Clinical Practice Updates (CPUs) are intended to inform clinicians, payors and other interested parties of AGA’s concerning areas of clinical practice and/or technologies that are widely available or new to the practice of gastroenterology. CPUs present the current state-of-the-art and by definition will include a combination of strong, evidence-based information, and when not available, best consensus opinion.
Laura Raffals, MD, Geoffrey Nguyen, MD and David Rubin, MD, AGAF discuss the need to disseminate information about biosimilars and their approval process to increase the comfort levels of gastroenterologists, as the initial biologic therapies introduced to treat inflammatory bowel disease nearly 20 years ago, near the end of their patents and biosimilars emerge as an increasingly common treatment of IBD. Biosimilars have been introduced in hopes of lowering the cost of biologic therapy through increased competition and treatment options.
Steffen Husby, MD, PhD, Joseph Murray, MD, AGAF and David Katzka, MD address the importance of clinicians familiarizing themselves with the diagnostic options and uncertainties related to diagnosis and follow-up of celiac disease (CD). CD has risen in significance in recent years, with increased public concern about the effects of gluten on health and increased awareness about the symptoms and systemic effects of CD. It is also disease that has a strong genetic link and is seen as a common disease among both adults and children.
Bloating is a common presenting complaint to health care providers, but is often difficult to evaluate and manage. Amrit K. Kamboj, MD, Amy S. Oxentenko, MD, AGAF, propose an innovative acronym BLOATING to capture the various mechanisms responsible for bloating, including bowel disturbance, liquid, obstruction, adiposity, thoracic, increased sensitivity, neuromuscular and gas.
In this Clinical Practice Update, Laurie Keefer and colleagues describe the structure and efficacy of two major classes of psychotherapy—cognitive behavior therapy and gut-directed hypnotherapy. They focus on the impact of these brain–gut psychotherapies on gastrointestinal symptoms, as well as their ability to facilitate improved coping, resilience, and self-regulation.
Description of the key principles in the use of surgical interventions and device-aided therapy for managing fecal incontinence and defecatory disorders.