1,447 results match your criteria Current Gastroenterology Reports[Journal]


The Art of Selective Cannulation at ERCP.

Curr Gastroenterol Rep 2019 Feb 11;21(2). Epub 2019 Feb 11.

School of Medicine, Banner University Medical Center, University of Arizona, Tucson, AZ, USA.

Purpose Of Review: ERCP is undergoing its 50th anniversary with a steady conversion from a diagnostic procedure to a therapeutic procedure. This paper shows a reflection of my 42 years of experience in the accession of biliary and pancreatic ducts and how the techniques have evolved to achieve a high rate of primary duct cannulation.

Recent Findings: There has been an increase in the primary approach to cannulation involving different cannulation catheters and guidewires, and we will review some of those available, realizing that the selection may vary depending on operator preference and team approach. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-019-0673-xDOI Listing
February 2019

The Role of EUS in Liver Biopsy.

Curr Gastroenterol Rep 2019 Jan 31;21(2). Epub 2019 Jan 31.

Department of Gastroenterology and Nutrition, Geisinger Medical Center, 100 N. Academy Ave, 21-11, Danville, PA, 17822, USA.

Purpose Of Review: EUS-guided liver biopsy (EUS-LB) is being used with increased frequency to perform parenchymal liver biopsy. Evolution of the technique can now achieve excellent liver tissue cores. This review covers important developments in this procedure. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11894-019-0675-8
Publisher Site
http://dx.doi.org/10.1007/s11894-019-0675-8DOI Listing
January 2019
3 Reads

Back to the Colorectal Cancer Consensus Molecular Subtype Future.

Curr Gastroenterol Rep 2019 Jan 30;21(2). Epub 2019 Jan 30.

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard--Unit 0426, Houston, TX, 77030, USA.

Purpose Of Review: This review seeks to provide an informed prospective on the advances in molecular profiling and analysis of colorectal cancer (CRC). The goal is to provide a historical context and current summary on how advances in gene and protein sequencing technology along with computer capabilities led to our current bioinformatic advances in the field.

Recent Findings: An explosion of knowledge has occurred regarding genetic, epigenetic, and biochemical alterations associated with the evolution of colorectal cancer. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-019-0674-9DOI Listing
January 2019

The Microbiome-Host Interaction as a Potential Driver of Anastomotic Leak.

Curr Gastroenterol Rep 2019 Jan 26;21(1). Epub 2019 Jan 26.

Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Purpose Of Review: The goal of this paper is to review current literature on the gut microbiome within the context of host response to surgery and subsequent risk of developing complications, particularly anastomotic leak. We provide background on the relationship between host and gut microbiota with description of the role of the intestinal mucus layer as an important regulator of host health.

Recent Findings: Despite improvements in surgical technique and adherence to the tenets of creating a tension-free anastomosis with adequate blood flow, the surgical community has been unable to decrease rates of anastomotic leak using the current paradigm. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-019-0668-7DOI Listing
January 2019

The Spectrum of Small Intestinal Bacterial Overgrowth (SIBO).

Curr Gastroenterol Rep 2019 Jan 15;21(1). Epub 2019 Jan 15.

Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital, Weill Cornell Medical College, Houston, TX, USA.

Purpose Of Review: To critically review recent (past 3 years) literature on the definition, diagnosis, and management of small intestinal bacterial overgrowth (SIBO).

Recent Findings: While various series continue to illustrate the occurrence of SIBO in disease states where well-known risk factors for its occurrence are present (hypochlorhydria, disorders of intestinal structure or motor function, pancreatic insufficiency, and chronic liver disease, for example), the current challenge is in defining the limits of SIBO. Is SIBO truly common among those with "functional" gastrointestinal symptoms where there is no evidence of maldigestion or malabsorption; the original hallmarks of SIBO? Our attempts to address this question continue to be hampered by the limitations of our diagnostic tool kit. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-019-0671-zDOI Listing
January 2019
7 Reads

Managing Risks with Biologics.

Curr Gastroenterol Rep 2019 Jan 11;21(2). Epub 2019 Jan 11.

Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, OH, USA.

Purpose Of Review: With a rapidly evolving complement of advanced targeted therapies in inflammatory bowel disease, additional safety and side effect concerns emerge. It is the purpose of this review to consider various risks with biologic therapies in inflammatory bowel disease and discuss mitigating strategies.

Recent Findings: Two recently approved monoclonal antibodies (vedolizumab and ustekinumab) and a Janus kinase inhibitor small molecule (tofacitnib) have introduced a number of novel safety and risk considerations. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11894-019-0669-6
Publisher Site
http://dx.doi.org/10.1007/s11894-019-0669-6DOI Listing
January 2019
14 Reads

Cannabis and Turmeric as Complementary Treatments for IBD and Other Digestive Diseases.

