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Clinical introduction to colorectal polyps

Tomer Adar

Summary

AI Generated

An educational course provides a clinical introduction to colorectal polyps, covering their definition, classification, rationale for detection, and considerations before, during, and after polypectomy, excluding the polypectomy procedure itself.

  • The course addresses the definition and classification of colorectal polyps and explains why they are sought in clinical practice.
  • Learning objectives include understanding considerations before, during, and after polypectomy, as well as clinical management following polypectomy.
  • The polypectomy procedure itself is not covered in this course.
  • Target audience includes gastroenterologists in training, physicians and surgeons in other disciplines, nurses, bio-technicians, and advanced-years medical students with an interest in gastroenterology.
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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Overview

Colorectal polyps are an important clinical condition, frequently encountered in endoscopic practice. This course is designed to provide a clinical introduction to colorectal polyps, emphasising different aspects prior, during and following the endoscopic procedure.  

Learning objectives

  • To understand and be able to describe the definition of colorectal polyps and their different classification
  • To know why we look for colorectal polyps
  • To be familiar with the various relevant considerations before, during and after polypectomy (the polypectomy procedure itself is not covered in this course)
  • To be aware of clinical management following polypectomy

Target audience

This course is suitable for gastroenterologists in training, but is also built to serve physicians and surgeons in other disciplines, as well as nurses, bio-technicians and advanced-years’ medical students who have an interest in gastroenterology.

 

Event

Clinical introduction to colorectal polyps

Topics

Digestive Oncology Endoscopy

Accreditation status

not accredited

Duration

1 hour

Published

2016

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UEG Online Course
not accredited
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Hereditary gastrointestinal polyposis syndromes

Luigi Ricciardiello

Summary

AI Generated

Summary is not available for this content yet.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Overview

Hereditary gastrointestinal polyposis syndromes are rare diseases that confer a significant risk of colorectal and other cancers. Correct diagnosis is needed to ensure patients undergo appropriate screening and follow-up for cancer prevention, and to ascertain risk in family members. Multidisciplinary management is essential to ensure appropriate clinical choices are made, and the involvement of a clinical geneticist is mandatory.

This online course addresses the various types of hereditary gastrointestinal polyposis syndrome. The genetic basis of each syndrome is considered, along with their presentation, extracolonic features, cancer risk, diagnosis, screening, surveillance and treatment options.

Learning objectives

 

  • To become familiar with hereditary gastrointestinal polyposis syndromes
  • To correctly diagnose hereditary gastrointestinal polyposis syndromes
  • To appropriately manage hereditary gastrointestinal polyposis syndromes

Target audience

This course is suitable for gastroenterologists in training and physicians and surgeons in other disciplines, as well as nurses, biotechnicians and advanced-years’ medical students who have an interest in gastroenterology. 

Event

Hereditary gastrointestinal polyposis syndromes

Topics

Digestive Oncology

Accreditation status

not accredited

Duration

1 hour

Published

2018

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UEG Online Course
accredited
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Management of early-invasive (T1) colorectal cancer

Alexandra Langers, Jurjen J. Boonstra, James Hardwick

Summary

AI Generated

Summary is not available for this content yet.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Overview

With the introduction of population-based screening programs in several countries, the proportion of patients diagnosed with early invasive colorectal cancer (T1 CRC) has been vastly increasing. There are several major challenges in clinical management of this patient group, resulting in significant practice variations among physicians.

This online course covers the most relevant aspects of clinical management of T1 CRC patients, and provides an overview of latest insights and current knowledge gaps. To facilitate the learning process, several questions on real-life patient cases have been included in which learners can bring the acquired knowledge directly into practice.

Learning objectives

  • To systematically assess colorectal lesions and identify those suspicious for submucosally invasive (T1) cancer
  • To learn about local resection techniques for T1 colorectal cancer
  • To gain insight into histological assessment of local en bloc resection specimens of T1 colorectal cancer
  • To be aware of considerations from the oncological and patient perspective in therapeutic decision making after local treatment for T1 colorectal cancer

Target audience

This course is suitable for gastroenterologists, surgeons, pathologists, nurses and any other healthcare professionals interested in, or actively involved in clinical management of T1 CRC patients. 

