Current Opinion in Gastroenterology Current Opinion in Gastroenterology RSS feedThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Editorial: Back to endoscopy
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - August 10, 2022 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - August 10, 2022 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Esophageal adenocarcinoma phenotypes and risk factors
Purpose of review The incidence of esophageal adenocarcinoma (EAC) has increased significantly over the last several decades. The majority of EAC patients present without a prior history of Barrett's esophagus (BE). As a result, endoscopic surveillance has made a suboptimal impact on EAC survival. These concerns raise serious question whether the time has come to take a different direction. The aim of this article is to review evolving evidence of EAC phenotypes and risk factors. Recent findings A recent study has identified two phenotypes of EAC based on the presence or absence of intestinal metaplasia (IM) in ...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

Recent insights on functional heartburn and reflux hypersensitivity
Purpose of review Rome IV experts have proposed that gastroesophageal reflux disease (GERD) should be diagnosed only in patients with abnormal esophageal acid exposure, and that reflux hypersensitivity (RH) and functional heartburn (FH) both should be considered functional conditions separate from GERD. Although past and recent evidence support that FH can be completely distinguished from GERD, the concept that RH is not GERD is highly questionable. This review attempts to provide current data on these issues. Recent findings Many recent investigations have provided new data on the different pathophysiological f...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

Impact of gastroesophageal reflux disease on idiopathic pulmonary fibrosis and lung transplant recipients
Purpose of review Idiopathic pulmonary fibrosis (IPF) is a prevalent subset of interstitial lung disease (ILD) that often progresses to require lung transplantation. Gastroesophageal reflux disease (GERD) is common in the IPF population, and GER-related micro-aspiration appears to be an important risk factor for IPF pathogenesis and for the deterioration of transplanted lung function. Recent findings Many patients with IPF have elevated esophageal acid exposure on reflux testing despite having no or minimal symptoms. Studies on the effects of medical GERD therapy on IPF-related outcomes have had mixed results. A...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

How provocative tests in addition to wet swallows during high-resolution manometry can direct clinical management
We describe the commonly used provocative manometric manoeuvres [rapid drink challenge (RDC), multiple rapid swallows (MRS), solid swallows and the solid test meal (STM)], compare their diagnostic yield and accuracy to wet swallows, and outline their role in directing clinical management. Recent findings Provocative testing with RDC and STM identifies a proportion of achalasia cases missed by standard testing, and RDC can play a similar role to radiology in the evaluation of treatment response. In EGJOO, provocative testing with RDC and STM not only increase the diagnostic yield, but can also help differentiate betw...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

Refractory eosinophilic esophagitis: what to do when the patient has not responded to proton pump inhibitors, steroids and diet
Purpose of review Management for patients with refractory eosinophilic esophagitis (EoE) remains a clinical challenge. This review aims to define refractory EoE, explore rates and reasons for nonresponse, and discuss the evidence that informs the approach to these patients. Recent findings Many patients will fail first-line therapies for EoE. Longer duration of therapy can increase response rates, and initial nonresponders may respond to alternative first-line therapies. There are ongoing clinical trials evaluating novel therapeutics that hold promise for the future of EoE management. Increasingly, there is reco...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

Functional luminal imaging probe in the evaluation of esophago-gastric junction outflow obstruction
Purpose of review Esophagogastric junction outflow obstruction (EGJOO) comprises a heterogeneous group of conditions that demonstrate impaired deglutitive relaxation of the esophagogastric junction (EGJ) with intact esophageal peristalsis on high-resolution manometry. Functional luminal imaging probe (FLIP) panometry is a powerful tool that can help to clarify the etiology of this manometric diagnosis. The aim of this review is to summarize the use of FLIP for the evaluation and management of EGJOO. Recent findings FLIP panometry provides measures of esophageal compliance at the EGJ and information on esophageal...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

