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Therapeutic Advances in Gastroenterology

John S Kane, Andrew J Irvine, Yannick Derwa, Alexander C Ford
Background: Fatigue is a well-recognized symptom in patients with inflammatory bowel disease and irritable bowel syndrome (IBS), and has been associated with psychological comorbidity and impaired quality of life in both. However, features associated with fatigue in patients with microscopic colitis (MC) are less clear. Materials and methods: We conducted a cross-sectional survey of patients with a new diagnosis of MC including levels of anxiety, depression, somatization, quality of life, and IBS-type symptoms...
2018: Therapeutic Advances in Gastroenterology
Stefania Basili, Daniele Pastori, Valeria Raparelli, Francesco Violi
Portal vein thrombosis (PVT) is a frequent complication in the natural history of patients with liver cirrhosis (LC). The prevalence of PVT in LC is highly variable, ranging from 0.6% to 25% according to different reports. The impact of PVT on the natural history of LC is unclear, but it seems to negatively affect the prognosis of patients undergoing liver transplantation (LT) by increasing post-LT mortality and delaying waiting time. The antithrombotic treatment of PVT is still challenging as PVT may often remain asymptomatic and incidentally diagnosed, and a spontaneous partial/total regression of PVT is observed in an important proportion of patients, even in the absence of anticoagulation...
2018: Therapeutic Advances in Gastroenterology
Aleksandar Acovic, Bojana Simovic Markovic, Marina Gazdic, Aleksandar Arsenijevic, Nemanja Jovicic, Nevena Gajovic, Marina Jovanovic, Natasa Zdravkovic, Tatjana Kanjevac, C Randall Harrell, Crissy Fellabaum, Zana Dolicanin, Valentin Djonov, Nebojsa Arsenijevic, Miodrag L Lukic, Vladislav Volarevic
Background: Dendritic cell (DC)-derived indolamine 2,3-dioxygenase (IDO) degrades tryptophan to kynurenine, which promotes conversion of inflammatory T cells in immunosuppressive regulatory T cells (Tregs). We analyzed the significance of the IDO:Treg axis for inducing and maintaining mucosal healing in ulcerative colitis (UC). Methods: Dextran sodium sulphate (DSS)-induced colitis in BALB/c mice (model for mucosal healing) and C57BL/6 mice (model for persistent disease) was used...
2018: Therapeutic Advances in Gastroenterology
Simona Cammarota, Martina Cargiolli, Paolo Andreozzi, Bernardo Toraldo, Anna Citarella, Maria Elena Flacco, Gian Andrea Binda, Bruno Annibale, Lamberto Manzoli, Rosario Cuomo
Background: Scarce data are available on the epidemiological trend of diverticulitis and its financial burden in Italy. The aim of this work was to explore a potential variation in the rate and costs of hospital admissions for uncomplicated and complicated diverticulitis over the last decade. Methods: We selected all hospitalizations for diverticulitis of residents in the Abruzzo Region, Italy between 2005 and 2015. Age-standardized hospitalization rates (HRs) per 100,000 inhabitants for overall, uncomplicated and complicated diverticulitis were calculated...
2018: Therapeutic Advances in Gastroenterology
Priscila Santiago, Andrew R Scheinberg, Cynthia Levy
Cholestatic liver diseases result from gradual destruction of bile ducts, accumulation of bile acids and self-perpetuation of the inflammatory process leading to damage to cholangiocytes and hepatocytes. If left untreated, cholestasis will lead to fibrosis, biliary cirrhosis, and ultimately end-stage liver disease. Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are the two most common chronic cholestatic liver diseases affecting adults, and their etiologies remain puzzling. While treatment with ursodeoxycholic acid (UDCA) has significantly improved outcomes and prolonged transplant-free survival for patients with PBC, treatment options for UDCA nonresponders remain limited...
2018: Therapeutic Advances in Gastroenterology
Angel Lanas, Daniel Abad-Baroja, Aitor Lanas-Gimeno
Diverticular disease of the colon (DDC) includes a spectrum of conditions from asymptomatic diverticulosis to symptomatic uncomplicated diverticulosis, segmental colitis associated with diverticulosis, and acute diverticulitis without or with complications that may have serious consequences. Clinical and scientific interest in DDC is increasing because of the rising incidence of all conditions within the DDC spectrum, a better, although still limited understanding of the pathogenic mechanisms involved; the increasing socioeconomic burden; and the new therapeutic options being tested...
