Upper gastrointestinal bleeding is the leading emergency leading to hospitalization and urgent endoscopy. The field of gastrointestinal bleeding is rapidly evolving. The epidemiology is changing with more complex older patients on anticoagulant and antithrombotic agents presenting with upper gastrointestinal bleeding. The initial management has rapidly evolved with new transfusion thresholds, the use of risk stratification scores and no more nasogastric tubes. There is new data and recommendations on optimal timing of endoscopy. Medical therapies have also evolved with changes in proton pump inhibitor administration and the use of prokinetics to improve endoscopic visualization. Many modifications in endoscopic therapy have recently been advanced including the use of endoscopic ultrasound guided angiotherapy, topical sprays (i.e. Hemospray) and over-the-scope clips. In order to give optimal care to patients, it is critical that practicing gastroenterologists are aware of the many recent advances in management of patients with upper gastrointestinal bleeding.

Dr. Gralnek is considered an authority on GI bleeding, and he has invited experts in their respective fields to contribute to this issue. The content is divided up between Acute Non-Variceal Upper GI Hemorrhage and Acute Lower Gastrointestinal Hemorrhage. Articles are devoted to the follow topics: Initial assessment, risk stratification and early management; Endotherapy of peptic ulcer bleeding; Endoscopic hemostasis of non-variceal, non-ulcer UGIH; Emerging endoscopic treatments for NVUGIH; The cutting edge: doppler ultrasound in guiding endoscopic hemostasis; The role of interventional radiology in NVUGIH; Managing antithrombotic agents in the setting of acute GI bleeding; Patient presentation, risk stratification and initial management; Colonoscopy: Diagnosis, timing and bowel preparation; The role of endoscopic hemostasis therapy; and Prevention of recurrent lower GI hemorrhage. Readers will come away with the most current clinical infomration on how to manage and prevent GI bleeding.

Together with Consulting Editor Dr. Charles Lightdale, Dr. Qiang Cai has put together a comprehensive issue devoted to gastroparesis. Expert authors have contributed clinical review articles on the following topics: Epidemiology and Pathophysiology of Gastroparesis; Non-Diabetic Gastroparesis; Clinical Manifestations and Natural History of Patients with Gastroparesis; Evaluation of Patients with Suspected Gastroparesis; Symptomatic Management of Gastroparesis; Gastric Electrical Stimulator for treatment of Gastroparesis; Surgical Treatment for Gastroparesis; Botulinum Toxin Injection for Treatment of Gastroparesis; Stent Placement for Treatment for Gastroparesis; Technical Aspects of Per Oral Endoscopic Pyloromyotomy; Gastric Emptying Scintigraphy for Evaluation of Patients with Gastroparesis before Per Oral Endoscopic Myotomy; Outcomes of Per Oral Endoscopic Pyrolomyotomy in France; Outcomes of Per Oral Endoscopic Pyloromyotomy in China; Outcomes of Per Oral Endoscopic Pyloromyotomy in the United States.. Readers will come away with the information they need to improve endoscopic techniques and improve patient outcomes.

Over a short few decades, the field of pediatric endoscopy has matured from the exploratory to the routine. Performance of endoscopic procedures in children is now a fundamental aspect of the practice of more than 2000 pediatric gastroenterologists in North America, and endoscopic instruments are increasingly being developed with an eye to their pediatric applications. Ensuring safe and effective endoscopy in children requires specific medical knowledge and technical competency, in addition to appropriately designed equipment and settings. Obtaining consent from parents, as well as assent from patients, for the purposes of performing diagnostic and therapeutic gastrointestinal procedures begins with a deep understanding of risks and benefits that endoscopy affords and is typically gained through formal training in the field. Diagnostic endoscopy may help to confirm common pediatric conditions including eosinophilic esophagitis and inflammatory bowel disease, while therapeutic procedures to treat strictures in the GI tract may help children avoid more invasive surgeries. Using endoscopy in children to achieve hemostasis or to remove commonly swallowed foreign bodies, such as lithium batteries or high-powered magnets, can be lifesaving, and the insertion of feeding tubes can help medically complex patients to thrive. In short, pediatric endoscopy is an integral component of healthcare for children, and gaining and understanding of its best practices may help all clinicians to better recognize its role in pediatric disease outcomes.

In this issue of Gastrointestinal Endoscopy Clinics of North America, guest editors Drs. Kenneth J. Chang and Jason B. Samarasena bring their considerable expertise to the topic of The Endoscopic Oncologist. The practice of gastrointestinal endoscopy intersects with oncology in many ways, much of it involving pre-cancerous conditions. But the endoscopist's role in diagnosing, staging, and treating cancer patients is expanding. This issue is devoted to the current and future role of the endoscopic oncologist, with topics such as endoscopic diagnosis of luminal gastrointestinal cancer and extra-luminal cancer; endoscopic resection for early cancer; and more. - Contains 12 relevant, practice-oriented topics including endoscopic ultrasound cancer staging; management of biliary obstruction; endoscopic management of colonic obstruction; endoscopic treatment of tumor bleeding; endoscopic ultrasound-guided pain management; and more. - Provides in-depth clinical reviews on the endoscopic oncologist, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

