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Expert Review of Gastroenterology & Hepatology

Adil El Taghdouini, Leo A van Grunsven
Chronic liver injury to hepatocytes or cholangiocytes, when left unmanaged, leads to the development of liver fibrosis, a condition characterized by the excessive intrahepatic deposition of extracellular matrix proteins. Activated hepatic stellate cells constitute the predominant source of extracellular matrix in fibrotic livers and their transition from a quiescent state during fibrogenesis is associated with important alterations in their transcriptional and epigenetic landscape. Areas covered: We briefly describe the processes involved in hepatic stellate cell activation and discuss our current understanding of alterations in the epigenetic landscape, i...
October 20, 2016: Expert Review of Gastroenterology & Hepatology
Paul R Tarnasky
Post-cholecystectomy syndrome and the concept of a causal relationship to sphincter of Oddi dysfunction, despite the controversy, has presented a clinically relevant conflict for decades. Historically surgeons, and now gastroenterologists have expended tremendous efforts towards trying to better understand the dilemma that is confounded by unique patient phenotypes. Areas Covered: This review encompasses the literature from a century of experience on the topic of post-cholecystectomy syndrome. Relevant historical and anecdotal experiences are examined in the setting of insights from evaluation of recently available controlled data...
October 20, 2016: Expert Review of Gastroenterology & Hepatology
Alessandro Passardi, Chiara Molinari
No abstract text is available yet for this article.
October 18, 2016: Expert Review of Gastroenterology & Hepatology
Yuqin Huang, Sen Wang, Dong Tang, Youquan Shi, Wei Wang, Yang Chong, Huaicheng Zhou, Qingquan Xiong, Jie Wang, Daorong Wang
Uncut Roux-en-Y gastrojejunostomy is a modification of the Billroth II procedure with Braun anastomosis, in which a jejunal occlusion is fashioned to avoid the Roux Stasis Syndrome. This review aimed to summarize the current knowledge about the uncut Roux-en-Y anastomosis operation, so that surgeons may be able to make informed decisions about its clinical application. Additionally, we hope that our findings will guide future research on this topic. Areas covered: The original uncut technique was associated with dehiscence or recanalization of the jejunal occlusion, and was therefore not widely applied...
October 17, 2016: Expert Review of Gastroenterology & Hepatology
Gillian M Barlow, Ali Rezaie, Eugenia Lin, Mark Pimentel
No abstract text is available yet for this article.
October 11, 2016: Expert Review of Gastroenterology & Hepatology
Katarzyna Bąk-Drabik, Piotr Adamczyk, Agata Chobot, Jarosław Kwiecień, Wojciech Pluskiewicz
BACKGROUND: To determine the bone status in children with inflammatory bowel diseases (IBD) using quantitative ultrasound (QUS) measurement at hand phalanges and compare the obtained results with dual-energy X-ray absorptiometry (DXA). METHODS: Fifty-one children with IBD underwent DXA and QUS measurements at hand phalanges in the year 2013. The control group for the QUS consisted of 460 children. Reference data for DXA comes from Hologic Explorer. RESULTS: QUS measurements did not differ significantly between IBD patients and healthy controls...
October 11, 2016: Expert Review of Gastroenterology & Hepatology
Janette Vardy, Prunella Blinman, Erin B Moth
Colon cancer is common and can be considered a disease of older adults with more than half of cases diagnosed in patients aged over 70 years. Decision-making about treatment with chemotherapy for older adults may be complicated by age-related physiological changes, impaired functional status, limited social supports, concerns regarding the occurrence of and ability to tolerate treatment toxicity, and the presence of comorbidities. This is compounded by a lack of high quality evidence guiding cancer treatment decisions for older adults...
October 10, 2016: Expert Review of Gastroenterology & Hepatology
Elisabetta Degasperi, Flavio Caprioli, Omar El Sherif, David Back, Massimo Colombo, Alessio Aghemo
Inflammatory bowel diseases (IBD) require long-term administration of immunomodulatory treatments to maintain disease remission. Due to the high worldwide prevalence of hepatitis B (HBV) or C (HCV) virus infections, presence of concurrent hepatitis can be a relevant clinical issue to manage when treating IBD. Areas covered: The paper summarizes epidemiological data about IBD and HBV/HCV infection and reviews current knowledge about the natural history of HBV and HCV in the IBD setting, concentrating on risk of hepatitis reactivation during immunosuppressive treatment...
October 8, 2016: Expert Review of Gastroenterology & Hepatology
Vu Nguyen, Rajan Kanth, Joshua Gazo, Dario Sorrentino
Postoperative recurrence (POR) of Crohn's disease is common after surgical resection. How to best manage POR remains uncertain. Areas covered: In this review, we will first describe the natural course and the best modalities to diagnose this surgical sequela. We will then focus on the potential risk factors for relapse and highlight the main shortcomings in the current study designs and endoscopic and clinical scoring systems, which may partly explain the unexpected outcomes of recent clinical trials. Finally, we will propose a strategy to address the management of POR...
October 7, 2016: Expert Review of Gastroenterology & Hepatology
Takenori Kotani, Yoji Murata, Yasuyuki Saito, Takashi Matozaki
No abstract text is available yet for this article.
October 5, 2016: Expert Review of Gastroenterology & Hepatology
Emanuele Rondonotti, Alida Andrealli, Arnaldo Amato, Silvia Paggi, Clara Benedetta Conti, Giancarlo Spinzi, Franco Radaelli
Adenoma detection rate (ADR) is the most robust colonoscopy quality metric and clinical studies have adopted it as the ideal method to assess the impact of technical interventions. Areas covered: We reviewed papers focusing on the impact of colonoscopy technical issues on ADR, including withdrawal time and technique, second evaluation of the right colon, patient positional changes, gastrointestinal assistant participation during colonoscopy, water-aided technique, optimization of bowel preparation and antispasmodic administration...
