Gastroenterology Commons^™

“I Missed My Other Oncologist”: Established Relationships As Barriers And Facilitators To Accessing Car-T And Autologous Transplantation, Zachary A. K. Frosch, Clark Meshack, Caitlin Meeker, Asya Varshavsky-Yanovsky, Rashmi Khanal, Michael Bromberg, Ashwin Chandar, Emmanuel Quien, Jordan Carter, Shazia K. Nakhoda, Marcus Messmer, Charissa Montgomery, Jason A. Incorvati, Nadia D. Ali, Michael J. Styler, Carolyn Y. Fang

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Autologous stem cell transplantation (ASCT) and chimeric antigen receptor T-cell therapy (CAR-T) can provide significant clinical benefit, but are not equally available to all patients. Oncologist continuity and trust are important to patients, and may act as barriers to receipt of therapy. However, detailed data are lacking on the mechanism by which these might affect receipt of therapy, or how this barrier may be overcome.

METHODS: We conducted a qualitative interview study with patients with non-Hodgkin lymphoma (NHL), classic Hodgkin lymphoma (cHL) or multiple myeloma (MM) eligible for or treated with ASCT/CAR-T. Participants were recruited from a multi-site academic …

Epidemiology Of Metabolic Syndrome In Patients With Inflammatory Bowel Disease: A Population-Level Cohort Study From The United States, Aakash Desai, Himsikhar Khataniar, Jana G. Hashash, Priya Sehgal, Francis A. Farraye, Gursimran S. Kochhar

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Epidemiological data on metabolic syndrome (MetS) in patients with inflammatory bowel disease (IBD) are limited.

METHODS: A retrospective cohort study was conducted using the United States (US) Collaborative Network (TriNetX) to obtain data for patients with IBD between 2010 and 2023. The primary aim of the study was to estimate the prevalence of MetS in ulcerative colitis (UC) and Crohn's disease (CD). Prevalence was further characterized by age, sex, race, disease location, IBD medications, history of surgery, and IBD phenotype.

RESULTS: Among 100,890 patients with IBD, metabolic syndrome (MetS) affected 34.4% overall (UC 32.4%, CD 34.3%). Prevalence rose sharply …

Roux-En-Y Gastric Bypass Is Associated With Increased Intestinal Glucose Uptake In Humans, Florina Corpodean, Maryam Naseri, Michael Kachmar, Julia St Amant, Denis P. Blondin, Owen T. Carmichael, Vance L. Albaugh

School of Medicine Faculty Publications

CONTEXT: In animal models, Roux-en-Y gastric bypass (RYGB) is associated with increased Roux limb intestinal glucose uptake that may contribute to early metabolic benefits, though prospective clinical studies are lacking. OBJECTIVE: The present study aimed to test the hypothesis that Roux limb glucose uptake would increase relative to baseline in a cohort of patients undergoing RYGB. METHODS: RYGB patients underwent preoperative baseline, and 3- and 6-month positron emission tomography/computed tomography postoperative imaging. Maximum and mean standardized uptake values (SUV) were measured from the following predefined regions of interest: cecum, hepatic flexure, splenic flexure, sigmoid colon, duodenal bulb, Roux limb, and …

Hepatocellular Carcinoma Surveillance In Patients With Cirrhosis, Identifying Gaps In Clinical Practice, Abdullah Orakzai, Muhammad Hammad Sharif, Basil George Verghese, Shiamak Cooper, Venkat Arutla, Purva Shah, Himal Kharel, Aditya Sanjeevi, Aniket-Vijay Rao

Advances in Clinical Medical Research and Healthcare Delivery

Background:Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide, with rising mortality rates in the United States. Early detection of HCC through routine screening significantly improves survival rates in patients with cirrhosis. Current guidelines recommend bi-annual screening using abdominal ultrasound with or without serum AFP levels; however, adherence to these guidelines is suboptimal in clinical practice.

Methods:We conducted a retrospective study of 320 adult patients diagnosed with HCC at our institution between January 1, 2023, and July 31, 2023. Patients aged >22 years were included, and their medical records were reviewed to evaluate routine surveillance …

Juvenile Polyp And Lymphoid Hyperplasia “Leads” To Intussusception, Rasheed Ansari, Kirby Lampe, Ding-You Li

Posters

OP is an 8-year-old female who presented to the ED with 1 day of NBNB emesis and abdominal pain. • The CT abdomen showed colocolonic intussusception at the hepatic flexure with a possible polypoid lesion serving as a lead point. • Radiology did not recommend air enema for reduction given atypical age, atypical location, and visualization of lead point. • GI consulted for a possible colonoscopy to reduce intussusception. Colonoscopy contraindicated due to polypoid mass causing obstruction and inability for patient to tolerate cleanout. • Diagnostic laparoscopy performed. Noted Intussusception in the distal ascending colon/proximal transverse colon. Chronic inflammatory changes …

