Intestinal fibrosis: ready to be reversed
Purpose of review: Intestinal fibrosis is a common complication of several enteropathies, with inflammatory bowel disease (IBD) being the major cause. Intestinal fibrosis affects both ulcerative colitis and Crohn's disease, and no specific antifibrotic therapy exists. This review highlights recent developments in this area. Recent findings: The pathophysiology of intestinal stricture formation includes inflammation-dependent and inflammation-independent mechanisms. A better understanding of the mechanisms of intestinal fibrogenesis and the availability of compounds for other nonintestinal fibrotic diseases bring clincial ...
Source: Current Opinion in Gastroenterology - June 9, 2017 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Claudio Fiocchi Source Type: research

The extracellular matrix in IBD: a dynamic mediator of inflammation
Purpose of review: The extracellular matrix (ECM) is a frequently overlooked component of the pathogenesis of inflammatory bowel disease (IBD). However, the functional and clinically significant interactions between immune as well as nonimmune cells with the ECM have important implications for disease pathogenesis. In this review, we discuss how the ECM participates in process associated with IBD that involves diverse cell types of the intestine. Recent findings: Remodeling of the ECM is a consistent feature of IBD, and studies have implicated key ECM molecules in IBD pathogenesis. While the majority of prior studies have...
Source: Current Opinion in Gastroenterology - June 9, 2017 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Claudio Fiocchi Source Type: research

Inflammatory bowel disease treatment in Eastern Europe: current status, challenges and needs
Purpose of review: To analyze the available studies of course, diagnosis and treatment of Inflammatory bowel disease (IBD) in Eastern Europe. Recent findings: According to published data, full epidemiological studies were conducted only in Czech Republic, Estonia, Hungary and Romania. Russia was recently included in the EpiCom study, although only Moscow region data were provided. Summary: We summarize previously published and unpublished data on the epidemiology, IBD diagnosis and treatment in Eastern Europe. In addition, changes during several years are presented. These data show that IBD epidemiology in Eastern Europe...
Source: Current Opinion in Gastroenterology - June 9, 2017 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Claudio Fiocchi Source Type: research

Etiopathogenesis of inflammatory bowel disease: today and tomorrow
Purpose of review: Crohn's disease and ulcerative colitis, the two major forms of inflammatory bowel disease (IBD), represent chronic diseases of unknown cause, and they are regarded as prototypical complex diseases. Despite all the recent advances, a complete appreciation of the pathogenesis of IBD is still limited. In this review, we present recent information contributing to a better understanding of mechanisms underlying IBD. Recent findings: Here, we attempt to highlight novel environmental triggers, data on the gut microbiota, its interaction with the host, and the potential influence of diet and food components. We...
Source: Current Opinion in Gastroenterology - June 9, 2017 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Claudio Fiocchi Source Type: research

IBD: the need for sweeping new concepts in pathogenesis and therapy
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - June 9, 2017 Category: Gastroenterology Tags: INFLAMMATORY BOWEL DISEASE: Edited by Claudio Fiocchi Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - June 9, 2017 Category: Gastroenterology Tags: Editorial Introductions Source Type: research

Growth factors and their use in short bowel
Purpose of review: To examine the most recent literature on the clinical trials associated with the relevant growth factors that have been of interest in the treatment of short bowel. Recent findings: Short bowel is a rare but devastating condition that condemns patients to lifelong parenteral support. Historically, treatment options negating the need for parenteral support were limited. Therapeutic growth factor use is of interest, but the clinical trial data are inconclusive. The STEPS-2 trial was the first trial that showed a sustained positive effect of the growth factor glucagon-like peptide-2 (GLP-2). This led to a ...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by David S. Sanders Source Type: research

Intestinal transplantation: a review
Purpose of review: The purpose of this article is to review the existing literature on the current indications, surgical techniques, immunosuppressive therapy and outcomes following intestinal transplantation (ITx). Recent findings: Over recent years, ITx has become a more common operation with approximately 2500 procedures carried out worldwide by 2014. It is reserved for patients with intestinal failure and who have developed complications of home parenteral nutrition or who have a high risk of dying from their underlying disease. Recent advances such as the improvement in survival rates, not only for isolated small bow...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by David S. Sanders Source Type: research

