ACG CxA study guide
ACG CxA · Work through your exam, one topic at a time.
The ACG Certified Excellence in Gastroenterology (CxA) is presented here as a professional credential for gastroenterologists and advanced practice providers who want structured, exam-based validation of their clinical knowledge. This page is an independent study resource; it is not affiliated with, endorsed by, or sponsored by the American College of Gastroenterology. The ACG CxA study guide has 6 sections and about 1,579 words.
01Gastroenterology and Hepatology Clinical Knowledge
Build a symptom-to-mechanism map rather than memorizing isolated facts. For upper GI complaints, distinguish mucosal injury (peptic ulcer disease, gastritis), motor disorders (gastroparesis), and acid-hypersecretion states (Zollinger-Ellison).
320 words, about 2 min02Endoscopy and Gastrointestinal Procedures
Endoscopy questions test preparation, sedation, complications, and appropriate use. Colonoscopy preparation quality determines adenoma detection; split-dose bowel prep is standard, and inadequate prep should prompt rescheduling rather than a compromised exam.
291 words, about 1 min03Inflammatory Bowel Disease
Separate ulcerative colitis (continuous, mucosal, rectal involvement, no skip lesions) from Crohn disease (transmural, skip lesions, perianal disease, fistula). Extraintestinal manifestations include arthritis, erythema nodosum, pyoderma gangrenosum, uveitis, and primary sclerosing cholangitis, which is strongly associated with ulcerative colitis.
250 words, about 1 min04Liver Disease and Hepatology
Approach liver disease by pattern: hepatocellular versus cholestatic injury, acute versus chronic, and compensated versus decompensated cirrhosis. Know the Child-Pugh and MELD scores and their roles in prognosis and transplant listing.
247 words, about 1 min05Functional GI and Motility Disorders
Functional disorders are defined by symptom patterns, not by absence of disease. Know Rome criteria for irritable bowel syndrome (recurrent abdominal pain with altered stool form or frequency), functional dyspepsia, and functional constipation.
231 words, about 1 min06Practice Management, Quality, and Health Equity
Quality in endoscopy is measured by validated metrics: adenoma detection rate, cecal intubation rate, withdrawal time, bowel prep adequacy, and complication rates. Know that adenoma detection rate is a key screening quality indicator and that withdrawal time is a modifiable contributor.
240 words, about 1 min