Current Status and Future Perspective in Cholangiopancreatoscopy
AbstractPurpose of reviewWith the rapid growth of cholangiopancreatoscopy, several platforms of cholangiopancreatoscopy have been currently available. Since the introduction of digital single-operator cholangiopancreatoscopy, there have been several reports describing its efficacy for long-standing and novel applications. The purpose of this review is to show the current status and future perspective of cholangiopancreatoscopy.Recent findingsMeta-analysis of cholangiopancreatoscopy have demonstrated good diagnostic yield for visual impression; however, it should be noted that there is no standardized classification system ...
Source: Current Treatment Options in Gastroenterology - July 24, 2019 Category: Gastroenterology Source Type: research

The Role of Behind Folds Visualizing Techniques and Technologies in Improving Adenoma Detection Rate
AbstractPurpose of reviewColorectal cancer is one of the most common malignancies in the Western world and is thought to develop from premalignant polyps. Over the past decade, several behind folds visualizing techniques (BFTs) have become available to improve polyp detection. This systematic review and meta-analysis aims to compare BFTs with conventional colonoscopy (CC).Recent findingsIn the past five  years, 14 randomized controlled trials (RCTs) including 8384 patients comparing different BFTs with CC were published. The overall relative risks for adenoma detection rate, polyp detection rate, and adenoma miss rate...
Source: Current Treatment Options in Gastroenterology - July 22, 2019 Category: Gastroenterology Source Type: research

Interplay of Liver Disease and Gut Microbiota in the Development of Colorectal Neoplasia
AbstractPurpose of the reviewLiver disease, colon cancer, and the gut microbiome are intimately interrelated; however, the connections linking liver disease and colorectal neoplasia via the gut microbiota remain poorly understood and rarely addressed in a single space. The goal of this review is to take a broad perspective on the clinical problem of colorectal neoplasia in the liver disease population, recognize the significance of the clinical study findings, and delve into the evidence supporting putative molecular mechanisms connecting dysbiosis in the progression of liver disease to the development of colorectal neopla...
Source: Current Treatment Options in Gastroenterology - July 20, 2019 Category: Gastroenterology Source Type: research

Hepatitis C elimination: a Public Health Perspective
AbstractPurpose of reviewHepatitis C virus (HCV) infection is a principal cause of morbidity, mortality, and economic burden, and the global elimination of HCV is now considered a public health objective. Globally, an estimated 71 million have chronic HCV infection with an estimated annual mortality of 3,99,000.Recent findingsThe 69th World health Assembly has endorsed the global HCV elimination strategy by 2030, which is made possible because of all oral, cost-effective, efficacious, generic direct-acting antivirals. The public health strategy targets not only diagnosed chronic hepatitis C patients but also asymptomatic u...
Source: Current Treatment Options in Gastroenterology - July 18, 2019 Category: Gastroenterology Source Type: research

Endoscopic Methods for Gallbladder Drainage
AbstractPurpose of reviewAcute cholecystitis is conventionally managed with cholecystectomy; however, when this occurs in the non-operative patient, it requires consideration for alternative means of gallbladder drainage (GBD).Recent findingsSuitable endoscopic methods for GBD include transpapillary cystic duct stent or endoscopic ultrasound (EUS)-guided transmural stent placement. Importantly, patients who undergo endoscopic GBD have comparable outcomes to those who undergo placement of percutaneous transhepatic catheters by interventional radiology (IR).SummaryThere is evolving evidence to support endoscopic gallbladder ...
Source: Current Treatment Options in Gastroenterology - July 17, 2019 Category: Gastroenterology Source Type: research

Epigenetic Mechanisms of Pancreatobiliary Fibrosis
AbstractPurpose of reviewThe goal of this manuscript is to review the current literature related to fibrogenesis in the pancreatobiliary system and how this process contributes to pancreatic and biliary diseases. In particular, we seek to define the current state of knowledge regarding the epigenetic mechanisms that govern and regulate tissue fibrosis in these organs. A better understanding of these underlying molecular events will set the stage for future epigenetic therapeutics.Recent findingsWe highlight the significant advances that have been made in defining the pathogenesis of pancreatobiliary fibrosis as it relates ...
Source: Current Treatment Options in Gastroenterology - July 12, 2019 Category: Gastroenterology Source Type: research

