Editorial: Advances in Hepatology: 2019
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - April 6, 2019 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 6, 2019 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Genetics in biliary atresia
Purpose of review Biliary atresia is a poorly understood deadly disease. Genetic predisposition factors are suspected albeit not firmly established. This review summarizes recent evidence of genetic alterations in biliary atresia. Recent findings Whole-genome association studies in biliary atresia patients identified four distinct predisposition loci with four different genes potentially involved in the disease occurrence. Variations in these genes were searched for, but none were found in patients with biliary atresia suggesting complex mechanisms. Summary Despite decades since its description and decades of inten...
Source: Current Opinion in Gastroenterology - March 1, 2019 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Intestinal failure-associated liver disease: causes, manifestations and therapies
Purpose of review The goal of this review is to provide updates on the causes, manifestations and therapies IFALD in adults with an emphasis on recent discoveries on pathways of pathogenesis and interventions to reduce the incidence of IFALD. Recent findings IFALD is a multifactorial complication of long-term home parenteral therapy. Although exact pathways are unknown, altered bile acid metabolism, microbiome dysbiosis impact on the gut–liver axis and soybean-based lipid formulations are major drivers of IFALD development. Summary IFALD contributes to morbidity and mortality in patients on parenteral nutriti...
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Monitoring long-term parenteral nutrition
Purpose of review This review discusses the monitoring aimed at achieving good long-term outcomes in people dependent on home parenteral nutrition (HPN). Recent findings There have been recent studies highlighting the importance of treating low bone mineral density in HPN-dependent patients, methods of screening for liver disease, assessment of quality of life (QoL) and the need for early assessment for intestinal transplantation and growth factor therapy. Summary High-quality HPN services require expert multidisciplinary teams with a focus on strict aseptic catheter care protocols alongside regular monitoring and ...
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Food allergy: what it is and what it is not?
Purpose of review Food allergy is defined as an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food. Food intolerance, certain gastrointestinal or systemic diseases are often confused with or mislabeled as food allergy because of symptomatic similarity and general improvement from food avoidance. The differences between these diseases are crucial. Recent findings Compared with many food-related diseases that are isolated to gastrointestinal organs, food allergy can affect not only local but the whole immune system and may lead to a life-threatening allergi...
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Alcohol and gastrointestinal cancers
Purpose of review Alcohol is a type I carcinogen and the WHO stated that it caused 5% of all deaths in 2016, of which 13% because of cancers. Among digestive tract cancers, this association is clear for esophageal, liver and colorectal cancer, and more debated for gastric and pancreatic cancer. The present review will revise recent evidence on epidemiologic association and mechanisms linking alcohol with the risk of esophageal, gastric, colorectal and pancreatic cancers. Recent findings Moderate alcohol intake increases the risk of esophageal squamous cell carcinoma and colorectal cancer. Heavy alcohol intake is assoc...
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Diet and colon: what matters?
Purpose of review Colorectal cancer (CRC) is one of the most common cancers and the fourth leading cause of cancer-related deaths worldwide. Diet has a significant impact on the risk of developing CRC, but though processed meat is a known positive contributor, the effects of other dietary components are largely mixed. This review focuses on dietary patterns to describe the complexity of dietary diversity and overall food consumption and to examine the relationship between dietary patterns and risk of CRC. Recent findings After searching human studies published in 2017–2018, we selected and evaluated 30 articles,...
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Editorial: Thought for food: diet and gut health
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

