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Approach to the patient with infectious colitis: clinical features, work-up and treatment
Purpose of review To provide the definition, causes, and current recommendations for workup and treatment of acute infectious colitis in adults, a common medical problem of diverse cause. Recent findings The management of acute colitis in adults depend upon establishment of cause. Most forms of infectious colitis are treatable with antimicrobials. Multiplex polymerase chain reaction (PCR) followed by guided culture on PCR-positive pathogens can often confirm active infection while standard culture methods provide isolates for antibiotic susceptibility testing, subtyping, and Whole Genome Sequencing. Summary ...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

Solitary rectal ulcer syndrome
Purpose of review Solitary rectal ulcer syndrome (SRUS) is a rare disease which can puzzle the gastroenterologist. A review of the syndrome and new treatment options are discussed. Recent findings Its association with dyssynergia in general supports an important role for pelvic floor biofeedback, which can be successful in patients with SRUS. No other novel. Summary Awareness of this benign syndrome is important; endoscopic diagnosis and histological confirmation opens the way to a guided lifestyle therapy with regulation of defecation and pelvic floor biofeedback. A reluctance to proceed to surgery seems...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

Ileo-colonic lymphoma: presentation, diagnosis, and management
Purpose of review The gut-associated lymphoid tissue (GALT), the bulk of which is located in the ileo-colonic region comprises the lymphoid cells of the gastrointestinal tract and confers specific immunological responses. Repetitive antigenic stimulation of these cells predispose to a monoclonal proliferation of this tissue and the eventual development of lymphoma. The gastrointestinal tract is the most commonly involved site of extranodal lymphomas. This review will focus primarily on lymphomas of the ileo-colonic region (defined as the terminal ileum, the colon, and the rectum). We will discuss the epidemiology, path...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

Noninvasive strategies for colorectal cancer screening: opportunities and limitations
Purpose of review In the United States, only 67% of patients are up to date with colorectal cancer (CRC) screening. While colonoscopy is highly sensitive and specific for CRC and precursor lesion detection and removal, it is invasive, expensive and resource heavy. Hence, there is an unfulfilled need for multiple modality CRC screening that can improve current CRC screening rates and may be resource effective strategies when used in conjunction with a colonoscopy program. Our review highlights the complementary, often underutilized, noninvasive CRC screening methods with a focus on performance, risks, benefits, and rece...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

The patient with irritable bowel syndrome-type symptoms: when to investigate and how?
Purpose of review Irritable bowel syndrome (IBS) is a very common disorder whose clinical presentation varies considerably between patients as well as within the same individual over time. Many of its symptoms, such as pain, diarrhea, constipation and bloating, may be manifestations of a host of other gastrointestinal diseases; some accompanied by increased mortality. This presents the clinician with a real dilemma: how to sensibly investigate the patient in which one suspects IBS but there is a nagging doubt that ‘it could be something else’? Could one miss ‘something serious’? This short review attempts to pr...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

Editorial: Colon cancer detection and prevention in the age of COVID-19
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

Recent developments in antimicrobial therapy for gastrointestinal infections
Purpose of review This focused, narrative review summarizes human clinical trial data for direct-acting antimicrobials in development for the treatment of gastrointestinal infections that were published in the past 18 months (1 January 2019 to 30 June 2020). Recent findings Antimicrobial agents for Clostridioides difficile infection (n = 6), cryptosporidiosis (n = 1), cytomegalovirus infection (n = 3) and Helicobacter pylori infection (n = 1) have completed and/or are undergoing human clinical trials. Summary Although this review highlights significant advances in four disease states, many...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

Coronavirus disease-2019: implications for the gastroenterologist
Purpose of review The COVID-19 pandemic has impacted the practicing gastroenterologist in several ways. Although majority of COVID-19 patients present with respiratory symptoms, gastrointestinal symptoms are also seen. COVID-19 has also disrupted gastrointestinal endoscopy services in numerous ways. There are also concerns regarding the impact of these changes on gastrointestinal cancer screening and management of chronic gastrointestinal diseases. The purpose of this review is to provide an overview of the implications of COVID-19 for the practicing gastroenterologist. Recent findings COVID-19 patients can have...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

