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Gastroenterology

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By Jeff Bank Internal Medicine R2 at the University of Utah
https://www.readbyqxmd.com/read/30181534/functional-dyspepsia-a-revolution-in-management
#1
Tadayuki Oshima, Hiroto Miwa
No abstract text is available yet for this article.
September 4, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/30195459/acute-on-chronic-liver-failure-vs-traditional-acute-decompensation-of-cirrhosis
#2
REVIEW
Thierry Gustot, Richard Moreau
In this Grand Round presentation, the case of a woman with acute decompensation of cirrhosis due to spontaneous bacterial peritonitis is described. She subsequently developed liver failure, type 1 hepatorenal syndrome, severe hepatic encephalopathy, and respiratory failure requiring mechanical ventilation. Her critical illness raised several clinical and ethical dilemmas regarding prognosis, therapeutic options, and futility of care. We will discuss the utility of Acute-on-Chronic Liver Failure (ACLF) entity detection, the tools available for estimating outcomes, the current evidences on management of ACLF, and potential salvage therapies (including experimental)...
September 6, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/30222971/increasing-adenoma-detection-rates-in-the-right-side-of-the-colon-comparing-retroflexion-or-a-second-forward-view-a-systematic-review
#3
REVIEW
Madhav Desai, Mohammad Bilal, Nour Hamade, Venkata Subhash Gorrepati, Viveksandeep Thogulva Chandrasekar, Ramprasad Jegadeesan, Neil Gupta, Pradeep Bhandari, Alessandro Repici, Cesare Hassan, Prateek Sharma
BACKGROUND AND AIMS: Right-sided lesions are often missed during standard colonoscopy (SC). A second forward view examination or retroflexion in the right side of the colon, have both been proposed as techniques to improve ADR in the right side of the colon. Comparative data of examining the right side of the colon with a second forward view or retroflexion is not known in a pooled analysis. We performed a systematic review of the literature to assess the yield of a second forward view compared with retroflexion examination for the detection of right-sided adenomas...
September 14, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/30217726/a-randomized-controlled-trial-evaluating-general-endotracheal-anesthesia-versus-monitored-anesthesia-care-and-the-incidence-of-sedation-related-adverse-events-during-ercp-in-high-risk-patients
#4
Zachary L Smith, Daniel K Mullady, Gabriel D Lang, Koushik K Das, Robert M Hovis, Riddhi S Patel, Thomas G Hollander, Jeffery Elsner, Catherine Ifune, Vladimir M Kushnir
BACKGROUND AND AIMS: ERCP is a complex procedure and often performed in patients at high risk for sedation-related adverse events (SRAE). However, there is no current standard of care with regard to mode of sedation and airway management during ERCP. The aim of this study was to assess the safety of general endotracheal anesthesia (GEA) versus propofol-based monitored anesthesia care without endotracheal intubation (MAC) in patients undergoing ERCP at high risk for SRAE. METHODS: Consecutive patients undergoing ERCP at high risk for SRAE at a single center were invited to participate in this randomized-controlled trial (NCT02850887) comparing GEA and MAC...
September 11, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/30177784/effect-of-antidepressants-and-psychological-therapies-in-irritable-bowel-syndrome-an-updated-systematic-review-and-meta-analysis
#5
Alexander C Ford, Brian E Lacy, Lucinda A Harris, Eamonn Mm Quigley, Paul Moayyedi
OBJECTIVES: Irritable bowel syndrome (IBS) is a chronic functional bowel disorder that is thought to be due to a disorder of brain-gut function. Drugs acting centrally, such as antidepressants, and psychological therapies may, therefore, be effective. METHODS: We updated a previous systematic review and meta-analysis of randomized controlled trials (RCTs). MEDLINE, EMBASE, PsychINFO, and the Cochrane Controlled Trials Register were searched (up to July 2017). Trials recruiting adults with IBS, which compared antidepressants versus placebo, or psychological therapies versus control therapy or "usual management" were eligible...
September 3, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/30144524/is-asymptomatic-esophageal-eosinophilia-the-same-disease-entity-as-eosinophilic-esophagitis
#6
Norihisa Ishimura, Shohei Sumi, Mayumi Okada, Hironobu Mikami, Eiko Okimoto, Nahoko Nagano, Asuka Araki, Yuji Tamagawa, Tsuyoshi Mishiro, Naoki Oshima, Shunji Ishihara, Riruke Maruyama, Yoshikazu Kinoshita
Eosinophilic esophagitis (EoE) is an allergic inflammatory disorder that is characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation.1,2 Its prevalence has been increasing rapidly in both Western and Asian countries. In Japan, most of the cases of esophageal eosinophilia (EE) are found in an upper endoscopy examination for gastric cancer screening performed during a comprehensive health check-up.3,4 Indeed, we frequently encounter patients with asymptomatic EE showing typical endoscopic findings, such as linear furrows, as well as histologic findings compatible with EoE...
