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Gastrointestinal diseases

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852 papers 500 to 1000 followers This is a recopilation of basic knowledge about GI diseases. I hope you enjoy it
By Andres Gomez Aldana Gastroenterology specialist National University of Colombia - liver transplant
Jianwen Que, Katherine S Garman, Rhonda F Souza, Stuart Jon Spechler
In patients with Barrett's esophagus (BE), metaplastic columnar mucosa, containing epithelial cells with gastric and intestinal features, replaces esophageal squamous mucosa damaged by gastroesophageal reflux disease. This condition is estimated to affect 5.6% of adults in the United States, and is a major risk factor for esophageal adenocarcinoma. Despite the prevalence and importance of BE, its pathogenesis is incompletely understood and there are disagreements over the cells of origin. We review mechanisms of BE pathogenesis, including transdifferentiation and transcommitment, and discuss potential cells of origin including basal cells of the squamous epithelium, cells of esophageal submucosal glands and their ducts, cells of the proximal stomach, and specialized populations of cells at the esophago-gastric junction (residual embryonic cells and transitional basal cells)...
May 10, 2019: Gastroenterology
Michael Camilleri
The objectives of this review on 'leaky gut' for clinicians are to discuss the components of the intestinal barrier, the diverse measurements of intestinal permeability, their perturbation in non-inflammatory 'stressed states' and the impact of treatment with dietary factors. Information on 'healthy' or 'leaky' gut in the public domain requires confirmation before endorsing dietary exclusions, replacement with non-irritating foods (such as fermented foods) or use of supplements to repair the damage. The intestinal barrier includes surface mucus, epithelial layer and immune defences...
May 10, 2019: Gut
Ulrich Stölzel, Manfred O Doss, Detlef Schuppan
Physicians should be aware of porphyrias, which could be responsible for unexplained gastrointestinal, neurologic, or skin disorders. Despite their relative rarity and complexity, most porphyrias can be easily defined and diagnosed. They are caused by well-characterized enzyme defects in the complex heme biosynthetic pathway and are divided into categories of acute vs non-acute or hepatic vs erythropoietic porphyrias. Acute hepatic porphyrias (acute intermittent porphyria, variegate porphyria, hereditary coproporphyria, and aminolevulinic acid dehydratase deficient porphyria) manifest in attacks and are characterized by overproduction of porphyrin precursors, producing often serious abdominal, psychiatric, neurologic, or cardiovascular symptoms...
May 11, 2019: Gastroenterology
Giovanni Raimondo, Stephen Locarnini, Teresa Pollicino, Massimo Levrero, Fabien Zoulim, Anna S Lok
In October 2018 a large number of international experts with complementary expertise came together in Taormina to participate in a workshop on occult hepatitis B virus infection (OBI). The objectives of the workshop were to review the existing knowledge on OBI, to identify issues that require further investigation, to highlight both the existing controversial and newly emerging aspects, and ultimately to update the statements previously agreed in 2008. This paper represents the output from the workshop.
April 17, 2019: Journal of Hepatology
Jonathan G Stine, Patrick G Northup
Non-tumoral portal vein thrombosis (PVT) remains a highly relevant topic in the field of hepatology and liver transplantation with much surrounding controversy. Although multiple studies have shown that PVT is associated with adverse outcomes with increased morbidity and mortality rates, others have not reported the same clinical impact of PVT, arguing rather that incident PVT reflects worsening portal hypertension and the natural history of the disease. Despite this uncertainly, PVT is a dilemma facing the clinician on a daily basis often requiring a multidisciplinary team-based approach between hepatologists, transplant surgeons, interventional radiologists and hematologists...
March 2019: Digestive Diseases and Sciences
David H Ellison
No abstract text is available yet for this article.
