ASGE Annual GI Advanced Practice Provider Course (Virtual) (Day One)

Video Transcription

Video Summary

Clinicians discuss practical GI management questions. For acute IBD flares, intermittent upadacitinib (Rinvoq) may act as a rapid, steroid-sparing option, especially for severe ulcerative colitis and infliximab nonresponders, but choice is patient-dependent and combination therapy requires careful safety assessment; it’s not strictly “Rinvoq versus prednisone.” Fecal calprotectin is used broadly in diarrhea workups to distinguish IBS from inflammatory disease; elevated results in chronic diarrhea generally prompt colonoscopy, while suspected acute infection should be evaluated first since infections can transiently raise calprotectin. If calprotectin stays elevated with a normal colonoscopy, small-bowel evaluation with MRE or capsule endoscopy is considered. Experts address biopsy “seeding” risk: it’s theoretical but usually acceptable when sampled tissue would be removed surgically or when disease is already stage IV; avoid sampling suspected hilar cholangiocarcinoma when transplant/curative surgery is planned. Serous cystadenomas can grow benignly; after stable serial imaging and markers, surveillance may stop. Additional topics include pancreatic cancer risk screening (genetic testing), J-pouch diarrhea, gastroparesis limits, and imaging for exocrine pancreatic insufficiency.

Meta Tag

Concept Acute Inflammatory Bowel Disease Flare

Concept Fecal Calprotectin

Concept Diarrhea

Concept Inflammatory Bowel Disease

Concept Tumor Seeding

Keywords

Upadacitinib (Rinvoq) for acute IBD flare steroid-sparing therapy

Fecal calprotectin in chronic diarrhea workup (IBS vs IBD)

Persistent elevated calprotectin with normal colonoscopy—small bowel evaluation (MRE/capsule)

Biopsy tract seeding risk in cholangiocarcinoma and transplant planning

Serous cystadenoma surveillance discontinuation after stable imaging

Acute Inflammatory Bowel Disease Flare

Fecal Calprotectin

Diarrhea

Inflammatory Bowel Disease

Tumor Seeding