309 results match your criteria Clinical and Experimental Gastroenterology [Journal]


Assessment and management of patients with intestinal failure: a multidisciplinary approach.

Clin Exp Gastroenterol 2018 12;11:233-241. Epub 2018 Jun 12.

The Lennard Jones Intestinal Failure Unit, St. Mark's Hospital, Harrow, UK.

Intestinal failure (IF) is a condition characterized by the inability to maintain a state of adequate nutrition, or fluid and electrolyte balance due to an anatomical or a physiological disorder of the gastrointestinal system. IF can be an extremely debilitating condition, significantly affecting the quality of life of those affected. The surgical management of patients with acute and chronic IF requires a specialist team who has the expertise in terms of technical challenges and decision-making. Read More

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June 2018
1 Read

Tumor necrosis factor α-induced protein 3 (A20) is dysregulated in pediatric Crohn disease.

Clin Exp Gastroenterol 2018 30;11:217-231. Epub 2018 May 30.

Department of Pediatrics.

Purpose: A significant feature of pediatric inflammatory bowel diseases (IBD), which include Crohn disease (CD), and ulcerative colitis (UC), is failure to suppress inflammation. The inability to regulate inflammation renders a major challenge toward establishing effective treatments in IBD. Nuclear factor kappa-light-chain-enhancer of activated B-cells-induced inflammation is inhibited by A20 through interactions with TAX1BP1 (Tax1-binding protein 1) and A20-binding inhibitor of NF-κβ activation (ABIN)-1 (A20 binding and inhibitor of NF-κβ) and upon phosphorylation by inhibitor of nuclear factor kappa-β kinase subunit beta (IKKβ), which stabilizes it. Read More

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A model of blood-ammonia homeostasis based on a quantitative analysis of nitrogen metabolism in the multiple organs involved in the production, catabolism, and excretion of ammonia in humans.

Clin Exp Gastroenterol 2018 24;11:193-215. Epub 2018 May 24.

Research Service, Veterans Affairs Medical Center, Minneapolis, MN, USA.

Increased blood ammonia (NH) is an important causative factor in hepatic encephalopathy, and clinical treatment of hepatic encephalopathy is focused on lowering NH. Ammonia is a central element in intraorgan nitrogen (N) transport, and modeling the factors that determine blood-NH concentration is complicated by the need to account for a variety of reactions carried out in multiple organs. This review presents a detailed quantitative analysis of the major factors determining blood-NH homeostasis - the N metabolism of urea, NH, and amino acids by the liver, gastrointestinal system, muscle, kidney, and brain - with the ultimate goal of creating a model that allows for prediction of blood-NH concentration. Read More

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Elevated lactate level predicts intensive care unit admissions, endoscopies and transfusions in patients with acute gastrointestinal bleeding.

Clin Exp Gastroenterol 2018 23;11:185-192. Epub 2018 May 23.

Division of Gastroenterology, University of Arizona College of Medicine, Tucson, AZ, USA.

Background And Aims: Initial clinical management decision in patients with acute gastrointestinal bleeding (GIB) is often based on identifying high- and low-risk patients. Little is known about the role of lactate measurement in the triage of patients with acute GIB. We intended to assess if lactate on presentation is predictive of need for intervention in patients with acute GIB. Read More

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Does the Internet promote the unregulated use of fecal microbiota transplantation: a potential public health issue?

Clin Exp Gastroenterol 2018 1;11:179-183. Epub 2018 May 1.

Department of Gastroenterology, St Mark's Hospital, Harrow, UK.

Introduction: The Internet has become an increasingly popular resource for medical information. Fecal microbiota transplantation (FMT) has changed the treatment of with cure rates of 81% following one infusion of FMT, further studies have since validated these findings. The Medicines and Health care Products Regulatory Agency has classified FMT as a medicine and hence should be only utilized in strict clinical settings. Read More

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Endoscopic comparison of gastroduodenal injury with over-the-counter doses of new fast-dissolving ibuprofen and paracetamol formulations: a randomized, placebo-controlled, 4-way crossover clinical trial.

Clin Exp Gastroenterol 2018 16;11:169-177. Epub 2018 Apr 16.

Global Clinical Development, GlaxoSmithKline, Collegeville, PA, USA.

Background: While gastrointestinal (GI) effects of standard ibuprofen and N-acetyl-p-aminophenol (APAP) have been reported, upper GI injury following treatment with fast-dissolving (FD) formulations of these analgesics has not been investigated. We evaluated upper GI effects of over-the-counter doses of 2 FD ibuprofen products and 1 FD-APAP product.

