699 results match your criteria Current Treatment Options in Gastroenterology[Journal]


Predictors of Progression in Barrett's Esophagus.

Curr Treat Options Gastroenterol 2019 Feb 22. Epub 2019 Feb 22.

Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Purpose Of Review: To review recently published data on factors that predict the risk of progression of Barrett's esophagus (BE) to high grade dysplasia (HGD) or esophageal adenocarcinoma (EAC).

Recent Findings: Computer models have been developed that could help predict the risk of progression with greater accuracy. The progression of BE score (PIB) is one such model based on clinical and endoscopic features, while a second uses automated image analysis of formalin-fixed and paraffin-embedded tissues looking for morphologic features and immunostaining patterns for molecular markers. Read More

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http://dx.doi.org/10.1007/s11938-019-00214-9DOI Listing
February 2019
1 Read

Endoscopic Retrograde Cholangiopancreatography in Pediatric Populations.

Curr Treat Options Gastroenterol 2019 Feb 12. Epub 2019 Feb 12.

Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USA.

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http://dx.doi.org/10.1007/s11938-019-00225-6DOI Listing
February 2019
1 Read

Optical Diagnosis of Colorectal Polyps: Recent Developments.

Curr Treat Options Gastroenterol 2019 Feb 12. Epub 2019 Feb 12.

Montreal University Hospital Research Center (CRCHUM), Montreal, Canada.

Purpose Of Review: Optical diagnosis of diminutive colorectal polyps has been recently proposed as an alternative to histopathologic diagnosis. Recent developments in imaging techniques, new classification systems, and the use of artificial intelligence have allowed for increased viability of optical diagnosis. This review provides an up-to-date overview of optical diagnosis recommendations, classifications, outcomes, and recent developments. Read More

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http://dx.doi.org/10.1007/s11938-019-00220-xDOI Listing
February 2019
1 Read

Overlap Between GERD and Functional Esophageal Disorders-a Pivotal Mechanism for Treatment Failure.

Curr Treat Options Gastroenterol 2019 Feb 8. Epub 2019 Feb 8.

Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.

ᅟRefractory GERD is very common, and while many different underlying mechanisms have been identified, the main focus has remained on residual reflux (acidic or non-acidic). Recently, Rome IV introduced two new concepts with important impact on patients with refractory GERD. They include the introduction of the reflux hypersensitivity group and the proposal that GERD can overlap with a functional esophageal disorder. Read More

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http://dx.doi.org/10.1007/s11938-019-00224-7DOI Listing
February 2019
1 Read

Colorectal Cancer in Young Adults.

Curr Treat Options Gastroenterol 2019 Feb 2. Epub 2019 Feb 2.

Department of Internal Medicine, University of Michigan, Ann Arbor, USA.

Purpose Of Review: Routine screening for colorectal cancer (CRC) in adults > 50 years of age has led to overall reductions in CRC incidence and CRC-related mortality. Yet CRC incidence among young adults age < 50 continues to increase without a clear explanation. This review examines the changing epidemiology of CRC and emerging evidence regarding the influence of genetic and lifestyle factors on risk for colorectal neoplasia. Read More

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http://dx.doi.org/10.1007/s11938-019-00219-4DOI Listing
February 2019
1 Read

New Developments in Esophageal Motility Testing.

Curr Treat Options Gastroenterol 2019 Feb 2. Epub 2019 Feb 2.

University of Colorado Reflux & Esophageal Diseases Center, Division of Gastroenterology & Hepatology, Department of Medicine, University of Colorado, Anschutz Medical Campus, Academic Office 1 Room 7605, 12631 E. 17th Ave, Aurora, CO, 80045, USA.

Purpose Of Review: The purpose of this review is to present the latest developments in esophageal motility testing and summarize the current paradigm of esophageal motility disorders.

Recent Findings: While high-resolution esophageal pressure topography interpreted according to the Chicago Classification represents the gold standard to evaluate esophageal motility, recent studies highlight the additional value of novel manometric applications. Novel applications include provocative measures to assess for obstructive physiology at the esophagogastric junction (EGJ), esophageal peristaltic reserve, and rumination and supragastric belching disorders. Read More

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http://link.springer.com/10.1007/s11938-019-00218-5
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http://dx.doi.org/10.1007/s11938-019-00218-5DOI Listing
February 2019
18 Reads

New Developments in the Diagnosis and Treatment of Eosinophilic Esophagitis.

Curr Treat Options Gastroenterol 2019 Feb 1. Epub 2019 Feb 1.

Division of Gastroenterology & Hepatology, Scripps Clinic, 10666 N. Torrey Pines Road, Suite 203N, La Jolla, CA, 92037, USA.

Purpose Of Review: Eosinophilic esophagitis (EoE) is a chronic, allergen-driven, immune-mediated disease of the esophagus that progresses to esophageal fibrostenosis if left untreated. The aim of this review is to provide a concise update on recent clinically relevant advances in the development of diagnostic and therapeutic approaches for EoE.

