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

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    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

    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

    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

    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

    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

    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

    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

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

    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

    Lymphoid follicles in children with Helicobacter pylori-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 Helicobacter pylori gastritis has been declining, whereas H. pylori-negative gastritis has become more common. We evaluated chronic gastritis in children with regard to H. Read More

    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

    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

    High prevalence of subclass-specific binding and neutralizing antibodies against Clostridium difficile toxins in adult cystic fibrosis sera: possible mode of immunoprotection against symptomatic C. difficile 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 Clostridium difficile, the occurrence of C. difficile infection in patients with cystic fibrosis is rare. The aim of this study was to compare the prevalence of binding C. Read More

    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

    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

    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

    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

    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

    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

    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

    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

    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

    Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis.
    Clin Exp Gastroenterol 2017 3;10:67-74. Epub 2017 Apr 3.
    Hurley Medical Center, Michigan State University, Flint, MI, USA.
    The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%-7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Read More

    Bioavailability of a dexlansoprazole delayed-release orally disintegrating tablet: effects of food and mode of administration.
    Clin Exp Gastroenterol 2017 17;10:47-56. Epub 2017 Feb 17.
    Takeda Development Center Americas, Inc., Deerfield, IL, USA.
    Background: Dexlansoprazole is a proton pump inhibitor (PPI) approved for use in dual delayed-release capsule and orally disintegrating tablet (ODT) formulations.

    Aim: To assess effects of food, water, and route of administration on the bioavailability of dexlansoprazole 30-mg ODT.

    Methods: Two separate open-label, phase 1, single-dose crossover studies were conducted in healthy adults. Read More

    Perianal Crohn's disease: challenges and solutions.
    Clin Exp Gastroenterol 2017 8;10:39-46. Epub 2017 Feb 8.
    Department of General Surgery, Division of Gastrointestinal and General Surgery, Oregon Health and Sciences University, Portland, OR, USA.
    Perianal Crohn's disease affects a significant number of patients with Crohn's disease and is associated with poor quality of life. The nature of the disease, compounded by presentation of various disease severities, has made the treatment of perianal Crohn's disease difficult. The field continues to evolve with the use of both historical and contemporary solutions to address the challenges associated with it. Read More

    Bile salt receptor TGR5 is highly expressed in esophageal adenocarcinoma and precancerous lesions with significantly worse overall survival and gender differences.
    Clin Exp Gastroenterol 2017 7;10:29-37. Epub 2017 Feb 7.
    Department of Pathology and Laboratory Medicine.
    Bile acid reflux in the esophagus plays an important role in the carcinogenesis of esophageal adenocarcinoma (EAC). The G-protein coupled bile acid receptor (TGR5) has been associated with the development of gastrointestinal cancer. However, little is known regarding the role of TGR5 in esophageal carcinoma and precancerous lesions. Read More

    Autoimmune atrophic gastritis: current perspectives.
    Clin Exp Gastroenterol 2017 7;10:19-27. Epub 2017 Feb 7.
    Division of Gastroenterology, Hepatology and Parenteral Nutrition.
    At present there is no universally accepted classification for gastritis. The first successful classification (The Sydney System) that is still commonly used by medical professionals was first introduced by Misiewicz et al in Sydney in 1990. In fact, it was the first detailed classification after the discovery of Helicobacter pylori by Warren and Marshall in 1982. Read More

    Autoimmune hepatitis: current challenges and future prospects.
    Clin Exp Gastroenterol 2017 19;10:9-18. Epub 2017 Jan 19.
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University Katsushika Medical Center, Katsushika-ku, Tokyo, Japan.
    Autoimmune hepatitis (AIH) is a chronic progressive liver disease characterized by high levels of aminotransferases and autoantibodies, hypergammaglobulinemia, and interface hepatitis. AIH affects all races and all ages worldwide, regardless of sex, although a preponderance of females is a constant finding. The etiology of AIH has not been completely elucidated, but immunogenetic background and environmental parameters may contribute to its development. Read More

    Correlation between obesity and metabolic syndrome-related factors and cecal intubation time during colonoscopy.
    Clin Exp Gastroenterol 2017 5;10:1-7. Epub 2017 Jan 5.
    Department of Gastroenterology and Hepatology.
    Purpose: To investigate which colonoscopy (CS) cases should be presided over by endoscopists in training, using factors including obesity and metabolic syndrome.