Methods: In a randomized, placebo-controlled, endoscopist-blinded, 4-way crossover study, 28 healthy subjects received FD ibuprofen 2×200 mg liquid capsules 3 times daily (TID), ibuprofen 2×200 mg tablets TID, FD-APAP 2×500 mg tablets 4 times daily (QID), and placebo 2×500 mg tablets QID for 7 days. Read More

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Complete esophageal obstruction following endoscopic variceal ligation: a case report and literature review.

Clin Exp Gastroenterol 2018 10;11:165-168. Epub 2018 Apr 10.

Department of Gastroenterology, Hawkes Bay Hospital, Hastings, New Zealand.

Endoscopic variceal ligation (EVL) is an important treatment modality in managing complications of portal hypertension. Since its advent 30 years ago, the procedural complications have decreased significantly, especially when compared with variceal sclerotherapy. With the current widespread use of EVL, rare complications are now becoming increasingly recognized. Read More

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Colonic transit time and pressure based on Bernoulli's principle.

Authors:
Yoshiharu Uno

Clin Exp Gastroenterol 2018 5;11:153-163. Epub 2018 Apr 5.

Office Uno Column, Yota, Onoe-Cho, Kakogawa, Japan.

Purpose: Variations in the caliber of human large intestinal tract causes changes in pressure and the velocity of its contents, depending on flow volume, gravity, and density, which are all variables of Bernoulli's principle. Therefore, it was hypothesized that constipation and diarrhea can occur due to changes in the colonic transit time (CTT), according to Bernoulli's principle. In addition, it was hypothesized that high amplitude peristaltic contractions (HAPC), which are considered to be involved in defecation in healthy subjects, occur because of cecum pressure based on Bernoulli's principle. Read More

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April 2018
2 Reads

Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: a retrospective cohort study.

Clin Exp Gastroenterol 2018 9;11:143-152. Epub 2018 Apr 9.

Medicine and Hepatogastroenterology Unit, Centre Hospitalier et Universitaire de Yopougon, Abidjan, Côte d'Ivoire.

Background: Systemic inflammatory response syndrome (SIRS) and model for end-stage liver disease (MELD) predict short-term mortality in patients with cirrhosis. Prediction of mortality at initial hospitalization is unknown in black African patients with decompensated cirrhosis.

Aim: This study aimed to look at the role of MELD score and SIRS as the predictors of morbidity and mortality at initial hospitalization. Read More

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April 2018
3 Reads

Validation of a risk prediction model for Barrett's esophagus in an Australian population.

Clin Exp Gastroenterol 2018 28;11:135-142. Epub 2018 Mar 28.

School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.

Background: Esophageal adenocarcinoma is a disease that has a high mortality rate, the only known precursor being Barrett's esophagus (BE). While screening for BE is not cost-effective at the population level, targeted screening might be beneficial. We have developed a risk prediction model to identify people with BE, and here we present the external validation of this model. Read More

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March 2018
1 Read

Proton pump inhibitor-refractory gastroesophageal reflux disease: challenges and solutions.

Clin Exp Gastroenterol 2018 21;11:119-134. Epub 2018 Mar 21.

Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.

A significant percentage of patients with gastroesophageal reflux disease (GERD) will not respond to proton pump inhibitor (PPI) therapy. The causes of PPI-refractory GERD are numerous and diverse, and include adherence, persistent acid, functional disorders, nonacid reflux, and PPI bioavailability. The evaluation should start with a symptom assessment and may progress to imaging, endoscopy, and monitoring of esophageal pH, impedance, and bilirubin. Read More

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March 2018
2 Reads

Postoperative pancreatic fistula: a review of traditional and emerging concepts.

Clin Exp Gastroenterol 2018 15;11:105-118. Epub 2018 Mar 15.

Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, Australia.

Postoperative pancreatic fistula (POPF) remains the major cause of morbidity after pancreatic resection, affecting up to 41% of cases. With the recent development of a consensus definition of POPF, there has been a large number of reports examining various risk factors, prediction models, and mitigation strategies for this costly complication. Despite these strategies, the rates of POPF have not significantly diminished. Read More

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March 2018
1 Read

Clinical and laboratory features of intestinal tuberculosis.

