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Current Gastroenterology Reports

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https://www.readbyqxmd.com/read/28608155/pathophysiology-of-gastric-nets-role-of-gastrin-and-menin
#1
REVIEW
Sinju Sundaresan, Anthony J Kang, Juanita L Merchant
PURPOSE OF REVIEW: Neuroendocrine tumors (NETs) were initially identified as a separate entity in the early 1900s as a unique malignancy that secretes bioactive amines. GI-NETs are the most frequent type and represent a unique subset of NETs, because at least 75% of these tumors represent gastrin stimulation of the enterochromaffin-like cell located in the body of the stomach. The purpose of this review is to understand the specific role of gastrin in the generation of Gastric NETs (G-NETs)...
July 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28593453/targeting-small-bowel-receptors-to-treat-constipation-and-diarrhea
#2
REVIEW
Elizabeth S John, Sita Chokhavatia
BACKGROUND: The options for the treatment of diarrhea and constipation are evolving as emerging therapies target small bowel receptors. The goal of this review is to discuss small bowel receptors involved in intestinal absorption, secretion, and motility. The review highlights therapies already approved or currently being studied for the modulation of these receptors. METHODS: The articles cited in this review focus on the molecular level of pathways involved in diarrhea and constipation, and highlight the respective pharmacotherapies...
July 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28567655/the-evaluation-and-office-management-of-hemorrhoids-for-the-gastroenterologist
#3
REVIEW
Mitchel Guttenplan
PURPOSE OF REVIEW: Hemorrhoid disease is extremely common, and seldom requires surgical intervention. The vast majority of patients can be cared for in the office setting and by the gastroenterologist. This piece aims to summarize the epidemiology and pathophysiology of hemorrhoid disease, along with the proper evaluation and office-based treatment of these patients. RECENT FINDINGS: Most GI fellowship training programs spend little time on these topics, and the recommendation has been made to include anorectal care in the GI's "core curriculum...
July 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28540669/tropical-enteropathies
#4
REVIEW
John Louis-Auguste, Paul Kelly
PURPOSE OF REVIEW: The term 'tropical enteropathy' originated in observations in the 1960s that small intestinal morphology and function differed in the tropics from the norms found in temperate climates. It was subsequently shown that this enteropathy is more closely related to environmental conditions than latitude, and it was re-labelled 'environmental enteropathy'. It is now recognised that environmental enteropathy (also now called environmental enteric dysfunction) has implications for the health and linear growth of children in low- and middle-income countries, and it may underlie poor responses to oral vaccination in these countries...
July 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28439845/a-systematic-review-of-the-clinical-presentation-diagnosis-and-treatment-of-small-bowel-obstruction
#5
REVIEW
Srinivas R Rami Reddy, Mitchell S Cappell
PURPOSE OF REVIEW: This study aimed to systematically review small bowel obstruction (SBO), focusing on recent changes in diagnosis/therapy. RECENT FINDINGS: SBO incidence is about 350,000/annum in the USA. Etiologies include adhesions (65%), hernias (10%), neoplasms (5%), Crohn's disease (5%), and other (15%). Bowel dilatation occurs proximal to obstruction primarily from swallowed air and secondarily from intraluminal fluid accumulation. Dilatation increases mural tension, decreases mucosal perfusion, causes bacterial proliferation, and decreases mural tensile strength that increases bowel perforation risks...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28429202/small-bowel-motility
#6
REVIEW
Carolina Malagelada, Juan R Malagelada
PURPOSE OF REVIEW: Small bowel motility disorders constitute a relatively small but important segment of clinical gastroenterology. Presenting features encompass a broad range of symptom manifestations and severity: from chronic functional-type complaints to life-threatening nutritional impairment. Diagnostic assessment of patients with suspected intestinal motility disorders is often hampered by the complexity of measuring intestinal contractile activity in humans. In this review, we describe and critically comment the main current and forthcoming methodologies...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28429201/how-to-approach-lymphocytic-esophagitis
#7
REVIEW
Anh D Nguyen, Kerry B Dunbar
PURPOSE OF REVIEW: Lymphocytic esophagitis (LE) is an unusual esophageal condition defined by an increased number of lymphocytes in the esophageal epithelium. With few published studies of LE available, it is unclear whether LE is a truly distinct clinical entity or a histological manifestation of other known gastrointestinal disorders. This review summarizes recent studies of lymphocytic esophagitis. RECENT FINDINGS: Studies have suggested that LE may be related to eosinophilic esophagitis (EoE) or a manifestation of gastroesophageal reflux disease (GERD)...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28429200/achalasia-it-is-not-all-black-and-white
