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American Journal of Gastroenterology

Andrew J Irvine, William D Chey, Alexander C Ford
OBJECTIVES: Celiac disease (CD) and irritable bowel syndrome (IBS) share similar symptoms, leading to confusion between the two and diagnostic delay. International guidelines recommend screening individuals with IBS for CD, via serological testing. However, studies published recently have cast doubt on the utility of this. We updated a previous meta-analysis examining this issue. METHODS: MEDLINE, EMBASE, and EMBASE Classic were searched through to May 2016. Eligible studies recruited adults with IBS according to symptom-based criteria, physician's opinion, or questionnaire data...
October 18, 2016: American Journal of Gastroenterology
Douglas J Robertson, Jeffrey K Lee, C Richard Boland, Jason A Dominitz, Francis M Giardiello, David A Johnson, Tonya Kaltenbach, David Lieberman, Theodore R Levin, Douglas K Rex
The use of the fecal occult blood test (FOBT) for colorectal cancer (CRC) screening is supported by randomized trials demonstrating effectiveness in cancer prevention and widely recommended by guidelines for this purpose. The fecal immunochemical test (FIT), as a direct measure of human hemoglobin in stool has a number of advantages relative to conventional FOBT and is increasingly used relative to that test. This review summarizes current evidence for FIT in colorectal neoplasia detection and the comparative effectiveness of FIT relative to other commonly used CRC screening modalities...
October 18, 2016: American Journal of Gastroenterology
Sean C Rice, Tina Higginbotham, Melanie J Dean, James C Slaughter, Patrick S Yachimski, Keith L Obstein
OBJECTIVES: Successful outpatient colonoscopy (CLS) depends on many factors including the quality of a patient's bowel preparation. Although education on consumption of the pre-CLS purgative can improve bowel preparation quality, no study has evaluated dietary education alone. We have created an educational video on pre-CLS dietary instructions to determine whether dietary education would improve outpatient bowel preparation quality. METHODS: A prospective randomized, blinded, controlled study of patients undergoing outpatient CLS was performed...
October 18, 2016: American Journal of Gastroenterology
Grigorios I Leontiadis
No abstract text is available yet for this article.
October 18, 2016: American Journal of Gastroenterology
James Kwan, Libby Stein, Sean Delshad, Sunny Johl, Hannah Park, Bibiana Martinez, Lindsey Topp, Brennan M R Spiegel
No abstract text is available yet for this article.
October 11, 2016: American Journal of Gastroenterology
Shanti L Eswaran, William D Chey, Theresa Han-Markey, Sarah Ball, Kenya Jackson
OBJECTIVES: There has been an increasing interest in the role of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) in irritable bowel syndrome (IBS). We report results from the first randomized controlled trial of the low FODMAP diet in US adults with IBS and diarrhea (IBS-D). The objectives were to compare the efficacy of the low FODMAP diet vs. a diet based upon modified National Institute for Health and Care Excellence guidelines (mNICE) on overall and individual symptoms in IBS-D patients...
October 11, 2016: American Journal of Gastroenterology
Lawrence J Brandt, Paul Feuerstadt
No abstract text is available yet for this article.
October 11, 2016: American Journal of Gastroenterology
Dustin A Carlson, Peter J Kahrilas, Zhiyue Lin, Ikuo Hirano, Nirmala Gonsalves, Zoe Listernick, Katherine Ritter, Michael Tye, Fraukje A Ponds, Ian Wong, John E Pandolfino
OBJECTIVES: Esophagogastric junction (EGJ) distensibility and distension-mediated peristalsis can be assessed with the functional lumen imaging probe (FLIP) during a sedated upper endoscopy. We aimed to describe esophageal motility assessment using FLIP topography in patients presenting with dysphagia. METHODS: In all, 145 patients (aged 18-85 years, 54% female) with dysphagia that completed upper endoscopy with a 16-cm FLIP assembly and high-resolution manometry (HRM) were included...
