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Journal of Clinical Gastroenterology

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https://www.readbyqxmd.com/read/28098578/helicobacter-pylori-and-risk-of-nonalcoholic-fatty-liver-disease-a-systematic-review-and-meta-analysis
#1
Karn Wijarnpreecha, Charat Thongprayoon, Panadeekarn Panjawatanan, Wuttiporn Manatsathit, Veeravich Jaruvongvanich, Patompong Ungprasert
BACKGROUND/OBJECTIVES: Helicobacter pylori (H. pylori) is the most common chronic bacterial infection. Patients with H. pylori infection may be at an increased risk of nonalcoholic fatty liver disease (NAFLD) because of chronic inflammation and insulin resistance. Several epidemiologic studies attempting to determine this risk have yielded inconsistent results. This meta-analysis was conducted with the aims to summarize all available evidence and estimate the risk of NAFLD in patients with H...
January 17, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28059940/histologic-tumor-grade-and-preoperative-bilary-drainage-are-the-unique-independent-prognostic-factors-of-survival-in-pancreatic-ductal-adenocarcinoma-patients-after-pancreaticoduodenectomy
#2
Nicolás Macías, José M Sayagués, Carmen Esteban, Manuel Iglesias, Luís M González, Jose Quiñones-Sampedro, María L Gutiérrez, Luís A Corchete, Maria M Abad, Oscar Bengoechea, Luís Muñoz-Bellvis
BACKGROUND AND AIM: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal types of cancer; most patients die during the first 6 months after diagnosis. With a 5% 5-year survival rate, is the fourth leading cause of cancer death in developed countries. In this regard, several clinical, histopathologic and biological characteristics of the disease favoring long-term survival after pancreaticoduodenectomy have been reported to be significant prognostic factors. Despite the availability of this information, there is no consensus about the different prognostic factors reported in the literature, probably due to variations in patient selection, methods, and sample size studied...
January 13, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28067753/long-term-extent-change-of-pediatric-onset-ulcerative-colitis
#3
Firas Rinawi, Amit Assa, Corina Hartman, Yael Mozer Glassberg, Vered Nachmias Friedler, Yoram Rosenbach, Ari Silbermintz, Noam Zevit, Raanan Shamir
BACKGROUND: Data describing extent change (progression or regression) in pediatric-onset ulcerative colitis (UC) are scarce. GOAL: We aimed to describe extent change in pediatric-onset UC during long-term follow-up and to assess predictors of extent change. STUDY: Medical charts of pediatric-onset UC patients with at least 5-year follow-up were analyzed retrospectively. Disease extent was determined using the Paris classification. It was examined at diagnosis and during follow-up at different time points...
January 6, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28059943/efficacy-safety-and-outcomes-of-endoscopic-retrograde-cholangiopancreatography-with-per-oral-pancreatoscopy-a-multicenter-experience
#4
Sheeva K Parbhu, Ali A Siddiqui, Megan Murphy, Arish Noor, Linda J Taylor, Alyssa Mills, Douglas G Adler
INTRODUCTION: Per-oral pancreatoscopy can be used for both evaluation and treatment of pancreatic duct stones during endoscopic retrograde cholangiopancreatography, evaluating and treating pancreatic duct strictures of indeterminate etiology, and visual inspection and direct biopsy of pancreatic duct mucosa for diagnosis of intraductal papillary mucinous neoplasm (IPMN). We aim to describe the efficacy, safety, and outcomes of pancreatoscopy in a large, multicenter series of patients...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28059942/efficacy-of-biofeedback-therapy-in-the-treatment-of-dyssynergic-defecation-in-community-dwelling-elderly-women
#5
Miguel A Simón, Ana M Bueno
AIM OF THE STUDY: The aim of this study was to evaluate the efficacy of biofeedback therapy in the treatment of dyssynergic defecation in chronically constipated community-dwelling elderly women. MATERIALS AND METHODS: After an initial assessment phase carried out during 1 month, 20 chronically constipated women with dyssynergic defecation were randomly assigned to either electromyographic biofeedback (EMG-BF) group (n=10) or control group (n=10). Outcome measures used to evaluate the efficacy of treatment were weekly stool frequency, sensation of incomplete evacuation, difficulty evacuation level, mean EMG-activity (μV) of the external anal sphincter during straining to defecate and Anismus index...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28059941/adenoma-detection-rates-for-screening-colonoscopies-in-smokers-and-obese-adults-data-from-the-new-hampshire-colonoscopy-registry
#6
Joseph C Anderson, Julia E Weiss, Christina M Robinson, Lynn F Butterly
