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Current Gastroenterology Reports

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https://www.readbyqxmd.com/read/28337726/opioid-related-constipation-in-patients-with-non-cancer-pain-syndromes-a-review-of-evidence-based-therapies-and-justification-for-a-change-in-nomenclature
#1
REVIEW
Darren M Brenner, Emily Stern, Brooks D Cash
PURPOSE OF REVIEW: Opioids are a mainstay in the treatment of chronic non-cancer pain syndromes, but their analgesic benefits come at a cost as opioid-related constipation occurs in 40-80% of individuals taking chronic opioids. Furthermore, as 10-20% of the population suffers from constipation at baseline, it should be expected that while a proportion of individuals will develop constipation as a direct consequence of opioids (OIC), others will experience it as an exacerbation of their baseline constipation (OEC)...
March 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28289859/diagnosis-of-swallowing-disorders-how-we-interpret-pharyngeal-manometry
#2
REVIEW
Charles Cock, Taher Omari
PURPOSE OF REVIEW: We provide an overview of the clinical application of novel pharyngeal high-resolution impedance manometry (HRIM) with pressure flow analysis (PFA) in our hands with example cases. RECENT FINDINGS: In our Centre, we base our interpretation of HRIM recordings upon a qualitative assessment of pressure-impedance waveforms during individual swallows, as well as a quantitative assessment of averaged PFA swallow function variables. We provide a description of two global swallowing efficacy measures, the swallow risk index (SRI), reflecting global swallowing dysfunction (higher SRI = greater aspiration risk) and the post-swallow impedance ratio (PSIR) detecting significant post-swallow bolus residue...
March 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28289858/donor-considerations-in-fecal-microbiota-transplantation
#3
REVIEW
Danielle Barnes, K T Park
PURPOSE OF REVIEW: Tremendous acceleration has been made in understanding the gut microbiota in the past decade and, with it, further understanding of the pathologic role of dysbiosis and the use of fecal microbiota transplantation (FMT) as therapy. FMT has been studied in many disease states including the most common indication of Clostridium difficile infection (CDI), though many questions regarding stool donor selection remain. RECENT FINDINGS: Though traditionally, one donor has provided stool for one patient, research is underway to explore many donor selection considerations from the use of pooled donor stool to selection of a high diversity donor...
March 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28281203/recent-advances-in-non-invasive-esophageal-tissue-sampling
#4
REVIEW
David A Katzka
PURPOSE OF REVIEW: The costs to society and accuracy of screening for esophageal cancer and other esophageal diseases with standard endoscopy are formidable. As a result, the applicability of endoscopy as a general screening tool has been challenged. RECENT FINDINGS: To maintain accuracy but reduce the price of endoscopy on society, multiple adjunct or replacement technologies are being developed that are less expensive and more easily applied. These devices include image-enhancing techniques that more reliably identify dysplasia and cancer reducing the need for extensive biopsy sampling during standard endoscopy...
March 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28265892/current-approach-to-the-evaluation-and-management-of-microscopic-colitis
#5
REVIEW
Thomas G Cotter, Darrell S Pardi
PURPOSE OF REVIEW: Microscopic colitis is a common cause of chronic watery diarrhea, particularly in the elderly. The accompanying symptoms, which include abdominal pain and fatigue, can markedly impair patients' quality of life. Diagnosis is based upon characteristic histologic findings of the colonic mucosa. This review focuses on the current approach to evaluation and management of patients with microscopic colitis. RECENT FINDINGS: Although the incidence of microscopic colitis has been increasing over time, recent epidemiological studies show stabilization at 21...
February 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28220362/the-role-of-impedance-planimetry-in-the-evaluation-of-esophageal-disorders
#6
REVIEW
Nitin K Ahuja, John O Clarke
PURPOSE OF REVIEW: Impedance planimetry measures tissue wall distensibility as a function of pressure and cross-sectional area. Recent interest in this technique's relevance to the gastrointestinal tract has been accelerated by the availability of the functional lumen imaging probe, a catheter-based system that dynamically quantitates these biomechanical properties. Herein, we review the device's particular utility in the setting of esophageal pathology, including processes affecting the esophageal body as well as the upper and lower esophageal sphincters...
February 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28155088/the-enigmatic-gut-in-cystic-fibrosis-linking-inflammation-dysbiosis-and-the-increased-risk-of-malignancy
#7
REVIEW
Millie Garg, Chee Y Ooi
PURPOSE OF REVIEW: Intestinal inflammation, dysbiosis, and increased gastrointestinal malignancy risks are well-described in patients with cystic fibrosis (CF). However, there is limited understanding of their pathophysiology. This review aims to discuss these issues and assess potential links between them. RECENT FINDINGS: Evidence of links between intestinal inflammation and dysbiosis (an imbalance in intestinal microbial populations) exist. Recent studies have demonstrated reduction in intestinal inflammation with probiotic administration...
