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BMJ Open Gastroenterology

Hassan Tariq, Muhammad Umar Kamal, Binita Sapkota, Fady ElShikh, Usman Ali Pirzada, Nanda Pullela, Sara Azam, Aiyi Zhang, Ahmed Baiomi, Hafsa Abbas, Jasbir Makker, Bhavna Balar, Ariyo Ihimoyan, Myrta Daniel, Anil Dev
Background: Colonoscopy is a commonly used modality for screening and surveillance of colorectal cancer (CRC). Therefore, it is essential to have adequate bowel preparation (prep) for the procedure which depends on type of bowel regimens, diet before colonoscopy and timing of the procedure. Aims: The purpose of this study is to analyse the effect of multiple factors on adenoma detection rate (ADR) and prep quality of colonoscopy. This is the also the first study determining outcomes based on various combinations of diet, timing of the procedure and bowel prep regimens...
2019: BMJ Open Gastroenterology
(no author information available yet)
[This corrects the article DOI: 10.1136/bmjgast-2018-000232.].
2018: BMJ Open Gastroenterology
Mohammed Hussein Kamareddine, Youssef Ghosn, Karam Karam, Anwar Andrew Nader, Ahmad El-Mahmoud, Naseem Bou-Ayash, Mansour El-Khoury, Said Farhat
Background and aim: Colorectal cancer (CRC) has an increased impact on the Lebanese population's morbidity and mortality. This study evaluated the situation of adenoma detection in an outpatient clinic in Lebanon. Patients and methods: 918 patients underwent colonoscopy over a period of 24 months by a qualified physician. Biopsy results were divided into normal versus abnormal colonic tissue, which was further subdivided into number of polyps and cancer. Results: Out of 918 individuals included, 82 cases of Crohn's colitis (8...
2018: BMJ Open Gastroenterology
John Ong, Leila Mebarek, Michael Bath, Carla Swift, Babur Javaid, Jenish Patel, Yasseen Al-Naeeb
The gut-liver axis describes the complex interactions between gut microbiota, the small and large bowel, the immune system and the liver. Current evidence associates abnormalities within the gut-liver axis with liver disease such as primary sclerosing cholangitis (PSC). PSC is believed to be an immune-mediated disease though the exact mechanism of its pathogenesis remains unknown. Here, we report a case of a 66 -year-old woman with treatment-resistant ulcerative colitis and PSC which continued to be active following subtotal colectomy...
2018: BMJ Open Gastroenterology
Eric J Mao, Sara Lewin, Jonathan P Terdiman, Kendall Beck
Uncertainty exists regarding safety and efficacy of dual biological therapy (DBT) in inflammatory bowel disease. We present four cases of DBT in Crohn's disease. Three patients had refractory disease non-responsive to biological monotherapy or combination therapy with immunomodulators. One patient had concomitant ankylosing spondylitis. DBT was implemented by combining vedolizumab with an anti tumour necrosis antibody or with ustekinumab. DBT was well-tolerated, though two patients did experience self-limited infections...
2018: BMJ Open Gastroenterology
Magdalena Freckmann, Alexander Seipp, Martin W Laass, Sibylle Koletzko, Martin Claßen, Antje Ballauff, Jenny Peplies, Antje Timmer
Objective: We describe school performance and experience in children with inflammatory bowel disease (IBD) across Germany and Austria. Predictors of compromised performance and satisfaction were evaluated to identify subgroups of increased risk. Design: This cross-sectional analysis was based on a postal survey in children aged 10-15 with Crohn's disease, ulcerative colitis or unclassified IBD and their families. Multivariate regression analysis was used to assess influential factors on parental satisfaction with school, attending advanced secondary education (ASE), having good marks and having to repeat a class...
2018: BMJ Open Gastroenterology
Esther Kwong, Jenny Neuburger, Dave Murray, Nick Black
Introduction: Audit of emergency surgery is usually limited to immediate clinical outcomes relating to outcomes during the acute hospital episode with little attempt to capture patients' views of their longer-term outcomes. Our aim was to determine the response rate to patient-reported outcome measures (PROMs) for patients who underwent an emergency laparotomy for gastrointestinal conditions, identify response bias and explore the feasibility of comparing outcomes with their prior health based on their recalled view collected during their admission...