The genetics of primary biliary cholangitis
Purpose of review Primary biliary cholangitis (PBC) is a female predominant chronic autoimmune disease of the intrahepatic bile ducts and with a long latent period. It is crucial to understand how genetics contribute to the disease. Recent findings Geo-epidemiological studies in PBC have provided evidence of familial risk; case–control studies and genome wide association studies have identified various human leukocyte antigen (HLA) and non-HLA alleles that are associated with PBC. However, these alleles are non-PBC specific and most of the identified non-HLA loci were also found to be susceptible genes in other ...
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Modifier genes in cystic fibrosis-related liver disease
Purpose of review Cystic fibrosis (CF; OMIM 219700) is caused by variations in the cystic fibrosis transmembrane conductance regulator gene. CF-related liver disease (CFLD) affects approximately one-third of patients with CF, but the severity of CFLD is highly variable. This review provides the latest knowledge in the pathophysiology and CF genetic modifier research in CFLD. Recent findings So far, the only modifier gene validated in CFLD is SERPINA1 (α-1-antitrypsin) Z allele. Recent studies support the view that cholangiopathy arising in CF is the result of an ill-adapted innate immune response to endotoxins c...
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Genetics of gallstone disease revisited: updated inventory of human lithogenic genes
Purpose of review Gallstone disease is one of the most frequent diseases in gastroenterology and treatment by endoscopy and surgery causes high costs in our health-care systems. Family and twin studies have demonstrated that gallstones are, in part, genetically determined. Here we review all recent genome-wide and phenome-wide studies of gallstones in humans and provide an updated ‘inventory of human lithogenic genes.’ Recent findings The largest population attributable risk is conferred by the common variant (p.D19H) of the hepatic and intestinal cholesterol transporter ABCG5/G8. A second ABC transporter,...
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Genetics in biliary atresia
Purpose of review Biliary atresia is a poorly understood deadly disease. Genetic predisposition factors are suspected albeit not firmly established. This review summarizes recent evidence of genetic alterations in biliary atresia. Recent findings Whole-genome association studies in biliary atresia patients identified four distinct predisposition loci with four different genes potentially involved in the disease occurrence. Variations in these genes were searched for, but none were found in patients with biliary atresia suggesting complex mechanisms. Summary Despite decades since its description and decades of inten...
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Genetics of polycystic liver diseases
Purpose of review This review provides an outline of the most recent insights and significant discoveries regarding the genetic mechanisms involved in polycystic liver disease. Recent findings Polycystic liver disease includes a heterogeneous group of genetic disorders characterized by multiple hepatic cysts. Isolated liver cysts are caused by mutations in Protein Kinase C Substrate 80K-H (PRKCSH), SEC63, and LDL Receptor Related Protein 5 (LRP5), whereas Polycystic Kidney Disease (PKD)1, PKD2, and PKHD1 mutations cause kidney cysts often accompanied by liver cysts. Glucosidase II Alpha Subunit (GANAB) has been report...
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Editorial: Genetics of cholangiopathies
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - February 1, 2019 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Excluding irritable bowel syndrome in the inflammatory bowel disease patient: how far to go?
Purpose of review Irritable bowel syndrome (IBS) is among the most commonly encountered conditions in primary care and gastroenterology. There is ample evidence that an IBS diagnosis based on symptom-based criteria and exclusion of alarm features that would otherwise support diagnostic testing is accurate and durable. For many clinicians, however, IBS remains a diagnosis of exclusion because of concern surrounding missed diagnoses of inflammatory bowel disease (IBD) or other organic gastrointestinal diseases. Using blood and/or fecal biomarker tests to shift the precolonoscopy probability of IBD in patients with symptoms...
Source: Current Opinion in Gastroenterology - November 30, 2018 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

Bowel preparation for colonoscopy: what is best and necessary for quality?
Purpose of review Colonoscopy is recognizably, the best colon cancer prevention test, provided the quality of the preparation is adequate for detection of precancerous polyps but also allowing for accurate identification of margins, thereby facilitating complete endoscopic resection. As there are many aspects effecting colon prep outcomes, it is timely to review new standards for optimizing outcomes, including product selection based on patient demographics. Recent findings New national guidelines have set a minimum quality threshold for adequacy and also defined a split day delivery for oral options as the “sta...
Source: Current Opinion in Gastroenterology - November 30, 2018 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

Eosinophilic colitis and colonic eosinophilia
Purpose of review Eosinophilic colitis is a rare condition, with a prevalence rate in the USA of 2–3/100 000 persons (0.003%), but diagnosed in 0.1% of biopsies in those colonoscoped for diarrhoea. Secondary colonic eosinophilia is more common and associated with systemic, colonic and infectious diseases. In this review, the latest advances in diagnosis, treatment and prognosis are summarized and discussed. Recent findings What constitutes a ‘normal’ count of eosinophils is poorly documented but there are recent studies that establish normal colonic eosinophil ranges as well as distinguishing histo...
Source: Current Opinion in Gastroenterology - November 30, 2018 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