2018: Therapeutic Advances in Gastroenterology
Sayoko Kunihara, Shiro Oka, Shinji Tanaka, Akiyoshi Tsuboi, Ichiro Otani, Kazuaki Chayama
Background: There is no consensus regarding the management of occult obscure gastrointestinal bleeding (OGIB) patients without a confirmed bleeding source. This study aimed to consider the management of occult OGIB patients based on their long-term outcomes. Methods: We retrospectively enrolled 357 consecutive occult OGIB patients (203 men; mean age: 59.7 years) who underwent capsule endoscopy (CE) at Hiroshima University Hospital, Japan and were followed up for more than 12 months (mean follow-up period; 50...
2018: Therapeutic Advances in Gastroenterology
Nick A Heywood, James S Pearson, James E Nicholson, Clare Molyneux, Abhiram Sharma, Edward S Kiff, Peter J Whorwell, Karen J Telford
Background: Posterior tibial nerve stimulation (PTNS) is a novel treatment for patients with faecal incontinence (FI) and may be effective in selected patients; however, its mechanism of action is unknown. We sought to determine the effects of PTNS on anorectal physiological parameters. Methods: Fifty patients with FI underwent 30 min of PTNS treatment, weekly for 12 weeks. High-resolution anorectal manometry, bowel diaries and Vaizey questionnaires were performed before and after treatment...
2018: Therapeutic Advances in Gastroenterology
Ruth Byrne, Ivana Carey, Kosh Agarwal
Tenofovir alafenamide (TAF), a novel prodrug of tenofovir was developed to deliver enhanced antiviral potency and reduced systemic toxicities by more efficient intracellular delivery of the active metabolite tenofovir disphosphate than tenofovir disoproxil fumarate (TDF). In two randomized, double-blind, multinational phase III trials in patients with hepatitis B e antigen (HBeAg)-positive or -negative infection, TAF 25 mg was non-inferior to TDF 300 mg in achieving the primary efficacy outcome of a hepatitis B virus (HBV) DNA level < 29 IU/ml at week 48 and was associated with higher rates of alanine aminotransferase (ALT) normalization based on AASLD (American Association for the Study of Liver Diseases) criteria...
2018: Therapeutic Advances in Gastroenterology
Zachary Zator, Matthew Klinge, Wolfgang Schraut, Allan Tsung, Asif Khalid
Background: Endoscopic management of pelvic abscesses not amenable to percutaneous drainage has been described. The technique employs endoscopic ultrasound (EUS)-guided placement of stents or drains, which may require multiple procedures, is cumbersome and uncomfortable for the patient. We describe the successful management of these abscesses in a single step involving EUS-guided lavage and instillation of antibiotics. Methods: Six consecutive patients with seven symptomatic pelvic abscesses not amenable to percutaneous drainage were referred for EUS-guided drainage...
2018: Therapeutic Advances in Gastroenterology
Michael H K Chu, Irene X Y Wu, Robin S T Ho, Charlene H L Wong, Anthony L Zhang, Yan Zhang, Justin C Y Wu, Vincent C H Chung
Background: Pharmacotherapy, including prokinetics and proton pump inhibitors for functional dyspepsia (FD) have limited effectiveness, and their safety has been recently questioned. Chinese herbal medicine (CHM) could be considered as an alternative. A systematic review (SR) of SRs was performed to evaluate the potential effectiveness and safety of CHM. Method: We conducted a comprehensive literature search for SRs with meta-analyses in eight international and Chinese databases...
2018: Therapeutic Advances in Gastroenterology
Yuen Sau Tham, Diana E Yung, Shmuel Fay, Takayuki Yamamoto, Shomron Ben-Horin, Rami Eliakim, Anastasios Koulaouzidis, Uri Kopylov
Background: Anastomotic recurrence is frequent in patients with Crohn's disease (CD) following ileocecal resection. The degree of endoscopic recurrence, quantified by the Rutgeerts score (RS), correlates with risk of clinical and surgical recurrence. Several studies demonstrate the accuracy of fecal calprotectin (FC) for detection of endoscopic recurrence, however the optimal threshold FC value remains to be established. The aim of our meta-analysis was to evaluate the accuracy of common FC cut-offs for detection of endoscopic recurrence...
2018: Therapeutic Advances in Gastroenterology
Irene Pérez, Lidia Fernández, Silvia Sánchez-Ramón, Cristina Alba, Ana Zatarain, Mercedes Cañas, Olga N López, David Olivares, Enrique Rey, Carlos Taxonera
Background: The aim of this study was to evaluate reliability of four different assays for measuring infliximab trough levels and antibodies to infliximab (ATI). Methods: In this non-interventional, cross-sectional study including IBD patients, infliximab levels and ATI were measured using four different assays: Lisa-Tracker, Promonitor, Q-Inflixi and Sanquin. Reliability and agreement for infliximab levels was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots...
