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    4909 results match your criteria Clinical Gastroenterology and Hepatology[Journal]

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    High Prevalence of Liver Fibrosis Among European Adults with Unknown Liver Disease. A Population-Based Study.
    Clin Gastroenterol Hepatol 2018 Feb 13. Epub 2018 Feb 13.
    Liver Unit, Hospital Clínic, Barcelona; Institutd'InvestigacionsBiomèdiquesAugust Pi iSunyer (IDIBAPS); Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD). Electronic address:
    Background And Aims: Liver fibrosis is the main determinant of long-term outcome in chronic liver diseases. Little is known about prevalence of liver fibrosis in general population. Aim of the study was to investigate the prevalence of liver fibrosis in general adult population with unknown liver disease. Read More

    Use of Appropriate Surveillance for Patients With Non-Dysplastic Barrett's Esophagus.
    Clin Gastroenterol Hepatol 2018 Feb 9. Epub 2018 Feb 9.
    Barrett's Esophagus Program, Division of Gastroenterology, University of Michigan, Ann Arbor, MI; Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI.
    Background & Aims: Barrett's Esophagus (BE) is a precursor to esophageal adenocarcinoma (EAC). Guidelines recommend that patients with nondysplastic BE (NDBE) undergo surveillance endoscopy every 3-5 years. We aimed to identify factors associated with surveillance endoscopy of patients with NDBE and identify trends in appropriate surveillance endoscopy of NDBE at a large tertiary care center. Read More

    Increased Waitlist Mortality and Lower Rate for Liver Transplantation in Hispanic Patients with Primary Biliary Cholangitis.
    Clin Gastroenterol Hepatol 2018 Feb 7. Epub 2018 Feb 7.
    Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA, United States. Electronic address:
    Background & Aims: Data on the differences in ethnicity and race among patients with primary biliary cholangitis (PBC) awaiting liver transplantation (LT) are limited. We evaluated liver transplant waitlist trends and outcomes based on ethnicity and race in patients with PBC in the United States.

    Methods: Using the United Network for Organ Sharing (UNOS) registry, we collected data on patients with PBC on the liver transplant waitlist, and performed analysis with a focus on ethnicity and race-based variations clinical manifestations, waitlist mortality and LT rates from 2000 to 2014. Read More

    EXTRAESOPHAGEAL SYMPTOMS AND DISEASES ATTRIBUTED TO GERD: Where is the pendulum swinging now?
    Clin Gastroenterol Hepatol 2018 Feb 7. Epub 2018 Feb 7.
    CHU Bordeaux, Department of Gastroenterology, Hepatology and Digestive oncology, Univ. Bordeaux, Bordeaux, France.
    Background And Aims: The purpose of this review is to outline the recent developments in the field of extraesophageal reflux disease and provide clinically relevant recommendations.

    Methods: The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed and EMbase. The Clinical Practice Updates Committee of the American Gastroenterological Association proposes the following recommendations: 1. Read More

    Risk of Oral and Upper Gastrointestinal Cancers in Persons With Positive Results From a Fecal Immunochemical Test in a Colorectal Cancer Screening Program.
    Clin Gastroenterol Hepatol 2018 Feb 7. Epub 2018 Feb 7.
    Cancer Center Amsterdam, Department of Gastroenterology and Hepatology, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands, Rotterdam, The Netherlands. Electronic address:
    Background & Aims: European guidelines recommend screening for colorectal cancer (CRC) using the fecal immunochemical test (FIT), with follow-up colonoscopies for individuals with positive test results. However, more than half of participants with positive results from the FIT are not found to have advanced neoplasia in the colonoscopy examination. Fecal occult blood might also come from the upper gastrointestinal (GI) tract, so perhaps we should consider esophagogastroduodenoscopy (EGD), to detect upper GI cancers. Read More

    Single Fluid-Filled Intragastric Balloon Safe and Effective for Inducing Weight Loss in a Real-world Population.
    Clin Gastroenterol Hepatol 2018 Feb 6. Epub 2018 Feb 6.
    Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States. Electronic address:
    Background & Aims: The Orbera Intragastric Balloon (OIB) is a single fluid-filled intra-gastric balloon approved for induction of weight loss and treatment of obesity. However, little is known about the effectiveness and safety of outside clinical trials, and since approval, the Food and Drug Administration has issued warnings to healthcare providers about risk of balloon hyper-inflation requiring early removal, pancreatitis, and death. We analyzed data on patients who have received the OIB since its approval determine its safety, effectiveness, and tolerance in real-world clinical settings. Read More

    Risk of Pancreatic Cancer in Patients with Pancreatic Cysts and Family History of Pancreatic Cancer.
    Clin Gastroenterol Hepatol 2018 Feb 6. Epub 2018 Feb 6.
    Division of Gastroenterology and Hepatology. Electronic address:
    Background & Aims: A diagnosis of pancreatic cancer in a first-degree relative increases an individuals' risk of this cancer. However, it is not clear whether this cancer risk increases in individuals with pancreatic cystic lesions who have a first-degree relative with pancreatic cancer. The Fukuoka criteria are used to estimate risk of pancreatic cancer for patients with pancreatic cystic lesions: individuals with cysts with high risk or worrisome features (Fukuoka positive) have a higher risk of pancreatic cancer than individuals without these features (Fukuoka negative). Read More