Clin Exp Gastroenterol 2018 13;11:97-103. Epub 2018 Mar 13.

Department of Surgical Gastroenterology, Ronak Endo-laparoscopy and General Surgical Hospital, Patan, Gujarat, India.

Background/aims: As increasing numbers of Crohn's disease (CD) cases are being recognized in India, so the differential diagnosis of CD and gastrointestinal tuberculosis (GITB) is becoming increasingly important. If patients are misdiagnosed with GITB, toxicity may result from unnecessary anti-TB therapy and treatment of the primary disease (ie, CD) gets delayed. We therefore aimed to assess the accuracy of various parameters that can be used to predict GITB diagnosis at index evaluation. Read More

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March 2018
2 Reads

Effects of resistant maltodextrin on bowel movements: a systematic review and meta-analysis.

Clin Exp Gastroenterol 2018 1;11:85-96. Epub 2018 Mar 1.

Laboratory of Food and Nutrition, Graduate School of Horticulture, Chiba University, Chiba, Japan.

It is well known that dietary fiber helps to relieve and prevent constipation, and there are a number of scientific papers, including systematic reviews and meta-analyses on the effects of naturally derived dietary fiber on bowel movements. In recent years, there has been an increase in the manufacture of dietary fiber ingredients obtained from food raw materials, and these are now commonly available in the market. Resistant maltodextrin (RMD), a soluble dietary fiber, is manufactured from starch, and industrially produced soluble dietary fiber is used worldwide. Read More

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March 2018
2 Reads

Cyclic vomiting syndrome: diagnostic approach and current management strategies.

Clin Exp Gastroenterol 2018 26;11:77-84. Epub 2018 Feb 26.

Department of Pharmacy Practice, South Dakota State University, College of Pharmacy and Allied Health Professions, Rapid City Regional Hospital, Rapid City, SD, USA.

Cyclic vomiting syndrome (CVS) is a disorder characterized by episodes of nausea and vomiting lasting for 1-5 days followed by asymptomatic periods. The etiology of CVS is unknown, but it shares similar characteristics to migraine headaches. CVS is generally classified as having four phases: prodromal, acute/vomiting/hyperemesis, recovery, and remission/interepisodic. Read More

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February 2018
3 Reads

Bouveret syndrome: current management strategies.

Clin Exp Gastroenterol 2018 15;11:69-75. Epub 2018 Feb 15.

Department of Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.

Bouveret syndrome is a rare complication of cholelithiasis that usually presents with signs and symptoms of gastric outlet obstruction. Given the relative rarity of this condition, there are no standardized guidelines for the management of this condition. In this paper, we review the diagnosis and management options (endoscopic, laparoscopic, and open approaches) of patients with Bouveret syndrome, including a report of one case to illustrate some of the endoscopic and surgical principles of management. Read More

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February 2018
6 Reads

Prolonged-release oxycodone/naloxone reduces opioid-induced constipation and improves quality of life in laxative-refractory patients: results of an observational study.

Clin Exp Gastroenterol 2018 24;11:57-67. Epub 2018 Jan 24.

Mundipharma International Limited, Cambridge, UK.

Background: Opioids are an effective treatment for moderate-to-severe pain. However, they are associated with a number of gastrointestinal side effects, most commonly constipation. Laxatives do not target the underlying mechanism of opioid-induced constipation (OIC), so many patients do not have their symptoms resolved. Read More

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January 2018
4 Reads

Rationale and design of the VISION study: a randomized, open-label study to evaluate the long-term safety of vonoprazan as maintenance treatment in patients with erosive esophagitis.

Clin Exp Gastroenterol 2018 24;11:51-56. Epub 2018 Jan 24.

Takeda Pharmaceutical Co., Ltd, Osaka, Japan.

Erosive esophagitis (EE) occurs when the epithelial mucosa is damaged due to gastric acid reflux, and the incidence of this disease is increasing in Japan due to changes in diet and lifestyle. The condition can be treated using proton pump inhibitors (PPIs) that act by irreversibly blocking the H,K-ATPase responsible for acid secretion. Vonoprazan is a K competitive channel inhibitor, which reversibly and potently inhibits gastric acid secretion. Read More

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January 2018
3 Reads

Ethnic/racial differences in gastrointestinal symptoms and diagnosis associated with the risk of infection in the US.

Clin Exp Gastroenterol 2018 18;11:39-49. Epub 2018 Jan 18.

Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.