In this issue of Gastrointestinal Endoscopy Clinics of North America, guest editor Dr. Catharine M. Walsh brings her considerable expertise to the topic of Pediatric Endoscopy. Since its inception in the early 1980s, pediatric endoscopy has seen dramatic innovations in both diagnostic procedures and advanced procedures that are increasingly being performed by pediatric trained endoscopists. In this issue, top experts bring you fully up to date with recent advances in this fast-changing field. - Contains 14 practice-oriented topics including pediatric unsedated transnasal endoscopy; tools for improving quality in pediatric endoscopy; artificial intelligence in pediatric endoscopy; advances in endoscopy for pediatric inflammatory bowel disease; and more. - Provides in-depth clinical reviews on pediatric endoscopy, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

Adoption of video capsule endoscopy has been slow, but there are now four FDA-approved devices and others available in China. It is now generally realized that there is an expanding role for these devices, not only in the small intestine but in the GI tract in general. In collaboration with Consulting Editor, Dr. Charles Lightdale, guest editor Dr. David Cave has assembled expert authors to provide clinical reviews that address where we are now, areas of controversy that still need resolution, and where the field is likely to develop over the next 5 to 10 years. Articles are specifically devoted to the following topics: Training, Reading and Reporting for Video Capsule Endoscopy; Indications and Contraindications: Complications of Capsule Endoscopy; Preparation, Prokinetics, and Surface Active Agents; Role of Capsule in Small Intestinal Bleeding; Role of Capsule Endoscopy in IBD; Role of Video Capsule Endoscopy in Liver Disease; Role of Video Capsule Endoscopy in Alternative Settings; Timing and Use of the Capsule Endoscopy in the Acute Care Setting; Role of Video Capsule Endoscopy as a Prelude to Deep Enteroscopy; Location of Capsule and Provocation Testing; Cost Effectiveness of Video Capsule Endoscopy; Artificial Intelligence in Capsule Endoscopy; and Novel Clinical Applications and Technical Developments in Video Capsule Endoscopy.

The Guest Editors have assembled key opinion leaders to provide state of the art articles on this important update on ERCP. A chapter on cannulation techniques and sphincterotomy will highlight recent literature on wire-guided cannulation, use of papillotomes, when and if to precut for entry and the use of smart circuitry for papillotomy. A chapter on surgically altered anatomy will highlight the increasing occurrence of biliary tract disease in patient’s s/p gastric bypass for obesity along with other surgery and the use of balloon enteroscopes, overtubes and intraoperative procedures A chapter on EUS assisted biliary and pancreatic access will highlight the growing experience with these combine techniques. There is growing literature on preventing post-ercp pancreatitis which is changing the standard of care and Joe Elmunzer is the best person to highlight this. Stu Sherman will review advances in the management of bile duct stones and when to intervene in gallstone pancreatitis. Peter Cotton just published a landmark study on SOD that will change the standard of care and will review the state of the science on this disease as it relates to both biliary tract and pancreatic disease. The management of benign biliary strictures and leaks is evolving with the introduction of covered metal stents and Jacques Deviere is at the forefront. Amrita Sethi will discuss diagnosis of biliary malignancy highlighting the use of FISH, molecular markers and enhanced imaging such as pCLE. Michele Kahaleh will review recent experience with biliary tumor ablation using RFA probes and PDT. Alan Barkun helps endoscopists determine when to use plastic stents, metal stents, and covered stents and when to drain one, two or three segments of liver in patients with malignant biliary obstruction. George Papachristo and Dhiraj Yadav will review most recent data on endoscopic therapy for acute recurrent and smoldering acute pancreatitis. Nagy Reddy will provide on update on endotherapy for painful chronic pancreatitis. Finally, Raj Shah will update on advances in pancreatoscopy and cholangioscopy including the use of ultra slim per-oral scopes and new digital mother/baby scopes.

The topics covered in this issue, an update from what was first published in the Gastrointestinal Endoscopy Clinics in 2008, reflect the fact that NOTES is seeing a resurgence in popularity. Now, eight years later, there is more data to confirm safety, to look at the best options for using natural orifices, and to talk about optimal training scenarios. The Guest Editor has enlisted some of the top experts on NOTES to contribute articles devoted to Seminal Developments: SM Tunnel Technique; Peroral Endoscopic Myotomoy (POEM); Submucosal Tumor Endoscopic Resection; Endoscopic Full Thickness Resection; Submucosal Tunneling for NOTES Procedures Beyond Resection; Pyloromyotomy; New NOTES: Western Perspective; and Why Did the Old NOTES Fail: Lessons Learned that can Guide New NOTES Development.

In this issue of Gastrointestinal Endoscopy Clinics of North America, guest editor Dr. Amrita Sethi brings her considerable expertise to the topic of Submucosal and Third Space Endoscopy. Endoscopic submucosal dissection (ESD) is now recognized as one of the preferred treatment modalities for premalignant gastrointestinal epithelial lesions and early gastric cancer without lymph node metastasis. ESD techniques require advanced skills, and this issue brings together top experts in the field who provide the information endoscopists need to improve these skills. - Contains 15 practice-oriented topics including building the toolbox of devices to optimize a practice in submucosal endoscopy; understanding the principles of electrocautery for submucosal endoscopy; endoscopic submucosal dissection in the colon and rectum; techniques for peroral endoscopic myotomy, from mouth to anus; management of adverse events of submucosal endoscopy; and more. - Provides in-depth clinical reviews on submucosal and third space endoscopy, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.