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1. The evolution of endoscopic therapy for Barrett’s esophagus

Author

Ashwinee Condon and V. Raman Muthusamy

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Barrett’s esophagus is the condition in which a metaplastic columnar epithelium replaces the stratified squamous epithelium that normally lines the distal esophagus. The condition develops as a consequence of chronic gastroesophageal reflux disease and predisposes the patient to the development of esophageal adenocarcinoma. The diagnosis and management of Barrett’s esophagus have undergone dramatic changes over the years and continue to evolve today. Endoscopic eradication therapy has revolutionized the management of dysplastic Barrett’s esophagus and early esophageal adenocarcinoma by significantly reducing the morbidity and mortality associated with the prior gold standard of therapy, esophagectomy. The purpose of this review is to highlight current principles in the management and endoscopic treatment of this disease.

Published
2021
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2. Development of a scoring system to predict a positive diagnosis on video capsule endoscopy for suspected small bowel bleeding

Author

Stephen Kim, David R. Cave, Ashwinee Condon, Jennifer Phan, Sonya Dasharathy, Vivy T. Cusumano, Alireza Sedarat, Adarsh M. Thaker, M. Phillip Fejleh, Li Wang, Tien S. Dong, V. Raman Muthusamy, and Neil B. Marya

Subjects
medicine.medical_specialty, Gastrointestinal bleeding, Scoring system, business.industry, Gastroenterology, Odds ratio, Logistic regression, medicine.disease, Confidence interval, law.invention, Video capsule endoscopy, Capsule endoscopy, law, Internal medicine, Cohort, medicine, Radiology, Nuclear Medicine and imaging, business
Abstract

Background In stable patients, video capsule endoscopy (VCE) is the recommended first test for patients presenting with suspected small bowel bleeding (SSB). The aim of this study is to develop a scoring system to aid clinicians in deciding which patients with SSB would benefit from VCE. A multicenter database of patients who underwent VCE for SSB was created. Methods A multivariable logistic regression analysis was utilized on a developmental cohort to determine independent predictors of a positive diagnosis on VCE and develop the scoring system. Receiver operating characteristic analysis compared the performance of the scoring system between the developmental cohort and the validation cohort. Results Three hundred fourteen patients underwent VCE for SSB. Multivariable analysis revealed 3 variables—age less than 54 years old (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.11-0.58), inpatient status with overt bleeding (OR 2.38, 95% CI 1.05-5.39), and hemoglobin less than 6.4 g/dL (OR 2.68, 95% CI 1.11-6.48) as independent predictors of a diagnosis on VCE. The performance of the scoring system in the developmental cohort (C-statistic 0.70; 95% CI 0.62-0.77) and the validation cohort (C-statistic 0.69; 95% CI 0.61-0.75) was not significantly different (P = 0.91). Conclusions For patients with suspected small bowel bleeding, age older than 54 years, hemoglobin

Published
2020

3. Gender and Other Factors Associated with Endoscopy Volume Among U.S. Gastroenterology Fellows

Author

Lin Chang, Adrienne Lenhart, Ashwinee Condon, Ucla Gi Division Biostatistics, Frank W. Chen, Najwa El-Nachef, and Ani Kardashian

Subjects
Male, medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, education, Gastroenterology, MEDLINE, Endoscopy, Gastrointestinal, Endoscopy, Education, Medical, Graduate, Internal medicine, medicine, Humans, Female, Clinical Competence, Gender gap, Fellowships and Scholarships, business, Career choice, Accreditation, Gastrointestinal endoscopy
Abstract

Gastroenterology (GI) fellows' ability to perform procedures are evaluated by the level of competency in the cognitive and technical components of procedures in Accreditation Council for Graduate Medical Education-accredited fellowship programs.1 However, competency in endoscopic procedures correlates with the number of procedures performed.2 The American Society for Gastrointestinal Endoscopy has recommended that a minimum of 130 esophagogastroduodenoscopies (EGDs) and 275 colonoscopies be performed before procedural competency can be assessed.3 Few studies have examined program or trainee-related factors, such as trainee gender, that may influence procedural volume. In other procedural subspecialties, a gender gap exists in trainee procedural volumes, with female residents performing fewer surgical cases than males.4,5 However, whether gender-related disparities exist in endoscopy volume among GI trainees is unknown. The primary aim of this study was to determine the impact of GI fellow gender on endoscopic procedural volume during training. Secondary aims were to determine if fellow career choice or other training program-related factors, such as program size, location, or setting, affect procedure volume during fellowship.