February 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28155087/the-association-between-helicobacter-pylori-infection-and-nonalcoholic-fatty-liver-disease
#8
REVIEW
Derek M Tang, Sheila Kumar
PURPOSE OF REVIEW: Helicobacter pylori (HP) infection is known to be a significant risk factor in the development of certain gastric conditions, such as ulcers, gastritis, and malignancy. Recently, however, the systemic effect of HP infection on other organ systems has come to be appreciated. In this review, we will explore the association between HP infection and nonalcoholic fatty liver disease (NAFLD), the hepatic component of metabolic syndrome. RECENT FINDINGS: The possible association between HP infection and NAFLD initially stemmed from the isolation of HP bacteria in the livers of patients with NAFLD...
February 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28144844/surveillance-in-patients-with-esophageal-atresia-tracheoesophageal-fistula
#9
REVIEW
Arunjot Singh, William Middlesworth, Julie Khlevner
PURPOSE OF REVIEW: Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a congenital aerodigestive anomaly with high survival rates after surgical repair. Care should now be focused on prevention of long-term complications using appropriate surveillance techniques. RECENT FINDINGS: The incidence of gastroesophageal reflux disease (GERD) is high in patients with EA/TEF. Consequences of untreated GERD include esophagitis, strictures, and Barrett esophagus. Subjective symptoms are an unreliable indicator of presence or severity of GERD, and therefore, diagnostic testing is needed to assess esophageal heath and monitor the effectiveness of anti-reflux treatment...
January 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28124291/gastrointestinal-and-hepatic-complications-of-immune-checkpoint-inhibitors
#10
REVIEW
Peyton Cramer, Robert S Bresalier
PURPOSE OF REVIEW: Gastrointestinal complications are very common in patients undergoing cancer treatment. Some of these complications can be life threatening and require prompt and appropriate diagnosis and treatment. The purpose of this review is to address luminal gastrointestinal and hepatic complications associated with a new class of anticancer drugs, immune checkpoint inhibitors (CPIs), and focuses on the identification, evaluation, and management of the complications associated with this class of drugs...
January 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28110453/update-on-the-diagnosis-and-treatment-of-cholangiocarcinoma
#11
REVIEW
Bryan Doherty, Vinod E Nambudiri, William C Palmer
PURPOSE OF REVIEW: Cholangiocarcinoma is a rare biliary adenocarcinoma associated with poor outcomes. Cholangiocarcinoma is subdivided into extrahepatic and intrahepatic variants. Intrahepatic cholangiocarcinoma is then further differentiated into (1) peripheral mass-forming tumors and (2) central periductal infiltrating tumors. We aimed to review the currently known risk factors, diagnostic tools, and treatment options, as well as highlight the need for further clinical trials and research to improve overall survival rates...
January 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28101791/strategies-to-reduce-30-day-readmissions-in-patients-with-cirrhosis
#12
REVIEW
Elliot B Tapper, Michael Volk
PURPOSE OF REVIEW: Approximately, one quarter of patients discharged after a hospitalization for decompensated cirrhosis will be readmitted within 30 days. These readmissions have been associated with increased morbidity and mortality, can be financially harmful to the health system, and may be partially preventable. This review summarizes the literature on readmissions, providing clinicians with tools for risk prediction and a taxonomy for preventative interventions. RECENT FINDINGS: Readmission strategies can be categorized according to complexity (simple versus complex) and specificity (focused versus broad)...
January 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27787787/malnutrition-and-nutritional-support-in-alcoholic-liver-disease-a-review
#13
REVIEW
Andrew Chao, Dan Waitzberg, Rosangela Passos de Jesus, Allain A Bueno, Victor Kha, Karen Allen, Matthew Kappus, Valentina Medici
Malnutrition is associated with alcoholic liver disease (ALD) and related complications such as hepatic encephalopathy and increased rate of infections. Avoidance of prolonged fasting and overly restrictive diets is important to avoid poor nutrition. Adequate intake of calories, protein, and micronutrients via frequent small meals and evening supplements and/or enteral and parenteral nutrition when indicated has been associated with reduced mortality and morbidity in patients with ALD. Modification of protein/fat sources and composition in addition to probiotic supplementation are promising interventions for decreased progression of ALD and its complications...