Recent Findings: Current diagnostic and disease monitoring protocols for EoE rely on repetitive endoscopic evaluations and esophageal tissue acquisition for histopathologic analysis. Read More

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http://link.springer.com/10.1007/s11938-019-00216-7
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http://dx.doi.org/10.1007/s11938-019-00216-7DOI Listing
February 2019
6 Reads

New Advances in the Treatment of Acute Pancreatitis.

Curr Treat Options Gastroenterol 2019 Jan 30. Epub 2019 Jan 30.

Division of Gastroenterology, Johns Hopkins Medical Institutions, 1830 E. Monument Street, Room 428, Baltimore, MD, 21205, USA.

Purpose Of Review: Despite the increasing incidence of acute pancreatitis, the overall mortality of AP has decreased.

Recent Findings: The findings of recent studies on fluid therapy, analgesics, antibiotics, and enteral nutrition as well as the management of AP complications have led to improvements in clinical care. However, there are still no pharmacologic treatment(s) for AP. Read More

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http://link.springer.com/10.1007/s11938-019-00223-8
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http://dx.doi.org/10.1007/s11938-019-00223-8DOI Listing
January 2019
6 Reads

Esophageal Third Space Endoscopy: Recent Advances.

Curr Treat Options Gastroenterol 2019 Jan 26. Epub 2019 Jan 26.

Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.

Purpose Of The Review: The novel concept of third space endoscopy was first applied to humans in 2008 for the management of achalasia through peroral endoscopic myotomy (POEM) procedure. Over the ensuing 10 years, this revolutionary procedure, which started in Japan, has been adopted and mastered by surgeons and gastroenterologists across the globe. In this article, we review the recent innovations and applications of third space endoscopy in the management of esophageal disorders. Read More

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http://dx.doi.org/10.1007/s11938-019-00217-6DOI Listing
January 2019
7 Reads

Advances in the Diagnosis and Treatment of GERD: New Tricks for an Old Disease.

Curr Treat Options Gastroenterol 2019 Jan 25. Epub 2019 Jan 25.

Division of Gastroenterology, Hepatology, and Nutrition, Center for Swallowing and Esophageal Disorders, Digestive Disease Center, Vanderbilt University Medical Center, 1660 TVC, Nashville, TN, 37232-5280, USA.

Purpose Of Review: Gastroesophageal reflux disease (GERD) is a common diagnosis encountered by both primary care providers and specialists, but despite its prevalence, there are limitations in the current diagnostic tests for GERD. Once an accurate diagnosis is made, treatment options can be offered, and this field continues to burgeon with options. In this review, we seek to review the recent advances in GERD diagnostics and subsequent treatment options. Read More

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http://dx.doi.org/10.1007/s11938-019-00213-wDOI Listing
January 2019
21 Reads

Advances in Therapeutic Drug Monitoring for Small-Molecule and Biologic Therapies in Inflammatory Bowel Disease.

Curr Treat Options Gastroenterol 2019 Jan 25. Epub 2019 Jan 25.

Robarts Clinical Trials, Inc., #200, 100 Dundas Street, London, Ontario, N6A 5B6, Canada.

Purpose Of Review: Therapeutic drug monitoring (TDM) is increasingly utilized as a strategy to optimize inflammatory bowel disease (IBD) therapeutics. As management paradigms have evolved towards treat-to-target strategies, there has been growing interest in expanding the role of TDM to guide drug optimization for achieving objective endpoints. This review summarizes the evidence for using TDM with biologic and oral small-molecule therapies, evaluates the role of reactive versus proactive TDM in treatment algorithms, and identifies potential future applications for TDM. Read More

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http://link.springer.com/10.1007/s11938-019-00222-9
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http://dx.doi.org/10.1007/s11938-019-00222-9DOI Listing
January 2019
5 Reads

Challenges in Endoscopic Therapy of Dysplastic Barrett's Esophagus.

Curr Treat Options Gastroenterol 2019 Jan 19. Epub 2019 Jan 19.

Division of Gastroenterology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY, 11040, USA.

Purpose Of Review: Barrett's esophagus (BE) is the only known measurable factor associated with esophageal adenocarcinoma. The development of endoscopic eradication therapy (EET) has transformed the way BE is managed. Given the fairly recent development of EET, its role in BE is still evolving. Read More

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http://dx.doi.org/10.1007/s11938-019-00215-8DOI Listing
January 2019
6 Reads

The Gut Microbiome as a Target for IBD Treatment: Are We There Yet?

Curr Treat Options Gastroenterol 2019 Jan 19. Epub 2019 Jan 19.

IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.

Purpose Of Review: This review aims to highlight recent research on the gut microbiome in IBD and the application of microbiome-modulating therapies for the treatment of IBD including the use of the microbiome as an indicator for disease severity and treatment response.

Recent Findings: Despite the high number of gut microbiome studies and emerging evidence supporting the gut microbiome's involvement in disease pathogenesis, no single microorganism has been identified as a pathogenic agent in IBD. Retrospective studies and meta-analyses on antibiotic use in ulcerative colitis and Crohn's disease and long-term outcomes are conflicting. Read More

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http://link.springer.com/10.1007/s11938-019-00221-w
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http://dx.doi.org/10.1007/s11938-019-00221-wDOI Listing
January 2019
7 Reads

Gastroduodenal "Dysbiosis": a New Clinical Entity.