Curr Gastroenterol Rep 2019 Jan 11;21(2). Epub 2019 Jan 11.

Department of Medicine, Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.

Purpose Of Review: Complementary therapies for inflammatory bowel disease (IBD) have earned growing interest from patients and investigators alike, with a dynamic landscape of research in this area. In this article, we review results of the most recent studies evaluating the role of cannabis and turmeric for the treatment of IBD and other intestinal illnesses.

Recent Findings: Cannabinoids are well-established modulators of gut motility and visceral pain and have demonstrated anti-inflammatory properties. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11894-019-0670-0
Publisher Site
http://dx.doi.org/10.1007/s11894-019-0670-0DOI Listing
January 2019
13 Reads

A Brief Update on the Management of Hepatitis Delta.

Curr Gastroenterol Rep 2018 Dec 14;20(12):60. Epub 2018 Dec 14.

Loyola University Medical Center, 2160 S First Ave., Maywood, IL, 60153, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0666-1DOI Listing
December 2018
1 Read

Dietary Fiber and Gastrointestinal Disease: an Evolving Story.

Curr Gastroenterol Rep 2018 Nov 8;20(12):59. Epub 2018 Nov 8.

Department of Medicine and APC Microbiome Ireland, University College Cork, National University of Ireland, Cork, Ireland.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0667-0DOI Listing
November 2018
1 Read

Update on the Diagnosis and Management of Wilson Disease.

Authors:
Eve A Roberts

Curr Gastroenterol Rep 2018 Nov 5;20(12):56. Epub 2018 Nov 5.

Paediatrics, Medicine, and Pharmacology & Toxicology, University of Toronto, Toronto, Canada.

Purpose Of Review: Exciting developments relating to Wilson disease (WD) have taken place with respect to both basic biological and clinical research. This review critically examines some of these findings and considers their implications for current thinking about WD. It is not a comprehensive review of WD as a clinical disorder. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0660-7DOI Listing
November 2018
1 Read

New Metrics in High-Resolution and High-Definition Anorectal Manometry.

Curr Gastroenterol Rep 2018 Nov 5;20(12):57. Epub 2018 Nov 5.

Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.

Purpose Of Review: To review recently published diagnostic methods that use high-resolution (HR-) or high-definition- (HD-) anorectal manometry (ARM) techniques.

Recent Findings: The integrated pressurized volume (IPV) is a new measure based on spatiotemporal plots obtained from HR-ARM. The IPV may be clinically useful for improving the prediction of abnormal balloon expulsion test in patients with constipation and for discriminating patients with anorectal disorders from asymptomatic controls. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11894-018-0662-5
Publisher Site
http://dx.doi.org/10.1007/s11894-018-0662-5DOI Listing
November 2018
20 Reads

Psychotropics, Antidepressants, and Visceral Analgesics in Functional Gastrointestinal Disorders.

Curr Gastroenterol Rep 2018 Nov 5;20(12):58. Epub 2018 Nov 5.

Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina, Chapel Hill, NC, USA.

Purpose Of Review: The functional gastrointestinal disorders, or disorders of gut-brain interaction as defined by the Rome IV criteria, are the most common diagnostic entities in gastroenterology. Treatments that address the dysregulation of gut-brain interaction with these disorders are increasingly gaining interest as a better option than for example traditional analgesics, particularly opioids. Antidepressants, antianxiety and antipsychotic medications, and visceral analgesics, now termed neuromodulators, are included in this update addressing the evidence of treatment benefit in disorders of brain-gut interaction. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0664-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6223713PMC
November 2018
11 Reads

New Approaches to Diagnosis and Treatment of Functional Dyspepsia.

Curr Gastroenterol Rep 2018 Oct 18;20(12):55. Epub 2018 Oct 18.

Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.

Purpose Of Review: The purpose of this article is to review the recent literature and discuss the new approaches to the diagnosis and treatment of functional dyspepsia (FD).

Recent Findings: According to the recent American College of Gastroenterology (ACG) and Canadian Association of Gastroenterology (CAG) guideline for dyspepsia, Helicobacter pylori (H. pylori) eradication is recommended as a first treatment option, and proton pump inhibitors (PPIs), tricyclic antidepressants, and prokinetics are listed as second-line therapy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0663-4DOI Listing
October 2018
6 Reads

Advanced Imaging for Barrett's Esophagus and Early Neoplasia: Surface and Subsurface Imaging for Diagnosis and Management.

Curr Gastroenterol Rep 2018 Oct 9;20(12):54. Epub 2018 Oct 9.

