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Protein-losing enteropathy
Purpose of review The present review offers its readers a practical overview of protein-losing enteropathy, particularly with regard to diagnostic and therapeutic approaches. The aim is to support clinicians in their daily practice with a practical tool to deal with protein-losing enteropathy. Recent findings The literature covering protein-losing enteropathy does not appear to be quite recent and also guidelines are scanty. The main innovations during the last decade probably regard the introduction of enteroscopic techniques in the diagnostic flowchart. The use of video-capsule and device-assisted enteroscopy has en...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research

Update on chronic intestinal pseudo-obstruction
Purpose of review Chronic intestinal pseudo-obstruction (CIPO) is the most severe and disabling form of gastrointestinal dysmotility characterized by an impairment of coordinated propulsive activity in the gastrointestinal tract mimicking mechanical intestinal obstruction. Over the last few years, major advances have been made in the diagnostic and therapeutic management of this rare disorder. Recent findings The present narrative review aims to summarize the current literature about the management of CIPO focusing on significant novelties about definition, epidemiology, diagnosis, and therapeutic options. The most si...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research

Advances in chronic intestinal failure management and therapies
Purpose of review To summarize changes and recent advances in therapies for chronic intestinal failure (CIF). Recent findings In the last few years, the management of CIF has significantly improved through better prevention and treatment of catheter-related bloodstream infections (CRBSIs) and intestinal failure-associated liver disease (IFALD), as well as improved enteral autonomy by using small bowel growth factors in selected patients. This may have been reflected by a recent reduction in small bowel transplantations. Summary Although CIF management has become more established and effective, the long-term implica...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research

Refractory coeliac disease: what should we be doing different?
Purpose of review The aim of this review is to provide insight into the diagnosis and management of patients with refractory coeliac disease (RCD) and highlight recent advances in this field. Recent findings The diagnosis of RCD can be more accurately confirmed with flow cytometry in addition to immunohistochemistry. Dietary input and excretion of gluten immunogenic peptides can help rule out gluten contamination, and therefore, substantiate a diagnosis of RCD type I. Small bowel capsule endoscopy (SBCE) is important at diagnosis and follow-up in addition to duodenal histology. Apart from ruling out complications, it ...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research

Radiation enteritis: from diagnosis to management
Purpose of review As cancer treatments improve more patients than ever are living for longer with the side effects of these treatments. Radiation enteritis is a heterogenous condition with significant morbidity. The present review aims to provide a broad overview of the condition with particular attention to the diagnosis and management of the condition. Recent findings Radiation enteritis appears to be more prevalent than originally thought because of patient underreporting and a lack of clinician awareness. Patient-related and treatment-related risk factors have now been identified and should be modified where possi...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research

Editorial: The ‘ailing small bowel’
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research

Signatures in drug-induced liver injury
Purpose of review Drug-induced liver injury (DILI) can be induced by a myriad of drugs. Assessing whether the patient has DILI and assessing which drug is the most likely culprit are challenging. There has been too little attention paid to the concept that certain drugs appear to have unique clinical features or ‘phenotypes’. Recent findings Several case series of DILI because of various drugs have been published, and analysis of these case series points to the fact that individual drugs have characteristic DILI signatures. These clinical phenotypes can be characterized by latency, biochemical features (R-value), ...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Hepatic manifestations of cystic fibrosis
Purpose of review Liver disease in cystic fibrosis (CF) usually develops before puberty, is often asymptomatic and slowly progressive. Multilobular cirrhosis develops in approximately 5–10% of patients by the age of 18, and is a significant contributor to the morbidity and mortality. No therapy, including ursodeoxycholic acid and cystic fibrosis transmembrane conductance regulator correctors or potentiators, has proven effective to prevent or halt the progression of liver disease towards cirrhosis and portal hypertension. This review provides the current knowledge in the epidemiology of CF liver disease and development...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

The utility of liver biopsy in 2020
Purpose of review Over the past decade, imaging modalities and serological tests have emerged as important tools in the evaluation of liver diseases, in many cases supplanting the use of liver biopsy and histological examination. Nonetheless, the accuracy and diagnostic value of these methods may not always be conclusive and the assessment of liver histology often remains the gold standard for diagnostic evaluation. The purpose of this review is to summarize the current role of liver biopsy in contemporary hepatology practice. Recent findings Technical factors were found to influence the diagnostic value of liver biop...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

New systemic agents for hepatocellular carcinoma: an update 2020
Purpose of review Despite major therapeutic improvements in most cancer entities, hepatocellular carcinoma (HCC) has remained a dismal disease. In fact, incidence and mortality are increasing in many parts of the world, including the United States. Given that a number of systemic agents has recently been tested positive in phase 3 clinical trials, the objective of this review is to summarize the current treatment landscape for advanced HCC. Recent findings Following the positive SHARP trial in 2008, sorafenib has been the only systemic agent for advanced HCC for almost a decade. However, in first line, lenvatinib was ...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Coagulation testing and management in liver disease patients
Purpose of review The present article aims to provide clinicians with an overview of coagulation testing in individuals with liver disease, to discuss available procoagulants and the rationale for their use, and to provide management strategies in a variety of common clinical scenarios. Recent findings Clinicians and researchers are gaining an increased understanding of the shortfalls of assessing bleeding risk using traditional tests of coagulation. The use of global tests of clot formation, including viscoelastic testing and thrombin generation analysis, continues to evolve and guide the management of these patients...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

The natural history of alcohol-related liver disease
Purpose of review This review will describe the natural history of alcohol-related liver disease (ArLD) in light of recent data that have synthesized existing knowledge on this topic and described new research cohorts to improve our understanding of progression and outcomes in ArLD. Recent findings ArLD occurs after a threshold of alcohol consumption, but this threshold is lowered by the presence of comorbid factors of which obesity is the most common. The most common stage of ArLD is alcohol-related steatosis: this is associated with a low rate of progression to cirrhosis (3%/year) and nonliver-related morbidity is m...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Liver transplantation for alcoholic hepatitis: update
Purpose of review Alcoholic liver disease continues to be a major public health concern in the United States and around the world. Alcoholic liver disease remains the third most common indication for liver transplantation in the United States. Mortality has been reported in up to 30–50% of patients with severe alcoholic hepatitis. Liver transplantation can be lifesaving for patients with alcoholic hepatitis. Liver transplantation for alcoholic liver disease was traditionally only considered in patients who have achieved 6 months of abstinence. The majority of patients with severe alcoholic hepatitis who fail medical th...
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Editorial: Advances in hepatology – 2020
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - April 8, 2020 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

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