WGO & WGOF News - AGA Clinical Congress of Gastroenterology and Hepatology: Clinical Practice Skills in a Changing World - Gary W. Falk, MD, MS

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16 WORLD GASTROENTEROLOGY NEWS JULY 2014 Editorial | Expert Point of View | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events AGA Clinical Congress of Gastroenterology and Hepatology: Clinical Practice Skills in a Changing World Gary W. Falk, MD, MS Professor of Medicine Division of Gastroenterology University of Pennsylvania Perelman School of Medicine Philadelphia, Pennsylvania The American Gastroenterological Association (AGA) recently concluded their annual Clinical Congress of Gastroenterology and Hepatology: Clinical Practice Skills in a Changing World, on January 17 and 18, 2014, at the Loews Miami Beach Hotel, FL, USA. This live program is designed by GI clinicians for GI clinicians. The Congress provides practical and immediately applicable solutions on how to improve patient outcomes and strengthen professional competence in a rapidly changing GI field. In 2014, attendees explored recent developments in the detection, management and treatment of GI and liver disorders including esophageal, small bowel, colonic and pancreatico-biliary disorders as well as inflamma-tory bowel disease and hepatolgy. The course directors and faculty contrib-uted the latest updates on key clinical issues to help the audience enhance their clinical decision-making skills and delivery of patient care. Attendees took away practical information on the full spectrum of GI and hepatic disorders, immediately applicable in both practice and hospi-tal settings. The audience found out what lies ahead for GI practices in the ever-changing health-care environ-ment with our practice management session on day one of the Congress. Along with practical information of GI and hepatic disorders, the revised practice management session provided information on important changes in health care that will impact GI practice management. At the end of the congress, Gary Falk, MD, course director of this year’s congress, provided the audi-ence with the top 10 take-away points from each lecture. Here are some of the highlights. • For esophageal eosinophilia, ex-clude proton-pump inhibitor (PPI) responsive esophageal eosinophilia (PPI-REE) first. • Think medications in addition to opiates in patients with suspected gastroparesis: o Oral hypoglycemics, tramadol. o Tacrolimus in organ transplant patients. • Remember IgG anti-DGP moving forward in equivocal celiac disease testing. • Evidence accumulating for fecal transplant in C. difficile infection, • Be proactive in IBD management — ongoing disease activity prob-lematic for recurrence: o Mucosal healing is important. o Risk stratify for prevention of postoperative recurrence. o TNF response correlates to trough levels. • Beware right-sided colon lesions: o Mucus cap. o Decreased vascular markings. o Utilize image enhancement: - Chromoendoscopy. - Narrow-band imaging. • Resect and discard may be coming: o NICE criteria for adenomas versus hyperplastic polyps: - Color. - Vessels. - Pit pattern. • Management of pancreatic cystic le-sions best done by consulting 2012 guidelines. • Acute pancreatitis may be triaged for severity by systematic inflamma-tory response syndrome: o Early infections typically extra-pancreatic. o Think step-up therapy for pan-creatic necrosis. • New HCV clinical trials have remarkable results with greater than 90 percent sustained virologic response: • NAFLD is not NASH: o Weight loss and exercise reduces steatosis.


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