Background: In the US, neither the prevalence nor the gastrointestinal (GI) diagnosis/symptoms associated with (HP) have been examined in different racial/ethnic groups.

Aim: To determine the racial/ethnic differences in HP infection associated with GI diagnoses/symptoms using the Cerner Health Facts database.

Methods: This cross-sectional study collected data during the period of 2000-2015 from the following ethnic/racial groups: 8,236,317 white, 2,085,389 black, 426,622 Hispanic, 293,156 Asian Pacific/Islander (APIs), and 89,179 Native American/Alaskan Native (NA/AN) patients aged 21-65 years old; the data were then analyzed. Read More

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January 2018
7 Reads

Isolation and gene expression profiling of intestinal epithelial cells: crypt isolation by calcium chelation from in vivo samples.

Clin Exp Gastroenterol 2018 12;11:29-37. Epub 2018 Jan 12.

School of Medicine and Medical Science, University College Dublin, Belfield, Dublin.

Aim: The epithelial layer within the colon represents a physical barrier between the luminal contents and its underlying mucosa. It plays a pivotal role in mucosal homeostasis, and both tolerance and anti-pathogenic immune responses. Identifying signals of inflammation initiation and responses to stimuli from within the epithelial layer is critical to understanding the molecular pathways underlying disease pathology. Read More

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January 2018
1 Read

Relationship of vitamin D receptor gene polymorphisms in gastric patients.

Clin Exp Gastroenterol 2018 12;11:19-27. Epub 2018 Jan 12.

Immunogenetics Laboratory, Institute of Biological Sciences, Federal University of Pará.

Purpose: The present study aimed to investigate the association between the human gene and infection.

Patients And Methods: A cross-sectional study was conducted on 208 adult patients with upper gastrointestinal symptoms. Gastric biopsy specimens were obtained from each patient for molecular DNA and histological examination. Read More

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January 2018
5 Reads

Endoscope-connected water pump with high flow rates improves the unsedated colonoscopy performance by water immersion method.

Clin Exp Gastroenterol 2018 12;11:13-18. Epub 2018 Jan 12.

Sepulveda Ambulatory Care Center, Veterans Affairs Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Objectives: The aim of this study was to determine if different water pump flow rates influence the insertion time of water immersion method in unsedated patients. We tested the hypothesis that high flow rate (HFR) is more effective than low flow rate (LFR) in facilitating insertion. Clinical registration number: NCT01869296. Read More

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January 2018
5 Reads

Exercise in patients with inflammatory bowel diseases: current perspectives.

Clin Exp Gastroenterol 2018 22;11:1-11. Epub 2017 Dec 22.

Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, NC, USA.

Inflammatory bowel diseases (IBDs), including both Crohn's disease (CD) and ulcerative colitis (UC), are chronic autoimmune diseases. Both CD and UC have relapsing and remitting courses. Although effective medical treatments exist for these chronic conditions, some patients do not respond to these traditional therapies. Read More

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December 2017
3 Reads

Preventive effect of on N-methyl-N-nitrosourea-(NMU) induced gastric cancer in rats.

Clin Exp Gastroenterol 2017 11;10:327-332. Epub 2017 Dec 11.

School of Medicine, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.

Background: Currently, gastric cancer (GC) is considered a public health problem worldwide. Using medicinal plants for the prevention of chronic diseases such as cancer constitutes new alternatives in traditional medicine. (OR) could be an option, but it needs to be evaluated. Read More

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December 2017
5 Reads

A novel scoring system for prediction of esophageal varices in critically ill patients.

Clin Exp Gastroenterol 2017 7;10:315-325. Epub 2017 Dec 7.

Tropical Medicine Department, Tanta University, Tanta.

Background And Aims: Patients with advanced systemic illness or critically ill patients may present with upper gastrointestinal tract (GIT) bleeding which may need endoscopic intervention; however, this may expose them to unnecessary endoscopy. The aim was to validate a novel scoring system for risk stratification for urgency of GIT endoscopy in critically ill patients.

Methods: This is an observational study conducted from January 2013 to January 2016 to analyze 300 patients with critical medical conditions and presenting with upper gastrointestinal bleeding. Read More

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December 2017
7 Reads

Interdependency between mechanical parameters and afferent nerve discharge in remodeled diabetic Goto-Kakizaki rat intestine.

Clin Exp Gastroenterol 2017 1;10:303-314. Epub 2017 Dec 1.

Giome Center, Department of Surgery, Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong.

