Eugene A Trowers

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Scholarly Contributions

Books

• Trowers, E. A., Spear-Ellinwood, K. C., & Tischler, M. E. (2018). Gut feelings.
• Trowers, E. A., & Tischler, M. E. (2014). Gastrointestinal Physiology: A Clinical Approach. Springer.

Journals/Publications

• Shrestha, M. P., & Trowers, E. A. (2017). Does digital rectal examination (DRE) affect initial clinical management decision in patients with acute gastrointestinal (GI) bleeding?. The American Journal of Medicine.
• Shrestha, M., & Trowers, E. A. (2018). Elevated Lactate Predicts Intensive Care Unit Admissions, Endoscopies, Transfusions and use of Medical Therapy in Patients with Acute Gastrointestinal Bleeding. Journal of Clinical Gastroenterology.
• Shrestha, M. P., Borgstrom, M., & Trowers, E. (2018). The Reply. The American journal of medicine, 131(1), e35-e36.
• Shrestha, M. P., Borgstrom, M., & Trowers, E. A. (2018). Elevated lactate level predicts intensive care unit admissions, endoscopies and transfusions in patients with acute gastrointestinal bleeding. Clinical and experimental gastroenterology, 11, 185-192.
  More info

  Initial clinical management decision in patients with acute gastrointestinal bleeding (GIB) is often based on identifying high- and low-risk patients. Little is known about the role of lactate measurement in the triage of patients with acute GIB. We intended to assess if lactate on presentation is predictive of need for intervention in patients with acute GIB.
• Trowers, E. A., Borgstrom, M., & Shrestha, M. (2018). The Reply.. Am J Med.. doi:10.1016/j.amjmed.2017.08.025
• Shrestha, M. P., Borgstrom, M., & Trowers, E. (2017). Digital Rectal Examination Reduces Hospital Admissions, Endoscopies, and Medical Therapy in Patients with Acute Gastrointestinal Bleeding. The American journal of medicine, 130(7), 819-825.
  More info

  Although digital rectal examination is an established part of physical examinations in patients with acute gastrointestinal bleeding, clinicians are reluctant to perform a rectal examination. We intended to assess whether rectal examination affects the clinical management decision in these patients.
• Shrestha, M. P., Borgstrom, M., & Trowers, E. (2017). It Takes More than Just a Finger to Determine Emergency Room Disposition for Possible Gastrointestinal Bleeding Reply. AMERICAN JOURNAL OF MEDICINE, 130(9), E409-E410.
• Shrestha, M. P., Borgstrom, M., & Trowers, E. (2017). Rectal Examination May Not be Necessary in Gastrointestinal Bleeding Reply. AMERICAN JOURNAL OF MEDICINE, 130(12), E561-E562.
• Shrestha, M. P., Borgstrom, M., & Trowers, E. (2017). The Reply. The American journal of medicine, 130(12), e561-e562.
• Shrestha, M. P., Borgstrom, M., & Trowers, E. (2017). The Reply. The American journal of medicine, 130(9), e409-e410.
• Trowers, E. A., Borgstrom, M., & Shrestha, M. (2017). Elevated Lactate Predicts Intensive Care Unit Admissions, Endoscopies, Transfusions and use of Medical Therapy in Patients with Acute Gastrointestinal Bleeding. Am J Gastroenterol, 112: S290. doi:doi:10.1038/ajg.2017.302
• Trowers, E. A., Borgstrom, M., & Shrestha, M. (2017). The Reply.. Am J Med. doi:10.1016/j.amjmed.2017.07.036
• Trowers, E. A., Borgstrom, M., & Shrestha, M. P. (2017). Digital Rectal Examination Reduces Hospital Admissions, Endoscopies and Medical Therapy in Patients With Acute Gastrointestinal Bleeding. The American Journal of Medicine. doi:10.1016/j.amjmed.2017.01.036
• Trowers, E. A., Borgstrom, M., Shrestha, M. P., Trowers, E. A., Borgstrom, M., & Shrestha, M. P. (2017). The Reply. Am J Med. doi:10.1016/j.amjmed.2017.04.031
• Banerjee, B., Shaheen, N. J., Martinez, J. A., Hsu, C., Trowers, E., Gibson, B. A., Della'Zanna, G. J., Richmond, E., & Chow, H. S. (2016). Clinical Study of Ursodeoxycholic Acid in Barrett's Esophagus Patients. Cancer prevention research (Philadelphia, Pa.).
  More info

