Digestive System Diseases Commons^™

Biotic Therapies For Irritable Bowel Syndrome: Current Interventions, Gina Wodarczyk, Maria Winte, Diana Mastellone, Termen Singh, Joshua Desipio, Sangita Phadtare

Division of Gastroenterology and Hepatology Faculty Papers

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by recurrent abdominal pain and changes in bowel habits without measurable disease processes. Recent research emphasizes the gut-brain-microbiome (GBM) axis and explores how microbiota influence gastrointestinal and central nervous system functions. Here, we first discuss a brief overview of various treatment approaches for IBS, focusing on interventions such as probiotics, prebiotics, or synbiotics that target the GBM axis in adults with IBS. Relevant trials discussed the use of probiotics, prebiotics, or synbiotics.

Transition To Noninvasive Testing From The Gold Standard Of Liver Biopsy, Heidi Bien, Sabina Choudhry, Christine Pocha, University Of South Dakota Sanford School Of Medicine & Avera Health System

Scholarship Pathways Program

Purpose: Metabolic dysfunction–associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease, represents a rapidly growing public health concern, affecting roughly 30% of the global population. MASLD encompasses a spectrum from simple steatosis to its more progressive form, metabolic dysfunction–associated steatohepatitis (MASH). Early and accurate assessment of liver disease is critical for risk stratification and management, yet the current gold standard-liver biopsy remains invasive, costly, and limited by sampling variability and interpretive subjectivity. Noninvasive imaging modalities, particularly magnetic resonance elastography (MRE), have emerged as promising alternatives, but their concordance with biopsy in real-world clinical practice remains underexplored.

 Methods: …

Point-Of-Care Intestinal Ultrasound Is Associated With Reduced Colonoscopy Utilization And Improved Clinical Decision-Making In Ibd, Lakumi Dias, Ashlyn Mcclelland, Amy Glasofer, Charalampos Papachristou, Yecheskel Schneider, Sanket Patel

Rowan-Virtua Research Day

Background:

Point-of-care intestinal ultrasound (IUS) enables real-time assessment of bowel inflammation, and it is underutilized in the United States. IUS provides visualization of bowel wall thickness, vascularity, and complications without radiation or bowel preparation. Prior studies demonstrate that IUS changes management and reduces reliance on invasive testing. This study hypothesizes that IUS will impact downstream clinical decision-making in a U.S. outpatient IBD cohort by decreasing invasive procedures and supporting appropriate treatment decisions.

Methods:

A retrospective cohort study was performed. Logistic regression and chi-square tests assessed associations between IUS use, colonoscopy referral, hospital utilization, and treatment modification. A derived “surveillance-due” variable …

Refeeding Syndrome In A Person Experiencing Homelessness: A Case Report, James Espinosa, Jose Gerald Aragon, Md Fateha, Alan Lucerna

Rowan-Virtua Research Day

Refeeding syndrome (RFS) is a potentially life-threatening metabolic disturbance that occurs following nutritional reintroduction in severely malnourished individuals. It is characterized by rapid intracellular shifts of electrolytes—most notably hypophosphatemia—driven by insulin-mediated metabolic changes. Although commonly associated with eating disorders and chronic illness, RFS may also occur in socially vulnerable populations.

We report the case of a 64-year-old male experiencing homelessness who presented to the emergency department with weakness, muscle cramps, and confusion after resuming regular meals at a local shelter following prolonged minimal intake. Laboratory evaluation revealed severe hypophosphatemia (0.7 mg/dL), hypokalemia (3.0 mmol/L), and hypomagnesemia (1.2 mg/dL). Electrocardiogram demonstrated …

Reducing Surgical Site Infection After Colorectal Surgery: A Multidisciplinary Review Of Process Improvement, Robin Daemmrich, Quentin Dipasquale, Deborah Klepac, Nick Mathers, Travis Holloway

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

The Role Of Extracellular Vesicles As Diagnostic Tools In Gut-Brain Axis Disorders, Patricia Marçal Da Costa, Paulo Iury Gomes Nunes, Gabriella Cunha Vieira Ciurleo, José Wagner Leonel Tavares Junior, Pedro Braga Neto, Ludmila Belayev, Reinaldo Barreto Oriá

School of Graduate Studies Faculty Publications

The gut–brain axis represents a dynamic two-way signaling network whose dysregulation has been implicated in a wide range of neurogastrointestinal disorders. In this context, extracellular vesicles (EVs) have emerged as critical mediators of intercellular signaling and as promising non-invasive biomarkers. Derived from host and microbial cells, EVs carry bioactive cargo—including proteins, lipids, nucleic acids, and metabolites—that reflect the physiological or pathological state of their cells of origin. Their ability to cross biological barriers, such as the blood–brain barrier, underscores their potential for diagnosing and monitoring gut–brain axis dysfunctions. In this mini-review, we integrate microbial and brain-derived EVs within the framework …