VA Boston Healthcare, Harvard Medical School, 1400 VFW Parkway, West Roxbury, MA, 02132, USA.

Purpose Of Review: Esophageal adenocarcinoma bears one of the fastest rising incidence of any cancers and generally arises in the setting of gastroesophageal reflux and Barrett's esophagus. However, early detection of neoplasia can be challenging since most patients are asymptomatic until they progress to more advanced and less curable stages, and early dysplastic lesions can be small, multifocal, and difficult to detect. Clearly, new imaging tools are needed in light of sampling error associated with random biopsies, the current standard of practice. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0661-6DOI Listing
October 2018
14 Reads

Update on the Use of Thiopurines and Methotrexate in Inflammatory Bowel Disease.

Curr Gastroenterol Rep 2018 Sep 28;20(11):53. Epub 2018 Sep 28.

Baylor University Medical Center, Baylor Scott and White Health, 3409 Worth St #640, Dallas, TX, 75246, USA.

Purpose Of Review: The increased use of biologic agents over the past two decades has led to a reappraisal of the role of the immunomodulators (thiopurines and methotrexate) in the treatment of inflammatory bowel disease. The purpose of this review is to summarize recent data on the use of thiopurines and methotrexate either as monotherapy or as part of combination therapy with biologic agents.

Recent Findings: Recent studies have addressed the need for concomitant immunomodulatory therapy in treatment-naïve patients starting anti-TNF-α therapy, the appropriate dose of the immunomodulator in this setting, the minimum duration of combination therapy, and the possible mechanisms by which immunomodulators enhance the effectiveness of anti-TNF-α agents. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11894-018-0658-1
Publisher Site
http://dx.doi.org/10.1007/s11894-018-0658-1DOI Listing
September 2018
12 Reads

Cellular Origins of Barrett's Esophagus: the Search Continues.

Curr Gastroenterol Rep 2018 Sep 26;20(11):51. Epub 2018 Sep 26.

Division of Hematology and Oncology, Esophageal Diseases Center, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8584, USA.

Purpose Of Review: The cellular origins of Barrett's esophagus remain elusive. In this review, we discuss the potential cellular mechanisms behind squamous to columnar metaplasia as well as the limitations of these proposed mechanisms.

Recent Findings: Several theories have been proposed, including the reprogramming of native squamous cells, repopulation from submucosal glands, contributions from circulating bone marrow-derived cells, and direct extension of gastric cells. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0657-2DOI Listing
September 2018
17 Reads

Wireless 24, 48, and 96 Hour or Impedance or Oropharyngeal Prolonged pH Monitoring: Which Test, When, and Why for GERD?

Curr Gastroenterol Rep 2018 Sep 26;20(11):52. Epub 2018 Sep 26.

The Joy McCann Culverhouse Center for Esophageal Diseases, Division of Digestive Diseases and Nutrition, University of South Florida, Morsani College of Medicine, 12901 Bruce B. Downs Blvd., MDC 72, Tampa, FL, 3361, USA.

Purpose Of Review: pH monitoring technologies are routinely utilized in practice to further evaluate symptoms of gastro-esophageal reflux disease and laryngopharyngeal reflux (LPR). This is a review of the recent literature of the available pH monitoring technology and creates an algorithm in the diagnostic work up of a patient with GERD or LPR.

Recent Findings: The catheter-free wireless pH monitor traditionally collects data for 48 h. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0659-0DOI Listing
September 2018
2 Reads

Should Sarcopenia Increase Priority for Transplant or Is It a Contraindication?

Curr Gastroenterol Rep 2018 Sep 26;20(11):50. Epub 2018 Sep 26.

Division of Gastroenterology & Liver Unit, Zeidler Ledcor Centre, University of Alberta Hospital, 8540 112 Street NW, Edmonton, T6G 2X8, Canada.

Purpose Of Review: The purpose of this review is to discuss the current evidence regarding the impact of sarcopenia on patients with cirrhosis awaiting liver transplantation and to determine if its presence should be considered a criterion for expedited transplantation or a contraindication for transplantation.

Recent Findings: Sarcopenia is a negative predictor of survival in patients on a waiting list and after liver transplant. The gut-liver axis and the liver-muscle axis have been explored to understand the complex pathophysiology of sarcopenia. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11894-018-0656-3
Publisher Site
http://dx.doi.org/10.1007/s11894-018-0656-3DOI Listing
September 2018
6 Reads

Treatment of NASH with Gastric Bypass.

Curr Gastroenterol Rep 2018 Sep 22;20(10):49. Epub 2018 Sep 22.

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.

