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How IBS Disrupts Daily Life: AGA Survey

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Sun, 08/24/2025 - 21:26

Despite more treatments and heightened awareness, Americans with irritable bowel syndrome (IBS) report worsening impacts on work, home, and social life compared with a decade ago. 

new survey from AGA, in partnership with The Harris Poll, revealed that IBS symptoms interfere with people’s lives an average of 19 days each month — about 11 days affecting work or school and 8 days curtailing personal activities. 

Missed work or school has climbed to 3.6 days per month from 2.1 days in 2015 — the last time the AGA released the “IBS in America” survey. And more patients report spending less time with family and friends because of their symptoms (58% now, up from 48% in 2015). 

The latest survey was conducted in fall 2024 among more than 2000 patients with IBS and 600 healthcare providers, including gastroenterologists, primary care physicians, and advanced practitioners.

 

Stark Realities of Life With IBS

Fewer patients in 2024 described their IBS symptoms as very or extremely bothersome (43%, compared to 62% in 2015), yet three quarters said it’s tough to manage their symptoms and most can’t accurately predict whether they will experience symptoms on a given day.

All this affects patients’ willingness or ability to make plans. More than three quarters (77%) said they avoid situations where bathroom access is limited, and nearly that many (72%) said their symptoms cause them to stay home more often.

About 7 in 10 patients said their IBS symptoms make them feel like they’re not “normal” or that their symptoms prevent them from reaching their full potential.

“The findings of this survey underscore the persistent challenges and impact IBS has on patients’ lives,” said Andrea Shin, MD, gastroenterologist with UCLA Health, Los Angeles, and AGA patient education advisor. 

Dr. Andrea Shin



“Despite progress in the medical community’s approach to diagnosing and managing IBS, patients continue to suffer significant disruptions to their personal and professional lives,” Shin noted. 

 

How Is IBS Treated?

Treatment options for IBS have evolved over the last decade or so and now include several FDA-approved agents, such as plecanatide (Trulance) and tenapanor (Ibsrela) for IBS with constipation (IBS-C) and rifaximin (Xifaxan) and eluxadoline (Viberzi) for IBS with diarrhea (IBS-D).

According to patients who have tried them, prescription medications are among the most helpful treatments (18% for IBS-C and 19% for IBS-D).

Yet, clinicians tend to prioritize fiber, nonprescription laxatives, and exercise for IBS-C, and diet changes, antidiarrheals, and probiotics for IBS-D, over prescription medications, the survey found. 

Nonetheless, about 78% of patients reported being satisfied with what they take for their symptoms, with about one quarter very satisfied.

Compared to 10 years ago, more physicians in the latest survey said effective relief of abdominal pain (49% vs 39%) or diarrhea/constipation (47% vs 33%) and the availability of treatment options (49% vs 34%) are what is most lacking in IBS treatment today, despite advancements in the IBS treatment landscape.

“IBS is a condition that continues to challenge patients to find a treatment that consistently works for them,” said Jeffrey Roberts, founder of the IBS Patient Support Group community and World IBS Day.

Mr. Jeffrey Roberts



“The AGA IBS in America Survey sheds light on patients who are still not being offered a variety of treatments that could provide them with a better quality of life. This continues to result in disruptions to their career, schooling, and life with their families and friends,” Roberts added.

A version of this article appeared on Medscape.com.

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Despite more treatments and heightened awareness, Americans with irritable bowel syndrome (IBS) report worsening impacts on work, home, and social life compared with a decade ago. 

new survey from AGA, in partnership with The Harris Poll, revealed that IBS symptoms interfere with people’s lives an average of 19 days each month — about 11 days affecting work or school and 8 days curtailing personal activities. 

Missed work or school has climbed to 3.6 days per month from 2.1 days in 2015 — the last time the AGA released the “IBS in America” survey. And more patients report spending less time with family and friends because of their symptoms (58% now, up from 48% in 2015). 

The latest survey was conducted in fall 2024 among more than 2000 patients with IBS and 600 healthcare providers, including gastroenterologists, primary care physicians, and advanced practitioners.

 

Stark Realities of Life With IBS

Fewer patients in 2024 described their IBS symptoms as very or extremely bothersome (43%, compared to 62% in 2015), yet three quarters said it’s tough to manage their symptoms and most can’t accurately predict whether they will experience symptoms on a given day.

All this affects patients’ willingness or ability to make plans. More than three quarters (77%) said they avoid situations where bathroom access is limited, and nearly that many (72%) said their symptoms cause them to stay home more often.

About 7 in 10 patients said their IBS symptoms make them feel like they’re not “normal” or that their symptoms prevent them from reaching their full potential.

“The findings of this survey underscore the persistent challenges and impact IBS has on patients’ lives,” said Andrea Shin, MD, gastroenterologist with UCLA Health, Los Angeles, and AGA patient education advisor. 

Dr. Andrea Shin



“Despite progress in the medical community’s approach to diagnosing and managing IBS, patients continue to suffer significant disruptions to their personal and professional lives,” Shin noted. 

 

How Is IBS Treated?

Treatment options for IBS have evolved over the last decade or so and now include several FDA-approved agents, such as plecanatide (Trulance) and tenapanor (Ibsrela) for IBS with constipation (IBS-C) and rifaximin (Xifaxan) and eluxadoline (Viberzi) for IBS with diarrhea (IBS-D).

According to patients who have tried them, prescription medications are among the most helpful treatments (18% for IBS-C and 19% for IBS-D).

Yet, clinicians tend to prioritize fiber, nonprescription laxatives, and exercise for IBS-C, and diet changes, antidiarrheals, and probiotics for IBS-D, over prescription medications, the survey found. 

Nonetheless, about 78% of patients reported being satisfied with what they take for their symptoms, with about one quarter very satisfied.

Compared to 10 years ago, more physicians in the latest survey said effective relief of abdominal pain (49% vs 39%) or diarrhea/constipation (47% vs 33%) and the availability of treatment options (49% vs 34%) are what is most lacking in IBS treatment today, despite advancements in the IBS treatment landscape.

“IBS is a condition that continues to challenge patients to find a treatment that consistently works for them,” said Jeffrey Roberts, founder of the IBS Patient Support Group community and World IBS Day.

Mr. Jeffrey Roberts



“The AGA IBS in America Survey sheds light on patients who are still not being offered a variety of treatments that could provide them with a better quality of life. This continues to result in disruptions to their career, schooling, and life with their families and friends,” Roberts added.

A version of this article appeared on Medscape.com.

