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https://www.readbyqxmd.com/read/29090081/eluxadoline-in-irritable-bowel-syndrome-with-diarrhea-rationale-evidence-and-place-in-therapy
#1
REVIEW
Kenneth Barshop, Kyle Staller
Irritable bowel syndrome (IBS) is the most common gastrointestinal (GI) disorder worldwide, however treatment options for diarrhea-predominant IBS (IBS-D) remain limited. Eluxadoline, a µ- and κ-opioid receptor agonist and δ-opioid receptor antagonist, was recently approved for the treatment of IBS-D. A novel compound first described in 2008, eluxadoline was shown to normalize GI transit, with a subsequent phase I demonstrating its safety and tolerability in healthy adults. In 2016, two randomized, double-blind, placebo-controlled phase III trials studying eluxadoline use at 75 mg and 100 mg twice daily over 26 weeks demonstrated a significant improvement in stool consistency and many global symptoms of IBS...
November 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/29070912/bi-directional-regulation-of-acupuncture-on-extrahepatic-biliary-system-an-approach-in-guinea-pigs
#2
Jingjun Zhao, Yutian Yu, Man Luo, Liang Li, Peijing Rong
Clinically, acupuncture affects the motility of the extrahepatic biliary tract, but the underlining mechanisms are still unknown. We applied manual acupuncture (MA) and electrical acupuncture (EA) separately at acupoints Tianshu (ST25), Qimen (LR14), Yanglingquan (GB34), and Yidan (CO11) in forty guinea pigs (4 groups) with or without atropinization under anesthesia while Sphincter of Oddi (SO) myoelectric activities and gallbladder pressure were monitored. In both MA and EA groups, stimulation at ST25 or LR14 significantly increased the frequency and amplitude of SO myoelectrical activities and simultaneously decreased the gallbladder pressure as compared to the pre-MA and pre-EA (P < 0...
October 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29025382/biliary-complications-in-recipients-of-living-donor-liver-transplant-a-single-center-review-of-120-patients
#3
Mohamed D Sarhan, Ayman M A Osman, Mahmoud Aly Mohamed, Omar Abdelaziz, Dalia K Serour, Doaa A Mansour, Sherif Mogawer, Ayman S Helmy, Mostafa A El-Shazli, Adel A Hosny
OBJECTIVES: Biliary complications are common after living-donor liver transplant. This retrospective study reviewed our experience with biliary complications in recipients of living-donor liver transplant. MATERIALS AND METHODS: Over our 9-year study period, 120 patients underwent living-donor liver transplant. Patients were divided into 2 groups, with group A having biliary complications and group B without biliary complications. Both groups were compared, and different treatment modalities for biliary complications were evaluated...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28944138/surgical-treatments-for-patients-with-recurrent-bile-duct-stones-and-oddis-sphincter-laxity
#4
REVIEW
Boxuan Zhou, Jinxiong Hu, Yuesi Zhong
Recurrent bile duct stones is the most common complication after gallstone surgery and the incidence is about 4-24%. Sphincter of Oddi laxity will lead to duodenal content flow into the bile or pancreatic duct. Patients with recurrent bile duct stones and Oddis sphincter laxity were intractable. Here we sought to present the possible and helpful surgical treatments for such patients. Prospective randomized clinical trial are needed for evaluating the outcome of surgical treatments.
August 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28898571/risk-factors-of-post-ercp-pancreatitis-in-biliary-type-sphincter-of-oddi-dysfunction-in-japanese-patients
#5
Hiroyuki Miyatani, Satohiro Matsumoto, Hirosato Mashima
OBJECTIVES: Suspected sphincter of Oddi dysfunction (SOD) is a well-known risk factor for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). The indication of ERCP for suspected SOD patients was very low in Japan compared to other countries. Therefore, the risk of PEP may be different in Japanese SOD patients. The objective of this study was to evaluate the risk of PEP in suspected biliary type SOD in Japan. METHODS: From December 1996 to January 2017, 72 patients were suspected to have biliary type SOD by questionnaire, liver function tests, hepatobiliary scintigraphy, abdominal ultrasonography, upper gastrointestinal endoscopy, endoscopic ultrasonography, and magnetic resonance cholangiopancreatography...