Curr Treat Options Gastroenterol 2018 Dec;16(4):591-604

Department of Gastroenterology and Hepatology, Princess Alexandra Hospital Brisbane, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia.

Purpose Of Review: Like the rest of the gastrointestinal tract, the small intestine is colonised by microbes, but how this "microbiome" affects the immune system and digestive functions has largely been overlooked, especially in the "omics" era. Here, we present recent findings that show that the diversity, density and interactions of these microbes in the small intestine can play an important role in the pathogenesis of a number of gastrointestinal and extraintestinal disorders.

Recent Findings: Changes in the small intestinal mucosa-associated microbiota (SI-MAM) have been shown to occur with inflammatory bowel diseases, functional gastrointestinal disorders, metabolic disorders such as obesity and type 2 diabetes. Read More

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http://link.springer.com/10.1007/s11938-018-0207-x
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http://dx.doi.org/10.1007/s11938-018-0207-xDOI Listing
December 2018
12 Reads

Helicobacter pylori Infection: New Facts in Clinical Management.

Curr Treat Options Gastroenterol 2018 Dec;16(4):605-615

Department of Medicine II, University Hospital, LMU, Munich, Germany.

Purpose: The global prevalence of Helicobacter pylori remains high in spite of its significant downwards trajectory in many regions. The clinical management of H. pylori infection merits guidance to meet ongoing challenges on whom and how to test, prevent, and cure related diseases. Read More

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http://link.springer.com/10.1007/s11938-018-0209-8
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http://dx.doi.org/10.1007/s11938-018-0209-8DOI Listing
December 2018
17 Reads

The Role of Botulinum Toxin Injections for Esophageal Motility Disorders.

Curr Treat Options Gastroenterol 2018 Dec;16(4):528-540

Gastroenterology Section, Department of Medicine, Lewis Katz School of Medicine at Temple University, 3401 N. Broad St., 8th floor Parkinson Pavilion, Philadelphia, PA, 19140, USA.

Purpose Of Review: The advancement of high-resolution esophageal manometry has led to improvement in the diagnosis of esophageal motility disorders. We reviewed the recent medical literature regarding the use of botulinum toxin (BTx) injections in the esophagus and the indications, current outcomes, and reported complications of this therapy.

Recent Findings: The response rates of BTx injection therapy vary depending on the esophageal motility disorder. Read More

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http://link.springer.com/10.1007/s11938-018-0212-0
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http://dx.doi.org/10.1007/s11938-018-0212-0DOI Listing
December 2018
13 Reads

The Role of Botox in Colorectal Disorders.

Curr Treat Options Gastroenterol 2018 Dec;16(4):541-547

Sackler Faculty of Medicine, Tel Aviv University, P.O.B 39040, 69978, Ramat Aviv, Israel.

Purpose Of Review: To overview the current medical literature on the efficacy of botulism toxin treatment (BTX-A) for lower gastrointestinal disorders (GIT).

Recent Findings: BTX-A was found to have a short-term efficacy for the treatment of dyssynergic defecation. Surgical treatment was found to be more effective than BTX-A for the healing of chronic anal fissures, and BTX-A can be considered when surgery is undesirable. Read More

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http://link.springer.com/10.1007/s11938-018-0205-z
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http://dx.doi.org/10.1007/s11938-018-0205-zDOI Listing
December 2018
12 Reads

Which Patient-Related Factors Determine Optimal Bowel Preparation?

Curr Treat Options Gastroenterol 2018 Dec;16(4):406-416

Division of Gastroenterology, McGill University Health Center, McGill University, Montreal, Canada.

Purpose Of Review: Adequate bowel cleansing before colonoscopy is a simple concept but the high rate of inadequate or incomplete bowel cleanliness and its consequences have been the subject of many studies, guidelines, and meta-analysis. The complexity resides in all the factors surrounding preparation intake such as type and regimen of bowel preparation, diets, compliance, and also patient-related factors that all influence quality of the bowel preparation. The purpose of this review is to focus specifically on patient-related factors and their challenges. Read More

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http://link.springer.com/10.1007/s11938-018-0208-9
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http://dx.doi.org/10.1007/s11938-018-0208-9DOI Listing
December 2018
22 Reads

Opioid-Induced Esophageal Dysfunction: An Emerging Entity with Sweeping Consequences.

Curr Treat Options Gastroenterol 2018 Dec;16(4):616-621

Center for Swallowing and Esophageal Disorders, Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA.

Adverse effects of opioids on the gastrointestinal tract are well known. However, with the rising epidemic of opioids, its detrimental effects on esophageal physiology are now being increasingly recognized. In this commentary, we briefly review the current evidence behind opioid-induced esophageal dysfunction with potential pathophysiology and treatment options. Read More

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http://link.springer.com/10.1007/s11938-018-0210-2
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http://dx.doi.org/10.1007/s11938-018-0210-2DOI Listing
December 2018
4 Reads

Endoscopic Full-Thickness Defects and Closure Techniques.

