Journals Expert Review of Gastroenterol...

Expert Review of Gastroenterology & Hepatology
Feng Xiong, Yu-Wen Zhou, Ya-Ting Hao, Gui-Xia Wei, Xiao-Rong Chen, Meng Qiu
INTRODUCTION: Monoclonal antibodies binding the EGFR, such as cetuximab and panitumumab, have been extensively used as targeted therapy for the treatment of mCRC. However, in clinical practice, it has been found that these treatment options have some limitations and fail to fully exploit their immunoregulatory activities. Meanwhile, because of the limited effects of current treatments, immunotherapy is being widely studied for patients with mCRC. However, previous immunotherapy trials in mCRC patients have had unsatisfactory outcomes as monotherapy...
September 13, 2023: Expert Review of Gastroenterology & Hepatology
Line Ravndal, Katrine P Lindvig, Ellen L Jensen, Anita Sunde, Damoun Nassehi, Maja Thiele, Aleksander Krag, Svein Kjosavik
INTRODUCTION: Fatty liver disease affects almost 30% of the adult population worldwide.Most patients are asymptomatic and there is not a linear relationship between exposure to risk factors and the risk of developing fibrosis. The combination of a very large, asymptomatic risk population where only a few percent will develop life-threatening liver disease, is a growing diagnostic challenge for the health services. Accurate fibrosis assessment in primary care is limited by poor correlation with liver blood tests and low availability of elastography...
September 11, 2023: Expert Review of Gastroenterology & Hepatology
Jennifer Halma, Henry C Lin
INTRODUCTION: Alagille syndrome (ALGS) is an autosomal dominant, multisystem genetic disorder with wide phenotypic variability caused by mutations in the Notch signaling pathway, specifically from mutations in either the Jagged1 (JAG1) or NOTCH2 gene. The range of clinical features in ALGS can involve various organ systems including the liver, heart, eyes, skeleton, kidney, and vasculature. Despite the genetic mutations being well-defined, there is variable expressivity and individuals with the same mutation may have different clinical phenotypes...
September 5, 2023: Expert Review of Gastroenterology & Hepatology
Sahil Khanna, Elida Voth
INTRODUCTION: Clostridioides difficile infection (CDI) is a major healthcare problem in the developed world, and effective management of recurrent infection remains one of the biggest challenges. Several advances have occurred in the management of CDI and in the last 15 years, multiple new agents have been tested. Since 2011, four new products have been approved by the United States FDA for treatment of CDI or prevention of recurrent CDI. AREAS COVERED: This review focuses on therapeutics of CDI and includes sections on primary prevention, management of active infection and prevention of recurrent CDI...
August 22, 2023: Expert Review of Gastroenterology & Hepatology
Timo Rath, Raja Atreya, Markus F Neurath
INTRODUCTION: The intestinal barrier is a multi-faced structure lining the surface of the intestinal mucosa of the GI tract. To exert its main functions as a physical and immunological defense barrier, several components of the intestinal barrier act in a concerted and cooperative manner. AREAS COVERED: Herein, we first introduce to the basic organization of the intestinal barrier and then summarize different methods to assess barrier function in and ex vivo. Finally, we provide an in-depth overview of the relevance of intestinal barrier dysfunction in inflammatory bowel diseases...
August 22, 2023: Expert Review of Gastroenterology & Hepatology
Hao Wei, Yihan Zhao, Lisha Xiang
INTRODUCTION: Inflammatory bowel disease (IBD) is a chronic disease characterized by the presence of systemic inflammation, manifesting not only as gastrointestinal symptoms but also as extraintestinal bone complications, including osteopenia and osteoporosis. However, the association between IBD and osteoporosis is complex, and the presence of multifactorial participants in the development of osteoporosis is increasingly recognized. Unlike in adults, delayed puberty and growth hormone/insulin-like growth factor-1 axis abnormalities are essential risk factors for osteoporosis in pediatric patients with IBD...
August 20, 2023: Expert Review of Gastroenterology & Hepatology
Joost Algera, Jenny Lövdahl, Jessica Sjölund, Navkiran Thind Tornkvist, Hans Törnblom
INTRODUCTION: Irritable bowel syndrome (IBS) is characterized by chronic symptoms (>6 months) of abdominal pain in combination with a disturbed bowel habit. There is an association between the intensity of abdominal pain and the need for health care utilization. A bidirectionally disordered gut-brain interaction is central in the pathophysiology of IBS where a number of factors, gastrointestinal and non-gastrointestinal, can contribute to the illness experience. In order to treat abdominal pain in IBS, mapping these factors in a multidimensional clinical profile is helpful...