This course was developed by Alexandra M.J. Langers, Jurjen J. Boonstra, James C.H. Hardwick, Richard (H.) Dang et al. in receipt of an Activity Grant from UEG.

Reviewed & updated December 2022

Event

Management of early-invasive (T1) colorectal cancer

Topics

Digestive Oncology

Accreditation status

accredited

Duration

1 hour

Published

2020

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UEG Podcast Episode
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Colorectal cancer in young patients with Michael Bretthauer

Michael Bretthauer, Egle Dieninyte - Misiune

Summary

AI Generated

Summary is not available for this content yet.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Topics

Digestive Oncology

Published

2026

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Panu Luukkonen Panu Luukkonen, Ville Männistö, Juho Asteljoki, Fredrik Åberg

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UEG Poster
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TREATMENT OF CHOLESTATIC PRURITUS IN PATIENTS WITH PRIMARY BILIARY CHOLANGITIS (PBC): BASELINE DATA FROM THE PHASE 2B GLIMMER TRIAL

Helen Smith 1, Sugato Das 2, Alexander Currie 3, Andrea Ribiero 4, andrew walker 1, Megan M. McLaughlin 5

Affiliations

1 GSK, London, United Kingdom

2 GSK, Hyderabad, India

3 GSK, Uxbridge, United Kingdom

4 GSK, Madrid, Spain

5 GSK, Collegeville, United States

Summary

AI Generated

Summary is not available for this content yet.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

GLIMMER (NCT02966834) was a Phase 2b study of the ileal bile acid transport (IBAT) inhibitor, linerixibat, for treatment of cholestatic pruritus in primary biliary cholangitis (PBC). The study included 147 patients: the largest trial in this population to date. GLIMMER had few restrictions on concomitant medications with the exceptions of other IBAT inhibitors, bile acid sequestrants and obeticholic acid; stable doses of other treatments were permitted.

Aims & Methods

In this analysis we explore the pruritus treatment history of patients entering GLIMMER. Investigators recorded details of prior and concomitant use of itch medications on the electronic case report form. For categorisation of prior and/or concomitant itch medication: prior only included patients who had tried and stopped at ≥1 pruritus medication before first study treatment and were not using anything else during treatment with linerixibat/placebo; concomitant only included patients who had used ≥1 pruritus medication in the past, which they continued to use during treatment; prior and concomitant included patients who had tried and stopped ≥1 pruritus medication prior to the study and, continued to use ≥1 pruritus medication during treatment with linerixibat/placebo. This post hoc analysis included all treatments prescribed for itch; guideline treatments were defined as bile acid sequestrants, naloxone, naltrexone, nalmefene, nalfurafine, sertraline, rifampicin or gabapentin. Pruritus severity was defined using worst itch numeric rating scale (NRS).

Results

At baseline, 24% of patients had mild (NRS <4), 52% moderate (NRS ≥4–<7) and 25% severe (NRS ≥7–10) pruritus. Mean age at baseline was 55.8 years but varied by itch severity, with mild patients being older (60.1 years) than those with moderate and severe pruritus (56.8 and 49.6 years, respectively). Median duration of pruritus at baseline was 6.3 years and those with mild pruritus tended to have a longer history than those with moderate or severe itch. Overall, a large proportion of patients were never previously treated: 37% (n = 55) had no prior/concomitant itch medications. Similar proportions of patients, 24% (n = 36) and 26% (n = 38), had received only prior itch medications or received prior and concomitant treatment for pruritus, respectively; 12% (n = 18) of patients were using only concomitant itch medications. Only 25% of patients were treated with cholestyramine, despite it being the guideline-recommended first-line therapy. Treatment history differed by baseline itch severity: 43% of mild patients had no prior or concomitant treatment versus 28% of severe patients. However, differences were less marked for concomitant pruritus therapy use: 43%, 36% and 39% of mild, moderate and severe patients, respectively, continued concomitant itch medicines in GLIMMER. The majority of concomitant itch treatments were non-guideline recommended, with only 39% receiving guideline treatments.