Curr Treat Options Gastroenterol 2018 Dec;16(4):386-405

Brigham and Women's Hospital, Harvard Medical School, Boston, USA.

Purpose Of Review: Gastrointestinal transmural defects are defined as total rupture of the gastrointestinal wall and can be divided into three main categories: perforations, leaks, and fistulas. Due to an increase in the number of therapeutic endoscopic procedures including full-thickness resections and the increase incidence of complications related to bariatric surgeries, there has been an increase in the number of transmural defects seen in clinical practice and the number of non-invasive endoscopic treatment procedures used to treat these defects.

Recent Findings: The variety of endoscopic approaches and devices, including closure techniques using clips, endoloop, and endoscopic sutures; covering techniques such as the cardiac septal occluder device, luminal stents, and tissue sealants; and drainage techniques including endoscopic vacuum therapy, pigtail, and septotomy with balloon dilation are transforming endoscopy as the first-line approach for therapy of these conditions. Read More

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http://dx.doi.org/10.1007/s11938-018-0199-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392034PMC
December 2018
14 Reads

Timing of Endoscopic Necrosectomy Following Transmural Stent Placement for Pancreatic Necrosis.

Curr Treat Options Gastroenterol 2018 Dec;16(4):622-625

Division of Gastroenterology, Hepatology and Nutrition Nashville, Vanderbilt University Medical Center, Nashville, TN, 37232-5280, USA.

Purpose Of The Review: Pancreatic walled-off necrosis (WON) may require adjunctive direct endoscopic necrosectomy (DEN) following transmural stent placement. DEN is performed immediately or delayed in relation to index endoscopy. There is currently no consensus on the optimal timing of DEN. Read More

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http://link.springer.com/10.1007/s11938-018-0211-1
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http://dx.doi.org/10.1007/s11938-018-0211-1DOI Listing
December 2018
23 Reads

Potent Acid Suppression with PPIs and P-CABs: What's New?

Curr Treat Options Gastroenterol 2018 Dec;16(4):570-590

Clinical Pharmacology and Digestive Pathophysiology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.

Purpose Of The Review: Acid suppression treatment has revolutionized the management of the acid-related disorders since the introduction of the H-receptor antagonists (H-RAs) and the proton pump inhibitors (PPIs). However, there has been increasing identification of needs for improvement in antisecretory therapy, especially in gastroesophageal reflux disease (GERD), the eradication of Helicobacter pylori (H. pylori), protection from aspirin (ASA) and non-steroidal inflammatory drug (NSAID) injury and the management of upper gastrointestinal (UGI) bleeding. Read More

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http://dx.doi.org/10.1007/s11938-018-0206-yDOI Listing
December 2018
37 Reads

Gastric Cancer: an Evolving Disease.

Curr Treat Options Gastroenterol 2018 Dec;16(4):561-569

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr., BG 9609/6E338, Rockville, MD, 20852, USA.

Purpose Of Review: Prevalence of Helicobacter pylori, the primary risk factor for gastric cancer, is declining globally. Paralleling this trend, gastric cancer incidence is also decreasing. Historically, the populations most affected by this neoplasia have been males, Asians, and groups with low socioeconomic status. Read More

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http://link.springer.com/10.1007/s11938-018-0203-1
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http://dx.doi.org/10.1007/s11938-018-0203-1DOI Listing
December 2018
3 Reads

Migraine, Cyclic Vomiting Syndrome, and Other Gastrointestinal Disorders.

Curr Treat Options Gastroenterol 2018 Dec;16(4):511-527

Division of Gastroenterology and Hepatology, The Hub for Collaborative Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.

Purpose Of Review: Cyclic vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder characterized by episodic nausea and vomiting and is diagnosed using Rome IV criteria. CVS is being recognized more frequently in adults with a prevalence of 2%. It is associated with several functional disorders like autonomic dysfunction, anxiety, and depression, but the strongest association is with migraine. Read More

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http://link.springer.com/10.1007/s11938-018-0202-2
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http://dx.doi.org/10.1007/s11938-018-0202-2DOI Listing
December 2018
11 Reads

Parkinson's Disease and Current Treatments for Its Gastrointestinal Neurogastromotility Effects.

Curr Treat Options Gastroenterol 2018 Dec;16(4):489-510

Carolinas Healthcare-Charlotte, UNC School of Medicine, Charlotte Campus, 1025 Morehead Medical Dr. Suite 300, Charlotte, NC, 28204, USA.

Purpose Of Review: Gastrointestinal disturbances are seen in nearly all patients with Parkinson's disease and lead to impaired quality of life, affect drug pharmacodynamics, and potentially worsen patient's existing motor fluctuations, leading to further disability. Recent evidence links abnormal accumulations of α-synuclein aggregates in the periphery (gut) as seen in the cortex which causes dysfunctions impacting every level of the gastrointestinal tract from the esophagus, to the stomach, small bowel, colon, and rectum and can even predate the onset of the central neurologic disorder itself. Many treatments exist for the clinical phenotypes that result from the autonomic dysfunction and neuropathy involved in this neurodegenerative disorder. Read More

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http://dx.doi.org/10.1007/s11938-018-0201-3DOI Listing
December 2018
13 Reads

Update on the Prevention of Post-ERCP Pancreatitis.

