Integrating Gastrointestinal Bleeding Risk Scores into Clinical Practice No abstract available

Chronic Nausea and Vomiting: Sifting Through the Smoke and Weed No abstract available

A Rare Complication of Colonoscopy: Iatrogenic Right Inguinal Hernia of the Ascending Colon No abstract available

Immunotherapy-Associated Pseudomembranous Colitis No abstract available

Endoscopic Ultrasonography–Guided Radiofrequency Ablation for a Perianastomotic Neoplastic Colorectal Recurrence No abstract available

Continuing Medical Education Questions: November 2019 Article Title: Morbidity and Mortality Following Surgery for Non-Malignant Colorectal Polyps: A 10-Year Nationwide Analysis

Continuing Medical Education Questions: November 2019 Article Title: Opioid-Induced Foregut Dysfunction

The Growing Challenge of Advanced Liver Disease Due to Alcohol Use in the United States Through detailed analyses of the National Health and Nutrition Examination Survey, the Nationwide Inpatient Sample, and the United Network for Organ Sharing registry, the authors provide a view of the epidemiology of the spectrum of alcohol liver disease (ALD) in the United States. Although the prevalence of ALD among the general population has been relatively stable at 8%, over the last decade, there has been an increase in ALD with advanced fibrosis, including increased hospitalizations for liver cirrhosis and its complications, and an increase in ALD as a cause for liver transplant listing, as well as a greater proportion of liver cancer cases associated with ALD.

The Impact of Obesity and Type 2 Diabetes on Chronic Liver Disease The growing global epidemic of obesity and type 2 diabetes mellitus (T2DM) has led to the increasing prevalence of nonalcoholic fatty liver disease. In addition, the presence of obesity and T2DM has been shown to increase the likelihood of adverse outcomes in patients with chronic liver disease. In a study by Harris et al., a combination of obesity and T2DM was associated with an increased risk for higher liver stiffness, as measured by transient elastography. It is possible that public health and clinical intervention targeting these components of metabolic syndrome can lead to improved outcomes of subjects with nonalcoholic fatty liver disease and other chronic liver diseases.

Opioid-Induced Foregut Dysfunction The impact of opioid use on the lower gastrointestinal tract is well described, but recent opioid crisis has caused increased awareness of the detrimental effects of these drugs on esophageal and gastroduodenal motility. Opioid use has been associated with increased incidence of spastic esophageal motility disorders and gastroduodenal dysfunction. Opioid receptors are present with high abundance in the myenteric and submucosal plexus of the enteric nervous system. Activation of these receptors leads to suppressed excitability of the inhibitory musculomotor neurons and unchecked tonic contraction of the autogenic musculature (such as the lower esophageal sphincter and the pylorus).