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Gastroenterology Research

Sindhura Kolli, Amit Mori, Isaac Moshenyat
Our patient with primary biliary cholangitis, previously termed as primary biliary cirrhosis, presented with an unexpected and unusual cause of hematemesis in the form of multiple esophageal ulcers in-between variceal columns. Given that upon endoscopic examination, the esophageal ulcers were found to bleeding instead of the varices; they should be considered in the differential in the etiology of hematemesis in primary biliary cholangitis and thoroughly searched for during an endoscopic procedure for early treatment and subsequent secondary prevention...
October 2018: Gastroenterology Research
Jun Lu, Roberto J Firpi-Morell, Long H Dang, Jinping Lai, Xiuli Liu
The programmed death 1 (PD-1), programmed death ligand 1 (PD-L1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) immune checkpoints are negative regulators of T-cell immune function. Inhibition of these targets by antibodies (PD-1 blocking therapy) has been explored to treat solid malignancies such as melanoma, non-small cell lung cancer and other cancers. PD-1 blocking therapy is known to cause gastrointestinal tract adverse events in some patients and some of the adverse events are thought to be immune-mediated...
October 2018: Gastroenterology Research
Ashraf Abugroun, Arjun Natarajan, Hussein Daoud, Habeeb Khalaf
Spontaneous isolated celiac artery dissection (SICAD) is extremely rare. We herein report a case of a 43-year-old male with no known history of cardiovascular disease who presented to the emergency department (ED) with sudden onset severe epigastric abdominal pain without a known trigger. Abdominal computed tomography (CT) scan showed a focal dissection and irregular enhancement of the celiac trunk with associated splenic artery embolus and large splenic infarct. The patient was successfully treated conservatively with blood pressure control, antiplatelet and anticoagulation therapy...
October 2018: Gastroenterology Research
Hussein Daoud, Ashraf Abugroun, Ahmed Subahi, Habeeb Khalaf
Spontaneous isolated superior mesenteric artery dissection (ISMAD) is an uncommon cause of abdominal pain. Clinical presentation ranges from an asymptomatic incidental finding to acute bowel ischemia or fatal aneurysmal super mesenteric artery (SMA) rupture. We report the case of a 58-year-old male presenting with abdominal pain. Imaging studies revealed an ISMAD without radiological evidence of bowel ischemia. The patient was successfully treated using a conservative approach including bowel rest and anticoagulation...
October 2018: Gastroenterology Research
Jamil Shah, Abul Shahidullah, Stanlee Richards
Background: Since their introduction in 1980, gastrostomy tubes have become effective means of providing both short-term and long-term enteral access and nutritional support. These feeding tubes are ubiquitous in many health care facilities that care for the elderly, but carry high rates of unintended dislodgement - a complication that, if not detected promptly, is associated with substantial morbidity and health care costs. This study determined the dislodgment rate of gastrostomy tubes at 90 days in a cohort of 221 patients and tested the hypothesis that the implementation of a concise protocol to care for patients' gastrostomy tubes would reduce these unintended dislodgements...
October 2018: Gastroenterology Research
Arjun R Sondhi, Jacob E Kurlander, Stacy B Menees, Sameer D Saini
Background: This systematic review aims to assess the accuracy of hydrogen breath testing as a predictor of bowel preparation. Methods: Studies were identified from MEDLINE, Embase, Web of Science, Cochrane Library and Two investigators evaluated abstracts for inclusion criteria - report of correlation between hydrogen breath levels and bowel preparation quality, prospective design and non-emergent colonoscopy in adults. Included studies underwent duplicate data extraction using a standardized approach...
October 2018: Gastroenterology Research
Chen Yang, Yaman Tarabishy, Themistocles Dassopoulos, ILKe Nalbantoglu
Background: Colorectal serrated polyps (SP), which include hyperplastic polyps (HP), sessile serrated adenomas/polyps (SSA/P), and traditional serrated adenomas, are not uncommon and have been implicated to play a role in the pathogenesis in a subset of sporadic colorectal carcinomas; however, their significance in patients with prolonged inflammatory bowel disease (IBD) remains unclear. Methods: We retrospectively studied the clinicopathologic features, BRAF and β-catenin immunohistochemistry staining patterns in 36 SPs from 28 patients with IBD compared with 40 SPs in patients without IBD...
