GiT Updates and More

Endoscopic features of H. pylori gastritis, intestinal metaplasia

Relative/Absolute Contraindications for Choice of Treatment in IBD ▪️Latent TB ▪️Chronic hepatitis B ▪️Melanoma ▪️Anti-drug antibodies to first TNFi ▪️Uveitis & Macular Edema ▪️Type 2 heart block ▪️Personal hx or FDR w/ Lymphoma ▪️Smokers, age >65, other CV/CAD risks ACG2024

ANTIMIGRAINE MEDICINES YOU SHOULD REMEMBER: 1. Beta blockers: They reduce the frequency of migraines by stabilizing blood vessels and decreasing activation of the nervous system. 2. Ergotamine and triptans: They constrict dilated vessels and block the transmission of pain to the brain. 3. Antiepileptics: They reduce neuronal hyperexcitability, reducing frequency and intensity. 4. Anti-CGRP antibodies: Block CGRP, a protein that causes vasodilation and pain, preventing migraines. 5. Antiemetics: Control nausea and vomiting related to migraines.

Activity of Central Neuromodulators on Abdominal Pain, Gl Motility, & Psychological Symptoms ▪️⬇️ Abdominal pain ▪️⬆️ GI transit rate ▪️⬇️ GI transit rate ▪️⬇️ Anxiety ▪️⬇️ Nausea ▪️⬇️ Depression ACG2024

Activity of Central Neuromodulators on Abdominal Pain, Gl Motility, & Psychological Symptoms ▪️⬇️ Abdominal pain ▪️⬆️ GI transit rate ▪️⬇️ GI transit rate ▪️⬇️ Anxiety ▪️⬇️ Nausea ▪️⬇️ Depression ACG2024

H. pylori eradication with vonoprazan combined with amoxicillin & levofloxacin is more effective than omeprazol, amoxi and clarithromycine, according to a large multicenter study. ACG2024

“New” Paradigm - RULE OF FIVE For compensated advanced chronic liver disease (cACLD) & clinically significant portal hypertension (CSPH) ACG2024

Optimal Timing of PPI Dosing Pre-meal PPI (approx 60 min) results in optimal control of daytime gastric acidity ACG2024

Emerging Anti-Reflux Therapies ▪️RFA (Stretta) ▪️Endoscopic fundoplication (EFTP) using novel GERDxTM ▪️ Medigus ultrasonic surgical endostapler (MUSE) ▪️Antireflux mucosectomy (ARMS) ▪️Anti-reflux mucosal ablation (ARMA) ▪️Resection and plication (RAP) ▪️C-BLART ACG2024

How Certain Foods Contribute to Reflux ▪️Direct esophageal mucosal irritant ▪️Increased gastric dissection/TLESRs ▪️Reduced in LES tone ▪️Increased gastric acid production ACG2024

Lifestyle modifications that reduce the risk of RECURRENT DIVERTICULITIS 1️⃣ BMI 18-25 2️⃣ Red meat <4x/week 3️⃣ ≥ 23 g fiber / day 4️⃣ Exercise 2hr/week 5️⃣ No smoking Account for 50% of population attributable risk! ACG2024