October 5, 2016: Expert Review of Gastroenterology & Hepatology
Jean-Marc Dumonceau, Jacques Devière
In Bouveret's syndrome, a biliary stone obstructs the duodenum. Surgical treatment is plagued by high morbidity and mortality. Therefore, endoscopic treatment has become a first-line approach. Areas covered: A literature search of Medline and Google Scholar databases was performed using the terms endoscopic treatment, non-operative treatment, Bouveret's syndrome, and gallstone ileus. Sixty-one cases of successful endoscopic treatment were found over the period 1978-2016 and are summarized herein. Therapeutic modalities used in 52 patients with complete success included mechanical lithotripsy (40% of cases), electrohydraulic lithotripsy (21% of cases), extraction of the intact stone and laser lithotripsy (15% of cases each), extracorporeal shockwave lithotripsy and duodenal stenting (4% of cases each)...
October 5, 2016: Expert Review of Gastroenterology & Hepatology
Christoph Lübbert, Sophie Schneitler
In recent years, global and regional crises have led to extraordinary worldwide migration, accompanied by an increase in long-distance travel from Western countries. Both are linked to a rising incidence of rare parasitic and infectious diseases in first world countries, including in the biliary tract. Areas covered: A selective literature research in PubMed was performed to review the most important parasitic and infectious biliary diseases, which are caused by a wide variety of pathogens and may be latent over long periods, with chronic courses leading to cholangitis, hepatic failure or development of cholangiocarcinoma...
October 4, 2016: Expert Review of Gastroenterology & Hepatology
Vicente Gimeno-Ballester, Miguel Ángel Simón, Cristina Trigo, Javier Mar, Ramón San Miguel
INTRODUCTION: Sofosbuvir (SOF) with simeprevir (SIM) combination was the first interferon-free regimen that reached optimal results in terms of sustained viral response (SVR). AREAS COVERED: A systematic review of the scientific literature concerning the effects that the SOF/SIM combination had on hepatitis C genotype 1 patients yielded 771 references. After the revision process, four clinical trials and 15 observational studies met the inclusion criteria; in total, these studies involved 5,766 patients...
September 21, 2016: Expert Review of Gastroenterology & Hepatology
Chee-Kiat Tan
INTRODUCTION: The current curative treatment modalities for hepatocellular carcinoma (HCC) are unfortunately fraught with high rates of HCC recurrence. Hence there is a need to prevent or reduce HCC recurrence after initial curative therapy. Peretinoin is a synthetic oral retinoid showing significant reduction in the incidence of recurrent or new HCC in patients who had received curative HCC therapy. AREAS COVERED: Peretinoin is analysed against the background of molecular pathogenesis of the different causes of HCC...
September 20, 2016: Expert Review of Gastroenterology & Hepatology
Ivan Gentile, Alberto E Maraolo, Massimo Niola, Vincenzo Graziano, Guglielmo Borgia, Mariano Paternoster
INTRODUCTION: Hepatitis C virus (HCV) infection affects about 200 million people worldwide and represents a leading cause of liver-related mortality. Eradication of HCV infection, achieved mainly through direct-acting antivirals (DAA), results in a decrease of mortality and an improvement of quality of life. These drugs have a maximal efficacy and an optimal tolerability. However, their high cost precludes a universal access even in wealthy countries. AREAS COVERED: This article deals with the policies adopted for the use of the new anti-HCV drugs, especially in Europe and most of all in Italy, supposedly the developed country with the highest HCV prevalence...
September 8, 2016: Expert Review of Gastroenterology & Hepatology
David E J Jones
INTRODUCTION: There is significant unmet need in Primary Biliary Cholangitis (PBC) in patients under-responsive to the only approved therapy Ursodeoxycholic Acid (UDCA) who are at increased risk of progressing to end-stage liver disease. Obeticholic Acid (OCA) is a farnesoid X receptor (FXR) agonist which has been evaluated as a second line therapy in PBC and has recently been licenced by the FDA. AREAS COVERED: The pharmacology and biology of OCA as an FXR agonist and its clinical benefits...
September 2, 2016: Expert Review of Gastroenterology & Hepatology
Edward C Oldfield Iv, Parth J Parekh, David A Johnson
INTRODUCTION: Gastroesophageal reflux disease (GERD) is a common clinical condition afflicting millions of patients, whose prevalence continues to rise owing to the aging population and increasing burden of comorbid conditions, such as obesity. Currently, the mainstay of therapy for GERD is treatment with proton pump inhibitors (PPIs). Despite their overall efficacy, safety, and tolerability, there are still a considerable number of patients who fail treatment and have refractory symptoms to PPI therapy...
August 31, 2016: Expert Review of Gastroenterology & Hepatology
Ahmed Al-Khazraji
No abstract text is available yet for this article.
August 25, 2016: Expert Review of Gastroenterology & Hepatology
Tara M Connelly, Liam Devane, John C Kelly, Paula Wrafter, Evangelos Messaris
BACKGROUND: The identification of the top 100 papers in ulcerative colitis (UC) using citation analysis provides a unique insight into the advancement of disease understanding and subsequent treatment innovations that have progressed over time. METHODS: The Thomson Reuters Web of Knowledge was used to identify the 100 most cited UC manuscripts. Title, first and senior authors, institution and department of first author, journal, country of origin, year and topic of each manuscript were analyzed...
August 22, 2016: Expert Review of Gastroenterology & Hepatology
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