Background: Gastrointestinal disorders are very common in diabetic patients, but the pathogenesis is still not well understood. Peripheral afferent nerves may be involved due to the complex regulation of gastrointestinal function by the enteric nervous system.

Objective: We aimed to characterize the stimulus-response function of afferent fibers innervating the jejunum in the Goto-Kakizaki (GK) type 2 diabetic rat model. Read More

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December 2017
4 Reads

Evaluation of a fecal immunochemistry test prior to colonoscopy for outpatients with various indications.

Clin Exp Gastroenterol 2017 10;10:285-292. Epub 2017 Nov 10.

Division of Emergency Medicine, Jewish General Hospital, McGill University School of Medicine, Montreal, Quebec, Canada.

Background: Stool tests can predict advanced neoplasms prior to colonoscopy. Results of immunochemical stool tests to predict findings at colonoscopy for various indications are less often reported. We compared pre-colonoscopy stool tests with findings in patients undergoing colonoscopy for different indications. Read More

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November 2017
5 Reads

Next generation of biologics for the treatment of Crohn's disease: an evidence-based review on ustekinumab.

Clin Exp Gastroenterol 2017 15;10:293-301. Epub 2017 Nov 15.

Department of Gastroenterology, Universitair Ziekenhuis Antwerpen, University of Antwerp, Antwerp, Belgium.

The limited efficacy of the currently available medical therapies in a proportion of patients with Crohn's disease has led to the research and development of molecules that can block new inflammatory pathways. Ustekinumab is a fully human IgG1 monoclonal antibody which targets the common p40 subunit of the cytokines interleukin-12 as well as interleukin-23. Consequently, the Th1 and Th17 inflammatory responses are inhibited. Read More

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November 2017
5 Reads

Duodenal and jejunal Dieulafoy's lesions: optimal management.

Clin Exp Gastroenterol 2017 7;10:275-283. Epub 2017 Nov 7.

Eren Hospital, General Surgery Unit, Istanbul, Turkey.

Dieulafoy's lesions (DLs) are rare and cause gastrointestinal bleeding resulting from erosion of dilated submucosal vessels. The most common location for DL is the stomach, followed by duodenum. There is little information about duodenal and jejunal DLs. Read More

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November 2017
5 Reads

Primary sclerosing cholangitis: diagnostic and management challenges.

Clin Exp Gastroenterol 2017 6;10:265-273. Epub 2017 Nov 6.

Department of Medicine, University of Western Ontario, London, ON, Canada.

Primary sclerosing cholangitis (PSC) is a chronic immune-mediated disease affecting intra- and extrahepatic bile ducts, primarily the large biliary ducts. Clinical manifestations are broad, and the spectrum encompasses asymptomatic cholestasis, icteric cholangitis with pruritis, cirrhosis, and cholangiocarcinoma. Though rare, PSC has a propensity to affect young to middle-aged males and is strongly associated with inflammatory bowel disease. Read More

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November 2017
3 Reads

Characterization and prevalence of spondyloarthritis and peripheral arthritis among patients with inflammatory bowel disease.

Clin Exp Gastroenterol 2017 27;10:259-263. Epub 2017 Sep 27.

Department of Medicine, Baylor College of Medicine.

Background: Joint complaints such as spondyloarthritis and peripheral arthritis are the most common extraintestinal manifestations in patients with inflammatory bowel disease (IBD); however, the evaluation of these symptoms are poorly described.

Objectives: To examine the clinical characteristics and prevalence of ankylosing spondylitis (AS) and other joint complaints among patients with IBD.

Methods: In a local cohort of patients diagnosed with IBD between 1996 and 2009, we performed a retrospective study at the Veterans Affairs Hospital. Read More

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September 2017
3 Reads

Tacrolimus versus anti-tumor necrosis factor agents for steroid-refractory active ulcerative colitis based on the severity of endoscopic findings: a single-center, open-label cohort study.

Clin Exp Gastroenterol 2017 26;10:249-258. Epub 2017 Sep 26.

Department of Gastroenterology, Saitama Medical Center, Jichi Medical University, Saitama, Saitama, Japan.

Background And Aims: At Saitama Medical Center, for remission induction in active ulcerative colitis (UC) patients with endoscopic evidence of severe disease, we tend to preferentially use tacrolimus (TAC) over anti-tumor necrosis factor (TNF)-α agents. We conducted this study to evaluate the validity of our therapeutic strategies.

