Posts Tagged ‘gastroenterology’

November 15th, 2011

Water-aided colonoscopy: Does the temperature matter?

Many, if not most, colonoscopists are now convinced that using water infusion during scope insertion leads to less patient discomfort and lower sedation needs. What is often used in this situation is water that has been warmed under the assumption that warm is better (i.e., causing less spasm). However, using warm water out of the […]

June 13th, 2011

Foreign-body retrieval from the stomach: how do you do it?

I have observed extreme variation in how my colleagues manage GI foreign-body retrieval from the stomach. Some always use general anesthesia and endotracheal intubation; others (myself included) use conscious sedation. Some use an overtube to withdraw the object into if possible; others simply pull it up to the endoscope and use the endoscope to guide […]

March 1st, 2010

When Should We Stop Surveillance of Barrett’s Patients?

Some of my patients who have undergone successful ablation therapy for Barrett’s esophagus ask a really good question: If I haven’t had Barrett’s for years, why do I need to keep having endoscopies?”  I admit, I do not have a uniform answer for that, nor do GI society guidelines. I would say that for patients […]

February 25th, 2010

Who Is Better Qualified to Perform Colonoscopy?

Consider this: The American Society for Gastrointestinal Endoscopy requires physicians to perform at least 200 colonoscopies before it will assess their competency (much less grant them privileges), and most fellows complete at least 500 during their 3-year training programs.  However, the American Board of Surgery now “mandates” that surgical residents need to perform only 50 […]

January 23rd, 2009

Ambulatory Endoscopy Centers: No Seniors Allowed!

Ambulatory endoscopy centers (AECs) have proven so successful in providing convenient, efficient, low-cost, high-quality endoscopy services to outpatients that they are now ubiquitous around the country. Given this success, you might assume that payers would steer business their way. However, that’s not the case with the Centers for Medicare & Medicaid Services (CMS). In fact, […]

December 3rd, 2008

Are We Telling Patients the Truth About Colonoscopy?

Last week I heard one of our really talented GI fellows talking with a patient before her open access colonoscopy, and she told the patient that this test prevents colon cancer. I was somewhat surprised at the definitive implication of that statement and later asked her how much protection from colon cancer does colonoscopy screening provide? What […]

November 4th, 2008

Whither Gastroenterology?

What does it mean to be a gastroenterologist in 2008? Is our field moving in the right direction? I suspect that most gastroenterologists were and are attracted to the specialty because it offered the opportunity to deal with multiple organs and diseases. My generation of gastroenterologists came of age along with the exciting and emerging ability to diagnose–and […]

Gastroenterology Research: Author M. Brian Fennerty, M.D.

M. Brian Fennerty, MD


NEJM Journal Watch Gastroenterology

Biography | Disclosures | Summaries

Learn more about Gut Check on Gastroenterology.