Curr Treat Options Gastroenterol 2018 Dec;16(4):428-440

Department of Medicine, Division of Gastroenterology, Keck School of Medicine, University of Southern California, D & T Building Room B4H100, 1983 Marengo St, Los Angeles, CA, 90033-1370, USA.

Purpose Of Review: Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly performed procedure to manage pancreaticobiliary disease. Post-ERCP pancreatitis (PEP) is the most common adverse event of ERCP with a significant burden of morbidity and cost.

Recent Findings: Appropriate indication and counseling is mandatory especially for patients at increased risk for PEP such as those with suspected sphincter of Oddi dysfunction, pancreatic indications, and a prior history of PEP. Read More

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http://link.springer.com/10.1007/s11938-018-0194-y
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http://dx.doi.org/10.1007/s11938-018-0194-yDOI Listing
December 2018
16 Reads

Update on Vaccinating the Patient With Inflammatory Bowel Disease.

Curr Treat Options Gastroenterol 2018 Dec;16(4):548-560

Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, 85 East Concord Street, Boston, MA, 02118, USA.

Purpose Of Review: Patients with inflammatory bowel disease (IBD) are at increased risk of infectious diseases independent of their immunosuppression status, and yet, studies suggest that this population is not receiving standard vaccinations at the same rate as the general population. This review seeks to understand why IBD patients may not be receiving recommended immunizations and to provide guidelines on vaccinating this vulnerable population.

Recent Findings: Inactive vaccines are recommended for patients with IBD regardless of immunosuppression status due to the increased risk for many vaccine-preventable illnesses. Read More

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http://link.springer.com/10.1007/s11938-018-0200-4
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http://dx.doi.org/10.1007/s11938-018-0200-4DOI Listing
December 2018
18 Reads

Botulinum Toxin as a Treatment for Refractory Gastroparesis: a Literature Review.

Curr Treat Options Gastroenterol 2018 Dec;16(4):479-488

Division of Gastroenterology, Oregon Health & Science University, 3303 SW Bond Avenue, Portland, OR, 97239, USA.

Purpose Of Review: Gastroparesis (GP) is a disorder of gastrointestinal motility which leads to delayed gastric emptying in the absence of mechanical obstruction. Treatment is limited as many patients are refractory to dietary modification and the use prokinetic medications carry significant adverse risks. These limitations necessitate more research into experimental therapies. Read More

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http://link.springer.com/10.1007/s11938-018-0187-x
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http://dx.doi.org/10.1007/s11938-018-0187-xDOI Listing
December 2018
11 Reads

Selection of EMR and ESD for Laterally Spreading Lesions of the Colon.

Curr Treat Options Gastroenterol 2018 Dec;16(4):376-385

Department of Gastroenterology and Hepatology, Westmead Hospital and Western Clinical School, University of Sydney, Sydney, New South Wales, Australia.

Introduction: Colonic laterally spreading lesions (LSL) are increasingly managed using endoscopic methods that comprise two main techniques: endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD).

Purpose Of Review: In this review, we aimed to review the most recent literature on selection of the best endoscopic technique in the management of colonic LSL.

Recent Findings: EMR and ESD are complimentary techniques in the management of patients with colonic LSL. Read More

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http://link.springer.com/10.1007/s11938-018-0198-7
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http://dx.doi.org/10.1007/s11938-018-0198-7DOI Listing
December 2018
5 Reads

Recurrent Acute Pancreatitis: Current Concepts in the Diagnosis and Management.

Curr Treat Options Gastroenterol 2018 Dec;16(4):449-465

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.

Purpose Of Review: There have been significant developments in the diagnosis, clinical approach, and management of patients with recurrent acute pancreatitis (RAP) in the last decade. This review systematically summarizes our current understanding of RAP.

New Findings: Gallstones and alcohol are common causes of RAP. Read More

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http://link.springer.com/10.1007/s11938-018-0196-9
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http://dx.doi.org/10.1007/s11938-018-0196-9DOI Listing
December 2018
13 Reads

What Is the Best Endoscopic Strategy in Acute Non-variceal Gastrointestinal Bleeding?

Curr Treat Options Gastroenterol 2018 Dec;16(4):363-375

Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, Palermo, Italy.

Opinion Statement: PURPOSE OF REVIEW: Upper non-variceal gastrointestinal bleeding (UNVGIB) remains an important clinical challenge for endoscopists, requiring skill and expertise for correct management. In this paper, we suggest the best strategy for an effective treatment of this complex category of patients.

Recent Findings: Early endoscopic examination, the increasingly widespread use of endoscopic hemostasis methods, and the most powerful antisecretory agents that induce clot stabilization have radically modified the clinical scenario for treating this pathology. Read More

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http://dx.doi.org/10.1007/s11938-018-0192-0DOI Listing
December 2018
3 Reads

Pancreatic Cancer and Diabetes Mellitus.