#8
REVIEW
Santosh Sanagapalli, Rami Sweis
PURPOSE OF REVIEW: This review aims to shed light on subtleties of achalasia diagnosis, including potential pitfalls that may lead to errors. Optimal methods for assessment of disease severity and the relationship between achalasia and other motility disorders will also be reviewed with an emphasis on recent findings from the literature. RECENT FINDINGS: Adjunctive testing with viscous substances or larger water volumes should be used routinely as it improves the accuracy of achalasia diagnosis...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28429199/gastric-bypass-and-influence-on-improvement-of-nafld
#9
REVIEW
Vamsi Alli, Ann M Rogers
PURPOSE OF REVIEW: Obesity is recognized as a chronic and recurring disease, often accompanied by other weight-related comorbid conditions such as obstructive sleep apnea, hypertension, type 2 diabetes, and non-alcoholic fatty liver disease (NAFLD). This chapter will seek to focus on the effect of weight loss surgery (WLS), in particular Roux-en-Y gastric bypass (RYGB), on NAFLD. RECENT FINDINGS: Among several modalities available to treat NAFLD, the one most likely to achieve rapid, significant, and sustained improvement of liver disease is WLS...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28421381/lactase-non-persistence-and-lactose-intolerance
#10
REVIEW
Theodore M Bayless, Elizabeth Brown, David M Paige
PURPOSE OF REVIEW: To evaluate the clinical and nutritional significance of genetically determined lactase non-persistence and potential lactose and milk intolerance in 65-70% of the world's adult population. RECENT FINDINGS: Milk consumption is decreasing in the USA and is the lowest in countries with a high prevalence of lactase non-persistence. The dairy industry and Minnesota investigators have made efforts to minimize the influence of lactose intolerance on milk consumption...
May 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28397133/the-role-of-diet-in-inflammatory-bowel-disease
#11
REVIEW
Raina Shivashankar, James D Lewis
PURPOSE OF REVIEW: Diet may play both a causal and therapeutic role for inflammatory bowel disease (IBD). Physicians caring for patients with IBD are often asked to make dietary recommendations. However, there are no well-established guidelines on the use of diet as a treatment of IBD. In this review, we describe the evidence supporting diet as a potential cause for IBD, patient-perceived symptoms based on diet, current research on various diets as a treatment for IBD, and areas of future research...
May 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28397132/modifiable-environmental-factors-in-inflammatory-bowel-disease
#12
REVIEW
Kristin E Burke, Christine Boumitri, Ashwin N Ananthakrishnan
PURPOSE OF REVIEW: Environmental factors may influence predisposition to develop inflammatory bowel diseases (Crohn's disease, ulcerative colitis) or alter its natural history by modification of both the host immune response and intestinal microbial composition. The purpose of this review is to translate such evidence into clinical practice by a focus on interventional studies that have modified such environmental influences to improve disease outcomes. RECENT FINDINGS: Several environmental influences have been identified in the recent literature including tobacco use, diet, antibiotics, vitamin D deficiency, stress, appendectomy, and oral contraceptive use...
May 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28397131/making-a-medical-home-for-ibd-patients
#13
REVIEW
Lawrence R Kosinski, Joel Brill, Miguel Regueiro
PURPOSE OF REVIEW: The transformation from fee for service to fee for value requires structural changes to the way gastroenterologists manage patients with inflammatory bowel disease (IBD). A team-based approach using technology to engage patients is necessary for success. The Patient-Centered Medical Home (PCMH) represents a unique model that brings together these essential features. This paper describes how the PCMH model has been successfully applied to the management of patients with IBD...
May 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28397130/antidiarrheal-drug-therapy
#14
REVIEW
Lawrence R Schiller
INTRODUCTION: Acute diarrhea often runs a self-limited course and little by way of treatment is needed except for oral rehydration therapy. Chronic diarrhea poses a longer-term problem. If not treatable with specific therapy aimed at the underlying pathophysiology, chronic diarrhea often needs long-term symptomatic therapy. PURPOSE OF REVIEW: This paper aims to examine the options for symptomatic, nonspecific treatment of diarrhea. RECENT FINDINGS: The most frequently used therapies are opiate antidiarrheal drugs...
