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Current Gastroenterology Reports

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https://www.readbyqxmd.com/read/29767340/speculation-as-to-why-the-frequency-of-eosinophilic-esophagitis-is-increasing
#1
REVIEW
Stuart Jon Spechler
PURPOSE OF REVIEW: The frequency of eosinophilic esophagitis (EoE), an immune/antigen-mediated disorder first described in 1993, has been increasing rapidly. The purpose of this review is to consider hypotheses proposed to explain this increase and to speculate on their validity. RECENT FINDINGS: The hygiene hypothesis attributes the rise of EoE to modern hygienic conditions resulting in fewer childhood infections with microbes that might have protected against allergy development...
May 16, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29767318/strategies-for-effective-discontinuation-of-proton-pump-inhibitors
#2
REVIEW
Judith Kim, John W Blackett, Daniela Jodorkovsky
PURPOSE OF REVIEW: Proton pump inhibitors (PPIs) are effective for many conditions but are often overprescribed. Recent concerns about long-term risks have made patients re-evaluate their need to take PPIs chronically, though these population-based studies have methodological weaknesses. The goal of this review is to provide evidenced-based strategies for discontinuation of PPI therapy. RECENT FINDINGS: Given that some patients experience rebound symptoms when abruptly stopping continuous PPI therapy due to its effect on hypergastrinemia, strategies focus on avoiding rebound...
May 16, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29687294/endoscopic-therapies-for-gastroparesis
#3
REVIEW
Andrew Su, Jeffrey L Conklin, Alireza Sedarat
PURPOSE OF REVIEW: Gastroparesis remains a difficult-to-treat disease with limited therapeutic options. Though patients often have a common syndrome of stereotypic symptoms, the underlying pathophysiology is heterogeneous, often leading to variable treatment responses. Due to limitations in medical and surgical therapies, endoscopic options have been increasingly explored. These options can be broadly categorized into pyloric-directed therapy, non-pyloric-directed therapy, and nutritional support...
April 23, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29675753/the-stomach-as-an-endocrine-organ-expression-of-key-modulatory-genes-and-their-contribution-to-obesity-and-non-alcoholic-fatty-liver-disease-nafld
#4
REVIEW
Aybike Birerdinc, Sasha Stoddard, Zobair M Younossi
PURPOSE OF REVIEW: Obesity is currently seen in epidemic proportions globally and is one of the largest contributors to the development of NAFLD. The spectrum of NAFLD, particularly the progressive forms of NASH, is likely to become the leading cause of liver disease in the next decade. RECENT FINDINGS: Soluble molecules, encoded by the stomach tissue, have been shown to have pleiotropic effects in both central and peripheral systems involved in energy homeostasis and obesity regulation...
April 19, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29666967/health-maintenance-in-inflammatory-bowel-disease
#5
REVIEW
Fazia A Mir, Sunanda V Kane
PURPOSE OF REVIEW: Patients with inflammatory bowel disease (IBD) are not receiving preventative care services at the same rate as the general population. IBD patients are at increased risk for infections, osteoporosis, and certain malignancies secondary to their disease and as they are on immunosuppressive therapy. They are a younger population and often times consider their gastroenterologist as their primary care physician. In this review, we discuss up-to-date evidence pertaining to vaccine-preventable illnesses in the immunosuppressed IBD patient, screening for bone health, cervical cancer, skin malignancies, psychological wellbeing, and smoking cessation...
April 17, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29644509/applications-of-colon-capsule-endoscopy
#6
REVIEW
Shabana F Pasha
PURPOSE OF REVIEW: This is a review of colon capsule endoscopy (CCE) with a focus on its recent developments, technological improvements, and current and potential future indications. RECENT FINDINGS: Based on the current literature, CCE II demonstrates comparable polyp detection rates as optical colonoscopy and CT colonography, and improved cost-effectiveness. The main limitation to patient acceptance is the requirement of a rigorous bowel preparation. Preliminary studies show good correlation between CCE and optical colonoscopy for assessment of colonic disease activity in inflammatory bowel disease (IBD)...
April 12, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29644492/update-on-the-therapeutic-management-of-hepatic-encephalopathy
#7
REVIEW
Linda Skibsted Kornerup, Lise Lotte Gluud, Hendrik Vilstrup, Gitte Dam
PURPOSE OF REVIEW: Hepatic encephalopathy (HE) is a common and devastating complication to chronic liver disease. In this paper, we summarize the latest research and evidence of both conventional and up-coming treatments. RECENT FINDINGS: Meta-analyses report beneficial effects of lactulose, branched-chain amino acids, rifaximin, and to some degree L-ornithine L-aspartate on the manifestations of HE in patients with cirrhosis, and generally the numbers needed to treat are low...