Curr Treat Options Gastroenterol 2018 Dec;16(4):466-478

Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Sciences, 200 First St SW, Rochester, MN, 55905, USA.

Purpose Of Review: The relationship between pancreatic ductal adenocarcinoma (PDAC) and diabetes mellitus (DM) is complex. We reviewed the recent medical literature regarding the effect of anti-diabetic medication on PDAC risk and survival, risk of PDAC in DM, and role of DM in early detection of PDAC.

Recent Findings: Studies report that while some anti-diabetic medications (e. Read More

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http://dx.doi.org/10.1007/s11938-018-0197-8DOI Listing
December 2018
13 Reads

Endoscopic Ultrasound-Guided Management of Pain in Chronic Pancreatitis and Pancreatic Cancer: an Update.

Curr Treat Options Gastroenterol 2018 Dec;16(4):417-427

Division of Gastroenterology, Center Hospitalier de l'Université de Montréal, Montreal, QC, Canada.

Opinion Statement: PURPOSE OF REVIEW: Unrelenting pain from chronic pancreatitis (CP) and pancreatic cancer (PC) remain clinical challenges for the physician and a significant cause of decreased quality of life for the patient. Endoscopic ultrasound (EUS)-guided therapy for each condition is distinct and builds on the endosonographer's straightforward access to the celiac axis.

Recent Findings: Over the past 20 years, generally small studies of modest methodology have surfaced for both EUS-guided celiac plexus block (CPB) and celiac plexus neurolysis (CPN). Read More

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http://dx.doi.org/10.1007/s11938-018-0193-zDOI Listing
December 2018
2 Reads

Management of Intraductal Papillary Mucinous Neoplasms: Controversies in Guidelines and Future Perspectives.

Curr Treat Options Gastroenterol 2018 Sep;16(3):316-332

Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Floor Na-6, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.

Purpose Of Review: Management of intraductal papillary mucinous neoplasm (IPMN) is currently based on consensus, in the absence of evidence-based guidelines. In recent years, several consensus guidelines have been published, with distinct management strategies. In this review, we will discuss these discrepancies, in order to guide treating physicians in clinical management. Read More

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http://link.springer.com/10.1007/s11938-018-0190-2
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http://dx.doi.org/10.1007/s11938-018-0190-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153570PMC
September 2018
13 Reads

Genomic Profiling and Potentially Targetable Alterations in Pancreatic Ductal Adenocarcinoma.

Curr Treat Options Gastroenterol 2018 Dec;16(4):441-448

Division of Gastroenterology & Hepatology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.

Purpose Of Review: Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-associated mortality with continued poor outcome and a short-lived treatment response to conventional therapy. However, with the rapidly evolving field of precision oncology, new and novel genomic information is emerging, identifying tumor subtypes by revealing somatic and germline mutations.

Recent Findings: There is growing interest in determining the tumor BRCA status to guide potential PARP inhibitor targeted therapy and for evaluating tumor microsatellite instability status for immune checkpoint inhibitor therapy which has been reported in up to 3% of PDAC patients. Read More

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http://dx.doi.org/10.1007/s11938-018-0195-xDOI Listing
December 2018
19 Reads

Endoscopic Management of Infected Necrotizing Pancreatitis: an Evidence-Based Approach.

Curr Treat Options Gastroenterol 2018 Sep;16(3):333-344

Department of Gastroenterology & Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.

Purpose Of Review: Endoscopic management of infected necrotizing pancreatitis has evolved rapidly over the past years and there have been interesting innovations in this field. This review provides an update on the most recently published literature regarding endoscopic management of infected necrotizing pancreatitis.

Recent Findings: A recent randomized trial demonstrated no difference in mortality and major morbidity between endoscopic and surgical step-up treatment of infected necrotizing pancreatitis. Read More

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http://dx.doi.org/10.1007/s11938-018-0189-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153579PMC
September 2018
25 Reads

Diagnosis and Management of Exocrine Pancreatic Insufficiency.

Authors:
Chris E Forsmark

Curr Treat Options Gastroenterol 2018 Sep;16(3):306-315

Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Box 100214, 1329 SW 16th St, Suite 5251, Gainesville, FL, 32610-0214, USA.

Purpose Of Review: Recent studies have documented that many patients with pancreatic exocrine insufficiency (EPI) are not identified and are not treated with appropriate dosages of pancreatic enzyme replacement therapy. This review will summarize the approach to diagnosis, treatment, and monitoring for treatment effect and complications in patients with exocrine insufficiency.

Recent Findings: While chronic pancreatitis is the most commonly identified cause of EPI, pancreatic cancer and pancreatic surgery are increasingly important. Read More

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http://dx.doi.org/10.1007/s11938-018-0186-yDOI Listing
September 2018
3 Reads

Training in Endoscopy.

Curr Treat Options Gastroenterol 2018 Sep;16(3):345-361

Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK.

