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Robotic Surgeries in Benign and Malignant Pancreatic Disease
AbstractPurpose of reviewPancreatic resection stands as one of the most challenging abdominal surgeries, primarily indicated for pancreatic malignancies such as pancreatic ductal adenocarcinoma (PDAC), pre-malignant conditions like intraductal papillary mucinous neoplasm (IPMN), and benign pathologies that manifest with significant symptoms, including intractable pain, often concomitant with endocrine or exocrine dysfunction. The inherent complexity and morbidity associated with pancreatic resection, exacerbated by the high risk of pancreatic anastomosis complications, including pancreatic leaks of amylase-rich fluid, is f...
Source: Current Treatment Options in Gastroenterology - April 17, 2024 Category: Gastroenterology Source Type: research

Tools for Bedsite Pain Assessments in Chronic Pancreatitis
AbstractPurpose of ReviewChronic pancreatitis (CP), a condition marked by severe pain, necessitates precise pain assessment for effective treatment. This review explores recent advances in CP pain assessment, including CP-specific tools, quantitative sensory testing (QST), and the emerging use of wearable devices.Recent FindingsUnidimensional pain assessment tools are constrained in capturing the multifaceted nature of CP pain. CP-specific tools, such as the Comprehensive Pain Assessment Tool (COMPAT) and its briefer variant, COMPAT-SF, exhibit promise but may necessitate further validation for broader adoption. QST provid...
Source: Current Treatment Options in Gastroenterology - April 3, 2024 Category: Gastroenterology Source Type: research

FLIP in Clinical Practice: When Is It Helpful?
AbstractPurpose of ReviewFunctional lumen imaging probe (FLIP) Panometry is as an important tool in the diagnosis and management of esophageal disorders.Recent FindingsUsing high-resolution impedance planimetry, FLIP assesses esophagogastric junction (EGJ) and esophageal body distensibility as well as the contractile response to distension (secondary peristalsis) at the time of sedated endoscopy. These features can be incorporated to classify esophageal motility, which often parallels high-resolution manometry (HRM) and the Chicago Classification (CCv4.0). The role of FLIP Panometry has been evaluated in multiple clinical ...
Source: Current Treatment Options in Gastroenterology - March 27, 2024 Category: Gastroenterology Source Type: research

Correction to: Therapy of Upper Gastrointestinal Symptoms: Experience with a Medical Device Made of Natural Substances
(Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - March 23, 2024 Category: Gastroenterology Source Type: research

The Diagnostic Approach of Benign Esophageal Tumors: A Narrative Review
AbstractPurpose of ReviewBenign esophageal tumors (BETs) pose diagnostic challenges due to overlapping clinical and imaging features, necessitating advancements in diagnostic techniques. Distinguishing between tumors with and without malignant potential is essential to guide management. We aim to review the diagnostic approach to BETs with an emphasis on recent advances.Recent FindingsEUS-guided tissue acquisition is the current gold standard, particularly in subepithelial lesions (SELs). EUS with fine-needle biopsy (FNB) is considered superior to fine-needle aspiration (FNA), unless rapid on-site evaluation (ROSE) is avai...
Source: Current Treatment Options in Gastroenterology - March 15, 2024 Category: Gastroenterology Source Type: research

Barrett ’s Esophagus: Who and How Do We Screen?
AbstractPurpose of ReviewBarrett ’s esophagus (BE) is the precursor of most Esophageal Adenocarcinomas (EACs) and progresses via the development of dysplasia. Hence BE screening is recommended by gastroenterology societies in patients with risk factors. Endoscopic surveillance enables the detection of dysplasia and early stage EA C, which can be treated successfully endoscopically, reducing the incidence and mortality of EAC. Despite these recommendations, only 10% of all EACs are detected in a surveillance program, and only a third or less of all BE cases are diagnosed.Recent FindingsWhile cost associated with endoscopi...
Source: Current Treatment Options in Gastroenterology - March 12, 2024 Category: Gastroenterology Source Type: research

Therapy of Upper Gastrointestinal Symptoms: Experience with a Medical Device Made of Natural Substances
AbstractPurpose of reviewMedical devices made of substances are widely used in clinical practice, but they are considered to have less therapeutic efficacy than pharmacological agents. In this narrative review, we report a recent RCT experience of a medical device made of natural substances (Poliprotect) that proved as effective as the standard reference treatment.The RCT addressed three questions: (1) Is Poliprotect useful in the initial treatment of heartburn and epigastric pain/burning as an alternative to the reference standard therapy with PPI, (2) is Poliprotect useful in the medium-term treatment of heartburn and ep...
Source: Current Treatment Options in Gastroenterology - January 24, 2024 Category: Gastroenterology Source Type: research

Infective Esophagitis: a Review of Esophageal Diseases in HIV
AbstractPurpose of ReviewEsophageal diseases are a common manifestation of HIV infection, and in some cases may be the first presentation of an underlying, severely immunocompromised state. The esophagus may be the site of the first acquired immunodeficiency syndrome (AIDS) –defining opportunistic illness in a large number of patients, and this review highlights varying clinical presentations and symptoms of esophageal diseases in HIV.Recent FindingsInfective esophagitis often signals the onset of symptomatic HIV infection and endoscopic evaluation with biopsies is instrumental in their diagnosis and management. As esoph...
Source: Current Treatment Options in Gastroenterology - December 22, 2023 Category: Gastroenterology Source Type: research

