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Gastroenterology Clinics of North America

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https://www.readbyqxmd.com/read/29173532/complementary-and-alternative-treatments-are-needed-to-enhance-the-care-of-the-inflammatory-bowel-disease-patient
#1
EDITORIAL
Ali Keshavarzian, Ece A Mutlu
No abstract text is available yet for this article.
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173531/the-practical-pros-and-cons-of-complementary-and-alternative-medicine-in-practice-integrating-complementary-and-alternative-medicine-into-clinical-care
#2
REVIEW
Rachel W Winter, Joshua R Korzenik
Complementary and alternative medicine (CAM) is changing health care for individuals with inflammatory bowel disease. The move toward increasing patient autonomy and addressing lifestyle and psychosocial factors contributes to this shift. Numerous clinics and centers are offering new models to incorporate these elements. There is need for better and more robust data regarding CAM efficacy and safety. CAM offers a test kitchen for new approaches to care and care delivery, which are now being developed and studied, and has the possibility to affect patient quality of life, disease morbidity, cost, and use of health care...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173530/exercise-and-inflammatory-bowel-disease-insights-into-etiopathogenesis-and-modification-of-clinical-course
#3
REVIEW
Jana G Hashash, David G Binion
There is sparse information regarding exercise and inflammatory bowel disease (IBD). Furthermore, the importance of regular exercise in the optimal management of IBD has not received attention in guidelines and is often overlooked by practitioners. This article summarizes evidence regarding health benefits of exercise, guidelines regarding exercise in the general population and chronic inflammatory disorder populations, limitations regarding exercise capacity in patients with IBD, the association of lack of exercise with IBD pathogenesis, the role of exercise in beneficially modulating IBD clinical course, and extraintestinal benefits of exercise in patients with IBD...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173529/sleep-and-circadian-hygiene-and-inflammatory-bowel-disease
#4
REVIEW
Garth R Swanson, Helen J Burgess
There is increasing evidence that sleep and circadian disruption can worsen the disease course in inflammatory bowel disease (IBD). Sleep and circadian disruption are prevalent in society and are associated with worse outcomes in IBD. Emerging research suggests sleep and circadian disruption can impact key components in IBD disease flares, including intestinal permeability, translocation of bacterial endotoxins, intestinal dysbiosis, and proinflammatory cytokines. Much of this research has been conducted in animal models...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173528/massage-acupuncture-moxibustion-and-other-forms-of-complementary-and-alternative-medicine-in-inflammatory-bowel-disease
#5
REVIEW
Daniel J Stein
Complementary and alternative medicine is frequently used by inflammatory bowel disease (IBD) patients; most common are massage, acupuncture, and moxibustion therapy. Massage therapy is poorly studied in IBD patients; therefore, its benefits remain unknown. Acupuncture and moxibustion therapy have been shown to improve inflammation and symptoms in animal and human studies. However, current clinical trials of acupuncture and moxibustion are of insufficient quality to recommend them as alternative therapy. Nonetheless, because these therapies seem generally to be safe, they may have a role as complementary to conventional therapy...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173527/mindfulness-based-interventions-in-inflammatory-bowel-disease
#6
REVIEW
Megan M Hood, Sharon Jedel
Mindfulness-based interventions may be beneficial psychosocial treatments for improving the health and well-being of patients with inflammatory bowel disease. This article reviews eight studies, assessing seven psychosocial interventions, which include mindfulness and/or meditation components. Strongest effects of the interventions were found in quality of life and anxiety/depression, with inconsistent or minimal changes in other psychosocial areas, such as perceived stress and in disease-related outcomes and other physiologic functioning...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173526/psychological-considerations-and-interventions-in-inflammatory-bowel-disease-patient-care
#7
REVIEW
Tiffany H Taft, Sarah Ballou, Alyse Bedell, Devin Lincenberg