Small intestinal bacterial overgrowth as a cause for irritable bowel syndrome: guilty or not guilty?
Purpose of review: Small intestinal bacterial overgrowth (SIBO) has been proposed as a cause of irritable bowel syndrome (IBS). However, this relationship has been subject to controversy. This review aims to provide a current perspective on the SIBO-IBS hypothesis. Recent findings: Case–control studies evaluating the prevalence of SIBO in IBS and healthy individuals have shown conflicting results. Moreover, the tests available in routine clinical practice to diagnose SIBO are not valid and lack both sensitivity and specificity. Hence, interpreting the effect of interventions based on these tests is fraught with unce...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by David S. Sanders Source Type: research

Bile acid disease: the emerging epidemic
Purpose of review: Our objective was to review advances in bile acids in health and disease published in the last 2 years. Bile acid diarrhea (BAD) is recognized as a common cause of chronic diarrhea, and its recognition has been facilitated by development of new screening tests. Recent findings: Primary BAD can account for 30% of cases of chronic diarrhea. The mechanisms leading to BAD include inadequate feedback regulation by fibroblast growth factor 19 (FGF-19) from ileal enterocytes, abnormalities in synthesis or degradation of proteins involved in FGF-19 regulation in hepatocytes and variations as a function of the b...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by David S. Sanders Source Type: research

An update on small bowel endoscopy
Purpose of review: The breakthrough success of capsule endoscopy and device-assisted enteroscopy has inspired researchers to test and push the boundary of these technologies. The authors herein summarize the latest and most significant studies with clinical impact. Recent findings: Competing capsule endoscopy models have enriched the platform of this wireless device. The role of capsule endoscopy in Crohn's disease is expanding as we learn more of the significance of disease distribution and response to treatment. The benefit of capsule endoscopy in abdominal pain has previously been sceptical, but may have a role. Device...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by David S. Sanders Source Type: research

Optimizing the diagnosis of celiac disease
Purpose of review: The diagnostic approach in celiac disease is continuously evolving as our understanding of its pathophysiology improves. This review aims to provide a summary of contemporary work that supports optimization of the diagnosis of this common yet underdiagnosed condition. Recent findings: The recently updated National Institute of Clinical Excellence and European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines and the contentious biopsy-free diagnostic approach will be discussed. We will review the evidence advocating optimal biopsy techniques such as single bite biopsy and cont...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by David S. Sanders Source Type: research

The dawn of the small bowel expert cometh!
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by David S. Sanders Source Type: research