2018: Therapeutic Advances in Gastroenterology
Taiwo A Ajose, Titilope Olanipekun, Valery S Effoe, Nicolas Bakinde
No abstract text is available yet for this article.
2018: Therapeutic Advances in Gastroenterology
Carolina Vieira de Almeida, Antonio Taddei, Amedeo Amedei
Colorectal cancer (CRC) is a complex and widespread disease, currently ranked as the third most frequent cancer worldwide. It is well known that the gut microbiota has an essential role in the initiation and promotion of different cancer types, particularly gastrointestinal tumors. In fact, bacteria can trigger chronic inflammation of the gastric mucosal, which can induce irreversible changes to intestinal epithelial cells, thus predisposing individuals to cancer. Some bacterial strains, such as Helicobacter pylori, Streptococcus bovis, Bacteroides fragilis, Clostridium septicum and Fusobacterium spp...
2018: Therapeutic Advances in Gastroenterology
Paulo Gustavo Kotze, Christopher Ma, Nicholas Mckenna, Abdulelah Almutairdi, Gilaad G Kaplan, Laura E Raffals, Edward V Loftus, Remo Panaccione, Amy L Lightner
Background: Vedolizumab (VDZ) is a gut-specific α4-β7 integrin antagonist that has demonstrated efficacy in Crohn's disease (CD) and ulcerative colitis (UC). The safety of VDZ in the perioperative period remains unclear. The aim of this study was to evaluate postoperative complications and perioperative safety in VDZ-treated patients undergoing nonintestinal operations. Methods: A case-matched study was performed at two inflammatory bowel disease (IBD) referral centers...
2018: Therapeutic Advances in Gastroenterology
John S Kane, Andrew J Irvine, Yannick Derwa, Olorunda Rotimi, Alexander C Ford
Background: Patients with microscopic colitis (MC) often present with abdominal pain and diarrhoea, and previous data suggest that there may be overlap between MC and irritable bowel syndrome (IBS). We evaluated the prevalence of IBS-type symptoms in patients with MC, and assess the impact of these symptoms on psychological health and quality of life. Methods: We conducted a cross-sectional survey of individuals with a histological diagnosis of MC, collecting demographic data, Rome III IBS-type symptoms, and mood, somatization, and quality of life data...
2018: Therapeutic Advances in Gastroenterology
Satish S C Rao
Chronic constipation affects millions of Americans, consumes significant healthcare resources, and significantly affects quality of life (QOL). Recently, several new treatment options have become available for the treatment of constipation, including intestinal secretagogues such as lubiprotone, and linaclotide, prokinetics such as prucalopride, and bile acid transporter antagonists. Plecanatide is the newest of the secretagogue class of compounds that has been approved by the US Food and Drug Administration for the treatment of adults with chronic idiopathic constipation (CIC) in the USA...
2018: Therapeutic Advances in Gastroenterology
Ren Mao, Rui-Han Tang, Yun Qiu, Bai-Li Chen, Jing Guo, Sheng-Hong Zhang, Xue-Hua Li, Rui Feng, Yao He, Zi-Ping Li, Zhi-Rong Zeng, Rami Eliakim, Shomron Ben-Horin, Min-Hu Chen
Background: The Montreal classification defines L4 Crohn's disease (CD) as any disease location proximal to the terminal ileum, which anatomically includes L4-esophagogastroduodenal (EGD), L4-jejunal, and L4-proximal ileal involvement. L4-jejunal disease was established to be associated with poor prognosis. However, the outcome of patients with L4-proximal ileal disease or L4-EGD remains to be clarified. Our study aimed to investigate whether the outcome differs among CD patients with L4-EGD, L4-jejunal, and L4-proximal ileal disease...
2018: Therapeutic Advances in Gastroenterology
Kazuki Boda, Shiro Oka, Shinji Tanaka, Hidenori Tanaka, Kenta Matsumoto, Ken Yamashita, Kyoku Sumimoto, Daiki Hirano, Yuzuru Tamaru, Yuki Ninomiya, Nana Hayashi, Kazuaki Chayama
Background: Few studies have investigated the use of endoscopic submucosal dissection (ESD) for cecal tumors extending into the appendiceal orifice. Herein, we assessed the feasibility and safety of ESD for cecal tumors extending into the appendiceal orifice. Methods: We retrospectively examined the outcomes of ESD for 78 patients with 78 cecal tumors (male/female ratio, 40/38; mean [standard deviation, SD] age, 67 [9] years; mean [SD] tumor size, 32 [15] mm), who underwent ESD at the Hiroshima University Hospital between October 2008 and March 2016...
2018: Therapeutic Advances in Gastroenterology
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