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Therapeutic Advances in Gastroenterology

Doron Yablecovitch, Adi Lahat, Sandra Neuman, Nina Levhar, Benjamin Avidan, Shomron Ben-Horin, Rami Eliakim, Uri Kopylov
Background: Small-bowel capsule endoscopy (CE) is a prime modality for evaluation of the small bowel. The Lewis score (LS) and the Capsule Endoscopy Crohn's Disease Activity Index (CECDAI) are validated endoscopic indices for quantification of small-bowel inflammation on CE. It is unclear whether these indexes are interchangeable for the evaluation of mucosal inflammation in established Crohn's disease (CD). The aim of this study was to compare the quantitative evaluation of small- bowel inflammation by LS and CECDAI...
2018: Therapeutic Advances in Gastroenterology
Wen-Hung Hsu, Yao-Kuang Wang, Meng-Shu Hsieh, Fu-Chen Kuo, Meng-Chieh Wu, Hsiang-Yao Shih, I-Chen Wu, Fang-Jung Yu, Huang-Ming Hu, Yu-Chung Su, Deng-Chyang Wu
Gastric antral vascular ectasia (GAVE) is an uncommon but important cause of chronic gastrointestinal bleeding. It is often associated with systemic diseases such as autoimmune diseases, liver cirrhosis, chronic renal insufficiency and cardiovascular disease. The etiology of GAVE has not been fully explored and remains controversial. Diagnosis is mainly based on endoscopic presentation with flat or raised erythematous stripes radiating from the pylorus to the antrum and resembles a watermelon. Clinical presentation may range from iron-deficiency anemia secondary to occult blood loss, melena to hematemesis...
2018: Therapeutic Advances in Gastroenterology
Yoshiyasu Kono, Seiji Kawano, Yuki Okamoto, Yuka Obayashi, Yuki Baba, Hiroyuki Sakae, Makoto Abe, Tatsuhiro Gotoda, Toshihiro Inokuchi, Hiromitsu Kanzaki, Masaya Iwamuro, Yoshiro Kawahara, Hiroyuki Okada
Background: The clinical outcome of patients with obscure gastrointestinal bleeding (OGIB) during antithrombotic drug therapy has not been fully investigated. Methods: Patients who underwent video capsule endoscopy (VCE) for the investigation of OGIB at Okayama University Hospital from January 2009 to March 2016 were enrolled. We evaluated the VCE findings, the patterns of OGIB, and the rate of rebleeding within 1 year in antithrombotic drug users and antithrombotic drug nonusers...
2018: Therapeutic Advances in Gastroenterology
Marion J Torres, Jean-Marc Sabate, Michel Bouchoucha, Camille Buscail, Serge Hercberg, Chantal Julia
Introduction: Diet plays an important role for patients with irritable bowel syndrome (IBS). The aim of this study was to compare the diets in terms of food consumption and nutrient intake between subjects with IBS and controls in a large French population. Methods: This study included 36,448 subjects from the Nutrinet-Santé cohort study, who completed a questionnaire pertaining to functional bowel disorders based on the Rome III criteria. Dietary data were obtained from at least three self-administered 24 h records via the internet...
2018: Therapeutic Advances in Gastroenterology
Séverine Vermeire, Ann Gils, Paola Accossato, Sadiq Lula, Amy Marren
Crohn's disease and ulcerative colitis are chronic inflammatory disorders of the gastrointestinal tract. Treatment options include biologic therapies; however, a proportion of patients lose response to biologics, partly due to the formation of anti-drug antibodies (ADAbs). Concomitant immunosuppressive agents reduce the development of ADAbs. This review article aims to assess the immunogenicity of biologic therapies and their clinical implications. A comprehensive literature search was conducted for articles published January 2009 to August 2015 reporting immunogenicity to adalimumab (ADM), certolizumab pegol (CZP), golimumab, infliximab (IFX), ustekinumab, and vedolizumab in inflammatory bowel disease (IBD)...
2018: Therapeutic Advances in Gastroenterology
Wee Sing Ngu, Colin Rees
Colorectal cancer is the third most common cancer worldwide and the second most common cause of cancer-related death in Europe and North America. Colonoscopy is the gold standard investigation for the colon but is not perfect, and small or flat adenomas can be missed which increases the risk of patients subsequently developing colorectal cancer. Adenoma detection rate is the most widely used marker of quality, and low rates are associated with increased rates of post-colonoscopy colorectal cancer. Standards of colonoscopy and adenoma detection vary widely between different endoscopists...
