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Tests of intestinal mucosal hyperpermeability: many diseases, many biomarkers and a bright future
Publication date: Available online 20 July 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Dominic-Luc WebbAbstractThe number of disorders now linked to increased intestinal mucosal permeability implies that a substantial percent of the population is affected. Drug interventions targeting reduced tight junctional permeability are being pursued. Although hyper-permeability in itself is not a clinically recognized disease entity, its relationship to disease processes has driven interest in measuring, and even monitoring mucosal permeability in vivo. Along with improved knowledge of gut barrier physio...
Source: Best Practice and Research Clinical Gastroenterology - July 21, 2019 Category: Gastroenterology Source Type: research

Editorial Board
Publication date: February–April 2019Source: Best Practice & Research Clinical Gastroenterology, Volumes 38–39Author(s): (Source: Best Practice and Research Clinical Gastroenterology)
Source: Best Practice and Research Clinical Gastroenterology - July 19, 2019 Category: Gastroenterology Source Type: research

The Rome IV: irritable bowel syndrome - a functional disorder
Publication date: Available online 18 July 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Per M. Hellström, Peter BennoAbstractFunctional gastrointestinal disorders are the most common disorders encountered in the clinical gastroenterology setting. Over the years the Rome process has generated consensus definitions of functional gastrointestinal disorders, and given diagnostic criteria, based on various symptom patterns, that have evolved over the years. The latest Rome IV consensus was presented in May, 2016. This summary points out some of the important changes made from the Rome III 2006 conse...
Source: Best Practice and Research Clinical Gastroenterology - July 19, 2019 Category: Gastroenterology Source Type: research

Preface – Gastrointestinal bleeding
Publication date: Available online 9 July 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Vipul Jairath (Source: Best Practice and Research Clinical Gastroenterology)
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2019 Category: Gastroenterology Source Type: research

Publisher's note
Publication date: Available online 28 June 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Victoria Wetherell (Source: Best Practice and Research Clinical Gastroenterology)
Source: Best Practice and Research Clinical Gastroenterology - June 29, 2019 Category: Gastroenterology Source Type: research

Is there still a role for the surgeon in the management of gastrointestinal bleeding ?
Publication date: Available online 14 June 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Claire L. Donohoe, Timothy A. RockallAbstractModern investigation of gastrointestinal bleeds allows for reliable source identification in most cases. Current treatment algorithms utilise therapeutic endoscopy or interventional radiology and surgery now plays a limited role in the treatment of gastrointestinal bleeds. Approximately 2–4% of patients admitted with GI bleeds, however, require surgery to control their haemorrhage. (Source: Best Practice and Research Clinical Gastroenterology)
Source: Best Practice and Research Clinical Gastroenterology - June 20, 2019 Category: Gastroenterology Source Type: research

“Can Magnetic Resonance Enterography (MRE) replace ileo-colonoscopy for evaluating disease activity in Crohn's disease?”
Publication date: Available online 31 May 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Fumi Varyani, Sunil SamuelAbstractCrohn's disease is a form of chronic inflammatory bowel disease that can lead to structural bowel damage due to transmural inflammation. Ileo-colonosocopy is currently essential for initial diagnosis. Reassessment of disease burden is frequently needed during episodes of active disease and when evaluating treatment efficacy. This review compares the role of Magnetic Resonance Enterography (MRE) and ileocolonoscopy in Crohn's disease management and whether cross-sectional imagi...
Source: Best Practice and Research Clinical Gastroenterology - June 20, 2019 Category: Gastroenterology Source Type: research

Preface - Evolving approaches to the evaluation and management of Crohn’s Disease
Publication date: Available online 19 June 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Vipul Jairath (Source: Best Practice and Research Clinical Gastroenterology)
Source: Best Practice and Research Clinical Gastroenterology - June 20, 2019 Category: Gastroenterology Source Type: research