Diagnosis and evaluation of hyperbilirubinemia
Purpose of review: Jaundice, the physical finding associated with hyperbilirubinemia, results when the liver is unable to properly metabolize or excrete bilirubin. The purpose of this review is to examine some of the most common causes of jaundice in adults, provide insight into the diagnostic evaluation of jaundice, and review information on the outcomes of patients with jaundice. Recent findings: An elevated level of bilirubin almost always indicates the presence of an underlying disease state. The best approach to evaluating a patient with jaundice is to start with a careful history and physical examination, followed b...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Current concepts in ischemic hepatitis
Purpose of review: The current review seeks to define ischemic hepatitis and its associated comorbidities. It means to review the pathophysiology, clinical presentation, clinical course, outcomes, and any potential therapies. Recent findings: Ischemic hepatitis has long been associated with cardiovascular disease; recent reports have found a substantial link between preexisting cardiovascular disease and the risk for developing ischemic hepatitis. A proposed mechanism by which hepatic congestion predisposes the liver to hemodynamic injury further defines this link. Treatment is aimed at the underlying hemodynamic disturba...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Emerging pharmacologic therapies for primary sclerosing cholangitis
Purpose of review: The only currently approved treatment for primary sclerosing cholangitis (PSC) is liver transplantation, with a median time to transplant of 12–18 years after diagnosis. There are a number of emerging drugs that have the potential to meet this critically unmet need that will be summarized and discussed herein. Recent findings: Although the cause of PSC is unknown, there are a number of novel therapeutics under development. These drugs target presumed pathogenic mechanisms largely extrapolated from ex-vivo and in-vivo preclinical models, as well as translational observations. Summary: Future thera...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Alcoholic hepatitis: current trends in management
Purpose of review: Alcohol consumption is increasing globally, as are complications of alcohol-related liver disease, including the most severe manifestation, alcoholic hepatitis. Despite the increased prevalence, many patients hospitalized with alcoholic hepatitis are either not diagnosed or inadequately treated leading to significant morbidity and high mortality rates. The purpose of this review is to discuss current challenges in the diagnosis and management of this frequently fatal condition. Recent findings: Recent studies and meta-analyses have improved our understanding of both the evaluation and treatment of alcoh...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Current and future pharmacologic treatment of nonalcoholic steatohepatitis
Purpose of review: Nonalcoholic steatohepatitis (NASH), the aggressive form of nonalcoholic fatty liver disease (NAFLD), can progress to cirrhosis and hepatocellular cancer in 5–15% of patients and is rapidly becoming the leading cause for end-stage liver disease. Dietary caloric restriction and exercise, currently the cornerstone of therapy for NAFLD, can be difficult to achieve and maintain, underscoring the dire need for pharmacotherapy. This review presents the agents currently used in managing NAFLD and their pharmacologic targets. It also provides an overview of NAFLD agents currently under development. Recent...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Intestinal microbiota and nonalcoholic steatohepatitis
Purpose of review: Nonalcoholic fatty liver disease (NAFLD) is a liver disease with high prevalence in western countries. Progression from NAFLD to nonalcoholic steatohepatitis (NASH) occurs in 10–20%. NASH pathogenesis is multifactorial including genetic and environmental factors. The gut microbiota is involved in disease progression and its role is complex. Recent findings: NASH is associated with changes in the intestinal microbiota, although findings in recent studies are inconsistent. Dysbiosis can trigger intestinal inflammation and impair the gut barrier. Microbial products can now reach the liver, induce hep...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Update in HIV–hepatitis C virus coinfection in the direct acting antiviral era
Purpose of review: Availability of direct acting antivirals (DAAs) that demonstrate remarkable clinical efficacy and safety has revolutionized the ability to treat chronic infection with hepatitis C virus (HCV). An equal measure of clinical success has now been achieved in persons coinfected with HCV and the HIV, a historically harder to cure cohort with interferon-based therapy. Global goals include identifying all HIV–HCV-infected persons, gaining access to DAA therapy, preventing de novo and reinfection, and managing the sequelae of chronic infection. This review will discuss advances in the field of HIV–HCV...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Updates on hepatitis C virus therapy in the direct-acting antiviral era
Purpose of review: Hepatitis C virus (HCV) is a major cause of clinical burden in the United States and worldwide, as a percentage of patients can develop complications such as cirrhosis and hepatocellular carcinoma. Recent findings: Therapy for chronic HCV infection was previously interferon-based, but with the advent of direct-acting antivirals (DAAs), there has been a dramatic improvement in eradicating the virus with favourable side effect profiles. Summary: Emerging data are demonstrating new successful agents in difficult-to-manage populations. This review is aimed to provide a brief overview of currently accepted ...
Source: Current Opinion in Gastroenterology - April 6, 2017 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Advances in hepatology
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - April 6, 2017 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, 2017 Category: Gastroenterology Tags: Editorial Introductions Source Type: research

Diet and gastroesophageal reflux disease: role in pathogenesis and management
Purpose of review: Gastroesophageal reflux disease (GERD) is a common disease that presents with a variety of symptoms including heartburn and acid regurgitation. Although dietary modification is currently regarded as first-line therapy for the disease, the role of diet in the pathogenesis and management of GERD is still poorly understood. The present article aims to review recent literature that examines the relationship of diet and GERD. Recent findings: Increased awareness of medications side effects and widespread overuse has brought nonpharmacological therapies to the forefront for the management of GERD. Recent find...
Source: Current Opinion in Gastroenterology - February 3, 2017 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Nutritional management of acute pancreatitis
Purpose of review: Acute pancreatitis is one of the most common causes for hospitalization related to a gastrointestinal disorder. It carries significant morbidity, and when severe, significant mortality. Multiple interventions have been studied to treat pancreatitis. Of all these interventions, none is more important or impactful than nutrition. Recent findings: High-quality evidence along with society guidelines have recommended the use of enteral nutrition over parenteral nutrition in patients with pancreatitis. Recent systematic reviews and meta-analyses have been published and will be reviewed here. Summary: The use...
Source: Current Opinion in Gastroenterology - February 3, 2017 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