    Patients And Methods: Items investigated were sex, age, body mass index (BMI), waist circumference, hypertension, diabetes, hyperlipidemia, history of abdominal surgery (excluding colectomy), colon diverticulosis, prescription of antithrombotic agents, and quality of bowel preparation. Expert physicians were defined as those with at least 9 years of endoscopy experience; all other physicians were defined as being in training. Read More

    Absorption and safety of serum-derived bovine immunoglobulin/protein isolate in healthy adults.
    Clin Exp Gastroenterol 2016 5;9:365-375. Epub 2016 Dec 5.
    Clinical Development, Entera Health, Inc.
    Purpose: Previous studies have shown that oral administration of bovine immunoglobulin protein preparations is safe and provides nutritional and intestinal health benefits. The purpose of this study was to evaluate the plasma amino acid response following a single dose of serum-derived bovine immunoglobulin/protein isolate (SBI) and whether bovine immunoglobulin G (IgG) is present in stool or in blood following multiple doses of SBI in healthy volunteers.

    Methods: A total of 42 healthy adults were administered a single dose of placebo or SBI at one of three doses (5 g, 10 g, or 20 g) in blinded fashion and then continued on SBI (2. Read More

    HCVerso1 and 2: faldaprevir with deleobuvir (BI 207127) and ribavirin for treatment-naïve patients with chronic hepatitis C virus genotype-1b infection.
    Clin Exp Gastroenterol 2016 24;9:351-363. Epub 2016 Nov 24.
    Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA.
    The interferon-free combination of once-daily faldaprevir 120 mg, twice-daily deleobuvir 600 mg, and weight-based ribavirin was evaluated in two Phase III studies (HCVerso1, HCVerso2) in hepatitis C virus genotype-1b-infected, treatment-naïve patients, including those ineligible for peginterferon (HCVerso2). Patients without cirrhosis were randomized to 16 weeks (Arm 1; n=208 HCVerso1, n=213 HCVerso2) or 24 weeks (Arm 2; n=211 in both studies) of faldaprevir + deleobuvir + ribavirin. Patients with compensated cirrhosis received open-label faldaprevir + deleobuvir + ribavirin for 24 weeks (Arm 3; n=51, n=72). Read More

    Necrotizing pancreatitis: challenges and solutions.
    Clin Exp Gastroenterol 2016 31;9:345-350. Epub 2016 Oct 31.
    Department of Surgery, Duke University, Durham, NC, USA.
    Acute pancreatitis is a common disease that can progress to gland necrosis, which imposes significant risk of morbidity and mortality. In general, the treatment for pancreatitis is a supportive therapy. However, there are several reasons to escalate to surgery or another intervention. Read More

    Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding.
    Clin Exp Gastroenterol 2016 31;9:337-343. Epub 2016 Oct 31.
    Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran.
    Background: Various risk scoring systems have been recently developed to predict clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). The two commonly used scoring systems include full Rockall score (RS) and the Glasgow-Blatchford score (GBS). Bleeding scores were assessed in terms of prediction of clinical outcomes in patients with UGIB. Read More

    Managing inflammatory bowel disease in pregnancy: current perspectives.
    Clin Exp Gastroenterol 2016 14;9:325-335. Epub 2016 Oct 14.
    Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust; University of Leeds, Leeds, UK.
    Inflammatory bowel disease (IBD) affects many women of childbearing age. The course of IBD is closely related to pregnancy outcomes with poorly controlled IBD increasing the risk of prematurity, low weight for gestation, and fetal loss. As such, women with IBD face complex decision making weighing the risks of active disease versus those of medical treatments. Read More

    Systematic review: treatment pattern and clinical effectiveness and safety of pharmaceutical therapies for Crohn's disease in Europe.
    Clin Exp Gastroenterol 2016 5;9:311-323. Epub 2016 Oct 5.
    Pharmerit International, Rotterdam, the Netherlands.
    Background: Although many clinical trials have been conducted in treatments of Crohn's disease (CD), whether the trial results were representative of daily practice needs to be supported by studies conducted in real-world settings.

    Aim: This study aims to identify how CD is treated and what are the clinical effectiveness and safety of the pharmaceutical therapies of CD in real-world settings.

    Methods: A systematic literature review was conducted based on Medline(®), Embase(®), and Cochrane. Read More

    Cigarette smoking adversely affects disease activity and disease-specific quality of life in patients with Crohn's disease at a tertiary referral center.
    Clin Exp Gastroenterol 2016 22;9:307-310. Epub 2016 Sep 22.
    Division of Gastroenterology and Hepatology.
    Purpose: Smoking has a negative impact on disease activity in Crohn's disease (CD). Smoking may also affect the quality of life, but this has not been evaluated using validated measures over time. We assessed the relationship between smoking and disease-specific quality of life over time in a tertiary referral inflammatory bowel disease cohort. Read More