Despite more treatments and heightened awareness, Americans with irritable bowel syndrome (IBS) report worsening impacts on work, home, and social life compared with a decade ago. 

new survey from AGA, in partnership with The Harris Poll, revealed that IBS symptoms interfere with people’s lives an average of 19 days each month — about 11 days affecting work or school and 8 days curtailing personal activities. 

Missed work or school has climbed to 3.6 days per month from 2.1 days in 2015 — the last time the AGA released the “IBS in America” survey. And more patients report spending less time with family and friends because of their symptoms (58% now, up from 48% in 2015). 

The latest survey was conducted in fall 2024 among more than 2000 patients with IBS and 600 healthcare providers, including gastroenterologists, primary care physicians, and advanced practitioners.

 

Stark Realities of Life With IBS

Fewer patients in 2024 described their IBS symptoms as very or extremely bothersome (43%, compared to 62% in 2015), yet three quarters said it’s tough to manage their symptoms and most can’t accurately predict whether they will experience symptoms on a given day.

All this affects patients’ willingness or ability to make plans. More than three quarters (77%) said they avoid situations where bathroom access is limited, and nearly that many (72%) said their symptoms cause them to stay home more often.

About 7 in 10 patients said their IBS symptoms make them feel like they’re not “normal” or that their symptoms prevent them from reaching their full potential.

“The findings of this survey underscore the persistent challenges and impact IBS has on patients’ lives,” said Andrea Shin, MD, gastroenterologist with UCLA Health, Los Angeles, and AGA patient education advisor. 

Dr. Andrea Shin



“Despite progress in the medical community’s approach to diagnosing and managing IBS, patients continue to suffer significant disruptions to their personal and professional lives,” Shin noted. 

 

How Is IBS Treated?

Treatment options for IBS have evolved over the last decade or so and now include several FDA-approved agents, such as plecanatide (Trulance) and tenapanor (Ibsrela) for IBS with constipation (IBS-C) and rifaximin (Xifaxan) and eluxadoline (Viberzi) for IBS with diarrhea (IBS-D).

According to patients who have tried them, prescription medications are among the most helpful treatments (18% for IBS-C and 19% for IBS-D).

Yet, clinicians tend to prioritize fiber, nonprescription laxatives, and exercise for IBS-C, and diet changes, antidiarrheals, and probiotics for IBS-D, over prescription medications, the survey found. 

Nonetheless, about 78% of patients reported being satisfied with what they take for their symptoms, with about one quarter very satisfied.

Compared to 10 years ago, more physicians in the latest survey said effective relief of abdominal pain (49% vs 39%) or diarrhea/constipation (47% vs 33%) and the availability of treatment options (49% vs 34%) are what is most lacking in IBS treatment today, despite advancements in the IBS treatment landscape.

“IBS is a condition that continues to challenge patients to find a treatment that consistently works for them,” said Jeffrey Roberts, founder of the IBS Patient Support Group community and World IBS Day.

Mr. Jeffrey Roberts



“The AGA IBS in America Survey sheds light on patients who are still not being offered a variety of treatments that could provide them with a better quality of life. This continues to result in disruptions to their career, schooling, and life with their families and friends,” Roberts added.

A version of this article appeared on Medscape.com.

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AGA Women’s Committee Outlines Roadmap Towards Gender Equity

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Despite the increasing number of women joining the field, GI remains one of the most male-dominated medical subspecialties. The AGA Women’s Committee has developed a comprehensive strategy to identify and address disparities and has highlighted future directions to achieve gender equality in GI.

The AGA Gender Equity Framework outlines six domains of action, the current state and desired future state: bias & gender disparities, leadership & career advancement, wellness & balance, retention & recruitment, mentorship & sponsorship, and recognition.

Based on the desired future state, the group created a roadmap towards gender equity with measurable tactics. Career development workshops, including the Women in GI regional workshops and Women’s Executive Leadership Conference, are both crucial tactics.



AGA outlined a few key areas for future gender equity efforts to focus on:

  • Clearer GI-specific transparency guidelines regarding recruitment, salary, promotions, funding, and leadership.
  • Pathway and research programs that help students from underrepresented backgrounds get involved and stay engaged in GI.
  • Support networks (through GI societies, institutions, or other organizations) that help women connect, collaborate, and grow their careers.

The AGA Women’s Committee, along with other AGA committees, will continue to work to achieve the vision laid out in the AGA Gender Equity Framework and Gender Equity Road Map.







 

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Despite the increasing number of women joining the field, GI remains one of the most male-dominated medical subspecialties. The AGA Women’s Committee has developed a comprehensive strategy to identify and address disparities and has highlighted future directions to achieve gender equality in GI.

The AGA Gender Equity Framework outlines six domains of action, the current state and desired future state: bias & gender disparities, leadership & career advancement, wellness & balance, retention & recruitment, mentorship & sponsorship, and recognition.

Based on the desired future state, the group created a roadmap towards gender equity with measurable tactics. Career development workshops, including the Women in GI regional workshops and Women’s Executive Leadership Conference, are both crucial tactics.



AGA outlined a few key areas for future gender equity efforts to focus on:

  • Clearer GI-specific transparency guidelines regarding recruitment, salary, promotions, funding, and leadership.
  • Pathway and research programs that help students from underrepresented backgrounds get involved and stay engaged in GI.
  • Support networks (through GI societies, institutions, or other organizations) that help women connect, collaborate, and grow their careers.

The AGA Women’s Committee, along with other AGA committees, will continue to work to achieve the vision laid out in the AGA Gender Equity Framework and Gender Equity Road Map.







 

Despite the increasing number of women joining the field, GI remains one of the most male-dominated medical subspecialties. The AGA Women’s Committee has developed a comprehensive strategy to identify and address disparities and has highlighted future directions to achieve gender equality in GI.

The AGA Gender Equity Framework outlines six domains of action, the current state and desired future state: bias & gender disparities, leadership & career advancement, wellness & balance, retention & recruitment, mentorship & sponsorship, and recognition.

Based on the desired future state, the group created a roadmap towards gender equity with measurable tactics. Career development workshops, including the Women in GI regional workshops and Women’s Executive Leadership Conference, are both crucial tactics.



AGA outlined a few key areas for future gender equity efforts to focus on:

  • Clearer GI-specific transparency guidelines regarding recruitment, salary, promotions, funding, and leadership.
  • Pathway and research programs that help students from underrepresented backgrounds get involved and stay engaged in GI.
  • Support networks (through GI societies, institutions, or other organizations) that help women connect, collaborate, and grow their careers.

The AGA Women’s Committee, along with other AGA committees, will continue to work to achieve the vision laid out in the AGA Gender Equity Framework and Gender Equity Road Map.