Current Management of Pouchitis
AbstractPurpose of reviewPouchitis is common after restorative proctocolectomy and ileal pouch-anal anastomosis in patients with underlying ulcerative colitis. A majority of patients with acute antibiotic-responsive pouchitis develop chronic antibiotic-dependent pouchitis or antibiotic-refractory pouchitis. Contributing factors for chronic pouchitis includeClostridium difficile infection, the use of non-steroidal anti-inflammatory drugs, concurrent autoimmune disorders, surgical ischemia, and fecal stasis from structural or functional pouch outlet obstruction. Chronic antibiotic-refractory pouchitis is considered one of ...
Source: Current Treatment Options in Gastroenterology - December 11, 2023 Category: Gastroenterology Source Type: research

Management of Abdominal Pain in Patients with Gastroparesis and Gastroparesis-Like Syndromes
AbstractPurpose of reviewThe prevalence of abdominal pain in gastroparesis ranges from 42 to 89%. Severe/very severe abdominal pain is often correlated with somatization, psychiatric conditions, and opioid use and affects the quality of life significantly. Treatment of abdominal pain in gastroparesis is complex and based on pathophysiology: phenotypes and endotypes of gastroparesis. However, the pathophysiology of gastroparesis itself is not clearly known, which makes its treatment more intriguing. In this article, we reviewed details of the pathophysiology and treatment modalities of abdominal pain in gastroparesis.Recent...
Source: Current Treatment Options in Gastroenterology - December 5, 2023 Category: Gastroenterology Source Type: research

The Management of Postoperative Recurrence in Crohn ’s Disease
AbstractPurpose of ReviewAlthough the need for intestinal resection as a treatment for Crohn ’s disease (CD) has significantly decreased as the use of advanced therapies has increased in recent decades, approximately one-half of patients with CD will require intestinal resection within 10 years of diagnosis. We sought to review emerging concepts in the postoperative management of patient s with CD, including the use of novel advanced therapies, new diagnostic and/or imaging modalities, and new methods of endoscopic scoring.Recent FindingsIleocolonoscopy remains the predominant method of assessing recurrence after ileoco...
Source: Current Treatment Options in Gastroenterology - December 2, 2023 Category: Gastroenterology Source Type: research

Artificial Intelligence in IBD: How Will It Change Patient Management?
AbstractPurpose of reviewArtificial intelligence (AI) is quickly evolving and will be integral to the management of IBD patients. In this review, we provide an overview of technologies powering applications for Crohn ’s disease and ulcerative colitis, with particular attention to information extraction from imaging and text records.Recent findingsRecent data highlight machine learning capability to replicate expert interpretation and judgment at population scale with accuracy in endoscopic and histology disease grading. Computer vision techniques are also detecting important findings difficult for even expert clinicians ...
Source: Current Treatment Options in Gastroenterology - December 1, 2023 Category: Gastroenterology Source Type: research

When and How Should Resistance Testing Be Performed to Improve H. pylori Eradication?
AbstractPurpose of ReviewTreatment ofHelicobacter pylori (H. pylori) has historically been managed with empiric regimens comprising proton pump inhibitors and a small number of common antibiotics. This has led to rising rates of antibiotic resistance, especially with regimens involving clarithromycin or levofloxacin. To improve falling eradication rates, there is now considerable interest in the role of antimicrobial susceptibility testing ofH. pylori strains to individualize or “tailor” treatment according to the resistance profile.Recent FindingsThe rates at which antimicrobial resistance inH. pylori has shifted upwa...
Source: Current Treatment Options in Gastroenterology - November 27, 2023 Category: Gastroenterology Source Type: research

Sleep: An Overlooked Lifestyle Factor in Disorders of Gut-Brain Interaction
AbstractPurpose of reviewThis review outlines the relationship between sleep and the GI tract in health, before appraising the association between sleep and the GI tract in disease, namely disorders of gut-brain interaction (DGBI). We aim to explore whether sleep disturbance exacerbates DGBI symptoms or vice versa, and summarise the evidence for pharmacological and psychological treatment options.Recent findingsSleep disorders are more common in patients with irritable bowel syndrome (IBS) compared to healthy subjects, with a pooled prevalence of 37.6%. Sufficient evidence exists to support the use of melatonin to ameliora...
Source: Current Treatment Options in Gastroenterology - October 10, 2023 Category: Gastroenterology Source Type: research

Diagnosis and Treatment of Refractory GERD
AbstractPurpose of ReviewRefractory GERD (rGERD) is a common condition with a significant and costly impact on patients and healthcare systems alike. As such, it is imperative to understand the tools available to diagnose and treat rGERD.Recent FindingsIn this review, the modalities used to diagnose rGERD are discussed in detail, including esophagogastroduodenoscopy (EGD) and ambulatory reflux monitoring (the “gold standard”). The adjunctive role of high-resolution esophageal manometry (HREM) is also addressed. A comprehensive discussion of the various treatment options is provided, including lifestyle modifications, p...
Source: Current Treatment Options in Gastroenterology - August 9, 2023 Category: Gastroenterology Source Type: research