The presence of psychological comorbidities, specifically anxiety and depression, is well documented in inflammatory bowel disease (IBD). The drivers of these conditions typically reflect 4 areas of concern: disease impact, treatment concerns, intimacy, and stigma. Various demographic and disease characteristics increase risk for psychological distress. However, the risk for anxiety and depression is consistent throughout IBD course and is independent of disease activity. Early intervention before psychological distress becomes uncontrolled is ideal, but mental health often is unaddressed during patient visits...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173525/the-brain-gut-axis-and-stress-in-inflammatory-bowel-disease
#8
REVIEW
Charles N Bernstein
The brain-gut axis serves as a circuit that incorporates the human experience, the state of mind, the gut microbiome, and the immune response that ultimately drives the phenotypic expression of inflammatory bowel disease (IBD). There are several biological pathways through which stress can play a deleterious role, including through increasing intestinal permeability, which can facilitate intestinal translocation of bacteria. Stress has an impact on symptoms in IBD; however, there is limited evidence that stress triggers increased intestinal inflammation...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173524/fecal-transplant-in-inflammatory-bowel-disease
#9
REVIEW
Alexander S Browne, Colleen R Kelly
Patients with inflammatory bowel disease (IBD) have differences in their gastrointestinal microbiome compared with healthy individuals, although it is unclear whether this is a cause or consequence of chronic inflammation. There is hope that manipulation of the gut microbiome through fecal microbiota transplant (FMT), commonly used to treat patients with Clostridium difficile infection, may also be an effective therapy in IBD. This article reviews the evidence supporting FMT in IBD, including case reports, case series, and randomized controlled trials...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173523/herbs-and-inflammatory-bowel-disease
#10
REVIEW
Gregory M Sebepos-Rogers, David S Rampton
Although herbal preparations are widely used by patients with inflammatory bowel disease (IBD), evidence for their efficacy is limited and they may not always be safe. Mainly small studies of varying quality have suggested that several herbal preparations could be of benefit in IBD, but larger better-designed trials are needed to establish their place in inducing and maintaining remission. Patients and health care workers need to be made more aware of the limitations and risks of using herbal products for IBD...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173522/vitamins-and-minerals-in-inflammatory-bowel-disease
#11
REVIEW
Fayez K Ghishan, Pawel R Kiela
Indiscriminate use of multivitamin/mineral supplements in the general population may be misguided, but patients with chronic Inflammatory Bowel Diseases (IBD) should be monitored and compensated for nutritional deficiencies. Mechanistic links between vitamin/mineral deficiencies and IBD pathology has been found for some micronutrients and normalizing their levels is clinically beneficial. Others, like vitamin A, although instinctively desirable, produced disappointing results. Restoring normal levels of the selected micronutrients requires elevated doses to compensate for defects in absorptive or signaling mechanisms...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173521/prebiotics-and-inflammatory-bowel-disease
#12
REVIEW
Heather E Rasmussen, Bruce R Hamaker
Dietary fiber, specifically prebiotics, is the primary source of energy for the gut microbiota and thus has the potential to beneficially modify microbiota composition. Prebiotics have been used in both in vitro studies and with animal models of colitis with largely positive results. Human studies are few and have been conducted with only a few select prebiotics, primarily fructan-containing fibers. Although disease activity and inflammatory markers have improved, more needs to be learned about the specific prebiotic compounds and how they can be used to best improve the gut microbiota to counter changes induced by inflammatory bowel disease...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173520/probiotics-in-inflammatory-bowel-disease
#13
REVIEW
Bincy P Abraham, Eamonn M M Quigley
Evidence indicates that the gut microbiota and/or interactions between the microbiota and the host immune system are involved in the pathogenesis of inflammatory bowel disease (IBD). Strategies that target the microbiota have emerged as potential therapies and, of these, probiotics have gained the greatest attention. Data derived from animal models of IBD have revealed the potential of several bacterial strains to modify the natural history of IBD. However, thought there is some evidence for efficacy in ulcerative colitis and in pouchitis, in particular, there has been little indication that probiotics exert any benefit in Crohn disease...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173519/diet-as-a-therapeutic-option-for-adult-inflammatory-bowel-disease
#14
REVIEW
