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Current Treatment Options in Gastroenterology

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https://www.readbyqxmd.com/read/30421297/gastroduodenal-dysbiosis-a-new-clinical-entity
#1
REVIEW
Ayesha Shah, Mark Morrison, Gerald J Holtmann
PURPOSE OF REVIEW: Like the rest of the gastrointestinal tract, the small intestine is colonised by microbes, but how this "microbiome" affects the immune system and digestive functions has largely been overlooked, especially in the "omics" era. Here, we present recent findings that show that the diversity, density and interactions of these microbes in the small intestine can play an important role in the pathogenesis of a number of gastrointestinal and extraintestinal disorders...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30415359/helicobacter-pylori-infection-new-facts-in-clinical-management
#2
REVIEW
Peter Malfertheiner, Marino Venerito, Christian Schulz
PURPOSE: The global prevalence of Helicobacter pylori remains high in spite of its significant downwards trajectory in many regions. The clinical management of H. pylori infection merits guidance to meet ongoing challenges on whom and how to test, prevent, and cure related diseases. RECENT FINDINGS: Several international guidelines and consensus reports have updated the management strategies for cure of the H. pylori infection. The definition of H. pylori gastritis as an infectious disease independent of whether or not presenting with clinical manifestations and symptoms has broadened the use of the test and treat strategy...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30406479/the-role-of-botulinum-toxin-injections-for-esophageal-motility-disorders
#3
REVIEW
Jessica L Sterling, Ron Schey, Zubair Malik
PURPOSE OF REVIEW: The advancement of high-resolution esophageal manometry has led to improvement in the diagnosis of esophageal motility disorders. We reviewed the recent medical literature regarding the use of botulinum toxin (BTx) injections in the esophagus and the indications, current outcomes, and reported complications of this therapy. RECENT FINDINGS: The response rates of BTx injection therapy vary depending on the esophageal motility disorder. Studies have shown that response is transient in achalasia patients and given the more effective therapies available, it is only recommended in patients who are not surgical candidates...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30397849/the-role-of-botox-in-colorectal-disorders
#4
REVIEW
Dan Carter, Ram Dickman
PURPOSE OF REVIEW: To overview the current medical literature on the efficacy of botulism toxin treatment (BTX-A) for lower gastrointestinal disorders (GIT). RECENT FINDINGS: BTX-A was found to have a short-term efficacy for the treatment of dyssynergic defecation. Surgical treatment was found to be more effective than BTX-A for the healing of chronic anal fissures, and BTX-A can be considered when surgery is undesirable. Data regarding the effects of BTX-A injection for the treatment of chronic anal pain is limited...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30390208/which-patient-related-factors-determine-optimal-bowel-preparation
#5
REVIEW
Myriam Martel, Charles Ménard, Sophie Restellini, Omar Kherad, Majid Almadi, Maïté Bouchard, Alan N Barkun
PURPOSE OF REVIEW: Adequate bowel cleansing before colonoscopy is a simple concept but the high rate of inadequate or incomplete bowel cleanliness and its consequences have been the subject of many studies, guidelines, and meta-analysis. The complexity resides in all the factors surrounding preparation intake such as type and regimen of bowel preparation, diets, compliance, and also patient-related factors that all influence quality of the bowel preparation. The purpose of this review is to focus specifically on patient-related factors and their challenges...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30382573/opioid-induced-esophageal-dysfunction-an-emerging-entity-with-sweeping-consequences
#6
REVIEW
Dhyanesh Patel, Michael Vaezi
Adverse effects of opioids on the gastrointestinal tract are well known. However, with the rising epidemic of opioids, its detrimental effects on esophageal physiology are now being increasingly recognized. In this commentary, we briefly review the current evidence behind opioid-induced esophageal dysfunction with potential pathophysiology and treatment options.