Unclear Source Of Gastrointestinal Bleeding: Utilizing Small Bowel Capsule To Detect An Enteric Duplication Cyst, Victoria Sarata, Kirby Lampe, Kathryn Clarkston

Posters

Introduction Enteric duplication cysts (EDCs) are rare congenital malformation formed during embryonic development of the gastrointestinal tract. Symptoms may include vomiting, abdominal distension, palpable abdominal mass, or bleeding but may vary based on location of the lesion [1]. We present a case of a 9-year-old-male with presented with recurrent rectal bleeding and had abnormalities on small bowel capsule which were diagnosed as enteric duplication cyst on exploratory laparoscopy. Case This is a 9 year old male with a history of persistent iron deficiency anemia, gallstones s/p cholecystectomy and recurrent hematochezia. Patient was initially admitted for recurrent red bloody stools and …

Symptomatic Severe Hyponatremia: A Rare Complication Of Double Balloon Enteroscopy, Victoria Sarata, Kirby Lampe, Thomas M. Attard

Posters

Previously healthy 11-year-old female, newly diagnosed Peutz-Jeghers Syndrome (PJS) confirmed by genetic testing STK11 PV (c.464+1dupG) underwent double balloon enteroscopy (DBE) after small bowel capsule showed multiple small intestinal polyps including >1.5 cms diameter. Pre-procedure, she completed a two-day MiraLAX clean out with >10 x 17g doses of MiraLAX each mixed in 6-8oz of water and other clear liquids. DBE completed with resection of 17 total small intestinal (SI), jejunal and ileal polyps. Procedure lasted approximately 4hrs and 5L of sterile water was used for underwater technique and irrigation.Sterile water was used for copious irrigation needed for direct visualization, and …

Refractory Benign Esophageal Strictures Complicated By Esophageal Perforation And Treated With Serial Dilations And Stent Placement In A Pediatric Patient, Kirby Lampe, Victoria Sarata, Nadia Ibrahimi

Posters

Patient is a 2-year-old male who was originally referred to GI for failure to thrive and recurrent vomiting following feeds. Upper GI showed long-segment stricture with mid-thoracic tapering and initial EGD revealed 2mmx5cm distal esophageal stricture that was balloon dilated with serial dilations and triamcinolone injections. He presented one week after his 3rd dilation with fever, vomiting and respiratory distress and was found to have cardiac tamponade, left pleural effusion, septic shock and esophageal perforation. He was transferred to the ICU and started on broad-spectrum antibiotics, IV fluids and chest tube placement. He required intubation and vasopressors. After stabilization, esophogram …

A Rare Case Of Ogilvie’S Syndrome In A Pediatric Patient With A Complex Medical History, Kirby Lampe, Victoria Sarata, Aileen Har

Posters

Acute colonic pseudo-obstruction (ACPO) or Ogilvie’s syndrome is an acute dilatation of the small or large bowel without an obstructive lesion. Symptoms include abdominal distension, nausea and vomiting, constipation and occasional dyspnea. The disorder most commonly involves the cecum and right colon and is most frequently seen in male patients above the age of 60 (1). It is rare for Ogilvie’s to occur in the pediatric population though some infrequent instances have been reported. Here, we report a case of a patient with significant abdominal distension and gaseous distension seen on x-ray, which was diagnosed and treated as Ogilvie’s syndrome. …

A Case Report: Ansa Pancreatica As A Cause Of Recurrent Pancreatitis, Chase Branstetter, Elizaveta Khenner, Victoria Sarata, Nadia Ibrahimi

Posters

No abstract provided.

The 10-Year Status Of Pediatric Gastroenterologists' Perception Of Their Roles In The Management Of Childhood Obesity., Sara Karjoo, Senthilkumar Sankararaman, Fotini Tania Mitsinikos, Marwa Abu El Haija, Sheela Mahendra, Ayesha Baig, Ruba A. Abdelhadi, Ruben E. Quiros-Tejeira, Timothy Sentongo

Manuscripts, Articles, Book Chapters and Other Papers

In 2013, a survey of NASPGHAN members on their involvement in managing pediatric obesity revealed that most pediatric gastroenterologists viewed their roles as primarily supportive, focusing on the management of obesity-related gastrointestinal comorbidities. This 10-year follow-up survey, which targeted pediatric gastroenterology programs and practices, found similar perceptions, along with an increased interest in learning about obesity pharmacotherapy. Additionally, most programs and practices reported limited access to dedicated dietitians, a lack of funding, and a desire for greater institutional support for multidisciplinary programs addressing obesity. Notably, none of the funded programs cited philanthropy as a source of funding. These findings underscore …