October 11, 2016: American Journal of Gastroenterology
Robert J Hilsden, Ronald Bridges, Catherine Dube, S Elizabeth McGregor, Christopher Naugler, Sarah M Rose, Alaa Rostom, Steven J Heitman
OBJECTIVES: Although there is an accepted benchmark for adenoma detection rate (ADR) in average risk screening colonoscopy, a benchmark for ADR or the associated quality indicator, adenomas per colonoscopy (APC), for colonoscopies performed for a positive fecal immunochemical test (FIT+) has not been established. The purpose of this study was to propose methods for establishing a benchmark ADR and APC for FIT+ patients. METHODS: In this historical cohort study, we included 15,329 patients aged 50-74 years who underwent a colonoscopy at Alberta Health Services' Colon Cancer Screening Centre, Calgary, Canada, from 1 January 2014 to 30 June 2015 for either investigation of a positive FIT or average risk screening...
October 11, 2016: American Journal of Gastroenterology
Athidi Guthikonda, Cary C Cotton, Ryan D Madanick, Melissa B Spacek, Susan E Moist, Kathleen Ferrell, Evan S Dellon, Nicholas J Shaheen
OBJECTIVES: Radiofrequency ablation (RFA) is an effective treatment for Barrett's esophagus (BE). However, recurrence of BE after initially successful RFA is common, and outcomes following recurrence not well described. We report the outcomes associated with recurrence following initially successful RFA. METHODS: We performed a retrospective cohort study of 306 patients treated with RFA for dysplastic BE. Complete eradication of intestinal metaplasia (CE-IM) was defined as complete histological and endoscopic remission of IM...
October 11, 2016: American Journal of Gastroenterology
Stuart McPherson, Tim Hardy, Jean-Francois Dufour, Salvatore Petta, Manuel Romero-Gomez, Mike Allison, Claudia P Oliveira, Sven Francque, Luc Van Gaal, Jörn M Schattenberg, Dina Tiniakos, Alastair Burt, Elisabetta Bugianesi, Vlad Ratziu, Christopher P Day, Quentin M Anstee
OBJECTIVES: Non-invasive fibrosis scores are widely used to identify/exclude advanced fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). However, these scores were principally developed and validated in patients aged between 35 and 65 years of age. The objective of this study was to assess the effect of age on the performance of non-invasive fibrosis tests in NAFLD. METHODS: Patients were recruited from European specialist hepatology clinics. The cohort was divided into five age-based groups: ≤35 (n=74), 36-45 (n=96), 46-55 (n=197), 56-64 (n=191), and ≥65 years (n=76), and the performance of the aspartate aminotransferase (AST)/alanine transaminase (ALT) ratio, fibrosis 4 (FIB-4), and NAFLD fibrosis score (NFS) for advanced fibrosis (stage F3-F4) for each group was assessed using liver biopsy as the standard...
October 11, 2016: American Journal of Gastroenterology
Hamed Khalili, Martin Neovius, Anders Ekbom, Jonas F Ludvigsson, Johan Askling, Andrew T Chan, Ola Olen
OBJECTIVES: Oral contraceptive (OC) use has been consistently linked to increased risk of inflammatory bowel disease. Nonetheless, a specific role of OC in the natural history of ulcerative colitis (UC) is unknown. METHODS: We identified 6,104 incident female UC cases aged 16-51 years at diagnosis from the Swedish National Patient Register starting in January of 2003. Information on current OC use was obtained from the Prescribed Drug Register starting in July of 2005...
October 11, 2016: American Journal of Gastroenterology
Sunhee Park, Tsion Abdi, Mark Gentry, Loren Laine
OBJECTIVES: Endoscopic remission in ulcerative colitis (UC) is associated with improved clinical outcomes. We assessed whether histological remission predicts clinical outcomes, estimated the magnitude of effect, and determined whether histological remission provides additional prognostic utility beyond clinical or endoscopic remission. METHODS: Bibliographic databases were searched for studies in inflammatory bowel disease providing baseline histological status and relation to an outcome of clinical relapse or exacerbation...
October 11, 2016: American Journal of Gastroenterology
Brennan Spiegel, Brian E Lacy
No abstract text is available yet for this article.