Purpose Of The Review: Progress towards the goal of high-quality endoscopy across health economies has been founded on high-quality structured training programmes linked to credentialing practice and ongoing performance monitoring. This review appraises the recent literature on training interventions, which may benefit performance and competency acquisition in novice endoscopy trainees.

Recent Findings: Increasing data on the learning curves for different endoscopic procedures has highlighted variations in performance amongst trainees. Read More

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http://dx.doi.org/10.1007/s11938-018-0191-1DOI Listing
September 2018
3 Reads

Inflammatory Bowel Disease in the Baby to Baby Boomer: Pediatric and Elderly Onset of IBD.

Curr Treat Options Gastroenterol 2018 Sep;16(3):289-305

NYU Langone Nassau Gastroenterology Associates, New York University School of Medicine, Great Neck, NY, USA.

Purpose Of Review: Early- and late-onset of inflammatory bowel disease (IBD) may perhaps be etiologically distinct and potentially attributed to genetics, environmental or microbial factors. We review disease factors and clinical characteristics, as well as unique management and treatment strategies to consider when caring for the "baby" or "baby boomer" with IBD.

Recent Findings: Around 25% of cases of initial diagnosis of IBD is made before the age of 18 years old, and another 15-20% made after the age of 60. Read More

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http://dx.doi.org/10.1007/s11938-018-0188-9DOI Listing
September 2018
8 Reads

Outcomes and Management of the Ileal Pouch-Anal Anastomosis in the Elderly.

Curr Treat Options Gastroenterol 2018 Sep;16(3):275-288

Division of Colorectal Surgery, New York University Langone Health, NYU Langone Health, 240 East 38th Street, 23rd Floor, New York, NY, 10016, USA.

Purpose Of Review: Ileal pouch-anal anastomosis (IPAA) is the preferred surgical treatment for patients undergoing colectomy to maintain intestinal continuity. Earlier studies have suggested that outcomes are worse in elderly patients who underwent IPAA. However, more recent reports have shown that IPAA outcomes in the elderly are comparable to younger patients. Read More

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http://dx.doi.org/10.1007/s11938-018-0184-0DOI Listing
September 2018
6 Reads

Management of Hepatic Encephalopathy Not Responsive to First-Line Treatments.

Curr Treat Options Gastroenterol 2018 Jun;16(2):253-259

Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.

Purpose Of Review: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome that occurs in up to 30% of patients with cirrhosis. HE may be a consequence of pure liver failure, as in patients with fulminant hepatitis, or of the combination of liver failure and portal-systemic shunting, as in patients with liver cirrhosis. Episodes of HE are usually related to precipitating events, such as infections or gastrointestinal bleeding; a minority of cirrhotic patients experienced a chronic HE, refractory to standard medical treatment. Read More

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http://dx.doi.org/10.1007/s11938-018-0183-1DOI Listing
June 2018
4 Reads

Intensive Care Management of Patients with Cirrhosis.

Authors:
Jody C Olson

Curr Treat Options Gastroenterol 2018 Jun;16(2):241-252

University of Kansas Medical Center, 3901 Rainbow Blvd., MS 1023, Kansas City, Kansas, 66160, USA.

Purpose Of Review: Cirrhosis is a major worldwide health problem which results in a high level of morbidity and mortality. Patients with cirrhosis who require intensive care support have high mortality rates of near 50%. The goal of this review is to address the management of common complications of cirrhosis in the ICU. Read More

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http://dx.doi.org/10.1007/s11938-018-0182-2DOI Listing
June 2018
3 Reads

Frailty in Patients With Cirrhosis.

Curr Treat Options Gastroenterol 2018 Jun;16(2):215-225

Division of Gastroenterology (Liver Unit), University of Alberta, 1-40 Zeidler Ledcor Building, Edmonton, Alberta, T6G 2X8, Canada.

Purpose Of Review: This review gives an overview of the evolving concept of physical frailty in patients with cirrhosis. As well as summarizing the available metrics that have been used to diagnose it, this review also examines the major recent trials that have investigated frailty in patients with cirrhosis. The complex relationship between sarcopenia and frailty is explored, and strategies to optimize frailty, such as including pharmacological and non-pharmacological therapies, are discussed. Read More

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http://dx.doi.org/10.1007/s11938-018-0179-xDOI Listing
June 2018
7 Reads

The Use of Statins in Patients With Chronic Liver Disease and Cirrhosis.

Curr Treat Options Gastroenterol 2018 Jun;16(2):226-240

Division of Gastroenterology and Liver Unit, University of Alberta, 8540 112 Street NW, Zeidler Ledcor Centre, Room 1-20B, Edmonton, Alberta, T6G 2X8, Canada.

Purpose Of Review: Statins are drugs developed to treat hypercholesterolemia. Its use in patients with liver disease has been limited because one of its potential and most feared side effects is hepatotoxicity. However, there is robust evidence that supports the safety of statins in this population in the absence of severe liver dysfunction. Read More

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http://link.springer.com/10.1007/s11938-018-0180-4
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http://dx.doi.org/10.1007/s11938-018-0180-4DOI Listing
June 2018
8 Reads

Interaction Between Hepatocellular Carcinoma and Hepatitis C Eradication With Direct-acting Antiviral Therapy.