May 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28397129/the-evolving-evidence-for-therapeutic-drug-monitoring-of-monoclonal-antibodies-in-inflammatory-bowel-disease
#15
REVIEW
Christopher Sheasgreen, Geoffrey C Nguyen
PURPOSE OF REVIEW: Biological medications are effective in inflammatory bowel disease (IBD) but adverse events, cost, and loss of response make their use challenging. Therapeutic drug monitoring (TDM) allows clinicians to more safely, effectively, and efficiently use medications. The purpose of this article is to review and summarize the most recent literature pertaining to TDM in IBD. RECENT FINDINGS: Measurement of biological drug trough levels predicts ongoing patient response and can be used to titrate the medication to be more effective and efficient...
May 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28374310/what-does-lesion-blood-flow-tell-us-about-risk-stratification-and-successful-management-of-non-variceal-ugi-bleeding
#16
REVIEW
Kevin A Ghassemi, Dennis M Jensen
PURPOSE OF REVIEW: There has been a decline in mortality associated with upper gastrointestinal (UGI) hemorrhage as the use of urgent endoscopy has increased. This review will examine endoscopic risk stratification of non-variceal UGI bleeding (e.g., ulcers, Dieulafoy lesions, and Mallory-Weiss tears), including the use of the Doppler endoscopic probe (DEP). RECENT FINDINGS: Prospective studies evaluating the use of DEP in non-variceal UGI hemorrhage showed that lesions with high-risk stigmata of recent hemorrhage (SRH) have a higher rate of a positive DEP signal compared to those with intermediate-risk SRH...
April 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28374309/early-and-peri-operative-prognostic-indicators-in-infants-undergoing-hepatic-portoenterostomy-for-biliary-atresia-a-review
#17
REVIEW
Robert N Lopez, Chee Y Ooi, Usha Krishnan
PURPOSE OF REVIEW: Biliary atresia is the most common indication for liver transplantation among children. In recent years, prospective, multi-centre collaboration has been underway with the aim of providing high-quality data on the natural history of the condition, prior to and following hepatic portoenterostomy. RECENT FINDINGS: There is increasing evidence that specific histological findings, and age, at the time of portoenterostomy have relevance as prognostic indicators...
April 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28374308/update-on-rome-iv-criteria-for-colorectal-disorders-implications-for-clinical-practice
#18
REVIEW
Magnus Simren, Olafur S Palsson, William E Whitehead
PURPOSE OF REVIEW: The purpose of the review was to provide an update of the Rome IV criteria for colorectal disorders with implications for clinical practice. RECENT FINDINGS: The Rome diagnostic criteria are expert consensus criteria for diagnosing functional gastrointestinal disorders (FGIDs). The current version, Rome IV, was released in May of 2016 after Rome III had been in effect for a decade. It is the collective product of committees that included more than 100 leading functional GI experts...
April 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28374307/medical-child-abuse-munchausen-syndrome-by-proxy-multidisciplinary-approach-from-a-pediatric-gastroenterology-perspective
#19
REVIEW
Andrea Z Ali-Panzarella, Tamika J Bryant, Hannah Marcovitch, Jeffery D Lewis
PURPOSE OF REVIEW: We highlight the need for a multidisciplinary approach to the diagnosis of medical child abuse, also known as factitious disorder imposed on another (FDIA) or Munchausen syndrome by proxy (MSP), and review our experience focusing on the variety of symptoms that often present to the pediatric gastroenterologist many months before the diagnosis is made. RECENT FINDINGS: Recent literature on medical child abuse, mostly case reports, is markedly limited, highlighting a need for increased research on this topic...
April 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28365899/characterization-of-esophageal-motility-disorders-in-children-presenting-with-dysphagia-using-high-resolution-manometry
#20
Francis Edeani, Adeel Malik, Ajay Kaul
PURPOSE OF REVIEW: The Chicago classification was based on metrics derived from studies in asymptomatic adult subjects. Our objectives were to characterize esophageal motility disorders in children and to determine whether the spectrum of manometric findings is similar between the pediatric and adult populations. RECENT FINDINGS: Studies have suggested that the metrics utilized in manometric diagnosis depend on age, size, and manometric assembly. This would imply that a different set of metrics should be used for the pediatric population...
March 2017: Current Gastroenterology Reports
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