Precision medicine: how multiomics will shape the future of inflammatory bowel disease?
Purpose of review In this article, we provide an overview of studies examining multiomic profiling in various clinical scenarios in the management of inflammatory bowel diseases (IBDs). Recent findings IBD arises as a result of an interplay between genetic, environmental, microbial and immunologic perturbations. The access to high throughput technology as well as the decrease in costs associated with such studies has led to a growing wealth of literature examining the utility of single or multiomic profiles in the management of IBD. Such studies have commonly examined the genome (and less frequently the epigenom...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Matthew A. Ciorba Source Type: research

The future of telemedicine and wearable technology in IBD
Purpose of review Telemedicine has quickly become an essential part of modern healthcare, particularly in the management of chronic conditions like inflammatory bowel disease. The purpose of this review is to describe the current use of telehealth, mobile applications and wearable devices in inflammatory bowel disease and potential future applications. Recent findings Telemedicine was increasingly used during the Coronavirus Disease 2019 pandemic. Virtual consultations allowed clinical care to continue despite pandemic-related restrictions without compromising the quality of care for patients with inflammatory b...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Matthew A. Ciorba Source Type: research

Diet as a treatment for inflammatory bowel disease: is it ready for prime time?
Purpose of review Diet remains an important topic for patients with inflammatory bowel disease (IBD), yet few guidelines for dietary recommendations exist. There is a growing interest in the use of diet as treatment or adjuvant therapy for both ulcerative colitis and Crohn's disease. Here, we highlight the latest evidence on the use of diet for treatment of symptoms, active disease and maintenance of remission in ulcerative colitis and Crohn's disease. Recent findings The Crohn's Disease Exclusion Diet (CDED) and the Specific Carbohydrate Diet (SCD) are studied diets that have gained popularity, but there is gro...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Matthew A. Ciorba Source Type: research

Management of refractory inflammatory bowel disease
Purpose of review Nearly one-third of patients with inflammatory bowel disease (IBD) do not achieve remission despite our best therapies. When this happens, it is critical to understand the reason for treatment failure. Once nonresponse is confirmed, these patients should be referred to an IBD centre for multidisciplinary care. This review will discuss the remaining treatment options, including escalation of biologics to unlicensed doses, combination biologics, nonvalidated therapies and surgical options. It will additionally provide updates in the management of acute severe ulcerative colitis (ASUC). Recent finding...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Matthew A. Ciorba Source Type: research

Comparative efficacy trials in inflammatory bowel disease: current and future implications for practice
Purpose of review Over the last decade, there has been rapid expansion of the therapeutic armamentarium, and evolution of treatment strategies, for the management of inflammatory bowel diseases (IBDs). Consequently, there is an increasing need for head-to-head or comparative efficacy trials to inform optimal positioning of therapies, and pragmatic trials comparing treatment strategies to inform treatment approach. In this review, we will discuss the current status and future of comparative efficacy clinical trials in IBD. Recent findings Pivotal phase IIIB superiority clinical trials have demonstrated superiorit...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Matthew A. Ciorba Source Type: research

Integrating new and emerging therapies into inflammatory bowel disease clinical practice
Purpose of review The purpose of this review is to highlight new and emerging therapies in inflammatory bowel disease (IBD) and provide insight on how these therapies can be integrated into clinical practice. Recent findings The article covers clinical and real-world data for Janus kinase inhibitors, anti-interleukin antibodies, sphingosine-1-phosphate receptor modulators, and anti-integrin therapies. It also explores the potential role of antifibrotic agents, microbiota-based innovations, and for personalized medicine in IBD. Summary The treatment of IBD has evolved significantly in the last two decades,...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Matthew A. Ciorba Source Type: research

Inflammatory bowel disease in underserved populations: lessons for practice
Purpose of review The incidence of inflammatory bowel disease (IBD) is increasing in minority groups across the USA. There are racial and ethnic disparities in IBD care and outcomes that are rooted in historical injustice and inequities in the social determinants of health. Recent findings Current literature has identified racial, ethnic and sociodemographic disparities in therapeutics and outcomes for IBD, including disease severity, morbidity and mortality. Summary Strategies to achieve equity in IBD include tackling structural racism as a driver of health disparities and making actionable changes again...
Source: Current Opinion in Gastroenterology - July 1, 2022 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Matthew A. Ciorba Source Type: research