October 2018: Gastroenterology Research
Jordan Burlen, Matt Runnels, Minesh Mehta, Stina Andersson, Philippe Ducrotte, Guillaume Gourcerol, Greger Lindberg, Greg Fullarton, Hasse Abrahamsson, Amar Al-Juburi, Chris Lahr, Hani Rashed, Thomas Abell
Background: Gastric electrical stimulation (GES) is used in both the US and Europe, but little research has investigated the demographics of gastroparesis patients receiving GES by geographic location. Methods: We compared data from 380 patients, 296 female and 84 males, mean age 42 years, 246 idiopathic (ID), 107 diabetic (DM), and 27 post-surgical (PS). The statistical significance was calculated by Chi-square test and a P-value obtained for ID, DM, and PS. The statistical significance was calculated by Fischer exact test and a P-value obtained comparing male vs...
October 2018: Gastroenterology Research
Carmine Noviello, Alfonso Papparella, Mercedes Romano, Giovanni Cobellis
Background: Pediatric cholelithiasis unrelated to hematological disorders is an increasing disease. We analyzed our experience in the surgical treatment of these cases to evaluate risk factors, clinical presentation, intervention and follow-up. Methods: From January 2010 to December 2016, we retrospectively recorded all data (hematological study, familiarity, use of lithogenic drugs and parenteral nutrition) of cholecystectomies for cholelithiasis not related to hematological diseases...
October 2018: Gastroenterology Research
Yousef Nassar, Seth Richter
Background: Gastroparesis is a syndrome characterized by delayed gastric emptying in the absence of any mechanical cause. While often associated with diabetes mellitus, most cases of gastroparesis are idiopathic. The purpose of the present paper is to review the co-morbid conditions that most likely associate with non-diabetic gastroparesis. Methods: The Healthcare Cost and Utilization Project: Nationwide Inpatient Sample (HCUP-NIS) data were used from the year 2013 - 2014 and the Apriori algorithm was run on this subset of patients to identify what co-morbid conditions are most likely associated with gastroparesis...
October 2018: Gastroenterology Research
Debra Guss, Jagannath Sherigar, Smruti R Mohanty
Background: Cirrhosis of the liver is often not recognized until late in the disease state, when patients decompensate or develop hepatocellular carcinoma (HCC). This inquiry considered factors associated with undiagnosed cirrhosis. Methods: Patients with undiagnosed cirrhosis were compared to patients with known diagnosis of cirrhosis, to evaluate the differences between these two groups. The study population is patients with confirmed diagnosis of HCC, stratified into patients with known diagnosis of cirrhosis (n = 36) and patients without the known diagnosis of cirrhosis who have features of cirrhosis (n = 36)...
October 2018: Gastroenterology Research
Jamil Shah, Abul Shahidullah
Colorectal polyps are growths that form on the epithelium of the colon and rectum. While their prevalence varies considerably from region to region, they are common in adults. In fact, among asymptomatic, average-risk individuals at 50 years of age, the prevalence of colorectal polyps averages roughly 10% in sigmoidoscopy studies and more than 25% in colonoscopy studies. Approximately two-thirds of all colorectal polyps are adenomatous precancerous lesions that have the potential to become malignant. Usually, they are discovered and resected during colonoscopy...
August 2018: Gastroenterology Research
Abubakr Adam, Mechu Narayanan, Christine Hachem
Endometriosis is the presence of endometrial glands outside the uterine cavity. Endometriosis can involve any part of the bowel but most commonly affects the recto-sigmoid part of the bowel. This case shows the endoscopic views of bowel endometriosis and also elaborates on how to approach and manage similar cases of bowel endometriosis. Patients with bowel endometriosis are better managed and treated with a multidisciplinary team including gastroenterologist, gynecologist and colorectal surgeon.
August 2018: Gastroenterology Research
Vijay Gayam, Amrendra Kumar Mandal, Mazin Khalid, Jaspreet Kaler, Shivani Thapa, Pavani Garlapati, Arshpal Gill, Ragin Alex, Binav Shrestha
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease which can manifest in many different organ systems. Gastrointestinal (GI) involvement is common in SLE, but the symptoms are usually mild. More severe GI complications including acute pancreatitis and peptic ulcer bleeding are rare but represent a significant risk of morbidity and mortality. We present a case of a 25-year-old Hispanic female with a severe SLE flare. The initial presentation included symptoms of hematemesis and epigastric abdominal pain secondary to both gastric ulceration and acute pancreatitis, an atypical presentation of an SLE flare...
