February Issue of AJG Features New Guideline on Acute Lower GI Bleeding

The February issue of The American Journal of Gastroenterology features a new ACG Clinical Guideline on Acute Lower GI Bleeding, a common reason for hospitalization in digestive diseases that can be challenging to assess and triage. This update to the 2016 guideline provides specific, evidence-based recommendations for common scenarios GI physicians encounter when assessing patients with acute lower GI bleeding. The authors propose recommendations for the use of risk stratification tools, thresholds for red blood cell transfusion, reversal agents for patients on anticoagulants, diagnostic testing such as colonoscopy and computed tomography angiography, endoscopic therapeutic options, and management of antithrombotic medications after hospital discharge.

This month we also highlight studies and articles on women in medicine, biliary disorders, colorectal cancer, inflammatory bowel disease, pediatrics, healthcare disparities, irritable bowel syndrome, and more.

Several articles are highlighted below and access to any articles from this issue, or past issues, is available upon request. The College is also able to connect members of the press with study authors or outside experts who can comment on the articles.

Management of Patients With Acute Lower Gastrointestinal Bleeding: An Updated ACG Guideline
Sengupta, et al.
Author Podcast

Characteristics and Effect of Anxiety and Depression Trajectories in Inflammatory Bowel Disease
Fairbrass, et al.
Authors of this study compared characteristics of IBD patients with persistently normal or improving anxiety or depression scores with those with persistently abnormal or worsening scores over 12 months. They found that IBD patients with worsening or persistently abnormal trajectories of anxiety or depression required significantly more outpatient appointments, radiological investigations, and endoscopic procedures for IBD-related symptoms, but were not at an increased risk of future adverse disease outcomes.

Meditation and Yoga for Irritable Bowel Syndrome: A Randomized Clinical Trial
D’Silva, et al.
In this randomized controlled trial, authors compared two groups to determine whether their assigned intervention was effective in reducing IBS symptoms. One group was assigned eight weekly online Hatha yoga classes, and the other received video instruction with information about IBS, the mind-gut connection in IBS, and the role of mind-body therapies. The advice-only group also received a list of IBS-related resources, a link to an IBS patient support group, and physical activity guidelines. While there was no significant difference found in outcomes between the two groups, the virtual yoga program was found to be a safe, feasible, and effective intervention for reducing IBS symptoms, providing another option for physicians to recommend to their patients with IBS.

Efficacy and Safety of a Novel Hemostatic Peptide Solution During Endoscopic Submucosal Dissection: A Multicenter Randomized Controlled Trial
Uraoka, et al.
In this multicenter, open-label, randomized controlled trial, authors compared the effectiveness of TDM-621, a novel hemostatic peptide derived from nonliving sources and consisting of 16 amino acid residues, with conventional hemostatic methods in treating bleeding during endoscopic submucosal dissection. The number of coagulations with hemostatic forceps was significantly reduced in the TDM-621 group, compared to the control group, for both highly and less experienced endoscopists with no serious safety concerns.
Visual Abstract

About the American College of Gastroenterology
Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of over 18,000 individuals from 86 countries. The College’s vision is to be the preeminent professional organization that champions the prevention, diagnosis, and treatment of digestive disorders, serving as a beacon to guide the delivery of the highest quality, compassionate, and evidence-based patient care. The mission of the College is to enhance the ability of our members to provide world class care to patients with digestive disorders and advance the profession through excellence and innovation based upon the pillars of Patient Care, Education, Scientific Investigation, Advocacy and Practice Management. www.gi.org 

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