Practical Management of Variceal Bleeding and Hepatorenal Syndrome

For patients with refractory constipation, it’s important to evaluate the psychological impact of these symptoms. Unfortunately, this disorder can easily affect a patient’s quality of life and keep them from doing their normal routine. So what treatment options can help alleviate some of the burden? Dive in with Dr. Peter Buch as he speaks with Dr. Joy Liu, Instructor of Gastroenterology and Hepatology at the Feinberg School of Medicine at Northwestern.

Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is the most dreaded complication of this procedure. So what are the patient-related, procedure-related, and operator-related risk factors for developing post-ERCP pancreatitis, and how can we work to prevent it? Join Dr. Peter Buch as he speaks with Dr. Prabhleen Chahal, Program Director of the Advanced Endoscopy Fellowship at the Cleveland Clinic.

Affecting over 25 percent of Crohn's disease patients, perianal disease is a persistent and difficult-to-treat condition. Due to its complex management and significant impact on patients' quality of life, a multidisciplinary approach to care is crucial. Here to discuss the management of perianal Crohn’s disease, Dr. Peter Buch is joined by Dr. Benjamin Cohen, Co-Section Head and Clinical Director for Inflammatory Bowel Disease at Cleveland Clinic, and Dr. Stefan Holubar, IBD Surgery Section Chief and Director of Research at Cleveland Clinic.

Extrahepatic manifestations of decompensated cirrhosis confer significant additional risks for mortality, and a multidisciplinary team of healthcare professionals is involved in the care of these patients. This program will discuss two critical aspects of advanced liver disease: variceal bleeding and hepatorenal syndrome (HRS). These complications pose significant challenges in the management of patients with cirrhosis. Clinically-significant portal hypertension, identified by a hepatic venous pressure gradient >10mmHg, predicts the development of variceal hemorrhage, hepatic encephalopathy, ascites, and HRS, all hallmarks of decompensation and multi-organ failure. Faculty will discuss a common patient presentation to highlight best practices in evidence-based care of patients with variceal bleeding and HRS/acute kidney injury.

In patients with chronic live disease, consuming alcohol could contribute to progressive liver damage and a variety of cancers. So alcohol consumption should not be a regular occurrence for those who have underlying chronic liver disease. And approximately four percent of patients with alcohol use disorder are referred at early stages for intervention compared to other liver diseases. To learn more, join Dr. Peter Buch to hear insights from Dr. Paul Kwo, Professor of Medicine and the Director of Hepatology at Stanford University.

Pouchitis is a common inflammatory complication after ileal pouch-anal anastomosis (J-pouch) surgery, but the why behind patients who develop this condition seems to be unclear. So to dive into the updated guidelines for the management of pouchitis and to also hear about some knowledge gaps in preventing pouchitis, join Dr. Peter Buch as he takes a deep dive with Dr. Edward Barnes, Associate Professor of Medicine and Associate Fellowship Program Director at the University of North Carolina School of Medicine and Primary Author of article, titled “AGA Clinical Practice Guideline on the Management of Pouchitis and Inflammatory Pouch Disorders,” which was published in Gastroenterology in 2024.

Symptoms of portal vein thrombosis (PVT) are primarily driven by the extent of the obstruction that the PVT is causing, and some of it’s also driven by how quickly the thrombosis has developed. There’s also some cases where symptoms can be nonspecific. So the role of a multidisciplinary team in helping to address this condition is very important because every case is unique. This collaboration can help provide the best care to our patients case by case. Dive in with Dr. Peter Buch and Dr. Shilpa Junna, Transplant Hepatologist and Assistant Professor at the Cleveland Clinic, to learn more.

C. difficile is a major problem in the United States. On top of that, patients who are diagnosed with this infection have the chance of getting caught in a vicious cycle of recurrence. So how can we provide our patients with the best care and work with them to give them the best treatment option? Learn more with Dr. Peter Buch as he takes a deep dive with Dr. Paul Feuerstadt, Assistant Clinical Professor of Medicine at Yale-New Haven Hospital.

There are a lot of considerations to keep in mind when it comes to liver transplantation in patients with various diseases, like metabolic-associated stereotactic liver diseases, alcoholic liver disease, hepatitis B and C, and more. Joining Dr. Peter Buch to discuss those key considerations surrounding liver transplantation is Dr. Michael Lucey, Professor of Medicine at the University of Wisconsin School of Medicine and Public Health.

Until recently, surgery was always utilized for appendicitis, but now, antibiotics are an alternative treatment. Find out who the best candidates are for an antibiotic regimen, the efficacy and safety of this approach to treating acute uncomplicated appendicitis, and more with Dr. Peter Buch and Dr. David Talan, Professor of Medicine at UCLA Geffen School of Medicine.