The dark side of the colon: current issues surrounding the significance, prevalence, detection, diagnosis and management of serrated polyps
This article will review the current evidence while highlighting some of the issues regarding serrated polyps. Recent findings One challenge has been pathologically distinguishing hyperplastic polyps from SSPs, which is an important distinction, given the potential for progression of SSPs to CRC. Other challenges regarding serrated polyps include adequate detection and resection. Surveillance guideline recommendations for some serrated polyps have been changed in current guidelines to reflect the malignant potential, recommending closer surveillance intervals than the 10-year follow-up that has been traditionally provid...
Source: Current Opinion in Gastroenterology - November 30, 2018 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

Irritable bowel syndrome and colonic diverticular disease: overlapping symptoms and overlapping therapeutic approaches
Purpose of review Irritable bowel syndrome (IBS) is a common symptomatic disorder in the Western world and colonic diverticula are also prevalent; however, relationships between IBS-type symptoms and diverticula have been a source of much debate. Our goal was to reassess these relationships in the light of new data. Recent findings On removing from consideration clinical scenarios which are directly related to diverticula (i.e., diverticulitis, diverticular hemorrhage, and complications of diverticulitis, such as stricture and fistula), relationships between IBS and diverticula can be seen to revolve around a number o...
Source: Current Opinion in Gastroenterology - November 30, 2018 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

Editorial: From eosinophils to serrated adenomas and beyond late breaking news from the dark continent
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - November 30, 2018 Category: Gastroenterology Tags: LARGE INTESTINE: Edited by Eamonn M.M. Quigley Source Type: research

Comparison of the 2010 and 2017 Infectious Diseases Society of America guidelines on the diagnosis and treatment of Clostridium difficile infection
Purpose of review To highlights the key changes in the updated Infectious Diseases Society of America and Society for Healthcare Epidemiology of America guidelines with respect to the diagnosis and treatment of Clostridium difficile infection (CDI). Recent findings CDI continues as a major threat to healthcare institutions and as a community-associated infection related primarily to antibiotic exposure. Infectious Diseases Society of America/Society for Healthcare Epidemiology of America produced extensive CDI guidelines in 2010; in 2018, updated guidance has been published. The new guidelines include key changes with...
Source: Current Opinion in Gastroenterology - November 30, 2018 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

Control of norovirus infection
Purpose of review The purpose of the review is to provide an update on control measures for norovirus (NoV), which is the most commonly implicated pathogen in acute gastroenteritis and outbreaks, causing major disruption in nurseries, schools, hospitals and care homes. Recent findings Important developments include the discovery that virus particles, previously considered to be the infectious unit, also occur in clusters, which appear to be more virulent than individual virus particles; a working culture system using human stem-cell derived enteroids; promising results from early phase clinical trials of candidate NoV...
Source: Current Opinion in Gastroenterology - November 30, 2018 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

Helicobacter pylori resistance to current therapies
Purpose of review Helicobacter pylori eradication rates have fallen in recent years, mainly because of the emergence of antibiotic-resistant infections. Indeed the WHO has recently designated clarithromycin-resistant H. pylori infection a high priority for antibiotic resistance research and development. This review aims to discuss the most up-to-date information on the methods to detect H. pylori antibiotic resistance, the recent data on resistance rates, and the most appropriate treatment strategies to overcome antibiotic resistance. Recent findings There has been active research into the development and assessment o...
Source: Current Opinion in Gastroenterology - November 30, 2018 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

Irritable bowel syndrome following Clostridium difficile infection
Purpose of review The aim of this review was to provide an overview of the current understanding of the diagnosis, pathophysiology, and the role of the gut microbiome in Clostridium difficile infection (CDI)-related postinfectious irritable bowel syndrome (PI-IBS). Recent findings PI-IBS is a recognized pathological entity and was estimated to affect 1 in 10 patients with infectious enteritis. CDI remains a major healthcare burden worldwide with a one in four chance of recurrence of symptoms following treatment. While there is growing interest in functional gastrointestinal disorders including PI-IBS, studies examinin...
Source: Current Opinion in Gastroenterology - November 30, 2018 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 - November 30, 2018 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Endoscopic treatment of pain in chronic pancreatitis
Purpose of review Pain is the most common symptom of chronic pancreatitis, having a profound effect on patients and a broad socioeconomic impact. Endoscopy is guideline recommended as first-line management for chronic pancreatitis pain in certain clinical scenarios. Herein, we provide an evidence-based review of the endoscopic treatment of pain due to chronic pancreatitis while highlighting some important confounders in the measurement of this outcome in clinical practice and research. Recent findings Multiple recent studies have reported on the efficacy of current endoscopic therapies for chronic pancreatitis pain. D...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: SPECIAL COMMENTARY Source Type: research