2018: Therapeutic Advances in Gastroenterology
Kentaro Sugano
Potassium-competitive acid blocker (P-CAB) is a class of drug that competitively blocks the potassium-binding site of H+, K+-adenosine triphosphate (ATP)ase. Although the history of this class of drugs started over 30 years ago, clinical use of two P-CABs, revaprazan and vonoprazan, were only recently approved in Korea and Japan, respectively. Among them, vonoprazan has several advantages over conventional proton-pump inhibitors (PPIs), including rapid onset of action, long duration of acid suppression, fewer interindividual variations in terms of acid suppression, and minimum dietary influence on its action...
2018: Therapeutic Advances in Gastroenterology
Mathurin Flamant, Xavier Roblin
The management of inflammatory bowel disease (IBD) has been transformed over the last two decades by the arrival of tumor necrosis factor (TNF) antagonist agents. Recently, alternative drugs have been approved, directed at leukocyte-trafficking molecules (vedolizumab) or other inflammatory cytokines (ustekinumab). New therapeutics are currently being developed in IBD and represent promising targets as they involve other mechanisms of action (JAK molecules, Smad 7 antisense oligonucleotide etc.). Beyond TNF antagonist agents, these alternative drugs are needed for early-stage treatment of patients with aggressive IBD or when the disease is resistant to conventional therapy...
2018: Therapeutic Advances in Gastroenterology
Yannick Derwa, Christopher J M Williams, Ruchit Sood, Saqib Mumtaz, M Hassan Bholah, Christian P Selinger, P John Hamlin, Alexander C Ford, David J Gracie
Objectives: Patient-reported symptoms correlate poorly with mucosal inflammation. Clinical decision-making may, therefore, not be based on objective evidence of disease activity. We conducted a study to determine factors associated with clinical decision-making in a secondary care inflammatory bowel disease (IBD) population, using a cross-sectional design. Methods: Decisions to request investigations or escalate medical therapy were recorded from outpatient clinic encounters in a cohort of 276 patients with ulcerative colitis (UC) or Crohn's disease (CD)...
2018: Therapeutic Advances in Gastroenterology
Gideon Charach, Ori Argov, Karyn Geiger, Lior Charach, Ori Rogowski, Itamar Grosskopf
Background: Patients with coronary artery disease (CAD) had significantly lower bile acid excretion (BAE) compared with non-CAD patients, leading to the hypothesis that the inability to efficiently excrete bile acids leads to coronary atherosclerosis development. We investigated the long-term role of BAE in CAD development and related mortality in 50 patients with proven CAD compared with that of 50 patients with chest pain and no CAD (controls) matched for clinical and laboratory characteristics...
2018: Therapeutic Advances in Gastroenterology
Meritxell Ventura-Cots, Isabel Carmona, Carolina Moreno, Javier Ampuero, Macarena Simón-Talero, Francesc Sanpedro, Iñigo Les, Manuel Romero-Gómez, Joan Genescà
Background: Episodes of hepatic encephalopathy (HE) have been related to low survival rate. However, the relation between its clinical evolution and mortality has not been assessed. Methods: A retrospective analysis of 245 cirrhotic patients admitted for an acute episode of HE (⩾grade 2) or who developed an HE episode after an upper gastrointestinal bleeding (UGIB) event was performed to assess the relation between time in HE and transplant-free survival. Results: Median (IQR25-75) time in HE was 48 h (24-96 h) in the whole cohort...
2018: Therapeutic Advances in Gastroenterology
Shiran Shapira, Ari Leshno, Daniel Katz, Nitsan Maharshak, Gil Hevroni, Maayan Jean-David, Sarah Kraus, Lior Galazan, Ilan Aroch, Dina Kazanov, Aharon Hallack, Stewart Becker, Mark Umanski, Menachem Moshkowitz, Iris Dotan, Nadir Arber
Background: Curcumin, green tea polyphenols and selenium possess anti-inflammatory and anti-oxidant properties. Individually they have demonstrated some efficacy in animal models and human subjects with inflammatory bowel disease (IBD). To evaluate the efficacy and safety of Coltect [Curcumin (500 mg), green tea (250 mg) and selenium (100 µg)] in vivo and in patients with ulcerative colitis (UC). Methods: Each component was compared to placebo in a DSS mice colitis model...
2018: Therapeutic Advances in Gastroenterology
Bodil Ohlsson, Rita Gustafsson, Fredrik Swahn, Ervin Toth, Béla Veress, Henrik Thorlacius
Gastrointestinal complaints without obvious organic causes confirmed by clinical laboratory analyses, endoscopy or radiology are often referred to functional entities. Irritable bowel syndrome (IBS) is the most common functional disorder in the gut. Careful examination of these patients may reveal other diagnoses of defined etiologies, e.g., enteric neuropathy, microscopic colitis, and primary Sjögre's syndrome. The present case describes a young patient with incapacitating gastrointestinal symptoms presumed to be IBS, who underwent endoscopic full-thickness biopsy in sigmoid colon...