GOAL: To examine screening adenoma detection rates (ADR) and serrated detection rates (SDR) among smokers and obese adults in the New Hampshire Colonoscopy Registry. BACKGROUND: ADR, a quality measure for screening colonoscopies, is associated with protection from interval colorectal cancer. Currently, only sex-specific ADR benchmarks are reported. However, obesity and smoking ≥20 pack-years are strong predictors for colorectal neoplasia, as highlighted by the 2009 American College of Gastroenterology CRC Screening Guidelines...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28059939/endoscopic-stenting-for-colorectal-cancer-lessons-learned-from-a-15-year-experience
#7
Enrico Fiori, Antonietta Lamazza, Antonio V Sterpetti, Alberto Schillaci
GOAL: The aim of our prospective study was to analyze the results of endoscopic stenting to treat obstruction due to colorectal cancer and complications after colorectal resection for cancer. BACKGROUND: Endoscopic stenting for obstructing colorectal cancer has become a common place in clinical practice. However, there is a 2% to 5% risk of bowel perforation, and a percentage of technical failure of 2% to 10%. MATERIALS AND METHODS: In a 15-year period (August, 1999 to December, 2013), 153 patients with colorectal cancer had endoscopic placement of a self-expandable metal stent for treatment of an obstructing colorectal cancer (133 patients) or for treatment of complications after colorectal resection for cancer (20 patients)...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28059938/the-effects-of-probiotics-and-symbiotics-on-risk-factors-for-hepatic-encephalopathy-a-systematic-review
#8
Daniela Viramontes Hörner, Amanda Avery, Ruth Stow
Alterations in the levels of intestinal microbiota, endotoxemia, and inflammation are novel areas of interest in the pathogenesis of hepatic encephalopathy (HE). Probiotics and symbiotics are a promising treatment option for HE due to possible beneficial effects in modulating gut microflora and might be better tolerated and more cost-effective than the traditional treatment with lactulose, rifaximin or L-ornithine-L-aspartate. A systematic search of the electronic databases PubMed, ISI Web of Science, EMBASE, and Cochrane Library was conducted for randomized controlled clinical trials in adult patients with cirrhosis, evaluating the effect of probiotics and symbiotics in changes on intestinal microflora, reduction of endotoxemia, inflammation, and ammonia, reversal of minimal hepatic encephalopathy (MHE), prevention of overt hepatic encephalopathy (OHE), and improvement of quality of life...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28059937/laparoscopic-adhesiolysis-in-chronic-abdominal-pain-15-year-follow-up-study
#9
Paavo Paajanen, Anne Fagerström, Hannu Paajanen
BACKGROUND/GOAL: Intra-abdominal adhesions are probably underdiagnosed cause for chronic abdominal pain. Our aim was to evaluate late (>10 y) effect of laparoscopic adhesiolysis on chronic abdominal pain. STUDY: This was a nonrandomized follow-up study of 68 patients (9 males, 59 females) who suffered chronic abdominal pain. The index operation (laparoscopy and adhesiolysis; n=72 patients) was performed during 1997 to 2001. A quality-of-life questionnaire was asked after the mean follow-up time of 15 years...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28059936/depression-but-not-symptom-severity-is-associated-with-work-and-school-absenteeism-in-refractory-chronic-constipation
#10
Kyle Staller, Kenneth Barshop, Braden Kuo, Ashwin N Ananthakrishnan
GOALS: We sought to determine the patient characteristics associated with increased absenteeism and Emergency Department (ED) utilization among patients with constipation. BACKGROUND: Chronic constipation is associated with significant direct and indirect economic costs. There has been limited study of the predictors of direct and indirect costs in a population with refractory constipation. STUDY: We conducted a cross-sectional cohort study of patients with chronic constipation who presented to a tertiary care center for anorectal manometry...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28030510/clinical-and-fecal-microbial-changes-with-diet-therapy-in-active-inflammatory-bowel-disease
#11
David L Suskind, Stanley A Cohen, Mitchell J Brittnacher, Ghassan Wahbeh, Dale Lee, Michele L Shaffer, Kimberly Braly, Hillary S Hayden, Jani Klein, Benjamin Gold, Matthew Giefer, Angela Stallworth, Samuel I Miller
GOAL: To determine the effect of the specific carbohydrate diet (SCD) on active inflammatory bowel disease (IBD). BACKGROUND: IBD is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Diet is a potential therapeutic option for IBD based on the hypothesis that changing the fecal dysbiosis could decrease intestinal inflammation. STUDY: Pediatric patients with mild to moderate IBD defined by pediatric Crohn's disease activity index (PCDAI 10-45) or pediatric ulcerative colitis activity index (PUCAI 10-65) were enrolled into a prospective study of the SCD...
