Section Resources

New York Gastroenterology Associates Research

As part of their academic mission, the physicians at NYGA are dedicated educators. Students from Mount Sinai Medical School and from other institutions come to our offices to train in clinical gastroenterology and gastroenterology research with our physician-leaders.

Endoscopy

At NYGA, we are continuing to study the role of new techniques including the M2A™ and BRAVO™ capsules for the evaluation of various digestive ailments. Our findings are presented at national meetings and have been published in peer-reviewed journals.We are collaborating with the best and most innovative device manufacturer in the field. During your visit, you may be given the opportunity to participate in a research study. This may give you access to techniques not available elsewhere, and will also help patients around the country evaluate these exciting breakthroughs in diagnostic medicine.

At New York Gastroenterology Associates (NYGA), we combine our widely-recognized expertise with state-of-the-art technologies to improve your digestive health. Some of these tests and their benefits to you are highlighted below.

Colorectal Cancer

The physicians at New York Gastroenterology Associates are leaders in the fields of colonoscopy and endoscopic sedation. Our research has been presented at meetings throughout the United States, and other physicians rely on our opinions and help. We continue to develop and evaluate methods to improve your colonoscopy experience. During your visit, you may be given the opportunity to participate in a research study. This may give you access to techniques not available elsewhere, and will also help patients around the country evaluate these exciting breakthroughs in diagnostic medicine. We welcome your questions or comments.

The article below has been accepted for presentation at ACG conference and will be published in the coming months

ACG 2009: The American College of Gastroenterology Annual Scientific Meeting

ABSTRACT

TITLE: Is a “good” colonoscopy bowel prep adequate for optimal detection of adenomas? Implications from a study of two colon cleansing formulations.

AUTHORS: Cohen, Lawrence B; von Althann, Caroline; Sanyal, Shefali; Whitson, Matthew; Bodian, Carol; Miller, Kenneth M; Aisenberg, James.

INSTITUTIONS (ALL): Mount Sinai School of Medicine, New York, NY

ABSTRACT BODY

BACKGROUND/AIM: The 2-L polyethylene glycol (PEG) prep was developed to improve pt tolerance for bowel cleansing compared with 4-L solutions. Two 2-L PEG formulations are commercially available; one (HalfLytely®, Braintree Laboratories) combines PEG with 2 bisacodyl tablets (PEG+BIS), while the other (MoviPrep®, Salix Pharmaceuticals) consists of PEG with electrolytes plus ascorbic acid (PEG+Asc). This study was designed to compare these two solutions in pts undergoing colonoscopy.

METHODS: Pts scheduled for elective colonoscopy at a single center were randomized to receive either PEG+Asc or PEG+BIS. Four endoscopists, each having an adenoma detection rate > 35%, participated in the study. The PEG+BIS prep was started at noon on the day prior to colonoscopy when pts ingested 2 bisacodyl tablets. Once the initial bowel movement occurred or < 6 hrs after consuming the tablets, pts drank 2L of PEG+BIS over 80 mins. The PEG+Asc group consumed 1L of PEG+Asc followed by 500 mL at 6pm the evening before the procedure and repeated this step 6 hrs before the procedure. The primary endpoint was colon-cleansing score, assessed by a blinded investigator using a validated 4-point scale (1=excellent 2=good, 3=fair, and 4=poor). Secondary endpoints included adenoma detection rate, pt tolerability and safety. Outcomes were compared using t-tests and chi-square in an intention-to-treat analysis.

RESULTS: 52 pts received PEG+Asc and 55 pts received PEG+BIS. The groups were comparable for age, gender, race, weight, and history colon adenomas. Mean colon-cleansing score (±SD) was 1.40±0.69 vs. 1.75±0.70 (P < 0.003) in the PEG-Asc and PEG+BIS groups, respectively. Excellent and good bowel cleansing were recorded in 69% and 23% receiving PEG+Asc vs. 38% and 51% receiving PEG+BIS (P =0.01), with an adequate bowel prep (good or excellent) in a similar proportion of each group. Scope insertion and withdrawal times were similar in both groups. Twenty pts (38.5%) in the PEG+Asc group had > 1 adenoma vs. 11 pts (20%) in PEG+BIS group (P =0.03). Advanced adenomas (>10 mm) were found in a similar proportion within each group (5.8% vs. 7.2%). Smaller adenomas (< 9 mm) were more frequent in pts receiving PEG+Asc than PEG+BIS (32.7% vs. 12.7%, P = 0.039). Pt compliance and tolerability for the preps were similar in both groups. No serious adverse events were reported.

CONCLUSIONS: 1. PEG+Asc produced superior bowel cleansing compared to PEG+BIS. 2. Small and medium-sized adenomas were more often detected in pts receiving PEG+Asc than in pts receiving PEG+BIS. These findings suggest that adenoma detection rates during colonoscopy may be higher with an excellent bowel preparation compared to one that is considered “good”.

Production Pressure in Endoscopy: Balancing Quantity and Quality” an editorial by Dr. Lawrence Cohen was published in Gastroenterology 2008, the official journal of the AGA Institute. Read More Download PDF

“ENDOSCOPIC SEDATION: PREPARING FOR THE FUTURE, AN ISSUE OF GASTROINTESTINAL ENDOSCOPY CLINICS” edited by Lawrence Cohen, M.D. and James Aisenberg, M.D. was published in February 2009 by Elsevier. This volume is a result of the conference co-sponsored by DDRF, Mount Sinai Medical Center and the ACG in 2007.

4th Annual Endoscopic Sedation: Preparing for the Future

Friday & Saturday November 9-10th, 2007

The New York Academy of Medicine New York, NY