A Practical Approach to IBD Care in the Pregnant Patient
AbstractPurpose of ReviewAs the incidence of inflammatory bowel disease (IBD) rises, gastroenterologists are more commonly facing management of the disease in women of childbearing age. This coincides with the development of new IBD therapies whose use in pregnancy must be considered.Recent FindingsThis review provides updated recommendations for newer biologic agents and small molecules that have been approved for IBD treatment since the previous guidelines were published. In addition, recent research has found that prior IBD-related surgeries, not just ileal pouch-anal anastomosis, can impact pregnancy outcomes. Reassuri...
Source: Current Gastroenterology Reports - November 23, 2022 Category: Gastroenterology Source Type: research
The Role of Pediatric Gastroenterologists in the Evaluation of Complex Aerodigestive Disorders
AbstractPurpose of ReviewChildren with aerodigestive disorders frequently have concerns regarding difficulty breathing, swallowing, and growing. In this review, we explored the role of pediatric gastroenterologists in the evaluation of complex aerodigestive disorders and the overall approach to these often-challenging patients.Recent FindingsPediatric gastroenterologists evaluate children with aerodigestive concerns ranging from dysphagia and gastroesophageal reflux to complex congenital abnormalities such as esophageal atresia. Diagnostic tools, such as multichannel intraluminal impedance-pH monitoring, are used for diagn...
Source: Current Gastroenterology Reports - November 19, 2022 Category: Gastroenterology Source Type: research
Gastrocolonic Response
AbstractPurpose of ReviewThe gastrocolonic response (GCR), is a physiologic increase in motor activity of the colon, which usually occurs within minutes following meal ingestion. Over the years several triggers that provoke GCR were recognized including gastric dilation, caloric intake, and fat component of the meal. The response is mediated by the vagal nerve and neurohumoral mechanisms, and it can be modified by several pharmacological factors. Assessment of GCR is part of high-resolution colonic manometry studies, performed in patients with suspected colonic dysmotility. This review highlights the physiologic basis of G...
Source: Current Gastroenterology Reports - November 3, 2022 Category: Gastroenterology Source Type: research
Article Topic: Positioning Ulcerative Colitis Therapies in 2022 and Beyond
AbstractPurpose of ReviewUlcerative colitis (UC) is a chronic disease with an increasing incidence. Recent guidelines emphasize treating toward objective targets, requiring the use of effective, steroid-sparing therapies. This review summarizes the safety and efficacy data of available therapies as well comparative effectiveness studies in order to help the reader make rational treatment decisions.Recent FindingsFollowing the approval of tumor necrosis factor alpha antagonists, we have seen recent regulatory approval of several additional biologic and small molecule agents from several therapeutic classes (integrin antagon...
Source: Current Gastroenterology Reports - November 3, 2022 Category: Gastroenterology Source Type: research
Gastrocolonic Response
AbstractPurpose of ReviewThe gastrocolonic response (GCR), is a physiologic increase in motor activity of the colon, which usually occurs within minutes following meal ingestion. Over the years several triggers that provoke GCR were recognized including gastric dilation, caloric intake, and fat component of the meal. The response is mediated by the vagal nerve and neurohumoral mechanisms, and it can be modified by several pharmacological factors. Assessment of GCR is part of high-resolution colonic manometry studies, performed in patients with suspected colonic dysmotility. This review highlights the physiologic basis of G...
Source: Current Gastroenterology Reports - November 3, 2022 Category: Gastroenterology Source Type: research
Article Topic: Positioning Ulcerative Colitis Therapies in 2022 and Beyond
AbstractPurpose of ReviewUlcerative colitis (UC) is a chronic disease with an increasing incidence. Recent guidelines emphasize treating toward objective targets, requiring the use of effective, steroid-sparing therapies. This review summarizes the safety and efficacy data of available therapies as well comparative effectiveness studies in order to help the reader make rational treatment decisions.Recent FindingsFollowing the approval of tumor necrosis factor alpha antagonists, we have seen recent regulatory approval of several additional biologic and small molecule agents from several therapeutic classes (integrin antagon...
