American College of Gastroenterology, Oct. 5-10
The annual meeting of the American College of Gastroenterology was held from Oct. 5 to 10 in Philadelphia and attracted approximately 5,000 participants from around the world, including gastroenterology and digestive specialists and other health care professionals. The conference featured presentations focusing on clinical updates in gastroenterology and hepatology as well as the latest advances in digestive health and gastrointestinal disorders.
In one study, Tarek Alansari, M.D., from Metropolitan Hospital in Brooklyn, N.Y., and colleagues examined how cannabis use is emerging as a rare, possibly overlooked cause of acute pancreatitis, with few cases reported in the literature.
"In the United States, only five cases of cannabis-induced acute pancreatitis have been reported through September 2017. The review of literature revealed that only 26 cases of cannabis-induced acute pancreatitis have been reported worldwide," Alansari said. "Our case report at the ACG 2018, along with a growing body of evidence in the literature, suggests that people who use cannabis recreationally or for medical use are at risk for developing acute pancreatitis, especially if they are younger than 35. With the rising prevalence of cannabis use and its role as an overlooked cause of acute pancreatitis, health care providers should include cannabis in the differential diagnosis of acute pancreatitis cases with unknown etiology, particularly in patients under age 35 years."
In another study, Mohammad Bilal, M.D., from the University of Texas Medical Branch in Galveston, and colleagues evaluated the predictors of an increased prevalence of adenomas in 40- to 49-year-old individuals undergoing colonoscopy.
"Recently, the American Cancer Society has published recommendations to begin colorectal cancer screening at age 45 years in average-risk patient populations," Bilal said. "These recommendations were primarily based on modeling studies since there is a paucity of data for younger age groups in regards to prevention and detection of colorectal cancer. Despite these new recommendations from the American Cancer Society, there is limited direct evidence to support colorectal cancer screening at a younger age."
The investigators found that in addition to family history of colorectal carcinoma, patient age, male gender, body mass index, and chronic kidney disease are all independent predictors of increased adenoma detection rates in patients aged 40 to 49 years old.
"Our study suggests that rather than performing early colonoscopy on everyone, a select group of individuals (e.g., obese males with chronic kidney disease) might benefit from early colonoscopic colon cancer screening," Bilal added. "Large multicenter prospective studies are needed to validate these findings."
In an effort to improve colonoscopy adherence and gain insight into preparation issues, Nadim Mahmud, M.D., from the Hospital of the University of Pennsylvania in Philadelphia, and colleagues performed a pilot study of 21 patients using automated text messages sent over the course of one week prior to scheduled colonoscopy.
"These texts included instructional, educational, and reminder messages regarding aspects of the colonoscopy preparation process. We found significantly improved colonoscopy adherence among patients who received the text message program as compared to routine-care controls (90 versus 62 percent). Furthermore, patient satisfaction and likelihood to recommend the text messaging program was high," Mahmud said. "Our research suggests that timely text messages from the health care system can simplify the bowel preparation process, and are likely to help patients successfully complete their colonoscopy."
Benjamin A. Lerner, M.D., from the Columbia University Medical Center in New York City, and colleagues found that many restaurants require better education in preventing gluten cross-contamination.
"Thirty-two percent of restaurant foods labeled gluten-free contained detectable levels of gluten. Rates of gluten contamination were higher at dinner time (34 percent) than at breakfast time (27 percent). Gluten-free pizza and pasta were particularly likely to be contaminated, with more than half of each of these foods containing gluten," Lerner said. "Clinicians should warn their patients with celiac disease that there is significant risk of gluten exposure when dining out, even when selecting gluten-free-labeled dishes. Furthermore, those wishing to avoid ingesting gluten at restaurants should feel empowered to inquire about practices in place to reduce cross-contamination, such as use of separate cooking areas, equipment, ovens, etc."