Clinical Question Library
200 Clinical Questions in Gastroenterology & Hepatology
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Clinical Reasoning
- 1How Should a Gastroenterologist Approach Chronic Diarrhea?
- 2How Should Abnormal Liver Enzymes Be Evaluated?
- 14How Should an Incidental Liver Lesion Be Evaluated?
- 6How Should Clinicians Choose Among Biologic and Small-Molecule Therapies for IBD?
- 8How Should Gastric Intestinal Metaplasia Be Managed?
- 3How Should Unexplained Dysphagia Be Evaluated?
- 7What Does Treat-to-Target Mean in Inflammatory Bowel Disease?
- 4What Has Changed in the Treatment of Crohn's Disease?
- 5What Has Changed in the Treatment of Ulcerative Colitis?
- 10What Is the Current Approach to Diagnosing and Treating Eosinophilic Esophagitis?
- 15What Is the Current Approach to Hepatic Encephalopathy?
- 11What Is the Current Approach to MASLD and MASH?
- 13What Is the Role of Semaglutide in MASH?
- 12Which Patients With MASLD Need Fibrosis Assessment?
- 9Who Should Be Screened for Barrett's Esophagus?
Esophagus, Stomach & Upper GI
- 19Does AI-Assisted Colonoscopy Actually Improve Colorectal Cancer Prevention?
- 22How Can Advanced Endoscopy Detect Early Malignant and Premalignant Lesions?
- 28How Should a Patient With Chronic Abdominal Pain Be Evaluated?
- 17How Should an Incidental Pancreatic Cyst Be Evaluated?
- 105How Should an Upper GI Bleed Be Risk-Stratified Before Endoscopy?
- 107How Should Anticoagulation Be Managed After a GI Bleed?
- 112How Should Autoimmune Gastritis Be Diagnosed and Monitored?
- 16How Should Diverticulitis Be Managed in 2026?
- 118How Should Functional Dysphagia Be Diagnosed After Structural Disease Is Excluded?
- 114How Should Gastric Neuroendocrine Tumors Be Classified and Managed?
- 110How Should Gastric Subepithelial Lesions Be Evaluated?
- 25How Should Gastroenterologists Use AI Without Weakening Clinical Reasoning?
- 117How Should Hypercontractile Esophagus and Distal Esophageal Spasm Be Managed?
- 108How Should Nonvariceal Upper GI Bleeding Be Treated Endoscopically?
- 103How Should Peptic Ulcer Disease Be Managed in the Era of PPIs and H. pylori Eradication?
- 101How Should Refractory H. pylori Infection Be Treated After Initial Therapy Fails?
- 30How Should Unexplained Nausea and Vomiting Be Investigated?
- 27How Should Unexplained Weight Loss With Gastrointestinal Symptoms Be Investigated?
- 115How Should Zenker Diverticulum Be Diagnosed and Treated?
- 21What Can Narrow-Band Imaging Detect That Standard White-Light Endoscopy May Miss?
- 29What Causes an Isolated Elevation in Alkaline Phosphatase?
- 116What Does Esophagogastric Junction Outflow Obstruction Mean on Manometry?
- 109What Is the Best Management of a Bleeding Peptic Ulcer After Successful Endoscopic Hemostasis?
- 113What Is the Cancer Risk in Autoimmune Gastritis and Pernicious Anemia?
- 26What Is the Differential Diagnosis of Iron-Deficiency Anemia When Endoscopy Is Negative?
- 23What Makes a High-Quality Colonoscopy?
- 111When Does a Gastric Subepithelial Lesion Require EUS, Biopsy or Resection?
- 104When Should a Gastric Ulcer Be Re-Endoscoped to Confirm Healing?
- 18When Should Capsule Endoscopy Be Used for Small-Bowel Disease?
- 20When Should Chromoendoscopy Be Used?
- 106When Should Endoscopy Be Performed in Acute Upper GI Bleeding?
- 24When Should Fecal Calprotectin Be Used in IBD?
- 102Which H. pylori Salvage Regimen Should Be Used After Clarithromycin or Bismuth Therapy?