Source: Current Gastroenterology Reports - November 3, 2022 Category: Gastroenterology Source Type: research
Update on Immune Checkpoint Inhibitor Enterocolitis
AbstractPurpose of ReviewImmune checkpoint inhibitor (ICI) therapy revolutionized the treatment of multiple solid and hematologic malignancies. Yet, with it came profound inflammatory toxicities that mimic autoimmune diseases, termed immune-related adverse events (irAEs). Prominent among these is gastrointestinal inflammation, including a spectrum of gastritis, enteritis, and colitis. Here we synthesize an approach to immune checkpoint related enterocolitis (irEC) – including diagnostics and therapeutics – underpinned by new insights into the mechanism behind these phenomena.Recent FindingsThis review presents updated ...
Source: Current Gastroenterology Reports - October 20, 2022 Category: Gastroenterology Source Type: research
Incorporating Nutrition-Based Strategies into IBD Treatment
We present an overview of evidence-based recommendations and recent research in dietary therapy and nutrition management for patients with IBD.Recent FindingsPatients with IBD should undergo a comprehensive nutrition assessment with the assistance of a registered dietitian (RD), including screening for micronutrient deficiencies. Multiple specialized whole foods and liquid formula diets have been evaluated as part of induction and maintenance therapy for IBD. Nutritional status should ideally be optimized in the perioperative setting as well.SummaryNutritional issues are prevalent among IBD patients and should be addressed...
Source: Current Gastroenterology Reports - October 20, 2022 Category: Gastroenterology Source Type: research
Update on Immune Checkpoint Inhibitor Enterocolitis
AbstractPurpose of ReviewImmune checkpoint inhibitor (ICI) therapy revolutionized the treatment of multiple solid and hematologic malignancies. Yet, with it came profound inflammatory toxicities that mimic autoimmune diseases, termed immune-related adverse events (irAEs). Prominent among these is gastrointestinal inflammation, including a spectrum of gastritis, enteritis, and colitis. Here we synthesize an approach to immune checkpoint related enterocolitis (irEC) – including diagnostics and therapeutics – underpinned by new insights into the mechanism behind these phenomena.Recent FindingsThis review presents updated ...
Source: Current Gastroenterology Reports - October 20, 2022 Category: Gastroenterology Source Type: research
Incorporating Nutrition-Based Strategies into IBD Treatment
We present an overview of evidence-based recommendations and recent research in dietary therapy and nutrition management for patients with IBD.Recent FindingsPatients with IBD should undergo a comprehensive nutrition assessment with the assistance of a registered dietitian (RD), including screening for micronutrient deficiencies. Multiple specialized whole foods and liquid formula diets have been evaluated as part of induction and maintenance therapy for IBD. Nutritional status should ideally be optimized in the perioperative setting as well.SummaryNutritional issues are prevalent among IBD patients and should be addressed...
Source: Current Gastroenterology Reports - October 20, 2022 Category: Gastroenterology Source Type: research
Disease Monitoring of the Ileoanal Pouch: How to Utilize Biomarkers, Imaging, and Pouchoscopy
AbstractPurpose of Review:Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis has been associated with multiple short- and long-term complications. In this review, we examine the role of biomarkers, imaging, and pouchoscopy in the assessment of patients after ileal pouch-anal anastomosis, with a particular focus on the emergence of novel biomarkers and techniques for evaluating and risk stratifying patients after this procedure in the hopes of improving outcomes in this specific population.Recent Findings:There are indications that that the incidence of pouchitis may be increasing in recent...
Source: Current Gastroenterology Reports - October 18, 2022 Category: Gastroenterology Source Type: research
Impact of Clostridioides Difficle Infection and its Therapy on Nutritional Status
AbstractPurpose of reviewClostridiodes difficile infection (CDI) is a leading nosocomial cause of increased morbidity and mortality in hospitalized patients and the presentation can vary from asymptomatic infection to severe fulminant colitis and sepsis. It can significantly impact nutritional status in hospitalized patients and lead to longer length of stay with increased morbidity and mortality.Recent findingsAn interplay of various intrinsic and extrinsic factors such as systemic inflammation, diarrheal losses, and impact of isolation influence the nutritional status of patients with CDI. While diarrheal losses can lead...
Source: Current Gastroenterology Reports - September 3, 2022 Category: Gastroenterology Source Type: research