Samir Kakodkar, Ece A Mutlu
There are many mechanisms to explain how food may drive and ameliorate inflammation. Although there are no consistent macronutrient associations inflammatory bowel disease (IBD) development, many exclusion diets have been described: IgG-4 guided exclusion diet; semivegetarian diet; low-fat, fiber-limited exclusion diet; Paleolithic diet; Maker's diet; vegan diet; Life without Bread diet; exclusive enteral nutrition (EEN), the Specific Carbohydrate Diet (SCD) and the low FODMAP diet. The literature on diet and IBD is reviewed with a particular focus on EEN, SCD, and low FODMAP diets...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173518/dietary-therapies-in-pediatric-inflammatory-bowel-disease-an-evolving-inflammatory-bowel-disease-paradigm
#15
REVIEW
Erin R Lane, Dale Lee, David L Suskind
Nutrition has long been recognized as a critical component in the treatment of pediatric inflammatory bowel disease (IBD). Formerly, nutritional interventions have focused on targeting improved weight gain and linear growth, as well as correction of micronutrient deficiencies. Recently, there has been growing interest and study of dietary interventions for induction and maintenance of remission. In addition to exclusive enteral nutrition, successes have been achieved with specific exclusion diets. This article evaluates current literature regarding the role of diet and nutrition in pathogenesis of disease, as well as the role of diet as primary therapy for pediatric IBD...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173517/complementary-and-alternative-medicine-strategies-for-therapeutic-gut-microbiota-modulation-in-inflammatory-bowel-disease-and-their-next-generation-approaches
#16
REVIEW
Abigail R Basson, Minh Lam, Fabio Cominelli
The human gut microbiome exerts a major impact on human health and disease, and therapeutic gut microbiota modulation is now a well-advocated strategy in the management of many diseases, including inflammatory bowel disease (IBD). Scientific and clinical evidence in support of complementary and alternative medicine, in targeting intestinal dysbiosis among patients with IBD, or other disorders, has increased dramatically over the past years. Delivery of "artificial" stool replacements for fecal microbiota transplantation (FMT) could provide an effective, safer alternative to that of human donor stool...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29173516/use-of-complementary-and-alternative-medicine-in-inflammatory-bowel-disease-around-the-world
#17
REVIEW
Petros Zezos, Geoffrey C Nguyen
Use of complementary sand alternative medicine (CAM) is common among patients with inflammatory bowel disease (IBD). CAM can be broadly categorized as whole medical systems, mind-body interventions, biologically based therapies, manipulative and body-based methods, and energy therapies. Most do not use it to treat IBD specifically, and most take it as an adjunct to conventional therapy not in place of it. However, patients are frequently uncomfortable initiating a discussion of CAM with their physicians, which may impact adherence to conventional therapy...
December 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28838422/crohn-s-disease-etiology-complications-assessment-therapy-and-management
#18
EDITORIAL
Edward V Loftus
No abstract text is available yet for this article.
September 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28838421/the-evolution-of-treatment-paradigms-in-crohn-s-disease-beyond-better-drugs
#19
REVIEW
Reena Khanna, Vipul Jairath, Brian G Feagan
Despite advances in care, most patients with Crohn's disease (CD) develop complications, such as fistulas, or require surgery. Given the recent advances in drug therapy, an opportunity exists to optimize the management of this chronic disease through early use of effective therapies, clear definition of treatment targets, and application of the principles of personalized medicine. In this article, the authors discuss the evolution of treatment algorithms for CD to incorporate these strategies.
September 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28838420/update-on-therapeutic-drug-monitoring-in-crohn-s-disease
#20
REVIEW
Valérie Heron, Waqqas Afif
In patients with Crohn's disease on biologic medications, the use of therapeutic drug monitoring leads to a personalized approach to optimize treatment. Using an algorithmic approach, measurement of drug concentrations and anti-drug antibodies can be used to improve treatment outcomes. Therapeutic drug concentrations and absence of antibodies are associated with improved clinical and endoscopic outcomes. In clinical practice, therapeutic drug monitoring has been shown to be clinically useful and cost-effective in patients experiencing a loss of response to treatment...
September 2017: Gastroenterology Clinics of North America
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