September 12, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28802556/randomized-sham-controlled-trials-in-endoscopy-a-systematic-review-and-meta-analysis-of-adverse-events
#6
REVIEW
Allison R Schulman, Violeta Popov, Christopher C Thompson
BACKGROUND AND AIMS: Sham procedures in endoscopy are used with the intention of controlling for placebo response, potentially allowing more precise evaluation of treatment effect. Nevertheless, this type of study may impose significant risk without potential benefit for those in the sham group. The aim of the current study was to systematically review and analyze the endoscopic literature to assess the safety of sham controls. METHODS: MEDLINE and Embase databases were searched for endoscopic sham procedures for all dates to July 2017...
August 9, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28711688/aga-institute-series-focus-on-enhancing-high-value-care-cost-effective-therapy-for-sphincter-of-oddi-dysfunction
#7
Dennis Yang, Patrick Yachimski
No abstract text is available yet for this article.
July 12, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28691687/pancreaticobiliary-maljunction-and-congenital-biliary-dilatation
#8
REVIEW
Terumi Kamisawa, Kenitiro Kaneko, Takao Itoi, Hisami Ando
Pancreaticobiliary maljunction is a congenital malformation in which the pancreatic and bile ducts join outside the duodenal wall, usually forming a long common channel. Because the action of the sphincter of Oddi does not regulate the function of the pancreaticobiliary junction in patients with pancreaticobiliary maljunction, two-way regurgitation occurs. Reflux of pancreatic juice into the biliary tract is associated with a high incidence of biliary cancer. Biliary carcinogenesis in patients with pancreaticobiliary maljunction is thought to follow the hyperplasia, dysplasia, then carcinoma sequence due to chronic inflammation caused by pancreatobiliary reflux...
August 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28625150/update-on-the-molecular-mechanisms-underlying-the-effect-of-cholecystokinin-and-cholecystokinin-1-receptor-on-the-formation-of-cholesterol-gallstones
#9
Helen H Wang, Piero Portincasa, David Q-H Wang
Cholecystokinin (CCK) is an important neuro-intestinal peptide hormone produced by the enteroendocrine I-cells in the upper part of small intestine. Protein- and fat-enriched food plays an important role in triggering CCK secretion from the intestine. Carbohydrates stimulate only small amounts of CCK release. The CCK-1 receptor (CCK-1R) is largely localized in the gallbladder, sphincter of Oddi, pancreas, small intestine, gastric mucosa, and pyloric sphincter, where it is responsible for CCK to regulate multiple digestive processes including gallbladder contraction, pancreatic secretion, small intestinal transit, and gastric emptying...
June 19, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28622182/reflux-associated-cholecystopathy-analysis-of-76-gallbladders-from-patients-with-supra-oddi-union-of-the-pancreatic-duct-and-common-bile-duct-pancreatobiliary-maljunction-elucidates-a-specific-diagnostic-pattern-of-mucosal-hyperplasia-as-a-prelude-to-carcinoma
#10
Takashi Muraki, Bahar Memis, Michelle D Reid, Takeshi Uehara, Tetsuya Ito, Osamu Hasebe, Shinji Okaniwa, Naoto Horigome, Takeshi Hisa, Pardeep Mittal, Alexa Freedman, Shishir Maithel, Juan M Sarmiento, Alyssa Krasinskas, Jill Koshiol, Volkan Adsay
Pancreaticobiliary maljunction (PBM) is the anomalous union of the main pancreatic duct and common bile duct outside the Oddi-sphincter, allowing the reflux of pancreatic juice to the gallbladder. There is only limited awareness and understanding of the pathologic correlates of this condition, mostly from Japan; this entity is largely unrecognized in the West. In this study, 76 gallbladders from patients with PBM (64 from Japan; 12 from the United States) were analyzed and contrasted with 66 from non-PBM patients...