Atypical Abdominal Pain: Uncovering Malignant Peritoneal Mesothelioma In Suspected Crohn's Disease: A Case Report, Catherine Loehr, Lara Boudreaux, Ann Porter Uhlhorn, Nisha Loganantharaj

School of Medicine Faculty Publications

BACKGROUND: Malignant peritoneal mesothelioma (MPM) is a rare and aggressive cancer from the serosal membranes of the abdominal cavity. In the United States, MPM accounts for about 10-15% of all mesothelioma cases, and translates into approximately 600 new cases diagnosed annually. It is typically diagnosed in Caucasian individuals, and while asbestos exposure is a well-established risk factor for pleural mesothelioma, its association with peritoneal mesothelioma remains less clear. Clinical symptoms of MPM, such as abdominal pain, bloating, and weight loss, overlap with other gastrointestinal disorders, which often leads to delayed diagnosis. This case report presents a unique instance of MPM …

Use Of Emr Automated Fib-4 As A Tool For Masld Screening In The Primary Care Setting, Maria Winte, Md, Rebecca Loh, Md, Sanjna Shelukar, Md, Ananya Venkatesh, Md, Bryan O'Connell, Md, Dina Halegoua-De Marzio, Md

Division of Gastroenterology and Hepatology Posters

Introduction

• MASLD affects up to 40% of the population in North America and is increasing.
• Screening for advanced fibrosis is now widely recommended, including formal guidelines from the AGA, AASLD, and ADA.
• We implemented an automated Fibrosis-4 (FIB-4) Index for liver fibrosis screening as a tool within our electronic medical record (EMR) to increase screening in patients with risk factors for MASLD.
• Our study examines the impact of this intervention on the appropriate MASLD screening rates among 50–65- year-old patients in the primary care clinic.

Nutritional Management Of The Complex Fontan Physiology Patient In The Pre-Transplant Phase, Mona Kasik, Jill Rockwell

2025

No abstract provided.

Glucagon-Like Peptide 1 Receptor Agonists And The Clinical Outcomes Of Inflammatory Bowel Disease: A Systematic Review And Meta-Analysis, Ahmed B. Bayoumy, Lindsay M. Clarke, Parakkal Deepak, Aakash Desai, Priya Sehgal, Uri Gorelik, Haggai Bar-Yoseph, Marie Villumsen, Chris J. J. Mulder, Dirk J. Stenvers, Maarten E. Tushuizen, Nanne K. H. De Boer

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Prior studies showed worse outcomes in obese inflammatory bowel disease (IBD) patients, especially those related to hospitalizations, surgery, and steroid-free remission. Glucagon-like peptide-1 receptor agonists (GLP1-RAs) have demonstrated significant metabolic benefits for patients with type 2 diabetes mellitus (T2DM) and obesity. Hence, GLP1-RAs may improve clinical outcomes in patients with IBD, especially those with obesity. The objective was to systematically evaluate the impact of GLP1-RAs on clinical outcomes in patients with IBD.

METHODS: A comprehensive literature search was performed using the databases PubMed, Embase, Web of Science, and Cochrane Library from inception to March 15, 2025. Studies reporting outcomes …

Complications Of Ovarian Metastases From Well-Differentiated Small Bowel Neuroendocrine Neoplasms: A Focus On Bowel And Ureteral Obstruction, Sydney J. Wellens, Nicholas J. Skill, Kevin M. Sullivan, Mary A. Maluccio, Kristen E. Limbach

School of Medicine Faculty Publications

Ovarian metastasis from small bowel neuroendocrine neoplasms (SBNENs) was traditionally considered rare, but more recent series have suggested a higher prevalence. This case series seeks to examine the features and outcomes of patients with neuroendocrine ovarian metastases (NOM). Female patients with histologically confirmed well-differentiated SBNENs were identified using a prospectively maintained database (2014–2024). The electronic medical record was reviewed for details of diagnosis, histopathology, biomarkers, and outcomes among patients with and without NOM. 175 patients met inclusion criteria. 35 patients (20 %) had ovarian metastasis; for this group, 31.4 % had small bowel obstruction only, 5.7 % had ureteral obstruction …

Neighborhood Social Cohesion Associated With Chronic Liver Disease Prevalence And All-Cause Mortality, Tiange P. Zhang, Jennifer L. Dodge, Divya Ayyala-Somayajula, Norah A. Terrault

Division of Gastroenterology and Hepatology Faculty Papers

Background and Aims: Neighborhood social cohesion (NSC)—the degree of trust and solidarity within a community—may influence health through multiple pathways including shaping healthy norms, perception of safety, and stress. Whether NSC influences chronic liver disease (CLD) prevalence and associated mortality in the United States is unknown. Methods: Using 172,047 adults from the 2013–2018 National Health Interview Survey with linkage to National Death Index mortality data, NSC was measured using questions on help availability, accountability, trustworthiness, and connectedness among neighbors, with composite scores (4–16) categorized as minimal (4–7), low (8–10), moderate (11–13), and high (14–16). Logistic and Cox regression tested the …