August 8, 2023: Expert Review of Gastroenterology & Hepatology
Anuraag Jena, Shubham Jain, Sridhar Sundaram, Anupam Kumar Singh, Sanjay Chandnani, Pravin Rathi
INTRODUCTION: Electrosurgical unit (ESU) is integral to the endoscopy unit. The proper knowledge of the Mode with setting is essential for good therapeutic outcomes and the safety of the patients. AREAS COVERED: ESU generates high-frequency electric current, which could perform cutting and coagulation for various therapeutic interventions. We review the proper settings for common endoscopic interventions like hemostasis, polypectomy, sphincterotomy, and advanced procedures like endoscopic ultrasound-guided cysto-gastrostomy, bile duct drainage, and endoscopic Ampullectomy...
August 4, 2023: Expert Review of Gastroenterology & Hepatology
Ningyuan Wen, Yaoqun Wang, Yulong Cai, Guilin Nie, Sishu Yang, Shaofeng Wang, Xianze Xiong, Bei Li, Jiong Lu, Nansheng Cheng
BACKGROUND: Common bile duct stones (CBDS) have a reported recurrence rate of 4%-24% after stone extraction. The most commonly applied stone extraction method is endoscopic cholangiopancreatography (ERCP). We conducted a systematic review and meta-analysis to identify all available risk factors for recurrent CBDS following stone retraction. RESEARCH DESIGN AND METHODS: A literature search of studies with case-control design was performed to identify potential risk factors for recurrent CBDS...
August 3, 2023: Expert Review of Gastroenterology & Hepatology
Giuseppe Losurdo, Milena Di Leo, Salvatore Rizzi, Ilaria Lacavalla, Francesca Celiberto, Andrea Iannone, Maria Rendina, Enzo Ierardi, Giuseppe Iabichino, Luca De Luca, Alfredo Di Leo
INTRODUCTION: Hereditary polyposis syndromes are a group of inherited disorders associated with a high risk of developing colorectal cancer. The best known ones are familial adenomatous polyposis (FAP), Peutz-Jeghers (PJS), juvenile polyposis and Cowden syndromes, as well as conditions predisposing to cancer, such as Lynch syndrome. Some of them are characterized by an increased risk of small bowel polyps occurrence. AREAS COVERED: Literature search in PubMed was performed in November 2022 and a narrative review was carried out...
July 29, 2023: Expert Review of Gastroenterology & Hepatology
Annarosa Floreani, Daniela Gabbia, Sara De Martin
INTRODUCTION: Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease characterized by the immune-mediated destruction of small and medium intrahepatic bile ducts, involving predominantly females. PBC has long been described as an autoimmune liver disease, also because it is very often associated with many autoimmune conditions. More recently, another pathogenic mechanism exploring the damage of cholangiocytes has been hypothesized, i.e. a defect in the biliary umbrella which is physiologically responsible for the exchange of the ions Cl- and HCO3 - and maintains the integrity of glycocalyx...
July 29, 2023: Expert Review of Gastroenterology & Hepatology
Mario Bartiromo, Michele Nardolillo, Serena Ferrara, Giuseppina Russo, Emanuele Miraglia Del Giudice, Anna Di Sessa
INTRODUCTION: As the pediatric obesity epidemic, non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in childhood. Pediatric NAFLD pathophysiology is tangled and still unclear, but insulin resistance (IR), genetics, epigenetics, oxidative stress, and inflammation act as key players. Due to the increased cardiometabolic risk of these patients, several biomarkers have been proposed for early NAFLD identification, but their clinical utility is poor...
July 27, 2023: Expert Review of Gastroenterology & Hepatology
Ali A Alali, Antoine Boustany, Myriam Martel, Alan N Barkun
INTRODUCTION: Despite advances in the management of patients with upper gastrointestinal bleeding (UGIB), associated morbidity and mortality remain significant. Most patients, however, will experience favorable outcomes without a need for hospital-based interventions. Risk assessment scores may assist in such early risk-stratification. These scales may optimize identification of low-risk patients, resulting in better resource utilization, including a reduced need for early endoscopy and fewer hospital admissions...
