Novel advances in surgery for Gallstone Disease
AbstractPurpose of reviewExamine recent advances in the treatment of patients with complex gallstone disease.Recent findingsLaparoscopic common bile duct exploration (LCBDE) has been shown to be an effective and safe treatment for choledocholithiasis, resulting in decreased hospital length of stay and costs when compared with ERCP plus laparoscopic cholecystectomy (LC). Novel simulator-based curricula have recently been developed to address the educational gap that has resulted in an underutilization of LCBDE. Patients with cholecystitis who are too ill to safely undergo LC have traditionally been treated with percutaneous...
Source: Current Gastroenterology Reports - July 13, 2022 Category: Gastroenterology Source Type: research

Organizing and Developing a GI Motility Lab in Community Practice: Challenges and Rewards
AbstractPurpose of ReviewNeurogastroenterology and motility is a rapidly evolving subspecialty that encompasses over 33% of gastroenterological disorders, and up to 50% of referrals to gastroenterology practice. It includes common problems such as dysphagia, gastroesophageal reflux disease, irritable bowel syndrome, chronic constipation, gastroparesis, functional dyspepsia, gas/bloating, small intestinal bacterial overgrowth, food intolerance and fecal incontinence Standard diagnostic tests such as endoscopy or imaging are normal in these conditions. To define the underlying mechanism(s)/etiology of these disorders, diagno...
Source: Current Gastroenterology Reports - June 8, 2022 Category: Gastroenterology Source Type: research

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