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Current Opinion in Gastroenterology

Agostino Di Ciaula, David Q-H Wang, Piero Portincasa
PURPOSE OF REVIEW: Gallstone disease is a major epidemiologic and economic burden worldwide, and the most frequent form is cholesterol gallstone disease. RECENT FINDINGS: Major pathogenetic factors for cholesterol gallstones include a genetic background, hepatic hypersecretion of cholesterol, and supersaturated bile which give life to precipitating cholesterol crystals that accumulate and grow in a sluggish gallbladder. Additional factors include mucin and inflammatory changes in the gallbladder, slow intestinal motility, increased intestinal absorption of cholesterol, and altered gut microbiota...
December 27, 2017: Current Opinion in Gastroenterology
Heidi M Staudacher, Matthew Kurien, Kevin Whelan
PURPOSE OF REVIEW: The aim of this review is to summarize some of the key dietary interventions recommended for common gastrointestinal disorders and to discuss recent evidence regarding their nutritional implications. RECENT FINDINGS: The gluten-free diet has been shown to negatively influence overall diet quality. The gluten-free diet is essential in celiac disease, although it is increasingly used for other perceived health benefits for which an analysis of perceived benefit should be weighed against any nutritional risks...
December 22, 2017: Current Opinion in Gastroenterology
Chantal Housset
No abstract text is available yet for this article.
December 20, 2017: Current Opinion in Gastroenterology
Marco Arrese, Víctor Cortés, Francisco Barrera, Flavio Nervi
PURPOSE OF REVIEW: Gallstone disease (GSD) and nonalcoholic fatty liver disease (NAFLD often coexist in a given patient and both conditions are associated to obesity and insulin resistance. The relationship between GSD and NAFLD is complex and bidirectional. In the present review, we summarize the existing information on the complex link between GSD and NAFLD and the potential implications for patient care. RECENT FINDINGS: Several clinical studies and systematic reviews have addressed the association between NAFLD and GSD underscoring that NAFLD is an independent risk factor for GSD...
December 20, 2017: Current Opinion in Gastroenterology
Tony Y Wang, Piero Portincasa, Min Liu, Patrick Tso, David Q-H Wang
PURPOSE OF REVIEW: The establishment of mouse models of gallstones, and the contribution of mouse models to genetic studies of gallstone disease, as well as the latest advances in the pathophysiology of gallstones from mouse experiments are summarized. RECENT FINDINGS: The combined uses of genomic strategies and phenotypic studies in mice have successfully led to the identification of many Lith genes, which pave the way for the discovery of human LITH genes. The physical-chemical, genetic, and molecular biological studies of gallstone disease in mice with knockout or transgene of specific target genes have provided many novel insights into the complex pathophysiological mechanisms of this very common hepatobiliary disease worldwide, showing that interactions of five primary defects play a critical role in the pathogenesis of cholesterol gallstones...
December 20, 2017: Current Opinion in Gastroenterology
Eamonn M M Quigley
No abstract text is available yet for this article.
December 18, 2017: Current Opinion in Gastroenterology
Daniel Mønsted Shabanzadeh
PURPOSE OF REVIEW: The purpose of this review was to describe the epidemiology of gallstone disease in the era of ultrasound screening and laparoscopic cholecystectomy. RECENT FINDINGS: Recent general population cohorts, including ultrasound screenings, have contributed to our understanding of formation and clinical course of gallstone disease. Cohorts of symptomatic gallstone disease have been informative about symptom recurrence and need of treatment. Preventive targets for gallstone formation may include obesity and the associated metabolic changes...
December 18, 2017: Current Opinion in Gastroenterology
Mark P Lamberts
PURPOSE OF REVIEW: Recent studies showed new insights in the indication and timing of cholecystectomy in gallstone disease. This review will provide an overview. RECENT FINDINGS: Considerable variations in indication for gallbladder surgery have been noticed leading to a significant number of unnecessary cholecystectomies. As a consequence, up to 33% of patients with uncomplicated symptomatic gallstone disease have persistent abdominal pain after cholecystectomy...
December 18, 2017: Current Opinion in Gastroenterology
John P Mills, Krishna Rao, Vincent B Young
PURPOSE OF REVIEW: Probiotics may prevent Clostridium difficile infection (CDI), a leading healthcare-associated infection in the United States. However, prior studies were limited by heterogeneity in products and patient populations. Recent clinical evidence and new approaches to probiotic development are reviewed. RECENT FINDINGS: Probiotic use may reduce incident CDI in high-risk populations by as much as 50%, though prior clinical trials have yielded conflicting results...
November 17, 2017: Current Opinion in Gastroenterology
Mark H Wilcox
No abstract text is available yet for this article.
November 10, 2017: Current Opinion in Gastroenterology
Javier A Villafuerte-Gálvez, Ciarán P Kelly
PURPOSE OF REVIEW: The rising burden of Clostridium difficile infection (CDI) requires urgent identification of preventable risk factors. Observational studies suggest an association between proton-pump inhibitor (PPI) use and CDI risk. RECENT FINDINGS: Key historical literature on PPI and CDI associations is reviewed as a prelude to evaluating the plausibility of a causative association. Impactful literature from the past 18 months is examined in detail and critically appraised through the lens of the Bradford Hill Criteria for determination of causality...