The gut response to food: a physiological perspective on food-induced gastrointestinal symptoms – it's not all allergy and intolerance!
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - February 3, 2017 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Immunogenetics in primary sclerosing cholangitis
Purpose of review: Primary sclerosing cholangitis (PSC) is a progressive biliary liver disorder strongly associated with inflammatory bowel disease (PSC-IBD). We summarize the genetics of PSC-IBD and highlight recent findings that further differentiate PSC-IBD as a unique disease. Recent findings: To date, genome-wide studies have uncovered 23 susceptibility loci for PSC-IBD, the majority of which have been previously reported as risk factors in other immune-mediated disorders. For most candidates, the pathological relationship to PSC-IBD remains largely unknown. Several candidate genes appear to be liver related but the ...
Source: Current Opinion in Gastroenterology - February 3, 2017 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Intestinal microbiota in primary sclerosing cholangitis
Purpose of review: Alterations of the gut-liver axis have been linked to the pathogenesis of primary sclerosing cholangitis (PSC) since the disease was first described. The purpose of this review is to discuss multiple recent studies on the intestinal microbiota in human PSC and experimental models of this disease. Recent findings: Data are available from eight cross-sectional studies of human PSC, which include a variable number of patients (n = 11–85), material (mucosal or fecal), and microbiota profiling methodology. Despite the heterogeneity of the studies, a pattern of differences is observed that could rep...
Source: Current Opinion in Gastroenterology - February 3, 2017 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Risk of cholangiocarcinoma in patients with primary sclerosing cholangitis: diagnosis and surveillance
Purpose of review: Primary sclerosing cholangitis (PSC) is associated with an increased risk of hepatobiliary and extrahepatic malignancy. Particularly the risk of cholangiocarcinoma (CCA) is greatly increased. To provide potentially curative treatments for affected patients an early diagnosis of CCA is crucial. We here review the current advances with respect to CCA diagnosis and surveillance and discuss a rational approach on how to perform surveillance of CCA in PSC patients. Recent findings: Given the shortcomings of the current modalities for the surveillance and diagnosis of CCA in PSC, recent studies have focused o...
Source: Current Opinion in Gastroenterology - February 3, 2017 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

The evolution of natural history of primary sclerosing cholangitis
Purpose of review: Primary sclerosing cholangitis (PSC) is a rare, idiopathic biliary disease often with an insidious onset, variable disease course, and premature death related to benign and malignant PSC-related sequelae. This review aims to discuss the epidemiology, clinical variants, and natural history of PSC, incorporating data from recent population-based studies. Recent findings: PSC naturally leads to cirrhosis, cholangiocarcinoma, other hepatobiliary malignancies, dominant strictures, hepatic osteodystrophy, and bacterial cholangitis. The incidence of PSC appears to be increasing, the reasons for which are uncle...
Source: Current Opinion in Gastroenterology - February 3, 2017 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Updates on primary sclerosing cholangitis
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - February 3, 2017 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 3, 2017 Category: Gastroenterology Tags: Editorial Introductions Source Type: research

Mesenchymal stem/stromal cell therapy for inflammatory bowel disease: an updated review with maintenance of remission
Purpose of review: There is a need for novel therapies for inflammatory bowel diseases (IBDs) that are well tolerated and effective. Currently, mesenchymal stem/stromal cells (MSCs) are being investigated in clinical trials for treatment of IBD. In this review, we update the recently published studies with an emphasis on the long-term efficacy of MSC therapy for IBD. Recent findings: A cumulative body of data, including a recent phase III randomized controlled trial demonstrated excellent fistula healing in patients with refractory Crohn's perianal fistulae treated via local injections of MSCs and with a good safety profi...
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Review Source Type: research

Role of visceral fat in colonic inflammation: from Crohn's disease to diverticulitis
Purpose of review: The composition of activated adipose tissue with adipocytes secreting a broad spectrum of immune-modulatory adipokines next to adipose tissue-derived stromal cells and professional immune effector cells in the visceral fat creates a complex network of inflammatory processes shaping local immune responses in the adjacent inflamed intestinal mucosa. Recent findings: In Crohn's disease a particular phenomenon called ‘creeping fat’ can be observed. Here the hyperplastic mesenteric fat tissue not only grows around inflamed small intestinal segments but also furthermore affects the regulation of t...
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Review Source Type: research

The genetics and molecular biology of colonic neoplasia: practical implications for the clinician
Purpose of review: Despite the large investment of resources from screening, the fact that colorectal cancer remains the second leading cause of cancer deaths among Americans underscores the need for alternative strategies. Thus, a major clinical and research imperative is personalize clinical care, while focusing on risk stratification for screening, surveillance, chemoprevention, and therapeutic intervention. Recent findings: A complicating factor that colorectal cancer is biologically heterogeneous for at least four consensus molecular subtypes presents clear challenges for developing robust molecular biomarkers. Summ...
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Review Source Type: research