December 27, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28009687/eus-guided-versus-percutaneous-gallbladder-drainage-isn-t-it-time-to-convert
#12
Amy Tyberg, Monica Saumoy, Enrique V Sequeiros, Marc Giovannini, Everson Artifon, Anthony Teoh, Jose Nieto, Amit P Desai, Nikhil A Kumta, Monica Gaidhane, Reem Z Sharaiha, Michel Kahaleh
BACKGROUND AND AIMS: Endoscopic ultrasound-guided drainage (EUS-GLB) is a minimally invasive option for patients with cholecystitis who are poor surgical candidates. Compared with percutaneous drainage (PC-GLB), earlier studies have demonstrated similar efficacy with improved quality of life. We present a multicenter, international experience comparing PC-GLB and EUS-GLB in nonsurgical patients with cholecystitis. METHODS: All patients who underwent either PC-GLB drainage or EUS-GLB drainage from 7 centers between January 2010 and December 2015 were included...
December 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28009686/etiology-and-pathogenesis-of-idiopathic-achalasia
#13
Amanda Pressman, Jose Behar
This review examines the etiology and pathogenesis of idiopathic achalasia. This disease is clinically characterized by dysphagia of solids and liquids due to the presence of simultaneous or absent esophageal contractions and impaired or absent relaxation of the lower esophageal sphincter. It includes a review of (a) etiology and pathogenesis of this inflammatory process that damage the ganglion cells of the Auerbach plexus that is limited to the esophagus; (b) genetic abnormalities and polymorphisms associated with this disease that may help explain its heterogeneity expressed by the different motility abnormalities of its phenotypes as well as differences in its clinical progression...
December 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28009685/there-is-significant-practice-pattern-variability-in-the-management-of-the-hospitalized-ulcerative-colitis-patient-at-a-tertiary-care-and-ibd-referral-center
#14
Shailja C Shah, Steven Naymagon, Benjamin L Cohen, Bruce E Sands, Marla C Dubinsky
BACKGROUND AND GOALS: Despite published clinical guidelines, substantive data underlying the approach to the management of hospitalized ulcerative colitis (UC) patients failing outpatient therapy are lacking. Variability in practice is therefore not uncommon and may impact clinical outcomes. The degree of variability, however, is not well-studied. Our aim was to evaluate variability in management of the hospitalized UC patient to inform future efforts targeting care optimization for this high-risk population...
December 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28009684/within-stool-and-within-day-sample-variability-of-fecal-calprotectin-in-patients-with-inflammatory-bowel-disease-a-prospective-observational-study
#15
Lillian Du, Rae Foshaug, Vivian W Huang, Karen I Kroeker, Levinus A Dieleman, Brendan P Halloran, Karen Wong, Richard N Fedorak
BACKGROUND AND GOALS: The use of fecal calprotectin (FC) as a stool biomarker for differentiating inflammatory bowel disease (IBD) from IBS has been well validated, and there is a strong correlation between FC and the presence of endoscopic inflammatory lesions. However, recent studies have demonstrated intraindividual sample variability in patients with IBD, possibly limiting the reliability of using a single sample for monitoring disease activity. Our aim was to assess the within-stool and within-day sample variability of FC concentrations in patients with IBD...