Purpose Of Review: Nonalcoholic steatohepatitis (NASH) is a spectrum of nonalcoholic fatty liver disease (NAFLD). It is defined as the presence of fatty liver along with inflammation and hepatocyte injury. To date, weight loss achieved via lifestyle intervention remains the mainstay of NASH treatment. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0653-6DOI Listing
September 2018
2 Reads

Pediatric Endoscopic Procedure Complications.

Curr Gastroenterol Rep 2018 Sep 1;20(10):48. Epub 2018 Sep 1.

Sheffield Children's Hospital, Western Bank, Sheffield, S10 2TH, UK.

Purpose Of Review: This review summarizes the current body of research, define high-risk patients and endoscopic processes, and outline evidence-based countermeasures aimed at minimizing the incidence of complications during endoscopy in children.

Recent Findings: Significant complications of endoscopy requiring emergency department or inpatient admission in otherwise healthy children are unusual, but more common with therapeutic procedures; risk from procedures increases incrementally with preoperative coexisting conditions. Duodenal hematoma is predominantly a pediatric endoscopic complication and is more likely in hematology-oncology patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0646-5DOI Listing
September 2018
1 Read

Imaging of Hepatic Fibrosis.

Curr Gastroenterol Rep 2018 Aug 29;20(10):45. Epub 2018 Aug 29.

Department of Radiology, Mayo Clinic, Mayo Clinic College of Medicine, 200, First Street SW, Rochester, MN, 55905, USA.

Purpose Of Review: The purpose of this review is to discuss the current imaging techniques for non-invasive assessment of liver fibrosis (LF).

Recent Findings: Elastography-based techniques are the most widely used imaging methods for the evaluation of LF. Currently, MR elastography (MRE) is the most accurate non-invasive method for detection and staging of LF. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0652-7DOI Listing
August 2018
10 Reads

Bowel Dysfunction in Spinal Cord Injury.

Curr Gastroenterol Rep 2018 Aug 29;20(10):47. Epub 2018 Aug 29.

Neurogastroenterology Unit and Department of Gastroenterology, Royal North Shore Hospital, Reserve Road, St Leonards, NSW, 2065, Australia.

Purpose Of Review: To evaluate and report current evidence regarding the management of bowel dysfunction in spinal cord injury. There is a paucity of high-quality large studies on which to base management advice.

Recent Findings: Recent research has focused on defining the nature of symptomatology of bowel dysfunction in SCI and describing the effects on quality of life and social interactions. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0655-4DOI Listing
August 2018
3 Reads

Cyclic Vomiting Syndrome in Children and Adults: What Is New in 2018?

Curr Gastroenterol Rep 2018 Aug 29;20(10):46. Epub 2018 Aug 29.

Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI, USA.

Purpose Of Review: Cyclic vomiting syndrome (CVS) is a disabling functional gastrointestinal disorder characterized by severe vomiting episodes that alternate with symptom-free periods. The purpose of this review is to summarize current knowledge and highlight most recent data on prevalence, diagnosis, management, and impact of CVS in children and adults.

Recent Findings: Originally thought to be a pediatric disorder, the past decade has witnessed a considerable increase in CVS diagnosed in adults. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11894-018-0654-5
Publisher Site
http://dx.doi.org/10.1007/s11894-018-0654-5DOI Listing
August 2018
9 Reads

Post-Transplant Disease Recurrence in Pediatric PSC.

Curr Gastroenterol Rep 2018 Aug 6;20(9):44. Epub 2018 Aug 6.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Utah, Salt Lake City, UT, 84113, USA.

Purpose Of Review: Review the current knowledge about recurrent primary sclerosing cholangitis (rPSC) after transplant in children.

Recent Findings: Recurrent PSC is a significant complication that afflicts 16% of children after liver transplantation for primary sclerosing cholangitis (PSC) at a median onset of 38 months post-transplant. Possible risk factors include younger age at PSC diagnosis or transplant, the presence of overlap syndrome or IBD, and post-transplant induction with thymoglobulin. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0649-2DOI Listing
August 2018
3 Reads

The Relevance of Spastic Esophageal Disorders as a Diagnostic Category.

Curr Gastroenterol Rep 2018 Aug 6;20(9):42. Epub 2018 Aug 6.

Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Purpose Of Review: This review addresses the similarities and differences between the spastic esophageal disorders, including jackhammer esophagus, distal esophageal spasm (DES), and type III (spastic) achalasia. The pathophysiology, diagnosis, and treatment of each separate disorder are discussed herein, with an emphasis on overlapping and discordant features.

Recent Findings: The Chicago Classification is a hierarchical organizational scheme for esophageal motility disorders, currently in its third iteration, with direct impact on the definitions of these three disorders. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0650-9DOI Listing
August 2018
20 Reads

Small Bowel Lesions Mimicking Crohn's Disease.