Published
2022

4. Ulcerative jejunitis in refractory celiac disease diagnosed on capsule endoscopy

Author

Jasleen Grewal, Stephen Kim, Ashwinee Condon, and Neil B. Marya

Subjects
medicine.medical_specialty, Ulcerative jejunitis, business.industry, Gastroenterology, Disease, Capsule Endoscopy, Enteritis, law.invention, Celiac Disease, Refractory, Capsule endoscopy, law, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, business, Ulcer
Published
2020

5. S1319 The Impact of the COVID-19 Pandemic on Graduating Gastroenterology Trainees and Perceptions of Program Directors

Author

Neva Castro, Joseph LaComb, Ashwinee Condon, Adrienne Lenhart, Jennifer Kolb, Venkatara Muthusamy, Badih Joseph Elmunzer, Sachin Wani, Darwin Conwell, Amar Deshpande, William Tierney, Eric Shah, Swati Pawa, Georgios I. Papachristou, Luis Lara, Sheryl A. Pfeil, Erin Taub, Adam Gonzalez, and Olga C. Aroniadis

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, Hepatology, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Family medicine, Pandemic, Gastroenterology, medicine, business
Published
2021

6. A Practical Approach to Refractory and Recurrent Barrett's Esophagus

Author

Ashwinee Condon, Domenico A. Farina, Srinadh Komanduri, and V. Raman Muthusamy

Subjects
Male, medicine.medical_specialty, Esophageal Neoplasms, 03 medical and health sciences, Barrett Esophagus, 0302 clinical medicine, Esophagus, Refractory, Recurrence, Recurrent disease, medicine, Humans, In patient, Aged, business.industry, Gastroenterology, Reflux, Intestinal metaplasia, Middle Aged, medicine.disease, digestive system diseases, Surgery, medicine.anatomical_structure, Dysplasia, 030220 oncology & carcinogenesis, Barrett's esophagus, cardiovascular system, lipids (amino acids, peptides, and proteins), 030211 gastroenterology & hepatology, Female, Esophagoscopy, Neoplasm Recurrence, Local, business, Precancerous Conditions
Abstract

Endoscopic eradication therapy (EET) is recommended for patients with Barrett's esophagus (BE)-associated neoplasia and is effective in achieving complete eradication of intestinal metaplasia (CE-IM). However, BE that is refractory to EET, defined as partial or no improvement in dysplasia after less than or equal to 3 ablative sessions, and the development of recurrence post-EET is not uncommon. Identification of refractory BE or recurrent intestinal metaplasia should prompt esophageal physiologic testing and modification of antireflux strategy, as appropriate. In patients who ultimately fail standard EET despite optimization of reflux control, salvage EET with alternate modalities may need to be considered.

Published
2020

7. Association between pre-admission acid suppressive medication exposure and severity of illness in patients hospitalized with COVID-19