2018: Therapeutic Advances in Gastroenterology
Osman O Ahsen, Hsiang-Chieh Lee, Kaicheng Liang, Zhao Wang, Marisa Figueiredo, Qin Huang, Benjamin Potsaid, Vijaysekhar Jayaraman, James G Fujimoto, Hiroshi Mashimo
No abstract text is available yet for this article.
December 2017: Therapeutic Advances in Gastroenterology
Mette Reilev, Per Damkier, Lotte Rasmussen, Morten Olesen, Martin Thomsen Ernst, Rikke Mie Rishøj, Morten Rix Hansen, Anne Broe, Alexander Steenberg Dastrup, Maja Hellfritzsch, Sidsel Arnspang, Anton Pottegård, Jesper Hallas
Background: Some studies indicate a reduced risk of serious upper gastrointestinal bleeding (UGIB) for users of beta-blockers, but the association remains to be confirmed in larger studies and characterized with respect to differences among beta-blockers. We aimed to assess whether beta-blocker use decreases the risk of UGIB. Methods: We conducted a register-based, population-based case-control study in Denmark. We identified cases with a first validated discharge diagnosis of UGIB during the period 1995-2006...
December 2017: Therapeutic Advances in Gastroenterology
Ezekiel Wong Toh Yoon, Kazuki Nishihara
Background: Percutaneous transesophageal gastro-tubing (PTEG) is a minimally invasive technique to access the gut via an esophagostomy. However, this procedure is not well known and the literature available is still fairly limited. This observational study was conducted to evaluate our experience using this method as an alternative long-term tube feeding procedure when gastrostomy is not suitable. Methods: A total of 15 patients (10 males and 5 females) who underwent PTEG at our institution from 2012 to 2016 were observed and analyzed in this study...
December 2017: Therapeutic Advances in Gastroenterology
Mohmadshakil Kathawala, Gideon M Hirschfield
Wilson's disease is a rare, inherited autosomal recessive disease of copper metabolism, in which the causative gene, ATP7B, results in absent or reduced function of the ATP7B transporter important for biliary excretion of copper and incorporation of copper into caeruloplasmin. Affected patients accumulate excessive copper within the liver, brain and other tissues. A disease mainly of children, adolescents and young adults; clinical features vary from the asymptomatic state to chronic liver disease, acute liver failure, and neuropsychiatric manifestations...
November 2017: Therapeutic Advances in Gastroenterology
Anam Omer, Eamonn M M Quigley
Chronic constipation (CC) is a highly prevalent and often under-appreciated gastrointestinal disorder associated with significant impairment in quality of life. Symptoms of constipation are typically present for a number of years prior to a patient seeking help. Lifestyle modifications followed by, or coupled with, over-the-counter laxatives represent the initial treatment option; however, relief for many is limited and dissatisfaction rates for these approaches remain high. Over recent years, therefore, considerable effort has been exerted on the development of novel pharmacological approaches...
November 2017: Therapeutic Advances in Gastroenterology
Patrick B Allen, Corinne Gower-Rousseau, Silvio Danese, Laurent Peyrin-Biroulet
Disability is a common worldwide health challenge and it has been increasing over the past 3 decades. The treatment paradigm has changed dramatically in inflammatory bowel diseases (IBDs) from control of symptoms towards full control of disease (clinical and endoscopic remission) with the goal of preventing organ damage and disability. These aims are broadly similar to rheumatoid arthritis and multiple sclerosis. Since the 1990s, our attention has focused on quality of life in IBD, which is a subjective measure...
November 2017: Therapeutic Advances in Gastroenterology
Xu-Dong Wen, Tao Wang, Zhu Huang, Hong-Jian Zhang, Bing-Yin Zhang, Li-Jun Tang, Wei-Hui Liu
Hepatolithiasis is the presence of calculi within the intrahepatic bile duct specifically located proximal to the confluence of the left and right hepatic ducts. The ultimate goal of hepatolithiasis treatment is the complete removal of the stone, the correction of the associated strictures and the prevention of recurrent cholangitis. Although hepatectomy could effectively achieve the above goals, it can be restricted by the risk of insufficient residual liver volume, and has a 15.6% rate of residual hepatolithiasis...
November 2017: Therapeutic Advances in Gastroenterology
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