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Advances in the treatment of gastric cancer
Purpose of review To provide an up-to-date review on the management of cancers of the stomach and esophagogastric junction (EGJ). Recent findings Microsatellite instable (MSI) high status in gastric cancer may portend a relatively good prognosis and indicate that adjuvant chemotherapy is of no added benefit to primary surgical management. In the preoperative treatment of HER2 (ErbB2)-positive EGJ adenocarcinoma with chemoradiotherapy, the addition of trastuzumab, a recombinant humanized mAb directed against the extracellular domain of Her2, failed to improve outcome over conventional chemoradiotherapy alone. Escalatin...
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

Management of Helicobacter pylori
Purpose of review Gastroenterologists and many general internists and primary care physicians confront questions regarding the management of Helicobacter pylori on a daily basis. The subject remains of global interest and continue to generate debate and research. Using the search terms ‘pylori and treatment’ or ‘pylori and management’ we identified over 1000 relevant articles in PubMed published over the time period 1 January 2019 to 30 April 2020. We have selected the most highly clinically relevant of these to review here. Recent findings Clinical evidence grows regarding the benefits of H. pylori eradicatio...
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

Gastroparesis and functional dyspepsia: different diseases or different ends of the spectrum?
Purpose of review This review assesses the relationship between gastroparesis and functional dyspepsia, in light of recent research assessing cause, pathophysiology and treatment. Recent findings The Gastroparesis Cardinal Symptom Index (GCSI) lacks the ability to readily distinguish functional dyspepsia from gastroparesis based on symptoms. Although prior studies found that the extent of delay in gastric emptying did not accurately predict severity of symptoms, when optimally measured, delayed gastric emptying may in fact correlate with gastroparesis symptoms. Enteric dysmotility may be an important risk factor for g...
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

Duodenal chemosensory system: enterocytes, enteroendocrine cells, and tuft cells
Purpose of review The gut barrier serves as the primary interface between the environment and host in terms of surface area and complexity. Luminal chemosensing is a term used to describe how small molecules in the gut lumen interact with the host through surface receptors or via transport into the subepithelial space. In this review, we have summarized recent advances in the understanding of the luminal chemosensory system in the gastroduodenal epithelium consisting of enterocytes, enteroendocrine, and tuft cells, with particular emphasis on how chemosensing affects mucosal protective responses and the metabolic syndrom...
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

Proton pump inhibitors: misconceptions and proper prescribing practice
Purpose of review The current review summarizes and attempts to place in proper perspective the past year's literature regarding purported adverse effects of proton pump inhibitors (PPIs). Recent findings Although generally considered safe, physicians are inundated with retrospective database-driven epidemiologic studies, and meta-analyses on the same studies, claiming a panoply of serious adverse effects associated with long-term use of PPIs. The quality of the evidence underlying most of these associations is very low and cannot ascribe cause and effect. Nonetheless, these reports have stoked fears, in both prescrib...
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

Editorial: Stomach and duodenum
No abstract available (Source: Current Opinion in Gastroenterology)
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

Treatment for eosinophilic esophagitis
Purpose of review To summarize current dietary and pharmacologic approaches in the treatment of eosinophilic esophagitis (EoE). Recent findings Studies comparing dietary approaches in EoE treatment support empiric elimination diets as the preferred approach to dietary EoE treatment, with no data to support use of currently available allergy tests to guide specific food elimination diets. Swallowed topical corticosteroid therapy is the current standard of care in pharmacologic EoE treatment, with similar effectiveness of fluticasone and budesonide, but their discontinuation results in return of both EoE symptoms and di...
Source: Current Opinion in Gastroenterology - October 13, 2020 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Jocelyn A. Silvester Source Type: research

Host immune interactions in chronic inflammatory gastrointestinal conditions
Purpose of review We performed a literature review of the latest studies on the interactions between the host immune system and microbes in chronic intestinal inflammatory conditions. Recent findings The mechanisms leading to celiac disease (CeD) and inflammatory bowel disease (IBD), the most common chronic inflammatory gastrointestinal conditions, are complex. The intestinal homeostasis depends on the interactions between the microbiota, the intestinal mucosa and the host immune system. Failure to achieve or maintain equilibrium between a host and its microbiota has the potential to induce chronic conditions with an ...
Source: Current Opinion in Gastroenterology - October 13, 2020 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Jocelyn A. Silvester Source Type: research

Innate and adaptive immunity in celiac disease
Purpose of review The current review is prompted by recent studies indicating that adaptive immunity could be sufficient to explain rapid onset symptoms as well as many chronic effects of gluten in celiac disease. Recent findings Gluten re-exposure in treated celiac disease drives a coordinated systemic cytokine release response implicating T-cell activation within 2 h. Instead of direct effects of gluten on innate immunity, long lasting memory CD4+ T cells activated within 2 h of ingesting gluten or injecting purified gluten peptides now appear to be responsible for acute digestive symptoms. In addition, memory B...
Source: Current Opinion in Gastroenterology - October 13, 2020 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Jocelyn A. Silvester Source Type: research

Evaluation of very early-onset inflammatory bowel disease
Purpose of review Very early-onset inflammatory bowel disease (VEO-IBD) is a rare presentation defined as onset of intestinal inflammation at the age of (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - October 13, 2020 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Jocelyn A. Silvester Source Type: research

Editorial: Advances in Gastrointestinal Immunology
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - October 13, 2020 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Jocelyn A. Silvester Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - October 13, 2020 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Early detection of pancreatic cancer
Purpose of review Pancreatic cancer is the third leading cause of cancer death and with a dismal 5-year survival of 10%. Poor survival of pancreatic cancer is mostly due to its presentation and diagnosis at a late stage. The present article aims to update clinicians with recent progress in the field of early detection of pancreatic cancer. Recent findings Pancreatic cancer screening is not recommended in the general population due to its low prevalence. In this review, we discuss high-risk groups for pancreatic cancer, including inherited predisposition to pancreatic cancer, new-onset diabetes, mucinous pancreatic cys...
Source: Current Opinion in Gastroenterology - August 4, 2020 Category: Gastroenterology Tags: PANCREAS: Edited by Timothy B. Gardner Source Type: research

Expanding indications for pancreatic islet cell transplantation
Purpose of review We aimed to summarize the current state of performing pancreatic islet autotransplantation (IAT) for indications other than total pancreatectomy for chronic pancreatitis. Recent findings The current article will review expanded indications for IAT including partial pancreatectomy for benign inflammatory disease, trauma, pancreatic islet cell tumor and pancreatic adenocarcinoma. In the context of more access for IAT as more centers are offering this clinical service, these expanded indications will continue to push the limits of our ability to make IAT accessible. Summary Pancreatic islet cell tran...
Source: Current Opinion in Gastroenterology - August 4, 2020 Category: Gastroenterology Tags: PANCREAS: Edited by Timothy B. Gardner Source Type: research

Panorama of mediators in postpancreatitis diabetes mellitus
Purpose of review To provide an overview of mediators involved in the pathogenesis of postacute pancreatitis diabetes mellitus. Recent findings The ‘holistic prevention of pancreatitis’ framework has brought to the fore the sequelae of not only end-stage chronic pancreatitis and extensive pancreatic necrosis but also mild acute pancreatitis. Insights from the DORADO project have provided a wealth of information on the signalling molecules that do and do not affect glucose metabolism in individuals after mild acute pancreatitis and have challenged conventional views of the pathogenesis of postpancreatitis diabetes ...
Source: Current Opinion in Gastroenterology - August 4, 2020 Category: Gastroenterology Tags: PANCREAS: Edited by Timothy B. Gardner Source Type: research