Author

Teldon B. Alford, Millie Chau, Kulwinder S. Dua, Gail McNulty, Abdul Haseeb, Gulsum Anderson, Joy M. Hutchinson, Gabriela N. Kuftinec, Amar R. Deshpande, Vaishali Patel, Soumil Patwardhan, Melanie Mays, Sunil Amin, B. Joseph Elmunzer, Amy Hosmer, Andrew M. Aneese, Rosemary Nustas, Weijing Tang, Natalia H. Zbib, Liam Hilson, Benita K. Glamour, Molly Orosey, Amitabh Chak, Christopher J. DiMaio, Vladimir M. Kushnir, Mohamed Azab, Maria Ines Pinto-Sanchez, Bryan G. Sauer, Georgios I. Papachristou, Ji Zhu, Jordan Wood, Rajesh N. Keswani, Raman Muthusamy, Nancy L. Furey, Emad Qayed, Anish Patel, James Philip G. Esteban, Stephanie Mitchell, Judy A. Trieu, Jeong Yun Yang, Melissa Saul, Lujain Jaza, Rebekah E. Dixon, Mary K. West, Joseph F. LaComb, Fadi Odish, Swati Pawa, Luis F. Lara, Harsh K. Patel, Lauren Wakefield, Ali Zakaria, Rishi Pawa, Ambreen A. Merchant, Zachary L. Smith, Sachin Wani, Uchechi Okafor, Jason R. Taylor, Alexandria M. Lenyo, Nick Hajidiacos, Dhiraj Yadav, Ahmed I. Edhi, Cyrus R. Piraka, Field F. Willingham, Katherine A. Hanley, V. Mihajlo Gjeorgjievski, Olga C. Aroniadis, Anish A. Patel, Vikesh K. Singh, Nauzer Forbes, Collins O. Ordiah, Laura Mathews, Ashwinee Condon, Heiko Pohl, Vikram S. Kanagala, Eric D. Shah, William M. Tierney, Christopher Huang, Harminder Singh, Lilian Cruz, Darwin L. Conwell, Kelley Wood, Evan Mosier, Patrick S. Yachimski, Janak N. Shah, Eric F. Howard, Molly Caisse, Sheryl J. Korsnes, Emil Agarunov, Yueyang Zhang, Galina Diakova, Andrew Canakis, Bethany J. Wolf, Duyen T. Dang, Zahra Solati, Haley Nitchie, Rebecca L. Spitzer, Michael L. Volk, James M. Scheiman, Nicholas G. Brown, Richard S. Kwon, Amrita Sethi, John A. Damianos, Thomas Hollander, Olga Reykhart, Delia Calo, Zaid Imam, Robin B. Mendelsohn, E. Fogel, Don C. Rockey, Charlie Fox, Adrienne Lenhart, Selena Zhou, Ian Sloan, Laith H. Jamil, Akbar K. Waljee, M. I. Canto, Michael S. Bronze, Ayesha Kamal, Jennifer M. Kolb, Caroline G. McLeod, James Buxbaum, Casey L. Koza, Marc S. Piper, and Abhinav Tiwari

Subjects
Adult, Male, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.drug_class, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Proton-pump inhibitor, Severity of Illness Index, Article, Internal medicine, Severity of illness, medicine, Humans, In patient, Aged, Retrospective Studies, Hepatology, business.industry, SARS-CoV-2, Gastroenterology, COVID-19, Proton Pump Inhibitors, Odds ratio, Middle Aged, Hospitalization, Histamine H2 Antagonists, Female, business
Published
2020

