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Current Treatment Options in Gastroenterology

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https://www.readbyqxmd.com/read/29445907/management-of-serrated-polyps-of-the-colon
#1
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...
February 14, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29435819/expanding-role-of-third-space-endoscopy-in-the-management-of-esophageal-diseases
#2
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...
February 12, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29411220/novel-therapies-and-treatment-strategies-for-patients-with-inflammatory-bowel-disease
#3
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...
February 6, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29404921/update-on-bowel-preparation-for-colonoscopy
#4
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...
February 5, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29404920/management-of-anemia-in-patients-with-inflammatory-bowel-disease-ibd
#5
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...
February 5, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29359275/the-natural-history-of-ibd-lessons-learned
#6
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...
January 23, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29357016/new-developments-in-the-diagnosis-therapy-and-monitoring-of-eosinophilic-esophagitis
#7
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...
January 22, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29350340/poem-in-the-treatment-of-esophageal-disorders
#8
REVIEW
Nasim Parsa, Mouen A Khashab
OPINION STATEMENT: PURPOSE OF THE REVIEW: Peroral endoscopic myotomy (POEM) is a novel minimally invasive technique that has emerged as the preferred option for the treatment of achalasia and spastic esophageal disorders (SED) at many centers around the world. In this article, we review and summarize the recent literature on POEM in patients with achalasia and SED. The current article is largely focused on the new developments and findings, extended applications, and long-term outcomes of POEM in patients with achalasia and SED...
January 19, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29350339/emerging-insights-into-the-esophageal-microbiome
#9
REVIEW
Michael May, Julian A Abrams
PURPOSE OF REVIEW: Analysis of the esophageal microbiome remains a relatively new field of research, and most studies to date have focused on characterizing the esophageal microbiome in states of health and disease. Microbiome alterations have been implicated in the pathogenesis of inflammatory and neoplastic conditions in the colon and elsewhere in the gastrointestinal tract. The epidemiology of various esophageal conditions including Barrett's esophagus (BE), esophageal adenocarcinoma (EAC), esophageal squamous cell carcinoma (ESCC), and eosinophilic esophagitis (EoE) point to the microbiome as a potential co-factor in disease pathogenesis, and the possibility exists that these microbiome alterations could contribute directly to the inflammatory environments necessary for the carcinogenesis or atopy involved in these conditions...
January 19, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29340935/endoscopic-treatments-of-gerd
#10
REVIEW
Carol Rouphael, Ruthvik Padival, Madhusudhan R Sanaka, Prashanthi N Thota
OPINION STATEMENT: PURPOSE OF REVIEW: Endoscopic therapies for gastroesophageal reflux disease (GERD) are minimally invasive techniques which fill the gap between the medical therapy with proton pump inhibitors (PPIs) and surgical fundoplication. The main endoscopic therapies currently available in the USA are transoral incisionless fundoplication (TIF) using EsophyX device or less commonly, Medigus Ultrasonic Surgical Endostapler, and radiofrequency energy delivery to lower esophageal sphincter using Stretta device...
January 16, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29330747/recent-advances-in-screening-for-barrett-s-esophagus
#11
REVIEW
Sarmed S Sami, Prasad G Iyer
OPINION STATEMENT: PURPOSE OF REVIEW: There is a pressing need for effective strategies to halt the increase in both the incidence and mortality of esophageal adenocarcinoma (EAC). Screening for Barrett's esophagus, which is the only known precursor of EAC, remains a ripe area for research, particularly with regard to identifying the target population, screening tools, and management of screen-detected populations. This review aims to explore in depth the rationale for screening for Barrett's esophagus, recent biotechnological advances which may have the potential of making screening feasible, and also highlight the challenges which will have to be overcome in order make screening for BE a realistic prospect...
