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Current Treatment Options in Gastroenterology

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https://www.readbyqxmd.com/read/30030678/endoscopic-management-of-infected-necrotizing-pancreatitis-an-evidence-based-approach
#1
REVIEW
Lotte Boxhoorn, Paul Fockens, Marc G Besselink, Marco J Bruno, Jeanin E van Hooft, Robert C Verdonk, Rogier P Voermans
PURPOSE OF REVIEW: Endoscopic management of infected necrotizing pancreatitis has evolved rapidly over the past years and there have been interesting innovations in this field. This review provides an update on the most recently published literature regarding endoscopic management of infected necrotizing pancreatitis. RECENT FINDINGS: A recent randomized trial demonstrated no difference in mortality and major morbidity between endoscopic and surgical step-up treatment of infected necrotizing pancreatitis...
July 20, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30027527/diagnosis-and-management-of-exocrine-pancreatic-insufficiency
#2
REVIEW
Chris E Forsmark
PURPOSE OF REVIEW: Recent studies have documented that many patients with pancreatic exocrine insufficiency (EPI) are not identified and are not treated with appropriate dosages of pancreatic enzyme replacement therapy. This review will summarize the approach to diagnosis, treatment, and monitoring for treatment effect and complications in patients with exocrine insufficiency. RECENT FINDINGS: While chronic pancreatitis is the most commonly identified cause of EPI, pancreatic cancer and pancreatic surgery are increasingly important...
July 19, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30019105/training-in-endoscopy
#3
REVIEW
Keith Siau, Neil D Hawkes, Paul Dunckley
PURPOSE OF THE REVIEW: Progress towards the goal of high-quality endoscopy across health economies has been founded on high-quality structured training programmes linked to credentialing practice and ongoing performance monitoring. This review appraises the recent literature on training interventions, which may benefit performance and competency acquisition in novice endoscopy trainees. RECENT FINDINGS: Increasing data on the learning curves for different endoscopic procedures has highlighted variations in performance amongst trainees...
July 17, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30006766/inflammatory-bowel-disease-in-the-baby-to-baby-boomer-pediatric-and-elderly-onset-of-ibd
#4
REVIEW
Anita Afzali, Seymour Katz
PURPOSE OF REVIEW: Early- and late-onset of inflammatory bowel disease (IBD) may perhaps be etiologically distinct and potentially attributed to genetics, environmental or microbial factors. We review disease factors and clinical characteristics, as well as unique management and treatment strategies to consider when caring for the "baby" or "baby boomer" with IBD. RECENT FINDINGS: Around 25% of cases of initial diagnosis of IBD is made before the age of 18 years old, and another 15-20% made after the age of 60...
July 13, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29998454/outcomes-and-management-of-the-ileal-pouch-anal-anastomosis-in-the-elderly
#5
REVIEW
James Q Zhou, Sean Michael Duenas, Tarik Kirat, Feza Remzi, Shannon Chang
PURPOSE OF REVIEW: Ileal pouch-anal anastomosis (IPAA) is the preferred surgical treatment for patients undergoing colectomy to maintain intestinal continuity. Earlier studies have suggested that outcomes are worse in elderly patients who underwent IPAA. However, more recent reports have shown that IPAA outcomes in the elderly are comparable to younger patients. We review the recent medical literature regarding outcomes and treatments for common complications in elderly IPAA patients...
July 12, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29705917/management-of-hepatic-encephalopathy-not-responsive-to-first-line-treatments
#6
REVIEW
Silvia Nardelli, Lorenzo Ridola, Stefania Gioia, Oliviero Riggio
PURPOSE OF REVIEW: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome that occurs in up to 30% of patients with cirrhosis. HE may be a consequence of pure liver failure, as in patients with fulminant hepatitis, or of the combination of liver failure and portal-systemic shunting, as in patients with liver cirrhosis. Episodes of HE are usually related to precipitating events, such as infections or gastrointestinal bleeding; a minority of cirrhotic patients experienced a chronic HE, refractory to standard medical treatment...
June 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29616404/intensive-care-management-of-patients-with-cirrhosis
#7
REVIEW
Jody C Olson
PURPOSE OF REVIEW: Cirrhosis is a major worldwide health problem which results in a high level of morbidity and mortality. Patients with cirrhosis who require intensive care support have high mortality rates of near 50%. The goal of this review is to address the management of common complications of cirrhosis in the ICU. RECENT FINDINGS: Recent epidemiological studies have shown an increase in hospitalizations due to advanced liver disease with an associated increase in intensive care utilization...