Motility & Functional GI
- 122Do GLP-1 Drugs Increase the Risk of Retained Gastric Contents or Aspiration During Endoscopy?
- 129How Reliable Are Breath Tests for SIBO?
- 126How Should Bile Acid Diarrhea Be Diagnosed?
- 124How Should Functional Dyspepsia Be Diagnosed and Treated?
- 119How Should Gastroparesis Be Diagnosed in 2026?
- 121How Should GLP-1 Receptor Agonists Be Managed Before Endoscopy?
- 131How Should Intestinal Methanogen Overgrowth Be Diagnosed and Treated?
- 123How Should Rumination Syndrome Be Recognized and Treated?
- 130How Should SIBO Be Treated and When Should Antibiotics Be Repeated?
- 128How Should Small Intestinal Bacterial Overgrowth Be Diagnosed?
- 120What Are the Best Current Treatments for Gastroparesis?
- 132What Is the Role of the Low-FODMAP Diet in IBS?
- 127When Should Bile Acid Sequestrants Be Used Empirically for Chronic Diarrhea?
- 133Which IBS Therapies Should Be Chosen for IBS-C Versus IBS-D?
- 125Which Treatments Actually Work for Functional Dyspepsia?
Inflammatory Bowel Disease
- 141How Can Postoperative Crohn's Disease Recurrence Be Prevented?
- 41How Do You Distinguish Achalasia From Other Causes of Dysphagia?
- 33How Should a Gastroenterologist Approach Unexplained Jaundice?
- 134How Should Acute Severe Ulcerative Colitis Be Managed During the First 72 Hours?
- 38How Should Barrett's Esophagus Be Monitored for Dysplasia and Cancer?
- 150How Should Biologic Therapy Be Managed Around Surgery in IBD?
- 144How Should Chronic Antibiotic-Dependent Pouchitis Be Managed?
- 146How Should Clostridioides difficile Infection Be Managed in Patients With IBD?
- 140How Should Crohn's Disease Be Managed After Intestinal Resection?
- 145How Should Crohn's-Like Disease of the Pouch Be Recognized and Treated?
- 31How Should Gastrointestinal Bleeding of Obscure Origin Be Investigated?
- 48How Should Helicobacter pylori Infection Be Confirmed After Treatment?
- 148How Should Immunosuppressive IBD Therapy Be Managed During a Serious Infection?
- 138How Should Perianal Crohn's Disease Be Evaluated?
- 143How Should Pouchitis Be Diagnosed and Treated?
- 35How Should Recurrent Gastrointestinal Bleeding With Negative Endoscopy Be Investigated?
- 149How Should Venous Thromboembolism Be Prevented in Hospitalized IBD Patients?
- 136Infliximab or Cyclosporine: Which Rescue Therapy Should Be Used for Acute Severe UC?
- 45What Are the Important Causes of Esophageal Food Impaction?
- 36What Are the Important Causes of Hypoalbuminemia From Gastrointestinal Disease?
- 44What Causes a Benign Esophageal Stricture and How Is It Managed?
- 139What Is the Best Medical and Surgical Strategy for Perianal Crohn's Fistulas?
- 32What Is the Diagnostic Approach to Persistent Bloating and Abdominal Distension?
- 34What Should Be Considered When a Patient Has Early Satiety?
- 40What Should Be Done When GERD Symptoms Persist Despite a Proton Pump Inhibitor?
- 151When and How Should Advanced IBD Therapy Be De-Escalated?
- 135When Has IV Steroid Therapy Failed in Acute Severe Ulcerative Colitis?
- 42When Is Esophageal Manometry Indicated?
- 50When Should Advanced Therapy Be Started in Crohn’s Disease?
- 43When Should Ambulatory pH Monitoring Be Used for Reflux Symptoms?
- 37When Should an Incidental Gastrointestinal Imaging Abnormality Be Investigated Further?
- 147When Should CMV Colitis Be Suspected in Ulcerative Colitis?
- 142When Should Ileocolonoscopy Be Performed After Crohn's Surgery?
- 39When Should Proton Pump Inhibitor Therapy Be Continued Long Term?
- 137When Should Surgery Be Recommended in Acute Severe Ulcerative Colitis?
