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Gastroenterology

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https://www.readbyqxmd.com/read/29034088/emerging-dilemmas-in-the-diagnosis-and-management-of-gastroesophageal-reflux-disease
#1
REVIEW
Peter Kahrilas, Rena Yadlapati, Sabine Roman
Gastroesophageal reflux disease (GERD) is common, but less so than widely reported because of inconsistencies in definition. In clinical practice, the diagnosis is usually based on a symptom assessment without testing, and the extent of diagnostic testing pursued should be limited to that which guides management or which protects the patient from the risks of a potentially morbid treatment or an undetected early (or imminent) esophageal adenocarcinoma or which does both. When testing is pursued, upper gastrointestinal endoscopy is the most useful initial diagnostic test because it evaluates for the major potential morbidities (Barrett's, stricture, and cancer) associated with GERD and facilitates the identification of some alternative diagnostic possibilities such as eosinophilic esophagitis...
2017: F1000Research
https://www.readbyqxmd.com/read/28760445/coeliac-disease
#2
REVIEW
Benjamin Lebwohl, David S Sanders, Peter H R Green
Coeliac disease occurs in about 1% of people in most populations. Diagnosis rates are increasing, and this seems to be due to a true rise in incidence rather than increased awareness and detection. Coeliac disease develops in genetically susceptible individuals who, in response to unknown environmental factors, develop an immune response that is subsequently triggered by the ingestion of gluten. The disease has many clinical manifestations, ranging from severe malabsorption to minimally symptomatic or non-symptomatic presentations...
July 28, 2017: Lancet
https://www.readbyqxmd.com/read/28721213/diagnostic-approaches-and-treatment-of-eosinophilic-esophagitis-a-review-article
#3
REVIEW
Hossein Akhondi
Eosinophilic Esophagitis (EoE) is a condition that involves eosinophilic influx into the esophageal epithelium. It affects both children and adults; Adults present with dysphagia whereas children with vague abdominal complaints. The clinical symptoms as well as pathologic features of EoE and gastro esophageal reflux disease (GERD) are similar. Since eosinophilia in the esophagus is a non-specific finding, the clinical presentation in conjunction with endoscopic findings and pathology, is crucial in determining a differential diagnosis...
August 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28728670/fifteen-years-of-ercp
#4
EDITORIAL
John Baillie
No abstract text is available yet for this article.
August 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28757269/proton-pump-inhibitors-and-chronic-kidney-disease-causation-or-another-false-alarm
#5
EDITORIAL
David J Bjorkman
No abstract text is available yet for this article.
July 27, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28827081/management-of-gastroesophageal-reflux-disease
#6
C Prakash Gyawali, Ronnie Fass
Management of GERD commonly starts with an empiric trial of proton pump inhibitor (PPI) therapy and complementary lifestyle measures, for patients without alarm symptoms. Optimization of therapy (improving compliance and timing of PPI doses), or increasing PPI dosage to twice daily in select circumstances, can reduce persistent symptoms. Patients with continued symptoms can be evaluated with endoscopy and tests of esophageal physiology, to better determine their disease phenotype and optimize treatment. Laparoscopic fundoplication, magnetic sphincter augmentation, and endoscopic therapies can benefit patients with well-characterized GERD...
August 4, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28797639/the-irony-of-long-term-acid-suppression
#7
EDITORIAL
Paul C Adams
No abstract text is available yet for this article.
September 2017: Gastroenterology
https://www.readbyqxmd.com/read/28692443/a-single-test-combining-blood-markers-and-elastography-is-more-accurate-than-other-fibrosis-tests-in-the-main-causes-of-chronic-liver-diseases
#8
Alexandra Ducancelle, Vincent Leroy, Julien Vergniol, Nathalie Sturm, Brigitte Le Bail, Jean Pierre Zarski, Eric Nguyen Khac, Dominique Salmon, Victor de Ledinghen, Paul Calès
BACKGROUND AND GOAL: International guidelines suggest combining a blood test and liver stiffness measurement (LSM) to stage liver fibrosis in chronic hepatitis C (CHC) and non-alcoholic fatty liver disease (NAFLD). Therefore, we compared the accuracies of these tests between the main etiologies of chronic liver diseases. STUDY: Overall, 1968 patients were included in 5 etiologies: CHC: 698, chronic hepatitis B: 152, human immunodeficiency virus/CHC: 628, NAFLD: 225, and alcoholic liver disease (ALD): 265...
August 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28684104/acid-base-disorders-in-liver-disease
#9
REVIEW
Bernhard Scheiner, Gregor Lindner, Thomas Reiberger, Bruno Schneeweiss, Michael Trauner, Christian Zauner, Georg-Christian Funk
Alongside the kidneys and lungs, the liver has been recognised as an important regulator of acid-base homeostasis. While respiratory alkalosis is the most common acid-base disorder in chronic liver disease, various complex metabolic acid-base disorders may occur with liver dysfunction. While the standard variables of acid-base equilibrium, such as pH and overall base excess, often fail to unmask the underlying cause of acid-base disorders, the physical-chemical acid-base model provides a more in-depth pathophysiological assessment for clinical judgement of acid-base disorders, in patients with liver diseases...
November 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28786407/strategies-to-combat-physician-burnout-in-gastroenterology
#10
Joseph C Anderson, Sheryl Pfeil, Christina Surawicz
No abstract text is available yet for this article.
September 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28631728/acg-and-cag-clinical-guideline-management-of-dyspepsia
#11
REVIEW
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...