September 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28548201/-morphine-induced-biliary-pain-case-report
#11
Zoltán Berger, Mario Arcos, Fernanda Matamala, Claudia Rojas
Morphine produces contraction of Oddi’s sphincter, which can be severe and of longer duration in some pathological conditions. This exaggerated response can manifest as a colicky biliary pain, frequently accompanied by a dramatic increase in hepatic enzymes. We report a 32 years old female who consulted in the emergency room for severe low abdominal pain of gynecologic origin, which was completely controlled by morphine. However, she presented a sudden epigastric colicky pain irradiating in the back, which persisted for several hours in spite of the repeated administration of analgesics...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28511162/improvement-of-the-complex-medical-treatment-for-the-patients-w%C3%B1-th-chronic-biliary-pancreatitis
#12
L S Babinets, K Yu Kytsai, Yu Ya Kotsaba, I M Halabitska, N A Melnyk, I V Semenova, O S Zemlyak
INTRODUCTION: The most common reason of chronic pancreatitis is liver and bile ducts disease: functional disorders, chronic cholecystitis, cholelithiasis and cholecystectomy in medical history. All these changes are associated with the colloidal structure of bile, increased lithogenicity, gallstones formation, Oddi's sphincter dysfunction, dysmotility and inflammation in the bile ducts. THE AIM: to study the effectiveness of using medicine Liveria IC (metadoxine) in standard therapy as well as effect on spectrum of blood serum lipids and structural condition of liver (stiffness) and pancreas in patients with chronic biliary pancreatitis combined with obesity...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28493170/eluxadoline-a-review-in-diarrhoea-predominant-irritable-bowel-syndrome
#13
REVIEW
Gillian M Keating
Eluxadoline (Truberzi(®)) is an orally administered, minimally absorbed agent that acts locally in the gastrointestinal tract as a mixed µ-opioid receptor agonist and δ-opioid receptor antagonist. The randomized, double-blind, placebo-controlled, multinational, phase 3 IBS-3001 and IBS-3002 trials examined the efficacy of eluxadoline in patients with diarrhoea-predominant irritable bowel syndrome (IBS-D). The composite response rate (i.e. the proportion of patients with improvement in both worst abdominal pain and stool consistency on ≥50% of days; primary endpoint), was significantly higher in patients receiving eluxadoline 100 mg twice daily than in those receiving placebo after 12 and 26 weeks' therapy...
June 2017: Drugs
https://www.readbyqxmd.com/read/28488091/outcomes-of-endoscopic-retrograde-cholangiopancreatography-ercp-and-sphincterotomy-for-suspected-sphincter-of-oddi-dysfunction-sod-post-roux-en-y-gastric-bypass
#14
Chin Hong Lim, Cyrus Jahansouz, Martin L Freeman, Daniel B Leslie, Sayeed Ikramuddin, Stuart K Amateau
BACKGROUND: Sphincter of Oddi dysfunction (SOD) is thought to be a cause of chronic abdominal pain post Roux-en-Y gastric bypass, and current practice of performing endoscopic retrograde cholangiopancreatography (ERCP) with or without sphincterotomy is not supported by evidence. In addition to the complexity and risks of the procedure in patients with Roux-en-Y anatomy, the outcomes are uncertain and debatable. We performed a retrospective review and analysis of post-gastric bypass patients who had undergone ERCP with sphincterotomy to determine the effectiveness in patients with suspected SOD...
May 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28465786/analysis-of-the-risk-factors-for-severity-in-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-the-indication-of-prophylactic-treatments
#15
Hiroshi Matsubara, Fumihiro Urano, Yuki Kinoshita, Shozo Okamura, Hiroki Kawashima, Hidemi Goto, Yoshiki Hirooka
AIM: To determine the risk factors of severe post endoscopic retrograde cholangiopancreatography pancreatitis (sPEP) and clarify the indication of prophylactic treatments. METHODS: At our hospital, endoscopic retrograde cholangiopancreatography (ERCP) was performed on 1507 patients from May 2012 to December 2015. Of these patients, we enrolled all 121 patients that were diagnosed with post endoscopic retrograde PEP. Fourteen of 121 patients diagnosed as sPEP were analyzed...
