December 22, 2020
4 min read
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Looking Back at 2020’s Top 10, Peer Tested by You

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Healio Gastroenterology looks back at the Peer Tested content from online and print as it fared throughout the year and what made us stand out in 2020.

We comprise our publication based on the numbers. Analytics brings to you in the print pages what your colleagues in gastroenterology are reading online.

It is easy to see that the interests for physicians reflect those of the general public, with the largest being the COVID-19 pandemic, its effect on gastrointestinal conditions and the many recommendations that came from various organizations. In addition, the list reflects the continued interest in keeping on top of recent FDA approvals and data.

We thank you for recognizing the quality content and look forward to the news to come in 2021!

1. Diarrhea may be common symptom in patients with COVID-19

Digestive symptoms were common in patients with COVID-19, according to the American Journal of Gastroenterology. Patients with these symptoms had a longer time from onset to admission and their prognosis was worse compared with patients without symptoms.

In this instance, Healio Gastroenterology gathered a perspective from a gastroenterologist on what these findings could mean.
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2. Proton pump inhibitor use doubles risk for COVID-19

An independent, dose-response relationship was seen between proton pump inhibitor use and COVID-19 positivity, according to a study published in the American Journal of Gastroenterology.

“We found that PPI use, particularly twice-daily dosing, is associated with increased odds for reporting a positive COVID-19 test, even after accounting for a wide range of sociodemographic, lifestyle, and clinical variables,” Christopher V. Almario, MD, MSHPM, from the department of Medicine at Cedars-Sinai Medical Center in Los Angeles, told Healio Gastroenterology. “Our findings continue to emphasize that PPIs should only be used when clinically indicated at the lowest effective dose.”
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3. VIDEO: Telehealth may be ‘game changer’ after COVID-19 pandemic

In an exclusive video, C. Jonathan D. Foster, DO, from the Jefferson Washington Township Hospital in New Jersey, said the use of telehealth will be a game changer in the future. Foster said patients may not want to come back for office visits. He also noted that his institution has canceled non-urgent procedures and that so far patients have been very understanding.
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4. Patients with COVID-19 GI symptoms experience delayed diagnosis, viral clearance

Patients who develop new-onset digestive symptoms, like diarrhea, after a possible exposure to COVID-19 should be suspected for the illness, according to research published in The American Journal of Gastroenterology.

“This study is vital because it represents the 80% or more of patients who do not have severe or critical disease,” Brennan M.R. Spiegel, MD, MSHS, FACG, director of health research at Cedars Sinai, said in a press release issued by the American College of Gastroenterology. “This is about the more common scenario of people in the community struggling to figure out if they might have COVID-19 because of new-onset diarrhea, nausea, or vomiting.”
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5. FDA recommends discontinuation of OTC Zantac

The FDA has requested that manufacturers withdraw all prescription and over-the-counter ranitidine drugs and advised patients to discontinue taking over-the-counter versions of the drug, according to an agency release.

Janet Woodcock, MD, director of the FDA’s Center for Drug Evaluation and Research, said in a press release, “We didn’t observe unacceptable levels of NDMA in many of the samples that we tested. However, since we don’t know how or for how long the product might have been stored, we decided that it should not be available to consumers and patients unless its quality can be assured.”
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6. GI symptoms plus loss of taste, smell, fever highly specific to COVID-19

While gastrointestinal symptoms like anorexia and diarrhea are common in both patients with COVID-19 and those without, these symptoms plus a loss of smell, taste and fever were 99% specific for COVID-19, according to a study published in Gastroenterology.

Alan Chen, MD, from the Institute of Digestive Health and Liver Diseases at Mercy Medical Center, and colleagues said, “Current testing guidelines should highlight the symptoms of loss of smell, taste, fever, anorexia and diarrhea as highly specific for COVID-19 infection.”
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7. Patients with COVID-19 may experience GI symptoms, possible fecal-oral transmission

Results from two studies published in Gastroenterology discussed manifested gastrointestinal symptoms and possible fecal-oral transmission in patients with COVID-19, the disease caused by the novel coronavirus.

One study said before respiratory symptoms, many patients with COVID-19 had diarrhea, nausea, vomiting and abdominal discomfort.
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8. Crohn’s and Colitis Foundation issues guidance on COVID-19 for patients with IBD

The Crohn’s and Colitis Foundation issued guidelines for patients with IBD to protect themselves from COVID-19 such as talk with their gastroenterologist about medications, their health status and any precautions they should take related to COVID-19.

According to the guidance, patients should get information from either the CDC or their local health department websites for specific guidance for local risk and precautions within their community.
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9. FDA issues safety alert for FMT

Two patients died and four were hospitalized after receiving fecal microbiota transplantations from OpenBiome stool donors, according to a safety alert from the FDA and a press release from the company.

In a perspective on the safety alert for FMT, Gautam Mankaney, MD, said, “Though we take many measures to ensure safety in the process, there is a risk associated with FMT. Efficacy rates at treating recurrent C.diff are higher than 90%, and, in my experience, patients have been extremely satisfied with the results, especially after factoring in the costs associated with hospitalizations, antibiotics, days of work missed, as well as the symptoms caused by C.diff.
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10. Google trends of GI symptoms may be ‘harbinger’ of COVID-19

Analysis of Google search trends correlated with increases in COVID-19 cases several weeks before any actual spike, according to study results.

Kyle Staller, MD, MPH, of the division of gastroenterology at Massachusetts General Hospital, told Healio Gastroenterology, “we know that many patients with COVID-19 develop GI symptoms early in their course, often before manifesting more typical respiratory symptoms. We were curious if internet search data would bear a similar story such that people would search these symptoms as they occur, thereby giving us an insight into disease incidence before respiratory symptoms develop and they undergo formal testing.”
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