2018: BMJ Open Gastroenterology
John David Chetwood, Peter J Finch, Anstead Kankwatira, Jane Mallewa, Melita A Gordon, Leo Masamba
Background: Oesophageal squamous cell carcinoma (OSCC) is increasing worldwide and has an exceptionally high prevalence in certain distinct geographical locations such as the African oesophageal SCC corridor. Despite this, there is a paucity of evidence to characterise the disease particularly in the Malawian context. Method: We retrospectively audited our endoscopy database over 5 years, including for patient demographics, endoscopy findings, therapeutic intervention and recommendations for treatment...
2018: BMJ Open Gastroenterology
Xi Sun, Naoki Hosoe, Ryoichi Miyanaga, Kayoko Kimura, Shinta Mizuno, Kaoru Takabayashi, Makoto Naganuma, Hironori Niizeki, Atsuhito Seki, Haruhiko Ogata, Takanori Kanai
Objective: To further disseminate the nomenclature of chronic enteropathy associated with SLCO2A1 (CEAS), especially for physicians in China and Korea where the genetic feature of SLCO2A1 gene mutations related hypertrophic osteoarthropathy and pachydermia had been extensively studied. SLCO2A1 gene mutations related hypertrophic osteoarthropathy and pachydermia had been extensively studied. Design: A case report with literature review of SLCO2A1 gene mutations-related disorders...
2018: BMJ Open Gastroenterology
Thomas Banister, Josesph Spiking, Lakshmana Ayaru
Objective: To use an extended Glasgow-Blatchford Score (GBS) cut-off of ≤1 to aid discharge of patients presenting with acute upper gastrointestinal bleeding (AUGIB) from emergency departments. Background: The GBS accurately predicts the need for intervention and death in AUGIB, and a cut-off of 0 is recommended to identify patients for discharge without endoscopy. However, this cut-off is limited by identifying a low percentage of low-risk patients. Extension of the cut-off to ≤1 or ≤2 has been proposed to increase this proportion, but there is controversy as to the optimal cut-off and little data on performance in routine clinical practice...
2018: BMJ Open Gastroenterology
Bin Wei, Fanpu Ji, Yee Hui Yeo, Eiichi Ogawa, Christopher D Stave, Shuangsuo Dang, Zongfang Li, Norihiro Furusyo, Ramsey C Cheung, Mindie H Nguyen
Background: Genotype 3 (GT3) is a common chronic hepatitis C (CHC) genotype in Asia. Direct-acting antiviral (DAA) regimens have high cure rates, but real-world results are limited for Asia. Aim: To determine the real-world effectiveness of DAAs for patients with CHC GT3 in Asia. Methods: A systematic search was performed in PubMed (including MEDLINE), Embase, and selected international meeting abstract repositories. Eligible studies were postmarketing observational studies from Asia with the primary outcome of sustained virological response 12 weeks after completion of treatment (SVR12)...
2018: BMJ Open Gastroenterology
Anne M Rowat, Catriona Graham, Martin Dennis
Objective: The correct placement of a nasogastric feeding tube is usually confirmed by establishing that an aspirate is acidic using a pH stick. However, antacid medication and achlorhydria can cause false negative pH tests that may delay feeding and increase resource use. The purpose of this study was to evaluate a modified pH stick designed to detect gastric lipase and therefore reduce false negative tests. Methods: In this prospective observational study, a convenience sample of adult patients who had either gastric and oesophageal samples taken during routine diagnostic gastroscopy (n=97) or bronchial and saliva samples taken during a bronchoscopy (n=106)...
2018: BMJ Open Gastroenterology
Carlos Fernández Moro, Béla Bozóky, Marco Gerling
Background: Colorectal cancer liver metastases (CRLM) grow in distinct histological patterns that have been associated with outcome after surgical resection. We conducted a systematic review to evaluate the frequency of different CRLM growth patterns and their impact on prognosis. Methods: We searched Embase and MEDLINE databases from inception to 1 December 2017 to identify studies that reported CRLM growth pattern histopathology, their frequencies, and/or data related to outcome...
2018: BMJ Open Gastroenterology
Ahmad Qasem, Saleh A Naser
Background The role of Mycobacteriumavium subspecies paratuberculosis (MAP) in Crohn's disease (CD) is increasingly accepted as evident by detection of the bacteria in the blood and intestinal tissue from patients with CD, and by supporting data from several open-label anti-MAP treatment studies. Tumour necrosis factor alpha (TNFα) monoclonal antibodies (anti-TNFα) have been widely used for CD treatment. Despite the short-term benefit of anti-TNFα in controlling CD symptoms, most patients suffer from detrimental adverse effects, including higher susceptibility to mycobacterial infections...
