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
Newborn Screening for Biliary Atresia: a Review of Current Methods
AbstractPurpose of ReviewBiliary atresia is a serious neonatal liver disease due to obstructed bile ducts that has better outcomes when detected and treated in the first 30 –45 days of life. This review examines different methods to screen newborns for biliary atresia as well as discusses observations from ongoing screening programs implemented in parts of the United States.Recent FindingsScreening strategies for biliary atresia include detecting persistent jaundice, examining stool color, testing fractionated bilirubin levels, or measuring bile acid levels from dried blood spot cards. The stool color card program is th...
Source: Current Gastroenterology Reports - November 24, 2021 Category: Gastroenterology Source Type: research
How I Approach Laryngopharyngoesophageal Reflux (LPR)
AbstractThe purpose of this article is to review the cornerstone and most recent literature regarding laryngopharynoesophageal reflux (LPR) including epidemiological characteristics, pathophysiology, symptoms, diagnosis, and management. The role of pepsin in the pathophysiology of LPR is highlighted in addition to new diagnostic modalities and pharmacologic therapies that target pepsin. (Source: Current Gastroenterology Reports)
Source: Current Gastroenterology Reports - November 19, 2021 Category: Gastroenterology Source Type: research
When Pandemics Collide: the Interplay of Obesity and COVID-19
AbstractPurpose of ReviewThe COVID-19 pandemic has been associated with significant morbidity and mortality worldwide. In addition to those with advanced age and co-morbidities such as heart disease or cancer, obese individuals have also had very high rates of hospitalization, critical illness, need for ventilator support, as well as mortality. A number of factors associated with obesity have led to devastating consequences as these two pandemics have interacted.Recent FindingsObese individuals through a combination of structural and cellular level changes have greater risk of ischemic heart disease, diabetes, cancer, and ...
Source: Current Gastroenterology Reports - November 4, 2021 Category: Gastroenterology Source Type: research
The Management of the Hospitalized Ulcerative Colitis Patient, the Medical —Surgical Conundrum
In this study we present the evidence based management for patients hospitalized for UC with a special focus on the synergic approach of the two key actors of the inflammatory bowel disease multidisciplinary team (IBD-MDT): gastroenterologist and surgeon.Recent FindingsFocused treatment by a specialized IBD-MDT and early involvement of the colorectal surgeon in the management of hospitalized ulcerative colitis patients is advocated. The colectomy rate has not changed over the years. Moreover delayed surgery after admission is burden by increase complication and mortality. Thus, it is pivotal to identify the patients who ar...
Source: Current Gastroenterology Reports - October 30, 2021 Category: Gastroenterology Source Type: research
Innovations in Screening Tools for Barrett ’s Esophagus and Esophageal Adenocarcinoma
AbstractPurpose of ReviewEsophageal adenocarcinoma (EAC) is a lethal disease with rapidly rising incidence. Screening for EAC and its metaplastic precursor, Barrett ’s esophagus (BE), followed by endoscopic surveillance and endoscopic treatment of dysplasia or early EAC are promising approaches to decreasing EAC incidence and EAC mortality. Historically, screening for EAC has been completed with a traditional per-oral esophagogastroduodenoscopy (EGD); however , this method has limitations including cost, tolerability, and accessibility. For this reason, much effort has been put forward to develop more effective, minimall...
Source: Current Gastroenterology Reports - October 15, 2021 Category: Gastroenterology Source Type: research
Portal Vein Thrombosis In Cirrhosis: Interventional Treatment Options
AbstractPurpose of ReviewPortal vein thrombosis (PVT) is a frequent consequence of cirrhosis and its management is variable and controversial. Herein we highlight interventional treatment options and outcomes, together with mention of the physiology, presentation and imaging of PVT.Recent FindingsUtilization of transjugular intrahepatic portosystemic shunt (TIPS) for acute and chronic PVT is expanding. In acute PVT, TIPS improves hepatopetal flow which promotes thrombus resorption and prevents rethrombosis. The TIPS also functions as a conduit for thrombectomy devices and allows for embolization of variceal shunts. Chronic...
Source: Current Gastroenterology Reports - October 15, 2021 Category: Gastroenterology Source Type: research
Dietary Approaches for Management of Non-Alcoholic Fatty Liver Disease: A Clinician ’s Guide
AbstractNon-alcoholic fatty liver disease (NAFLD) is closely associated with obesity, insulin resistance, and hyperlipidemia. There is strong clinical evidence that reduction in at least 5 –7% total body weight is associated with improvement in hepatic steatosis and regression of fibrosis, with weight loss representing the primary approach to treatment. This guide reviews recent data on dietary approaches studied in NAFLD management. The strongest evidence currently supports a hypoc aloric diet to induce weight loss and subsequent improvement in liver enzymes and histology, as well as a Mediterranean diet, which can lead...
Source: Current Gastroenterology Reports - October 15, 2021 Category: Gastroenterology Source Type: research
Foregut Dysmotility in the Lung Transplant Patient
AbstractPurpose of ReviewTo explore the role of upper gastrointestinal disease in the clinical course of lung transplant patients – including its pathophysiology, diagnostic testing, and treatment options.Recent FindingsGastroesophageal reflux disease (GERD) and foregut motility disorders are more prevalent among end-stage lung disease patients and are associated with poorer outcomes in lung transplant recipients. A proposed mechanism is the exposure of the lung allograft to aspirated contents, resulting in inflammation and rejection. Diagnostic tools to assess for these disorders include multichannel intraluminal impeda...
Source: Current Gastroenterology Reports - October 15, 2021 Category: Gastroenterology Source Type: research
Innovations in Screening Tools for Barrett ’s Esophagus and Esophageal Adenocarcinoma
AbstractPurpose of ReviewEsophageal adenocarcinoma (EAC) is a lethal disease with rapidly rising incidence. Screening for EAC and its metaplastic precursor, Barrett ’s esophagus (BE), followed by endoscopic surveillance and endoscopic treatment of dysplasia or early EAC are promising approaches to decreasing EAC incidence and EAC mortality. Historically, screening for EAC has been completed with a traditional per-oral esophagogastroduodenoscopy (EGD); however , this method has limitations including cost, tolerability, and accessibility. For this reason, much effort has been put forward to develop more effective, minimall...
Source: Current Gastroenterology Reports - October 15, 2021 Category: Gastroenterology Source Type: research