Patients And Methods: This retrospective study was conducted in 52 steroid-refractory active UC patients with a Clinical Activity Index (CAI) score of ≥7 who were receiving remission induction therapy with TAC or anti-TNF-α agents. Read More

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September 2017
12 Reads

Laparoscopic esophageal myotomy versus pneumatic dilation in the treatment of idiopathic achalasia: a meta-analysis of randomized controlled trials.

Clin Exp Gastroenterol 2017 26;10:241-248. Epub 2017 Sep 26.

Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint, MI, USA.

Background: Achalasia is a primary esophageal motility disorder of unknown etiology associated with abnormalities in peristalsis and lower esophageal sphincter relaxation. The disease is incurable; however, definitive treatment procedures like pneumatic dilation (PD)/balloon dilation and laparoscopic esophageal myotomy (LEM) are performed to relieve dysphagia and related symptoms. Currently, there is paucity of data comparing the outcomes of these procedures. Read More

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September 2017
6 Reads

Spotlight on eluxadoline for the treatment of patients with irritable bowel syndrome with diarrhea.

Clin Exp Gastroenterol 2017 25;10:229-240. Epub 2017 Sep 25.

Gastrointestinal Services, University College London Hospitals, London, UK.

Background: Irritable bowel syndrome with diarrhea (IBS-D) has limited options for treatment currently, including mainly anti-motility medications, antispasmodics, and antidepressants. This review discusses the properties of a new drug, eluxadoline, a gut-targeting mu- and kappa-opioid receptor agonist and a delta-opioid receptor antagonist, and its efficacy and safety in patients with IBS-D.

Materials And Methods: A systematic review of the literature was undertaken to identify studies that had investigated eluxadoline as a treatment in IBS-D. Read More

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September 2017
6 Reads

Risks of PEG tube placement in patients with cirrhosis-associated ascites.

Clin Exp Gastroenterol 2017 1;10:211-214. Epub 2017 Sep 1.

Internal Medicine Department, Texas Tech University Health and Sciences Center, Amarillo, TX, USA.

This study examined the safety of placing percutaneous endoscopic gastrostomy (PEG) tube in people with liver cirrhosis. The target population was further subdivided into people with ascites (case group) and people without ascites (control). We compare the morbidity and the mortality difference of PEG placement in cirrhotic patients with ascites vs cirrhotic patients without ascites. Read More

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September 2017
32 Reads

Quality of care in inflammatory bowel disease: results of a prospective controlled cohort study in Germany (NET).

Clin Exp Gastroenterol 2017 4;10:215-227. Epub 2017 Sep 4.

Gastroenterology Practice Minden, Uferstraße, Minden, Germany.

Background/aims: Patients with inflammatory bowel disease (IBD) need comprehensive, interdisciplinary and cross-sectoral health care. In Germany, evidence-based care pathways have been developed to improve the quality of care of IBD patients. We aimed to evaluate the effects of the implementation of some of these recommendations on patient-related outcomes. Read More

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September 2017
12 Reads

Serum levels of caspase-cleaved cytokeratin 18 (CK18-Asp396) predict severity of liver disease in chronic hepatitis B.

Clin Exp Gastroenterol 2017 11;10:203-209. Epub 2017 Aug 11.

Erasmus MC Cancer Institute, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands.

Background And Aim: Caspase-cleaved cytokeratin 18 (CK18-Asp396) is a potential clinically useful biomarker in liver disease as it is released from hepatocytes during apoptosis. In this study, we investigated serum CK18-Asp396 levels in chronic hepatitis B (CHB).

Patients And Methods: Overall, 163 patients with CHB were included. Read More

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August 2017
10 Reads

Lymphoid follicles in children with -negative gastritis.

Clin Exp Gastroenterol 2017 11;10:195-201. Epub 2017 Aug 11.

Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel.

Purpose: The prevalence of gastritis has been declining, whereas -negative gastritis has become more common. We evaluated chronic gastritis in children with regard to status and celiac disease (CD).

Patients And Methods: Demographic, clinical, endoscopic, and histologic features of children who underwent elective esophagogastroduodenoscopy were reviewed retrospectively. Read More

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August 2017
10 Reads

Esophageal motility after laparoscopic sleeve gastrectomy.

Clin Exp Gastroenterol 2017 20;10:187-194. Epub 2017 Jul 20.

Department of Surgery.

