Near-focus narrow-band imaging for endoscopic assessment of duodenal villi: Making the case more than ever?

Examination of the duodenal mucosa is necessary to rule out, rule in, and monitor various digestive disorders and is a common indication for EGD. Celiac disease (CD), a complex, polygenic, gluten-induced inflammatory enteropathy, is a hallmark example of a disorder wherein duodenal mucosal examination plays a fundamental role  in clinical management. EGD has the benefit of facilitating direct and expedient assessment in this regard, and in CD, several classic endoscopic manifestations may be observed, including mucosal fissuring (ie, “cracked mud appearance”), scalloping or loss of the valvulae conniventes, and of c ourse villous atrophy (VA).
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Editorial Source Type: research

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CONCLUSION: In our cohort of patients, females were clearly more often affected and also showed a small deviation in height and weight. Our finding of 10% of all patients having no symptoms at all is in line with other studies observing a decline in symptoms. A complicating factor for the clinician is the fact that overall no vitamin deficiencies were detected. As the incidence continues to rise but the clinical presentation of coeliac disease is changing from a malabsorption syndrome to a silent disease, further observational studies are needed to monitor this trend.PMID:34815196 | DOI:10.1016/j.zefq.2021.09.011
Source: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen - Category: Health Management Authors: Source Type: research
Condition:   Celiac Disease Interventions:   Diagnostic Test: High-definition white light endoscopy (HD-WLE);   Diagnostic Test: HD-WLE plus I-Scan optical enhancement (OE) virtual chromoendoscopy with High-definition optical magnification (HD-OM) Sponsor:   Instituto Ecuatoriano de Enfermedades Digestivas Active, not recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
AI and machine learning have the potential to redefine the management of several GI disorders.John Halamka, M.D., president, Mayo Clinic Platform, and Paul Cerrato, senior research analyst and communications specialist, Mayo Clinic Platform, wrote this article.Colonoscopy is one of the true success stories in modern medicine.Studies have demonstrated that colonoscopy screening detects the cancer at a much earlier stage, reducing the risk of invasive tumors and metastatic disease, andreducing mortality. However, while colorectal cancer is highly preventable, it is thethird leading cause of cancer-related deathsin the U.S. A...
Source: Life as a Healthcare CIO - Category: Information Technology Source Type: blogs
ConclusionScreening for celiac disease should be considered in patients with iron deficiency anemia of obscure origin
Source: QJM - Category: Internal Medicine Source Type: research
Am J Clin Pathol. 2021 Sep 20:aqab104. doi: 10.1093/ajcp/aqab104. Online ahead of print.ABSTRACTOBJECTIVES: Forgoing biopsy for the diagnosis of celiac disease in children with tissue transglutaminase immunoglobulin A (tTG-IgA) levels greater than or equal to 10 times the upper limit of normal (≥10×ULN) has been advocated by the European Society of Paediatric Gastroenterology, Hepatology and Nutrition.METHODS: Our retrospective study tested the specificity and positive predictive value (PPV) of the BioPlex 2200 assay (Bio-Rad Laboratories) in diagnosing celiac disease at the ≥10×ULN tTG-IgA threshold, whi...
Source: American Journal of Clinical Pathology - Category: Pathology Authors: Source Type: research
J Clin Res Pediatr Endocrinol. 2021 Aug 18. doi: 10.4274/jcrpe.galenos.2021.2021.0139. Online ahead of print.ABSTRACTIt is well-known that in children with type 1 diabetes (T1D), the frequency of celiac disease (CD) is increased due to unclear mechanisms including autoimmune injury as well as shared genetic predisposition. Although histopathologic examination is gold standard, avoiding unnecessary endoscopy is crucial. Therefore, from the perspective of the clinicians and patients' families, the diagnosis of celiac disease remains challenging. With these in mind, a joint working group (Type 1 Diabetes and Celiac Disease Jo...
Source: JCRPE Journal of Clinical Research in Pediatric Endocrinology - Category: Endocrinology Authors: Source Type: research
We examined the yield of colonoscopy and upper endoscopy in IBS for several organic diseases.METHODS: Matched population-based prevalence study in Sweden. We identified 21,944 participants diagnosed with IBS from 1987 to 2016 undergoing colonoscopy with a biopsy from all of Sweden's 28 pathology departments within 6 months of diagnosis. We compared prevalence of histopathology-proven diagnoses of inflammatory bowel disease (IBD), colorectal cancer, precancerous polyps, and microscopic colitis between patients recently diagnosed with IBS and matched controls without IBS (n = 81,101) undergoing colonoscopy. We also compared ...
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Source Type: research
Eur J Pharmacol. 2021 Aug 18:174434. doi: 10.1016/j.ejphar.2021.174434. Online ahead of print.ABSTRACTCeliac Disease (CeD) is estimated to currently affect 2 million Americans in the United States. This autoimmune disorder occurs when the consumption of gluten-based products leads to an inflammatory response in the small intestine. Over time, this inflammatory response permanently damages the villi in the small intestine. Celiac disease patients generally present with fatigue, diarrhea, and weight loss due to the disease. The current gold standard for diagnosing CeD is the endoscopy with duodenal biopsy indicating villous ...
Source: European Journal of Pharmacology - Category: Drugs & Pharmacology Authors: Source Type: research
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