Systemic Therapy in Metastatic Hepatocellular Carcinoma
AbstractPurpose of ReviewMultiple new tyrosine kinase inhibitors, immunotherapies and anti-angiogenic therapies are now available for the treatment of advanced hepatocellular carcinoma (HCC). In this article, we reviewed the evidence supporting these new therapies.Recent FindingsThe combination of atezolizumab and bevacizumab has become a new standard of care for initial systemic therapy in eligible patients, replacing sorafenib in the first line for many patients. Lenvatinib, a multikinase inhibitor, is also a new first line treatment option for patients who are not eligible for immunotherapy. Several additional options f...
Source: Current Gastroenterology Reports - April 13, 2022 Category: Gastroenterology Source Type: research
Role of Traditional Chinese Herbal Medicines in Functional Gastrointestinal and Motility Disorders
AbstractPurpose of ReviewTraditional Chinese medicine (TCM) has been in use for thousands of years in Asian countries and is rapidly gaining popularity in the Western world. Among different forms of TCM, the traditional Chinese herbal therapy and acupuncture are the most popular modalities. Here, we review the fundamentals of TCMs for clinicians practicing in the West and will also detail the evidence-based utility of Chinese herbal medicine in the management of functional gastrointestinal disorders (FGIDs).Recent FindingsIn the recent decades, the popularity and usage of traditional Chinese herbal medicine in FGIDs is inc...
Source: Current Gastroenterology Reports - March 30, 2022 Category: Gastroenterology Source Type: research
Preparative Fasting Orders for Medical/Surgical Interventions and Imaging Studies: Time to Review and Revise!
AbstractPurpose of the ReviewPreparative fasting orders arose out of a purported need to enhance imaging studies, reduce interference of food with intended medical/surgical interventions, and protect the patient from vomiting and aspiration pneumonia. This review discusses the frequency, appropriateness, and efficacy of fasting orders in meeting those needs and whether their use should be modified in the future.Recent FindingsNil per os (NPO) orders are overused, as they are often inappropriate, typically excessive, and routinely create barriers which may increase risk for patients. Fasting orders are used more often for m...
Source: Current Gastroenterology Reports - March 3, 2022 Category: Gastroenterology Source Type: research
Sarcopenia in Chronic Pancreatitis – Prevalence, Diagnosis, Mechanisms and Potential Therapies
AbstractPurpose of ReviewTo investigate the prevalence, pathogenesis, diagnosis, clinical sequelae, and management of sarcopenia to improve mortality and quality of life in those with Chronic Pancreatitis.Recent FindingsSarcopenia is prevalent in chronic pancreatitis and can significantly affect clinical outcomes.SummarySarcopenia is prevalent in chronic pancreatitis. While effects on some clinical outcomes is has been shown, there is a significant gap in knowledge regarding effects on outcomes, pathophysiology, and options for management. (Source: Current Gastroenterology Reports)
Source: Current Gastroenterology Reports - February 15, 2022 Category: Gastroenterology Source Type: research
Impact of Obesity on Inflammatory Bowel Disease
AbstractPurpose of ReviewThis review highlights recent work that evaluates the impact of obesity on inflammatory bowel disease (IBD) pathogenesis and management.Recent FindingsThe impact of obesity on IBD prevalence, clinical course, and management, has been studied and described more so in recent years. Studies have shown that obesity increases IBD disease activity, leads to longer hospitalization courses, and increases the likelihood of the development of extraintestinal manifestations. Recent evidence has also suggested that obese IBD patients have a higher frequency of extended steroid treatment and increased use of an...
Source: Current Gastroenterology Reports - February 12, 2022 Category: Gastroenterology Source Type: research
When Can we Feed after a Gastrointestinal Bleed?
AbstractPurpose of ReviewGastrointestinal (GI) bleeding can carry minimal or significant risk for recurrent hemorrhage. Timing of feeding after GI bleeding remains an area of debate, and here we review the evidence supporting recommendations.Recent FindingsImproved understanding of the pathophysiology of GI bleeding and the evolution of treatment strategies has significantly altered the management of GI bleeding and the associated propensity for rebleeding. Early feeding following peptic ulcer bleeding remains ill-advised for high risk lesions while early initiation of liquid diets following cessation of esophageal varicea...
Source: Current Gastroenterology Reports - February 11, 2022 Category: Gastroenterology Source Type: research
Models to Predict Development or Recurence of Hepatocellular Carcinoma (HCC) in Patients with Advanced Hepatic Fibrosis
AbstractPurpose of ReviewHepatocellular carcinoma (HCC) is the third leading cause of cancer-related death in the United States (U.S.).1 The purpose of this review is to highlight published models that predict development of HCC and estimate risk of HCC recurrence after treatments.Recent FindingsThere have been several models created for both de novo HCC and HCC recurrence, with the more recent models using a combination of age, sex, decompensation, and laboratory values (platelet count, albumin, bilirubin), and liver disease etiology to predict both 5 and 10-year HCC incidence. For chronic hepatitis C, sustained virologic...
Source: Current Gastroenterology Reports - February 10, 2022 Category: Gastroenterology Source Type: research
Evaluation of Esophageal Motility and Lessons from Chicago Classification version 4.0
AbstractPurpose of ReviewChicago Classification has standardized clinical approach to primary esophageal motility disorders. With new clinical data and advancing treatments, Chicago Classification has undergone multiple revisions to reflect updated findings and enhance diagnostic accuracy. This review will describe the recently published Chicago Classification version 4.0 (CCv4.0), which aimed to enhance diagnostic characterization and limit overdiagnosis of inconclusive esophageal motility diagnoses.Recent FindingsKey revisions outlined in CCv4.0 include (1) a modified standardized HRM study protocol performed in supine a...
Source: Current Gastroenterology Reports - January 27, 2022 Category: Gastroenterology Source Type: research