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Faecal microbiota replacement to eradicate antimicrobial resistant bacteria in the intestinal tract – a systematic review
Purpose of review Antimicrobial resistance is a rising threat to global health and is associated with increased mortality. Intestinal colonisation with multidrug-resistant organisms (MDRO) can precede invasive infection and facilitates spread within communities and hospitals. Novel decolonisation strategies, such as faecal microbiota transplantation (FMT), are being explored. The purpose of this review is to provide an update on how the field of FMT for MDRO decolonisation has developed during the past year and to assess the efficacy of FMT for intestinal MDRO decolonisation. Recent findings Since 2020, seven hi...
Source: Current Opinion in Gastroenterology - December 10, 2021 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

Can prediction scores be used to identify patients at risk of Clostridioides difficile infection?
Purpose of review To describe the current state of literature on modeling risk of incident and recurrent Clostridioides difficile infection (iCDI and rCDI), to underscore limitations, and to propose a path forward for future research. Recent findings There are many published risk factors and models for both iCDI and rCDI. The approaches include scores with a limited list of variables designed to be used at the bedside, but more recently have also included automated tools that take advantage of the entire electronic health record. Recent attempts to externally validate scores have met with mixed success. Summa...
Source: Current Opinion in Gastroenterology - December 10, 2021 Category: Gastroenterology Tags: GASTROINTESTINAL INFECTIONS: Edited by Mark H. Wilcox Source Type: research

The potential of microbiome replacement therapies for Clostridium difficile infection
Purpose of review There is a paradox when treating Clostridium difficile infection (CDI); treatment antibiotics reduce C. difficile colonization but cause further microbiota disruption and can lead to recurrent disease. The success of faecal microbiota transplants (FMT) in treating CDI has become a new research area in microbiome restorative therapies but are they a viable long-term treatment option? Recent findings C. difficile displays metabolic flexibility to use different nutritional sources during CDI. Using microbiome therapies for the efficient restoration of bile homeostasis and to reduce the bioavailabi...
Source: Current Opinion in Gastroenterology - December 10, 2021 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 - December 10, 2021 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research

The prevention of gastric cancer by Helicobacter pylori eradication
Purpose of review Gastric cancer remains one of the most common causes of death globally. Increasing evidence suggests that many gastric cancer cases can be prevented by eradicating its most important etiological agent, Helicobacter pylori. Using the search terms ‘H. pylori’ and ‘gastric cancer’ we reviewed the scientific literature regarding the association between H. pylori and gastric cancer published from 1 January 2020 to 30 May 2021. We review the most important articles relevant to the clinical issues regarding H. pylori eradication for gastric cancer prevention. Recent findings In randomized tria...
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Tilak U. Shah Source Type: research

Celiac disease: clinical update
Purpose of review This review highlights literature from the past year and explores the impact on current understanding of celiac disease pathogenesis, diagnosis, and management. Recent findings In contrast to earlier clinical trials, recent data suggests that early gluten introduction may protect against the development of celiac disease. Celiac disease is underdiagnosed, associated with high burden of disease and linked to excess mortality risk, yet, there remains considerable uncertainty regarding the utility of mass screening in asymptomatic individuals. The gut microbiome is increasingly implicated in celia...
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Tilak U. Shah Source Type: research

Advances in the treatment of gastric cancer: 2020–2021
Purpose of review To review studies from 2020 to 2021 in esophagogastric cancer. Recent findings After up front D2 gastrectomy for lymph node-positive gastric cancer, 6 months of adjuvant chemotherapy with S-1 and oxaliplatin achieved superior disease-free survival (DFS) compared with 1 year of S-1. The addition of adjuvant radiotherapy, however, added no benefit. After chemoradiotherapy and surgery in esophageal and gastroesophageal junction cancer, in patients with residual disease found at surgery, 1 year of adjuvant nivolumab substantially improved DFS compared with observation alone, leading to regulatory a...
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Tilak U. Shah Source Type: research