Authors:
David B Sachar

Curr Gastroenterol Rep 2018 Aug 6;20(9):43. Epub 2018 Aug 6.

Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Purpose Of Review: Not all injuries of the terminal ileum are Crohn's disease. It is the purpose of this review to consider the differential diagnosis of other acute and chronic ileal lesions.

Recent Findings: The recognition of a granulomatous disease of the terminal ileum, distinct from tuberculosis, dates back over 85 years and perhaps much farther, but over the past decades, many other clinical pathologic entities have been described that are neither tuberculosis nor Crohn's eponymous regional enteritis. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0651-8DOI Listing
August 2018
2 Reads

Can Specialized Pro-resolving Mediators Deliver Benefit Originally Expected from Fish Oil?

Curr Gastroenterol Rep 2018 Aug 4;20(9):40. Epub 2018 Aug 4.

Department of Surgery, Division of Vascular Surgery, University of Florida College of Medicine, Gainesville, FL, USA.

Purpose Of The Review: Fish oil (FO) supplementation has historically been used by individuals suffering from cardiovascular disease and other inflammatory processes. However, a meta-analysis of several large randomized control trials (RCTs) suggested FO conferred no benefit in reducing cardiovascular risk. Skeptics surmised that the lack of benefit was related to FO dose or drug interactions; therefore, the widely accepted practice of FO consumption was brought into question. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0647-4DOI Listing
August 2018
3 Reads

Evolution of Clinical Trials in Inflammatory Bowel Diseases.

Authors:
Siddharth Singh

Curr Gastroenterol Rep 2018 Aug 4;20(9):41. Epub 2018 Aug 4.

Division of Gastroenterology, University of California San Diego, 9452 Medical Center Drive, ACTRI 1W 501, La Jolla, CA, 92093, USA.

Purpose Of Review: Since the first clinical trial of cortisone in ulcerative colitis in 1955, remarkable progress has been made in the design and conduct of clinical trials in inflammatory bowel diseases (IBD). In this review article, we will discuss evolution of clinical trials in IBD over the last 3-5 years.

Recent Findings: Recognizing limitations intrinsic to clinical disease activity indices in IBD, regulatory authorities have recommended evaluating co-primary endpoints of patient-reported outcomes and endoscopic disease activity in clinical trials. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0648-3DOI Listing
August 2018
2 Reads

The Esophageal Microbiome in Health and Disease.

Curr Gastroenterol Rep 2018 Aug 1;20(8):39. Epub 2018 Aug 1.

Division of Gastroenterology and Hepatology, University of Virginia Health System, 1300 Jefferson Park Avenue Multi Story Building Room 2091, Charlottesville, VA, 22908, USA.

Purpose Of Review: Investigation of the esophageal microbiome is a relatively new field. This review will outline data characterizing the esophageal microbiome in both health and disease states, including gastroesophageal reflux disease (GERD), Barrett's esophagus, esophageal cancer, eosinophilic esophagitis, and motility disorders.

Recent Findings: While the esophagus was previously considered devoid of a significant bacterial population, development of culture-independent techniques, specifically 16S rRNA gene sequencing, as well as novel, minimally invasive microbial sampling modalities, has facilitated characterization of the esophageal microbiome in both health and several disease states. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0642-9DOI Listing
August 2018
2 Reads

The Diagnostic and Therapeutic Challenge of Anal Intraepithelial Neoplasia.

Curr Gastroenterol Rep 2018 Jul 5;20(8):38. Epub 2018 Jul 5.

Department of Surgery, Division of Colon and Rectal Surgery, University of South Alabama, 2451 USA Medical Center Drive, Mastin Building, Suite 702, Mobile, AL, 36617, USA.

Purpose Of Review: No single modality of care serves as the defined best practice for the treatment of anal intraepithelial neoplasia (AIN). This review aims to present the common treatment modalities germane to AIN while considering evolving evidence.

Recent Findings: AIN affords an opportunity to evaluate and treat patients before the development of invasive diseases. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0640-yDOI Listing
July 2018
4 Reads

Diagnosis, Natural History and Treatment of Eosinophilic Enteritis: a Review.

Curr Gastroenterol Rep 2018 Jul 2;20(8):37. Epub 2018 Jul 2.

Gastroenterology Department, Saint-Eloi Hospital, Montpellier University Hospital, Montpellier, France.

Purpose Of Review: To review recent findings regarding eosinophilic enteritis, including epidemiology, pathogenesis, natural history, and treatment.

Recent Findings: A 2017 population-based study using a US healthcare system database identified 1820 patients with a diagnosis of eosinophilic enteritis among 35,826,830 individuals. The majority of patients with eosinophilic enteritis in this study were women (57. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0645-6DOI Listing
July 2018
4 Reads

De-escalation of Therapy in Inflammatory Bowel Disease.