    Increased prevalence of rare sucrase-isomaltase (SI) pathogenic variants in irritable bowel syndrome patients.
    Clin Gastroenterol Hepatol 2018 Feb 2. Epub 2018 Feb 2.
    Department of Gastrointestinal and Liver Diseases, Biodonostia Health Research Institute, San Sebastián, Spain; Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; IKERBASQUE, Basque Science Foundation, Bilbao, Spain. Electronic address:

    Eicosapentaenoic Acid Reduces Fecal Levels of Calprotectin and Prevents Relapse in Patients With Ulcerative Colitis.
    Clin Gastroenterol Hepatol 2018 Jan 29. Epub 2018 Jan 29.
    Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, 40138, Italy. Electronic address:
    Background & Aims: High fecal levels of calprotectin indicate mucosal inflammation and have been shown to predict relapse in patients with ulcerative colitis (UC). Eicosapentaenoic acid (EPA), the major component of n-3 fish oil, has anti-inflammatory properties in patients with chronic inflammatory disorders. We performed a placebo-controlled trial of patients with UC at risk of relapse to determine the ability of the free-fatty acid form of EPA (EPA-FFA) to reduce intestinal inflammation, using fecal level of calprotectin as a marker. Read More

    Association Between Grade of Acute on Chronic Liver Failure and Response to Terlipressin and Albumin in Patients With Hepatorenal Syndrome.
    Clin Gastroenterol Hepatol 2018 Jan 29. Epub 2018 Jan 29.
    Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine - DIMED University of Padova, Padova, Italy. Electronic address:
    Background & Aims: Type-1 hepatorenal syndrome (HRS) is the most high-risk type of renal failure in patients with cirrhosis. Terlipressin and albumin are effective treatments for type-1 HRS. However, the effects of acute on chronic liver failure (ACLF) grade on response to treatment are not clear. Read More

    Lack of Association Between Proton Pump Inhibitor Use and Cognitive Decline.
    Clin Gastroenterol Hepatol 2018 Jan 29. Epub 2018 Jan 29.
    Department of Neurology, Odense University Hospital and Department of Clinical Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. Electronic address:
    Background & Aims: Studies of association between use of proton pump inhibitors (PPI) and dementia have yielded conflicting results. We investigated the effects of PPIs on cognitive decline in a study of middle-aged and elderly twins in Denmark.

    Methods: In a prospective study, we collected data from surveys of middle-aged individuals (46-67 years old; the Middle Aged Danish Twin study) and older individuals (the Longitudinal Study of Aging Danish Twins) who underwent cognitive assessments (a 5-component test battery) over a 10-year period (middle-age study, n=2346) or a 2-year period (longitudinal study of aging: n=2475). Read More

    Efficacy of Granulocyte Colony Stimulating Factor and N-acetyl Cysteine Therapies in Patients with Severe Alcoholic Hepatitis.
    Clin Gastroenterol Hepatol 2018 Jan 29. Epub 2018 Jan 29.
    Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh (INDIA).
    Background & Aims: Patients with alcoholic hepatitis (AH) have high mortality, so new therapies are needed. Administration of granulocyte colony stimulating factor (GCSF) increases survival times of patients with AH. It is not known whether addition of N-acetyl cysteine (NAC) to GCSF could further increase survival time. Read More

    Prevalence of Irritable Bowel Syndrome and Chronic Fatigue 10 Years after Giardia Infection.
    Clin Gastroenterol Hepatol 2018 Jan 25. Epub 2018 Jan 25.
    Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Research Unit for General Practice, Uni Research Health, Bergen, Norway.
    Background & Aims: Irritable bowel syndrome (IBS) is a complication that can follow gastrointestinal infection, but it is not clear if patients also develop chronic fatigue. We investigated the prevalence and odds ratio of IBS and chronic fatigue 10 years after an outbreak of Giardia lamblia, compared with a control cohort, and changes in prevalence over time.

    Methods: We performed a prospective follow-up study of 1252 laboratory-confirmed cases of giardiasis (exposed), which developed in Bergen, Norway in 2004. Read More

    Under-dilated TIPS Associate With Efficacy and Reduced Encephalopathy in a Prospective, Non-randomized Study of Patients With Cirrhosis.
    Clin Gastroenterol Hepatol 2018 Jan 25. Epub 2018 Jan 25.
    Division of Gastroenterology, Modena Hospital, University of Modena and Reggio Emilia, Modena, Italy.
    Background & Aims: Portosystemic encephalopathy (PSE) is a major complication of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement. Most devices are self-expandable polytetrafluoroethylene-covered stent grafts (PTFE-SGs) that are dilated to their nominal diameter (8 or 10 mm). We investigated whether PTFE-SGs dilated to a smaller caliber (under-dilated TIPS) reduce PSE yet maintain clinical and hemodynamic efficacy. Read More

    High Risk of Advanced Colorectal Neoplasia in Patients With Primary Sclerosing Cholangitis Associated With Inflammatory Bowel Disease.
    Clin Gastroenterol Hepatol 2018 Jan 25. Epub 2018 Jan 25.
    The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Surgical Department, Gastroenterology Division, Hospital Beatriz Ângelo, Loures, Portugal. Electronic address:
    Background & Aims: Patients with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC, termed PSC-IBD) are at increased risk for colorectal cancer (CRC), but their risk following a diagnosis of low-grade dysplasia (LGD) is not well described. We aimed to determine the rate of advanced colorectal neoplasia (aCRN), defined as high-grade dysplasia and/or colorectal cancer, following a diagnosis of indefinite dysplasia or LGD in this population.

