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Current Treatment Options in Gastroenterology

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https://www.readbyqxmd.com/read/29030800/endoscopic-treatment-of-subepithelial-lesions-of-the-gastrointestinal-tract
#1
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...
October 14, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29030799/gastric-peroral-endoscopic-pyloromyotomy-therapy-for-refractory-gastroparesis
#2
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...
October 14, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28975540/current-management-of-benign-epithelial-gastric-polyps
#3
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...
October 3, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28965290/endoscopic-treatments-for-obesity
#4
REVIEW
Gregory Pajot, Gerardo Calderon, Andrés Acosta
Purpose of review Endoscopic bariatric therapy (EBT) is a rapidly developing area that has now seen FDA approval of six endoscopic bariatric devices and procedures and there are a number of other novel EBTs progressing through various stages of development with newly published findings. This paper aims to assist readers in either selecting an appropriate therapy for their patient or deciding to incorporate these therapies into their practice. This paper provides an updated review of the available data on EBTs, both FDA approved and not, with a particular focus on effectiveness and safety, as well as guidance for discussing with your patient the decision to use endoscopic therapies...
September 30, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28932965/best-practice-recommendations-for-diagnosis-and-management-of-helicobacter-pylori-synthesizing-the-guidelines
#5
REVIEW
David J Bjorkman, Matthew Steenblik
Purpose of review Three guidelines on Helicobacter pylori have been published recently with recommendations that differ from past guidelines. In this review, we summarize the Toronto consensus statement, the Maastricht V/Florence consensus report and the American College of Gastroenterology guidelines on H. pylori, comparing and contrasting the recommendations. We also provide a proposed approach integrating the information from all three guidelines. Findings Increasing antibiotic resistance has decreased the effectiveness of past treatment regimens for H...
September 21, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28918484/drug-herb-interactions-in-the-elderly-patient-with-ibd-a-growing-concern
#6
REVIEW
Haider Rahman, Marina Kim, Galen Leung, Jesse A Green, Seymour Katz
Inflammatory bowel disease (IBD), which includes conditions such as Crohn's disease and ulcerative colitis, is becoming more prevalent with the elderly being the fastest growing group. Parallel to this, there is an increasing interest in the use of complementary and alternative medicine (CAM). Nearly half of patients with IBD have used CAM at one time. The elderly patients, however, are burdened by comorbid conditions, polypharmacy, and altered functional status. With increasing use of complementary and alternative medicine in our elderly patients with IBD, it is vital for the provider to provide counsel on drug-herb potential interactions...
September 16, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28913777/diabetes-and-the-small-intestine
#7
REVIEW
Jonathan Gotfried, Stephen Priest, Ron Schey
Diabetes mellitus (DM) and its associated complications are becoming increasingly prevalent. Gastrointestinal symptoms associated with diabetes is known as diabetic enteropathy (DE) and may manifest as either diarrhea, fecal incontinence, constipation, dyspepsia, nausea, and vomiting or a combination of symptoms. The long-held belief that vagal autonomic neuropathy is the primary cause of DE has recently been challenged by newer theories of disease development. Specifically, hyperglycemia and the resulting oxidative stress on neural networks, including the nitrergic neurons and interstitial cells of Cajal (ICC), are now believed to play a central role in the development of DE...
September 15, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28913607/diabetes-and-the-esophagus
#8
REVIEW
Roberto Monreal-Robles, José M Remes-Troche
Chronic hyperglycemia is a well-known cause of gastrointestinal motility disorders extending from the esophagus to the anorectum. Even though little attention has been paid to esophageal disorders in the context of DM, its prevalence is higher compared to gastroparesis. Heartburn, as a typical symptom of gastroesophageal reflux disease (GERD), is the most prevalent symptom and has been found in 25 to 41% of patients with DM. Furthermore, DM has recently been established as possible independent factor for the development of Barrett's esophagus...
