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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/28719593/long-term-treatment-of-eosinophilic-esophagitis-with-swallowed-topical-corticosteroids-development-and-evaluation-of-a-therapeutic-concept
#1
Thomas Greuter, Christian Bussmann, Ekaterina Safroneeva, Alain M Schoepfer, Luc Biedermann, Stephan R Vavricka, Alex Straumann
OBJECTIVES: Swallowed topical corticosteroids (STCs) are efficacious in inducing and presumably maintaining remission in patients with active eosinophilic esophagitis (EoE). Hitherto, it has not been evaluated whether long-lasting remission can be achieved, and whether treatment can be stopped once patients have achieved this remission. METHODS: Since 2007, EoE patients included into a large database at the Swiss EoE Clinics were put on STCs as induction/maintenance therapy...
July 18, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28719595/risk-of-postoperative-complications-among-inflammatory-bowel-disease-patients-treated-preoperatively-with-vedolizumab
#2
Akihiro Yamada, Yuga Komaki, Nayan Patel, Fukiko Komaki, Arthur S Aelvoet, Anthony L Tran, Joel Pekow, Sushila Dalal, Russell D Cohen, Lisa Cannon, Konstantin Umanskiy, Radhika Smith, Roger Hurst, Neil Hyman, David T Rubin, Atsushi Sakuraba
OBJECTIVES: Vedolizumab is increasingly used to treat patients with ulcerative colitis (UC) and Crohn's disease (CD), however, its safety during the perioperative period remains unclear. We compared the 30-day postoperative complications among patients treated preoperatively with vedolizumab, anti-tumor necrosis factor (TNF)-α agents or non-biological therapy. METHODS: The retrospective study cohort was comprised of patients receiving vedolizumab, anti-TNF-α agents or non-biological therapy within 4 weeks of surgery...
July 18, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28695451/the-endoscopic-findings-of-the-upper-gastrointestinal-tract-in-patients-with-crohn-s-disease
#3
REVIEW
Yoshiki Nomura, Kentaro Moriichi, Mikihiro Fujiya, Toshikatsu Okumura
Crohn's disease (CD) is a type of chronic inflammatory bowel disease (IBD) associated with ulceration, and the main foci of the inflammation in CD patients are typically the terminal ileum and colon. However, in the upper gastrointestinal tract (GIT), including the esophagus, stomach and duodenum, inflammatory lesions are also detected as well, with a relatively high frequency (30-75%). Recent advances in imaging modalities, including endoscopy, have aided in the diagnosis of CD. Various lesions, including aphtha, erosion, ulcers, bamboo-joint-like appearance and notch-like appearance, are detected in the upper GI of CD patients...
August 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28716721/the-evolving-genomic-landscape-of-barrett-s-esophagus-and-esophageal-adenocarcinoma
#4
REVIEW
Gianmarco Contino, Thomas L Vaughan, David Whiteman, Rebecca Fitzgerald
We have recently gained unprecedented insight into genetic factors that determine risk for Barrett's esophagus (BE) and progression to esophageal adenocarcinoma (EA). Next-generation sequencing technologies have allowed us to identify somatic mutations that initiate BE and track genetic changes during development of tumors and invasive cancer. These technologies led to identification of mechanisms of tumorigenesis that challenge the current multi-step model of progression to EA. Newer, cost-effective technologies create opportunities to rapidly translate the analysis of DNA into tools that can identify patients with BE at high risk for cancer, detect dysplastic lesions at earlier stages, and uncover mechanisms of carcinogenesis...
July 14, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28677333/review-article-new-treatments-in-non-alcoholic-fatty-liver-disease
#5
REVIEW
S A Townsend, P N Newsome
BACKGROUND: Non-alcoholic fatty liver disease is the fastest growing cause of liver disease in the Western world, yet there is no approved pharmacotherapy. While lifestyle modifications remain the mainstay of treatment, only a proportion of individuals are able to make or sustain them, and so more treatment options are required. AIM: To review the potential benefit of drugs used in clinical practice, those entering phase II trials, and compounds being investigated in pre-clinical studies...
July 4, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28602971/new-developments-in-hepatorenal-syndrome
#6
Ayse L Mindikoglu, Stephen C Pappas
Hepatorenal Syndrome (HRS) continues to be one of the major complications of decompensated cirrhosis leading to death in the absence of liver transplantation. Challenges in precisely evaluating renal function in the patient with cirrhosis remain due to the limitations of serum creatinine (Cr) alone in estimating glomerular filtration rate (GFR); current GFR estimating models appear to underestimate renal function. Newer models incorporating renal biomarkers, such as the Cr-Cystatin C GFR Equation for Cirrhosis appear to more accurately estimate true GFR...