August 2018: Gastroenterology Research
Binav Shrestha, Mazin Khalid, Vijay Gayam, Osama Mukhtar, Shivani Thapa, Amrendra K Mandal, Jaspreet Kaler, Mowyad Khalid, Pavani Garlapati, Shamah Iqbal, Gerald Posner
Granular cell tumors (GCTs) are uncommon tumors. They are believed to be neuronal in origin and are usually found in the head and/or neck area of the body. They have also been reported in various locations of the gastrointestinal (GI) system, usually discovered during routine screening colonoscopy. We report a case of GCT in a 58-year-old asymptomatic African American female as a metachronous tumor of a well-differentiated adenocarcinoma of the sigmoid colon, which was an incidental finding in screening colonoscopy...
August 2018: Gastroenterology Research
Vijay Gayam, Amrendra Kumar Mandal, Mazin Khalid, Osama Mukhtar, Arshpal Gill, Pavani Garlapati, Benjamin Tiongson, Jagannath Sherigar, Mohammed Mansour, Smruti Mohanty
Background: Low serum vitamin D levels in chronic hepatitis C (CHC) is associated with advanced liver fibrosis; and there remains an imprecise relationship with the treatment response based on the vitamin D levels. Previous studies have shown conflicting results on the vitamin D levels, and association with treatment response in CHC treated with interferon-based regimens. Methods: Patients with CHC treated with direct-acting antivirals (DAAs) between January 2016 and December 2017 in the community clinic setting were retrospectively analyzed...
August 2018: Gastroenterology Research
Koichiro Mandai, Koji Uno, Kenjiro Yasuda
Background: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is associated with a relatively high proportion of adverse events, and this is attributable to the lack of standardized protocols and specialized equipment. Although the outcomes of EUS-HGS may differ between patients with and those without surgically altered upper gastrointestinal anatomy, there have been no reports on this topic. The present study aimed to evaluate the efficacy and safety of EUS-HGS using our standardized method and to compare the outcomes between patients with and those without surgically altered upper gastrointestinal anatomy...
August 2018: Gastroenterology Research
Muhammad Yasir Khan, Ahmed Dirweesh, Waqas Javed Siddiqui
Background: Colorectal cancer (CRC) is a leading cause of death worldwide. Polyp detection rate (PDR) and adenoma detection rate (ADR) are key focus in endoscopic research for CRC screening and prevention. Use of anti-spasmodic agents during colonoscopy to help identify adenomas and polyps has remained a controversial topic. Hyoscine butyl bromide (HBB) is the most commonly used anti-spasmodic agent in patients undergoing colonoscopy. Some randomized controlled trials (RCTs) have questioned the clinical efficacy and safety of routine use of HBB for polyp and adenoma detection rates...
August 2018: Gastroenterology Research
Mustapha M El-Halabi, Patrick R Barrett, Melissa Martinez Mateo, Nabil F Fayad
Background: Adenoma detection rate (ADR) is a proven quality metric for colonoscopy. The value of ADR for the evaluation of gastroenterology fellows is not well established. The aim of this study is to calculate and evaluate the utility of ADR as a measure of competency for gastroenterology fellows. Methods: Colonoscopies for the purposes of screening and surveillance, on which gastroenterology fellows participated at the Richard L. Roudebush VAMC (one of the primary training sites at Indiana University), during a 9-month period, were included...
August 2018: Gastroenterology Research
Aya Cervantes, Ruma G Singh, Sayali A Pendharkar, Sakina H Bharmal, Maxim S Petrov
Background: Maori, indigenous people of New Zealand, have at least two times higher prevalence of obesity and diabetes in comparison with the general population in the country. Gut and pancreatic hormone profile differences as well as pro-inflammatory milieu may contribute to this disparity. The aim was to investigate the differences in gut hormones, pancreatic hormones and pro-inflammatory cytokines between Maori and non-Maori individuals. Methods: This was a cross-sectional study...
August 2018: Gastroenterology Research
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