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30382572/endoscopic-full-thickness-defects-and-closure-techniques
#7
REVIEW
Diogo T H de Moura, Amit H Sachdev, Christopher C Thompson
PURPOSE OF REVIEW: Gastrointestinal transmural defects are defined as total rupture of the gastrointestinal wall and can be divided into three main categories: perforations, leaks, and fistulas. Due to an increase in the number of therapeutic endoscopic procedures including full-thickness resections and the increase incidence of complications related to bariatric surgeries, there has been an increase in the number of transmural defects seen in clinical practice and the number of non-invasive endoscopic treatment procedures used to treat these defects...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30368764/timing-of-endoscopic-necrosectomy-following-transmural-stent-placement-for-pancreatic-necrosis
#8
REVIEW
Jordan Orr, Patrick Yachimski
PURPOSE OF THE REVIEW: Pancreatic walled-off necrosis (WON) may require adjunctive direct endoscopic necrosectomy (DEN) following transmural stent placement. DEN is performed immediately or delayed in relation to index endoscopy. There is currently no consensus on the optimal timing of DEN. We review the most recent literature addressing each practice. RECENT FINDINGS: Some expert opinion prefer delayed DEN; however, recent data reveal immediate DEN may reduce the number of endoscopic sessions required for successful clinical resolution of WON...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30361857/potent-acid-suppression-with-ppis-and-p-cabs-what-s-new
#9
REVIEW
Richard H Hunt, Carmelo Scarpignato
PURPOSE OF THE REVIEW: Acid suppression treatment has revolutionized the management of the acid-related disorders since the introduction of the H2 -receptor antagonists (H2 -RAs) and the proton pump inhibitors (PPIs). However, there has been increasing identification of needs for improvement in antisecretory therapy, especially in gastroesophageal reflux disease (GERD), the eradication of Helicobacter pylori (H. pylori), protection from aspirin (ASA) and non-steroidal inflammatory drug (NSAID) injury and the management of upper gastrointestinal (UGI) bleeding...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30361856/gastric-cancer-an-evolving-disease
#10
REVIEW
Minkyo Song, Charles S Rabkin, M Constanza Camargo
PURPOSE OF REVIEW: Prevalence of Helicobacter pylori, the primary risk factor for gastric cancer, is declining globally. Paralleling this trend, gastric cancer incidence is also decreasing. Historically, the populations most affected by this neoplasia have been males, Asians, and groups with low socioeconomic status. This review provides an update on recently published literature regarding changes in gastric cancer epidemiology. RECENT FINDINGS: Gastric cancer incidence trends vary by age, sex, race/ethnicity, and tumor anatomical location...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30361855/migraine-cyclic-vomiting-syndrome-and-other-gastrointestinal-disorders
#11
REVIEW
Elliot S Yu, Yasodara Priyadharsini S S, Thangam Venkatesan
PURPOSE OF REVIEW: Cyclic vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder characterized by episodic nausea and vomiting and is diagnosed using Rome IV criteria. CVS is being recognized more frequently in adults with a prevalence of 2%. It is associated with several functional disorders like autonomic dysfunction, anxiety, and depression, but the strongest association is with migraine. We will elucidate the close relationship between migraine and CVS and briefly discuss its association with other gastrointestinal disorders...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30361854/parkinson-s-disease-and-current-treatments-for-its-gastrointestinal-neurogastromotility-effects
#12
REVIEW
Chethan Ramprasad, Jane Yellowlees Douglas, Baharak Moshiree
Gastrointestinal disturbances are seen in nearly all patients with Parkinson's disease and lead to impaired quality of life, affect drug pharmacodynamics, and potentially worsen patient's existing motor fluctuations, leading to further disability. Recent evidence links abnormal accumulations of α-synuclein aggregates in the periphery (gut) as seen in the cortex which causes dysfunctions impacting every level of the gastrointestinal tract from the esophagus, to the stomach, small bowel, colon, and rectum and can even predate the onset of the central neurologic disorder itself...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30334143/update-on-the-prevention-of-post-ercp-pancreatitis
#13
REVIEW
Han Zhang, Jaehoon Cho, James Buxbaum
PURPOSE OF REVIEW: Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly performed procedure to manage pancreaticobiliary disease. Post-ERCP pancreatitis (PEP) is the most common adverse event of ERCP with a significant burden of morbidity and cost. RECENT FINDINGS: Appropriate indication and counseling is mandatory especially for patients at increased risk for PEP such as those with suspected sphincter of Oddi dysfunction, pancreatic indications, and a prior history of PEP...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30293209/update-on-vaccinating-the-patient-with-inflammatory-bowel-disease
