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Gastroenterology

The Gastroenterology Conference is moderated by Gary M. Gray, M.D., Professor of Medicine (Gastroenterology) Emeritus at the Stanford University School of Medicine.

This conference may include discussion of commercial products and services.

The opinions expressed herein are those of the authors and do not necessarily represent the views of the sponsor or its publisher. Please review complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

GI Manifestations of Covid-19

The coronavirus disease-2019 (COVID-19), the clinical name of the new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection that originated in the city of Wuhan, province of Hubei in China, in December 2019, was declared a pandemic by the World Health Organization on March 11, 2020. At the beginning of May 2020, the Centers for Disease Control and Prevention (CDC) in the United States recognized the presence of ??oegastrointestinal symptoms, like nausea, vomiting and diarrhea, as less common symptoms??? of
Authors: Max Schmulson, M.D., R.F.F.
Estimated Time: 1 Hour
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Gary M. Gray, M.D.

Gastroenterology

Dr. Gary M. Gray, Cyberounds® Gastroenterology Moderator, is Professor of Medicine and Director, NIH Digestive Disease Center, Stanford University School of Medicine, where he previously served as division chief for many years. Dr. Gray received his B.S. in chemistry and mathematics with honors from Seattle University, his M.D. from the University of Washington, and completed his postgraduate medical training at Bellevue(Cornell), University Hospitals, Cleveland, and Boston University, where he was a gastroenterology fellow under Dr. F.J. Ingelfinger. Board certified in internal medicine, he is the author of more than 140 peer-reviewed articles and textbook chapters, and has been the major contributor to the gastroenterology sections in Scientific American Medicine. Formerly on the editorial board of Gastroenterology and Viewpoints on Gastroenterology, and the American Gastroenterological Association's governing board, Gary has been a visiting professor at many universities, including Harvard, Yale, University of Florida, University of Michigan, and Yamagata, Tohoku and Keio in Japan. His medical research focuses on intestinal function, particularly the molecular events involved in the regulation and modulation of the intestinal disaccharidases, lactase and sucrase.

Dr. Gray reports no commercial conflict of interest.

Last Update: 2/21/2021

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Treatment of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide and one of the leading causes of death in patients with cirrhosis. Despite improvements in treatment, patients with HCC continue to have a dismal prognosis, with 5-year survival rates of only 18%. This poor survival is related to under-recognition of at-risk patients and under-utilization of surveillance, with nearly two-thirds of tumors being diagnosed at advanced stages. Further, there is underuse of treatment in many
Authors: Brian C. Davis, M.D., and Amit G. Singal, M.D., M.S.
Estimated Time: 1 Hour
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Pancreatic Adenocarcinoma

Although the 10th most common cause of cancer in the United States, pancreatic cancer continues to far outpace its incidence rate with respect to mortality. In 2011, an estimated 37,660 patients died of pancreatic cancer, making it the fourth most common cause of cancer death in men and women. The incidence and mortality rates have unfortunately remained almost unchanged for the past several decades. The majority of these tumors (85%) are adenocarcinomas arising from the ductal epithelium. In this presentation
Authors: Parvin Peddi, M.D., and Andrea Wang-Gillam, M.D.
Estimated Time: 1 Hour
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The Indigenous Gastrointestinal Microbiota in Health and Disease

The gastrointestinal tract of mammals is inhabited by a complex microbial community. This community of microbes, referred to as the microbiota, has gained increased prominence of late. The traditional view of the microbiota regarded them as “commensal,” merely organisms that had found a ready source of food but did not contribute anything of value to their host. More recently, however, evidence has emerged that suggests that the microbiota can play key roles both in maintenance of health as well as
Authors: John Y. Kao, M.D., Nirmal Kaur, M.D., and Vincent B. Young M.D., Ph.D.
Estimated Time: 1 Hour
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Liver Fibrosis: New Mechanisms, New Treatments, and Why They Matter

Dr. Wells will discuss the unapproved use of Fibroscan® and MR elastography. Liver fibrosis, like pathological fibrosis in other organs, has been termed "wound healing gone bad." Simply defined, it is the deposition of abnormal extracellular matrix (ECM) - scar tissue - in the chronically injured liver. The distribution of abnormal matrix can vary from periportal to pericentral. Similarly, the etiology of the chronic injury varies and can include chronic viral hepatitis (hepatitis B and C), alcohol abuse, non-alcoholic fatty liver
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Estimated Time: 1 Hour
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Chronic Pancreatitis: Diagnosis and Management

By far the most common etiology of chronic pancreatitis is alcohol abuse, estimated to cause 60-90% of the cases (Figure 1). Approximately 20% of the cases are classified as idiopathic. About 10% of the cases are caused by hereditary pancreatitis (a disorder resulting from mutations in trypsinogen), cystic fibrosis, hyperparathyroidism, hypertriglyceridemia, obstruction of the pancreatic duct, pancreatic divisum (a congenital abnormality of fusion of the ducts of the embryological ventral and dorsal pancreas), trauma, tropical pancreatitis and autoimmune pancreatitis. The
Authors: Stephen Pandol, M.D., and Hartley Cohen, M.D.
Estimated Time: 1 Hour
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Acute Pancreatitis: Diagnosis and Management

Acute pancreatitis is a disorder primarily of the exocrine pancreas involving varying degrees of acute inflammation and parenchymal injury of the gland. In its most severe forms, there is a widespread inflammatory response involving organs both adjacent and distant from the pancreas; and the parenchymal injury is manifest as necrosis of pancreatic tissue. The clinical syndrome resulting from an episode of acute pancreatitis includes the rapid onset of abdominal pain with variable abdominal findings ranging from mild tenderness to peritoneal
Authors: Stephen J. Pandol M.D.
Estimated Time: 1 Hour
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