Clostridioides difficile Infection in Pediatric Inflammatory Bowel Disease
AbstractPurpose of ReviewChildren with inflammatory bowel disease (IBD) are at increased risk ofC. difficile infection (CDI) and experience worse outcomes associated with an infection. In this article, we review recent research on the incidence, diagnosis, complications, and treatment options for CDI in children with IBD.Recent FindingsChildren with IBD have an elevated incidence of CDI, but their CDI risk does not associate with established risk factors in adults with IBD. Existing testing methodologies are inadequate at differentiating CDI fromC. difficile colonization in children with IBD. Fecal microbiota transplantati...
Source: Current Gastroenterology Reports - August 30, 2023 Category: Gastroenterology Source Type: research
Surgical Options for End-Stage Achalasia
This article reviews the definition of end-stage achalasia and summarizes past and present surgical treatment.Recent Findings: Myotomy of the lower esophageal sphincter remains the mainstay of treatment of achalasia, even in advanced disease. Esophagectomy may have benefit as a primary treatment modality in end-stage achalasia with sigmoid esophagus, but international guidelines recommend consideration of laparoscopic or endoscopic approaches initially in most patients. Novel peroral esophageal plication techniques may provide alternative treatment options in patients with significant esophageal dilation that fail myotomy ...
Source: Current Gastroenterology Reports - August 30, 2023 Category: Gastroenterology Source Type: research
Point-of-Care Intestinal Ultrasound in Pediatric Inflammatory Bowel Disease
AbstractPurpose of ReviewIntestinal ultrasound (IUS) is an emerging non-invasive point-of-care tool utilized by pediatric gastroenterologists for accurately detecting and monitoring inflammatory bowel disease (IBD) activity. In this article, we reviewed the evidence supporting and technique to perform IUS for children with IBD.Recent FindingsIUS technique can visualize the colon from the distal sigmoid until the cecum and the terminal ileum without the need for bowel preparation, fasting, or sedation in children with IBD. IUS has been shown to be accurate to endoscopy in children with ulcerative colitis and Crohn ’s dise...
Source: Current Gastroenterology Reports - August 25, 2023 Category: Gastroenterology Source Type: research
Current Status of Living Donor Liver Transplantation: Impact, Advantages, and Challenges
AbstractPurpose of this ReviewThis review provides an overview of the current status of Living Donor Liver Transplant (LDLT). It discusses the impact of LDLT on waitlist and post-transplantation outcomes, highlighting the technical challenges and unique advantages of LDLT.Recent FindingsRecent findings show that LDLT offers several theoretical advantages over deceased donor liver transplant, including shorter wait times, better graft quality, and improved post-transplant outcomes. Non-alcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC) are emerging as the leading indications for adult LDLT in the US. L...
Source: Current Gastroenterology Reports - August 21, 2023 Category: Gastroenterology Source Type: research
TIPS: indications, Contraindications, and Evaluation
AbstractPurpose of ReviewThis review summarizes the current and emerging indications, contraindications, and evaluation for TIPS. In the last three decades of use, there have been substantial changes and progress in this field, including the use of controlled-expansion, covered stents, which has broadened the clinical uses of TIPS.Recent FindingsRecent findings have rapidly expanded the indications for TIPS, including emerging uses in hepatorenal syndrome, hepatopulmonary syndrome and before abdominal surgery. The widespread use of controlled-expansion, covered stents has decreased rates of post-TIPS hepatic encephalopathy...
Source: Current Gastroenterology Reports - August 21, 2023 Category: Gastroenterology Source Type: research
Current Status of Living Donor Liver Transplantation: Impact, Advantages, and Challenges
AbstractPurpose of this ReviewThis review provides an overview of the current status of Living Donor Liver Transplant (LDLT). It discusses the impact of LDLT on waitlist and post-transplantation outcomes, highlighting the technical challenges and unique advantages of LDLT.Recent FindingsRecent findings show that LDLT offers several theoretical advantages over deceased donor liver transplant, including shorter wait times, better graft quality, and improved post-transplant outcomes. Non-alcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC) are emerging as the leading indications for adult LDLT in the US. L...
Source: Current Gastroenterology Reports - August 21, 2023 Category: Gastroenterology Source Type: research
TIPS: indications, Contraindications, and Evaluation
AbstractPurpose of ReviewThis review summarizes the current and emerging indications, contraindications, and evaluation for TIPS. In the last three decades of use, there have been substantial changes and progress in this field, including the use of controlled-expansion, covered stents, which has broadened the clinical uses of TIPS.Recent FindingsRecent findings have rapidly expanded the indications for TIPS, including emerging uses in hepatorenal syndrome, hepatopulmonary syndrome and before abdominal surgery. The widespread use of controlled-expansion, covered stents has decreased rates of post-TIPS hepatic encephalopathy...
Source: Current Gastroenterology Reports - August 21, 2023 Category: Gastroenterology Source Type: research
Update on the Diagnosis and Management of Acute Colonic Pseudo-obstruction (ACPO)
AbstractPurpose of ReviewAcute Colonic Pseudo-obstruction (ACPO) is a cause of large intestinal dilation and obstruction without any physical transition point. It remains difficult to diagnose and treat. We review the recent updates on diagnosis and management of ACPO.Recent FindingsRecent guidelines have posited that conservative management can be tried in most cases of ACPO, but that early decompression and surgery should be considered. Use of neostigmine is still a viable option but there is also promising data on pyridostigmine as well as prucalopride. Resolution of ACPO should be followed by daily use of polyethylene ...
Source: Current Gastroenterology Reports - July 24, 2023 Category: Gastroenterology Source Type: research
Providing Trauma Informed Care During Anorectal Evaluation
AbstractPurpose of ReviewPatients with a history of gastrointestinal (GI) conditions report high rates of psychological trauma. This review discusses the impact of previous trauma, as well as interactions with the medical system, on a patient ’s physical and mental health. Trauma-informed strategies for improving patient care during gastroenterology procedures are provided.Recent FindingsHistory of trauma increases risk of developing GI conditions and re-traumatization during sensitive anorectal procedures (i.e., anorectal manometry, balloon expulsion testing). Trauma-informed strategies include consistent trauma screeni...
Source: Current Gastroenterology Reports - July 20, 2023 Category: Gastroenterology Source Type: research
Who Places Feeding Tubes and in What Scenario?
AbstractPurpose of ReviewEnteral feeding is commonly used to provide patients with nutrition. Access via feeding tubes can be attained by multiple medical specialties through a variety of methods.Recent FindingsThere are limited data available on direct comparisons amongst gastroenterologist, interventional radiologists and surgeons, although there appears to be similar rates of complications. Fluroscopically and surgically placed feeding tubes may have a higher technical success rate than endoscopically placed tubes.SummaryThe preferred specialty for feeding tube placement varies per institution, often due to logistical m...
Source: Current Gastroenterology Reports - July 14, 2023 Category: Gastroenterology Source Type: research
The Use of Integrated Molecular Testing in the Assessment and Management of Pancreatic Cysts
We present the performance of individual biomarkers in cyst fluid analysis with an emphasis on an algorithmic approach to improve the accurate identification of both cyst type and risk of malignant transformation. (Source: Current Gastroenterology Reports)
Source: Current Gastroenterology Reports - July 6, 2023 Category: Gastroenterology Source Type: research
