Information sourced from NEJM Journal Watch:
NEJM Journal Watch Gastroenterology Top Stories of 2014
M. Brian Fennerty, MD
A perspective on the most important research in the field from the past year
As always, I look back on the year amazed at how much I have learned and marvel at the amount of new information that has markedly impacted the practice of gastroenterology. This year's top ten stories in NEJM Journal Watch Gastroenterology encapsulate the evidence making the greatest impact. Here's a quick overview:
In the esophagus, dietary management for eosinophilic esophagitis does work for lots of our patients and should be tried in all.
Advances in treating liver diseases seem to be speeding up even more and include a larger role for albumin, a smaller one for beta-blockers, and, finally, a cure for hepatitis C virus in over 90% of infected patients with a short all-oral drug regimen. (Who would have thought this possible in so little time?)
In the biliary system, the cholecystectomy should come first, and retrograde cholangiopancreatography should be relegated to back-up status.
For colonoscopy, we've got new low-tech ways to see behind folds, a better understanding of timing for bowel preparation, and continuing issues with phosphate preparations.
Finally, patients with diverticulosis are at minimal risk for diverticulitis, and we should use anti-infliximab antibodies to help us manage Crohn disease.
Among the many important papers published this year, these are a good start for your holiday reading!
The Gastroenterology Top Stories of 2014 are:
Dietary Elimination Works for Eosinophilic Esophagitis
[Wolf WA et al. Dietary elimination therapy is an effective option for adults with eosinophilic esophagitis. Clin Gastroenterol Hepatol 2014 Aug; 12:1272.
The Role of Albumin in Treating Patients with Cirrhosis
[Garcia-Martinez R et al. Albumin: Pathophysiologic basis of its role in the treatment of cirrhosis and its complications. Hepatology 2013 Nov; 58:1836.
Do Cholecystectomy First in Patients with Intermediate Risk for Choledocholithiasis
[Iranmanesh P et al. Initial cholecystectomy vs sequential common duct endoscopic assessment and subsequent cholecystectomy for suspected gallstone migration: A randomized clinical trial. JAMA 2014 Jul; 312:137.