June 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28695907/overuse-of-repeat-upper-endoscopy-in-the-veterans-health-administration-a-retrospective-analysis
#7
Joel H Rubenstein, Heiko Pohl, Megan A Adams, Eve Kerr, Robert Holleman, Sandeep Vijan, Jason A Dominitz, John M Inadomi, Dawn Provenzale, Joseph Francis, Sameer D Saini
OBJECTIVES: Americans undergo ∼7 million esophagogastroduodenoscopies (EGDs) annually, and one-third of Medicare beneficiaries undergo a repeat EGD within 3 years. As many as 43% of these repeat EGDs are inappropriate. We aimed to determine the rate of repeat inappropriate EGD within the Veterans Health Administration (VHA), and identify factors associated with repeat EGD. METHODS: We conducted retrospective analyses of Veterans undergoing an index EGD at 159 VHA facilities between 1 January 2003 and 30 June 2007...
July 11, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28695906/no-association-between-proton-pump-inhibitor-use-and-risk-of-alzheimer-s-disease
#8
Heidi Taipale, Anna-Maija Tolppanen, Miia Tiihonen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen
OBJECTIVES: The objective of the study was to investigate whether proton pump inhibitor (PPI) use is associated with an increased risk of clinically verified Alzheimer's disease (AD). METHODS: A Finnish nationwide nested case-control study MEDALZ includes all community-dwelling individuals with newly diagnosed AD during 2005-2011 (N=70,718), and up to four age-, sex-, and region of residence-matched comparison individuals for each case (N=282,858). Data were extracted from Finnish nationwide health-care registers...
July 11, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28695908/long-term-colorectal-cancer-incidence-after-negative-colonoscopy-in-the-state-of-utah-the-effect-of-family-history
#9
N Jewel Samadder, Lisa Pappas, Kenneth M Boucherr, Ken R Smith, Heidi Hanson, Alison Fraser, Yuan Wan, Randall W Burt, Karen Curtin
OBJECTIVES: Colonoscopy is widely recommended for colorectal cancer (CRC) screening, but evidence to guide the optimal frequency of repeat screening examination is limited. We examined the duration and magnitude of the risk of developing CRC, following a negative colonoscopy in those at average risk and those with a first-degree family history of CRC. METHODS: A cohort of Utah residents aged 50-80 years who had a negative colonoscopy between 1 January 2001 and 31 December 2011 was identified using the Utah Population Database...
July 11, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28631728/acg-and-cag-clinical-guideline-management-of-dyspepsia
#10
Paul M Moayyedi, Brian E Lacy, Christopher N Andrews, Robert A Enns, Colin W Howden, Nimish Vakil
We have updated both the American College of Gastroenterology (ACG) and the Canadian Association of Gastroenterology (CAG) guidelines on dyspepsia in a joint ACG/CAG dyspepsia guideline. We suggest that patients ≥60 years of age presenting with dyspepsia are investigated with upper gastrointestinal endoscopy to exclude organic pathology. This is a conditional recommendation and patients at higher risk of malignancy (such as spending their childhood in a high risk gastric cancer country or having a positive family history) could be offered an endoscopy at a younger age...
June 20, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28600070/colorectal-cancer-screening-recommendations-for-physicians-and-patients-from-the-u-s-multi-society-task-force-on-colorectal-cancer
#11
Douglas K Rex, C Richard Boland, Jason A Dominitz, Francis M Giardiello, David A Johnson, Tonya Kaltenbach, Theodore R Levin, David Lieberman, Douglas J Robertson
No abstract text is available yet for this article.
July 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28642198/treatment-of-intestinal-fibrosis-in-experimental-inflammatory-bowel-disease-by-the-pleiotropic-actions-of-a-local-rho-kinase-inhibitor
#12
Tom Holvoet, Sarah Devriese, Karolien Castermans, Sandro Boland, Dirk Leysen, Yves-Paul Vandewynckel, Lindsey Devisscher, Lien Van den Bossche, Sophie Van Welden, Melissa Dullaers, Roosmarijn E Vandenbroucke, Riet De Rycke, Karel Geboes, Arnaud Bourin, Olivier Defert, Pieter Hindryckx, Martine De Vos, Debby Laukens
BACKGROUND: Intestinal fibrosis resulting in (sub)obstruction is a common complication of Crohn's disease (CD). Rho kinases (ROCKs) play multiple roles in TGFβ1-induced myofibroblast activation that could be therapeutic targets. Because systemic ROCK inhibition causes cardiovascular side-effects, we evaluated the effects of a locally acting ROCK inhibitor (AMA0825) on intestinal fibrosis. METHODS: Fibrosis was assessed in mouse models using dextran sulfate sodium and adoptive T cell transfer...
June 19, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28631729/backwash-is-hogwash-the-clinical-significance-of-ileitis-in-ulcerative-colitis
#13
Deepa T Patil, Robert D Odze
No abstract text is available yet for this article.
June 20, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28600072/colorectal-cancer-screening-recommendations-for-physicians-and-patients-from-the-u-s-multi-society-task-force-on-colorectal-cancer
#14
Douglas K Rex, C Richard Boland, Jason A Dominitz, Francis M Giardiello, David A Johnson, Tonya Kaltenbach, Theodore R Levin, David Lieberman, Douglas J Robertson
This document updates the colorectal cancer (CRC) screening recommendations of the U.S. Multi-Society Task Force of Colorectal Cancer (MSTF), which represents the American College of Gastroenterology, the American Gastroenterological Association, and The American Society for Gastrointestinal Endoscopy. CRC screening tests are ranked in 3 tiers based on performance features, costs, and practical considerations. The first-tier tests are colonoscopy every 10 years and annual fecal immunochemical test (FIT). Colonoscopy and FIT are recommended as the cornerstones of screening regardless of how screening is offered...