Stem-cell-derived models: tools for studying role of microbiota in intestinal homeostasis and disease
Purpose of review In this review, we will summarize the recent progress made in generating stem-cell-based organoid and enteroid models of the gastrointestinal tract and their importance in understanding the role of microbes in intestinal epithelial homeostasis and disease. Recent finding Intestinal stem-cell-derived culture systems are self-organizing three-dimensional organotypic cultures that recapitulate many cellular, architectural and functional aspects of the human intestine. Progress has been made in the development of methods to incorporate additional cell lineages and physiological cues to better mimic...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

Is there a causal relationship between trehalose consumption and Clostridioides difficile infection?
Purpose of review Trehalose metabolism appears to play a role in the pathogenicity of some microbes. It has been claimed that trehalose consumption may be a risk factor for Clostridioides difficile infection (CDI), but the evidence for a causal link is contentious. Recent findings Epidemic ribotypes of C. difficile harbour mutations or have acquired extra genes that mean these strains can utilize lower concentrations of bioavailable trehalose, providing a competitive metabolic advantage in some CDI animal models. By contrast, evidence has emerged to show that trehalose-induced microbiota changes can help protect...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

Tracking COVID-19 via sewage
Purpose of review We discuss the potential role of the faecal chain in COVID-19 and highlight recent studies using waste water-based epidemiology (WBE) to track severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recent findings WBE has been suggested as an adjunct to improve disease surveillance and aid early detection of circulating disease. SARS-CoV-2, the aetiological agent of COVID-19, is an enveloped virus, and as such, typically not associated with the waste water environment, given high susceptibility to degradation in aqueous conditions. A review of the current literature supports the ability ...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

Is there a role of penicillin allergy in developing Clostridioides difficile infection?
Purpose of review To explore the evidence for an association between penicillin allergy, antibiotic prescribing and Clostridioides difficile (CDI) infection. Recent findings Several studies have highlighted the differences in antibiotic prescribing in penicillin allergic patients and the impact on rates of C. difficile infection. Summary Penicillin allergy leads to higher incidences of prescriptions for antibiotics that are known to predispose to CDI. In turn CDI is more common in patients with penicillin allergy. Penicillin allergy is often erroneously ascribed to patients and should be challenged. (Sour...
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Gastric vascular abnormalities: diagnosis and management
Purpose of review Gastric vascular abnormalities are a well known cause of gastrointestinal bleeding. Due to their recurrent bleeding tendency and potential to cause life-threatening blood loss, gastric vascular abnormalities can result in significant morbidity and cost. Recent findings There have been novel advances in medical and endoscopic management of gastric vascular lesions. New data suggest that endoscopic band ligation and ablation may be comparable, or even superior, to argon plasma coagulation (APC) for management of gastric antral vascular ectasia (GAVE). A creative, highly sensitive and specific computer-...
Source: Current Opinion in Gastroenterology - October 13, 2020 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert and Tilak U. Shah Source Type: research

Endoscopic diagnosis and management of gastric subepithelial lesions
Purpose of review The purpose of this manuscript is to provide an in-depth review of gastric subepithelial lesions (SELs) and describe the current approach to endoscopic diagnosis and management of these lesions. Recent findings Gastric SELs are a relatively frequent finding on routine endoscopy (incidence 0.2–3%). A systematic approach to diagnosis and management is key because many SELs are of little consequence, while others carry a high risk of malignant transformation. Because esophagogastroduodenoscopy (EGD) cannot delineate depth of invasion or subepithelial appearance, endoscopic ultrasound (EUS) should be c...
Source: Current Opinion in Gastroenterology - October 13, 2020 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert and Tilak U. Shah Source Type: research