8. Digestive Manifestations in Patients Hospitalized with COVID-19

Author

Rosemary Nustas, Vikesh K. Singh, Nauzer Forbes, Judy A. Trieu, Molly Caisse, Fadi Odish, James M. Scheiman, Rebecca L. Spitzer, Delia Calo, Casey L. Koza, Janak N. Shah, Mary K. West, Kelley Wood, Yueyang Zhang, Amy Hosmer, Rebekah E. Dixon, Galina Diakova, Jason R. Taylor, Heiko Pohl, Weijing Tang, Jordan Wood, Laith H. Jamil, Abdul Haseeb, Vaishali Patel, Abhinav Tiwari, Amitabh Chak, Field F. Willingham, Joy M. Hutchinson, Melanie Mays, Stephanie Mitchell, Jeong Yun Yang, William M. Tierney, Soumil Patwardhan, Maria Ines Pinto-Sanchez, Collins O. Ordiah, Zaid Imam, Georgios I. Papachristou, Rishi Pawa, Millie Chau, Amar R. Deshpande, Akbar K. Waljee, Caroline G. McLeod, Natalia H. Zbib, B. Joseph Elmunzer, James Buxbaum, Dhiraj Yadav, Rajesh N. Keswani, Ayesha Kamal, Melissa Saul, Sheryl Korsnes, Kulwinder S. Dua, Luis F. Lara, Haley Nitchie, Don C. Rockey, Charlie Fox, Harminder Singh, Jennifer M. Kolb, Zachary L. Smith, Katherine A. Hanley, Bryan G. Sauer, Michael S. Bronze, Lujain Jaza, Mohamed Azab, V. Mihajlo Gjeorgjievski, Teldon B. Alford, Olga C. Aroniadis, Joseph F. LaComb, Michael L. Volk, Zahra Solati, Nick Hajidiacos, Benita K. Glamour, Gabriela Kuftinec, Selena Zhou, Vikram Kanagala, Marcia I. Canto, Ian Sloan, Duyen T. Dang, Evan L. Fogel, Valerie Durkalski, Swati Pawa, Marc S. Piper, Patrick Yachimski, Amrita Sethi, Andrew Canakis, Christopher J. DiMaio, Anish A. Patel, Adrienne Lenhart, Laura Mathews, Darwin L. Conwell, Alexandria M. Lenyo, Ali Zakaria, Eric F. Howard, Nicholas G. Brown, Olga Reykhart, Sachin Wani, Eric D. Shah, Lilian Cruz, Molly Orosey, Nancy Furey, Cyrus Piraka, Evan Mosier, Robin B. Mendelsohn, Ashwinee Condon, Uchechi Okafor, Andrew M. Aneese, Sunil Amin, Emad Qayed, Anish Patel, Vladimir Kushnir, Harsh K. Patel, Gulsum Anderson, Ambreen A. Merchant, Thomas Hollander, James Philip G. Esteban, Ahmed I. Edhi, Lydia D. Foster, Christopher S. Huang, Ji Zhu, Raman Muthusamy, Liam Hilson, Richard S. Kwon, Emil Agarunov, Lauren Wakefield, John A. Damianos, and Gail McNulty

Subjects
Adult, Male, Abdominal pain, medicine.medical_specialty, Adolescent, Nausea, Gastrointestinal Diseases, medicine.medical_treatment, digestive manifestations, Article, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Interquartile range, Internal medicine, medicine, Humans, Aged, hepatic manifestations, Mechanical ventilation, Aged, 80 and over, Hepatology, business.industry, SARS-CoV-2, Confounding, Gastroenterology, COVID-19, Odds ratio, Middle Aged, Diarrhea, gastrointestinal symptoms, 030220 oncology & carcinogenesis, North America, Vomiting, 030211 gastroenterology & hepatology, Female, medicine.symptom, business
Abstract

Background & Aims The prevalence and significance of digestive manifestations in coronavirus disease 2019 (COVID-19) remain uncertain. We aimed to assess the prevalence, spectrum, severity, and significance of digestive manifestations in patients hospitalized with COVID-19. Methods Consecutive patients hospitalized with COVID-19 were identified across a geographically diverse alliance of medical centers in North America. Data pertaining to baseline characteristics, symptomatology, laboratory assessment, imaging, and endoscopic findings from the time of symptom onset until discharge or death were abstracted manually from electronic health records to characterize the prevalence, spectrum, and severity of digestive manifestations. Regression analyses were performed to evaluate the association between digestive manifestations and severe outcomes related to COVID-19. Results A total of 1992 patients across 36 centers met eligibility criteria and were included. Overall, 53% of patients experienced at least 1 gastrointestinal symptom at any time during their illness, most commonly diarrhea (34%), nausea (27%), vomiting (16%), and abdominal pain (11%). In 74% of cases, gastrointestinal symptoms were judged to be mild. In total, 35% of patients developed an abnormal alanine aminotransferase or total bilirubin level; these were increased to less than 5 times the upper limit of normal in 77% of cases. After adjusting for potential confounders, the presence of gastrointestinal symptoms at any time (odds ratio, 0.93; 95% CI, 0.76–1.15) or liver test abnormalities on admission (odds ratio, 1.31; 95% CI, 0.80–2.12) were not associated independently with mechanical ventilation or death. Conclusions Among patients hospitalized with COVID-19, gastrointestinal symptoms and liver test abnormalities were common, but the majority were mild and their presence was not associated with a more severe clinical course.

