Clinical Gastroenterology and Hepatology

Yao-Wen Cheng, Dana Alhaffar, Srishti Saha, Sahil Khanna, Matthew Bohm, Emmalee Phelps, Marwan Ghabril, Eric Orman, Sagi Sashidhar, Nicholas Rogers, Huiping Xu, Alexander Khoruts, Byron Vaughn, Dina Kao, Karen Wong, Giovanni Cammarota, Gianluca Ianiro, Tanvi Dhere, Colleen S Kraft, Nirja Mehta, H Michael Woodworth, Jessica R Allegretti, Lotem Nativ, Jenna Marcus, Najwa El-Nachef, Monika Fischer
BACKGROUND & AIMS: Clostridioides difficile infection (CDI) harms a large proportion of patients with cirrhosis. Fecal microbiota transplantation (FMT) is recommended for recurrent CDI, but its effects in patients with cirrhosis have not been established. We performed a multicenter, observational study to evaluate efficacy and safety of FMT for CDI in patients with cirrhosis. METHODS: We performed a retrospective study of 63 adults with cirrhosis (median model for end-stage liver disease score, 14...
July 6, 2020: Clinical Gastroenterology and Hepatology
K Van den Houte, Florencia Carbone, Nick Goelen, Jolien Schol, Imke Masuy, Joris Arts, Philip Caenepeel, Dirk Staessen, Philippe Vergauwe, Guy Van Roey, Pascale Latour, Hubert Piessevaux, Philippe Maldague, Ariane Gerkens, Fabien Wuestenberghs, Alain Vandenberghe, Jan Tack
BACKGROUND & AIMS: Functional dyspepsia (FD) is subdivided into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) according to the Rome III consensus. In clinical practice, there is a major overlap between these subgroups. The Rome IV criteria included postprandially occurring symptoms in the PDS subgroup. We aimed to analyze the effects of the Rome IV criteria, compared to Rome III, on FD subgroups in patients recruited from secondary care. METHODS: Patients with FD (n=224; mean age, 43±1 years; 77% women) were recruited from secondary-care units in Belgium and filled out symptom questionnaires, allowing subdivision according to Rome III and Rome IV criteria and identification of postprandial symptoms...
July 6, 2020: Clinical Gastroenterology and Hepatology
Qiuju Tian, Ruiyuan Yang, Yan Wang, Jimin Liu, Aileen Wee, Romil Saxena, Lan Wang, Min Li, Liwei Liu, Shan Shan, Yuanyuan Kong, Hong Ma, Xiaojuan Ou, Hong You, Xinyan Zhao, Jidong Jia
BACKGROUND & AIMS: Alterations in the serum levels of bile acids are associated with drug-induced liver injury (DILI). We investigated the association between serum levels of bile acids and the severity and outcome of DILI, along with the potential role of variants in the ATP binding cassette subfamily B member 11 (ABCB11) gene and expression of its product, ABCB11 (also called BSEP). METHODS: We performed this prospective study of 95 patients (median age, 53 years; 73...
July 4, 2020: Clinical Gastroenterology and Hepatology
Joshua E Melson, Thomas F Imperiale, Steven H Itzkowitz, Xavier Llor, Michael L Kochman, William M Grady, Robert E Schoen, Carol Burke, Aasma Shaukat, Linda Rabeneck, Uri Ladabaum, Robert Bresalier, Brennan Spiegel, Judy Yee, Thomas Wang, David Lieberman, Srinadh Komanduri, V Raman Muthusamy, Neelendu Dey
No abstract text is available yet for this article.
July 4, 2020: Clinical Gastroenterology and Hepatology
Cary C Cotton, Renee Betancourt, Cara Randall, Irina Perjar, Christine Bookhout, John T Woosley, Nicholas J Shaheen, Evan S Dellon
BACKGROUND AND AIMS: Updated diagnostic guidelines for eosinophilic esophagitis (EoE) have eliminated the requirement for a proton pump inhibitor (PPI) trial, but there are no models to identify patients with EoE based on these new criteria. We aimed to develop a predictive model for diagnosis of EoE based on the updated EoE diagnostic guidelines. METHODS: We performed a secondary analysis of a prospective study of adult patients referred for outpatient esophagogastroduodenoscopy at University of North Carolina who had symptoms of esophageal dysfunction; patients with prevalent EoE were excluded...