April 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28455162/the-episod-study-long-term-outcomes
#16
Peter B Cotton, Qi Pauls, Jamila Keith, Andre Thornhill, Douglas Drossman, April Williams, Valerie Durkalski-Mauldin
BACKGROUND AND AIMS: The EPISOD (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction) study randomized patients with post-cholecystectomy pain, and little or no objective evidence for biliary obstruction, to sphincterotomy or sham intervention. Results at 1 year showed no benefit for the active treatment. We now report the outcomes at up to 5 years. METHODS: One hundred three patients completing 1 year, and still blinded to treatment allocation, were enrolled and followed by phone every 6 months for a median of 58 months (range, 17-71 months)...
April 25, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28409067/lemmel-syndrome-secondary-to-duodenal-diverticulitis-a-case-report
#17
Keyur Desai, Joshua D Wermers, Nebiyu Beteselassie
Lemmel syndrome occurs when a duodenal diverticulum causes obstructive jaundice due to a mechanical obstruction of the common bile duct. Additional pathophysiologic processes may also contribute to the development of Lemmel syndrome. These include duodenal diverticula causing dysfunction of the sphincter of Oddi as well as compression of the common bile duct by duodenal diverticula. It is uncommon for duodenal diverticulum to become inflamed. We report the case of a 25-year-old female presenting with unintentional weight loss and fatigue...
March 1, 2017: Curēus
https://www.readbyqxmd.com/read/28365715/gall-bladder-agenesis-a-rare-embryonic-cause-of-recurrent-biliary-colic
#18
Aarthi Rajkumar, Albina Piya
BACKGROUND Gallbladder agenesis (GA) is an extremely rare anatomic anomaly with a reported incidence of less than 0.5%. It is usually asymptomatic, but can present with features of biliary colic and cholecystitis. We present here a case of GA in a patient with recurrent biliary colic.  CASE REPORT A 24-year-old African American woman presented with recurrent episodes of right upper-quadrant abdominal pain. During her first episode, she was found to have elevated transaminases and clinical features of cholecystitis, but ultrasound did not visualize a gallbladder and she was discharged with a diagnosis of biliary colic...
April 2, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28350202/outcomes-of-laparoscopic-cholecystectomy-for-biliary-dyskinesia-in-children
#19
Sarah W Lai, Steven S Rothenberg, Saundra M Kay, Kristin E Shipman, Bethany J Slater
PURPOSE: To determine the outcomes of laparoscopic cholecystectomy as a treatment for biliary dyskinesia in children. METHODS: With ethics approval, a retrospective chart review was performed on children (<21 years) at a single center diagnosed with biliary dyskinesia (defined as gallbladder ejection fraction [EF] <35% and/or pain with cholecystokinin [CCK] on cholescintigraphy, in the absence of gallstones or cholecystitis on ultrasound) and treated with laparoscopic cholecystectomy between March 2010 and February 2016...
August 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28344051/massive-biliary-dilation-after-roux-en-y-gastric-bypass-is-it-ampullary-achalasia
#20
Jeffrey L Ponsky, Noble Jones, John H Rodriguez, Matthew D Kroh, Andrew T Strong
BACKGROUND: This series of patients with a history of Roux-en-Y gastric bypass (RYGB) and cholecystectomy presented with symptoms consistent with obstructive biliary disease and massive biliary dilation of ≥15 mm, suggesting a structural cause. Findings from laparoscopic-assisted transgastric (TG) ERCP were a normal-appearing ampulla without structural lesions or stones, suggesting a functional cause instead. STUDY DESIGN: Patients who underwent TGERCP from January 2008 to October 2016 and had a surgical history of RYGB and cholecystectomy were identified from an institutional database...
June 2017: Journal of the American College of Surgeons
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