2018: BMJ Open Gastroenterology
George Triadafilopoulos, John O Clarke
Background: The Chicago Classification (CC) defines oesophagogastric junction outflow obstruction (EGJOO) as the presence of an elevated integrated residual pressure (IRP) together with preserved oesophageal body peristalsis but its clinical significance is evolving. Aims: To describe the clinical and manometric characteristics in patients with EGJOO and propose a new classification. Methods: In this retrospective cohort study, patients with functional oesophageal symptoms underwent clinical and endoscopic assessment and oesophageal high-resolution manometry (HRM)...
2018: BMJ Open Gastroenterology
Christopher Sj Probert, Shaji Sebastian, Daniel R Gaya, P John Hamlin, Gillian Gillespie, Anita Rose, Helen Tate, Colin Wheeler, Peter M Irving
Objective: GO-COLITIS aimed to measure the effectiveness of subcutaneous golimumab in tumour necrosis factor-α antagonist-naive patients with moderate to severe ulcerative colitis (UC) despite conventional treatment. Design: GO-COLITIS was an open label, single arm, phase 4 study with a pragmatic design which reflected UK clinical practice. Adult patients were eligible if diagnosed with UC ≥3 months, partial Mayo score (PMS) 4-9. Patients received subcutaneous golimumab induction (200 mg initially and 100 mg at week 2) followed at week 6 by 50 mg or 100 mg (depending on weight) every 4 weeks until week 54 with a 12-week follow-up...
2018: BMJ Open Gastroenterology
Bin Wei, Fanpu Ji, Yee Hui Yeo, Eiichi Ogawa, Biyao Zou, Christopher D Stave, Shuangsuo Dang, Zongfang Li, Norihiro Furusyo, Ramsey C Cheung, Mindie H Nguyen
Background: Sofosbuvir plus ribavirin (SOF+RBV) for 12 weeks is the standard treatment for chronic hepatitis C (CHC) genotype 2 (GT2) in most of Asia despite availability of new CHC medications. SOF-RBV real-world effectiveness has only been reported in small and/or single-centre studies. Our goal was to determine the real-world effectiveness of 12-week SOF+RBV therapy for CHC GT2 in Asia. Methods: A systematic search on PubMed and Embase was conducted through 30 June 2017...
2018: BMJ Open Gastroenterology
Anne M Rowat, Catriona Graham, Martin Dennis
Objective: To establish the likely accuracy of pH testing to identify gastric aspirates at different pH cut-offs to confirm nasogastric tube placement. Methods: This prospective observational study included a convenience sample of adult patients who had two (one fresh and one frozen) gastric and oesophageal samples taken during gastroscopy or two bronchial and saliva samples taken during bronchoscopy. The degree of observer agreement for the pH of fresh and frozen samples was indicted by kappa ( k ) statistics...
2018: BMJ Open Gastroenterology
Christoffer Soendergaard, Jakob Benedict Seidelin, Casper Steenholdt, Ole Haagen Nielsen
Objectives: Characterise the circulating inflammatory cytokine pattern among patients failing consecutive anti-tumour necrosis factor (anti-TNF) and anti-integrin treatments to identify predictors of response. Methods: A retrospective single-centre cohort study of 28 patients with inflammatory bowel disease (IBD) receiving anti-integrin therapy (vedolizumab) subsequent to the failure of anti-TNF treatment was conducted. Blood samples were obtained immediately prior to initiation of vedolizumab therapy, and the response to treatment was evaluated after completion of the 14-week induction regimen...
2018: BMJ Open Gastroenterology
Shinsuke Otagiri, Shunsuke Ohnishi, Arisa Miura, Hiroshi Hayashi, Izumi Kumagai, Yoichi M Ito, Takehiko Katsurada, Shiro Nakamura, Rika Okamoto, Kenichi Yamahara, Kyu Yong Cho, Toshiyuki Isoe, Norihiro Sato, Naoya Sakamoto
Introduction: The medical treatment options for patients with Crohn's disease (CD) are limited and patients resistant to those therapies are left requiring surgical operations that usually only achieve some symptomatic relief. Mesenchymal stem cells (MSC) have been shown to be effective for the treatment of CD, and we have demonstrated in animal experiments that human amnion-derived MSCs (AMSC) are a potential new therapeutic strategy. Therefore, we designed this study to investigate the safety and efficacy of AMSCs in patients with treatment-resistant CD...
2018: BMJ Open Gastroenterology
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