July 4, 2020: Clinical Gastroenterology and Hepatology
Aasma Shaukat, Lasse Kaalby, Gunnar Baatrup, Ole Kronborg, Sue Duval, Michael Shyne, Jack S Mandel, Timothy R Church
BACKGROUND & AIMS: Randomized trials have shown that biennial fecal occult blood test (FOBT) screening reduces mortality from colorectal cancer (CRC), but not overall mortality. Differences in benefit for men vs women, and by age, are unknown. We sought to evaluate long-term reduction in all-cause and CRC-specific mortality in men and women who comply with offered screening, and in different age groups, using individual participant data from 2 large randomized trials of biennial FOBT screening, compared with an intention to treat analysis...
July 4, 2020: Clinical Gastroenterology and Hepatology
Edward C Oldfield, Parth J Parekh
No abstract text is available yet for this article.
July 4, 2020: Clinical Gastroenterology and Hepatology
Andreas Geier, Mary Rinella, Maria-Magdalena Balp, Sarah Jane McKenna, Clifford Brass, Raymond Przybysz, Jennifer Cai, Amanda Knight, Meghan Gavaghan, Tanya Howe, Daniel Rosen, Vlad Ratziu
BACKGROUND & AIMS: Nonalcoholic steatohepatitis (NASH) is associated with an increase in healthcare resource use and poor health-related quality of life (HRQoL). We assessed the humanistic and economic burden of NASH, disease management, and patient journey. METHODS: We performed a cross-sectional analysis of data, collected from July through November 2017, from the Growth from Knowledge Disease Atlas Real-World Evidence program, reported by physicians in United States, France, and Germany...
July 4, 2020: Clinical Gastroenterology and Hepatology
Charlotte Knox, John Almeida
No abstract text is available yet for this article.
July 4, 2020: Clinical Gastroenterology and Hepatology
Brianna J Shinn, Thomas E Kowalski
No abstract text is available yet for this article.
July 3, 2020: Clinical Gastroenterology and Hepatology
Hadi Kuriry, Julia Casey, Lisette Krassenburg, Danie La, Magdalena Kuczynski, Hemant Shah, Harry L A Janssen, Bettina E Hansen, Jordan J Feld
BACKGROUND & AIMS: Direct-acting antivirals (DAAs) cure most cases of chronic hepatitis C virus (HCV) infections. However, a small percentage of patients relapse with reappearance of viremia after a full course of therapy. Although most who relapse require retreatment, some patients spontaneously clear HCV without additional therapy. We studied patients who relapsed with detectable HCV RNA after a full course of DAA therapy and then spontaneously cleared the HCV infection without retreatment...
July 3, 2020: Clinical Gastroenterology and Hepatology
Parakkal Deepak, Quazim A Alayo, Aava Khatiwada, Bixuan Lin, Marc Fenster, Christina Dimopoulos, Geoffrey Bader, Roni Weisshof, Michael Jacobs, Alexandra Gutierrez, Matthew A Ciorba, George P Christophi, Anish Patel, Robert P Hirten, Jean-Frederic Colombel, David T Rubin, Christina Ha, Poonam Beniwal-Patel, Ryan C Ungaro, Gaurav Syal, Joel Pekow, Benjamin L Cohen, Andres Yarur
BACKGROUND & AIMS: Adverse events (AEs) including reactivation of herpes zoster (HZ) and venous thromboembolism (VTE) have been reported from clinical trials of tofacitinib in ulcerative colitis (UC). We investigated the incidence rates of AEs in a real-world study of UC patients given tofacitinib. METHODS: We collected data from 260 patients with UC in the TROPIC consortium study, performed at 6 medical centers in the United States. Patients were followed for a median time of 6 months (interquartile range, 2...
July 3, 2020: Clinical Gastroenterology and Hepatology
Krutika Lakhoo, Christopher V Almario, Carine Khalil, Brennan M R Spiegel
BACKGROUND & AIMS: Abdominal pain is the most common gastrointestinal symptom reported in ambulatory clinics, but little is known about its prevalence and burden of illness in the general community. We conducted a population-based survey to determine the epidemiology, clinical characteristics, and healthcare-seeking behavior of persons with abdominal pain. METHODS: Using an online survey research firm, we recruited a representative sample of adults (18 years or older) with a history of abdominal pain...