  Prior research strongly implicates gastric acid and bile acids, two major components of the gastroesophageal refluxate, in the development of Barrett's esophagus (BE) and its pathogenesis. Ursodeoxycholic acid (UDCA), a hydrophilic bile acid, has been shown to protect esophageal cells against oxidative stress induced by cytotoxic bile acids. We conducted a pilot clinical study to evaluate the clinical activity of UDCA in patients with BE. Twenty-nine BE patients received UDCA treatment at a daily dose of 13-15 mg/kg/day for six months. The clinical activity of UDCA was assessed by evaluating changes in gastric bile acid composition and markers of oxidative DNA damage (8-hydroxydeoxyguanosine, 8OHdG), cell proliferation (Ki67), and apoptosis (cleaved caspase 3, CC3) in BE epithelium. The bile acid concentrations in gastric fluid were measured by liquid chromatography-mass spectrometry. At baseline, UDCA (sum of unchanged and glycine/taurine conjugates) accounted for 18.2% of total gastric bile acids. Post UDCA intervention, UDCA increased significantly to account for 93.39% of total gastric bile acids (p
• Banerjee, B., Shaheen, N. J., Martinez, J. A., Hsu, C., Trowers, E., Gibson, B. A., Della'Zanna, G., Richmond, E., & Chow, H. S. (2016). Clinical Study of Ursodeoxycholic Acid in Barrett's Esophagus Patients. CANCER PREVENTION RESEARCH, 9(7), 528-533.
• Tey, K. R., Kottey, J., Beatty, N., & Trowers, E. (2016). Methamphetamine-Induced Colonic Ischemia. AMERICAN JOURNAL OF GASTROENTEROLOGY, 111, S1316-S1317.
• Tey, K. R., Singh, N., Takyar, V., & Trowers, E. (2016). Role of Proton Pump Inhibitors in Recurrence of Clostridium difficile Infection: Systematic Review and Meta-Analysis. AMERICAN JOURNAL OF GASTROENTEROLOGY, 111, S449-S450.
• Walker, C. N., Takyar, V., Patel, S., Dominguez, C., Patel, K., Singh, N., Pham, T. N., Sakai, Y., Ahmed, B., Kisso, B., & Trowers, E. (2016). Effects of Low-Residue Diet Prior to Day of Screening Colonoscopy on Bowel Preparation Quality. GASTROENTEROLOGY, 150(4), S642-S642.
• Patel, K., Chatrath, H., & Trowers, E. (2015). Successful Treatment of Kommerell's Diverticulum: A Rare Cause for Massive Upper Gastrointestinal Bleed. AMERICAN JOURNAL OF GASTROENTEROLOGY, 110, S280-S281.
• Singh, N., Takyar, V. K., Etzion, O., & Trowers, E. (2015). Proton Pump Inhibitor Use as a Risk Factor for Recurrent Clostridium difficile Infection: A Systematic Review and Meta-analysis. AMERICAN JOURNAL OF GASTROENTEROLOGY, 110, S939-S939.
• Stephen, F. O., Reddy, P., Allen, L., Lakdawala, M., Singh, N., & Trowers, E. (2015). The Financial Burden and Health Care Utilization Related to Intentional Versus Unintentional Foreign Body Ingestion in a University Hospital: A Pilot Study. AMERICAN JOURNAL OF GASTROENTEROLOGY, 110, S950-S950.
• Fernandes, A., Patel, K., Takyar, V., & Trowers, E. (2014). Duodenal Diverticula: Unusual Cause of a Common Condition. AMERICAN JOURNAL OF GASTROENTEROLOGY, 109, S76-S76.
• Patel, K., Takyar, V., Fernandes, A., & Trowers, E. (2014). An Uncommon Case of Gastrobronchial Fistula. AMERICAN JOURNAL OF GASTROENTEROLOGY, 109, S23-S23.
• Patel, S., Takyar, V., & Trowers, E. (2014). Double Double Toil and Trouble: An Unusual Case of Dysphagia. AMERICAN JOURNAL OF GASTROENTEROLOGY, 109, S25-S25.
• Takyar, V., Patel, K., Walker, C., Dominguez, C., Singh, N., Kisso, B., & Trowers, E. (2014). Effects of Low-Residue Diet Prior to Day of Colonoscopy on Bowel Preparation Quality. AMERICAN JOURNAL OF GASTROENTEROLOGY, 109, S201-S201.
• Takyar, V., Singh, N., Patel, K., & Trowers, E. (2014). Low-Residue Diet in Colon Preparation Prior to Screening Colonoscopy: A Review of Literature. AMERICAN JOURNAL OF GASTROENTEROLOGY, 109, S218-S219.
• Murakami, T., Pugh, J., Ozden, N., & Trowers, E. (2013). Mimicking Inflammatory Bowel Disease during Treatment of Metastatic Melanoma: Immune Mediated Ipilimumab-induced Colitis. AMERICAN JOURNAL OF GASTROENTEROLOGY, 108, S386-S387.
• Al-Sayyed, L., & Trowers, E. (2012). Dysphagia and Warts: Might Be Related!. AMERICAN JOURNAL OF GASTROENTEROLOGY, 107, S248-S249.
• Al-Tamimi, H., & Trowers, E. (2002). The role of endoscopic ultrasonography in diagnosis and therapy of pancreatic and biliary tumors. LASERS IN SURGERY: ADVANCED CHARACTERIZATION, THERAPEUTICS, AND SYSTEMS XII, 4609, 354-361.
• Trowers, E. A. (2002). Linear array echoendoscopy in cancer management. LASERS IN SURGERY: ADVANCED CHARACTERIZATION, THERAPEUTICS, AND SYSTEMS XII, 4609, 347-353.
• Chennupati, R. S., & Trowers, E. (2001). Role of stents and laser therapy in biliary strictures. LASERS IN SURGERY: ADVANCED CHARACTERIZATION THERAPEUTICS, AND SYSTEMS XI, 4244, 287-293.
• Trowers, E., Ewalt, B., & Dalley, B. (2001). A window of opportunity. ACADEMIC MEDICINE, 76(2), 109-109.
• Balachandar, G., Chennupati, R., Badejo, B., & Trowers, E. (2000). Unsedated peroral ultrathin videoendoscopy-assisted delivery of an esophageal manometry catheter. GASTROINTESTINAL ENDOSCOPY, 51(4), AB261-AB261.
• Balachandar, G., Chennupati, R., Badejo, B., & Trowers, E. A. (2000). Unsedated peroral ultrathin videoendoscopy-assisted delivery of an esophageal manometry catheter. Gastrointestinal endoscopy, 51(6), 772.
• Chennupati, R. S., & Trowers, E. (2000). Role of laser photoablative therapy and expandable metal stents in colorectal carcinoma. LASERS IN SURGERY: ADVANCED CHARACTERIZATION, THERAPEUTICS, AND SYSTEMS X, 3907, 405-413.
• Balachandar, G., & Trowers, E. A. (1999). Early colorectal cancer in a flat adenoma. Journal of the National Medical Association, 91(11), 631-2.
  More info