December 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28009683/diabetes-mellitus-is-associated-with-mortality-in-acute-pancreatitis
#16
Ji Hye Huh, Hosung Jeon, Sun Min Park, EunHee Choi, Geun Sook Lee, Jae Woo Kim, Kyong Joo Lee
BACKGROUND AND AIM: Predicting severe pancreatitis is important for early aggressive management of patients with acute pancreatitis (AP). Despite the established role of diabetes mellitus (DM) in the risk of AP, the impact of DM on the clinical outcome in AP has not been fully elucidated. The objective of this study was to assess the risk of mortality and severity in AP among patients with type-2 DM. METHODS: Patients diagnosed with first attacks of AP were enrolled from January 2013 to June 2015...
December 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28009682/outcomes-with-fidaxomicin-therapy-in-clostridium-difficile-infection
#17
Clayton M Spiceland, Sahil Khanna, Darrell S Pardi
BACKGROUND AND GOALS: Fidaxomicin is a new antibiotic used to treat Clostridium difficile infection (CDI). Given limited clinical experience with fidaxomicin, we assessed outcomes in a diverse cohort of patients with CDI treated with fidaxomicin. STUDY: All CDI cases treated with fidaxomicin at 3 referral centers over a 4-year period were included. Response was defined as resolution of diarrhea and recurrence was defined by recurrence of CDI within 8 weeks of the end of treatment...
December 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28005634/the-role-of-esophageal-hypersensitivity-in-functional-esophageal-disorders
#18
Adam D Farmer, James K Ruffle, Qasim Aziz
The Rome IV diagnostic criteria delineates 5 functional esophageal disorders which include functional chest pain, functional heartburn, reflux hypersensitivity, globus, and functional dysphagia. These are a heterogenous group of disorders which, despite having characteristic symptom profiles attributable to esophageal pathology, fail to demonstrate any structural, motility or inflammatory abnormalities on standard clinical testing. These disorders are associated with a marked reduction in patient quality of life, not least considerable healthcare resources...
December 21, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27984403/the-glasgow-prognostic-score-at-the-time-of-palliative-esophageal-stent-insertion-is-a-predictive-factor-of-30-day-mortality-and-overall-survival
#19
Robert J Driver, Catherine Handforth, Ganesh Radhakrishna, Michael I Bennett, Alexander C Ford, Simon M Everett
BACKGROUND: Optimizing the timing of esophageal stent insertion is a challenge, partly due to difficulty predicting survival in advanced malignancy. The Glasgow prognostic score (GPS) is a validated tool for predicting survival in a number of cancers. GOALS: To assess the utility of the GPS in predicting 30-day mortality and overall survival postesophageal stent insertion. STUDY: Patients at a tertiary referral center who had received an esophageal stent for palliation of dysphagia were included if they had a measurement of albumin and C-reactive protein (CRP) in the week preceding the procedure (n=209)...
December 14, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27984402/adherence-to-surveillance-guidelines-in-nondysplastic-barrett-s-esophagus
#20
Kunal S Dalal, Jessica Coffing, Thomas F Imperiale
INTRODUCTION: Surveillance patterns in Barrett's esophagus (BE) are not well characterized. Guidelines published between 2002 and 2008 recommended surveillance esophagogastroduodenoscopy (sEGD) at 3-year intervals for nondysplastic BE (NDBE). We assessed guideline adherence in incident NDBE in a Veterans Affairs (VA)-based study. METHODS: At a single VA center, we identified incident cases of biopsy-confirmed NDBE between January, 2006 and December, 2008. We excluded patients aged 76 years and above and those who developed BE-associated dysplasia or cancer during follow-up...
December 14, 2016: Journal of Clinical Gastroenterology
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