January 13, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29127551/endoscopic-evaluation-management-of-bariatric-surgery-complications
#12
REVIEW
Allison R Schulman, Christopher C Thompson
Purpose of Review Bariatric surgery has become increasingly common given the increasing prevalence of obesity and its associated co-morbidities. As a result, patients who have surgically altered anatomy will be seen with increasing frequency by gastroenterologists. Recent Findings Complications that arise in this patient population are unique and require specific knowledge for appropriate treatment. Summary A basic understanding of surgical anatomy, possible complications, and endoscopic techniques for management is crucial...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29103188/management-of-inflammatory-fluid-collections-and-walled-off-pancreatic-necrosis
#13
REVIEW
Apeksha Shah, Richard Denicola, Cynthia Edirisuriya, Ali A Siddiqui
Pancreatic fluid collections are a frequent complication of acute pancreatitis. The revised Atlanta criterion classifies chronic fluid collections into pseudocysts and walled-off pancreatic necrosis (WON). Symptomatic PFCs require drainage options that include surgical, percutaneous, or endoscopic approaches. With the advent of newer and more advanced endoscopic tools and expertise, minimally invasive endoscopic drainage has now become the preferred approach. An endoscopic ultrasonography (EUS)-guided approach for pancreatic fluid collection drainage is now the preferred endoscopic approach...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29079901/diabetes-and-the-pancreatobiliary-diseases
#14
REVIEW
Muhammad Shafqet, Kaveh Sharzehi
PURPOSE OF REVIEW: The emphasis of this review article is to bring to the forefront the spectrum of pancreatobiliary disorders and their association with diabetes. We hope to systematically discuss the link between diabetes and disorders of the pancreas including acute and chronic pancreatitis, as well as pancreatic cancer. We also hope to review and highlight the literature with respect to other cancers of the biliary tree including gallbladder and cholangiocarcinoma. Lastly, we discuss diabetes and biliary dyskinesia...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29075963/endoscopic-evaluation-and-management-of-gastric-stromal-tumors
#15
REVIEW
Kambiz Kadkhodayan, Ehsan Rafiq, Robert H Hawes
Purpose of Review Gastrointestinal stromal tumors (GISTs) are both relatively common. Management of these lesions has been challenging with emerging interest in the endoscopic approach for both diagnostic and therapeutic interventions. Recent Findings Although these can be visualized on CT scan, endoscopic ultrasound (EUS) represents the standard method of evaluation and characterization using fine needle aspiration cytology (FNA) when indicated. While EUS-FNA can yield diagnostic cells, full characterization requires a sufficient volume of viable cells to do molecular analysis for c-KIT and determine the mitotic index...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29063998/diabetes-mellitus-and-the-colon
#16
REVIEW
Marc S Piper, Richard J Saad
Diabetes mellitus (DM) can affect the structure and function of the colon promoting commonly encountered lower gastrointestinal symptoms such as constipation, diarrhea, abdominal distention, bloating, and abdominal pain. Specific colonic disorders for which adults with DM are at greater risk include chronic constipation, enteropathic diarrhea, colorectal cancer (CRC), inflammatory bowel disease, microscopic colitis, and Clostridium difficile colitis. Smooth muscle structure and function, density of the interstitial cells of Cajal, and the health and function of the autonomic and enteric nerves of the colon are all potential affected by DM...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29063486/diagnosis-and-management-of-pancreatic-cystic-neoplasms
#17
REVIEW
Malcolm Kearns, Nuzhat A Ahmad
Pancreatic cystic neoplasms (PCNs) are being diagnosed with increasing frequency. PCNs have diverse presentations, natural history, and biological behavior. Obtaining an accurate diagnosis of the type of cyst and assessing the potential for malignancy are crucial in determining the appropriate management strategy. Cross-sectional imaging with computed tomography (CT) or magnetic resonance imaging (MRI), at experienced centers, is effective in defining the type of cyst as well as identifying high-risk features...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29030800/endoscopic-treatment-of-subepithelial-lesions-of-the-gastrointestinal-tract
#18
REVIEW
Vivien Wai Yin Wong, Osamu Goto, Hans Gregersen, Philip Wai Yan Chiu
Purpose of Review The study aimed to discuss novel endoscopic approaches to resection of submucosal lesions. Recent Findings Endoscopic resection by excavation, full-thickness resection, and submucosal tunneling are by now well-documented techniques for submucosal tumor resection. Combined approaches with laparoscopy such as several variations of laparoscopic endoscopic cooperation surgery (LECS) and non-exposed wall-inversion surgery (NEWS) are also possible now. Reports of these approaches show good results...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29030799/gastric-peroral-endoscopic-pyloromyotomy-therapy-for-refractory-gastroparesis
#19
REVIEW
Petros C Benias, Mouen A Khashab
Purpose of review Gastroparesis is a complex dysmotility disorder in which a number of normal gastric emptying mechanisms can be affected. The pylorus as an apparatus is particularly important since it stands as the last final gateway for gastric emptying. As such, pyloric interventions seem to be successful in reducing symptoms and also improving emptying of solids, an effect not observed with other medical interventions. Recent findings Gastric peroral endoscopic myotomy (G-POEM) is a novel technique which offers the promise of mimicking the success of a traditional surgical pyloroplasty, while embracing the minimally invasive paradigm of flexible endoscopic surgery...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28975540/current-management-of-benign-epithelial-gastric-polyps
#20
REVIEW
Antonio R Cheesman, David A Greenwald, Shailja C Shah
Purpose of review Benign epithelial gastric polyps, although typically asymptomatic, are identified incidentally on upper endoscopy in up to 23% of patients. These include fundic gland, hyperplastic, and adenomatous polyps. Their appropriate characterization is critical as some have malignant potential, may be indicative of a gastric mucosal field defect, or may be related to an underlying polyposis syndrome. This review will discuss the current management of benign epithelial gastric polyps. Recent findings Association of gastric polyps with proton pump inhibitor use, Helicobacter pylori infection, risk of malignant transformation, and association with polyposis syndromes have been the focus of recent literature...
December 2017: Current Treatment Options in Gastroenterology
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