Advances in the treatment of gastric cancer
Purpose of review To review the recent literature regarding treatment of gastric cancer. Recent findings Addition of postoperative radiation therapy to perioperative chemotherapy offers no survival benefit. Fluoropyrimidines, in particular 5-fluorouracil (5-FU), are the backbone for gastric cancer chemotherapy. S-1, an oral prodrug of 5-FU, has become the mainstay for gastric cancer chemotherapy in Japan. In a Japanese adjuvant chemotherapy trial, addition of docetaxel to standard S-1 chemotherapy improved disease-free survival; this regimen will become their new standard for adjuvant therapy. Microsatellite instabili...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Guilt by association: intestinal metaplasia does not progress to gastric cancer
Purpose of review This review integrates the new thinking about relationships between gastric cancer and intestinal metaplasia/pseudopyloric metaplasia (SPEM). We address whether recent studies have closed or widened the knowledge gap regarding gastric cancer pathogenesis in mice or humans. Recent findings Recent studies in mouse models have provided a variety of new insights into the cellular origin and progression of events resulting in gastric cancer. Many suggest a direct transformation from intestinal metaplasia/pseudopyloric metaplasia/SPEM to gastric cancer. However, results from different investigator and mode...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Adverse effects of proton pump inhibitors: fact or fake news?
Purpose of review The present review summarizes the past year's literature, both clinical and basic science, regarding potential adverse effects of proton pump inhibitors. Recent findings Proton pump inhibitors are amongst the most widely prescribed and overprescribed medications worldwide. Although generally considered well tolerated, epidemiologic studies mining large databases have reported a panoply of purported serious adverse effects associated with proton pump inhibitors, including chronic kidney disease, cognitive decline, myocardial infarction, stroke, bone fracture and even death. It should be noted that the...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Evolving techniques for endoscopic retrograde cholangiopancreatography in gastric bypass patients
Purpose of review The present review describes the current and evolving techniques available in approaching endoscopic retrograde cholangiopancreatography (ERCP) for patients with Roux-en-Y gastric bypass (RYGB) anatomy. Recent findings Recent studies have demonstrated that device-assisted enteroscopy (DAE) approaches have high failures rates when performing ERCP, but are currently considered the first-line approach for patients with RYGB anatomy because of lower costs and risks compared to surgery. In contrast, laparoscopicy-assisted-ERCP (LA-ERCP) exhibits high technical success rates but carries surgical risks and ...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Advances in management of nonvariceal upper gastrointestinal bleeding
Purpose of review To review new advances in managing nonvariceal upper gastrointestinal hemorrhage. Recent findings Implementation of various scoring systems in combination with video capsule endoscopy assists in stratifying and managing nonvariceal upper gastrointestinal bleeding. New techniques such as thermocoagulation and hemoclips are useful to treat bleeding. Summary The advancement of methods and procedures in managing nonvariceal upper gastrointestinal bleeding has decreased mortality of patients presenting with this type of hemorrhage. In this chapter, we will be discussing various scores to stratify nonva...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Gastroduodenal motility disorders
Purpose of review This review summarizes recent progress in the epidemiology, pathophysiology and treatment of gastroduodenal motility disorders with an emphasis on functional dyspepsia and gastroparesis. Recent findings Pathophysiological research has focused on the association of delayed emptying and impaired accommodation with symptom pattern. Studies also confirmed the presence of altered mucosal integrity and low-grade immune activation in the duodenum in functional dyspepsia, while changes in numbers of interstitial cells of Cajal and myenteric neurons were confirmed in gastroparesis. Treatment advances in gastr...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Duodenal chemosensing
Purpose of review 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 submucosa. In this review, we have summarized recent advances of understanding luminal chemosensing in the gastroduodenal mucosa, with a particular emphasis on how chemosensing affects mucosal protective responses and the metabolic syndrome. Recent findings In the past decade, data have supported the hypothesis that gut luminal chemosensing not only is important for the local or remote regulation of gut function but also contributes to the sys...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Stomach and duodenum
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