 

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Help Sustain GI Research

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Scientists are working hard to develop new treatments and therapies, and to discover cures to advance the field and better patient care. But they can’t do this without research funding.

A lack of funding can prevent talented individuals from pursuing a research career, thereby denying them the opportunity to conduct work that will ultimately benefit patients with critical needs.  

Donations to the AGA Research Foundation help support and fund investigators with a research grant in the field of gastroenterology and hepatology.

Treatment options for digestive diseases begin with rigorous research, but the limited funding available for physician-scientists to conduct research puts the field at risk of losing talented investigators.

As an AGA member, you have the power to make a difference. By increasing the number of talented women and men doing state-of-the-art research, you can help improve care for all patients suffering from digestive diseases.

Your gift to the AGA Research Foundation will catalyze discovery and career growth for a promising researcher in gastroenterology and hepatology. Please help us fund the next generation of GI researchers by donating today at https://foundation.gastro.org.







 

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Scientists are working hard to develop new treatments and therapies, and to discover cures to advance the field and better patient care. But they can’t do this without research funding.

A lack of funding can prevent talented individuals from pursuing a research career, thereby denying them the opportunity to conduct work that will ultimately benefit patients with critical needs.  

Donations to the AGA Research Foundation help support and fund investigators with a research grant in the field of gastroenterology and hepatology.

Treatment options for digestive diseases begin with rigorous research, but the limited funding available for physician-scientists to conduct research puts the field at risk of losing talented investigators.

As an AGA member, you have the power to make a difference. By increasing the number of talented women and men doing state-of-the-art research, you can help improve care for all patients suffering from digestive diseases.

Your gift to the AGA Research Foundation will catalyze discovery and career growth for a promising researcher in gastroenterology and hepatology. Please help us fund the next generation of GI researchers by donating today at https://foundation.gastro.org.







 

Scientists are working hard to develop new treatments and therapies, and to discover cures to advance the field and better patient care. But they can’t do this without research funding.

A lack of funding can prevent talented individuals from pursuing a research career, thereby denying them the opportunity to conduct work that will ultimately benefit patients with critical needs.  

Donations to the AGA Research Foundation help support and fund investigators with a research grant in the field of gastroenterology and hepatology.

Treatment options for digestive diseases begin with rigorous research, but the limited funding available for physician-scientists to conduct research puts the field at risk of losing talented investigators.

As an AGA member, you have the power to make a difference. By increasing the number of talented women and men doing state-of-the-art research, you can help improve care for all patients suffering from digestive diseases.

Your gift to the AGA Research Foundation will catalyze discovery and career growth for a promising researcher in gastroenterology and hepatology. Please help us fund the next generation of GI researchers by donating today at https://foundation.gastro.org.







 

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Hepatic Encephalopathy: Improve Diagnosis, Management, and Care

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Hepatic encephalopathy (HE) is no longer a rare complication – it’s an urgent clinical reality that’s a leading cause of hospitalization in patients with cirrhosis.1 HE can be deceptively subtle or profoundly severe, presenting with a wide clinical spectrum – from mild cognitive slowing to life-threatening coma. Without clear disease biomarkers, HE remains a diagnosis of exclusion, making it critical for clinicians to remain vigilant, especially in patients with chronic liver disease (CLD).

The incidence of CLD is climbing, fueled by rising rates of alcohol-associated liver disease, metabolic dysfunction-associated steatotic liver disease (MASLD), and hepatitis C, which is often undiagnosed. For example:

  • More than 2 million Americans had alcohol-associated cirrhosis as of 2017.2
  • Currently, 38% of all adults and 7–14% of children and adolescents have MASLD. By 2040, the MASLD prevalence rate for adults is projected to increase to more than 55%.3
  • The economic burden is staggering – from $1 billion4 in 2003 to over $7 billion5 in hospital costs for cirrhosis-related admissions today.

These figures aren’t just statistics – they represent a growing population of patients who are at risk of developing HE, sometimes without ever receiving a proper diagnosis or follow-up care.

Because HE mimics many other forms of neurological dysfunction – delirium, alcohol intoxication, diabetes-related confusion – it can be easy to miss or misdiagnose. But differentiating HE from other causes of altered mental status is critical, especially for patients who may ultimately require liver transplantation.6, 7

Moreover, patients frequently leave the hospital without adequate education or maintenance medication for episodic overt HE. Without coordinated follow-up between primary care, hepatology, and caregivers, these patients are at risk for recurrence.

To close these practice gaps, education is key. AGA’s course, “Missing the Mark: Hepatic Encephalopathy,” provides clinicians with up-to-date guidance on:

  • The changing epidemiology of cirrhosis and undiagnosed cirrhosis for patients with liver disease.
  • Assessment guidelines and best practices for HE diagnosis and management.
  • How to develop transition-of-care plans with patients, caretakers, and specialty providers after an initial HE diagnosis.

Take the course today: https://tinyurl.com/3muwhmj5

Don’t wait until HE is an emergency. Equip yourself with the tools to recognize it earlier, treat it effectively, and coordinate better care.

References

1. Wolf, DC. Hepatic Encephalopathy. Medscape. 2020 May 1. Retrieved from: https://emedicine.medscape.com/article/186101-overview

2. Singal AK, Mathurin P. Diagnosis and treatment of alcohol-associated liver disease A review. JAMA. 2021 Jul. doi:10.1001/jama.2021.7683.

3. Younossi ZM, et al. Epidemiology of metabolic dysfunction-associated steatotic liver disease. Clin Mol Hepatol. 2025 Feb. doi: 10.3350/cmh.2024.0431.

4. Vilstrup H, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014 Aug. doi: 10.1002/hep.27210.

5. Desai AP, et al. Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database. Clin Transl Gastroenterol. 2019 Jul. doi: 10.14309/ctg.0000000000000062.

6. Serper M, et al. Hepatic encephalopathy predicts early post-transplant cognitive and functional impairment: The Livcog cohort study. Hepatol Commun. 2025 Apr. doi: 10.1097/HC9.0000000000000696.

7. Montagnese S, Bajaj JS. Impact of Hepatic Encephalopathy in Cirrhosis on Quality-of-Life Issues. Drugs. 2019 Jan. doi: 10.1007/s40265-018-1019-y.

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Hepatic encephalopathy (HE) is no longer a rare complication – it’s an urgent clinical reality that’s a leading cause of hospitalization in patients with cirrhosis.1 HE can be deceptively subtle or profoundly severe, presenting with a wide clinical spectrum – from mild cognitive slowing to life-threatening coma. Without clear disease biomarkers, HE remains a diagnosis of exclusion, making it critical for clinicians to remain vigilant, especially in patients with chronic liver disease (CLD).