June 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29589278/frailty-in-patients-with-cirrhosis
#8
REVIEW
Beverley Kok, Puneeta Tandon
PURPOSE OF REVIEW: This review gives an overview of the evolving concept of physical frailty in patients with cirrhosis. As well as summarizing the available metrics that have been used to diagnose it, this review also examines the major recent trials that have investigated frailty in patients with cirrhosis. The complex relationship between sarcopenia and frailty is explored, and strategies to optimize frailty, such as including pharmacological and non-pharmacological therapies, are discussed...
June 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29572618/the-use-of-statins-in-patients-with-chronic-liver-disease-and-cirrhosis
#9
REVIEW
Carlos Moctezuma-Velázquez, Juan G Abraldes, Aldo J Montano-Loza
PURPOSE OF REVIEW: Statins are drugs developed to treat hypercholesterolemia. Its use in patients with liver disease has been limited because one of its potential and most feared side effects is hepatotoxicity. However, there is robust evidence that supports the safety of statins in this population in the absence of severe liver dysfunction. In this review, we will summarize the efficacy and safety of statins in cirrhosis. RECENT FINDINGS: Statins are effective in the treatment of dyslipidemia in patients with liver disease, because of their pleiotropic properties...
June 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29569093/interaction-between-hepatocellular-carcinoma-and-hepatitis-c-eradication-with-direct-acting-antiviral-therapy
#10
REVIEW
Venkata Rajesh Konjeti, Binu V John
PURPOSE OF REVIEW: The approval of direct-acting antiviral (DAA) therapy has revolutionized hepatitis C virus (HCV) treatment. However, the publication of a study from Barcelona in 2016 raised concern for an increased risk of recurrence of hepatocellular carcinoma (HCC) after potentially curative therapy in patients receiving DAAs. This article reviews the current literature on the interaction between HCC and hepatitis C eradication with DAAs. RECENT FINDINGS: Following publication of the initial observation in 2016, a number of studies have looked at the impact of active HCC on the success of antiviral therapy, as well as that of treatment with DAAs on both the occurrence and recurrence of HCC...
June 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29557070/esophageal-stenting-in-clinical-practice-an-overview
#11
REVIEW
Bram D Vermeulen, Peter D Siersema
OPINION STATEMENT: PURPOSE OF REVIEW: Esophageal stents are used in clinical practice for endoscopic treatment of a wide variety of esophageal diseases and conditions. This review provides key principles and a literature update on the utility and limitations of esophageal stenting in clinical practice. RECENT FINDINGS: Indications for esophageal stenting can be subdivided into two groups. The first group consists of patients with malignant or benign dysphagia, in which an esophageal stent restores luminal patency...
June 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29492747/biosimilars-in-the-treatment-of-inflammatory-bowel-disease-supporting-evidence-in-2017
#12
REVIEW
Frank I Scott, Gary R Lichtenstein
PURPOSE OF REVIEW: Monoclonal antibodies targeting tumor necrosis factor-alpha, integrin molecules, and interleukin-12/23 have become backbone therapies for Crohn's disease and ulcerative colitis. While clinically effective, these biologic therapies come with significant expense, contributing to overall healthcare spending in the USA. Biosimilars have the potential to significantly reduce expenditures secondary to the use of biologic medications such as infliximab and adalimumab, though their complicated manufacturing process results in inherent differences in structure when compared to the originator compounds...
March 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29479656/updates-on-women-s-health-issues-in-patients-with-inflammatory-bowel-disease
#13
REVIEW
Nirupama Bonthala, Sunanda Kane
PURPOSE OF REVIEW: Inflammatory bowel disease affects approximately 800,000 women in the USA with the peak incidence between ages 15 to 40. Thus for many females, IBD can impact nearly every stage of their life from menarche to pregnancy, menopause, and beyond. This paper will review the most recent updates on the topics of sexual health, cervical cancer screening, menstruation, fertility, contraception, and menopause. RECENT FINDINGS: Menarche can be delayed in females especially those who are underweight, malnourished, or with active inflammatory bowel disease...