Background: Laparoscopic sleeve gastrectomy (LSG) modifies the upper gastrointestinal tract motility. Controversial data currently exist. The aim of the study was to evaluate esophageal motility before and after LSG. Read More

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July 2017
4 Reads

Children's International Polyposis (CHIP) study: a randomized, double-blind, placebo-controlled study of celecoxib in children with familial adenomatous polyposis.

Clin Exp Gastroenterol 2017 19;10:177-185. Epub 2017 Jul 19.

Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Objective: To evaluate the efficacy and safety of celecoxib versus placebo in the prevention and treatment of colorectal polyposis in children with familial adenomatous polyposis (FAP).

Methods: In this Phase III, double-blind, randomized, placebo-controlled, multicenter trial patients aged 10-17 years with FAP were randomized to celecoxib (16 mg/kg/day) or placebo for up to 5 years. Patients underwent annual assessments, including colonoscopies, to detect the time from randomization to the earliest occurrence of ≥20 polyps (>2 mm in size) or colorectal malignancy. Read More

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July 2017
7 Reads

High prevalence of subclass-specific binding and neutralizing antibodies against toxins in adult cystic fibrosis sera: possible mode of immunoprotection against symptomatic infection.

Clin Exp Gastroenterol 2017 19;10:169-175. Epub 2017 Jul 19.

Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK.

Objectives: Despite multiple risk factors and a high rate of colonization for , the occurrence of infection in patients with cystic fibrosis is rare. The aim of this study was to compare the prevalence of binding toxin-specific immunoglobulin (Ig)A, IgG and anti-toxin neutralizing antibodies in the sera of adults with cystic fibrosis, symptomatic infection (without cystic fibrosis) and healthy controls.

Methods: Subclass-specific IgA and IgG responses to highly purified whole toxins A and B (toxinotype 0, strain VPI 10463, ribotype 087), toxin B from a toxin-B-only expressing strain (CCUG 20309) and precursor form of B fragment of binary toxin, pCDTb, were determined by protein microarray. Read More

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July 2017
9 Reads

Inflammatory bowel disease in Bahrain: single-center experience.

Clin Exp Gastroenterol 2017 14;10:133-145. Epub 2017 Jul 14.

Ibn Al Nafees Hospital, Manama, Bahrain.

Purpose: The number of newly diagnosed inflammatory bowel disease (IBD) cases such as ulcerative colitis (UC), Crohn's disease (CD), and indeterminate colitis (IC) is rapidly increasing in Gulf countries and Saudi Arabia. The aim of this study was to investigate the incidence and prevalence of IBD in patients who have attended the Salmaniya Medical Complex, Bahrain, between the years 1984 and 2014.

Patients And Methods: All patients who had attended the Salmaniya Medical Complex, Bahrain, and had been diagnosed with UC, CD, or IC, between the years 1984 and 2014, were included in the analysis. Read More

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July 2017
7 Reads

Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states.

Clin Exp Gastroenterol 2017 17;10:147-168. Epub 2017 Jul 17.

Research Service, Veterans Affairs Medical Center, Minneapolis, MN, USA.

Protein losing enteropathy (PLE) has been associated with more than 60 different conditions, including nearly all gastrointestinal diseases (Crohn's disease, celiac, Whipple's, intestinal infections, and so on) and a large number of non-gut conditions (cardiac and liver disease, lupus, sarcoidosis, and so on). This review presents the first attempt to quantitatively understand the magnitude of the PLE in relation to the associated pathology for three different disease categories: 1) increased lymphatic pressure (e.g. Read More

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July 2017
12 Reads

Colorectal endoscopic submucosal dissection: patient selection and special considerations.

Clin Exp Gastroenterol 2017 13;10:121-131. Epub 2017 Jul 13.

King's Institute of Therapeutic Endoscopy, King's College Hospital, London, UK.

Endoscopic submucosal dissection (ESD) enables en bloc resection of large complex colorectal superficial neoplastic lesions, resulting in very low rates of local recurrence, high-quality pathologic specimens for accurate histopathologic diagnosis and potentially curative treatment of early adenocarcinoma without resorting to major surgical resection. The safety and efficacy of the technique, which was pioneered in the upper gastrointestinal tract, has been established by the consistently impressive outcomes from expert centers in Japan and some other eastern countries. However, ESD is challenging to perform in the colorectum and there is a significant risk of complications, particularly in the early stages of the learning curve. Read More

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July 2017
4 Reads

Radiofrequency ablation using Barrx for the endoscopic treatment of gastric antral vascular ectasia: a series of three cases and a review of the literature on treatment options.