The incidence of CLD is climbing, fueled by rising rates of alcohol-associated liver disease, metabolic dysfunction-associated steatotic liver disease (MASLD), and hepatitis C, which is often undiagnosed. For example:

  • More than 2 million Americans had alcohol-associated cirrhosis as of 2017.2
  • Currently, 38% of all adults and 7–14% of children and adolescents have MASLD. By 2040, the MASLD prevalence rate for adults is projected to increase to more than 55%.3
  • The economic burden is staggering – from $1 billion4 in 2003 to over $7 billion5 in hospital costs for cirrhosis-related admissions today.

These figures aren’t just statistics – they represent a growing population of patients who are at risk of developing HE, sometimes without ever receiving a proper diagnosis or follow-up care.

Because HE mimics many other forms of neurological dysfunction – delirium, alcohol intoxication, diabetes-related confusion – it can be easy to miss or misdiagnose. But differentiating HE from other causes of altered mental status is critical, especially for patients who may ultimately require liver transplantation.6, 7

Moreover, patients frequently leave the hospital without adequate education or maintenance medication for episodic overt HE. Without coordinated follow-up between primary care, hepatology, and caregivers, these patients are at risk for recurrence.

To close these practice gaps, education is key. AGA’s course, “Missing the Mark: Hepatic Encephalopathy,” provides clinicians with up-to-date guidance on:

  • The changing epidemiology of cirrhosis and undiagnosed cirrhosis for patients with liver disease.
  • Assessment guidelines and best practices for HE diagnosis and management.
  • How to develop transition-of-care plans with patients, caretakers, and specialty providers after an initial HE diagnosis.

Take the course today: https://tinyurl.com/3muwhmj5

Don’t wait until HE is an emergency. Equip yourself with the tools to recognize it earlier, treat it effectively, and coordinate better care.

References

1. Wolf, DC. Hepatic Encephalopathy. Medscape. 2020 May 1. Retrieved from: https://emedicine.medscape.com/article/186101-overview

2. Singal AK, Mathurin P. Diagnosis and treatment of alcohol-associated liver disease A review. JAMA. 2021 Jul. doi:10.1001/jama.2021.7683.

3. Younossi ZM, et al. Epidemiology of metabolic dysfunction-associated steatotic liver disease. Clin Mol Hepatol. 2025 Feb. doi: 10.3350/cmh.2024.0431.

4. Vilstrup H, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014 Aug. doi: 10.1002/hep.27210.

5. Desai AP, et al. Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database. Clin Transl Gastroenterol. 2019 Jul. doi: 10.14309/ctg.0000000000000062.

6. Serper M, et al. Hepatic encephalopathy predicts early post-transplant cognitive and functional impairment: The Livcog cohort study. Hepatol Commun. 2025 Apr. doi: 10.1097/HC9.0000000000000696.

7. Montagnese S, Bajaj JS. Impact of Hepatic Encephalopathy in Cirrhosis on Quality-of-Life Issues. Drugs. 2019 Jan. doi: 10.1007/s40265-018-1019-y.

Hepatic encephalopathy (HE) is no longer a rare complication – it’s an urgent clinical reality that’s a leading cause of hospitalization in patients with cirrhosis.1 HE can be deceptively subtle or profoundly severe, presenting with a wide clinical spectrum – from mild cognitive slowing to life-threatening coma. Without clear disease biomarkers, HE remains a diagnosis of exclusion, making it critical for clinicians to remain vigilant, especially in patients with chronic liver disease (CLD).

The incidence of CLD is climbing, fueled by rising rates of alcohol-associated liver disease, metabolic dysfunction-associated steatotic liver disease (MASLD), and hepatitis C, which is often undiagnosed. For example:

  • More than 2 million Americans had alcohol-associated cirrhosis as of 2017.2
  • Currently, 38% of all adults and 7–14% of children and adolescents have MASLD. By 2040, the MASLD prevalence rate for adults is projected to increase to more than 55%.3
  • The economic burden is staggering – from $1 billion4 in 2003 to over $7 billion5 in hospital costs for cirrhosis-related admissions today.

These figures aren’t just statistics – they represent a growing population of patients who are at risk of developing HE, sometimes without ever receiving a proper diagnosis or follow-up care.

Because HE mimics many other forms of neurological dysfunction – delirium, alcohol intoxication, diabetes-related confusion – it can be easy to miss or misdiagnose. But differentiating HE from other causes of altered mental status is critical, especially for patients who may ultimately require liver transplantation.6, 7

Moreover, patients frequently leave the hospital without adequate education or maintenance medication for episodic overt HE. Without coordinated follow-up between primary care, hepatology, and caregivers, these patients are at risk for recurrence.

To close these practice gaps, education is key. AGA’s course, “Missing the Mark: Hepatic Encephalopathy,” provides clinicians with up-to-date guidance on:

  • The changing epidemiology of cirrhosis and undiagnosed cirrhosis for patients with liver disease.
  • Assessment guidelines and best practices for HE diagnosis and management.
  • How to develop transition-of-care plans with patients, caretakers, and specialty providers after an initial HE diagnosis.

Take the course today: https://tinyurl.com/3muwhmj5

Don’t wait until HE is an emergency. Equip yourself with the tools to recognize it earlier, treat it effectively, and coordinate better care.

References

1. Wolf, DC. Hepatic Encephalopathy. Medscape. 2020 May 1. Retrieved from: https://emedicine.medscape.com/article/186101-overview

2. Singal AK, Mathurin P. Diagnosis and treatment of alcohol-associated liver disease A review. JAMA. 2021 Jul. doi:10.1001/jama.2021.7683.

3. Younossi ZM, et al. Epidemiology of metabolic dysfunction-associated steatotic liver disease. Clin Mol Hepatol. 2025 Feb. doi: 10.3350/cmh.2024.0431.

4. Vilstrup H, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014 Aug. doi: 10.1002/hep.27210.

5. Desai AP, et al. Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database. Clin Transl Gastroenterol. 2019 Jul. doi: 10.14309/ctg.0000000000000062.

6. Serper M, et al. Hepatic encephalopathy predicts early post-transplant cognitive and functional impairment: The Livcog cohort study. Hepatol Commun. 2025 Apr. doi: 10.1097/HC9.0000000000000696.

7. Montagnese S, Bajaj JS. Impact of Hepatic Encephalopathy in Cirrhosis on Quality-of-Life Issues. Drugs. 2019 Jan. doi: 10.1007/s40265-018-1019-y.

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Simple Ways to Create Your Legacy

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Creating a legacy of giving is easier than you think. As the spring season begins, take some time to start creating your legacy while supporting the AGA Research Foundation.