March 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29445907/management-of-serrated-polyps-of-the-colon
#14
REVIEW
Claire Fan, Adam Younis, Christine E Bookhout, Seth D Crockett
PURPOSE OF REVIEW: The purpose of this review is to summarize the management of serrated colorectal polyps (SPs), with a particular focus on the most common premalignant SP, sessile serrated adenoma or polyp (SSA/P). These lesions present a challenge for endoscopists with respect to detection and resection, and are also susceptible to pathologic misdiagnosis. RECENT FINDINGS: Patients with SSA/Ps are at an increased risk of future colorectal neoplasia, including advanced polyps and cancer...
March 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29435819/expanding-role-of-third-space-endoscopy-in-the-management-of-esophageal-diseases
#15
REVIEW
Dennis Yang, Peter V Draganov
OPINION STATEMENT: "Third space" endoscopy, also commonly referred as submucosal endoscopy, is founded on the principle that the deeper layers of the gastrointestinal (GI) tract can be accessed by tunneling in the submucosal space without compromising the integrity of the overlying mucosa. Peroral endoscopic myotomy (POEM), endoscopic submucosal dissection (ESD), and submucosal tunneling endoscopic resection (STER) are innovative techniques within the field of third space endoscopy in the management of esophageal disorders...
March 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29411220/novel-therapies-and-treatment-strategies-for-patients-with-inflammatory-bowel-disease
#16
REVIEW
Marjolijn Duijvestein, Robert Battat, Niels Vande Casteele, Geert R D'Haens, William J Sandborn, Reena Khanna, Vipul Jairath, Brian G Feagan
PURPOSE OF REVIEW: This article reviews current treatment options and strategies and provides an update on the status of drug development programs of new therapeutic agents for inflammatory bowel diseases (IBD). RECENT FINDINGS: In the past two decades, tumor necrosis factor antagonist therapy has given clinicians better treatment options. However, not all patients respond to induction therapy with these agents, and of those initially responding, up to 40% ultimately lose response due to suboptimal drug exposure (e...
March 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29404921/update-on-bowel-preparation-for-colonoscopy
#17
REVIEW
Cristina C Rutherford, Audrey H Calderwood
PURPOSE OF REVIEW: Colonoscopy is the gold standard for visualization and diagnosis of conditions involving the colon and terminal ileum. It also facilitates screening and prevention of colorectal cancer, which is the second leading cause of cancer death in the USA. Adequate cleansing is essential for thorough visualization of the colon with successful detection of colon polyps. RECENT FINDINGS: While the original large-volume polyethylene glycol preparations are still commonly used, several lower volume regimens are widely available and selected based on provider and patient preferences...
March 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29404920/management-of-anemia-in-patients-with-inflammatory-bowel-disease-ibd
#18
REVIEW
Dhruvan Patel, Chinmay Trivedi, Nabeel Khan
PURPOSE OF REVIEW: Anemia is the most common complication as well as an extra intestinal manifestation of inflammatory bowel disease (IBD). It is associated with a significant impact on patient's quality of life (QoL); as well it represents a common cause of frequent hospitalization, delay of hospital inpatient discharge and overall increased healthcare burden. In spite of all these, anemia is still often underdiagnosed and undertreated. Our aim in this review is to provide a pathway for physicians to help them achieve early diagnosis as well as timely and appropriate treatment of anemia which in turn would hopefully reduce the prevalence and subsequent complications of this condition among IBD patients...
March 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29359275/the-natural-history-of-ibd-lessons-learned
#19
REVIEW
Petra Weimers, Pia Munkholm
PURPOSE OF REVIEW: Inflammatory bowel diseases (IBD), which include Crohn's disease (CD) and ulcerative colitis (UC), are chronic, relapsing diseases with unknown etiologies. The purpose of this review is to present the natural disease course evidenced in the latest epidemiology data. RECENT FINDINGS: The prevalence of IBD is rapidly increasing, affecting five million patients worldwide with the highest incidence observed in Northern Europe and Northern America...
March 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29357016/new-developments-in-the-diagnosis-therapy-and-monitoring-of-eosinophilic-esophagitis
#20
REVIEW
Ronak Vashi Patel, Ikuo Hirano
PURPOSE OF REVIEW: Eosinophilic esophagitis (EoE) has transformed over the past two decades from a little-known entity to a significant cause of morbidity in the adult and pediatric population. We reviewed the most recent advancements in the diagnosis, therapy, and long-term monitoring of EoE. RECENT FINDINGS: Based on clinical, endoscopic, histologic, immunologic, and genetic similarities, there is growing consensus to move away from distinguishing proton pump inhibitor responsive esophageal eosinophilia as an entity distinct from EoE...
March 2018: Current Treatment Options in Gastroenterology
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