mayo Clinic pancreas expert offers this suggestion: "Stop producing guidelines and s[...] Mar 18, 2016 Easing transition and transfer for pediatric patients with IBD Medical, physical and psychosocial barriers challenge young patients with IBD as they transition to self-management and the adult health care system. Mayo Clinic is developing programs to help ease the way. Feb 26, 2016 Most patients with HCV cured with new drugs — but at what price? Assessment of the extent of liver disease is critical in patients with hepatitis C virus (HCV). Insurers may be reluctant to cover patients with HCV who don't have advanced cirrhosis or fibrosis. Mayo offers noninvasive[...] Jan 21, 2016 Liver transplantation and obesity: Weighing the risks Although early studies linking obesity with worse survival among liver transplant recipients are flawed, obesity in general and post-transplant weight gain in particular increase the risk of perioperative and postoperat[...] Jan 19, 2016 Rethinking comparative effectiveness research IBD effectiveness trials are needed to foster evidence-based changes in clinical practice, but remain challenging to fund and recruit. An IBD specialist says investigators must become more creative in their approach to [...] Jan 16, 2016 FISH probes improve detection of cholangiocarcinoma Fluorescence in situ hybridization (FISH) and tumor genotyping may improve evaluation and management of challenging cholangiocarcinomas. May 30, 2015 Pulmonary vascular complications of chronic liver disease Mayo pulmonologists with expertise in the management of portopulmonary hypertension (POPH) and hepatopulmonary syndrome (HPS) help care for patients with chronic liver disease secondary to cirrhosis. Mar 28, 2015 FMT demonstrates consistently high success rates for recurrent CDI Fecal microbiota transplantation (FMT), although not yet a first line therapy, is increasingly recognized as a safe and effective intervention for patients with recurrent Clostridium difficile infection (CDI). FMT resto[...] Mar 28, 2015 Alpha-1-antitrypsin deficiency: A liver-lung connection Alpha-1-antitrypsin (AAt) deficiency is an inherited disorder that results in liver disease, lung disease or both. Patients with liver dysfunction and early-stage chronic obstructive lung disease or asthma that does not[...] Dec 3, 2014 Cologuard primed to change landscape of CRC screening Recently approved by the FDA and simultaneously covered by Medicare, Cologuard is a noninvasive stool DNA screening test for colorectal cancer with demonstrated 92 percent sensitivity in detecting cancer stages I-IV and[...] Oct 2, 2014 PCLE helps visualize changes in gut permeability Increased intestinal permeability has a pathogenic role in celiac disease, IBS and non-celiac gluten sensitivity. Now, two clinical trials are using probe-based confocal laser endomicroscopy to further investigate the r[...] Jun 4, 2014 Gluten may not be culprit in nonresponsive celiac disease Celiac disease patients fail to respond to a gluten-free diet for many reasons, including gluten contamination, misdiagnosis and other gastrointestinal disorders. When these possibilities have been excluded, refractory [...] Apr 2, 2014 Tests aid diagnosis of an under-recognized disorder Tests aid diagnosis of an under-recognized disorder — Bile acid malabsorption (BAM) is an underdiagnosed cause of chronic diarrhea, due mainly to limited availability of the gold standard SeHCAT retention test. Th[...] Dec 20, 2013 Plastic vs. metal stents for malignant biliary obstruction Biliary stent choice depends on cost, patient prognosis - Both plastic and metal stents used for symptom relief in patients with malignant biliary obstruction have limitations. Cost-effectiveness, safety and patient pro[...] Current and future treatments for irritable bowel syndrome associated with diarrhea Better agents needed for IBS-D - Pharmacological treatments for diarrhea-predominant irritable bowel syndrome (IBS-D) are limited and often fail to relieve pain or the full spectrum of associated symptoms. An expert dis[...] Medical Professionals News