September 15, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28895017/total-pancreatectomy-with-islet-autotransplantation-for-acute-recurrent-and-chronic-pancreatitis
#9
REVIEW
Varvara A Kirchner, Ty B Dunn, Gregory J Beilman, Srinath Chinnakotla, Timothy L Pruett, Joshua J Wilhelm, Sarah J Schwarzenberg, Martin L Freeman, Melena D Bellin
PURPOSE OF REVIEW: The first total pancreatectomy and islet autotransplantation (TP-IAT) was performed for chronic pancreatitis in 1977 with the goal to ameliorate the pain and simultaneously preserve islet function. We reviewed the recent medical literature regarding indications, patient suitability, current outcomes, and challenges in TP-IAT. RECENT FINDINGS: Current indications for TP-IAT include intractable pain secondary to chronic pancreatitis (CP) or acute recurrent pancreatitis (ARP) with failed medical and endoscopic/surgical management...
September 11, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28879488/diabetes-and-the-stomach
#10
REVIEW
Allen A Lee, William L Hasler
Longstanding diabetes mellitus (both type 1 and type 2) can impair gastric motor function and cause significant upper gastrointestinal symptoms which significantly degrade quality of life, cause nutritional deficits, and degrade healthcare resource use. The most commonly considered gut complication of diabetes, diabetic gastroparesis, is a syndrome of delayed gastric emptying in the absence of mechanical obstruction which leads to symptoms of nausea, vomiting, postprandial fullness, early satiation, bloating, and upper abdominal pain...
September 6, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28879469/pancreatic-cancer-screening
#11
REVIEW
Koushik K Das, Dayna Early
PURPOSE OF REVIEW: This review describes the rationale for pancreatic cancer screening, outlines groups that are at elevated risk for pancreatic cancer, and summarizes the relative risk in each setting. We also review the methods available for performing pancreatic cancer screening and the recommended screening intervals. RECENT FINDINGS: Several genetic mutations have been identified that increase the risk for pancreatic cancer. Most are rare, however, and at-risk individuals are most often those with a strong family history of pancreatic cancer (with multiple family members affected) but no identifiable genetic mutation...
September 6, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28852967/recent-advances-in-pancreatic-cancer-surgery
#12
REVIEW
Laura Maggino, Charles M Vollmer
Pancreatic cancer surgery is a continuously evolving field. Despite tremendous advances in perioperative outcomes, pancreatic resection is still associated with substantial morbidity, and mortality is not nil. Institutional caseload is a well-established determinant of patient outcomes, and centralization to experienced centers is essential to the safety and oncological appropriateness of the resection. Minimally invasive approaches are increasingly applied for pancreatic resection, even in cancer patients...
August 29, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28842855/diagnosis-and-management-of-autoimmune-pancreatitis
#13
REVIEW
Phil A Hart, Somashekar G Krishna, Kazuichi Okazaki
Although autoimmune pancreatitis is a relatively uncommon pancreatic disorder, it is an important consideration in the differential diagnosis of jaundice and pancreatic masses to avoid unnecessary surgical resection. The clinical diagnosis of autoimmune pancreatitis involves considering multiple pieces of information including the pancreatic imaging, serum IgG4 level, presence of characteristic other involvement, and histologic findings. Unlike other pancreatic disorders, this condition rapidly responds to treatment with steroids...
August 25, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28803403/endoscopic-surveillance-in-long-standing-colitis
#14
REVIEW
Brigid S Boland, Amandeep Shergill, Tonya Kaltenbach
There is a relative increase in the risk of colon cancer in patients with inflammatory bowel disease (IBD) affecting the colon, and endoscopic surveillance is advocated to mitigate this risk. The current standard practice is to survey this high-risk patient population using colonoscopy. Chromoendoscopy with targeted biopsies has emerged as the colonoscopy modality recommended by the major societies to optimize dysplasia detection. Studies over the past year support the improved yield from targeted as compared to random biopsies and improved dysplasia detection from chromoendoscopy as compared to white light endoscopy...