Indications for Single-Operator Cholangioscopy and Pancreatoscopy: an Expert Review
AbstractPurpose of reviewDirect endoscopic visualization of the biliary and pancreatic ducts by single-operator cholangioscopy (SOC) and pancreatoscopy (SOP) is an expanding technique with an increasing number of indications. This review provides technical tips and tricks and a literature update on the usefulness of SOC and SOP in clinical practice.Recent findingsSOC has shown a 91.3% and 87.3% diagnostic procedural success in indeterminate strictures and difficult stones respectively, with a 9.4% –16.4% complication rate. Although the interpretation of the images suspected for malignancy can be challenging, new clas...
Source: Current Treatment Options in Gastroenterology - June 4, 2019 Category: Gastroenterology Source Type: research

Update in Surveillance Recommendations in Individuals With Conventional Adenomas
AbstractPurpose of reviewConventional adenomas, which are precursors to almost 70% of colorectal carcinomas, are found in more than one-third of screening colonoscopies. Surveillance recommendations, based on adenoma size, histology, and number, have evolved over the years and are currently reflective of index adenoma categorization as either low-risk (LRA) or high-risk (HRA). In this review, recent guideline recommendations as well as primary data that have helped to shape these recommendations are presented.Recent findingsRecent data have demonstrated that individuals with HRA on index exams may be at increased risk for ...
Source: Current Treatment Options in Gastroenterology - May 14, 2019 Category: Gastroenterology Source Type: research

Updates on Chronic HBV: Current Challenges and Future Goals
AbstractPurpose of ReviewChronic HBV (CHB) remains a global public health problem with over 257 million people chronically infected worldwide. Without appropriate management, 20% of individuals infected with CHB will die from complications of cirrhosis, liver failure, or hepatocellular carcinoma (HCC). Despite an effective vaccination to prevent infection, HBV has yet to be successfully eradicated globally. Current treatments can only control and suppress the virus but cannot cure. Updates in the management of chronic HBV will be reviewed, including latest treatments and treatment strategies as well as potential curative t...
Source: Current Treatment Options in Gastroenterology - May 10, 2019 Category: Gastroenterology Source Type: research

Durability of Endoscopic Treatment for Dysplastic Barrett ’s Esophagus
AbstractPurpose of reviewThis review discusses the durability of the neo-squamous esophageal epithelium following endoscopic eradication therapy of dysplastic Barrett ’s esophagus. Our review will focus primarily on patients treated with radiofrequency ablation; however, we describe the known durability of cryotherapy. Additionally, we discuss the utility of novel imaging technologies and the efficacy of chemopreventive medications following endoscopic ablation .Recent findingsMounting data describe the durability of the post-ablation esophagus. Dysplastic Barrett ’s esophagus and adenocarcinoma following ablat...
Source: Current Treatment Options in Gastroenterology - May 10, 2019 Category: Gastroenterology Source Type: research

2007 –2019: a “Third”-Space Odyssey in the Endoscopic Management of Gastrointestinal Tract Diseases
AbstractPurpose of reviewThe main scope of this review article is to introduce readers to the innovative field of third-space endoscopy and offer a closer look at its history, milestones, and procedure spectrum while discussing ongoing and future challenges arising from its increasing adoption worldwide.Recent findingsOver the past few years, third-space endoscopy has been utilized in various diagnostic and interventional procedures performed throughout the gastrointestinal tract: obliteration of Zenker ’s diverticulum, myotomy for achalasia, gastroparesis or Hirschsprung’s disease, biopsy or removal of subepit...
Source: Current Treatment Options in Gastroenterology - April 29, 2019 Category: Gastroenterology Source Type: research