December 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27778304/understanding-the-mechanical-forces-of-self-expandable-metal-stents-in-the-biliary-ducts
#14
REVIEW
Hiroyuki Isayama, Yousuke Nakai, Tsuyoshi Hamada, Saburo Matsubara, Hirofumi Kogure, Kazuhiko Koike
Self-expandable metallic stent (SEMS) was an effective biliary endoprosthesis. Mechanical properties of SEMS, radial and axial force (RF, AF), may play important roles in the bile duct after placement. RF was well known dilation force and influenced on the occurrence of migration. AF, newly proposed by this author, was defined as the recovery force when the SEMS vended. AF was related with the cause of bile duct kinking, pancreatitis, and cholecystitis due to the compression of the bile duct, orifice of the cystic duct, and pancreatic orifice...
December 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27747460/non-celiac-gluten-sensitivity
#15
REVIEW
Maria Teresa Bardella, Luca Elli, Francesca Ferretti
PURPOSE OF REVIEW: A new syndrome responding to gluten-free diet and defined non-celiac gluten sensitivity entered the spectrum of gluten-related disorders, together with celiac disease and wheat allergy. However, its definition, prevalence, diagnosis, pathogenesis, treatment, and follow up are still controversial. The purpose of the review is to summarize the evidence and problems emerging from the current literature. RECENT FINDINGS: Direct implication of gluten in the onset of symptoms is often unproved as a low fermentable oligo-, di- and mono-saccharides and polyols diet or other components of cereals as wheat amylase trypsin inhibitor could be similarly involved...
December 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27747459/complementary-therapies-in-inflammatory-bowel-diseases
#16
REVIEW
Henit Yanai, Nir Salomon, Adi Lahat
Inflammatory bowel diseases (IBDs) often take a chronic debilitating course. Given the chronicity of IBD, the limitations of the available medications, their potential side effects, and the impact of the disease on patients' quality of life, it is not surprising IBD patients are ranked among the highest users of complementary and alternative medicine (CAM). Since CAM has become very popular in real-life practice of Western Communities, caregivers must gain more knowledge about these therapies, their mechanism of action, benefits, and risks...
December 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27747458/acute-on-chronic-liver-failure
#17
REVIEW
Shiv Kumar Sarin, Ashok Choudhury
Acute-on-chronic liver failure (ACLF) is a distinct entity that differs from acute liver failure and decompensated cirrhosis in timing, presence of treatable acute precipitant, and course of disease, with a potential for self-recovery. The core concept is acute deterioration of existing liver function in a patient of chronic liver disease with or without cirrhosis in response to an acute insult. The insult should be a hepatic one and presentation in the form of liver failure (jaundice, encephalopathy, coagulopathy, ascites) with or without extrahepatic organ failure in a defined time frame...
December 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27738966/chicago-classification-of-esophageal-motility-disorders-applications-and-limits-in-adults-and-pediatric-patients-with-esophageal-symptoms
#18
REVIEW
Kornilia Nikaki, Joanne Li Shen Ooi, Daniel Sifrim
The Chicago classification (CC) is most valued for its systematic approach to esophageal disorders and great impact in unifying practice for esophageal manometric studies. In view of the ever-growing wealth of knowledge and experience gained by the expanding use of high-resolution manometry (HRM) in various clinical scenarios, the CC is regularly updated. Its clinical impact and ability to predict clinical outcome, both in adults and pediatrics, will be further promoted by recognizing its current limitations, incorporating new metrics in its diagnostic algorithms and adjusting the HRM protocols based on the clinical question posed...
November 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27738965/how-to-optimally-apply-impedance-in-the-evaluation-of-esophageal-dysmotility
#19
REVIEW
Amit Patel, C Prakash Gyawali
The utilization of impedance technology has enhanced our understanding and assessment of esophageal dysmotility. Esophageal high-resolution manometry (HRM) catheters incorporated with multiple impedance electrodes help assess esophageal bolus transit, and the combination is termed high-resolution impedance manometry (HRIM). Novel metrics have been developed with HRIM-including esophageal impedance integral ratio, bolus flow time, nadir impedance pressure, and impedance bolus height-that augments the assessment of esophageal bolus transit...
November 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27726042/eosinophilic-esophagitis-from-an-allergy-perspective-how-to-optimally-pursue-allergy-testing-dietary-modification-in-the-adult-population
#20
REVIEW
Emily C McGowan, Thomas A Platts-Mills
Eosinophilic esophagitis (EoE) is a clinicopathologic condition characterized by symptoms of esophageal dysfunction and eosinophil-predominant inflammation. In adults, the three most common treatment options are swallowed steroids, elimination diets, and periodic esophageal dilations. Many different elimination diets have been studied in adults, including elemental diets, allergy testing-directed diets, and empiric elimination diets. This article will review the existing data on these dietary therapies and will propose an approach to dietary management in adult EoE...
November 2016: Current Gastroenterology Reports
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