August 23, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/30120957/eus-guided-celiac-ganglion-radiofrequency-ablation-versus-celiac-plexus-neurolysis-for-palliation-of-pain-in-pancreatic-cancer-a-randomized-controlled-trial-with-videos
#7
Ji Young Bang, Bryce Sutton, Robert H Hawes, Shyam Varadarajulu
BACKGROUND AND AIMS: Although frequently performed, the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) for palliation of pain in pancreatic cancer is suboptimal. Recently, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has been proposed as a palliative treatment option for pancreatic neoplasms. We performed a single-blind, randomized trial to compare the effectiveness of EUS-CPN and EUS-RFA for palliation of pain in pancreatic cancer. METHODS: Patients with abdominal pain due to locally advanced or metastatic pancreatic cancer underwent EUS-CPN (n=14) or EUS-RFA (n=12)...
August 15, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/30072778/postural-tachycardia-syndrome-pots-and-the-gi-tract-a-primer-for-the-gastroenterologist
#8
REVIEW
John K DiBaise, Lucinda A Harris, Brent Goodman
Postural tachycardia syndrome (POTS) is one of the most common causes of orthostatic intolerance and is being increasingly recognized in clinical practice. Gastrointestinal (GI) symptoms are reported commonly in patients with POTS and pose a considerable management challenge, making it imperative that gastroenterologists be aware of this condition and its GI comorbidities. Although the evidence presented herein does not prove causation, it does support an association between GI symptoms, GI dysmotility, and POTS...
August 3, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/30076842/performance-indicators-in-colonoscopy-after-certification-for-independent-practice-outcomes-and-predictors-of-competence
#9
Keith Siau, James Hodson, Roland M Valori, Stephen T Ward, Paul Dunckley
BACKGROUND: Robust real-world performance data of newly independent colonoscopists are lacking. In the United Kingdom, provisional colonoscopy certification (PCC) marks the transition from training to newly independent practice. We aimed to assess changes in key performance indicators (KPIs) such as cecal intubation rate (CIR) in the periods pre- and post-PCC, particularly regarding rates and predictors of trainees exhibiting a drop-in performance (DIP), defined as CIR <90% in the first 50 procedures post-PCC...
August 1, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/30076843/radiofrequency-ablation-compared-with-argon-plasma-coagulation-after-endoscopic-resection-of-high-grade-dysplasia-or-t1-adenocarcinoma-in-barrett-s-esophagus-a-randomized-pilot-study-bride
#10
Mohammad Farhad Peerally, Pradeep Bhandari, Krish Ragunath, Hugh Barr, Rehan Haidry, Laurence Lovat, Howard Smart, Rebecca Harrison, Clive Stokes, Karen Smith, Tom Morris, John S de Caestecker
BACKGROUND AND AIMS: Endoscopic resection (ER) is safe and effective for Barrett's esophagus (BE) containing high-grade dysplasia (HGD) or mucosal adenocarcinoma (T1A); risk of metachronous neoplasia is reduced by ablation of residual BE using radiofrequency ablation (RFA) or argon plasma coagulation (APC). These have not been directly compared. We aimed to recruit up to 100 patients with BE and HGD or T1A confirmed by ER over 1 year in 6 centres in a randomized pilot study. METHODS: Randomization was 1:1 to RFA or APC (4 treatments allowed at 2 month intervals); recruitment, retention, dysplasia clearance, clearance of benign BE, adverse events, healthcare costs, and quality of life (QoL) using EQ-5D, EORTC QLQ-C30, OES18 were assessed up to the end of the trial at 12 months...
August 1, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/30055267/fecal-microbiota-transplantation-current-status-in-treatment-of-gi-and-liver-disease
#11
REVIEW
Byron P Vaughn, Kevin M Rank, Alexander Khoruts
Fecal microbiota transplantation was originally introduced as a method to repair intestinal microbiota following failure of multiple treatments of recurrent Clostridiumdifficile infection with antibiotics. However, it is hypothesized that intestinal dysbiosis may contribute to the pathogenesis of many diseases, especially those involving the gastrointestinal tract. Therefore, fecal microbiota transplantation is increasingly being explored as a potential treatment that aims to optimize microbiota composition and functionality...
July 25, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/30046155/a-systematic-review-and-meta-analysis-evaluating-the-efficacy-of-a-gluten-free-diet-and-a-low-fodmaps-diet-in-treating-symptoms-of-irritable-bowel-syndrome
#12
REVIEW
Joanna Dionne, Alexander C Ford, Yuhong Yuan, William D Chey, Brian E Lacy, Yuri A Saito, Eamonn M M Quigley, Paul Moayyedi
OBJECTIVE: Dietary triggers such as gluten and highly fermentable oligo-, di- and monosaccharides and polyols (FODMAP)-containing foods have been associated with worsening irritable bowel syndrome (IBS) symptoms. However, the true impact of dietary restriction on IBS symptoms has remained unclear. The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the efficacy of exclusion diets (we focused on low FODMAP and gluten-free diets (GFD)) in IBS...