Published
2020

9. Digestive Manifestations in Patients Hospitalized with COVID-19

Author

Vikesh K. Singh, Ashwinee Condon, Rosemary Nustas, Judy A. Trieu, Robin B. Mendelsohn, Don C. Rockey, Joy M. Hutchinson, Nauzer Forbes, Lujain Jaza, Eric F. Howard, Christopher S. Huang, Sheryl J. Korsnes, Delia Calo, Gabriela Kuftinec, Rebecca L. Spitzer, Vikram Kanagala, Maria Ines Pinto-Sanchez, Georgios I. Papachristou, Mary K. West, Andrew M. Aneese, Janak N. Shah, Stephanie Mitchell, Jennifer M. Kolb, Benita K. Glamour, Selena Zhou, Luis F. Lara, Gail McNulty, Kulwinder S. Dua, Jordan Wood, Duyen T. Dang, Jason R. Taylor, Ayesha Kamal, William M. Tierney, Harminder Singh, Jeong Yun Yang, Liam Hilson, Cyrus R. Piraka, Sunil Amin, Rebekah E. Dixon, B. Joseph Elmunzer, Vladimir Kushnir, Teldon B. Alford, Millie Chau, Richard S. Kwon, Abdul Haseeb, Emil Agarunov, Lydia D. Foster, Evan L. Fogel, Caroline G. McLeod, Charlie Fox, Laith H. Jamil, Olga C. Aroniadis, Joseph F. LaComb, Emad Qayed, Eric D. Shah, Harsh K. Patel, Ambreen A. Merchant, Michael L. Volk, Ali Zakaria, Valerie Durkalski, Amrita Sethi, Adrienne Lenhart, Swati Pawa, Rishi Pawa, Amar R. Deshpande, Marc S. Piper, Alexandria M. Lenyo, Bryan G. Sauer, Zahra Solati, James M. Scheiman, Dhiraj Yadav, Andrew Canakis, Heiko Pohl, Zachary L. Smith, Vaishali Patel, and Katherine A. Hanley

Subjects
Mechanical ventilation, medicine.medical_specialty, Abdominal pain, business.industry, Nausea, medicine.medical_treatment, Confounding, Odds ratio, Confidence interval, Diarrhea, Internal medicine, medicine, Vomiting, medicine.symptom, business
Abstract

BackgroundThe prevalence and significance of digestive manifestations in COVID-19 remain uncertain.MethodsConsecutive patients hospitalized with COVID-19 were identified across a geographically diverse alliance of medical centers in North America. Data pertaining to baseline characteristics, symptomatology, laboratory assessment, imaging, and endoscopic findings from the time of symptom onset until discharge or death were manually abstracted from electronic health records to characterize the prevalence, spectrum, and severity of digestive manifestations. Regression analyses were performed to evaluate the association between digestive manifestations and severe outcomes related to COVID-19.ResultsA total of 1992 patients across 36 centers met eligibility criteria and were included. Overall, 53% of patients experienced at least one gastrointestinal symptom at any time during their illness, most commonly diarrhea (34%), nausea (27%), vomiting (16%), and abdominal pain (11%). In 74% of cases, gastrointestinal symptoms were judged to be mild. In total, 35% of patients developed an abnormal alanine aminotransferase or total bilirubin level; these were elevated to less than 5 times the upper limit of normal in 77% of cases. After adjusting for potential confounders, the presence of gastrointestinal symptoms at any time (odds ratio 0.93, 95% confidence interval 0.76-1.15) or liver test abnormalities on admission (odds ratio 1.31, 95% confidence interval 0.80-2.12) were not independently associated with mechanical ventilation or death.ConclusionsAmong patients hospitalized with COVID-19, gastrointestinal symptoms and liver test abnormalities were common but the majority were mild and their presence was not associated with a more severe clinical course