  A 56-year-old man presented with intermittent rectal bleeding of six months' duration. Colonoscopy revealed three left colon polyps, one of which harbored adenocarcinoma. Endoscopic mucosal resection (band-assisted colonoscopic polypectomy) was successful. Endoscopic ultrasonography did not demonstrate any local or regional spread; however, abdominal computed tomography (CT) scan raised suspicion of an isolated metastasis to the liver. The patient's mother had recently died from metastatic colorectal cancer. When presented with the options of no surgery, postendoscopic mucosal resection, and CT-directed needle biopsy of the suspected isolated metastasis to the liver versus segmental resection of the flat adenoma site and wedge resection of the liver lesion for the maximum chance of a surgical cure, the patient opted for the surgical approach. Histopathology revealed no evidence of malignancy in the rectosigmoid colon, pericolonic lymph, or liver specimen. Awareness of increased risk of early cancer in flat adenomas with central depression is important because prompt recognition can lead to curative therapy.
• Trowers, E. A., Rizk, R., & Ojo, E. (1999). Endoscopic hemorrhoidal band removal. Gastrointestinal endoscopy, 49(5), 672.
• Trowers, E. A., Ganga, U., Rizk, R., Ojo, E., & Hodges, D. (1998). Endoscopic hemorrhoidal ligation: preliminary clinical experience. Gastrointestinal endoscopy, 48(1), 49-52.
  More info