    Splenosis involving the gastric fundus, a rare cause of massive upper gastrointestinal bleeding: a case report and review of the literature.
    Clin Exp Gastroenterol 2016 22;9:301-305. Epub 2016 Sep 22.
    Department of Medicine.
    Splenosis, the autotransplantation of splenic tissue following splenic trauma, is uncommonly clinically significant. Splenosis is typically diagnosed incidentally on imaging or at laparotomy and has been mistakenly attributed to various malignancies and pathological conditions. On the rare occasion when splenosis plays a causative role in a pathological condition, a diagnostic challenge may ensue that can lead to a delay in both diagnosis and treatment. Read More

    Ineffective esophageal motility and the vagus: current challenges and future prospects.
    Clin Exp Gastroenterol 2016 20;9:291-299. Epub 2016 Sep 20.
    Department of Gastroenterology, Renmin Hospital, Wuhan University, Wuhan, People's Republic of China; Division of Gastroenterology, Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.
    Ineffective esophageal motility (IEM) is characterized by low to very low amplitude propulsive contractions in the distal esophagus, hence primarily affecting the smooth muscle part of the esophagus. IEM is often found in patients with dysphagia or heartburn and is commonly associated with gastroesophageal reflux disease. IEM is assumed to be associated with ineffective bolus transport; however, this can be verified using impedance measurements or evaluation of a barium coated marshmallow swallow. Read More

    Managing eosinophilic esophagitis: challenges and solutions.
    Clin Exp Gastroenterol 2016 16;9:281-290. Epub 2016 Sep 16.
    Department of Medicine, Gastroenterology Service, Walter Reed National Military Medical Center, Bethesda, MD, USA.
    Eosinophilic esophagitis (EoE) is a chronic and progressive immune-mediated condition defined by symptoms of esophageal dysfunction and dense eosinophilic infiltration of the esophageal mucosa. Therapies consist of anti-eosinophilic medications and specialized diets aimed to decrease the progression of EoE and alleviate its symptoms, namely, dysphagia and food impaction. Assessing response to therapy remains challenging, as treatment end points are not well defined and currently consist of clinical, histologic, and endoscopic features. Read More

    Influence of Saccharomyces boulardii CNCM I-745on the gut-associated immune system.
    Clin Exp Gastroenterol 2016 13;9:269-279. Epub 2016 Sep 13.
    Department of Clinical Nutrition, University of Hohenheim, Stuttgart, Germany.
    Background: The probiotic Saccharomyces boulardii CNCM I-745 (also known as Saccharomyces cerevisiae HANSEN CBS 5926; in the following S. boulardii) has proven its effectiveness in preventive and therapeutic treatment of many gastrointestinal diseases, especially diseases associated with acute diarrhea. In particular, antibiotic-associated diarrhea, Clostridium difficile-associated diarrhea, traveller's diarrhea, as well as acute diarrhea due to common viral and bacterial infections in children and adults. Read More

    Self-management in patients with inflammatory bowel disease: strategies, outcomes, and integration into clinical care.
    Clin Exp Gastroenterol 2016 23;9:259-67. Epub 2016 Aug 23.
    Department of Gastroenterology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
    Self-management, including medication adherence, is associated with improved health and outcomes for patients with inflammatory bowel disease. The concept of self-management is complex, but can be divided into those aspects that involve the individual patient, those that involve the provider-patient relationship, and those that encompass the social environment. At the individual level, enhancing problem-solving skills and self-efficacy have both been shown to improve self-management tasks, particularly adherence to treatment. Read More

    Acute left-sided colonic diverticulitis: clinical expressions, therapeutic insights, and role of computed tomography.
    Clin Exp Gastroenterol 2016 18;9:249-57. Epub 2016 Aug 18.
    Department of Surgery, Clinique Générale Beaulieu, Geneva, Switzerland.
    The diagnostic approach of patients with suspected acute diverticulitis remains debated. On the one hand, a scoring system with the best predictive value in diagnosing acute diverticulitis has been developed in order to reduce the use of computed tomography (CT) scan, while, on the other hand, patients with a high probability of acute diverticulitis should benefit from CT scan from a clinical viewpoint, ensuring that they will receive the most appropriate treatment. The place and classification of CT scan for acute diverticulitis need to be reassessed. Read More

    Hereditary pancreatitis: current perspectives.
    Clin Exp Gastroenterol 2016 26;9:197-207. Epub 2016 Jul 26.
    Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
    Hereditary pancreatitis (HP) is a rare cause of acute, recurrent acute, and chronic pancreatitis. It may present similarly to other causes of acute and chronic pancreatitis, and often there has been a protracted evaluation prior to the diagnosis of HP. Since it was first described in 1952, multiple genetic defects that affect the action of digestive enzymes in the pancreas have been implicated. Read More

