Search

IntroductionIn the setting of increasing attention to representation in medicine, we aimed to assess current perspectives of racial and ethnic workforce diversity and health care disparities among gastroenterology (GI) and hepatology professionals in the United States.MethodsWe developed and administered a 33-item electronic cross-sectional survey to members of 5 national GI and hepatology societies. Survey items were organized into thematic modules and solicited perspectives on racial and ethnic workforce diversity, health care disparities in GI and hepatology, and potential interventions to enhance workforce diversity and improve health equity.ResultsOf the 1,219 survey participants, 62.3% were male, 48.7% were non-Hispanic White, and 19.9% were from backgrounds underrepresented in medicine. The most frequently reported barriers to increasing racial and ethnic diversity in GI and hepatology were insufficient representation of underrepresented racial and ethnic minority groups in the education and training pipeline (n = 431 [35.4%]), in professional leadership (n = 340 [27.9%]), and among practicing GI and hepatology professionals (n = 324 [26.6%]). Suggested interventions were to increase career mentorship opportunities (n = 545 [44.7%]), medical student opportunities (n = 520 [42.7%]), and program and professional society leadership roles for underrepresented racial and ethnic minority groups (n = 473 [38.8%]).DiscussionOur survey explored imperative and timely perspectives on racial and ethnic representation and health equity among professionals in GI and hepatology. The findings should inform future interventions to address workforce diversity and establish priorities toward improving health equity, ultimately serving as a springboard for professional societies, academic institutions, and other organizations that aim to increase diversity, equity, and inclusion in our field.

BackgroundAlthough early adverse life events (EALs) are prevalent among patients with irritable bowel syndrome (IBS), the impact of fear or dissociation experienced during the trauma has not been evaluated. We investigated the prevalence of fear at the time of trauma and its association with IBS status among individuals with early-life trauma before the age of 18.MethodsAmong participants with ≥1 EAL, association of fear and dissociation with IBS status was determined with logistic regression, and improvement in prediction of IBS over ETI score alone was determined with the likelihood ratio test. Controlling for age, sex, and IBS status, we then examined the association of each EAL with reported fear.Key resultsCompared to healthy controls (HCs), IBS subjects reported a higher prevalence of fear (60.4% vs 36.2%, P

Foreign body ingestion encompasses a broad variety of ingested objects, clinical presentations, and treatment approaches, with a wide spectrum of severity and urgency. Herein, we describe the case of a 29-year-old man presenting with abdominal pain following the ingestion of empty plastic bags. Monitoring with serial imaging demonstrated the bags in the stomach 18 hours post-ingestion. Given this finding and worsening pain, a multidisciplinary decision was made to pursue endoscopic retrieval. This case uniquely demonstrates the benefit of rapid multidisciplinary meetings in an emergency room setting leading to the successful removal of ingested bags from the gastric body. While the phenomenon of "body stuffing," or hasty ingestion of bagged drugs to evade law enforcement has become common, there are few reports of endoscopic removal for such cases or those involving empty bag ingestion. This case highlights the importance of repeat abdominal imaging and early endoscopic intervention for foreign objects such as bags as they may be difficult to visualize on imaging, making it unreliable to track their progress. Dynamic imaging should be obtained, with computed tomography (CT) being the gold standard. This report represents the first case of empty bag ingestion, highlighting tenets of timely multidisciplinary management and considerations in endoscopic retrieval as a minimally invasive technique when a patient presents in the emergency department following bag ingestion.

Background: Cost-effectiveness analyses compare the value of different treatment strategies, given that one strategy is more effective but also more costly than the other. The results are often used as a pharmacoeconomic basis to support a particular treatment strategy., Objectives: To determine whether studies that reported favorable cost-effectiveness results in the antiviral treatment of hepatitis B and hepatitis C were more likely to be published., Methods: A systematic literature search was performed to identify all original cost-effectiveness studies published from 1987 through 2011 regarding antiviral treatment of hepatitis B or hepatitis C. Data were abstracted independently by 2 reviewers. Corresponding authors were also contacted., Results: Of the 77 original cost-effectiveness analyses, 55 (71.4%) utilized a cost-effectiveness ratio below $50,000 per quality-adjusted life-year (QALY) in reaching a main conclusion for the study. A total of 46 analyses (59.74%) utilized ratios below $20,000/QALY. Most analyses (71 [92.2%]) reported favorable cost-effectiveness results. Countries outside of the United States and Europe tended to report lower cost-effectiveness ratios. Academic-funded studies were less likely to report cost-effectiveness ratios below $20,000/QALY. Most of the corresponding authors stated that their cost-effectiveness studies were published., Conclusions: Most published cost-effectiveness analyses regarding antiviral treatment of hepatitis B or hepatitis C reported favorable results. These results may suggest that researchers only attempt cost-effectiveness studies when there is a high likelihood of positive results. Regardless of the explicit cause of the bias, more awareness and scrutiny are needed when utilizing cost-effectiveness studies in decision making.