  Endoscopic hemorrhoidal ligation may provide an alternative to surgical treatment of internal hemorrhoids. This study assessed the safety and efficacy of endoscopic elastic band ligation for bleeding internal hemorrhoids.
• Keung, Y. K., Cobos, E., & Trowers, E. (1997). Primary pancreatic lymphoma associated with short bowel syndrome: Review of carcinogenesis of gastrointestinal malignancies. LEUKEMIA & LYMPHOMA, 26(3-4), 405-408.
• Trowers, E. A., Dar, S., & Hodges, D. (1997). Tandem expandable stent technique for a fractured nitinol stent. Gastrointestinal endoscopy, 45(2), 217-8.
• Trowers, E. A., Dar, S., Ganga, U., Keung, Y. K., & Bravo-Large, M. (1997). Jejunal adenocarcinoma presenting as iron deficiency in a young man. Journal of the National Medical Association, 89(3), 205-7.
  More info

  A 30-year-old man presented with iron deficiency anemia and occult blood in his stools. Both upper and lower gastrointestinal tract endoscopy were initially unrevealing. This case illustrates the importance of small bowel follow through/enteroclysis supplemented by endoscopic examination and biopsy for adenocarcinoma of the proximal jejunum.
• Trowers, E., Nguyen, W., & Cobos, E. (1997). Decision making in colorectal cancer screening. JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, 89(1), 9-12.
• Batra, S. C., Trowers, E., Dayemo, K., & Singh, H. P. (1996). Novel approach to ampullary cannulation. GASTROINTESTINAL ENDOSCOPY, 44(3), 360-361.
• Taniguchi, D. K., Martin, R. W., Trowers, E. A., & Silverstein, F. E. (1995). Simultaneous M-mode echoesophagram and manometry in the sheep esophagus. Gastrointestinal endoscopy, 41(6), 582-6.
  More info

  We report the simultaneous measurement of esophageal wall layer thickness and intraluminal pressure in the sheep esophagus using a miniature suction device incorporating a high-frequency ultrasound transducer and a manometry system. Transnasal placement of the device into the distal esophagus of a conscious sheep allowed observation of 133 swallowing events during three trials, each lasting from 45 to 60 minutes. In a fourth trial, 11 sequential dry and 23 sequential wet swallows were compared. Maximum manometric pressure, esophageal wall layer thickness, and duration of contraction were measured. All swallowing events produced simultaneous increases in intraluminal pressure and esophageal wall thickness. Mean maximal pressures were lower for dry swallows (18 +/- 2.1 mm Hg) than wet swallows (22 +/- 3.0 mm Hg) (p < .01). Thickness of the inner (circular) muscle layer increased above baseline by 124% for dry swallows and 161% for wet swallows (p < .01). We conclude that thickening of the esophageal inner (circular) muscle layer may be important in the generation of intraluminal esophageal pressure in the sheep esophagus.
• Trowers, E. A., Batra, S. C., Buessler, J., & Anderson, L. K. (1995). Cost analysis for procedure comparisons. Medical group management journal / MGMA, 42(6), 58-65.
  More info

  Using the methodology of activity-based costing as a conceptual framework, the authors present the potential cost reduction of a new office routine and a medical procedure. The costs of a new instrument for colorectal cancer screening and a new surveying and follow-up of at-risk patients show that time and relevant costs in the G.I Clinic and G.I Endoscopy Lab were significantly reduced.
• Teefey, S. A., Kimmey, M. B., Bigler, S. A., Trowers, E. A., & Sillery, J. K. (1994). Gallbladder wall thickening: an in vitro sonographic study with histologic correlation. Academic radiology, 1(2), 121-7.
  More info

  We compared histologic sections with in vitro sonographic images for 40 resected gallbladder specimens to correlate the histopathologic processes with the sonographic appearance of the gallbladder wall.
• Trowers, E., Thomas, C., & Silverstein, F. E. (1994). Chemical- and radiation-induced esophageal injury. Gastrointestinal endoscopy clinics of North America, 4(4), 657-75.
  More info