April 11, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29623506/considerations-when-treating-hepatitis-c-in-a-cirrhotic-transplant-candidate
#8
REVIEW
Kimberly E Daniel, Adnan Said
PURPOSE OF REVIEW: This review examines the issues in determining the decision to treat a HCV-positive patient who is a liver transplant (LT) candidate with highly effective and well-tolerated direct-acting antiviral (DAA) therapies. RECENT FINDINGS: Cure of HCV with DAA can improve liver function and allow delisting in some patients. Beyond a threshold of hepatic impairment (likely MELD score > 16 to 20), patients may experience a decline in MELD score with HCV cure without improvement in liver-related complications resulting in decreased opportunity to receive a LT...
April 5, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29623492/therapy-for-crohn-s-disease-a-review-of-recent-developments
#9
REVIEW
Gregory J Eustace, Gil Y Melmed
PURPOSE OF REVIEW: To review recent advances in the treatment of Crohn's disease. RECENT FINDINGS: Several key advances are highlighted, including the increasing role of treatment algorithms and where new therapies can be used most effectively, the appropriate use of therapeutic drug monitoring, optimal management of post-surgical patients, and the role of multi-disciplinary clinics. The last several years have seen a number of exciting developments in the field of Crohn's therapy...
April 5, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29623490/food-allergy
#10
REVIEW
Onyinye I Iweala, Shailesh K Choudhary, Scott P Commins
PURPOSE OF REVIEW: The goal of this review is to present an updated summary of the natural history of major childhood and adult food allergies and report recent advances in potential treatments for food allergy. RECENT FINDINGS: The most common childhood food allergies are typically outgrown by adolescence or adulthood. However, peanut/tree nut allergies appear to more commonly persist into adulthood. Adults can develop new IgE-mediated food allergies; the most common is oral allergy syndrome...
April 5, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29623442/therapeutic-drug-monitoring-in-pediatric-inflammatory-bowel-disease
#11
REVIEW
Nicholas Carman, David R Mack, Eric I Benchimol
PURPOSE OF REVIEW: Therapeutic drug monitoring (TDM) has emerged as a useful tool to optimize the use of drug therapies in adults with inflammatory bowel disease (IBD), including both Crohn's disease (CD) and ulcerative colitis (UC), especially during the use of biological therapies, for which the pharmacokinetics and pharmacodynamics are highly variable among patients. Fewer data exist in children. This review examines the current literature on TDM in pediatric IBD. RECENT FINDINGS: Drug clearance is affected by a number of patient and disease factors...
April 5, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29616330/colorectal-cancer-in-the-young
#12
REVIEW
Swati G Patel, Dennis J Ahnen
PURPOSE OF REVIEW: Colorectal cancer incidence has been rapidly rising in those under the age of 50 over the last 20 years. This paper will review the epidemiology, clinicopathologic, molecular features, proposed risk factors, and prevention/treatment approach for early onset CRC (EOCRC) patients. RECENT FINDINGS: EOCRC appears to have a different spectrum of clinical, pathologic, and molecular presentation compared to CRC diagnosed in older individuals. EOCRCs are disproportionately located in the distal colon; these patients tend to present with symptoms, and there is a longer interval between symptoms and diagnosis...
March 28, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29594760/cmv-infection-in-pediatric-ibd
#13
REVIEW
Anat Yerushalmy-Feler, Sharona Kern-Isaacs, Shlomi Cohen
PURPOSE OF REVIEW: Patients with inflammatory bowel disease (IBD) are predisposed to infections. Cytomegalovirus (CMV) colitis in adult IBD patients, particularly ulcerative colitis (UC), is related to severe or steroid-refractory disease. The aim of this review is to summarize the data on the prevalence and role of CMV colitis in children with IBD. RECENT FINDINGS: Data on CMV colitis in children continue to be very limited due to its rarity. As in adults, children with coexisting UC and CMV tend to have more severe colitis, are resistant to corticosteroids, and are at high risk for colectomies on short- and long-term follow-up...