Mucosal defense: gastroduodenal injury and repair mechanisms
Purpose of review The mucosal barrier serves as a primary interface between the environment and host. In daily life, superficial injury to the gastric or duodenal mucosa occurs regularly but heals rapidly by a process called ‘restitution’. Persistent injury to the gastroduodenal mucosa also occurs but initiates a regenerative lesion with specific wound healing mechanisms that attempt to repair barrier function. If not healed, these lesions can be the site of neoplasia development in a chronic inflammatory setting. This review summarizes the past year of advances in understanding mucosal repair in the gastroduodenal...
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Tilak U. Shah Source Type: research

Gastric intestinal metaplasia: when to treat? How to treat?
Purpose of review Gastric intestinal metaplasia (GIM) is an attractive target for surveillance and treatment as it can progress to gastric adenocarcinoma (GAC). Yet, GIM remains a challenging area for clinicians as most patients do not progress to cancer, and there are conflicting data regarding the benefits of surveillance and therapy. This review aims to summarize recently published GIM surveillance guidelines, to discuss, which patients with GIM may benefit from treatment, and to review pivotal and recent literature on GIM therapy. Recent findings Guidelines published by American, British, and European gastro...
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Tilak U. Shah Source Type: research

Gastroparesis
Purpose of review This review highlights recent research advances regarding the pathophysiology and treatment of gastroparesis. Recent findings Differences in brain activity have been identified on functional MRI imaging in gastroparesis patients with nausea. Abdominal pain is common in patients with gastroparesis and does not correlate with the severity of gastric emptying delay, though may be associated with depression and anxiety. Autonomic dysfunction may play an important role in the pathophysiology of gastroparesis. There is increasing sentiment that gastroparesis should be considered a part of the same sp...
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Tilak U. Shah Source Type: research

Endoscopic simulators: training the next generation
Purpose of review To provide a review of current evidence evaluating endoscopic simulators as teaching platforms in gastroenterology training, with emphasis on upper gastrointestinal anatomy. Recent findings Endoscopic simulators have leveraged mechanical, virtual reality and ex-vivo or live animal platforms to deliver training in both general and therapeutic endoscopy. Simulators have demonstrated their greatest utility in training novice endoscopists. Intermediate and expert endoscopists may additionally benefit from simulator exposure when learning advanced therapeutic techniques including large tissue resect...
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Tilak U. Shah Source Type: research

Editorial: Stomach and duodenum: what's current in 2021
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Tilak U. Shah Source Type: research

Gut microbiota and sepsis: from pathogenesis to novel treatments
Purpose of review This review summarizes recent progress in our understanding of the role of the gut microbiota in sepsis pathogenesis and outlines the potential role of microbiota-targeted therapies. Recent findings The composition of the gut microbiome is profoundly distorted during sepsis, with a loss of commensal bacteria and an overgrowth of potential pathogenic micro-organisms. These alterations also extend to nonbacterial intestinal inhabitants. Disruptions of these intestinal communities are associated with both an increased susceptibility to develop sepsis, as well as a higher risk of adverse outcomes. ...
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Jocelyn A. Silvester Source Type: research

The bi-directional role of the gut–brain axis in inflammatory and other gastrointestinal diseases
Purpose of review There is a growing body of evidence implicating the role of the gut–brain axis in a multitude of inflammatory and non-inflammatory gastrointestinal disorders. The interaction between the gut and the brain is bidirectional and its therapeutic manipulation is gaining traction as the new frontier in the management of gastrointestinal disorders. This review summarizes the recent literature on this subject and serves as a reference for future research directions. Recent findings Recent studies have shown that the gut–brain axis, through its main communicator – the vagal nerve – plays a multi...
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Jocelyn A. Silvester Source Type: research

Role of gut–kidney axis in renal diseases and IgA nephropathy
Purpose of review Growing evidence show the importance of gut/kidney axis in renal diseases. Advances in gut microbiome sequencing, associated metabolites, detection of gut permeability and inflammation provide new therapeutic strategies targeting gut for kidney diseases and particularly for Immunoglobulin A (IgA) nephropathy (IgAN). Recent findings The diversity and composition of gut flora have been recently deeply explored in kidney diseases. Modulation and depletion of microbiota in animal models allowed the understanding of molecular mechanisms involved in the crosstalk between gut, immune system and kidney...
Source: Current Opinion in Gastroenterology - October 19, 2021 Category: Gastroenterology Tags: IMMUNOLOGY: Edited by Jocelyn A. Silvester Source Type: research