  The esophageal wall can only respond to injury in a limited fashion. This article explores some of the protective mechanisms involved as well as current approaches to diagnosis and management of chemical- and radiation-induced esophageal injury.
• Taniguchi, D. K., Martin, R. W., Trowers, E. A., Dennis, M. B., Odegaard, S., & Silverstein, F. E. (1993). Changes in esophageal wall layers during motility: measurements with a new miniature ultrasound suction device. Gastrointestinal endoscopy, 39(2), 146-52.
  More info

  We have developed a miniaturized ultrasound device that attaches to the gastrointestinal mucosa by suction and produces high-resolution (+/- 0.1 mm) images of the layers of the intestinal wall. The esophageal wall layers in a single sheep were measured during 20 occlusive contractions observed with simultaneous endoscopy, which revealed thickening of the inner circular muscle layer from 1.2 +/- 0.2 mm to 2.2 +/- 0.4 mm (p < 0.01), and during 20 dilations demonstrating thinning of the full thickness of the esophageal wall from 3.6 +/- 0.3 mm to 2.9 +/- 0.3 mm (p < 0.01). Safety experiments performed in two canine stomachs demonstrated no erosions or ulceration at any level of suction. Our investigations indicate that the M-mode suction ultrasound device can safely assess changes occurring in the layers of the esophageal wall during contractions and dilations and should be evaluated for the study of human intestinal motility.
• Trowers, E. (1993). Just one night for mr john doe. The Western journal of medicine, 158(4), 430.
• Trowers, E. A., & Singh, H. P. (1993). Esophageal carcinoma with obstruction. Digestive diseases (Basel, Switzerland), 16(1), 61-2.
• Trowers, E. A., Cabellero, E., Swenson, R. E., Okafo, O., & Reddix, M. C. (1992). A Nigerian man with fever and abdominal pain. Hospital practice (Office ed.), 27(4A), 149-50.
• Trowers, E. A., Lazcano, O., Swenson, R. E., & Reddix, M. C. (1989). Apudoma of the pancreas: benign or malignant?. Journal of the National Medical Association, 81(5), 601-3.
  More info

  A middle-aged, obese, black woman complained of abdominal pain and tenderness in the left upper quadrant. An abdominal computerized tomographic (CT) scan revealed an encapsulated cystic mass in the tail region of the pancreas. Selective angiography confirmed mass and hypervascularity, definite encapsulation, and lack of capsular invasion. The diagnostic value of the CT scan, angiography, and special staining in classifying the excised pancreatic mass as an apudoma is discussed. Malignancy was excluded by the lack of capsular-vascular invasion and the absence of metastases. Nonfunctional status was determined by lack of hormone hypersecretion.
• Trowers, E. A., Reddix, M. C., & Martinez, R. E. (1989). A military dependent with a hepatic mass. Hospital practice (Office ed.), 24(5A), 74, 76, 79-80.
• Trowers, E. A., Reddy, B. T., Roberts, B. W., Johnson, K., Limaye, R. D., & Reddix, M. C. (1987). 'Elephant man' with severe hypertension. Hospital practice (Office ed.), 22(11), 193-4, 197-200.

Presentations

• Trowers, E. A. (2019, September). Treatment Options in IBS. Southwest Regional Advances in Digestive Diseases. Tucson: University of Arizona.