Gifts to charitable organizations, such as the AGA Research Foundation, in your future plans ensure your support for our mission continues even after your lifetime. 

Here are two ideas to help you get started.

1. Name the AGA Research Foundation as a beneficiary. This arrangement is one of the most tax-smart ways to support the AGA Research Foundation after your lifetime. When you leave retirement plan assets to us, we bypass any taxes and receive the full amount.

2. Include the AGA Research Foundation in your will or living trust. This gift can be made by including as little as one sentence in your will or living trust. Plus, your gift can be modified throughout your lifetime as circumstances change.

Want to learn more about including a gift to the AGA Research Foundation in your future plans? Visit our website at https://foundation.gastro.org/gift-planning/.







 

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Creating a legacy of giving is easier than you think. As the spring season begins, take some time to start creating your legacy while supporting the AGA Research Foundation.

Gifts to charitable organizations, such as the AGA Research Foundation, in your future plans ensure your support for our mission continues even after your lifetime. 

Here are two ideas to help you get started.

1. Name the AGA Research Foundation as a beneficiary. This arrangement is one of the most tax-smart ways to support the AGA Research Foundation after your lifetime. When you leave retirement plan assets to us, we bypass any taxes and receive the full amount.

2. Include the AGA Research Foundation in your will or living trust. This gift can be made by including as little as one sentence in your will or living trust. Plus, your gift can be modified throughout your lifetime as circumstances change.

Want to learn more about including a gift to the AGA Research Foundation in your future plans? Visit our website at https://foundation.gastro.org/gift-planning/.







 

Creating a legacy of giving is easier than you think. As the spring season begins, take some time to start creating your legacy while supporting the AGA Research Foundation.

Gifts to charitable organizations, such as the AGA Research Foundation, in your future plans ensure your support for our mission continues even after your lifetime. 

Here are two ideas to help you get started.

1. Name the AGA Research Foundation as a beneficiary. This arrangement is one of the most tax-smart ways to support the AGA Research Foundation after your lifetime. When you leave retirement plan assets to us, we bypass any taxes and receive the full amount.

2. Include the AGA Research Foundation in your will or living trust. This gift can be made by including as little as one sentence in your will or living trust. Plus, your gift can be modified throughout your lifetime as circumstances change.

Want to learn more about including a gift to the AGA Research Foundation in your future plans? Visit our website at https://foundation.gastro.org/gift-planning/.







 

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Thu, 04/10/2025 - 09:33

Five Reasons to Update Your Will

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You have a will, so you can rest easy, right? Not necessarily. If your will is outdated, it can cause more harm than good.

Even though it can provide for some contingencies, an old will can’t cover every change that may have occurred since it was first drawn. Professionals advise that you review your will every few years and more often if situations such as the following five have occurred since you last updated your will. 

 

1. Family Changes

If you’ve had any changes in your family situation, you will probably need to update your will. Events such as marriage, divorce, death, birth, adoption, or a falling out with a loved one may affect how your estate will be distributed, who should act as guardian for your dependents, and who should be named as executor of your estate.

2. Relocating to a New State

The laws among the states vary. Moving to a new state or purchasing property in another state can affect your estate plan and how property in that state will be taxed and distributed.

3. Tax Law Changes

Federal and state legislatures are continually tinkering with federal estate and state inheritance tax laws. An old will may fail to take advantage of strategies that will minimize estate taxes.

4. You Want to Support a Favorite Cause

If you have developed a connection to a cause, you may want to benefit a particular charity with a gift in your estate. Contact us for sample language you can share with your attorney to include a gift to us in your will.

5. Changes in Your Estate’s Value

When you made your will, your assets may have been relatively modest. Now the value may be larger and your will no longer reflects how you would like your estate divided.



Consider including a gift to the AGA Research Foundation in your will. You will help spark future discoveries in GI. Visit our website at https://gastro.planmylegacy.org or contact us at [email protected].

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You have a will, so you can rest easy, right? Not necessarily. If your will is outdated, it can cause more harm than good.

Even though it can provide for some contingencies, an old will can’t cover every change that may have occurred since it was first drawn. Professionals advise that you review your will every few years and more often if situations such as the following five have occurred since you last updated your will. 

 

1. Family Changes

If you’ve had any changes in your family situation, you will probably need to update your will. Events such as marriage, divorce, death, birth, adoption, or a falling out with a loved one may affect how your estate will be distributed, who should act as guardian for your dependents, and who should be named as executor of your estate.

2. Relocating to a New State

The laws among the states vary. Moving to a new state or purchasing property in another state can affect your estate plan and how property in that state will be taxed and distributed.

3. Tax Law Changes

Federal and state legislatures are continually tinkering with federal estate and state inheritance tax laws. An old will may fail to take advantage of strategies that will minimize estate taxes.

4. You Want to Support a Favorite Cause

If you have developed a connection to a cause, you may want to benefit a particular charity with a gift in your estate. Contact us for sample language you can share with your attorney to include a gift to us in your will.

5. Changes in Your Estate’s Value

When you made your will, your assets may have been relatively modest. Now the value may be larger and your will no longer reflects how you would like your estate divided.



Consider including a gift to the AGA Research Foundation in your will. You will help spark future discoveries in GI. Visit our website at https://gastro.planmylegacy.org or contact us at [email protected].

You have a will, so you can rest easy, right? Not necessarily. If your will is outdated, it can cause more harm than good.

Even though it can provide for some contingencies, an old will can’t cover every change that may have occurred since it was first drawn. Professionals advise that you review your will every few years and more often if situations such as the following five have occurred since you last updated your will. 

 

1. Family Changes

If you’ve had any changes in your family situation, you will probably need to update your will. Events such as marriage, divorce, death, birth, adoption, or a falling out with a loved one may affect how your estate will be distributed, who should act as guardian for your dependents, and who should be named as executor of your estate.

2. Relocating to a New State

The laws among the states vary. Moving to a new state or purchasing property in another state can affect your estate plan and how property in that state will be taxed and distributed.

3. Tax Law Changes

Federal and state legislatures are continually tinkering with federal estate and state inheritance tax laws. An old will may fail to take advantage of strategies that will minimize estate taxes.

4. You Want to Support a Favorite Cause

If you have developed a connection to a cause, you may want to benefit a particular charity with a gift in your estate. Contact us for sample language you can share with your attorney to include a gift to us in your will.

5. Changes in Your Estate’s Value

When you made your will, your assets may have been relatively modest. Now the value may be larger and your will no longer reflects how you would like your estate divided.



Consider including a gift to the AGA Research Foundation in your will. You will help spark future discoveries in GI. Visit our website at https://gastro.planmylegacy.org or contact us at [email protected].