Runner's diarrhea: what is it, what causes it, and how can it be prevented?
Purpose of review: Runner's diarrhea is an acute exercise-induced diarrhea. Usually, this is not a pathological situation but it can affect performance. This review focuses on the discussion of the main causes of runner's diarrhea and nutritional recommendations to prevent it. Recent findings: Although based on limited data, multiple transportable carbohydrate intake during exercise instead of glucose alone can be recommended for preventing the urge to defecate and (possibly) diarrhea. Additionally, avoiding ingestion of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) is related to a lo...
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Review Source Type: research

Colonic ischemia: usual and unusual presentations and their management
Purpose of review: To provide an update on the epidemiology, pathophysiology, clinical presentation, and management of colonic ischemia. Recent findings: Formerly regarded as a rare cause of lower gastrointestinal hemorrhage, colonic ischemia is now recognized to be the most common manifestation of intestinal vascular compromise. In contrast to ischemic events in the small intestine wherein thrombotic and embolic events predominate, colonic ischemia typically results from a global reduction in blood flow to the colon and no occlusive lesion(s) are evident. Several risk factors for colonic ischemia have been identified and...
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Review Source Type: research

The care of the colorectal cancer survivor
Purpose of review: The gastroenterology literature emphasizes factors that increase colorectal cancer (CRC) incidence but presents little about management after initial CRC treatments. The purpose of this review is to describe the remarkably increasing numbers of CRC survivors in whom surveillance guidelines are often not followed and patient care is fragmented. The gastroenterologist can play an important role in this care to improve prognosis and overall health. Recent findings: Existing surveillance recommendations by specialty societies for CRC survivors are fairly consistent but implementation occurs in less than hal...
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Review Source Type: research

Progress with treating the microbial dysbiosis associated with irritable bowel syndrome
Purpose of review: Microbial dysbiosis is receiving increasing attention as possibly being important in the pathophysiology of irritable bowel syndrome. This review will summarize the most recent literature addressing attempts to explore and target the microbiome in patients with irritable bowel syndrome. Recent findings: Manipulation of the intestinal microbiota in irritable bowel syndrome is receiving increasing attention. Traditionally, dietary manipulation has been utilized. There is now evidence that a low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet has not only been able to improve ...
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Review Source Type: research

The consequences of Campylobacter infection
Purpose of review: The purpose of this review is to provide an update on the clinical, public health and economic consequences of Campylobacter infection. Recent findings: Campylobacter is a leading bacterial cause of food-related illness. Its importance is enhanced by the chronic sequelae that can result from acute infection. Recent advances include a new clinical classification system for neurological sequelae with the aim of speeding accurate diagnosis and appropriate treatment, a better understanding of the mechanisms underlying postinfectious functional gastrointestinal disorders, the emergence of Campylobacter conci...
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Review Source Type: research

Fecal microbiota transplantation for gastrointestinal disorders
Purpose of review: The importance of the gut microbiome in human health is being increasingly recognized. The purpose of this review is to examine the existing literature pertaining to alterations in the gut microbiome and the utility of microbiome restoration therapies in gastrointestinal disorders. Recent findings: Imbalance and maladaptation of the microbiome, termed dysbiosis, has been associated with several disease states such as irritable bowel syndrome, Clostridium difficile infection, inflammatory bowel diseases, nonalcoholic fatty liver disease, and obesity among others. The possibility of restoration of normal ...
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Review Source Type: research

Novel antibiotics in development to treat Clostridium difficile infection
Purpose of review: Clostridium difficile infections (CDI) remain a challenge to treat clinically due primarily to limited number of antibiotics available and unacceptably high recurrence rates. Because of this, there has been significant demand for creating innovative therapeutics, which has resulted in the development of several novel antibiotics. Recent findings: This review updates seven different antibiotics that are currently in development to treat CDI including fidaxomicin, surotomycin, ridinilazole, ramoplanin, cadazolid, LFF571, and CRS3123. Available preclinical and clinical data are compared between these antib...
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Review Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - December 3, 2016 Category: Gastroenterology Tags: Editorial Introductions Source Type: research

