How safe and effective are COVID-19 vaccines in patients with inflammatory bowel disease (IBD)? This timely question is explored in a review article in this month’s issue of Gastroenterology & Hepatology. As Ms Emily Spiera, Dr Ryan C. Ungaro, and Dr Asher Kornbluth note, the first studies on the safety and efficacy of COVID-19 vaccines did not include patients with immune-mediated conditions and patients on immunosuppressive therapy, including those with IBD. In our review article, the authors examine the research released to date on COVID-19 vaccines in patients who have IBD, as well as on whether IBD medications impact the effectiveness of these vaccines. The authors also review the current recommendations for patients with IBD and attitudes toward vaccination.
Our other review article this month highlights endoscopic mucosal resection (EMR). This technique can be used to remove sessile or flat lesions throughout the gastrointestinal tract, but its most common indication involves removing large colorectal polyps. Dr Sushrut Sujan Thiruvengadam, Dr Brian M. Fung, Dr Monique T. Barakat, and Dr James H. Tabibian review the assessment of polyps to determine whether EMR is feasible and when referral to an advanced endoscopist is appropriate. In addition, they examine hot-snare EMR, cold-snare EMR, and underwater EMR, along with recent research on these techniques. They also review EMR outcomes such as bleeding, perforation, and postpolypectomy coagulation syndrome, and note the importance of postprocedural surveillance.
Our Advances in Hepatology column highlights emerging immunomodulatory and antiviral therapies for patients who are infected with hepatitis B virus (HBV). Dr Adam J. Gehring discusses the difficulty of achieving HBV cure, the rationale for trying an immunomodulatory strategy, and lessons from earlier antiviral HBV therapies. He also provides an overview of the immunomodulatory and antiviral drugs currently in development for the treatment of HBV infection, and reviews related issues.
Fecal incontinence is the focus of our Advances in IBS column. Dr Satish S. C. Rao discusses the prevalence of this condition in adults, the importance of physician-patient communication, the main risk factors, initial evaluation of patients, and the various treatments currently available. He also points out a number of treatments in development, along with other important topics involving this common condition.
Finally, the relationship between the gut microbiome and nonalcoholic steatohepatitis (NASH) is examined in our NASH in Focus column. Among other issues, Dr Jörn M. Schattenberg discusses what is meant by a healthy microbiome, the gut microbiome’s role in the development of NASH, how the gut microbiome compares between lean and obese NASH patients, and the current data on the modulation of the gut microbiome for the treatment of NASH patients.
May this issue provide you with helpful information that you can put to good use in your clinical practice.
Gary R. Lichtenstein, MD, AGAF, FACP, FACG