Published
2020

10. Su1446 TRANSPAPILLARY GALLBLADDER STENT PLACEMENT: EXPANDING TREATMENT OPTIONS FOR SYMPTOMATIC GALLSTONE DISEASE IN PATIENTS WITH CIRRHOSIS AWAITING LIVER TRANSPLANTATION

Author

Stephen Kim and Ashwinee Condon

Subjects
medicine.medical_specialty, Cirrhosis, business.industry, Gallbladder, medicine.medical_treatment, Gastroenterology, Treatment options, Disease, Liver transplantation, medicine.disease, Surgery, Stent placement, medicine.anatomical_structure, Medicine, Radiology, Nuclear Medicine and imaging, In patient, business
Published
2020

13. Tu1539 PROLONGED GASTRIC TRANSIT ON VIDEO CAPSULE ENDOSCOPY MAY PREDICT GASTROPARESIS ON GASTRIC EMPTYING SCINTIGRAPHY

Author

Adrienne Lenhart, Neil B. Marya, Ashwinee Condon, Jasleen Grewal, Stephen Kim, and Puneet Kumar

Subjects
medicine.medical_specialty, medicine.diagnostic_test, Gastric emptying, business.industry, Gastroenterology, Scintigraphy, medicine.disease, Video capsule endoscopy, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, Transit (astronomy), Gastroparesis, business
Published
2020

15. Mo1262 EVALUATION OF SUTURED STENT FIXATION TO PREVENT ESOPHAGEAL STENT MIGRATION IN 187 PATIENTS: A MULTICENTER PROPENSITY SCORE MATCHING ANALYSIS

Author

Louis M. Wong Kee Song, Stephen Kim, Neil B. Marya, Jennifer Phan, Vinay Chandrasekhara, Andrew C. Storm, Ashwinee Condon, Barham K. Abu Dayyeh, Reem Matar, Alireza Sedarat, M. Phillip Fejleh, V. Raman Muthusamy, Navtej S. Buttar, John A. Martin, and Michael J. Levy

Subjects
Fixation (surgical), medicine.medical_specialty, Esophageal stent, business.industry, medicine.medical_treatment, Propensity score matching, Gastroenterology, medicine, Stent, Radiology, Nuclear Medicine and imaging, business, Surgery
Published
2020

17. Su1374 IS TIMING REALLY EVERYTHING? RESULTS OF A PROPENSITY SCORE MATCHING ANALYSIS COMPARING CAPSULE ENDOSCOPY DIAGNOSTIC YIELD IN PATIENTS WITH SUSPECTED SMALL BOWEL BLEEDING: A MULTICENTER STUDY

Author

Jennifer Phan, David R. Cave, Adarsh M. Thaker, Stephen Kim, Sonya Dasharathy, Ashwinee Condon, Neil B. Marya, Alireza Sedarat, Tien S. Dong, M. Phillip Fejleh, Li Wang, Vivy Tran, and V. Raman Muthusamy

Subjects
medicine.medical_specialty, business.industry, Yield (finance), Gastroenterology, law.invention, Multicenter study, Capsule endoscopy, law, Propensity score matching, medicine, Radiology, Nuclear Medicine and imaging, In patient, Radiology, business
Published
2019

18. 52 DEVELOPMENT AND PROSPECTIVE VALIDATION OF A SCORING SYSTEM TO PREDICT THE LIKELIHOOD OF IDENTIFYING A DIAGNOSIS ON VIDEO CAPSULE ENDOSCOPY FOR PATIENTS WITH SUSPECTED SMALL BOWEL BLEEDING: A MULTICENTER STUDY

Author

Ashwinee Condon, Neil B. Marya, Sonya Dasharathy, David R. Cave, M. Phillip Fejleh, Adarsh M. Thaker, Stephen Kim, Alireza Sedarat, Tien S. Dong, Vivy Tran, V. Raman Muthusamy, Jennifer Phan, and Li Wang

Subjects
Video capsule endoscopy, medicine.medical_specialty, Scoring system, Multicenter study, business.industry, Gastroenterology, medicine, Radiology, Nuclear Medicine and imaging, Radiology, business
Published
2019

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