What is the Evidence for Over the Counter Laxatives to Treat Childhood Constipation?
AbstractPurpose of ReviewFunctional constipation is a common pediatric GI disorder that is responsible for a significant portion of pediatric office visits each year. It presents a significant stressor for patients, their families, and providers alike. There are a variety of over the counter agents available for treatment of pediatric constipation.Recent FindingsOsmotic laxatives, such as polyethylene glycol 3350 (PEG 3350) and lactulose, remain the most effective and safe therapy for both long and short term treatment of pediatric functional constipation. Stimulant laxatives, like Senna and Bisacodyl, probiotics, fiber pr...
Source: Current Gastroenterology Reports - October 12, 2021 Category: Gastroenterology Source Type: research
Evaluation and Management of Persistent Problems After Surgery for Hirschsprung Disease in a Child
AbstractPurpose of ReviewIdeally, after operative intervention, a child born with Hirschsprung disease (HD) should thrive, achieve fecal continence, and avoid recurrent episodes of abdominal distention and enterocolitis. However, a significant number of patients continue to struggle following their pull-through procedure. The purpose of this review is to present an organized and practical approach to the evaluation and management of the symptomatic patient post pull-through operation for HD.Recent FindingsChildren diagnosed with HD who are not doing well after their initial operation can be categorized in three distinct gr...
Source: Current Gastroenterology Reports - October 11, 2021 Category: Gastroenterology Source Type: research
The Intestinal Microbiome and Cystic Fibrosis Transmembrane Conductance Regulator Modulators: Emerging Themes in the Management of Gastrointestinal Manifestations of Cystic Fibrosis
This article reviews major recent updates in gastroenterological CF care and research.Recent FindingsThe high burden of GI symptoms in CF has led to recent studies assessing GI-specific symptom questionnaires and scoring systems. Intestinal dysbiosis potentially contributes to gastrointestinal symptoms in patients with CF and an increased risk of gastrointestinal cancers in CF. An increased incidence of colorectal cancer (CRC) has led to CF-specific CRC screening and surveillance recommendations. Pharmacologic therapies targeting specific cystic fibrosis transmembrane conductance regulator (CFTR) mutations have shown promi...
Source: Current Gastroenterology Reports - August 27, 2021 Category: Gastroenterology Source Type: research
Fiber in the ICU: Should it Be a Regular Part of Feeding?
AbstractPurpose of ReviewTo highlight the controversy of fiber use in the current critical care nutrition guidelines; review the effect of fiber on the gut microbiota in the critically ill; and examine the data on fiber and outcomes in the intensive care setting.Recent FindingsFiber is increasingly recognized as a necessary component of colonic health and nutrition support. In critical illness there is a shift toward gut dysbiosis and immune dysregulation. Through fermentation and the generation of short-chain fatty acids, fiber has a role in maintaining intestinal homeostasis, immune function, and supporting commensal bac...
Source: Current Gastroenterology Reports - August 2, 2021 Category: Gastroenterology Source Type: research
Epidemiology of Colorectal Cancer in Inflammatory Bowel Disease – the Evolving Landscape
AbstractPurpose of ReviewTo update changes in the epidemiology of colorectal cancer in patients with ulcerative colitis and Crohn ’s disease over the past decades.Recent FindingsSince the mid twentieth century, studies have found that the incidence of colorectal cancer in patients with IBD has been greater than that of the general population, especially for patients with a family history of colorectal cancer, a diagnosis of primary sclerosing cholangitis, and/or pancolitis. While Crohn ’s disease and ulcerative colitis are still associated with a risk of colorectal cancer, current treatment approaches and surveillance ...
Source: Current Gastroenterology Reports - August 2, 2021 Category: Gastroenterology Source Type: research
Sorting out the Relationship between Gastroesophageal Reflux Disease and Sleep
AbstractPurpose of ReviewGastroesophageal reflux disease is one of the most common conditions encountered by primary care physicians, gastroenterologists, foregut surgeons and otolaryngologists. While approximately 50% of patients experience nocturnal reflux symptoms, the relationship between gastroesophageal reflux disease and sleep is often overlooked. The aim of this review is to provide an update on the current understanding of this relationship and its clinical implications. Recent studies pertaining to the association between GERD and sleep with focus on sleep disturbances, obstructive sleep apnea, extraesophageal ma...