Clin Exp Gastroenterol 2017 10;10:113-120. Epub 2017 Jul 10.

Department of Gastrointestinal Medicine, Richmond University Medical Center, Staten Island, NY, USA.

Gastric antral vascular ectasia (GAVE), also known as "watermelon stomach", is an uncommon condition, which can cause gastrointestinal bleeding due to rupture of blood vessels that line the stomach. The pathogenesis of GAVE remains unclear; however it is thought that hemodynamic changes, mechanical stress, and autoimmune factors all have a part to play. A range of conditions are also commonly associated with the syndrome, such as portal hypertensive gastropathy, liver cirrhosis, and autoimmune disorders. Read More

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July 2017
11 Reads

Secondary sclerosing cholangitis in critically ill patients: current perspectives.

Clin Exp Gastroenterol 2017 23;10:105-111. Epub 2017 Jun 23.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Landspitali, University Hospital of Iceland.

Secondary sclerosing cholangitis (SSC) is a term used for a group of chronic cholestatic disease affecting the intra- and/or extrahepatic biliary tree with inflammation and progressive stricture formation, which can lead to biliary cirrhosis. A newly recognized form of SSC is secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Pathogenesis is believed to involve ischemic injury of intrahepatic bile ducts associated with prolonged hypotension, vasopressors administration, and/or mechanical ventilation in patients treated in the intensive care unit (ICU). Read More

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June 2017
5 Reads

The ecological community of commensal, symbiotic, and pathogenic gastrointestinal microorganisms - an appraisal.

Clin Exp Gastroenterol 2017 5;10:91-103. Epub 2017 May 5.

Unit of Pharmacology, Faculty of Medicine and Defense Health, National Defense University of Malaysia, Kem Sungai Besi, Kuala Lumpur, Malaysia.

The human gastrointestinal tract is inhabited by a vast population of bacteria, numbering ~100 trillion. These microorganisms have been shown to play a significant role in digestion, metabolism, and the immune system. The aim of this study was to review and discuss how the human body interacts with its gut microbiome and in turn the effects that the microorganisms have on its host, overall resulting in a true mutualistic relationship. Read More

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May 2017
12 Reads

Fatigue in patients with inflammatory bowel disease is associated with distinct differences in immune parameters.

Clin Exp Gastroenterol 2017 2;10:83-90. Epub 2017 May 2.

Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam.

Background: Although it is well recognized that fatigue is an important problem in many of the quiescent inflammatory bowel disease (IBD) patients, it is unknown whether the immune status is different in fatigued versus non-fatigued patients. In this study, we contrasted various characteristics of the immune system in fatigued against non-fatigued patients with IBD in clinical remission.

Patients And Methods: Patients with IBD in clinical remission were phenotyped according to the Montreal classification, and the checklist individual strength-fatigue (CIS-fatigue) was used to assess fatigue (CIS-fatigue ≥ 35). Read More

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May 2017
11 Reads

Intravenous citrulline generation test to assess intestinal function in intensive care unit patients.

Clin Exp Gastroenterol 2017 28;10:75-81. Epub 2017 Apr 28.

Department of Gastroenterology, Small Bowel Disease Unit, VU University Medical Center, Amsterdam.

Background: Assessment of a quantifiable small intestinal function test is cumbersome. Fasting citrulline concentrations have been proposed as a measure of enterocyte function and elaborated into a citrulline generation test (CGT), which is applicable only when glutamine is administered orally. CGT is an oral test, limiting its use, for example, in critically ill patients. Read More

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April 2017
9 Reads

Vedolizumab: toward a personalized therapy paradigm for people with ulcerative colitis.

Clin Exp Gastroenterol 2017 3;10:57-66. Epub 2017 Mar 3.

Department of Gastroenterology, IBD Centre, St. Thomas' Hospital.

Ulcerative colitis (UC) is a chronic relapsing and remitting inflammatory bowel disease, with a characteristic leukocytic infiltration of the mucosa. Immunosuppression including anti-TNF-α therapy is a mainstay of treatment for many; however, systemic immunosuppression is not universally effective and is associated with potential side effects. The gut-tropic integrin α4β7, which is expressed on leukocytes, mediates migration from the circulation to the intestinal mucosa. Read More

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March 2017
4 Reads