July 26, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/30002466/current-management-of-hepatic-encephalopathy
#13
REVIEW
Chathur Acharya, Jasmohan S Bajaj
Hepatic encephalopathy is a state of brain dysfunction resulting from decompensation of cirrhosis. The mortality and morbidity associated with the overt form of hepatic encephalopathy are high, and even the covert form associates with poor outcomes and poor quality of life. We know that the dysfunction is not just an acute insult to the brain but rather results in long-standing cognitive issues that get worse with each episode of HE. Hence, there is an urgency to accurately diagnose these conditions, start appropriate therapy, and to maintain remission...
July 13, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29980848/the-state-of-the-art-on-treatment-of-crohn-s-disease
#14
REVIEW
Hai Yun Shi, Siew Chien Ng
Crohn's disease (CD) is a chronic, progressive, and destructive disease of the gastrointestinal tract. Although its incidence appears to be stable or decreasing in most countries in the North America and Europe, the incidence is rising rapidly in Asian countries. Immunomodulators and biologics are increasingly used to avoid long-term bowel damage and subsequent disability. Therapeutic drug monitoring facilitates optimizing thiopurines and anti-TNFs use. New biologic agents targeting various pathological pathways of CD are blooming in recent years, and the high cost of biologics and expiration of patents for several biologic agents have driven the utility of biosimilars for CD treatment...
September 2018: Journal of Gastroenterology
https://www.readbyqxmd.com/read/30036644/endoscopic-therapy-for-upper-gi-bleeding-on-antithrombotics-a-safe-option-or-do-questions-remain
#15
EDITORIAL
Neil Sengupta
No abstract text is available yet for this article.
July 20, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/30036646/association-between-intestinal-microbiota-collected-at-hospital-admission-and-outcomes-of-patients-with-cirrhosis
#16
Jasmohan S Bajaj, Hugo E Vargas, K Rajender Reddy, Jennifer C Lai, Jacqueline G O'leary, Puneeta Tandon, Florence Wong, Robert Mitrani, Melanie B White, Megan Kelly, Andrew Fagan, Rohan Patil, Shaimaa Sait, Masoumeh Sikaroodi, Leroy R Thacker, Patrick M Gillevet
BACKGROUND & AIMS: Inpatients with cirrhosis are prone to develop acute-on-chronic liver failure (ACLF). ACLF is associated with dysbiosis of the intestinal microbiota, which might serve as a prognostic factor. We investigated whether features of the intestinal microbiota associate organ failure, transfer to intensive care, and mortality within 30 days in patients admitted to the hospital with cirrhosis. METHODS: Stool samples were collected from 181 patients with cirrhosis (age 56 years; mean model for end-stage liver disease score, 21; 43% with infections) at time of admission, from multiple hospitals in North America...
July 20, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/30031175/environmental-factors-gut-microbiota-and-colorectal-cancer-prevention
#17
REVIEW
Mingyang Song, Andrew T Chan
The substantial burden of colorectal cancer and increasing trend in young adults highlight the importance of lifestyle modification as a complement to screening for colorectal cancer prevention. Several dietary and lifestyle factors have been implicated in the development of colorectal cancer, possibly through the intricate metabolic and inflammatory mechanisms. Likewise, as a key metabolic and immune regulator, the gut microbiota has been recognized to play an important role in colorectal tumorigenesis. Increasing data support that environmental factors are crucial determinants for the gut microbial composition and function, whose alterations induce changes in the host gene expression, metabolic regulation, and local and systemic immune response, thereby influencing cancer development...
July 18, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29981753/water-exchange-colonoscopy-increases-adenoma-detection-rate-a-systematic-review-with-network-meta-analysis-of-randomized-controlled-studies
#18
REVIEW
Lorenzo Fuccio, Leonardo Frazzoni, Cesare Hassan, Marina La Marca, Valentina Paci, Veronica Smania, Nicola De Bortoli, Franco Bazzoli, Alessandro Repici, Douglas Rex, Sergio Cadoni
BACKGROUND AND AIMS: Water-aided colonoscopy techniques, such as water immersion (WI) and water exchange (WE), have shown different results regarding adenoma detection rate (ADR). We determined the impact of WI and WE on ADR and other procedural outcomes versus gas (air, AI; CO2 ) insufflation colonoscopy. METHODS: A systematic search of multiple databases for randomized controlled trials comparing WI and/or WE with AI and/or CO2 and reporting ADR was conducted...
July 5, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29990592/adding-value-to-the-conversation-about-colorectal-cancer-screening-practical-pearls-for-gastroenterologists
#19
Jennifer K Maratt, Keith Naylor, Sameer D Saini
No abstract text is available yet for this article.
October 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29981436/microscopic-colitis-a-rare-cause-of-pseudomembranes
#20
Robert J Schenck, Greg S Cohen, Maryam K Pezhouh
No abstract text is available yet for this article.
July 4, 2018: Clinical Gastroenterology and Hepatology
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