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Colorectal Cancer Awareness Month is Here!

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Mon, 03/03/2025 - 16:15

Happy Colorectal Cancer (CRC) Awareness Month! Today, CRC is the third-most common cancer in men and women in the United States. But there’s good news: We know that screening saves lives. That’s why we need to raise awareness about the importance of getting screened starting at age 45 all throughout the year, but especially during CRC Awareness Month.

We have a variety of resources for both physicians and patients to navigate the CRC screening process.

 

Clinical Guidance

AGA’s clinical guidelines and clinical practice updates provide evidence-based recommendations to guide your clinical practice decisions. Visit AGA’s new toolkit on CRC for the latest guidance on topics including colonoscopy follow-up, liquid biopsy, appropriate and tailored polypectomy, and more.

Patient Resources

AGA’s GI Patient Center can help your patients understand the need for CRC screening, colorectal cancer symptoms and risks, available screening tests, and the importance of preparing for a colonoscopy. Visit patient.gastro.org to access patient education materials.

Join the Conversation

We’ll be sharing resources and encouraging screenings on social media all month long. Join us as we remind everyone that 45 is the new 50.

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Happy Colorectal Cancer (CRC) Awareness Month! Today, CRC is the third-most common cancer in men and women in the United States. But there’s good news: We know that screening saves lives. That’s why we need to raise awareness about the importance of getting screened starting at age 45 all throughout the year, but especially during CRC Awareness Month.

We have a variety of resources for both physicians and patients to navigate the CRC screening process.

 

Clinical Guidance

AGA’s clinical guidelines and clinical practice updates provide evidence-based recommendations to guide your clinical practice decisions. Visit AGA’s new toolkit on CRC for the latest guidance on topics including colonoscopy follow-up, liquid biopsy, appropriate and tailored polypectomy, and more.

Patient Resources

AGA’s GI Patient Center can help your patients understand the need for CRC screening, colorectal cancer symptoms and risks, available screening tests, and the importance of preparing for a colonoscopy. Visit patient.gastro.org to access patient education materials.

Join the Conversation

We’ll be sharing resources and encouraging screenings on social media all month long. Join us as we remind everyone that 45 is the new 50.

Happy Colorectal Cancer (CRC) Awareness Month! Today, CRC is the third-most common cancer in men and women in the United States. But there’s good news: We know that screening saves lives. That’s why we need to raise awareness about the importance of getting screened starting at age 45 all throughout the year, but especially during CRC Awareness Month.

We have a variety of resources for both physicians and patients to navigate the CRC screening process.

 

Clinical Guidance

AGA’s clinical guidelines and clinical practice updates provide evidence-based recommendations to guide your clinical practice decisions. Visit AGA’s new toolkit on CRC for the latest guidance on topics including colonoscopy follow-up, liquid biopsy, appropriate and tailored polypectomy, and more.

Patient Resources

AGA’s GI Patient Center can help your patients understand the need for CRC screening, colorectal cancer symptoms and risks, available screening tests, and the importance of preparing for a colonoscopy. Visit patient.gastro.org to access patient education materials.

Join the Conversation

We’ll be sharing resources and encouraging screenings on social media all month long. Join us as we remind everyone that 45 is the new 50.

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AGA Research Foundation Memorial and Honorary Gifts: A Special Tribute

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Tue, 01/28/2025 - 09:19

Did you know you can honor a family member, friend, or colleague whose life has been touched by GI research through a gift to the AGA Research Foundation? Your gift will honor a loved one or yourself and support the AGA Research Awards Program, while giving you a tax benefit.

  • Giving now or later. Any charitable gift can be made in honor or memory of someone.
  • A gift today. An outright gift will help fund the AGA Research Awards Program. Your gift will assist in furthering basic digestive disease research which can ultimately advance research into all digestive diseases. The financial benefits include an income tax deduction and possible elimination of capital gains tax. A cash gift of $5,000 or more qualifies for membership in the AGA Supporter Circle.
  • A gift through your will or living trust. You can include a bequest in your will or living trust stating that a specific asset, certain dollar amount, or more commonly a percentage of your estate will pass to the AGA Research Foundation in honor of your loved one. A gift in your will of $50,000 or more qualifies for membership in the AGA Legacy Society, which recognizes the foundation’s most generous individual donors.
  • Named commentary section funds. You can support a commentary section in a specific AGA journal to honor or memorialize a loved one. This can be established with a gift of $100,000 over the course of 5 years or through an estate gift. The AGA Institute Publications Committee will work with you to provide name recognition for the commentary section in a specific AGA journal for 5 years. All content and editing will be conducted by the editorial board of the journal.

Your Next Step

An honorary gift is a wonderful way to acknowledge someone’s vision for the future. To learn more about ways to recognize your honoree, visit our website at www.foundation.gastro.org.

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Did you know you can honor a family member, friend, or colleague whose life has been touched by GI research through a gift to the AGA Research Foundation? Your gift will honor a loved one or yourself and support the AGA Research Awards Program, while giving you a tax benefit.

  • Giving now or later. Any charitable gift can be made in honor or memory of someone.
  • A gift today. An outright gift will help fund the AGA Research Awards Program. Your gift will assist in furthering basic digestive disease research which can ultimately advance research into all digestive diseases. The financial benefits include an income tax deduction and possible elimination of capital gains tax. A cash gift of $5,000 or more qualifies for membership in the AGA Supporter Circle.
  • A gift through your will or living trust. You can include a bequest in your will or living trust stating that a specific asset, certain dollar amount, or more commonly a percentage of your estate will pass to the AGA Research Foundation in honor of your loved one. A gift in your will of $50,000 or more qualifies for membership in the AGA Legacy Society, which recognizes the foundation’s most generous individual donors.
  • Named commentary section funds. You can support a commentary section in a specific AGA journal to honor or memorialize a loved one. This can be established with a gift of $100,000 over the course of 5 years or through an estate gift. The AGA Institute Publications Committee will work with you to provide name recognition for the commentary section in a specific AGA journal for 5 years. All content and editing will be conducted by the editorial board of the journal.

Your Next Step

An honorary gift is a wonderful way to acknowledge someone’s vision for the future. To learn more about ways to recognize your honoree, visit our website at www.foundation.gastro.org.

Did you know you can honor a family member, friend, or colleague whose life has been touched by GI research through a gift to the AGA Research Foundation? Your gift will honor a loved one or yourself and support the AGA Research Awards Program, while giving you a tax benefit.