July 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28395507/pantoprazole-does-not-reduce-the-antiplatelet-effect-of-clopidogrel-a-randomized-controlled-trial-in-korea
#12
Yoon Jin Choi, Nayoung Kim, In-Jin Jang, Joo-Youn Cho, Ryoung Hee Nam, Ji Hyun Park, Hyun Jin Jo, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee, Hyun Chae Jung
Background/Aims: Concerns that proton pump inhibitors (PPIs) diminish the efficacy of clopidogrel could hamper the appropriate prescription of PPIs. We evaluated the influence of pantoprazole on the antiplatelet effect of clopidogrel compared with ranitidine, which is regarded as safe, after stratification of the population according to the presence of a cytochrome (CYP) 2C19 polymorphism in Korea. Methods: Forty patients who underwent dual antiplatelet therapy were randomized to receive pantoprazole (n=20) or ranitidine (n=20)...
July 15, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28494576/diverticular-disease-an-update-on-pathogenesis-and-management
#13
REVIEW
Mona Rezapour, Saima Ali, Neil Stollman
Diverticular disease is one of the most common conditions in the Western world and one of the most common findings identified at colonoscopy. Recently, there has been a significant paradigm shift in our understanding of diverticular disease and its management. The pathogenesis of diverticular disease is thought to be multifactorial and include both environmental and genetic factors in addition to the historically accepted etiology of dietary fiber deficiency. Symptomatic uncomplicated diverticular disease (SUDD) is currently considered a type of chronic diverticulosis that is perhaps akin to irritable bowel syndrome...
May 12, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28164856/the-gut-microbiome-in-irritable-bowel-syndrome-and-other-functional-bowel-disorders
#14
REVIEW
Yehuda Ringel
Emerging data from epidemiologic, microbiome, and physiology research in patients with functional bowel disorders (FBDs) provide evidence for a linkage between alterations in the intestinal microbiota and FBDs. However, currently most of the data is based on association studies, and the causality role of the microbiota in these disorders is not established. Growing evidence for compositional changes and the increasing recognition of the association between the intestinal microbiota and gut-brain functions that are relevant to the pathophysiology and/or clinical symptoms of FBDs have led to increased interest in manipulating the intestinal microbiota for the treatment of these disorders...
March 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28331567/what-is-the-best-algorithm-for-investigation-of-acute-lower-gastrointestinal-haemorrhage
#15
Ainkaran Santhirasekaram, Sherif Latif, Easha Arooj, Kamran Rostami, Sauid Ishaq
An 81-year-old male presented with multiple episode of severe PR bleeding over 2 days. CTA done prior to catheter angiography that enabled successful intervention. This case emphasises the importance of CTA prior to catheter angiography in acute LGIB.
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28316536/gas-and-bloating
#16
William L Hasler
Gaseous symptoms including eructation, flatulence, and bloating occur as a consequence of excess gas production, altered gas transit, or abnormal perception of normal amounts of gas within the gastrointestinal tract. There are many causes of gas and bloating including aerophagia, luminal obstructive processes, carbohydrate intolerance syndromes, small intestinal bacterial overgrowth, diseases of gut motor activity, and functional bowel disorders including irritable bowel syndrome (IBS). Because of the prominence of gaseous complaints in IBS, recent investigations have focused on new insights into pathogenesis and novel therapies of bloating...
September 2006: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28331479/the-current-use-of-proton-pump-inhibitor-therapy-in-clinical-gi-practice
#17
Philip O Katz
No abstract text is available yet for this article.
December 2006: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28508867/bloating-and-abdominal-distension-old-misconceptions-and-current-knowledge
#18
REVIEW
Juan R Malagelada, Anna Accarino, Fernando Azpiroz
Bloating, as a symptom and abdominal distension, as a sign, are both common functional-type complaints and challenging to manage effectively. Individual patients may weight differently the impact of bloating and distension on their well-being. Complaints may range from chronic highly distressing pain to simply annoying and unfashionable protrusion of the abdomen. To avoid mishaps, organic bloating, and distension should always be considered first and appropriated assessed. Functional bloating and distension often present in association with other manifestations of irritable bowel syndrome or functional dyspepsia and in that context patients tend to regard them as most troublesome...
August 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28456631/global-prevalence-of-helicobacter-pylori-infection-systematic-review-and-meta-analysis
#19
REVIEW
James K Y Hooi, Wan Ying Lai, Wee Khoon Ng, Michael M Y Suen, Fox E Underwood, Divine Tanyingoh, Peter Malfertheiner, David Y Graham, Vincent W S Wong, Justin C Y Wu, Francis K L Chan, Joseph J Y Sung, Gilaad G Kaplan, Siew C Ng
BACKGROUND & AIMS: The epidemiology of Helicobacter pylori infection has changed with improvements in sanitation and methods of eradication. We performed a systematic review and meta-analysis to evaluate changes in the global prevalence of H pylori infection. METHODS: We performed a systematic search of the MEDLINE and EMBASE databases for studies of the prevalence of H pylori infection published from January 1, 1970 through January 1, 2016. We analyzed data based on United Nations geoscheme regions and individual countries...
August 2017: Gastroenterology
https://www.readbyqxmd.com/read/28452210/functional-dyspepsia-advances-in-diagnosis-and-therapy
#20
REVIEW
Nicholas J Talley
Functional dyspepsia (FD) is a common but under-recognized syndrome comprising bothersome recurrent postprandial fullness, early satiety, or epigastric pain/burning. Epidemiologically, there are two clinically distinct FD syndromes (although these often overlap clinically): postprandial distress syndrome (PDS; comprising early satiety or meal-related fullness) and epigastric pain syndrome. Symptoms of gastroesophageal reflux disease overlap with FD more than expected by chance; a subset has pathological acid reflux...
May 15, 2017: Gut and Liver
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