mdedge.com/gihepnews February 2021 Volume 15 / Number 2 COVID-19 vaccines: INSIDE FROM THE AGA Are they safe for JOURNALS Pruritus in cholangiopathies immunocompromised Bezafibrate seems able AROLINA to help with “worst itch C possible.” • 6 ORTH patients? N OF BY ROXANNE NELSON, dose administration of the RN, BSN NIVERSITY /U MDedge News vaccine has been pegged Lessons in feeding at 95.0%, and the FDA has tubes TRICKLAND S - said that the 95% credible Training might not have RIAN covered it all. • 12 B Cality,oronavirus as they vaccines are interval for the vaccine Dr. Anne F. Peery, of University of North Carolina, Chapel Hill, have become a re clinicalefficacy trials,was 90.3%-97.6%. whether for recommends against surgery in certain patients. authorized for use in a But as with many initial GI ONCOLOGY growingnow being number approved of coun- and populations were repre- CRC in younger adults AGA Clinical Practice Update tries including the United senteddrugs or in vaccines, the trial cohort,not all Rates may be lower in adults under 50 than previously reported. • 15 Medical management of issuedStates. emergencyThe U.S. Food autho- and including individuals who rizationDrug Administration for the use of has the isare largely immunocompromised. unknown how ENDOSCOPY - As of December 2020, it- DOACs in elective colonic diverticulitis cine may be in this large procedures COVID-19 vaccine pro population,safe or effective many the of vacwhom It looks like they’re as BY AMY KARON duced by Pfizer and Bio- are at high risk for serious safe as vitamin K MDedge News NTech. Close behind was antagonists. • 22 diverticular stricture or - the vaccine developed of a two- by See Vaccines · page 19 new clinical practice toryfistula, bowel ischemic disease, colitis, Moderna. COVID-19 complications. update from the constipation, and, inflammaof the Uni- AGAThe efficacy Clinical Practice Update A - Anne F. Peery, MD, MSCR American Gastro - wroteversity in of North Carolina, How diet and exercise can help terologistsenterological with Association practical Chapel“In our Hill, practice, and associates patients seeks to provide gastroen are reassuredGastroenterology. to know that manage NAFLD for management of colonic ongoing symptoms are com- and evidence-based advice mon and often attributable BY AMY KARON tients with nonalcoholic - For example, clinicians MDedge News - shoulddiverticulitis. consider lower en- - FLD), according to a clin- progression,”fat, which provides wrote aZobair poten tionto visceral is particularly hypersensitivity,” import- xercise and a hypo- icalfatty practice liver disease update (NA from tial for reversal of disease they wrote. “This conversa Ecaloric, Mediterra- - - doscopy and CT scans of If needed, ongoing abdomi- nean-style diet remain M. Younossi, MD, MPH, of contrastthe abdomen to rule and out pelvis chronic nalant painafter cana negative be treated workup. with the“[W]eight American loss Gastroenter is associat- Inova Fairfax Medical Cam with oral and intravenous See Diverticulitis · page 5 - ological Association. pusSee in FallsDiet, Church, exercise Va., · page 6 first-line interventions with his associates. diverticular inflammation, that can benefit all pa ed with a reduction in liver At Digestive Disease Week® (DDW) 2021, now a fully virtual event, Centered you’ll explore today’s most pressing topics and exciting new on developments with leaders from around the globe in gastroenterology, Collaboration hepatology, endoscopy and gastrointestinal surgery. Rosemont, IL 60018 IL Rosemont, Suite 280 Suite 10255 W Higgins Road, Higgins W 10255 REGISTER ONLINE AT WWW.DDW.ORG/REGISTRATION. PERMIT 500 PERMIT CHANGE SERVICE REQUESTED SERVICE CHANGE HARRISBURG PA HARRISBURG PAID U.S. POSTAGE U.S. GI & Hepatology News Hepatology & GI PRSRT STD PRSRT May 21-23, 2021 | VIRTUAL 01_4 thru 9_19_20_GIHEP21_2.indd 1 1/22/2021 4:20:06 PM NEWS LETTER FROM THE EDITOR Finding common purpose, or else am composing this editorial 4 days after (Am J Gastroenterol. 