Review: Diagnostic Approach to Lower Gastrointestinal Bleeding

Surgeons holding endoscopic tools preparing for gastrointestinal evaluation

Daniel J. Stein, MD, MPH, in the Department of Gastroenterology, Hepatology and Endoscopy at Brigham and Women’s Hospital, Joseph D. Feuerstein, MD, and a colleague recently reviewed for hospitalists the first-line diagnostic and treatment options when acute lower gastrointestinal bleeding is suspected.

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Women With IBD Are Vulnerable to Postpartum Infections

Close up of woman holding newborn infant in hospital after giving birth

Brigham and Women’s Hospital conducted the first study that examined a wide spectrum of infectious complications and included a non-IBD control group. They report a higher risk of postpartum infections in women with IBD regardless of the mode of delivery.

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New Tool Predicts Success of Direct Endoscopic Necrosectomy With LAMS for Pancreatic Walled-Off Necrosis

Rendering of blue human body concept with pancreas highlighted in red

Marvin Ryou, MD, director of endoscopic innovation, and Christopher C. Thompson, MD, MSc, director of endoscopy, recently conducted the first study of which patients are most likely to respond to direct endoscopic necrosectomy with lumen-apposing metal stent (LAMS) for pancreatic walled-off necrosis.

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Disparities Noted in Uptake of Cholecystectomy for Idiopathic Pancreatitis

Surgeon performs laparoscopic cholecystectomy on patient

Idiopathic acute pancreatitis (IAP) is an emerging indication for empiric inpatient cholecystectomy. Researchers at Brigham and Women’s Hospital recently found an extremely low rate of adoption and also report disparities in uptake by demographics and geography.

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Rates of Spinal Symptoms and Spinal Surgery Are Lower After Bariatric Surgery

Doctor holds up x-ray of spine to show older patient

A study showed patients with a history of bariatric surgery had lower overall complication rates after spinal surgery than morbidly obese patients who did not have bariatric surgery. Now researchers report significant reductions in symptomatic spinal disorders and the need for spinal surgery after bariatric surgery.

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Brigham Offering Magnetic Sphincter Augmentation for Patients With GERD

LINX product shown banded around a diagram of the lower esophageal sphincter above stomach

Magnetic sphincter augmentation using the LINX® Reflux Management System is an alternative to acid suppression therapy with proton pump inhibitors or traditional surgical treatment. Gastrointestinal and bariatric surgeons Thomas C. Tsai, MD, MPH, and David Spector, MD, discuss bringing this procedure to the Brigham.

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Novel Low-Cost and Disposable GI Manometry Devices to Broaden Use in Low-Resource Settings

Standard digital manometer for GI diagnosis.

Working with scientists at MIT, Brigham and Women’s Hospital researchers have developed a much simpler alternative to GI manometers called quipu-inspired, liquid metal–enabled pressure transducers (QUILT).

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Novel POSE Techniques Developed at the Brigham Are Safe and Effective

Close up of doctor holding endoscopic examination tool before surgery

In 2018, Pichamol Jirapinyo, MD, MPH, and Christopher C. Thompson, MD, developed a modified technique they call distal POSE—which involves placing plications primarily in the gastric body, sparing the fundus. They have published a one-year study, concluding distal POSE appears safe and effective for treating obesity.

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Treatment Persistence Greater With First-line Vedolizumab Than TNFα Inhibitors for Ulcerative Colitis

Rendering of digestive system with inflammed large intestine from ulcerative colitis

The only head-to-head trial that compared biologics for treating ulcerative colitis (UC) found superiority of vedolizumab to adalimumab for clinical remission. Now, a retrospective study shows that biologic-naïve adults with UC stay on vedolizumab longer than either of the two tumor necrosis factor-α (TNFα) inhibitors.

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Plication Transoral Outlet Reduction Safely Treats Weight Regain After Gastric Bypass

Close up measuring waist with measuring tape

Endoscopists at Brigham and Women’s Hospital have conducted the first study in which plication endoscopic transoral gastric outlet reduction was combined with argon plasma coagulation to treat weight gain after Roux-en-Y gastric bypass.

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