Another Gastric Band Complication: Acute Appendicitis, Dustin Williamson, Naveed Ismail, John Weaver

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Biliary Obstruction From An Unexpected Source, Max Dinicola, Trevor Link, Derek Welch

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Spontaneous Pneumoperitoneum Presenting As An Acute Abdomen, Madison Mcinnis, Megan Tierney, Kaysie Banton

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Cecal Volvulus In The Setting Of Situs Inversus Totalis: A Rare Case Report, Alexandra Moody, Josie Bjorklund

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Surgical Approach To Colon Resection With Colostomy Creation Influences Reversal Rates And Postoperative Outcomes: A Retrospective Longitudinal Analysis, Benjamin Perkins, Ena Novakovic-Bennet, Salvatore Caleb Jerris, Alyssa Kozlowski, Andrew Schlussel

South Atlantic Division GME Research Days 2026

No abstract provided.

The Great Mimicker: Intrathecal Opioid-Induced Esophageal Dysfunction, Abhishek Desai, Lisa Persaud, Desiree Aird

South Atlantic Division GME Research Days 2026

No abstract provided.

Robotic Assisted Duodenojejunostomy In The Treatment Of Adult Annular Pancreas, Anthony Sciuva, Denise Vera Nemeth, Riley Burgon, Noaman Ali

South Atlantic Division GME Research Days 2026

No abstract provided.

Comparing Naloxegol And Alvimopan In Reducing Rates Of Post-Op Ileus In Colorectal Patients, Madison Harger, Nicholas Hrdlicka, Elizabeth Mckeown

South Atlantic Division GME Research Days 2026

No abstract provided.

Gross Findings With Point-Of-Care Ultrasound In Median Arcuate Ligament Syndrome: A Case Report, Justin Stanziola, Yelena Pecheny, Casey Wilson

South Atlantic Division GME Research Days 2026

No abstract provided.

Redefining Resectability In Pancreatic Cancer: A Modified Appleby And Radical Antegrade Modular Pancreatosplenectomy Procedure With Concomitant Left Lateral Sectionectomy In A Patient With Replaced Right And Left Hepatic Arteries, Monica Sciturro, Nada Belal, Jamii St. Julien

West Florida Division GME Research Day 2026

No abstract provided.

Case Report: Primary Recurrent Gallstones Following Cholecystectomy, Gabriel Noguera, Nimal Patel

West Florida Division GME Research Day 2026

No abstract provided.

From Peg To Perfusion: A Case Of Malnutrition Reversed By Mesenteric Revascularization, Sacha Saba, Mahi Basra, Alvin Newman Caro, Vikas Sethi, Marc Kudelko

West Florida Division GME Research Day 2026

No abstract provided.

Salvage Percutaneous Spyglass-Assisted Lithotripsy Via A Cholecystostomy Tract After Failed Ercp: A Case Report, Nicholas Gerden, Tiffany Hong, Asad Rehman, Long Hoang

North Texas GME Research Forum 2026

IR-driven percutaneous cholangioscopy with SpyGlass-assisted lithotripsy is an emerging salvage technique for biliary stone disease in patients with failed or contraindicated endoscopic retrograde cholangiopancreatography (ERCP) due to complex anatomy. We report an 85-year-old patient with an indwelling cholecystostomy tube and biliary stent who presented with recurrent obstructive jaundice, with cholangiography demonstrating occlusion of the common bile duct stent due to choledocholithiasis. Conventional ERCP was unsuccessful because of complex biliary and gastrointestinal anatomy. A multidisciplinary interventional radiology–gastroenterology approach was therefore pursued, utilizing antegrade percutaneous choledochoscopy through an existing cholecystostomy tract with SpyGlass-assisted lithotripsy, followed by cholecystostomy tube exchange. The procedure resulted …

Operative Localization Of Occult Gastrointestinal Bleeding Using Intraoperative Small Bowel Endoscopy, Shuda Xia, Furrukh Jabbar, Muhammad T. Siddique

North Texas GME Research Forum 2026

No abstract provided.

Trapped Beyond The Wall: Gastric Outlet Obstruction From A Ventral Hernia, Complicated By Ischemia And Hemorrhage, Carolyn Dudko, Saptarshi Biswas

South Atlantic Division GME Research Days 2026

No abstract provided.

Rapid Diagnosis Of Hemorrhagic Shock Due To Upper Gi Bleeding With Point-Of-Care Ultrasound In The Emergency Department, Tamari Ronen, Derrick Huang

Gulf Coast Division GME Research Day 2026

No abstract provided.