2020 Jun;115[6]:916-23), the U.S. Capitol was invaded and 10 days among others, emphasized that mild GI symp- EWS Ibefore the presidential inauguration. It is toms may be the only presenting complaint for N impossible to ignore what is happening in our people with COVID-19. Responses to COVID-19, EDGE country, but I hesitate to add my thoughts to such as limits on elective procedures and social MD the overwhelming sea of opinions circulating distancing, have upended our endoscopic pro- in standard media, social media, and the dark cesses and even altered the business models of that infant mortality among African American web. I hope, as do many, that we return to a GI practice. We will never go back to pre-COVID women is 2.3 times that of non-Hispanic Whites models. (https://minorityhealth.hhs.gov/omh/browse. I hope, as do many, The front page of this month’s GI & Hepatol- aspx?lvl=4&lvlid=23). Late effects of redlining that we return to ogy News features important articles for our continue to cause economic, health, and emo- practice. One article delves into an extensive tional harms (Badger E. “How Redlining’s Rac- a civil discourse, guideline from the American Gastroenterological ist Effects Lasted for Decades.” The New York recognize the Association on medical management of colonic Times. 2017 Aug 24). diverticulitis. In another article, they also de- “If Men were angels, no government would be voices of all scribe how efforts to encourage our patients necessary,” James Madison wrote. “In framing a people, respect with nonalcoholic fatty liver disease to exercise government which is to be administered by men each other, and and manage their diet can make a real difference in their health. Finally, another explores how return to a belief in and why your immunocompromised patients governed;over men, theand great the next difficulty place, liesoblige in this:it to youcontrol science and facts. - itself.”must first enable the government to control the Dr. Allen ease) should and can be safely vaccinated for John I. Allen, MD, MBA, AGAF COVID-19(including .those with inflammatory bowel dis Editor in Chief civil discourse, recognize the voices of all peo- Meanwhile, we need civility, science, and com- ple, respect each other, and return to a belief in munity. Without common purpose, we will expe- science and facts. rience the William Forster Lloyd’s Tragedy of the Correction SARS-CoV-2 has devastated the world and Commons. Incivility has economic and emotional will continue to cause preventable deaths until costs, according to the Harvard Business Review The perspective for “Bariatric surgery re- we adopt stricter mitigation measures, vac- (Porath C and Pearson C. “The Price of Incivility.” solved NASH long term” that ran on pages cinate most people, and develop widespread 2013 Feb). “Weathering,” the deterioration of 4-5 of the October 2020 issue should read immunity. We are gaining immense knowledge Black women’s health over time that’s related “Cirrhosis regressed to F3 in two out of about this virus, and as gastroenterologists, we to continued socioeconomic disadvantage, has three patients” instead of “in two-thirds are on the front lines in many aspects. A recent multigenerational impacts; for example the De- of patients.” article in American Journal of Gastroenterology partment of Health & Human Services reports mdedge.com/gihepnews EDITOR IN CHIEF, GI & HEPATOLOGY NEWS GI & HEPATOLOGY NEWS is the official newspaper of the American FRONTLINE MEDICAL COMMUNICATIONS John I. Allen, MD, MBA, AGAF Gastroenterological Association (AGA) Institute and provides the gastroenterologist SOCIETY PARTNERS EDITOR IN CHIEF, THE NEW GASTROENTEROLOGIST with timely and relevant news and commentary about clinical developments Executive Editor Kathy Scarbeck, MA Vijaya L. Rao, MD and about the impact of health care policy. Content for GI & HEPATOLOGY NEWS Editor Christopher Palmer ASSOCIATE EDITORS is developed through a partnership of the newspaper’s medical board of editors Megan A. Adams, MD, JD, MSc (Editor in Chief and Associate Editors), Frontline Medical Communications Inc. Creative Director Louise A. 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