    Translational and clinical perspectives on sphincter of Oddi dysfunction.
    Clin Exp Gastroenterol 2016 28;9:191-5. Epub 2016 Jul 28.
    Division of Gastroenterology and Hepatology, University of Alabama.
    Sphincter of Oddi dysfunction is a complex pathophysiologic entity that is associated with significant morbidity causing abdominal pain, nausea, and vomiting. The purpose of this review is to describe the anatomy and physiology of the sphincter of Oddi, to understand the pathologic mechanisms thought to be responsible for symptomatology, review recent major studies, explore endoscopic and pharmacologic therapies and their efficacy, and to explore future research avenues. Read More

    Optimal delivery of follow-up care after surgery for Crohn's disease: current perspectives.
    Clin Exp Gastroenterol 2016 8;9:237-48. Epub 2016 Aug 8.
    Department of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, USA.
    Despite improvements in medical therapies for Crohn's disease (CD), up to 70% of patients require surgery within 10 years of diagnosis. Surgery is not curative, and almost all patients will experience endoscopic recurrence, and many will go on to clinical recurrence. Identifying patients at high-risk of endoscopic recurrence and standardizing postoperative assessments are essential in preventing clinical recurrence of CD. Read More

    Improving outcomes of refractory celiac disease - current and emerging treatment strategies.
    Clin Exp Gastroenterol 2016 3;9:225-36. Epub 2016 Aug 3.
    Department of Gastroenterology and Clinical Nutrition, Addenbrooke's Hospital, Cambridge, UK.
    Intestinal inflammation and symptoms of celiac disease (CD) usually respond well to gluten withdrawal, but rare cases are refractory to diet. Two types of refractory CD are discriminated on the basis of the presence or absence of an atypical population of mucosal lymphocytes that may progress to enteropathy-associated T-cell lymphoma. Challenges remain in the secure diagnosis of both types of refractory disease, and evidence on which to base treatment recommendations is flawed by the small numbers of reported patients and the use of different diagnostic strategies. Read More

    An update on antibody-based immunotherapies for Clostridium difficile infection.
    Clin Exp Gastroenterol 2016 1;9:209-24. Epub 2016 Aug 1.
    Human Health Therapeutics Portfolio, National Research Council Canada, Ottawa; School of Environmental Sciences, University of Guelph, Guelph; Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada.
    Clostridium difficile continues to be one of the most prevalent hospital-acquired bacterial infections in the developed world, despite the recent introduction of a novel and effective antibiotic agent (fidaxomicin). Alternative approaches under investigation to combat the anaerobic Gram-positive bacteria include fecal transplantation therapy, vaccines, and antibody-based immunotherapies. In this review, we catalog the recent advances in antibody-based approaches under development and in the clinic for the treatment of C. Read More

    How do patients' clinical phenotype and the physiological mechanisms of the operations impact the choice of bariatric procedure?
    Clin Exp Gastroenterol 2016 22;9:181-9. Epub 2016 Jul 22.
    Division of Visceral and Transplantation Surgery, University Hospital Zurich (USZ), Zürich, Switzerland.
    Bariatric surgery is currently the most effective option for the treatment of morbid obesity and its associated comorbidities. Recent clinical and experimental findings have challenged the role of mechanical restriction and caloric malabsorption as the main mechanisms for weight loss and health benefits. Instead, other mechanisms including increased levels of satiety gut hormones, altered gut microbiota, changes in bile acid metabolism, and/or energy expenditure have been proposed as explanations for benefits of bariatric surgery. Read More

    Safety of polyethylene glycol 3350 solution in chronic constipation: randomized, placebo-controlled trial.
    Clin Exp Gastroenterol 2016 15;9:173-80. Epub 2016 Jul 15.
    Global Medical Affairs, Merck & Co., Inc., Kenilworth, NJ, USA.
    Purpose: To evaluate the safety and tolerability of aqueous solution concentrate (ASC) of polyethylene glycol (PEG) 3350 in patients with functional constipation.

    Patients And Methods: The patients who met Rome III diagnostic criteria for functional constipation were randomized in this multicenter, randomized, placebo-controlled, single-blind study to receive once daily dose of PEG 3350 (17 g) ASC or placebo solution for 14 days. The study comprised a screening period (visit 1), endoscopy procedure (visits 2 and 3), and followup telephone calls 30 days post-treatment. Read More

    Proton pump inhibitors for the treatment of patients with erosive esophagitis and gastroesophageal reflux disease: current evidence and safety of dexlansoprazole.
    Clin Exp Gastroenterol 2016 13;9:163-72. Epub 2016 Jul 13.
    Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
    Gastroesophageal reflux disease is the most common upper gastroenterology disorder in the US. It is associated with a variety of complications and significantly impacts quality of life. Proton pump inhibitors are the most effective treatment. Read More

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