#14
REVIEW
Jennifer Coukos, Francis A Farraye
PURPOSE OF REVIEW: Patients with inflammatory bowel disease (IBD) are at increased risk of infectious diseases independent of their immunosuppression status, and yet, studies suggest that this population is not receiving standard vaccinations at the same rate as the general population. This review seeks to understand why IBD patients may not be receiving recommended immunizations and to provide guidelines on vaccinating this vulnerable population. RECENT FINDINGS: Inactive vaccines are recommended for patients with IBD regardless of immunosuppression status due to the increased risk for many vaccine-preventable illnesses...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30259341/botulinum-toxin-as-a-treatment-for-refractory-gastroparesis-a-literature-review
#15
REVIEW
Ashley Thomas, Bruno de Souza Ribeiro, Miguel Malespin, Silvio W de Melo
PURPOSE OF REVIEW: Gastroparesis (GP) is a disorder of gastrointestinal motility which leads to delayed gastric emptying in the absence of mechanical obstruction. Treatment is limited as many patients are refractory to dietary modification and the use prokinetic medications carry significant adverse risks. These limitations necessitate more research into experimental therapies. The purpose of this article is to summarize the known information and guidelines on the diagnosis and management of GP and to review the latest literature on experimental treatments...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30242772/selection-of-emr-and-esd-for-laterally-spreading-lesions-of-the-colon
#16
REVIEW
Ji Young Bang, Michael J Bourke
INTRODUCTION: Colonic laterally spreading lesions (LSL) are increasingly managed using endoscopic methods that comprise two main techniques: endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). PURPOSE OF REVIEW: In this review, we aimed to review the most recent literature on selection of the best endoscopic technique in the management of colonic LSL. RECENT FINDINGS: EMR and ESD are complimentary techniques in the management of patients with colonic LSL...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30232693/recurrent-acute-pancreatitis-current-concepts-in-the-diagnosis-and-management
#17
REVIEW
Soumya Jagannath, Pramod Kumar Garg
PURPOSE OF REVIEW: There have been significant developments in the diagnosis, clinical approach, and management of patients with recurrent acute pancreatitis (RAP) in the last decade. This review systematically summarizes our current understanding of RAP. NEW FINDINGS: Gallstones and alcohol are common causes of RAP. Non-alcohol non-biliary RAP (nAnB RAP) is a difficult group of patients after excluding these two causes because extensive workup is required to elucidate the etiology...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30229463/what-is-the-best-endoscopic-strategy-in-acute-non-variceal-gastrointestinal-bleeding
#18
REVIEW
Livio Cipolletta, Fabio Cipolletta, Antonino Granata, Dario Ligresti, Luca Barresi, Ilaria Tarantino, Mario Traina
OPINION STATEMENT: PURPOSE OF REVIEW: Upper non-variceal gastrointestinal bleeding (UNVGIB) remains an important clinical challenge for endoscopists, requiring skill and expertise for correct management. In this paper, we suggest the best strategy for an effective treatment of this complex category of patients. RECENT FINDINGS: Early endoscopic examination, the increasingly widespread use of endoscopic hemostasis methods, and the most powerful antisecretory agents that induce clot stabilization have radically modified the clinical scenario for treating this pathology...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30215162/pancreatic-cancer-and-diabetes-mellitus
#19
REVIEW
Ayush Sharma, Suresh T Chari
PURPOSE OF REVIEW: The relationship between pancreatic ductal adenocarcinoma (PDAC) and diabetes mellitus (DM) is complex. We reviewed the recent medical literature regarding the effect of anti-diabetic medication on PDAC risk and survival, risk of PDAC in DM, and role of DM in early detection of PDAC. RECENT FINDINGS: Studies report that while some anti-diabetic medications (e.g., metformin) may decrease the risk of PDAC, others (insulin, sulfonylureas and incretin-based therapies) may increase the risk...
December 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30178242/genomic-profiling-and-potentially-targetable-alterations-in-pancreatic-ductal-adenocarcinoma
#20
REVIEW
Ferga C Gleeson, Michael J Levy
PURPOSE OF REVIEW: Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-associated mortality with continued poor outcome and a short-lived treatment response to conventional therapy. However, with the rapidly evolving field of precision oncology, new and novel genomic information is emerging, identifying tumor subtypes by revealing somatic and germline mutations. RECENT FINDINGS: There is growing interest in determining the tumor BRCA status to guide potential PARP inhibitor targeted therapy and for evaluating tumor microsatellite instability status for immune checkpoint inhibitor therapy which has been reported in up to 3% of PDAC patients...
December 2018: Current Treatment Options in Gastroenterology
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