    Methods: We performed a retrospective, longitudinal study of 1911 patients with colonic IBD (293 with PSC and 1618 without PSC) who underwent more than 2 surveillance colonoscopies from 2000 through 2015 in the Netherlands or the United States (9265 patient-years of follow up). Read More

    The unregulated probiotic market.
    Clin Gastroenterol Hepatol 2018 Jan 25. Epub 2018 Jan 25.
    Retired Prof of Infectious Diseases, University of L'Aquila, Italy. Electronic address:
    Background And Aims: This narrative review provides an overview of the current regulation of probiotics, with a focus on those used for the dietary management of medical conditions (Medical Foods).

    Findings: The probiotic market has grown rapidly, both for foods and supplements intended to enhance wellness in healthy individuals, and for preparations for the dietary management of disease. Regulation of probiotics varies between regions. Read More

    Symptoms do not Correlate With Findings From Colonoscopy in Children with Inflammatory Bowel Disease and Primary Sclerosing Cholangitis.
    Clin Gastroenterol Hepatol 2018 Jan 25. Epub 2018 Jan 25.
    Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, Canada. Electronic address:
    Background & Aims: Approximately 75% of children with primary sclerosing cholangitis (PSC) also have inflammatory bowel disease (IBD). IBD in patients with PSC (PSC-IBD) often has a unique phenotype, including a mild clinical course, yet it is associated with an increased risk of colorectal cancer compared to colonic IBD without PSC. We investigated whether subclinical endoscopic and histologic inflammation could account for the increased risk of colorectal cancer in patients with PSC-IBD, and whether these patients have increased fecal levels of calprotectin, a marker of inflammation. Read More

    Among Patients with Nonalcoholic Fatty Liver Disease, Modest Alcohol Use is Associated with Less Improvement in Histologic Steatosis and Steatohepatitis.
    Clin Gastroenterol Hepatol 2018 Jan 25. Epub 2018 Jan 25.
    Gastroenterology, UCSF, San Francisco, CA, United States.
    Background & Aims: Cross-sectional studies of patients with nonalcoholic fatty liver disease (NAFLD) have reported a lower prevalence of severe disease among modest drinkers compared to non-drinkers. We collected data from adult participants in the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) to evaluate the longitudinal association between modest use of alcohol and histology findings in patients with NAFLD, using paired liver biopsies collected more than 1 year apart.

    Methods: We studied NASH CRN participants 21 years or older, not receiving pharmacologic therapy, from whom 2 or more liver biopsies and data on alcohol use within 2 years of the initial biopsy were available. Read More

    Efficacy of Medical Therapies for Fistulizing Crohn's Disease: Systematic Review and Meta-analysis.
    Clin Gastroenterol Hepatol 2018 Jan 25. Epub 2018 Jan 25.
    Robarts Clinical Trials Inc, University of Western Ontario, London, Ontario, Canada; Department of Medicine, University of Western Ontario, London, Ontario, Canada; Department of Epidemiology and Biostatistics, University of Western Ontario, London Ontario, Canada. Electronic address:
    Background & Aims: Fistulas are debilitating complications of Crohn's disease (CD) that affect up to 50% of patients. We conducted a systematic review and meta-analysis of randomized controlled trials to assess the efficacy of treatments for fistulizing CD.

    Methods: We searched publication databases from inception through December 13, 2016 for trials comparing the efficacy of a therapeutic agent (single or combination) with placebo or another active therapy in adult patients with any form of fistulizing CD. Read More

    Efficacy of Treatments for Opioid-induced Constipation: A Systematic Review and Meta-Analysis.
    Clin Gastroenterol Hepatol 2018 Jan 25. Epub 2018 Jan 25.
    Beth Israel Deaconess Medical Center, Boston, MA, USA.
    Background & Aims: Opioid induced constipation (OIC) is a common problem in patients on chronic opioid therapy for cancer-related and non-cancer related pain. Approved treatments for OIC are methylnaltrexone, naloxone, naloxegol, alvimopan, naldemedine, and lubiprostone. Since a meta-analysis performed in 2014, 2 new agents have been approved by the Food and Drug Administration (FDA) for treatment of OIC (naloxegol and naldemedine). Read More

    Prolonged Time to Diagnosis of Eosinophilic Esophagitis Despite Increasing Knowledge of the Disease.
    Clin Gastroenterol Hepatol 2018 Jan 25. Epub 2018 Jan 25.
    Center for Esophageal Diseases and Swallowing, and Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC. Electronic address:

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