April 1, 2019: Clinical Journal of the American Society of Nephrology: CJASN
Jeffrey A Norton, Deshka S Foster, Tetsuhide Ito, Robert T Jensen
This article reviews the role of surgical and medical management in patients with Zollinger-Ellison syndrome (ZES) due to a gastrin-secreting neuroendocrine tumor (gastrinoma). It concentrates on the status at present but also briefly reviews the changes over time in treatment approaches. Generally, surgical and medical therapy are complementary today; however, in some cases, such as patients with ZES and multiple endocrine neoplasia type 1, the treatment approach remains controversial.
September 2018: Endocrinology and Metabolism Clinics of North America
Jacek Czepiel, Mirosław Dróżdż, Hanna Pituch, Ed J Kuijper, William Perucki, Aleksandra Mielimonka, Sarah Goldman, Dorota Wultańska, Aleksander Garlicki, Grażyna Biesiada
Clostridium difficile (C. difficile) is a Gram-positive, spore-forming, anaerobic bacillus, which is widely distributed in the intestinal tract of humans and animals and in the environment. In the last decade, the frequency and severity of C. difficile infection has been increasing worldwide to become one of the most common hospital-acquired infections. Transmission of this pathogen occurs by the fecal-oral route and the most important risk factors include antibiotic therapy, old age, and hospital or nursing home stay...
April 3, 2019: European Journal of Clinical Microbiology & Infectious Diseases
M F Neurath
Healing of the inflamed mucosa (mucosal healing) is an emerging new goal for therapy and predicts clinical remission and resection-free survival in inflammatory bowel diseases (IBDs). The era of antitumor necrosis factor (TNF) antibody therapy was a remarkable progress in IBD therapy and anti-TNF agents led to mucosal healing in a subgroup of IBD patients; however, many patients do not respond to anti-TNF treatment highlighting the relevance of finding new targets for therapy of IBD. In particular, current studies are addressing the role of other anticytokine agents including antibodies against interleukin (IL)-6R, IL-13, and IL-12/IL-23 as well as new anti-inflammatory concepts (regulatory T cell therapy, Smad7 antisense, Jak inhibition, Toll-like receptor 9 stimulation, worm eggs)...
January 2014: Mucosal Immunology
Brent A Neuschwander-Tetri
Nonalcoholic steatohepatitis (NASH) is increasingly recognized as a major form of chronic liver disease in adults and children. Although improved dietary habits and regular exercise remain the primary recommendations for patients with or at risk of having NASH, implementing and sustaining these lifestyle changes have proven to be challenging. Pharmacologic approaches are now being evaluated to prevent the development of cirrhosis and its complications in the approximately 1% of the population of countries consuming a Western diet at risk for NASH...
October 2018: Gastroenterology & Hepatology
Prashant Bhangui, Alexis Laurent, Roland Amathieu, Daniel Azoulay
No abstract text is available yet for this article.
October 2012: Journal of Hepatology
Joel E Richter, Steven B Clayton
No abstract text is available yet for this article.
January 21, 2019: American Journal of Gastroenterology
Guido Stirnimann, Maryam Ebadi, Albert J Czaja, Aldo J Montano-Loza
Clinical indications for liver transplantation (LT) in patients with autoimmune hepatitis (AIH) are identical to those of patients with other chronic liver diseases that end in acute or semiacute liver failure, decompensated cirrhosis, or hepatocellular carcinoma. Recurrent disease after LT has been reported in 10%-50% of patients with AIH, and the frequency of detection is influenced in part by the use of protocol or clinically indicated liver biopsy. De novo AIH connotes the development of AIH in patients transplanted for liver diseases other than AIH, and it has been reported in 5%-10% of pediatric and 1%-2% of adult recipients...
January 2019: Liver Transplantation
Timur Liwinski, Christoph Schramm
Autoimmune hepatitis (AIH) is a progressive immune mediated liver disease of unknown origin. Key diagnostic features include hypergammaglobulinemia/elevated serum-IgG, characteristic circulating autoantibodies, periportal hepatitis with interface activity on liver biopsy and the exclusion of hepatotropic viruses. However, the diagnosis is challenging in cholestatic and severe presentations. It can be difficult to differentiate AIH from drug-induced liver injury. Although many patients initially respond to standard immunosuppressive therapy, a significant proportion experiences intolerable side effects or insufficient treatment response...