July 3, 2020: Clinical Gastroenterology and Hepatology
Yeison Carlosama-Rosero, Darío Portillo-Miño, Nathalia Carlosama-Rosero
No abstract text is available yet for this article.
July 3, 2020: Clinical Gastroenterology and Hepatology
Vijay S Are, Raj Vuppalanchi, Eduardo Vilar-Gomez, Naga Chalasani
No abstract text is available yet for this article.
July 3, 2020: Clinical Gastroenterology and Hepatology
Henit Yanai, Idan Goren, Lihi Godny, Nitsan Maharshak, Yulia Ron, Irit Avni Biron, Haim Leibovitzh, Hagar Banai Eran, Maya Aharoni Golan, Keren Rabinowitz, Tomer Ziv Baran, Inbar Lavie, Karin Yadgar, Keren Zonensain, Uri Kopylov, Shomron Ben Horin, Rami Eliakim, Matti Waterman, Yehuda Chowers, Shay Ben-Shachar, Iris Dotan
BACKGROUND & AIMS: The early stages of Crohn's disease (CD) course are heterogeneous, and it is a challenge to predict the course of disease in patients with new diagnosis. METHODS: We performed an observational longitudinal study of 156 adults (79 male; median age, 27.7 years; 57 treatment naïve) with newly diagnosed CD (within 6 months of enrollment), referred from medical centers and community clinics in Israel from 2013 through 2017. Study participants each received semi-annual scheduled evaluations...
July 3, 2020: Clinical Gastroenterology and Hepatology
Aldo J Montano-Loza, Christophe Corpechot
Primary biliary cholangitis (PBC) is an immune-mediated chronic liver disease characterized by biliary epithelial injury, cholestasis, and progressive fibrosis that can lead to cirrhosis and requirement for liver transplantation. All patients with PBC should received initial treatment with ursodeoxycholic acid (UDCA) and odds for response are based on characteristics at baseline. It is important to have clear definitions of patients at risk for a poor response to therapy, of biochemical markers of an incomplete response, and standardized management...
July 3, 2020: Clinical Gastroenterology and Hepatology
Clara Yzet, Momar Diouf, Siddarth Singh, Franck Brazier, Justine Turpin, Eric Nguyen-Khac, Jonathan Meynier, Mathurin Fumery
BACKGROUND & AIMS: There is debate over whether patients with inflammatory bowel diseases (IBD) treated with biologics that are not tumor necrosis factor antagonists (such as vedolizumab or ustekinumab) should receive concomitant treatment with immunomodulators. We conducted a meta-analysis to compare the efficacy and safety of concomitant immunomodulator therapy vs vedolizumab or ustekinumab monotherapy. METHODS: In a systematic search of publications, through July 31, 2019, we identified 33 studies (6 randomized controlled trials and 27 cohort studies) of patients with IBD treated with vedolizumab or ustekinumab...
July 3, 2020: Clinical Gastroenterology and Hepatology
Ethan M Weinberg, Huy N Trinh, Roberto J Firpi, Kalyan Ram Bhamidimarri, Samuel Klein, Jonathan Durlam, Stephanie Watkins, K Rajender Reddy, Michael Weiss, Richard C Zink, Anna S Lok
BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) is typically associated with obesity. Little is known about the prevalence of cirrhosis in patients with NAFLD and a normal body mass index (BMI). METHODS: We determined prevalence of cirrhosis, cardiovascular disease (CVD), and metabolic abnormalities among participants in all BMI categories in the TARGET-NASH study. A total of 3386 patients with NAFLD were enrolled from August 2016 through March 2019...
July 3, 2020: Clinical Gastroenterology and Hepatology
Amit G Singal, Jasmin A Tiro, Caitlin C Murphy, James-Michael Blackwell, Jennifer R Kramer, Aisha Khan, Yan Liu, Song Zhang, Jessica L Phillips, Ruben Hernaez
BACKGROUND: More than 20% of patients with cirrhosis do not receive semi-annual hepatocellular carcinoma (HCC) surveillance as recommended. Few studies have evaluated the effects of patient-level factors on surveillance receipt. METHODS: We administered a telephone survey to a large cohort of patients with cirrhosis from 3 health systems (a tertiary care referral center, a safety-net health system, and Veterans Affairs) to characterize patient knowledge, attitudes, and perceived barriers of HCC surveillance...
July 3, 2020: Clinical Gastroenterology and Hepatology
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