June 2, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28585556/beneficial-effects-of-statins-on-the-rates-of-hepatic-fibrosis-hepatic-decompensation-and-mortality-in-chronic-liver-disease-a-systematic-review-and-meta-analysis
#15
REVIEW
Sehrish Kamal, Muhammad Ali Khan, Ankur Seth, George Cholankeril, Deepansh Gupta, Utkarsh Singh, Faisal Kamal, Colin W Howden, Christopher Stave, Satheesh Nair, Sanjaya K Satapathy, Aijaz Ahmed
OBJECTIVES: Statins may improve outcomes in patients with chronic liver disease (CLD). We conducted a systematic review and meta-analysis to evaluate the impact of statins in the setting of CLD. METHODS: We searched several databases from inception to 17 October 2016 to identify comparative studies evaluating the role of statins in CLD. Outcomes of interest were the associations between statin use and progression of fibrosis, development of hepatic decompensation in cirrhosis, and mortality in CLD...
June 6, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28515843/emerging-concepts-in-alcoholic-hepatitis
#16
REVIEW
Phoenix Fung, Nikolaos Pyrsopoulos
Severe alcoholic hepatitis is implicated as a costly, worldwide public health issue with high morbidity and mortality. The one-month survival for severe alcoholic hepatitis is low with mortality rates high as 30%-50%. Abstinence from alcohol is the recommended first-line treatment. Although corticosteroids remain as the current evidence based option for selected patients with discriminant function > 32, improvement of short-term survival rate may be the only benefit. Identification of individuals with risk factors for the development of severe alcoholic hepatitis may provide insight to the diverse clinical spectrum and prognosis of the disease...
April 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28531908/methods-and-reporting-studies-assessing-fecal-microbiota-transplantation-a-systematic-review
#17
REVIEW
Aïda Bafeta, Amelie Yavchitz, Carolina Riveros, Rui Batista, Philippe Ravaud
Background: Fecal microbiota transplantation (FMT) could be a novel treatment option for several chronic diseases associated with altered gut microbiota. Purpose: To examine the conduct and reporting of studies assessing FMT. Data Sources: Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and Web of Science from inception to 31 January 2017. Study Selection: Two reviewers independently examined titles and abstracts to identify all English-language reports of human clinical studies assessing the safety or efficacy of FMT...
July 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28429247/a-review-of-the-novel-application-and-potential-adverse-effects-of-proton-pump-inhibitors
#18
REVIEW
Li-Yuan Yu, Lu-Ning Sun, Xue-Hui Zhang, Yue-Qi Li, Lei Yu, Zi-Qing-Yun Yuan, Ling Meng, Hong-Wen Zhang, Yong-Qing Wang
Proton pump inhibitors (PPIs) are known as a class of pharmaceutical agents that target H(+)/K(+)-ATPase, which is located in gastric parietal cells. PPIs are widely used in the treatment of gastric acid-related diseases including peptic ulcer disease, erosive esophagitis and gastroesophageal reflux disease, and so on. These drugs present an excellent safety profile and have become one of the most commonly prescribed drugs in primary and specialty care. Except for gastric acid-related diseases, PPIs can also be used in the treatment of Helicobacter pylori infection, viral infections, respiratory system diseases, cancer and so on...
May 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28395784/acute-mesenteric-ischemia-part-i-incidence-etiologies-and-how-to-improve-early-diagnosis
#19
REVIEW
Jussi M Kärkkäinen, Stefan Acosta
Acute mesenteric ischemia (AMI) is generally thought to be a rare disease, but in fact, it is more common cause of acute abdomen than appendicitis or ruptured abdominal aortic aneurysm in patients over 75 years of age. In occlusive AMI, surgical treatment without revascularization is associated with as high as 80% overall mortality. It has been shown that early diagnosis with contrast-enhanced computed tomography and revascularization can reduce the overall mortality in AMI by up to 50%. However, only a minority of patients with AMI are being treated actively with revascularization in the United States, and the situation is very likely similar in Europe as well...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28427116/current-trends-in-the-management-of-gastroesophageal-reflux-disease
#20
REVIEW
Dalbir S Sandhu, Ronnie Fass
Gastroesophageal reflux disease (GERD) characterized by heartburn and/or regurgitation symptoms is one of the most common gastrointestinal disorders managed by gastroenterologists and primary care physicians. There has been an increase in GERD prevalence, particularly in North America and East Asia. Over the past three decades proton pump inhibitors (PPIs) have been the mainstay of medical therapy for GERD. However, recently there has been an increasing awareness amongst physicians and patients regarding the side effects of the PPI class of drugs...
April 24, 2017: Gut and Liver
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