March 28, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29594746/scaling-safe-access-to-fecal-microbiota-transplantation-past-present-and-future
#14
REVIEW
Pratik Panchal, Shrish Budree, Alex Scheeler, Geraldine Medina, Monica Seng, Wing Fei Wong, Ryan Eliott, Thomas Mitchell, Zain Kassam, Jessica R Allegretti, Majdi Osman
PURPOSE OF REVIEW: Universal stool banks (USBs) have emerged as a potential model for scaling access to fecal microbiota transplantation (FMT) for Clostridium difficile infection (CDI). In this review, we outline the historical barriers constraining access to FMT, the evidence on methods and outcomes of USBs, and potential future directions for expanding access. RECENT FINDINGS: Key historical barriers to FMT access include regulatory uncertainty, operational complexity of sourcing screened donor material, and logistical challenges of delivering fresh treatment preparations...
March 28, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29594739/the-ibd-and-psc-phenotypes-of-psc-ibd
#15
REVIEW
Amanda Ricciuto, Binita M Kamath, Anne M Griffiths
PURPOSE OF REVIEW: To review the characteristics of IBD and PSC that occur in association, as well as their reciprocal influences on disease evolution, in adult and pediatric populations. RECENT FINDINGS: IBD co-existing with PSC is genetically and clinically distinct from IBD alone. It is frequently characterized by pancolitis, rectal sparing, and possibly backwash ileitis, as well as a threefold increased risk of colorectal dysplasia. Adults and children with colitis and PSC appear to be at increased risk of active endoscopic and histologic disease in the absence of symptoms compared to individuals without PSC...
March 28, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29589185/contemporary-management-of-ulcerative-colitis
#16
REVIEW
Rohini Vanga, Millie D Long
PURPOSE OF REVIEW: We discuss the newest evidence-based data on management of ulcerative colitis (UC). We emphasize risk-stratification, optimizing medical therapies, and surgical outcomes of UC. RECENT FINDINGS: Recent medical advances include introduction of novel agents for UC. Vedolizumab, an anti-adhesion molecule, has demonstrated efficacy in moderate to severe UC. Tofacitinib, a small molecule, has also demonstrated efficacy. Data on optimization of infliximab show the superiority of combination therapy with azathioprine over monotherapy with infliximab or azathioprine alone...
March 27, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29582208/update-on-bile-acid-malabsorption-finally-ready-for-prime-time
#17
REVIEW
Priya Vijayvargiya, Michael Camilleri
PURPOSE OF REVIEW: To provide an update on the prevalence, pathophysiology, disease associations, and treatment options for bile acid malabsorption (BAM). RECENT FINDINGS: •Molecular mechanisms-BAs prevent water reabsorption and increase water secretion by intracellular mediators, increasing aquaporin channels and intracellular permeability. •Inflammatory bowel disease-new molecular mechanisms of BAM are identified in patients without ileal disease, including changes in expression of ileal BA transporter and nuclear receptors involved in BA homeostasis...
March 26, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29582184/small-bowel-amyloidosis
#18
REVIEW
Raghav Bansal, Umer Syed, Jacob Walfish, Joshua Aron, Aaron Walfish
PURPOSE OF REVIEW: The goal of this paper is to review the literature on small bowel amyloidosis. Our review focuses on the underlying etiology, histopathology, clinical features, endoscopic and radiologic findings, and the mainstay of management. RECENT FINDINGS: The latest research shows changing epidemiological trends of different types of amyloidosis. It also reveals a better understanding of its pathophysiology and shows improvement in treatment outcomes. Amyloidosis is a group of diseases of multiple etiologies and clinical presentations...
March 26, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29582182/diagnosis-and-management-of-fecal-incontinence
#19
REVIEW
Arnold Wald
PURPOSE OF REVIEW: The purpose of this review is to highlight current and newer therapeutic approaches to treat fecal incontinence in patients who do not respond to conservative measures. RECENT FINDINGS: Neurostimulation techniques, injection of bulking agents, and radiofrequency energy delivery to the anal canal have been proposed and tested for fecal incontinence over the last decade. Sacral stimulation is both effective and durable and is now the most popular of the invasive techniques whereas percutaneous tibial stimulation, radiofrequency energy, and bulking agents are either less effective or their evaluation has been handicapped by suboptimal study designs...
March 26, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29572696/endoscopic-management-of-difficult-bile-duct-stones
#20
REVIEW
Murad Aburajab, Kulwinder Dua
PURPOSE OF REVIEW: In 10-15% of the cases, conventional methods for removing bile duct stones by ERCP/balloon-basket extraction fail. The purpose of this review is to describe endoscopic techniques in managing these "difficult bile duct stones." RECENT FINDINGS: Endoscopic papillary large balloon dilation with balloon extraction ± mechanical lithotripsy is the initial approach used to retrieve large bile duct stones. With advent of digital cholangioscopy, electrohydraulic and laser lithotripsy are gaining popularity...
March 23, 2018: Current Gastroenterology Reports
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