Curr Gastroenterol Rep 2018 Jul 2;20(8):35. Epub 2018 Jul 2.

Surgical Department, Gastroenterology Division, Hospital Beatriz Ângelo, Loures, Portugal.

Purpose Of Review: Currently, inflammatory bowel disease treatment is based on immunomodulators (IM) and/or biologic as this strategy may prevent the development of irreversible damage. Nevertheless, long-term treatment may be associated with non-negligible side effects and with high costs, and therefore the question on whether therapy can be de-escalated is often posed in clinical practice.

Recent Findings: Recent studies have shown a predictable rate of relapse after stop biologic or IM therapy withdrawal. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11894-018-0643-8
Publisher Site
http://dx.doi.org/10.1007/s11894-018-0643-8DOI Listing
July 2018
8 Reads

Gastric Antral Vascular Ectasia Pathogenesis and the Link to the Metabolic Syndrome.

Curr Gastroenterol Rep 2018 Jul 2;20(8):36. Epub 2018 Jul 2.

Division of Gastroenterology and Hepatology, University of Virginia, JPA and Lee St., PO Box 800708, Charlottesville, VA, 22908-0708, USA.

Purpose Of Review: Gastric antral vascular ectasia (GAVE) is a well-described source of chronic blood loss. We aim to review the previously hypothesized etiologies of GAVE and focus on recent proposed mechanisms, including metabolic syndrome. We will support these theories with newly discovered clinical associations and possible therapeutic implications. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0644-7DOI Listing
July 2018
2 Reads

Mucosal Impedance: a New Approach to Diagnosing Gastroesophageal Reflux Disease and Eosinophilic Esophagitis.

Curr Gastroenterol Rep 2018 Jun 9;20(7):33. Epub 2018 Jun 9.

Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt Medical Center, 1660 TVC, 1301 -22nd Ave. South, Nashville, TN, 37232-5280, USA.

Purpose Of Review: In this review, we discuss current diagnostic testing modalities for both gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) and then introduce mucosal impedance (MI), a novel technology that measures epithelial integrity in real time during endoscopy. We describe the advantages and disadvantages of MI as compared with traditional diagnostic testing.

Recent Findings: We review studies that demonstrate that GERD and EoE have distinct MI patterns, and that physicians can accurately diagnose and distinguish the two during endoscopy with minimal time added to the procedure. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0639-4DOI Listing
June 2018
3 Reads

The Proton Pump Inhibitor Nonresponder: a Behavioral Approach to Improvement and Wellness.

Curr Gastroenterol Rep 2018 Jun 9;20(7):34. Epub 2018 Jun 9.

University of Michigan, Division of Gastroenterology, 3912 Taubman Center 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.

Purpose Of Review: Gastroesophageal reflux disease (GERD) is a difficult to treat medical condition, where nearly 40% of patients are refractory to standard medical intervention, which typically begins with a proton pump inhibitor (PPI). These PPI nonresponders represent a population of patients, where treatment planning must be individualized; multidisciplinary and psychiatric comorbidities should be considered. This review highlights treatment options that include neuromodulators, lifestyle, and psychological interventions for the PPI nonresponder. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0641-xDOI Listing
June 2018
2 Reads

Managing Incidental Pancreatic Cysts.

Curr Gastroenterol Rep 2018 Jun 9;20(7):32. Epub 2018 Jun 9.

Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 200 UCLA Medical Plaza, Suite 330-37, Los Angeles, CA, 90095, USA.

Purpose Of Review: The goal of this review is to critically analyze the current literature regarding the management of incidental pancreatic cysts. Given their increased rates of detection due to the frequent use of cross-sectional imaging, correctly identifying the subset of high risk lesions that are appropriate for surgical resection is critical. However, the existing consensus and societal guidelines discussed in this review lack high quality data to create evidence-based recommendations, making achieving this important aim challenging. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0638-5DOI Listing
June 2018
17 Reads

Technical Aspects of Fecal Microbial Transplantation (FMT).

Curr Gastroenterol Rep 2018 Jun 9;20(7):30. Epub 2018 Jun 9.

Department of Medicine, Division of Gastroenterology, University of Louisville, 550 S. Jackson St., Ambulatory Care Building 3nd Floor, Louisville, KY, 40202, USA.

Purpose Of Review: Fecal microbial transplantation (FMT) has become established as an effective therapeutic modality in the treatment of antibiotic-refractory recurrent Clostridium difficile colitis. A number of formulations and methods of delivery of FMT are currently available, each with distinct advantages. This review aims to review donor and patient selection for FMT as well as procedural aspects of FMT to help guide clinical practice. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0636-7DOI Listing
June 2018
16 Reads

Update in the Care and Management of Patients with Primary Sclerosing Cholangitis.