  • Giving now or later. Any charitable gift can be made in honor or memory of someone.
  • A gift today. An outright gift will help fund the AGA Research Awards Program. Your gift will assist in furthering basic digestive disease research which can ultimately advance research into all digestive diseases. The financial benefits include an income tax deduction and possible elimination of capital gains tax. A cash gift of $5,000 or more qualifies for membership in the AGA Supporter Circle.
  • A gift through your will or living trust. You can include a bequest in your will or living trust stating that a specific asset, certain dollar amount, or more commonly a percentage of your estate will pass to the AGA Research Foundation in honor of your loved one. A gift in your will of $50,000 or more qualifies for membership in the AGA Legacy Society, which recognizes the foundation’s most generous individual donors.
  • Named commentary section funds. You can support a commentary section in a specific AGA journal to honor or memorialize a loved one. This can be established with a gift of $100,000 over the course of 5 years or through an estate gift. The AGA Institute Publications Committee will work with you to provide name recognition for the commentary section in a specific AGA journal for 5 years. All content and editing will be conducted by the editorial board of the journal.

Your Next Step

An honorary gift is a wonderful way to acknowledge someone’s vision for the future. To learn more about ways to recognize your honoree, visit our website at www.foundation.gastro.org.

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AGA Legacy Society Members Sustain GI Research

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Wed, 01/08/2025 - 15:18

Research creates successful practices. Patients benefit from GI research daily in practices. Scientists are working hard to develop new treatments and therapies, and to discover cures to advance the field and better patient care. But they can’t do this without research funding.

AGA Legacy Society members have answered this call for support. They recognize the value that research has had in their profession, both in academic medicine and in private practice, and are showing their appreciation by giving back.

Dr. Michael Camilleri

“I donated to the AGA Research Foundation to ensure the vitality of our specialty, and to fund the research of future generations of gastroenterologists,” said Michael Camilleri, MD, AGAF, of Mayo Clinic, Rochester, Minn., and an AGA Legacy Society member who currently serves as AGA Research Foundation Chair. “Funding from organizations like the AGA Research Foundation is crucial for young scientists and gastroenterologists to launch their careers. At the start of my career, I received two AGA research awards. As a grateful recipient of such funding, I felt it was my turn to support the mission of the organization that I regard as my academic home away from home institution.”

AGA Legacy Society members see the promise the future holds and are committed to furthering research in gastroenterology and hepatology through their generous donations. 

AGA members who make gifts at the AGA Legacy Society level any time before Digestive Disease Week® (DDW) 2025 will receive an invitation to the AGA Research Foundation Benefactor’s Event in San Diego, California. Interested in learning more about the AGA Legacy Society membership? Contact [email protected] or visit https://foundation.gastro.org/our-donors/aga-legacy-society/ for more information about the AGA Legacy Society.







 

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Research creates successful practices. Patients benefit from GI research daily in practices. Scientists are working hard to develop new treatments and therapies, and to discover cures to advance the field and better patient care. But they can’t do this without research funding.

AGA Legacy Society members have answered this call for support. They recognize the value that research has had in their profession, both in academic medicine and in private practice, and are showing their appreciation by giving back.

Dr. Michael Camilleri

“I donated to the AGA Research Foundation to ensure the vitality of our specialty, and to fund the research of future generations of gastroenterologists,” said Michael Camilleri, MD, AGAF, of Mayo Clinic, Rochester, Minn., and an AGA Legacy Society member who currently serves as AGA Research Foundation Chair. “Funding from organizations like the AGA Research Foundation is crucial for young scientists and gastroenterologists to launch their careers. At the start of my career, I received two AGA research awards. As a grateful recipient of such funding, I felt it was my turn to support the mission of the organization that I regard as my academic home away from home institution.”

AGA Legacy Society members see the promise the future holds and are committed to furthering research in gastroenterology and hepatology through their generous donations. 

AGA members who make gifts at the AGA Legacy Society level any time before Digestive Disease Week® (DDW) 2025 will receive an invitation to the AGA Research Foundation Benefactor’s Event in San Diego, California. Interested in learning more about the AGA Legacy Society membership? Contact [email protected] or visit https://foundation.gastro.org/our-donors/aga-legacy-society/ for more information about the AGA Legacy Society.







 

Research creates successful practices. Patients benefit from GI research daily in practices. Scientists are working hard to develop new treatments and therapies, and to discover cures to advance the field and better patient care. But they can’t do this without research funding.

AGA Legacy Society members have answered this call for support. They recognize the value that research has had in their profession, both in academic medicine and in private practice, and are showing their appreciation by giving back.

Dr. Michael Camilleri

“I donated to the AGA Research Foundation to ensure the vitality of our specialty, and to fund the research of future generations of gastroenterologists,” said Michael Camilleri, MD, AGAF, of Mayo Clinic, Rochester, Minn., and an AGA Legacy Society member who currently serves as AGA Research Foundation Chair. “Funding from organizations like the AGA Research Foundation is crucial for young scientists and gastroenterologists to launch their careers. At the start of my career, I received two AGA research awards. As a grateful recipient of such funding, I felt it was my turn to support the mission of the organization that I regard as my academic home away from home institution.”

AGA Legacy Society members see the promise the future holds and are committed to furthering research in gastroenterology and hepatology through their generous donations. 

AGA members who make gifts at the AGA Legacy Society level any time before Digestive Disease Week® (DDW) 2025 will receive an invitation to the AGA Research Foundation Benefactor’s Event in San Diego, California. Interested in learning more about the AGA Legacy Society membership? Contact [email protected] or visit https://foundation.gastro.org/our-donors/aga-legacy-society/ for more information about the AGA Legacy Society.







 

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DDSEP Plus Can Help You Achieve Your Educational Goals

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Wed, 11/27/2024 - 03:11

Whether you’re gearing up for an ABIM exam or quarterly check-in test, or just updating your knowledge to provide exceptional care, DDSEP Plus is here to support your educational needs.

Challenge yourself with these practice questions! This is just a sample of the nearly 900 questions available with an annual DDSEP Plus subscription. AGA member trainees receive a discounted subscription.

Purchase a subscription to continue learning.

 

Practice Question #1

A 45-year-old woman diagnosed with irritable bowel syndrome with diarrhea presents to your clinic. Her diarrhea is well controlled with loperamide, but her abdominal pain persists.

Her primary care provider previously prescribed dicyclomine, but this did not improve her abdominal pain symptoms.

What is the next best medication to treat her abdominal pain?

