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Current Opinion in Gastroenterology

William T Clarke, Joseph D Feuerstein
PURPOSE OF REVIEW: This review article will discuss the risk of colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD), as well as the current recommendations for CRC screening and surveillance in patients with ulcerative colitis or Crohn's colitis involving one-third of the colon. RECENT FINDINGS: Given that most cases of CRC are thought to arise from dysplasia, previous guidelines have recommended endoscopic surveillance with random biopsies obtained from all segments of the colon...
May 15, 2018: Current Opinion in Gastroenterology
John Gubatan, Alan C Moss
PURPOSE OF REVIEW: The aim of this review is to explore the protective role of vitamin D on the gastrointestinal tract, summarize the epidemiology of vitamin D deficiency in inflammatory bowel disease (IBD), and highlight recent studies examining the impact of low vitamin D and vitamin D supplementation on IBD clinical outcomes. RECENT FINDINGS: Vitamin D protects the gut barrier by regulating tight junction proteins and inhibiting intestinal apoptosis. Vitamin D enhances innate immunity by inducing antimicrobial peptides and regulates adaptive immunity by promoting anti-inflammatory T cells and cytokines...
May 11, 2018: Current Opinion in Gastroenterology
Parakrama Chandrasoma
PURPOSE OF REVIEW: To provide new concepts regarding the early pathologic changes of gastroesophageal reflux disease (GERD) that are associated with damage to the lower esophageal sphincter (LES). RECENT FINDINGS: A body of evidence exists that cardiac mucosa is a metaplastic esophageal epithelium rather than a normal gastric epithelium. Recent studies in asymptomatic volunteers suggest a potential mechanism for cardiac metaplasia in the squamous epithelium of the esophagus...
April 27, 2018: Current Opinion in Gastroenterology
Andrew D Schreiner, Don C Rockey
PURPOSE OF REVIEW: Liver blood tests, including bilirubin, aminotransferases, and alkaline phosphatase, are among the most commonly encountered tests in medicine. With roles including the investigation of symptoms, medication monitoring, assessment of chronic disease, and routine assessment, these tests serve many purposes and result in abnormality in up to 40% of patients. RECENT FINDINGS: The toll of liver disease continues to rise and abnormal liver tests offer an opportunity to identify hepatic disease early, when treatment is most effective and before patients suffer the potential downstream consequences of cirrhosis, portal hypertension, and hepatocellular carcinoma...
April 24, 2018: Current Opinion in Gastroenterology
Annalisa Schiepatti, David S Sanders, Federico Biagi
PURPOSE OF REVIEW: Seronegative coeliac disease is a poorly defined form of coeliac disease that poses an important challenge to clinicians particularly with regards to the differential diagnosis. This is probably because of lack of a consensus on its definition and incorrect use of specific coeliac serology. Seronegative coeliac disease (SCD) is uncommon and epidemiological data are scarce and contrasting. Therefore, the aim of this review is to provide a critical summary of the most recent work on this topic and a definition of SCD...
May 2018: Current Opinion in Gastroenterology
Reena Sidhu
No abstract text is available yet for this article.
May 2018: Current Opinion in Gastroenterology
Don C Rockey
No abstract text is available yet for this article.
May 2018: Current Opinion in Gastroenterology
Stefania Chetcuti Zammit, Reena Sidhu
PURPOSE OF REVIEW: The objective is to provide an overview on the cause of small bowel bleeding. We discuss the role of small bowel endoscopy in the management of small bowel bleeding and provide an outline of pharmacotherapy that can be additionally beneficial. RECENT FINDINGS: Small bowel capsule endoscopy (SBCE) is the initial diagnostic investigation of choice in small bowel bleeding. Computed tomography (CT) can be helpful in the context of small bowel tumours...