On cell death in the intestinal epithelium and its impact on gut homeostasis
Purpose of review Both apoptotic and nonapoptotic cell extrusion preserve the barrier functions of epithelia. Live cell extrusion is the paradigm for homeostatic renewal of intestinal epithelial cells (IEC). By extension, as extruded cells are not apoptotic, this form of cell shedding is thought to be largely ignored by lamina propria phagocytes and without immune consequence. Recent findings Visualization of apoptotic IEC inside distinct subsets of intestinal phagocytes during homeostasis has highlighted apoptosis as a normal component of the natural turnover of the intestinal epithelium. Analysis of phagocytes with ...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Maria T. Abreu Source Type: research

Xenobiotic and endobiotic handling by the mucosal immune system
Purpose of review Mucosal immune cells in the intestinal tract are continuously exposed to a barrage of both foreign and endogenously generated metabolites, termed xenobiotics, and endobiotics, respectively. This review summarizes recent insights into the mechanisms by which xenobiotics and endobiotics regulate intestinal immunity and inflammation. Recent findings The community of enteric microbes (i.e., microbiota) has profound impacts on the development and function of the mucosal immune system. The composition and function of gut microbiota is dynamically regulated by diet, and this interplay dictates which and how...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Maria T. Abreu Source Type: research

Mucosal immune responses to fungi and the implications for inflammatory bowel disease
Purpose of review The intestinal microbiota plays a central role in inflammatory diseases of the gut. Although most investigations regarding how the mucosal immune system interacts with the microbiota have focused on bacteria, recent studies are elucidating the additional role of commensal fungi in health and disease in the gut. Recent findings New technical approaches are defining the makeup of the fungal communities in the intestines of humans and mice. The reported composition of these communities is influenced by the approaches used to define the fungi. Changes in the intestinal mycobiota are associated with gut i...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Maria T. Abreu Source Type: research

Macrophage interactions with fungi and bacteria in inflammatory bowel disease
Purpose of review In this review, we discuss recent advances into delineating the dual role of intestinal phagocytes in health and during intestinal disease. We further discuss the key role of gut-resident macrophages in recognition of bacterial and fungal microbiota in the gut. Recent findings Inflammatory bowel disease (IBD) commonly manifests with pathologic changes in the composition of gut bacterial and fungal microbiota. Intestinal macrophages are key regulators of the balance between tolerogenic immunity and inflammation. Recent studies have highlighted the role of resident intestinal macrophages in the control...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Maria T. Abreu Source Type: research

Reproducing the human mucosal environment ex vivo: inflammatory bowel disease as a paradigm
Purpose of review The medical management of inflammatory bowel disease (IBD) remains problematic with a pressing need for innovation in drug development as well as delivery of personalized therapies. Both the disease's inherent pathophysiologic complexity and heterogeneity in its etiology conspire in making it difficult to accurately model for either the purposes of basic research or drug development. Multiple attempts at creating meaningful experimental models have fallen short of adequately recapitulating the disease and most do not capture any aspect of the cause or the effects of patient heterogeneity that underlays ...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Maria T. Abreu Source Type: research

Checkpoint inhibitor colitis: a new model of inflammatory bowel disease?
Purpose of review Immune checkpoint inhibitors are monoclonal antibodies against the inhibitory, co-stimulatory molecules CTLA-4 and PD-1/PD-L1. Their use in oncology has been associated with frequent and diverse immune-related adverse events. In the digestive tract, such toxicity presents primarily as colonic inflammation, resembling inflammatory bowel disease (IBD). This review presents recent developments regarding the characteristics of checkpoint inhibitor colitis (CIC) and its relation to IBD. Recent findings Several reports from patient cohorts with CIC have outlined its similarities and differences with IBD. C...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Maria T. Abreu Source Type: research