Source: Current Gastroenterology Reports - August 2, 2021 Category: Gastroenterology Source Type: research
Fiber in the ICU: Should it Be a Regular Part of Feeding?
AbstractPurpose of ReviewTo highlight the controversy of fiber use in the current critical care nutrition guidelines; review the effect of fiber on the gut microbiota in the critically ill; and examine the data on fiber and outcomes in the intensive care setting.Recent FindingsFiber is increasingly recognized as a necessary component of colonic health and nutrition support. In critical illness there is a shift toward gut dysbiosis and immune dysregulation. Through fermentation and the generation of short-chain fatty acids, fiber has a role in maintaining intestinal homeostasis, immune function, and supporting commensal bac...
Source: Current Gastroenterology Reports - August 2, 2021 Category: Gastroenterology Source Type: research
Epidemiology of Colorectal Cancer in Inflammatory Bowel Disease – the Evolving Landscape
AbstractPurpose of ReviewTo update changes in the epidemiology of colorectal cancer in patients with ulcerative colitis and Crohn ’s disease over the past decades.Recent FindingsSince the mid twentieth century, studies have found that the incidence of colorectal cancer in patients with IBD has been greater than that of the general population, especially for patients with a family history of colorectal cancer, a diagnosis of primary sclerosing cholangitis, and/or pancolitis. While Crohn ’s disease and ulcerative colitis are still associated with a risk of colorectal cancer, current treatment approaches and surveillance ...
Source: Current Gastroenterology Reports - August 2, 2021 Category: Gastroenterology Source Type: research
Sorting out the Relationship between Gastroesophageal Reflux Disease and Sleep
AbstractPurpose of ReviewGastroesophageal reflux disease is one of the most common conditions encountered by primary care physicians, gastroenterologists, foregut surgeons and otolaryngologists. While approximately 50% of patients experience nocturnal reflux symptoms, the relationship between gastroesophageal reflux disease and sleep is often overlooked. The aim of this review is to provide an update on the current understanding of this relationship and its clinical implications. Recent studies pertaining to the association between GERD and sleep with focus on sleep disturbances, obstructive sleep apnea, extraesophageal ma...
Source: Current Gastroenterology Reports - August 2, 2021 Category: Gastroenterology Source Type: research
Eosinophilic Gastritis/Gastroenteritis
AbstractPurpose of ReviewEosinophilic gastritis/gastroenteritis (EG/EGE) are rare eosinophilic infiltrative disorders in children and adults that fall under the umbrella term eosinophilic gastrointestinal disorders (EGIDs). EGIDs also include eosinophilic esophagitis (EoE) and eosinophilic colitis. In this article, we present the current literature regarding the clinical presentation, diagnostic criteria, and management of EG/EGE.Recent FindingsThe underlying complex pathophysiology remains unknown, yet hypersensitivity response is a central component. Unlike EoE, standardized diagnostic criteria are lacking but, promising...
Source: Current Gastroenterology Reports - July 30, 2021 Category: Gastroenterology Source Type: research
Iron Deficiency and the Small bowel
This article reviews iron deficiency anemia (IDA) and suspected small bowel bleeding (SSBB) from initial consultation through laboratory evaluation, endoscopic evaluation, and therapeutic options.Recent FindingsRecent guidelines on management of SSBB, IDA, video capsule endoscopy (VCE), and device-assisted enteroscopy (DAE) are reviewed. The advantages and limitations of VCE, DAE, and imaging are discussed. Medical treatment for refractory small bowel bleeding is discussed.SummaryEvaluation of IDA starts with a detailed history and physical exam. Additional lab work can establish the diagnosis of IDA and evaluate for assoc...
Source: Current Gastroenterology Reports - July 8, 2021 Category: Gastroenterology Source Type: research
