The colon course

The colon course brought us numerous pearls on a broad range of topics, from how to perform quality endoscopy safely, to providing updates on genetic screening for colon cancer syndromes and fecal microbiota transplant.

Quality colonoscopy is no longer just a personal effort to provide the best care possible to our patients, it will become a barometer for not only government and private payers but also patients looking for top-notch care. Adenoma detection rate is an objective parameter that we should all monitor regularly and strive to meet or exceed national benchmarks.

We learned from Dr. Thomas Imperiale that advances in colonoscopy preparation have led to marked improvements in quality bowel preparation, with resultant improvements in adenoma detection rate (ADR). We now know that split preparations are most effective, and minimizing the time between prep completion and performance of colonoscopy improves bowel prep quality. Dr. Sameer Saini reviewed additional system-level factors to improve ADRs, such as high-definition and wide-angle colonoscopes, high-quality withdrawal techniques, and colonoscope adjuncts such as caps, chromoendoscopy, and narrow-band imaging.

A quality endoscopy is also a safe endoscopy, and Dr. Neena Abraham provided numerous “cardiogastroenterology” pearls to help guide our care of patients with gastrointestinal diseases requiring endoscopy in the setting of anticoagulant and antiplatelet therapy. If you remember one key point from her talk, it should be: Do not stop aspirin for endoscopy.

A major goal of colonoscopy is adenoma detection and removal, and Dr. Joseph Elmunzer guided us through techniques to tackle the “defiant polyp,” including submucosal injection, proper colonoscope positioning, clip closure of defects, and the importance of complete adenoma resection.

When we find adenomas and cancers, we should be vigilant in inquiring about patients’ family history, and be mindful of patterns suggestive of a hereditary cancer syndrome such as a large number of adenomas, right-sided sessile serrated adenomas, and family members with colorectal neoplasia at a young age. Dr. Elena Stoffel reviewed clinical features of common hereditary syndromes and emphasized that genetic testing is ideally performed in conjunction with genetic counseling.

In the evolving field of fecal microbiota transplant, Dr. Lawrence Brandt reviewed the history and current status of treatment of refractory or recurrent Clostridium difficile infection. He discussed therapy with fidaxomicin, which has been shown to be superior to vancomycin for C. difficile recurrence, and provided a thorough overview of the rationale, data, and process of fecal microbiota transplant.

Dr. Early, professor of medicine, Washington University, St. Louis, moderated this presentation during the 2014 Digestive Diseases Week.

The colon course brought us numerous pearls on a broad range of topics, from how to perform quality endoscopy safely, to providing updates on genetic screening for colon cancer syndromes and fecal microbiota transplant.

Quality colonoscopy is no longer just a personal effort to provide the best care possible to our patients, it will become a barometer for not only government and private payers but also patients looking for top-notch care. Adenoma detection rate is an objective parameter that we should all monitor regularly and strive to meet or exceed national benchmarks.

We learned from Dr. Thomas Imperiale that advances in colonoscopy preparation have led to marked improvements in quality bowel preparation, with resultant improvements in adenoma detection rate (ADR). We now know that split preparations are most effective, and minimizing the time between prep completion and performance of colonoscopy improves bowel prep quality. Dr. Sameer Saini reviewed additional system-level factors to improve ADRs, such as high-definition and wide-angle colonoscopes, high-quality withdrawal techniques, and colonoscope adjuncts such as caps, chromoendoscopy, and narrow-band imaging.

A quality endoscopy is also a safe endoscopy, and Dr. Neena Abraham provided numerous “cardiogastroenterology” pearls to help guide our care of patients with gastrointestinal diseases requiring endoscopy in the setting of anticoagulant and antiplatelet therapy. If you remember one key point from her talk, it should be: Do not stop aspirin for endoscopy.

A major goal of colonoscopy is adenoma detection and removal, and Dr. Joseph Elmunzer guided us through techniques to tackle the “defiant polyp,” including submucosal injection, proper colonoscope positioning, clip closure of defects, and the importance of complete adenoma resection.

When we find adenomas and cancers, we should be vigilant in inquiring about patients’ family history, and be mindful of patterns suggestive of a hereditary cancer syndrome such as a large number of adenomas, right-sided sessile serrated adenomas, and family members with colorectal neoplasia at a young age. Dr. Elena Stoffel reviewed clinical features of common hereditary syndromes and emphasized that genetic testing is ideally performed in conjunction with genetic counseling.

In the evolving field of fecal microbiota transplant, Dr. Lawrence Brandt reviewed the history and current status of treatment of refractory or recurrent Clostridium difficile infection. He discussed therapy with fidaxomicin, which has been shown to be superior to vancomycin for C. difficile recurrence, and provided a thorough overview of the rationale, data, and process of fecal microbiota transplant.

Dr. Early, professor of medicine, Washington University, St. Louis, moderated this presentation during the 2014 Digestive Diseases Week.

The colon course brought us numerous pearls on a broad range of topics, from how to perform quality endoscopy safely, to providing updates on genetic screening for colon cancer syndromes and fecal microbiota transplant.

Quality colonoscopy is no longer just a personal effort to provide the best care possible to our patients, it will become a barometer for not only government and private payers but also patients looking for top-notch care. Adenoma detection rate is an objective parameter that we should all monitor regularly and strive to meet or exceed national benchmarks.

We learned from Dr. Thomas Imperiale that advances in colonoscopy preparation have led to marked improvements in quality bowel preparation, with resultant improvements in adenoma detection rate (ADR). We now know that split preparations are most effective, and minimizing the time between prep completion and performance of colonoscopy improves bowel prep quality. Dr. Sameer Saini reviewed additional system-level factors to improve ADRs, such as high-definition and wide-angle colonoscopes, high-quality withdrawal techniques, and colonoscope adjuncts such as caps, chromoendoscopy, and narrow-band imaging.

A quality endoscopy is also a safe endoscopy, and Dr. Neena Abraham provided numerous “cardiogastroenterology” pearls to help guide our care of patients with gastrointestinal diseases requiring endoscopy in the setting of anticoagulant and antiplatelet therapy. If you remember one key point from her talk, it should be: Do not stop aspirin for endoscopy.

A major goal of colonoscopy is adenoma detection and removal, and Dr. Joseph Elmunzer guided us through techniques to tackle the “defiant polyp,” including submucosal injection, proper colonoscope positioning, clip closure of defects, and the importance of complete adenoma resection.

When we find adenomas and cancers, we should be vigilant in inquiring about patients’ family history, and be mindful of patterns suggestive of a hereditary cancer syndrome such as a large number of adenomas, right-sided sessile serrated adenomas, and family members with colorectal neoplasia at a young age. Dr. Elena Stoffel reviewed clinical features of common hereditary syndromes and emphasized that genetic testing is ideally performed in conjunction with genetic counseling.

In the evolving field of fecal microbiota transplant, Dr. Lawrence Brandt reviewed the history and current status of treatment of refractory or recurrent Clostridium difficile infection. He discussed therapy with fidaxomicin, which has been shown to be superior to vancomycin for C. difficile recurrence, and provided a thorough overview of the rationale, data, and process of fecal microbiota transplant.

Dr. Early, professor of medicine, Washington University, St. Louis, moderated this presentation during the 2014 Digestive Diseases Week.