Curr Gastroenterol Rep 2018 Jun 9;20(7):29. Epub 2018 Jun 9.

Division of Hepatology, University of Miami Miller School of Medicine, 1500 NW 12th Avenue, Suite 1101, Miami, FL, USA.

Purpose Of Review: Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease for which specific medical therapy is not available. The goals of treatment are primarily early detection and management of complications. In this review, we discuss novel therapies under evaluation and provide the foundation for surveillance strategies. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0635-8DOI Listing
June 2018
2 Reads

The Role of Therapeutic Endoscopy in Patients With Cirrhosis-Related Causes of Gastrointestinal Bleeding.

Curr Gastroenterol Rep 2018 Jun 9;20(7):31. Epub 2018 Jun 9.

Division of Gastroenterology and Nutrition, Loyola University Medical Center, 2160 S. First Ave., Building 54, Room 167, Maywood, IL, 60153, USA.

Purpose Of Review: This article aims to review current therapeutic endoscopic treatments available for the management of gastrointestinal bleeding related to cirrhosis.

Recent Findings: Endoscopic band ligation is an effective treatment for primary prophylaxis, acute bleeding, and secondary prophylaxis of esophageal varices as well as for acute bleeding and secondary prophylaxis of select gastric varices. Sclerotherapy is a treatment option for acute bleeding and secondary prophylaxis of esophageal varices when band ligation is technically difficult. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0637-6DOI Listing
June 2018
4 Reads

Correction to: Scaling Safe Access to Fecal Microbiota Transplantation: Past, Present, and Future.

Curr Gastroenterol Rep 2018 Jun 8;20(7):28. Epub 2018 Jun 8.

OpenBiome, Somerville, MA, USA.

In the original version of this article, author Ryan Elliott's name was misspelled as Ryan Eliott. The correct spelling of the name is Ryan Elliott. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0634-9DOI Listing
June 2018
3 Reads

Speculation as to why the Frequency of Eosinophilic Esophagitis Is Increasing.

Curr Gastroenterol Rep 2018 May 16;20(6):26. Epub 2018 May 16.

Baylor University Medical Center at Dallas, Baylor Scott & White Research Institute, 3500 Gaston Avenue 2 Hoblitzelle, Suite 250, Dallas, TX, 75246, USA.

Purpose Of Review: The frequency of eosinophilic esophagitis (EoE), an immune/antigen-mediated disorder first described in 1993, has been increasing rapidly. The purpose of this review is to consider hypotheses proposed to explain this increase and to speculate on their validity.

Recent Findings: The hygiene hypothesis attributes the rise of EoE to modern hygienic conditions resulting in fewer childhood infections with microbes that might have protected against allergy development. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0633-xDOI Listing
May 2018
4 Reads

Strategies for Effective Discontinuation of Proton Pump Inhibitors.

Curr Gastroenterol Rep 2018 May 16;20(6):27. Epub 2018 May 16.

Division of Digestive and Liver Diseases, Columbia University Medical Center, 161 Fort Washington Ave Suite 862, New York, NY, 10032, USA.

Purpose Of Review: Proton pump inhibitors (PPIs) are effective for many conditions but are often overprescribed. Recent concerns about long-term risks have made patients re-evaluate their need to take PPIs chronically, though these population-based studies have methodological weaknesses. The goal of this review is to provide evidenced-based strategies for discontinuation of PPI therapy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0632-yDOI Listing
May 2018
4 Reads

Endoscopic Therapies for Gastroparesis.

Curr Gastroenterol Rep 2018 Apr 23;20(6):25. Epub 2018 Apr 23.

Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 10945 Le Conte Avenue, Suite 2114, Los Angeles, CA, 90095, USA.

Purpose Of Review: Gastroparesis remains a difficult-to-treat disease with limited therapeutic options. Though patients often have a common syndrome of stereotypic symptoms, the underlying pathophysiology is heterogeneous, often leading to variable treatment responses. Due to limitations in medical and surgical therapies, endoscopic options have been increasingly explored. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0630-0DOI Listing
April 2018
4 Reads

The Stomach as an Endocrine Organ: Expression of Key Modulatory Genes and Their Contribution to Obesity and Non-alcoholic Fatty Liver Disease (NAFLD).

Curr Gastroenterol Rep 2018 Apr 19;20(6):24. Epub 2018 Apr 19.

Betty and Guy Beatty Center for Integrated Research, Inova Health System, Claude Moore Health Education and Research Building, 3300 Gallows Road, Falls Church, VA, 22042, USA.