December 2017: Clinics and Research in Hepatology and Gastroenterology
Joachim Labenz, Parakrama T Chandrasoma, Laura J Knapp, Tom R DeMeester
The progression of gastroesophageal reflux disease (GERD) in patients who are taking proton pump inhibitors (PPIs) has been reported by several investigators, leading to concerns that PPI therapy does not address all aspects of the disease. Patients who are at risk of progression need to be identified early in the course of their disease in order to receive preventive treatment. A review of the literature on GERD progression to Barrett's esophagus and the associated physiological and pathological changes was performed and risk factors for progression were identified...
September 16, 2018: World Journal of Gastrointestinal Endoscopy
Hideki Mori, Hidekazu Suzuki
Proton pump inhibitors are commonly utilized for the treatment of gastric acid-related conditions, such as gastroesophageal reflux disease, peptic ulcer disease, and Helicobacter pylori infection, and for the prevention of low-dose aspirin or nonsteroidal anti-inflammatory drug associated peptic ulcers. Vonoprazan is a first-in-class potassium-competitive acid blocker, which has distinct advantages compared to other conventional proton pump inhibitors in terms of the rate and effectiveness at which gastric acid suppression occurs...
November 20, 2018: Journal of Neurogastroenterology and Motility
Richard H Hunt, Carmelo Scarpignato
PURPOSE OF THE REVIEW: Acid suppression treatment has revolutionized the management of the acid-related disorders since the introduction of the H2 -receptor antagonists (H2 -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...
December 2018: Current Treatment Options in Gastroenterology
Trisha M Parab, Michael J DeRogatis, Alexander M Boaz, Salvatore A Grasso, Paul S Issack, David A Duarte, Olivier Urayeneza, Saloomeh Vahdat, Jian-Hua Qiao, Gudata S Hinika
Gastrointestinal stromal tumors (GISTs) are rare neoplasms of the gastrointestinal tract associated with high rates of malignant transformation. Most GISTs present asymptomatically. They are best identified by computed tomography (CT) scan and most stain positive for CD117 (C-Kit), CD34, and/or DOG-1. There have been many risk stratification classifications systems which are calculated based on tumor size, mitotic rate, location, and perforation. The approaches to treating GISTs are to resect primary low-risk tumors, resect high-risk primary or metastatic tumors with imatinib 400 mg daily for 12 months, or if the tumor is unresectable, neoadjuvant imatinib 400 mg daily followed by surgical resection is recommended...
February 2019: Journal of Gastrointestinal Oncology
Peter L Labib, George Goodchild, Stephen P Pereira
BACKGROUND: Cholangiocarcinomas are a heterogeneous group of malignancies arising from a number of cells of origin along the biliary tree. Although most cases in Western countries are sporadic, large population-based studies have identified a number of risk factors. This review summarises the evidence behind reported risk factors and current understanding of the molecular pathogenesis of cholangiocarcinoma, with a focus on inflammation and cholestasis as the driving forces in cholangiocarcinoma development...
February 28, 2019: BMC Cancer
Virginia Hernández-Gea, Andrea De Gottardi, Frank W G Leebeek, Pierre-Emmanuel Rautou, Riad Salem, Juan Carlos Garcia-Pagan
Budd-Chiari Syndrome (BCS) and non-cirrhotic non-tumoral portal vein thrombosis (NCPVT) are two rare disorders, with several similarities that are categorized under the term splanchnic vein thrombosis. Both disorders are frequently associated with an underlying pro-thrombotic disorder. They can cause severe portal hypertension and usually affect oung patients, negatively influencing life expectancy when the diagnosis and treatment is not done at an early stage. Yet, they have specific features that require individual considerations...
February 26, 2019: Journal of Hepatology
2019-03-06 15:13:30
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