Rotation Prep

Published April 21, 2022

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The field of gastroenterology has been shaped by advances in both technology and drug therapy. The colonoscope and gastroscope both trace back to 1806, when Dr. Philipp Bozzini, of Mainz, Germany, first used a tin tube with a candle and mirror to view the bladder — his version of a cystoscope. More than a century later, Dr. Rudolph Schindler modified the cystoscope into the form of a semiflexible gastroscope, and in 1957, Dr. Basil Hirschowitz developed the first fiberscope. Read more on the early use of endoscopy from the archives of the New England Journal of Medicine. Today, many variations of the original fiberscope — ranging from duodenoscopes to endoscopic ultrasound — can perform complex biliary procedures once reserved for surgeons.

New discoveries in drug therapy have changed treatment of many gastrointestinal (GI) diseases. With the advent of histamine-2 (H2) receptor blockers, and subsequently, proton pump inhibitors (PPIs), in the 1980s, most trainees today will rarely see a perforated ulcer. Tumor necrosis factor (TNF) inhibitors have drastically changed the treatment of inflammatory bowel disease (IBD), and the approval of sofosbuvir and nonstructural viral protein 5A (NS5A) inhibitors (e.g., daclatasvir and ledipasvir) have transformed hepatitis C virus (HCV) infection from a chronic disease to a curable one.