July 27, 2023: Expert Review of Gastroenterology & Hepatology
Abrar K Thabit, Huda J Aljedaani, Rawan H Alghamdi, Raghad M Badahdah, Manar O Lashkar, Abeer Alnajjar
INTRODUCTION: Clostridioides difficile infection (CDI) is the major cause for antibiotic-associated diarrhea. Specific factors put the pediatrics at risk. International guidelines list specific recommendations for the diagnosis and treatment of pediatric CDI. The practice of diagnosing and treating pediatric CDI in Saudi Arabia is slightly different from the recommendations of the guidelines. AREAS COVERED: This review summarizes pediatric CDI in Saudi Arabia in terms of epidemiology, current diagnostics and how the practice compares to recommendations of the guidelines, and available treatment options...
July 22, 2023: Expert Review of Gastroenterology & Hepatology
Marcello Fiorani, Livio Enrico Del Vecchio, Pasquale Dargenio, Francesco Kaitsas, Tommaso Rozera, Serena Porcari, Antonio Gasbarrini, Giovanni Cammarota, Gianluca Ianiro
INTRODUCTION: Gut microbiota produces thousands of metabolites, which have a huge impact on the host health. Specific microbial strains are able to synthesize histamine, a molecule with a crucial role in many physiologic and pathologic mechanisms of the host. This function is mediated by the histidine decarboxylase enzyme (HDC) that converts the amino acid histidine to histamine. AREAS COVERED: This review summarizes the emerging data on histamine production by gut microbiota, and the effect of bacterial-derived histamine in different clinical contexts, including cancer, irritable bowel syndrome, and other gastrointestinal and extraintestinal pathologies...
July 6, 2023: Expert Review of Gastroenterology & Hepatology
Natalia A Osna, Larisa Y Poluektova
INTRODUCTION: Liver disease is known as one of the leading co-morbidities in HIV infection, with 18% of non-AIDS-related mortality. There is constant crosstalk between liver parenchymal (hepatocytes) and non-parenchymal cells (macrophages, hepatic stellate cells, endothelial cells), and extracellular vesicles (EVs) is one of the most important ways of cell-to-cell communication. AREAS COVERED: We briefly cover the role of EVs in liver disease as well as what is known about the role of small EVs, exosomes, in HIV-induced liver disease potentiated by alcohol as one of the second hits...
June 28, 2023: Expert Review of Gastroenterology & Hepatology
Harout Ajoyan, Mark W Douglas, Thomas Tu
No abstract text is available yet for this article.
June 15, 2023: Expert Review of Gastroenterology & Hepatology
Paolo Lionetti, Eytan Wine, Rinat Ran Ressler, Gerard J Minor, Giles Major, Boutaina Zemrani, Frédéric Gottrand, Claudio Romano
INTRODUCTION: Children who require enteral nutrition often report gastrointestinal symptoms. There is a growing interest in nutrition formulas that meet nutritional requirements and also maintain gut ecology and function. Fiber-containing enteral formulas can improve bowel function, promote the growth of healthy gut microbiota, and improve immune homeostasis. Nonetheless, guidance in clinical practice is lacking. AREAS COVERED: This expert opinion article summarizes the available literature and collects the opinion of eight experts on the importance and use of fiber-containing enteral formulas in pediatrics...
June 5, 2023: Expert Review of Gastroenterology & Hepatology
Paola Balestrieri, Michele Cicala, Mentore Ribolsi
INTRODUCTION: Mental health disorders are common in inflammatory bowel disease (IBD) and affect patients' quality of life, impacting on disease outcomes and health care-related costs. AREAS COVERED: Even if psychological issues in IBD patients are highly burdened in terms of quality of life, psychiatric comorbidities still receive less attention into routine care than the physical symptoms of the disease. The present review provides an overview of recent literature, focusing on the association between perceived stress and IBD outcomes...
May 30, 2023: Expert Review of Gastroenterology & Hepatology
Alina Popp, Pilvi Laurikka, Diana Czika, Kalle Kurppa
INTRODUCTION: Duodenal biopsy is the gold standard in the diagnosis of celiac disease, with increasing utilization of serology. A gluten challenge may be required, for example, when dietary gluten reduction precedes appropriate diagnostic evaluations. Evidence on the best challenge protocol is currently sparse. Pharmaceutical trials in recent years may have provided new insights into the challenge and advanced the development of novel sensitive histological and immunological methods. AREAS COVERED: This review outlines the current perspectives on the use of gluten challenge in the diagnosis of celiac disease and explores future directions in this area...
May 27, 2023: Expert Review of Gastroenterology & Hepatology
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