Gut Check on Gastroenterology Archive

June 25th, 2014

Right-Sided Colon Polyps: Are You and Your Pathologist Up to Date?

It used to be relatively simple for gastroenterologists to determine colonoscopy surveillance intervals when removing right-sided polyps: We considered whether the polyp was hyperplastic or adenomatous and its size. Now, we have a new classification system that includes adenomas, hyperplastic lesions, sessile serrated polyps (SSPs), and sessile serrated adenomas (SSAs) — all of which may […]

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January 28th, 2014

What Bowel Prep for the Sensitive Stomach?

Although it is clear that split-dose polyethylene glycol (PEG), our first-line bowel prep, provides the optimal bowel cleansing for colonoscopy, many of my patients find it difficult or even impossible to tolerate this solution (i.e., due to vomiting). Although alternatives such as Gatorade/Miralax, with or without magnesium citrate and Dulcolax, are used by many endoscopy […]

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December 9th, 2013

Are You Removing Diminutive Colonic Polyps with a Forceps?

Small colorectal polyps are commonly encountered during colonoscopy, and their removal is important in colorectal cancer prevention. These smaller lesions (≤5 mm) are relatively easy to remove — usually done by either forceps “biopsy” or mini-snare polypectomy. The choice of removal tool is often based on operator preference, but with forceps biopsy removal, recovering the […]

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July 16th, 2013

Follow-up after Barrett esophagus ablation: How do you do it, and when do you stop (if ever)?

We have shifted the paradigm of treating neoplastic Barrett esophagus (BE) away from a choice between intensive surveillance or surgery and towards endoscopic ablation. In the last 5 years, I have done hundreds of BE ablations using radiofrequency ablation (RFA) and endoscopic mucosal resection (EMR), and many thousands have been performed worldwide. However, on post-ablation […]

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