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
Immunomodulatory Agents for Treatment of Patients with Inflammatory Bowel Disease (Review safety of anti-TNF, Anti-Integrin, Anti IL-12/23, JAK Inhibition, Sphingosine 1-Phosphate Receptor Modulator, Azathioprine / 6-MP and Methotrexate)
AbstractPurpose of the ReviewAs treatment options for Inflammatory Bowel Disease (IBD) expand each class of medication will have specific safety concerns and side-effect profiles that need to be considered for optimal treatment of patients. We will review the most recent safety data for the newly approved immunomodulator therapies for the treatment of IBD.Recent FindingsThere are a growing number of publications outlining safety concerns for medications used to treat IBD. We reviewed safety profile of anti-tumor necrosis factor antibodies (TNF) with specific attention to combination therapy (anti-TNF plus immunomodulator)....
Source: Current Gastroenterology Reports - December 16, 2021 Category: Gastroenterology Source Type: research
Beyond the Eckardt Score: Patient-Reported Outcomes Measures in Esophageal Disorders
AbstractPurpose of ReviewTo provide an overview of patient reported outcome measures (PROMs) and summarize their role in assessing undifferentiated dysphagia and common esophageal disorders, including achalasia, eosinophilic esophagitis (EoE), and gastroesophageal reflux disease (GERD).Recent FindingsGiven the subjective nature of swallowing disorders, accurate diagnoses often rely on capturing the patient experience. As a result, the number of PROMs used to characterize esophageal symptoms is increasing with a recent particular emphasis on EoE. Overall, esophageal-focused PROMs are used to interpret patient symptoms and q...
Source: Current Gastroenterology Reports - December 1, 2021 Category: Gastroenterology Source Type: research