Is there still a role for the surgeon in the management of gastrointestinal bleeding?
Publication date: Available online 14 June 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Claire L. Donohoe, Timothy A. RockallAbstractModern investigation of gastrointestinal bleeds allows for reliable source identification in most cases. Current treatment algorithms utilise therapeutic endoscopy or interventional radiology and surgery now plays a limited role in the treatment of gastrointestinal bleeds. Approximately 2-4% of patients admitted with GI bleeds, however, require surgery to control their haemorrhage. (Source: Best Practice and Research Clinical Gastroenterology)
Source: Best Practice and Research Clinical Gastroenterology - June 16, 2019 Category: Gastroenterology Source Type: research

Interfering with leukocyte trafficking in Crohn's disease
Publication date: Available online 28 May 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Sujata Biswas, Robert V. Bryant, Simon TravisAbstractThe discovery of gut-specific leukocytes and the ability to modulate their function has been a groundbreaking development in the treatment of inflammatory bowel disease. Drugs target the interaction between lymphocytes and endothelial cells via integrins and their ligand cellular adhesion molecules. Safety, efficacy and sustainability of effect are key to this drug class, notwithstanding the association of natalizumab with fatal polyoma virus infection. Vedo...
Source: Best Practice and Research Clinical Gastroenterology - June 11, 2019 Category: Gastroenterology Source Type: research

Network meta-analysis to inform positioning of biologics in patients with Crohn's disease: Promise and perils
Publication date: Available online 3 June 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Siddharth SinghAbstractWith availability of several different classes of biologic agents with variable efficacy and safety profiles for moderate-severe Crohn's disease (CD), positioning of different agents in treatment course is an important question for clinicians. Though in an ideal world, positioning would be personalized and driven by likelihood of response to different agents based on biomarkers in individual patients, that is still far from reality, and decisions are empiric. In the absence of head-to-he...
Source: Best Practice and Research Clinical Gastroenterology - June 10, 2019 Category: Gastroenterology Source Type: research

Optimal timing of endoscopy in patients with acute upper gastrointestinal bleeding
Publication date: Available online 3 June 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Sardar Chaudhary, Adrian J. StanleyAbstractEndoscopy is the gold standard for evaluating and treating acute upper gastrointestinal bleeding (UGIB). The optimal timing of endoscopy is a very important consideration in the overall management of UGIB, but there is on going uncertainty regarding timing of the procedure, particularly in those with more severe bleeding. This is reflected by inconsistencies between current guidelines. Although evidence suggests endoscopy should be undertaken within 24 h for all adm...
Source: Best Practice and Research Clinical Gastroenterology - June 4, 2019 Category: Gastroenterology Source Type: research

Network Meta-analysis to Inform Positioning of Biologics in Patients with Crohn’s Disease: Promise and Perils
Publication date: Available online 3 June 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Siddharth SinghAbstractWith availability of several different classes of biologic agents with variable efficacy and safety profiles for moderate-severe Crohn’s disease (CD), positioning of different agents in treatment course is an important question for clinicians. Though in an ideal world, positioning would be personalized and driven by likelihood of response to different agents based on biomarkers in individual patients, that is still far from reality, and decisions are empiric. In the absence of head-to-...
Source: Best Practice and Research Clinical Gastroenterology - June 3, 2019 Category: Gastroenterology Source Type: research

Therapeutic potential of an anaerobic cultured human intestinal microbiota, ACHIM, for treatment of IBS
Publication date: Available online 29 April 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): P. Benno, E. Norin, T. Midtvedt, P.M. HellströmAbstractBy administering an anaerobic cultivated human intestinal microbiota (ACHIM) via upper gastrointestinal route using endoscopy we aimed to rectify intestinal dysbiosis and simultaneously achieve a treatment response in IBS patients. The study population fulfilled the Rome III IBS criteria and comprised 50 patients. During 10 days, patients recorded the irritable bowel syndrome symptom severity scale (IBS-SSS) along with the Bristol stool scale and number...
Source: Best Practice and Research Clinical Gastroenterology - June 1, 2019 Category: Gastroenterology Source Type: research