Curr Treat Options Gastroenterol 2018 Jun;16(2):203-214

Department of Gastroenterology, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Blvd, Richmond, VA, 23249, USA.

Purpose Of Review: The approval of direct-acting antiviral (DAA) therapy has revolutionized hepatitis C virus (HCV) treatment. However, the publication of a study from Barcelona in 2016 raised concern for an increased risk of recurrence of hepatocellular carcinoma (HCC) after potentially curative therapy in patients receiving DAAs. This article reviews the current literature on the interaction between HCC and hepatitis C eradication with DAAs. Read More

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http://dx.doi.org/10.1007/s11938-018-0178-yDOI Listing
June 2018
8 Reads

Esophageal Stenting in Clinical Practice: an Overview.

Curr Treat Options Gastroenterol 2018 Jun;16(2):260-273

Department of Gastroenterology and Hepatology, Radboud University Medical Center, Geert Grooteplein-Zuid 8 (route 455), 6500, HB, Nijmegen, the Netherlands.

Opinion Statement: PURPOSE OF REVIEW: Esophageal stents are used in clinical practice for endoscopic treatment of a wide variety of esophageal diseases and conditions. This review provides key principles and a literature update on the utility and limitations of esophageal stenting in clinical practice.

Recent Findings: Indications for esophageal stenting can be subdivided into two groups. Read More

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http://dx.doi.org/10.1007/s11938-018-0181-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932108PMC
June 2018
4 Reads

Biosimilars in the Treatment of Inflammatory Bowel Disease: Supporting Evidence in 2017.

Curr Treat Options Gastroenterol 2018 Mar;16(1):147-164

Gastroenterology Division, Perelman School of Medicine, University of Pennsylvania, 7th Floor South Perelman Building, Room 753, 3400 Civic Center Boulevard, Philadelphia, PA, 19104-4283, USA.

Purpose Of Review: Monoclonal antibodies targeting tumor necrosis factor-alpha, integrin molecules, and interleukin-12/23 have become backbone therapies for Crohn's disease and ulcerative colitis. While clinically effective, these biologic therapies come with significant expense, contributing to overall healthcare spending in the USA. Biosimilars have the potential to significantly reduce expenditures secondary to the use of biologic medications such as infliximab and adalimumab, though their complicated manufacturing process results in inherent differences in structure when compared to the originator compounds. Read More

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http://dx.doi.org/10.1007/s11938-018-0177-zDOI Listing
March 2018
50 Reads

Updates on Women's Health Issues in Patients with Inflammatory Bowel Disease.

Curr Treat Options Gastroenterol 2018 Mar;16(1):86-100

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

Purpose Of Review: Inflammatory bowel disease affects approximately 800,000 women in the USA with the peak incidence between ages 15 to 40. Thus for many females, IBD can impact nearly every stage of their life from menarche to pregnancy, menopause, and beyond. This paper will review the most recent updates on the topics of sexual health, cervical cancer screening, menstruation, fertility, contraception, and menopause. Read More

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http://dx.doi.org/10.1007/s11938-018-0172-4DOI Listing
March 2018
7 Reads

Management of Serrated Polyps of the Colon.

Curr Treat Options Gastroenterol 2018 Mar;16(1):182-202

Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, CB#7080, 130 Mason Farm Road, Chapel Hill, NC, 27599, USA.

Purpose Of Review: The purpose of this review is to summarize the management of serrated colorectal polyps (SPs), with a particular focus on the most common premalignant SP, sessile serrated adenoma or polyp (SSA/P). These lesions present a challenge for endoscopists with respect to detection and resection, and are also susceptible to pathologic misdiagnosis.

Recent Findings: Patients with SSA/Ps are at an increased risk of future colorectal neoplasia, including advanced polyps and cancer. Read More

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http://dx.doi.org/10.1007/s11938-018-0176-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284520PMC
March 2018
4 Reads

Expanding Role of Third Space Endoscopy in the Management of Esophageal Diseases.

Curr Treat Options Gastroenterol 2018 Mar;16(1):41-57

Division of Gastroenterology, Hepatology and Nutrition, University of Florida, 1329 SW 16th Street Suite 5262, Gainesville, FL, 32608, USA.

OPINION STATEMENT: "Third space" endoscopy, also commonly referred as submucosal endoscopy, is founded on the principle that the deeper layers of the gastrointestinal (GI) tract can be accessed by tunneling in the submucosal space without compromising the integrity of the overlying mucosa. Peroral endoscopic myotomy (POEM), endoscopic submucosal dissection (ESD), and submucosal tunneling endoscopic resection (STER) are innovative techniques within the field of third space endoscopy in the management of esophageal disorders. POEM has become an accepted minimally invasive therapy for achalasia and related motility disorders with excellent short-term results, with early studies yielding similar efficacy to surgical myotomy and increased durability when compared to pneumatic balloon dilation (PBD). Read More

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http://dx.doi.org/10.1007/s11938-018-0169-zDOI Listing
March 2018
6 Reads