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Current Gastroenterology Reports

John T Cunningham
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...
February 11, 2019: Current Gastroenterology Reports
Shaffer R S Mok, David L Diehl
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. RECENT FINDINGS: Clinical studies have recently demonstrated that the 19G EUS core biopsy needle is superior to non-core needles for liver tissue acquisition. In addition, wet suction provides more robust tissue samples than dry suction...
January 31, 2019: Current Gastroenterology Reports
David G Menter, Jennifer S Davis, Bradley M Broom, Michael J Overman, Jeffrey Morris, Scott Kopetz
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...
January 30, 2019: Current Gastroenterology Reports
Victoria M Gershuni, Elliot S Friedman
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...
January 26, 2019: Current Gastroenterology Reports
Eamonn M M Quigley
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...
January 15, 2019: Current Gastroenterology Reports
Benjamin Click, Miguel Regueiro
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...
January 11, 2019: Current Gastroenterology Reports
Sandra M Quezada, Raymond K Cross
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...
January 11, 2019: Current Gastroenterology Reports
Nayantara Orekondy, Eric R Kallwitz
No abstract text is available yet for this article.
December 14, 2018: Current Gastroenterology Reports
John O'Grady, Fergus Shanahan
No abstract text is available yet for this article.
November 8, 2018: Current Gastroenterology Reports
Eve A Roberts
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. RECENT FINDINGS: The structure of the gene product of ATP7B, abnormal in WD, is being worked out in detail, along with a broader description of how the protein ATP7B (Wilson ATPase) functions in cells including enterocytes, not only in relation to copper disposition but also to lipid synthesis...
November 5, 2018: Current Gastroenterology Reports
Myeongsook Seo, Segyeong Joo, Kee Wook Jung, Eun Mi Song, Satish S C Rao, Seung-Jae Myung
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...
November 5, 2018: Current Gastroenterology Reports
Hans Törnblom, Douglas A Drossman
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...
November 5, 2018: Current Gastroenterology Reports
Toshihiko Tomita, Tadayuki Oshima, Hiroto Miwa
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...
October 18, 2018: Current Gastroenterology Reports
Mansoureh Mkarimi, Hiroshi Mashimo
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...
October 9, 2018: Current Gastroenterology Reports
Christopher M Johnson, Themistocles Dassopoulos
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...
September 28, 2018: Current Gastroenterology Reports
Horace Rhee, David H Wang
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...
September 26, 2018: Current Gastroenterology Reports
Soojong Chae, Joel E Richter
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. Recent studies have found that extending to 96 h can be helpful in patients with conflicting results on the first 2 days of the study...
September 26, 2018: Current Gastroenterology Reports
Guido Stirnimann, Maryam Ebadi, Puneeta Tandon, Aldo J Montano-Loza
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...
September 26, 2018: Current Gastroenterology Reports
Pichamol Jirapinyo, Christopher C Thompson
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. However, given the known benefit of weight loss on NASH and the known effect of bariatric surgery on weight loss, several studies have explored the potential role of bariatric surgery on the treatment of NASH...
September 22, 2018: Current Gastroenterology Reports
Thomas M Attard, Anne-Marie Grima, Mike Thomson
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...
September 1, 2018: Current Gastroenterology Reports
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