Surgical Management Of A Giant Colonic Diverticulum, Courtney Koplyay, Mason Workman, Michael Truitt, Muhammad T. Siddique

North Texas GME Research Forum 2026

INTRODUCTION: Giant colonic diverticulum (GCD), defined as a diverticulum >4 cm, is a rare manifestation of diverticular disease with less than 200 reported case reports. CT imaging is the preferred imaging modality to identify and confirm the presence of a GCD, which provides an accurate depiction of the size, location, and contents of the diverticulum GCD can present with nonspecific abdominal symptoms, abdominal pain, bloody stools, or an enlarging mass. Given the risk of serious complications, including diverticulitis, bowel obstruction, and perforation, early recognition and management are essential to prevent further complications. Surgical management with diverticulectomy or partial colectomy is …

Esophageal Squamous Cell Carcinoma Incidentally Detected On Barium Swallow: A Case Report, Muhammad Rubeel Akram, Aditya Rao, Muhammad T. Siddique

North Texas GME Research Forum 2026

Background: Esophageal cancer is an aggressive malignancy with a poor prognosis, and has high rates of recurrence despite curative-intent therapy. While endoscopy with biopsy remains the gold standard for diagnosis, non-diagnostic imaging studies are performed when evaluating for dysphagia, and may bring to light underlying pathology, warranting further workup. Surgical resection following neoadjuvant chemoradiation is often performed, but postoperative complications and disease recurrence are important concerns. This case highlights the crucial role of early detection via imaging and the clinical burden associated with esophageal squamous cell carcinoma.

Case Presentation: A 76-year-old female presented with dysphagia and underwent a barium esophagogram, …

Esophageal Stents: How High Can You Go? A Traumatic Injury Treated With High Esophageal Stent Placement, John W. Surbeck, Anthony P. Melillo, James S. Scott

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Case Report: Spontaneous Gastric Intramural Hematoma With Intramural Dissection, Pedro De Castro, Rachel Steffes, John Surbeck, Anthony Melillo, Vince Narciso, Mohsin Soliman

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Call Surgery First: Impact Of A Decision Aid Tool For Common Bile Duct (Cbd) Stones, Eleah Porter, Matthew Daniel, Zachery Hensel, Saptarshi Biswas, Andrew Pearson, Wesley Vosburg, B Fernando Santos

South Atlantic Division GME Research Days 2026

No abstract provided.

Post-Metabolites Of Two Commensal Bacteria Suppress Dna Damage In An Experimental Model Of Acid Reflux Disease, Maanya Pradeep

Honors Undergraduate Theses

Chronic heartburn or gastroesophageal reflux disease (GERD) affects approximately 25% of the US population [1]. Repeated bile acid exposure from the regurgitation of stomach contents leads to the production of reactive oxygen species (ROS), which can cause oxidative DNA damage and promote genomic instability [2]. Barrett’s esophagus (BE), which can develop as a response to chronic bile acid exposure, increases the risk of esophageal adenocarcinoma (EAC) by 30% to 125% [1].

There are more than 18,000 new cases of esophageal cancer in the United States each year, and while its incidence is relatively low compared to other cancers, its mortality …

A Blood-Based Test For Colorectal Cancer Screening, Joshua Cullison

HCA Healthcare Journal of Medicine

Within the United States (US), colorectal cancer (CRC) remains the fourth most common malignancy and is responsible for over 50 000 deaths annually, second only to lung cancer in cancer mortality. Despite increased public awareness and increasing screening rates, the US remains far below the 80% screening mark set by the National Colorectal Cancer Roundtable at 59%. The addition of non-invasive blood-based tests for CRC screening could potentially increase screening rates and lower CRC deaths.

I performed a PubMed search using the search term “blood-based colorectal cancer screening.” I was particularly interested in articles that looked at Shield, which is …

Application Of Flexible Endoscopy For Gastrointestinal Foreign Body Removal In A Leopard Gecko (Eublepharis Macularius), Jang-Hee Han, Seung Yoon Ahn, Do Na Lee, Seong Chan Yeon

The Thai Journal of Veterinary Medicine

A male captive-bred leopard gecko (Eublepharis macularius) presented with a history of inadvertent ingestion of a rubber tip from forceps during feeding. The foreign body was impalpable on physical examination, while radiographic evaluation confirmed its presence in the stomach. Considering the procedural risks associated with invasive surgical interventions, endoscopic retrieval under general anesthesia was pursued. An initial attempt using a 2.8 mm superfine flexible endoscope with 0.8 mm forceps was unsuccessful due to insufficient stability, which hindered effective navigation to the foreign body. In contrast, a second attempt using a larger 9.2 mm flexible endoscope with 2.3 mm …