Polypectomy Technique, Artificial Intelligence, and More in the May Issue of AJG

The May issue of The American Journal of Gastroenterology highlights new clinical science and reviews on hepatic encephalopathy management using a smartphone app’s artificial intelligence, cyclic vomiting syndrome prevalence and incidence, alcohol-associated liver disease and alcohol use disorder in young women, and polypectomy technique. This month we also published articles on esophageal cancer, GI bleeding, ulcerative colitis, irritable bowel syndrome, and more.

Several articles are highlighted below and access to any articles from this issue, or past issues, is available upon request. The College is also able to connect members of the press with study authors or outside experts who can comment on the articles.

Resectability of Small Duodenal Tumors: A Randomized Controlled Trial Comparing Underwater Endoscopic Mucosal Resection and Cold Snare Polypectomy
Miyazaki, et al.
In a randomized controlled trial, underwater endoscopic mucosal resection (UEMR) and cold snare polypectomy (CSP) were compared in patients with superficial nonampullary duodenal epithelial tumors less than 12mm, with sufficient vertical R0 resection (SVR0) as the primary endpoint—R0 resection including a sufficient submucosal layer. The authors found that the SVR0 rate was significantly higher in the UEMR group. However, the R0 rate was not significantly different, and the total procedure time was shorter and number of total bleeding events lower in the CSP group.

Artificial Intelligence Evaluation of Stool Quality Guides Management of Hepatic Encephalopathy Using a Smartphone App
Fagan, et al.
This study examined the use of a smartphone app to manage lactulose-based hepatic encephalopathy treatment, which requires titration based on daily bowel movements. The app used artificial intelligence to recognize stool images, based on the Bristol Stool Scale (BSS). Patients entered self-reported BSS information and AI-BSS data was also captured, as well as any dose changes. Authors found that self-reported and AI-BSS and the lactulose dose/AI-BSS correlation increased with usage of the app, and AI-BSS communications improved insight into self-reported BSS over time.
Visual Abstract

Epidemiology, Comorbidities, and Treatment of Cyclic Vomiting Syndrome in the United States
Chen, et al.
This cross-sectional study provides the first population-level estimates of cyclic vomiting syndrome (CVS) incidence and prevalence in the US based on claims data from commercial/Medicare and Medicaid databases. The estimated prevalence of CVS per 100,000 individuals was 16.7 (commercial/Medicare) and 42.9 (Medicaid). The estimated incidence per 100,000 individuals was 10.6 (commercial/Medicare) and 26.6 (Medicaid), with both prevalence and incidence higher among females. The authors found that comorbid conditions were common, including abdominal pain, anxiety, depression, cardiac conditions, and GERD. Only 32-35% of patients diagnosed with CVS had prescriptions for prophylactic treatment and 47-55% for acute treatment within the first 30 days after diagnosis.

About the American College of Gastroenterology
Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of over 18,000 individuals from 86 countries. The College’s vision is to be the preeminent professional organization that champions the prevention, diagnosis, and treatment of digestive disorders, serving as a beacon to guide the delivery of the highest quality, compassionate, and evidence-based patient care. The mission of the College is to enhance the ability of our members to provide world class care to patients with digestive disorders and advance the profession through excellence and innovation based upon the pillars of Patient Care, Education, Scientific Investigation, Advocacy and Practice Management. www.gi.org