Poster Presentations

• Trowers, E. A., Trowers, E. A., Shrestha, M. P., & Shrestha, M. P. (2017, Oct/ Fall). Elevated Venous Lactate on Presentation Predicts Intensive Care Unit Admissions, Endoscopies, Transfusions and use of Medical Therapy in Patients with Acute Gastrointestinal Bleeding. WCOG. Orlando: ACG.
• Tey, K. R., Kottey, J., Beatty, N., & Trowers, E. A. (2016, October). Methamphetamine-induced colonic ischemania. American College of Gastroenterology. Las Vegas, Nevada: American College of Gastorenterology.
• Tey, K. R., Singh, N., Takyar, V. K., & Trowers, E. A. (2016, October). Role of Proton Pump Inhibitors in Recurrence of Clostridium Difficile Infection: Systematic Review and Meta-analysis. American College of Gastroenterology. Las Vegas, nevada: American College of Gastroenterology.
• Patel, K., Chatrath, H., & Trowers, E. A. (2015, Fall). Successful treatment of Kommerell's diverticulum. American College of Gastroenterology 2015. Hawaii: ACG.
• Singh, N., Natt, B., Ainapurapu, B. B., & Trowers, E. A. (2015, November/Fall). Hereditary Spherocytosis Leading to Pulmonary Hypertension. American College of Physicians Arizona Meet. Tucson, AZ.
• August, J., Huang, J., Beatty, N., & Trowers, E. A. (2014, October). Throwing a Clot - A rare case of renal Infarct in an Anatomic Variant. American College of Physicians - Regional Scientific Meeting. Arizona.
• Beatty, N., August, J., Fernandes, A., & Trowers, E. A. (2013, October). Meth Colon: Ischemic Colitis Secondary to Methamphetamine Use. American College of Physicians - Regional Scientific Meeting. Tucson, Arizona: ACP Arizona Regional Chapter Scientific Meeting.
• Patel, S., Takyar, V., & Trowers, E. A. (2013, October). An Unusual Case of Dysphagia. American College of Physicians - Regional Scientific Meeting. Tucson, Arizona: ACP Arizona Regional Chapter Scientific Meeting.
• Tumanik, M., Dherange, P., Patel, K., & Trowers, E. A. (2013, October). A Bugging Pain. American College of Physicians - Regional Scientific Meeting. Tucson, Arizona: ACP Arizona Regional Chapter Scientific Meeting.

Creative Productions

• Trowers, E. A. (2023. Colonoscopy/Constipation. DoctorpediaDoctorpedia.
• Trowers, E. A. (2023. Colorectal Cancer. DoctorpediaDoctorpedia.
• Trowers, E. A. (2023. GERD. DoctorpediaDoctorpedia.
• Trowers, E. A. (2023. Gastric Ulcers. DoctorpediaDoctorpedia.

Others

• Kessler, R., & Trowers, E. A. (2017, Fall). Integrating Behavioral Health and Primary Care.
• Singh, N., & Trowers, E. A. (2016, May). Proton pump inhibitor use as a risk factor for recurrent Clostridium Difficile infection: A Systematic Meta-Analyis.
• Tey, K. R., Kottey, J., Beatty, N., & Trowers, E. A. (2016, July). Methamphetamine-induced colonic ischemania. American College of Gastroenterology.
• Trowers, E. A. (2016, May). Effect of low residue diet on the day of colonoscopy.
• Banerjee, B., Shaheen, N. J., Martinez, J. A., Hsu, C., Trowers, E., Gibson, B. A., Della'Zanna, G. J., Richmond, E., & Chow, H. S. (2016, Fall). Clinical Study of Ursodeoxycholic Acid in Barrett's Esophagus Patients. Cancer prevention research.
  More info

  Prior research strongly implicates gastric acid and bile acids, two major components of the gastroesophageal refluxate, in the development of Barrett's esophagus (BE) and its pathogenesis. Ursodeoxycholic acid (UDCA), a hydrophilic bile acid, has been shown to protect esophageal cells against oxidative stress induced by cytotoxic bile acids. We conducted a pilot clinical study to evaluate the clinical activity of UDCA in patients with BE. Twenty-nine BE patients received UDCA treatment at a daily dose of 13-15 mg/kg/day for six months. The clinical activity of UDCA was assessed by evaluating changes in gastric bile acid composition and markers of oxidative DNA damage (8-hydroxydeoxyguanosine, 8OHdG), cell proliferation (Ki67), and apoptosis (cleaved caspase 3, CC3) in BE epithelium. The bile acid concentrations in gastric fluid were measured by liquid chromatography-mass spectrometry. At baseline, UDCA (sum of unchanged and glycine/taurine conjugates) accounted for 18.2% of total gastric bile acids. Post UDCA intervention, UDCA increased significantly to account for 93.39% of total gastric bile acids (p
• Shrestha, M. P., & Trowers, E. A. (2016, Fall). Does digital rectal examination (DRE) affect initial clinical management decision in patients with acute gastrointestinal (GI) bleeding?. The American Journal of Medicine.
• Trowers, E. A. (2016, May). Cost of Foreign Body Ingestion.