January 2018: Current Opinion in Gastroenterology
Orla Craig
PURPOSE OF REVIEW: The purpose of this review is to examine the evidence supporting the use of recently developed pharmacological treatments for IBS together with new evidence supporting more traditional therapies in order to understand where the new agents are best used in the treatment pathway. RECENT FINDINGS: There is evidence to support the use of traditional treatments such as antispasmodics, antidepressants and dietary alteration in IBS. New therapeutic agents such as Linaclotide, Lubiprostone, Plecanatide, Rifaxamin and Eluxadoline are all more effective than placebo in treating symptoms of IBS with Tenapanor being a promising new agent...
January 2018: Current Opinion in Gastroenterology
Danny O Jacobs
PURPOSE OF REVIEW: Efforts continue to improve the treatment of patients with symptomatic hemorrhoidal disease by interventions designed to improve efficiency and effectiveness, including by reducing intraoperative and postoperative pain, decreasing operating times, minimizing blood loss and controlling symptoms and recurrence rates. Simultaneously, there are also renewed efforts to minimize the number of patients who will require procedural intervention by focusing on conservative measures that encourage better bowel regulation and habits...
January 2018: Current Opinion in Gastroenterology
Louissa R Macfarlane-Smith, Shadia Ahmed, Mark H Wilcox
PURPOSE OF REVIEW: Molecular-based diagnostic methods for the detection of gastrointestinal pathogens are becoming increasingly commonplace in microbiology laboratories. This review aims to summarize recent developments in this field and discuss the clinical application and limitations of implementing these techniques. RECENT FINDINGS: Recent evaluations of multiplex PCR assays show increased sensitivity whenever compared with standard microbiological culture-based methods...
January 2018: Current Opinion in Gastroenterology
Leila Neshatian
PURPOSE OF REVIEW: To summarize the advances in diagnostic modalities and management options for defecatory dysfunction and highlight the areas in need of further research. RECENT FINDINGS: The diagnostic utility of high-resolution anorectal manometry (ARM), which has emerged as a promising tool for the diagnosis of defecatory dysfunction, appears to be questionable in differentiating disease from normal physiology. There also seems to be discrepancy between results of various tests of anorectal function in the diagnosis of defecatory dysfunction...
January 2018: Current Opinion in Gastroenterology
Jason D Eckmann, Victor G Chedid, Conor G Loftus
PURPOSE OF REVIEW: Hematochezia is a common clinical presentation, with significant morbidity and economic burden. These patients often require costly interventions including hospitalization, blood transfusions, and radiologic or endoscopic procedures. The purpose of this review is to give a rational, concise approach to the patient with hematochezia, with special consideration of recent advances in the literature. RECENT FINDINGS: Recent studies pertaining to hematochezia have evaluated risk stratification, endoscopic intervention, evaluation of small bowel bleeding, and management of anticoagulation...
January 2018: Current Opinion in Gastroenterology
Benoit Chassaing, Matam Vijay-Kumar, Andrew T Gewirtz
PURPOSE OF REVIEW: Disturbances of the intestinal microbiota have been increasingly implicated in driving various diseases associated with a broad range of chronic inflammatory state. Such diseases have increased in incidence since the mid-20th century, and have roughly correlated with societal changes in food production during this period. RECENT FINDINGS: Considering how changes in diet may have impacted gut microbiota and exploring whether targeted modulations of diet might be a means of optimizing microbiota composition to promote health...
November 2017: Current Opinion in Gastroenterology
Andrew C Storm, Marvin Ryou
PURPOSE OF REVIEW: Disorders of gastric outflow and outlet obstruction include a variety of benign and malignant disorders such as peptic strictures, foreign bodies, gastroparesis, and cancers of the stomach, duodenum, and pancreas. Historically, a majority of patients presenting with gastric outlet obstruction (GOO) were to the result of peptic ulcers and surgical management of peptic ulcer complications was a mainstay of general surgical training. Invasive surgery is being performed less frequently today due to realization of the role of Helicobacter pylori in peptic ulcer disease and the introduction of novel endoscopic techniques for management of GOO...
November 2017: Current Opinion in Gastroenterology
Giorgos Bamias, Kristen O Arseneau, Fabio Cominelli
PURPOSE OF REVIEW: Currently several mouse models are considered representative of inflammatory bowel disease (IBD). This review presents recent developments regarding the role of animal models of intestinal inflammation as research tools in IBD. RECENT FINDINGS: Preclinical studies in animal models of intestinal inflammation have generated novel findings in several areas of IBD research. The combination of chemical and genetically engineered models have revealed protective or harmful roles for various components of the innate immune system in response to acute injury and repair mechanisms for the intestinal mucosa...
November 2017: Current Opinion in Gastroenterology
David H Ilson
PURPOSE OF REVIEW: To review recent studies in esophagogastric cancer. RECENT FINDINGS: Positive emission tomography (PET) scan in follow-up after curative treatment of esophagogastric cancer did not lead to improved survival. In the preoperative treatment of esophagogastric cancer, the addition of the antivascular endothelial growth factor agent bevacizumab to perioperative chemotherapy with combination epirubicin, cisplatinum, and 5-fluorouracil (5-FU; ECF) failed to improve survival compared with chemotherapy alone...
November 2017: Current Opinion in Gastroenterology
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