Update on innate immunity and perspectives on metabolite regulation in acute pancreatitis
Purpose of review: Acute pancreatitis is a major cause of gastrointestinal morbidity for which specific therapy is greatly needed to prevent progression to and induce resolution of severe disease. Recent findings: Innate immune components and metabolite signaling are recently identified as strong determinants of disease severity and resolution in acute pancreatitis and this work will be discussed herein. Summary: Targeting innate immune cell populations and metabolite signaling pathways in acute pancreatitis may result in broader and ultimately more efficacious re-direction of the inflammatory programme toward disease re...
Source: Current Opinion in Gastroenterology - October 11, 2016 Category: Gastroenterology Tags: Special Commentary Source Type: research

An update in the nonendoscopic treatment of gastric cancer
This article reviews the recent seminal studies in esophagogastric cancer. Recent findings: Regular low aspirin use may reduce the risk of esophagogastric cancer. Laparoscopic resection of locally advanced gastric cancer appears equivalent to open resection. There is no survival benefit for the addition of postoperative radiation therapy to adjuvant chemotherapy after primary gastric cancer resection. For tumors of the esophagus and gastroesophageal junction, the combination of preoperative radiation therapy with concurrent chemotherapy may be required to ensure achievement of a negative surgical margin and to reduce loca...
Source: Current Opinion in Gastroenterology - October 11, 2016 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

An update in the endoscopic management of gastric cancer
This article reviews the endoscopic management of gastric cancer, with emphasis on recent advances in the field. Recent findings: Long-term studies comparing surgery and endoscopic resection for early gastric cancer have shown no difference in 10-year survival rates. Second-look endoscopy, performed 2 days after endoscopic submucosal dissection (ESD) to address the concern of delayed bleeding, may not affect rebleeding rates. Magnesium, proton pump inhibitors, and bupivacaine may help reduce post-ESD pain. New devices such as the Clutch Cutter and EndoLifter may help make ESD easier and safer. Summary: Endoscopic therapy...
Source: Current Opinion in Gastroenterology - October 11, 2016 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Endoscopic treatment of obesity
Purpose of review: Obesity and its comorbid illnesses affect millions worldwide and are one of the major causes of preventable death in the world. Bariatric surgery is currently offered to individuals with a BMI greater than 40 kg/m2 or greater than 35 kg/m2 with obesity-related comorbidities such as hypertension or diabetes. Endoscopic bariatric therapies, with their reduced invasiveness and potential reversibility, may complement surgical approaches for achieving weight loss. Recent findings: At the time of this writing, two endoscopically placed intragastric balloons and an endoscopically placed aspiration tube hav...
Source: Current Opinion in Gastroenterology - October 11, 2016 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Bariatric surgery in managing diabetes mellitus
Purpose of review: Obesity is a worldwide epidemic, having profound effects on Western populations. Bariatric surgery has long been employed to treat obesity and its related comorbidities. Over time, researchers have amassed significant data to support bariatric surgery in the pursuit of treating diabetes mellitus. This review serves to introduce the most recent findings and their relation to the various bariatric surgical options as bariatric surgery will continue to cement itself in the treatment paradigm of diabetes mellitus. Recent findings: Numerous studies performed in the past 10 years have demonstrated the improve...
Source: Current Opinion in Gastroenterology - October 11, 2016 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Gastrointestinal bleeding secondary to the new anticoagulants
Purpose of review: To quantify direct oral anticoagulants (DOACs) related gastrointestinal bleeding (GIB), characterize patients at greatest risk and provide a pragmatic approach for the management of these drugs. This review will also summarize risk-management strategies and highlight evolving areas of clinical knowledge. Recent findings: DOACs permit anticoagulation with predictable dosing without the need for routine serum monitoring. Since their availability on the market, they have quickly emerged as a popular alternative for patients requiring short-term and lifelong anticoagulation. However, they are associated wit...
Source: Current Opinion in Gastroenterology - October 11, 2016 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research

Functional dyspepsia
Purpose of review: Functional dyspepsia affects 10% of the population. Emerging data are beginning to unravel the pathogenesis of this heterogeneous disorder, and new data on treatment are helping to guide evidence-based practice. In this review, the latest advances are summarized and discussed. Recent findings: The Rome IV criteria were published in 2016 and are similar to Rome III but further emphasize the subtypes (postprandial distress syndrome and epigastric pain syndrome) rather than focussing on the syndrome as a whole, and conclude that gastroesophageal reflux disease and irritable bowel syndrome are part of the f...
Source: Current Opinion in Gastroenterology - October 11, 2016 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research