- 47Which Gastric Polyps Require Biopsy, Removal or Surveillance?
- 49Which Patients With H. pylori Are at Increased Risk of Gastric Cancer?
- 46Who With Gastric Intestinal Metaplasia Requires Endoscopic Surveillance?
Colon & Colorectal Cancer
- 157Cold Snare or Hot Snare: What Is the Best Technique for Small Colorectal Polyps?
- 162How Can Post-Polypectomy Bleeding Be Prevented?
- 63How Do You Distinguish Inflammatory Bowel Disease From Irritable Bowel Syndrome?
- 153How Quickly Should Colonoscopy Be Performed After a Positive FIT?
- 53How Should a Crohn’s Disease Stricture Be Evaluated and Managed?
- 155How Should a Malignant Colorectal Polyp Be Managed?
- 55How Should Colorectal Cancer Surveillance Be Performed in Longstanding IBD?
- 161How Should Delayed Post-Polypectomy Bleeding Be Managed?
- 168How Should Familial Adenomatous Polyposis Be Recognized and Managed?
- 57How Should IBD Medications Be Managed During Pregnancy?
- 158How Should Large Nonpedunculated Colorectal Polyps Be Removed?
- 166How Should Patients Be Followed After Curative Colorectal Cancer Resection?
- 164How Should Rectal Bleeding in Adults Younger Than 50 Be Evaluated?
- 51How Should Response to IBD Therapy Be Monitored?
- 65How Should Surveillance Intervals Be Determined After Colon Polyps Are Removed?
- 62How Should Suspected Small-Bowel Bleeding Be Investigated?
- 169What Causes Post-Colonoscopy Colorectal Cancer and How Can It Be Prevented?
- 154What Does a Positive FIT With a Negative Colonoscopy Mean?
- 59What Is the Current Approach to Diagnosing Celiac Disease?
- 56What Preventive Care Should Patients With IBD Receive?
- 152What Should Be Done After a Positive FIT Test?
- 60What Should Be Done When Celiac Serology and Biopsy Results Disagree?
- 58What Should Be Done When Symptoms Persist but IBD Appears to Be in Remission?
- 54When Can Endoscopic Treatment Prevent or Delay Surgery in IBD?
- 163When Should a Polypectomy Defect Be Closed With Clips?
- 64When Should Colorectal Cancer Screening Begin and End?
- 159When Should EMR Be Used for a Large Colorectal Lesion?
- 160When Should ESD Be Preferred Over EMR in the Colon?
- 167When Should Lynch Syndrome Be Suspected and Tested For?
- 52When Should Therapeutic Drug Monitoring Be Used for IBD Biologics?
- 165When Should Young Adults With Rectal Bleeding Undergo Colonoscopy?
- 156Which Features of a Malignant Colorectal Polyp Require Surgical Resection?
- 61Why Do Symptoms Persist Despite a Gluten-Free Diet in Celiac Disease?
Hepatology
- 70How Can Bowel Preparation Quality Be Improved?
- 189How Is Hepatitis D Treated in 2026?
- 182How Should an HBsAg-Positive Patient With Normal ALT Be Managed?
- 193How Should Autoimmune Hepatitis Be Diagnosed?
- 195How Should Autoimmune Hepatitis Treatment Be Withdrawn?
- 200How Should Cholangiocarcinoma Surveillance Be Performed in Primary Sclerosing Cholangitis?
- 74How Should Chronic Constipation Be Investigated?
- 78How Should FIB-4 Be Used in Clinical Practice?
- 183How Should HBV DNA and ALT Be Interpreted Together?
- 186How Should Hepatitis B Reactivation Risk Be Managed Before Immunosuppression?
- 188How Should Hepatitis D Be Screened for in Patients With Hepatitis B?
- 76How Should Irritable Bowel Syndrome Be Diagnosed Without Excessive Testing?
- 73How Should Microscopic Colitis Be Diagnosed and Treated?
- 191How Should Patients Be Followed After Hepatitis C Cure?
- 196How Should Primary Biliary Cholangitis Be Diagnosed?
- 199How Should Primary Sclerosing Cholangitis Be Diagnosed and Monitored?