Updates in mucosal immunology for inflammatory bowel diseases
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Maria T. Abreu Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Total pancreatectomy and islet autotransplantion for chronic and recurrent acute pancreatitis
Purpose of review We reviewed the current state of total pancreatectomy with islet autotransplantation (TPIAT) for chronic pancreatitis and recurrent acute pancreatitis (RAP). Recent findings An increasing number of centers in the United States and internationally are performing TPIAT. In selected cases, TPIAT may be performed partially or entirely laparoscopically. Islet isolation is usually performed at the same center as the total pancreatectomy surgery, but new data suggest that diabetes outcomes may be nearly as good when a remote center is used for islet isolation. Ongoing clinical research is focused on patient...
Source: Current Opinion in Gastroenterology - August 3, 2018 Category: Gastroenterology Tags: PANCREAS: Edited by Timothy B. Gardner Source Type: research

Diagnosis and treatment of autoimmune pancreatitis
Purpose of review Clinical management of autoimmune pancreatitis changed over the last years. The lack of high-quality studies, probably due to the relative rarity of the disease, has not fully clarified many diagnostic and therapeutic aspects. Aim of this review is to overview the literature from a clinical point of view, focusing on diagnostic and therapeutic approach to this complicated disease. Recent findings They have been focused mainly on the risk of misdiagnosing a cancer. Many significant articles have been published on the treatment strategies of autoimmune pancreatitis, considering both induction and maint...
Source: Current Opinion in Gastroenterology - August 3, 2018 Category: Gastroenterology Tags: PANCREAS: Edited by Timothy B. Gardner Source Type: research

Myths and realities about alcohol and smoking in chronic pancreatitis
Purpose of review Alcohol and smoking play an important role in pancreatitis. The present review will address the myths and evidences about alcohol and smoking with pancreatitis to help improve the approach of healthcare professionals when managing of these patients. Recent findings There is a growing recognition that chronic pancreatitis is a multifactorial disease. Eliciting an accurate history of alcohol consumption and smoking from patients, and if necessary, family members, can help determine their contribution to the patient's disease. In the absence of a convincing history, physicians should be open to consider...
Source: Current Opinion in Gastroenterology - August 3, 2018 Category: Gastroenterology Tags: PANCREAS: Edited by Timothy B. Gardner Source Type: research

Diagnosis and treatment of pancreatic exocrine insufficiency
Purpose of review Pancreatic exocrine insufficiency (PEI), defined as a secretion of pancreatic enzymes and bicarbonate insufficient to maintain a normal digestion, is a frequent but frequently underdiagnosed and undertreated condition. PEI may be secondary to different pancreatic diseases and extrapancreatic conditions. Recent data support the high clinical relevance of PEI and its treatment. Recent findings Together with symptoms of maldigestion, PEI is associated with nutritional deficiencies leading to osteoporosis, low-trauma fractures, sarcopenia and increased mortality. No single widely available test allows to...
Source: Current Opinion in Gastroenterology - August 3, 2018 Category: Gastroenterology Tags: PANCREAS: Edited by Timothy B. Gardner Source Type: research

To resect or not to resect: a review of pancreatic cyst disease management
Purpose of review With recent advances in radiographic testing, there have been increases in the incidental identification of pancreatic cysts. Determining management, specifically, which cysts can be watched versus intervened upon has significant impact on at the patient–physician level as well as globally on resource allocation and healthcare expenditures. This review focuses on the three main guidelines (Fukuoka guidelines, European consensus, and American Gastroenterological Association recommendations) for management of pancreatic cystic disease after incidental identification. Recent findings There are ite...
Source: Current Opinion in Gastroenterology - August 3, 2018 Category: Gastroenterology Tags: PANCREAS: Edited by Timothy B. Gardner Source Type: research

Management of complications of acute pancreatitis
This article will review the latest developments and controversies regarding the endoscopic management of these conditions. Recent findings For patients with pancreatic pseudocysts, it remains to be clear what the role of routine ERCP is in this population. For WON, it is clear that when expertise is available, a minimally invasive approach may be the most suitable option. There is a growing literature raising concern about LAMS-associated bleeding in this group, however. Alterations in LAMS placement and stent dwell time may reduce this risk. Lastly, recognition of the DPDS is an important factor that needs to be recog...
Source: Current Opinion in Gastroenterology - August 3, 2018 Category: Gastroenterology Tags: PANCREAS: Edited by Timothy B. Gardner Source Type: research