October 4, 2016: American Journal of Gastroenterology
Dustin A Carlson, Zhiyue Lin, Peter J Kahrilas, Joel Sternbach, Eric S Hungness, Nathaniel J Soper, Michelle Balla, Zoe Listernick, Michael Tye, Katherine Ritter, Jenna Craft, Jody D Ciolino, John E Pandolfino
OBJECTIVES: We aimed to evaluate the value of novel high-resolution impedance manometry (HRIM) metrics, bolus flow time (BFT), and esophagogastric junction (EGJ) contractile integral (CI), as well as EGJ pressure (EGJP) and the integrated relaxation pressure (IRP), as indicators of treatment response in achalasia. METHODS: We prospectively evaluated 75 patients (ages 19-81, 32 female) with achalasia during follow-up after pneumatic dilation or myotomy with Eckardt score (ES), timed-barium esophagram (TBE), and HRIM...
October 4, 2016: American Journal of Gastroenterology
Qi Chen, Wei Zhang, Qingyan Fu, Xiao Liang, Wenzhong Liu, Shudong Xiao, Hong Lu
OBJECTIVES: To compare the efficacy and safety of bismuth-containing quadruple therapy with tetracycline or amoxicillin for rescue treatment of Helicobacter pylori. METHODS: The study was a non-inferiority trial of H. pylori eradication with at least two previous treatment failures. Subjects were randomized to receive 14-day therapy with b.i.d. lansoprazole 30 mg and bismuth 220 mg, plus metronidazole 400 mg q.i.d and amoxicillin 1 g t.i.d (amoxicillin group) or tetracycline 500 mg q...
September 27, 2016: American Journal of Gastroenterology
Ray K Boyapati, Rahul Kalla, Jack Satsangi, Gwo-Tzer Ho
The completion of the human genome project in 2003 represented a major scientific landmark, ushering in a new era with hopes and expectations of fresh insights into disease mechanisms and treatments. In inflammatory bowel disease (IBD), many important discoveries soon followed, notably the identification of >200 genetic susceptibility loci and characterization of the gut microbiome. As "big data", driven by advances in technology, becomes increasingly available and affordable, individuals with IBD and clinicians alike yearn for tangible outcomes from the promise of "precision medicine"-precise diagnosis, monitoring, and treatment...
September 27, 2016: American Journal of Gastroenterology
Masaaki Shimatani, Hisashi Hatanaka, Hirofumi Kogure, Koichiro Tsutsumi, Hiroki Kawashima, Keiji Hanada, Tomoki Matsuda, Tomoki Fujita, Makoto Takaoka, Tomonori Yano, Atsuo Yamada, Hironari Kato, Kazuichi Okazaki, Hironori Yamamoto, Hideki Ishikawa, Kentaro Sugano
OBJECTIVES: To evaluate the utility and safety of a short-type double-balloon endoscope (DBE) in the treatment of biliary disease in patients with surgically altered gastrointestinal (GI) anatomy. METHODS: This study was conducted as a multicenter, single-arm, prospective trial at five tertiary academic care centers and three community-based hospitals in Japan. Consecutive patients with biliary disease with altered GI anatomy were prospectively included in this study...
September 27, 2016: American Journal of Gastroenterology
Richa Shukla, Jennifer Kramer, Yumei Cao, Jun Ying, Aylin Tansel, Annette Walder, Shailesh Advani, Hashem B El-Serag, Fasiha Kanwal
OBJECTIVES: Prior studies have demonstrated the efficacy of non-selective beta-blockers (NSBB) in preventing first variceal bleeding in patients with cirrhosis. However, little is known about the overall effectiveness of NSBB in routine clinical care. METHODS: We conducted a retrospective cohort study of cirrhotic patients without prior bleeding who initiated a NSBB (propranolol, nadolol) at any Veterans Administration facility between 2008 and 2013. The primary outcome was variceal bleeding within 12 months...
September 27, 2016: American Journal of Gastroenterology
Mark T Osterman, William J Sandborn, Jean-Frederic Colombel, Laurent Peyrin-Biroulet, Anne M Robinson, Qian Zhou, James D Lewis
OBJECTIVES: Anti-tumor necrosis factor (TNF) drugs are commonly used to treat moderate-to-severe Crohn's disease (CD). Both the activity of CD and the concomitant immunosuppressants (corticosteroids and immunomodulators) used with anti-TNF drugs could increase the risk of infection. We determined the relative risk of serious and opportunistic infections associated with increasing disease activity and concomitant immunomodulators and corticosteroids in patients with CD treated with adalimumab...
September 27, 2016: American Journal of Gastroenterology
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