Purpose Of Review: Obesity is currently seen in epidemic proportions globally and is one of the largest contributors to the development of NAFLD. The spectrum of NAFLD, particularly the progressive forms of NASH, is likely to become the leading cause of liver disease in the next decade.

Recent Findings: Soluble molecules, encoded by the stomach tissue, have been shown to have pleiotropic effects in both central and peripheral systems involved in energy homeostasis and obesity regulation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0629-6DOI Listing
April 2018
3 Reads

Health Maintenance in Inflammatory Bowel Disease.

Curr Gastroenterol Rep 2018 Apr 17;20(5):23. Epub 2018 Apr 17.

Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st Street SW, Rochester, MN, USA.

Purpose Of Review: Patients with inflammatory bowel disease (IBD) are not receiving preventative care services at the same rate as the general population. IBD patients are at increased risk for infections, osteoporosis, and certain malignancies secondary to their disease and as they are on immunosuppressive therapy. They are a younger population and often times consider their gastroenterologist as their primary care physician. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0621-1DOI Listing
April 2018
3 Reads

Applications of Colon Capsule Endoscopy.

Authors:
Shabana F Pasha

Curr Gastroenterol Rep 2018 Apr 12;20(5):22. Epub 2018 Apr 12.

Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, AZ, USA.

Purpose Of Review: This is a review of colon capsule endoscopy (CCE) with a focus on its recent developments, technological improvements, and current and potential future indications.

Recent Findings: Based on the current literature, CCE II demonstrates comparable polyp detection rates as optical colonoscopy and CT colonography, and improved cost-effectiveness. The main limitation to patient acceptance is the requirement of a rigorous bowel preparation. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11894-018-0628-7
Publisher Site
http://dx.doi.org/10.1007/s11894-018-0628-7DOI Listing
April 2018
9 Reads

Update on the Therapeutic Management of Hepatic Encephalopathy.

Curr Gastroenterol Rep 2018 Apr 11;20(5):21. Epub 2018 Apr 11.

Department of Hepatology and Gastroenterology, Aarhus University Hospital, 44 Norrebrogade, 8000, Aarhus, Denmark.

Purpose Of Review: Hepatic encephalopathy (HE) is a common and devastating complication to chronic liver disease. In this paper, we summarize the latest research and evidence of both conventional and up-coming treatments.

Recent Findings: Meta-analyses report beneficial effects of lactulose, branched-chain amino acids, rifaximin, and to some degree L-ornithine L-aspartate on the manifestations of HE in patients with cirrhosis, and generally the numbers needed to treat are low. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0627-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895665PMC
April 2018
4 Reads

Considerations When Treating Hepatitis C in a Cirrhotic Transplant Candidate.

Curr Gastroenterol Rep 2018 Apr 5;20(5):20. Epub 2018 Apr 5.

Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health and Madison VAMC, Madison, WI, USA.

Purpose Of Review: This review examines the issues in determining the decision to treat a HCV-positive patient who is a liver transplant (LT) candidate with highly effective and well-tolerated direct-acting antiviral (DAA) therapies.

Recent Findings: Cure of HCV with DAA can improve liver function and allow delisting in some patients. Beyond a threshold of hepatic impairment (likely MELD score > 16 to 20), patients may experience a decline in MELD score with HCV cure without improvement in liver-related complications resulting in decreased opportunity to receive a LT. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0626-9DOI Listing
April 2018
2 Reads

Therapy for Crohn's Disease: a Review of Recent Developments.

Curr Gastroenterol Rep 2018 Apr 5;20(5):19. Epub 2018 Apr 5.

F Widjaja Inflammatory Bowel and Immunobiology Research Institute, Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.

Purpose Of Review: To review recent advances in the treatment of Crohn's disease.

Recent Findings: Several key advances are highlighted, including the increasing role of treatment algorithms and where new therapies can be used most effectively, the appropriate use of therapeutic drug monitoring, optimal management of post-surgical patients, and the role of multi-disciplinary clinics. The last several years have seen a number of exciting developments in the field of Crohn's therapy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0625-xDOI Listing
April 2018
3 Reads

Food Allergy.

Curr Gastroenterol Rep 2018 Apr 5;20(5):17. Epub 2018 Apr 5.

Department of Medicine and Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Purpose Of Review: The goal of this review is to present an updated summary of the natural history of major childhood and adult food allergies and report recent advances in potential treatments for food allergy.

Recent Findings: The most common childhood food allergies are typically outgrown by adolescence or adulthood. However, peanut/tree nut allergies appear to more commonly persist into adulthood. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11894-018-0624-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5940350PMC
April 2018
4 Reads