Conclusion

Consistent with the literature, increased itch severity is associated with younger age. Many patients do not receive treatment despite lengthy history of pruritus, while prior use of cholestyramine is limited despite its position in treatment guidelines.
Funding: GSK (201000).
Encore statement: This abstract was originally presented at the American Association for the Study of Liver Diseases (AASLD) The Liver Meeting on November 7, 2022, this encore is presented on behalf of the original authors with their permission.

Disclosure

HTS, AC, MMM, AJW and AR are employees of, and hold shares in GSK. SD is an employee of GSK.

Conference

UEG Week Copenhagen 2023

Topics

Hepatobiliary

Submission format

Abstract

Session

PP 07 Liver & biliary (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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SEQUENTIAL USE OF THE CLIVD SCORE AND FIB-4 IMPROVES THE PREDICTION OF LIVER-RELATED OUTCOMES AT A POPULATION LEVEL

Fredrik Åberg 1, Juho Asteljoki 2,3,1, Ville Männistö 4,5, Panu Luukkonen 2,3,1

Affiliations

1 Helsinki University Hospital, Helsinki, Finland

2 Minerva Foundation Institute for Medical Research, Helsinki, Finland

3 University of Helsinki, Helsinki, Finland

4 University of Eastern Finland, Kuopio, Finland

5 Kuopio University Hospital, Kuopio, Finland

Summary

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

The best risk-stratification strategy to predict liver-related outcomes (LROs) in the population remains unclear. The Chronic Liver Disease (CLivD) risk score was recently developed and validated to predict LROs in the population. It could thus identify the at-risk population that warrants liver fibrosis screening with non-invasive tests such as FIB-4. The ClivD score is based on age, sex, waist-hip ratio, alcohol use, smoking, diabetes, and gamma-glutamyltransferase measurement.

Aims & Methods

We investigated the combined/sequential use of the ClivD score and FIB-4 for stratifying the risk for LROs in the UK Biobank population.
From the UK Biobank data, we identified 362,330 individuals with no baseline liver disease and data available to calculate the CLivD score and FIB-4. LROs were ascertained through linkage with electronic healthcare registries for hospitalizations, cancers, and deaths related to compensated or decompensated liver cirrhosis or hepatocellular carcinoma. Discrimination performance was assessed by 10-year competing-risk area-under-the-curve (AUC) values and absolute cumulative risks by the cumulative incidence functions considering death without liver disease as a competing-risk event.

Results

Mean age was 56.6 years (SD 8.1), 48% were men, mean BMI 27.2 kg/m2 (SD 4.6), 5% had diabetes, mean alcohol intake was 16.7 g/week (SD 16.6), and 10% were current smokers.
During a median follow-up of 12.6 years (IQR 12.0-13.4), there were 1285 incident LROs. Both the CLivD score and FIB-4 were significantly associated with LROs (P<0.001). The 10-year AUC-value of the CLivD score was 0.80 (95% CI 0.80-0.80) and of FIB-4, 0.75 (95% CI 0.75-0.75) for the prediction of LROs. The predictive performance of FIB-4 improved as a function of increasing CLivD scores: 10-year AUC values of FIB-4 were 0.61 in the minimal-risk CLivD subgroup as compared to 0.81 in the high-risk CLivD subgroup (Table). This effect modification of CLivD for FIB-4’s discrimination performance was also evident for absolute risks. Namely, within the minimal-risk CLivD subgroup, 10-year cumulative incidences of LROs ranged from 0.05% to 0.3% between low and high FIB-4 strata (Table). In contrast, within the high-risk CLivD subgroup, 10-year cumulative incidences of LROs ranged from 1.7% to 21.6% between low and high FIB-4 strata.


Events / subjects10-yr AUC (95% CI) of FIB-4 for LROs10-yr risk for LROs
CLivD subgroup


Low FIB-4Intermediate FIB-4High FIB-4
Minimal risk
126 / 119,844
0.61 (0.61-0.62)
0.05%0.1%0.3%
Low risk
638 / 227,289
0.67 (0.67-0.67)
0.1%0.2%1.6%
Intermediate risk
179 / 10,936
0.74 (0.69-0.79)
0.5%1.5%7.3%
High risk
342 / 5,546
0.81 (0.79-0.84)
1.7%3.9%21.6%

Conclusion

Defining the at-risk population by the CLivD score markedly improves the predictive performance of FIB-4. Thus, sequential use of the CLivD score and FIB-4 emerges as a simple way to stratify the population regarding the risk for LRO.