Endoscopic Submucosal Dissection For Previously Attempted Colorectal Lesions: An International Multicenter Experience., Suchapa Arayakarnkul, Hiroyuki Aihara, Alessandro Repici, Roberta Maselli, Antonio Capogreco, Leonardo Da Rio, Fabio Shiguehissa Kawaguti, Fauze Maluf-Filho, Makoto Nishimura, Sera Satoi, Sayaka Nagao, Shai Friedland, Robert Bechara, Norio Fukami, Sonmoon Mohapatra, Amit Bhatt, Abel Joseph, Alex Schlachterman, Anand Kumar, Andrew Y Wang, Ross C D Buerlein, Louis M Wong Kee Song, Fnu Deepali, Dennis Yang, Muhammad K Hasan, Nikhil A Kumta, David L Diehl, Edward J Despott, Alberto Murino, Alessandro Rimondi, Laura Lucaciu, Neil R Sharma, Christina Zelt, Ashley Rumple Rn, Bsn, David Leslie Carr-Locke, Reem Z Sharaiha, Srihari Mahadev, Kamal M Hassan, Mohamad-Noor Abu-Hammour, Carlos Robles-Medranda, Martha Arevalo-Mora, Juan Alcivar-Vasquez, Vivek Kumbhari, Jongkyu Park, Salmaan Jawaid, Mai A Khalaf, Kasenee Tiankanon, Sarah S Al Ghamdi, Mohamed O Othman, Saowanee Ngamruengphong

PCI Publications and Projects

BACKGROUND & AIMS: Salvage endoscopic submucosal dissection (ESD) has been proposed for previously attempted colorectal lesions (PACLs), yet the extensive submucosal fibrosis impacts procedural difficulty and resection outcomes. The aim of this study was to evaluate the efficacy and safety of salvage ESD for the treatment of PACLs.

METHODS: This international, multicenter study enrolled consecutive patients who underwent ESD to manage PACLs. Rates of en bloc, R0 resection, and local recurrence were assessed for efficacy. Safety was assessed by adverse events (AEs), procedure-related mortality, and the need for surgical management.

RESULTS: Of 415 lesions, en bloc rate was 83.4%, the …

Survival Impact And Sociodemographic Correlates Of Colon Cancer Surgery, Refusal, Paola Berrios Jimenez, Angel Aguayo Merly, Ramin Shekouhi, Berkay Demirors, Jade C. Bowers, Vishal Abhimutt Mahesh, Anjali Yadav, Bansi P. Savaliya, Reed Popp, Syeda Hoorulain Ahmed, Esinam Ekpeh, Guido Chiriboga, Emmanuel Gabriel

School of Medicine Faculty Publications

Background/Aim: Surgical treatment for colon cancer is often curative when diagnosed early. This study evaluated the sociodemographic characteristics and survival outcomes associated with refusal of surgery among patients with colon cancer. The objective was to identify disparities to improve patient outcomes. Patients and Methods: We conducted a retrospective cohort study using National Cancer Data Base (NCDB) data from 2004 to 2019, including 1,048,575 patients with colon cancer. Variables analyzed included demographics, tumor characteristics, treatment facility type, and geographic and socioeconomic factors. Descriptive statistics were assessed using Wilcoxon Rank Sum and Chi-square tests. Survival outcomes were evaluated using Kaplan–Meier analysis and …

Metagenomic Characterization Of Gut Microbiota In Children With Autism Spectrum Disorder: Microbial Signatures And Modulation By Anti-Inflammatory Diet And Probiotics, Marysol Valencia-Buitrago, Rodrigo Dias Oliveira-Carvalho, Valbert Cardoso, Jessica Triviño-Valencia, Luisa Matilde Salamanca-Duque, Vanessa Martínez-Díaz, Jovanny Zabaleta, Narmer Fernando Galeano-Vanegas, Carlos Andrés Naranjo-Galvis

School of Medicine Faculty Publications

Background: Autism Spectrum Disorder (ASD) is increasingly associated with alterations in gut microbiota, intestinal permeability, and immune dysregulation. However, integrative studies exploring these mechanisms in Latin American populations are lacking. Objective: To characterize gut microbiota profiles in Colombian children with ASD and evaluate the effects of two microbiota-targeted interventions, an anti-inflammatory diet and a probiotic formulation, on microbial diversity and taxonomic composition. Methods: In a two-phase study, shotgun metagenomic sequencing was performed on fecal samples from 23 children with ASD and 7 typically developing (TD) controls. In the second phase, 17 children with ASD were randomized to receive a 12-week …