May 2018: Current Opinion in Gastroenterology
Tatyana Kushner, Douglas Dieterich, Behnam Saberi
PURPOSE OF REVIEW: Hepatocellular carcinoma (HCC) affects a significant portion of patients with hepatitis C. The use of direct-acting antiviral (DAA) agents has transformed the disease outcomes in this patient group. RECENT FINDINGS: Hepatitis C virus (HCV) response to DAAs can be affected by the presence of HCC, whereas DAA therapy may affect the risk of HCC recurrence in patients with a history of HCC. SUMMARY: Emerging data are demonstrating lower sustained virologic response (SVR) rates in patients with HCC compared with patients without HCC...
May 2018: Current Opinion in Gastroenterology
Ben L Da, Christopher Koh, Theo Heller
PURPOSE OF REVIEW: Noncirrhotic portal hypertension represents a heterogeneous group of liver disorders that is characterized by portal hypertension in the absence of cirrhosis. The purpose of this review is to serve as a guide on how to approach a patient with noncirrhotic portal hypertension with a focus on recent developments. RECENT FINDINGS: Recent studies pertaining to noncirrhotic portal hypertension have investigated aetiological causes, mechanisms of disease, noninvasive diagnostic modalities, clinical characteristics in the paediatric population and novel treatment targets...
May 2018: Current Opinion in Gastroenterology
Avash Kalra, Scott W Biggins
PURPOSE OF REVIEW: The 'Final Rule,' issued by the Health Resources and Service Administration in 2000, mandated that liver allocation policy should be based on disease severity and probability of death, and - among other factors - should be independent of a candidate's residence or listing. As a result, the Organ Procurement Transplantation Network/United Network for Organ Sharing (UNOS) has explored policy changes addressing geographic disparities without compromising outcomes. RECENT FINDINGS: Major paradigm shifts are underway in U...
May 2018: Current Opinion in Gastroenterology
Natasha Kamal, Pallavi Surana, Christopher Koh
PURPOSE OF REVIEW: The aim of this study was to provide an overview of the current understanding of the pathophysiology, diagnosis and management of cystic fibrosis-liver disease (CFLD). RECENT FINDINGS: CFLD has a variety of manifestations. Previously, it was thought that patients progressed from mild cholestatic disease to cirrhosis to decompensated cirrhosis with portal hypertension. Newer evidence suggests that some patients may develop cirrhosis while others develop noncirrhotic portal hypertension...
May 2018: Current Opinion in Gastroenterology
Foong Way David Tai, Mark E McAlindon
PURPOSE OF REVIEW: The review describes the effects of NSAID gastrointestinal toxicity on the small bowel, wherein injury is as prevalent as in the gastroduodenum. This is well documented by capsule endoscopy, which also provides an endoscopic endpoint for novel treatment strategies. RECENT FINDINGS: Appreciation of the prevalence of NSAID enteropathy has grown with capsule endoscopy and the use of composite end points that include obscure haemoglobin decreases in clinical studies...
May 2018: Current Opinion in Gastroenterology
Emanuele Rondonotti, Anastasios Koulaouzidis, Julius Georgiou, Marco Pennazio
PURPOSE OF REVIEW: The aim of this study was to summarize the role of recently developed diagnostic techniques in the diagnosis and management of patients with small bowel tumours (SBTs). RECENT FINDINGS: Recent studies show that the overall SBT incidence is increasing. The introduction of small bowel dedicated diagnostic tools [i.e. capsule endoscopy, device-assisted enteroscopy (DAE), computed tomography (CT) and MRI-enterography] might partially explain this trend...
May 2018: Current Opinion in Gastroenterology
Sophia M Swanson, Jason Harper, Timothy L Zisman
PURPOSE OF REVIEW: The review summarizes our current understanding of how obesity impacts diagnostic studies and therapies used in inflammatory bowel disease (IBD) as well as the safety and efficacy of medical and surgical weight loss therapies in the obese IBD patient. RECENT FINDINGS: Many of the diagnostic tools we rely on in the identification and monitoring of IBD can be altered by obesity. Obesity is associated with increased acute phase proteins and fecal calprotectin...
March 2018: 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...
March 2018: 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...
March 2018: Current Opinion in Gastroenterology
Chantal Housset
No abstract text is available yet for this article.
March 2018: 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...
March 2018: 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...
March 2018: Current Opinion in Gastroenterology
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