Conference

UEG Week Copenhagen 2023

Topics

Hepatobiliary

Submission format

Abstract

Session

Prognosis and prediction in liver disease (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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EXPRESSION OF TRANSIENT RECEPTOR POTENTIAL ANKYRIN-1 IN THE COLONIC MUCOSA AND ITS CORRELATION TO SYMPTOM SEVERITY IN IRRITABLE BOWEL SYNDROME

Sylvester R. Groen 1,2, Daniel Keszthelyi 1,2, Ellen Wilms 1,2, Justin Huig 1,2, Pan Xu 1,2, Montserrat Elizalde 1,2, Lisa Vork 2,1, Daisy Mae Jonkers 1,2, Zsuzsanna Helyes 3,4, Ad A Masclee 1,2, Zsa Zsa Weerts 1,2

Affiliations

1 Maastricht University Medical Center, Maastricht, Netherlands

2 Maastricht University, Maastricht, Netherlands

3 University of Pécs, Pécs, Hungary

4 National Laboratory for Drug Research and Development, Budapest, Hungary

Summary

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Abstract

Introduction

Visceral hypersensitivity is a hallmark of irritable bowel syndrome (IBS). Transient receptor potential (TRP) channels are known as molecules involved in the pathogenesis of visceral hypersensitivity. A putative role for the Transient Receptor Potential Ankyrin 1 (TRPA1) channel in colonic nociceptor activation and mechanosensitation has been shown in animal studies. We hypothesize there is a correlation in TRPA1 mRNA expression and the symptom-severity in IBS patients.

Aims & Methods

The main objective of this study was to determine TRPA1 mRNA expression in the colonic mucosa and ascertain its correlation with symptom-severity in IBS patients. Second, difference in TRPA1 mRNA expression between IBS patients and healthy controls along with regional differences in TRPA1 mRNA expression was analyzed.
IBS patients (Rome III) and healthy controls were included. Sigmoid biopsies were obtained in all subjects. Additional biopsies of the proximal colon were obtained in 24/30 IBS patients. TRPA1 mRNA levels were measured in duplicate by quantitative reverse-transcriptase–polymerase-chain-reaction (Biorad), using primers from Biolegio and normalized to GAPDH. Levels of mRNA were expressed as relative mRNA values using the -2ΔCt method. A multivariate regression was utilized to compare mRNA-expression between IBS patients vs healthy controls. Symptoms in IBS patients were assessed using the Gastrointestinal Symptom Rating Scale (GSRS).

Results

30 IBS patients (median age 39.0 yrs, 80% female) and 23 healthy controls (median age 22.7 yrs, 43.5% female) were included. Relative TRPA1 mRNA expression in the sigmoid was significantly higher in IBS patients compared to healthy controls (P<0.001), independent of age and gender. There was no significant difference in relative TRPA1 mRNA expression between IBS subtypes (P>0.05). Within IBS patients expression of TRPA1 mRNA of sigmoid-biopsies was significantly higher compared to biopsies of the proximal colon (p<0.001). No significant correlation between TRPA1 expression in sigmoid or proximal colon in GSRS scales (n=27) was found.

Conclusion

In IBS patients relative TRPA1 mRNA expression in colonic biopsies is significantly elevated compared to healthy controls. Furthermore, relative TRPA1 mRNA expression is higher in sigmoid colonic biopsies than in proximal colonic biopsies of IBS patients. These findings suggest a potential for the TRPA1 pathway as a target for IBS treatment in the future. However, no correlation between TRPA1 mRNA expression and symptom severity was found. Therefore, further research towards the clinical relevance of the increased TRPA1 mRNA-expression in IBS-patients along with its location-specific expression is warranted.

Conference

UEG Week Vienna 2024

Topics

Colorectal

Submission format

Abstract

Session

Mechanisms and treatment of IBS (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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