August 12, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28801825/intractable-constipation-in-the-elderly
#15
REVIEW
Noemi Baffy, Amy E Foxx-Orenstein, Lucinda A Harris, Susan Sterler
Chronic constipation is a common gastrointestinal disorder disproportionately affecting the elderly. Immobility, polypharmacy, and physiologic changes contribute to its increased prevalence in this population. Unidentified and undertreated constipation leads to a significant negative impact on quality of life and an increase in healthcare spending. Careful physical examination and exploration of the clinical history can unmask primary and secondary forms of constipation, guiding diagnostic and therapeutic considerations...
August 11, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28795293/endoscopic-palliation-of-pancreatic-cancer
#16
REVIEW
Vishal B Gohil, Jason B Klapman
Pancreas cancer is a fourth-leading cause of cancer death in the USA and its incidence is rising as the population is aging. The majority of patients present at an advanced stage due to the silent nature of the disease and treatment have focused more on palliation than curative intent. Gastroenterologists have become integral in the multidisciplinary care of these patients with a focus on providing endoscopic palliation of pancreas cancer. The three most common areas that gastroenterologists palliate endoscopically are biliary obstruction, cancer-related pain, and gastric outlet obstruction...
August 9, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28756531/dysphagia-in-the-elderly
#17
REVIEW
Scott M Smukalla, Irina Dimitrova, Jeremy M Feintuch, Abraham Khan
Dysphagia is a common problem in the elderly population with an especially high prevalence in hospitalized and institutionalized patients. If inadequately addressed, dysphagia leads to significant morbidity and contributes to decreased quality of life. Dysphagia can be categorized as emanating from either an oropharyngeal or esophageal process. A disproportionate number of elderly patients suffer from oropharyngeal dysphagia with a multifactorial etiology. Historically, treatment options have been limited and included mostly supportive care with a focus on dietary modification, food avoidance, and swallow rehabilitation...
July 29, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28748314/the-present-status-of-fecal-microbiota-transplantation-and-its-value-in-the-elderly
#18
REVIEW
Yao-Wen Cheng, Monika Fischer
OPINION STATEMENT: PURPOSE OF REVIEW: This article will review current literature describing fecal microbiota transplantation (FMT) in the treatment of various diseases, and its potential role in elderly patients (age ≥ 65 years). RECENT FINDINGS: Research on FMT has blossomed in the last decade and its pivotal role in the treatment of recurrent Clostridium difficile infection (CDI) has been recognized by the American College of Gastroenterology in the latest guidelines...
July 26, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28725941/endoscopic-stents-for-the-biliary-tree-and-pancreas
#19
REVIEW
Rajesh Krishnamoorthi, Mahendran Jayaraj, Richard Kozarek
OPINION STATEMENT: PURPOSE OF REVIEW: To review the recently published literature on biliary and pancreatic stents. RECENT FINDINGS: Covered self-expanding metal stents (SEMS) are increasingly being used in the endoscopic management of benign biliary strictures. Given the costs associated with SEMS, plastic stents are still the most commonly used stents. In this setting, SEMS are preferred over plastic stents for palliation of malignant biliary strictures due to superior patency and have a role in preoperative management of malignant biliary strictures...
July 20, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28702775/quality-indicators-in-colonoscopy
#20
REVIEW
Kjetil Garborg, Thomas de Lange, Michael Bretthauer
Colonoscopy is one of the most commonly performed endoscopic procedures. It is the gold standard examination for work-up of colonic symptoms, for follow-up of positive colorectal cancer screening tests and for detection and removal of neoplastic polyps. Colonoscopy is a complex and invasive procedure with a potential not only for colorectal cancer prevention, but also for serious complications. Numerous factors may affect the balance of benefit versus harm of colonoscopy, including the performance of the endoscopist...
July 12, 2017: Current Treatment Options in Gastroenterology
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