A. Amitriptyline

B. Codeine/acetaminophen

C. Hydrocodone

D. Meloxicam

Correct answer:

A. Amitriptyline

Commentary:

Amitriptyline is a tricyclic antidepressant medication that functions as a central neuromodulator. A systematic review of randomized controlled trials of 6-12 weeks’ duration showed a modest improvement in global symptom relief and abdominal pain in patients with IBS treated with tricyclic anti-depressants. Opioid medications and nonsteroidal anti-inflammatory medications are not recommended to treat abdominal pain in patients with IBS.

Practice Question #2

A 52-year-old man with hypertension and diabetes mellitus type 2 is referred to you for 8 months of troublesome regurgitation and heartburn. He has a body mass index of 29 kg/m2.

He had minimal relief with single-dose proton pump inhibitor (PPI) therapy before breakfast and partial response with double-dose PPI therapy taken before breakfast and before dinner. Regurgitation after dinner and at bedtime is his most troublesome symptom.

What is the next best step in management?

A. Counsel on weight management

B. Increase PPI to quadruple dose

C. Perform gastric emptying study

D. Refer for bariatric surgery evaluation

E. Switch PPI to before bedtime

Correct answer:

A. Counsel on weight management

Commentary:

This presentation represents typical symptoms of gastroesophageal reflux disease that are not responsive to an optimized regimen of PPI therapy.

Management of refractory gastroesophageal reflux disease symptoms begins with optimizing lifestyle and weight loss. 

Quadruple-dose PPI therapy has no established role. A gastric emptying study would be recommended if gastroparesis was suspected. 

This patient does not meet criteria for bariatric surgery as his body mass index is less than 30 kg/m2

PPI therapy optimization with before-meal dosing (30-60 min before breakfast for single-dose therapy and before breakfast and dinner for double-dose therapy) would be the next step after weight management.







 

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Whether you’re gearing up for an ABIM exam or quarterly check-in test, or just updating your knowledge to provide exceptional care, DDSEP Plus is here to support your educational needs.

Challenge yourself with these practice questions! This is just a sample of the nearly 900 questions available with an annual DDSEP Plus subscription. AGA member trainees receive a discounted subscription.

Purchase a subscription to continue learning.

 

Practice Question #1

A 45-year-old woman diagnosed with irritable bowel syndrome with diarrhea presents to your clinic. Her diarrhea is well controlled with loperamide, but her abdominal pain persists.

Her primary care provider previously prescribed dicyclomine, but this did not improve her abdominal pain symptoms.

What is the next best medication to treat her abdominal pain?

A. Amitriptyline

B. Codeine/acetaminophen

C. Hydrocodone

D. Meloxicam

Correct answer:

A. Amitriptyline

Commentary:

Amitriptyline is a tricyclic antidepressant medication that functions as a central neuromodulator. A systematic review of randomized controlled trials of 6-12 weeks’ duration showed a modest improvement in global symptom relief and abdominal pain in patients with IBS treated with tricyclic anti-depressants. Opioid medications and nonsteroidal anti-inflammatory medications are not recommended to treat abdominal pain in patients with IBS.

Practice Question #2

A 52-year-old man with hypertension and diabetes mellitus type 2 is referred to you for 8 months of troublesome regurgitation and heartburn. He has a body mass index of 29 kg/m2.

He had minimal relief with single-dose proton pump inhibitor (PPI) therapy before breakfast and partial response with double-dose PPI therapy taken before breakfast and before dinner. Regurgitation after dinner and at bedtime is his most troublesome symptom.

What is the next best step in management?

A. Counsel on weight management

B. Increase PPI to quadruple dose

C. Perform gastric emptying study

D. Refer for bariatric surgery evaluation

E. Switch PPI to before bedtime

Correct answer:

A. Counsel on weight management

Commentary:

This presentation represents typical symptoms of gastroesophageal reflux disease that are not responsive to an optimized regimen of PPI therapy.

Management of refractory gastroesophageal reflux disease symptoms begins with optimizing lifestyle and weight loss. 

Quadruple-dose PPI therapy has no established role. A gastric emptying study would be recommended if gastroparesis was suspected. 

This patient does not meet criteria for bariatric surgery as his body mass index is less than 30 kg/m2

PPI therapy optimization with before-meal dosing (30-60 min before breakfast for single-dose therapy and before breakfast and dinner for double-dose therapy) would be the next step after weight management.







 

Whether you’re gearing up for an ABIM exam or quarterly check-in test, or just updating your knowledge to provide exceptional care, DDSEP Plus is here to support your educational needs.

Challenge yourself with these practice questions! This is just a sample of the nearly 900 questions available with an annual DDSEP Plus subscription. AGA member trainees receive a discounted subscription.

Purchase a subscription to continue learning.

 

Practice Question #1

A 45-year-old woman diagnosed with irritable bowel syndrome with diarrhea presents to your clinic. Her diarrhea is well controlled with loperamide, but her abdominal pain persists.

Her primary care provider previously prescribed dicyclomine, but this did not improve her abdominal pain symptoms.

What is the next best medication to treat her abdominal pain?

A. Amitriptyline

B. Codeine/acetaminophen

C. Hydrocodone

D. Meloxicam

Correct answer:

A. Amitriptyline

Commentary:

Amitriptyline is a tricyclic antidepressant medication that functions as a central neuromodulator. A systematic review of randomized controlled trials of 6-12 weeks’ duration showed a modest improvement in global symptom relief and abdominal pain in patients with IBS treated with tricyclic anti-depressants. Opioid medications and nonsteroidal anti-inflammatory medications are not recommended to treat abdominal pain in patients with IBS.

Practice Question #2

A 52-year-old man with hypertension and diabetes mellitus type 2 is referred to you for 8 months of troublesome regurgitation and heartburn. He has a body mass index of 29 kg/m2.

He had minimal relief with single-dose proton pump inhibitor (PPI) therapy before breakfast and partial response with double-dose PPI therapy taken before breakfast and before dinner. Regurgitation after dinner and at bedtime is his most troublesome symptom.

What is the next best step in management?

A. Counsel on weight management

B. Increase PPI to quadruple dose

C. Perform gastric emptying study

D. Refer for bariatric surgery evaluation

E. Switch PPI to before bedtime

Correct answer:

A. Counsel on weight management

Commentary:

This presentation represents typical symptoms of gastroesophageal reflux disease that are not responsive to an optimized regimen of PPI therapy.

Management of refractory gastroesophageal reflux disease symptoms begins with optimizing lifestyle and weight loss. 

Quadruple-dose PPI therapy has no established role. A gastric emptying study would be recommended if gastroparesis was suspected. 

This patient does not meet criteria for bariatric surgery as his body mass index is less than 30 kg/m2

PPI therapy optimization with before-meal dosing (30-60 min before breakfast for single-dose therapy and before breakfast and dinner for double-dose therapy) would be the next step after weight management.







 

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