- 185Tenofovir or Entecavir: How Should First-Line Hepatitis B Therapy Be Chosen?
- 77What Alarm Features in Lower-GI Symptoms Should Prompt Further Investigation?
- 69What Constitutes an Adequate Bowel Preparation for Colonoscopy?
- 67What Is a Sessile Serrated Lesion and Why Does It Matter?
- 68What Should Be Done After an Incomplete Colonoscopy?
- 184When Can Hepatitis B Antiviral Therapy Be Stopped?
- 72When Does Recurrent Diverticulitis Require Surgical Consultation?
- 197When Is Ursodeoxycholic Acid Inadequate in Primary Biliary Cholangitis?
- 194When Should Autoimmune Hepatitis Be Treated With Steroids and Azathioprine?
- 79When Should Transient Elastography Be Ordered?
- 66Which Colorectal Polyps Carry the Greatest Cancer Risk?
- 75Which Patients With Constipation Require Colonoscopy?
- 71Which Patients With Diverticulitis Need Colonoscopy Afterward?
- 80Which Patients With MASH Are Candidates for Drug Treatment?
- 198Which Second-Line Therapies Should Be Used for Primary Biliary Cholangitis?
- 187Who Needs Hepatitis B Prophylaxis During Chemotherapy or Biologic Therapy?
- 181Who Should Be Treated for Chronic Hepatitis B in 2026?
- 192Who Still Needs HCC Surveillance After HCV Eradication?
- 190Who Still Needs Treatment for Hepatitis C?
Pancreas & Biliary
- 88How Should Acute Pancreatitis Be Managed During the First 48 Hours?
- 81How Should an Incidental Fatty Liver Finding Be Evaluated?
- 85How Should Ascites in Cirrhosis Be Evaluated and Treated?
- 86How Should Nutrition and Malnutrition Be Managed in Cirrhosis?
- 84How Should Patients With Cirrhosis Be Screened for Esophageal Varices?
- 87How Should Perioperative Risk Be Assessed in a Patient With Cirrhosis?
- 90How Should Recurrent Acute Pancreatitis Be Investigated?
- 82What Causes Persistently Elevated ALT and AST?
- 89When Should ERCP Be Performed in Acute Pancreatitis?
- 83Who With Cirrhosis Requires Hepatocellular Carcinoma Surveillance?
Endoscopy & Procedures
- 91How Is Chronic Pancreatitis Diagnosed?
- 94How Should an Incidentally Dilated Pancreatic Duct Be Investigated?
- 170How Should Aspirin Be Managed Before GI Endoscopy?
- 171How Should DOACs Be Managed Before and After Endoscopy?
- 177How Should Post-ERCP Bleeding Be Managed?
- 175How Should Post-ERCP Pancreatitis Be Prevented?
- 178How Should Post-Polypectomy Electrocoagulation Syndrome Be Recognized and Treated?
- 96How Should Unexplained Dilation of the Common Bile Duct Be Evaluated?
- 172How Should Warfarin Be Managed for Colonoscopy and Polypectomy?
- 176Rectal NSAIDs, Pancreatic Stents or IV Fluids: What Best Prevents Post-ERCP Pancreatitis?
- 98What Are the Advantages of High-Definition Endoscopy Over Standard White-Light Endoscopy?
- 97What Is Computer-Aided Polyp Detection and Should Gastroenterologists Use It?
- 100What Makes a High-Quality Upper Gastrointestinal Endoscopy?
- 174When Is Antibiotic Prophylaxis Needed for GI Endoscopy?
- 180When Should a Difficult Colorectal Lesion Be Referred to an Advanced Endoscopist Instead of Surgery?
- 179When Should Endoscopic Full-Thickness Resection Be Used?
- 95When Should EUS Be Used for Pancreatic Disease?
- 99When Should EUS Replace or Complement CT or MRI?
- 92When Should Pancreatic Enzyme Replacement Therapy Be Used?
- 173Which Endoscopic Procedures Are High Risk for Bleeding in Anticoagulated Patients?
- 93Which Pancreatic Cysts Require Surveillance or Surgery?