Infections in Cirrhosis
AbstractPurpose of reviewPatients with cirrhosis are at high risk of developing serious infections. Bacterial infections remain the most common cause of morbidity and mortality in these patients. This review is focused on the prevalence of infections in those with cirrhosis, including multidrug-resistant (MDR) pathogens, pathogenesis of infection-related acute-on-chronic liver failure (ACLF), current treatment recommendations, and prophylactic strategies in patients with cirrhosis.Recent findingsRecent epidemiological studies have noted an emerging prevalence of MDR bacterial infections and associated with poor prognosis, ...
Source: Current Treatment Options in Gastroenterology - April 12, 2019 Category: Gastroenterology Source Type: research

Colorectal Cancer Screening and Surveillance Colonoscopy in Older Adults
AbstractPurpose of reviewThe purpose of this chapter is to highlight current recommendations regarding colorectal cancer (CRC) screening and post-polypectomy surveillance colonoscopy in older adults and to review the available literature in order to help inform decision-making in this age group.Recent findingsAge is a risk factor for CRC; however, older adults with a history of prior screening are at lower risk for CRC compared to those who have never been screened. Decision-making for CRC screening and post-polypectomy surveillance colonoscopy in older adults is complex and several factors including age, screening history...
Source: Current Treatment Options in Gastroenterology - April 9, 2019 Category: Gastroenterology Source Type: research

Albumin in Cirrhosis: More Than a Colloid
AbstractPurpose of reviewAlbumin has repeatedly been shown to be beneficial in treating patients with decompensated cirrhosis. We reviewed the medical literature regarding indications for the use of intravenous albumin in cirrhosis, with particular focus on the ways in which albumin can help mitigate hepatorenal physiology.Recent findingsAlbumin has long been used as the preferred agent for volume expansion in patients with decompensated cirrhosis. It is used in conjunction with vasoconstrictors for the treatment of type 1 hepatorenal syndrome, and in combination with antibiotics for the treatment of spontaneous bacterial ...
Source: Current Treatment Options in Gastroenterology - April 9, 2019 Category: Gastroenterology Source Type: research

Diet as Adjunctive Treatment for Inflammatory Bowel Disease: Review and Update of the Latest Literature
AbstractPurpose of reviewDiet plays an integral role in development of inflammatory bowel disease (IBD) and continues to act as a mediator of intestinal inflammation once disease sets in. Most clinicians provide little dietary guidance to IBD patients, in part due to lack of knowledge in nutrition and lack of available nutritional resources. The purpose of this review is to provide clinicians with a brief summary of the latest evidence behind diets popular among IBD patients, to highlight diets with known efficacy, and to provide guidance that may help busy practitioners.Recent findingsThe latest studies show that exclusiv...
Source: Current Treatment Options in Gastroenterology - April 9, 2019 Category: Gastroenterology Source Type: research

Endoscopic Bariatric Therapies: Intragastric Balloons, Tissue Apposition, and Aspiration Therapy
AbstractPurpose of reviewEndoscopic bariatric therapies (EBTs) have been identified as a group of procedures that can bridge the treatment gap between bariatric surgical procedures and non-procedural treatments such as pharmacotherapy and lifestyle therapy. We will review the recent progress that has been made in this important area in the past several years.Recent findingsTraditional intragastric balloons (IGB) that are both placed and removed endoscopically have been the fixture of IGB therapy. They have been shown to be safe and effective, when kept in place for 6  months. Newer IGBs, both currently FDA approved an...
Source: Current Treatment Options in Gastroenterology - April 8, 2019 Category: Gastroenterology Source Type: research

Contemporary Epidemiology of Cirrhosis
AbstractPurpose of ReviewWe sought to review the contemporary epidemiology of cirrhosis, focusing on the relative burden of the most common chronic liver diseases.Recent FindingsThe key findings in the review highlight the increasing prevalence and impact of alcohol-related liver disease, particularly among young people, and the epidemic of nonalcoholic fatty liver commensurate with rising rates of obesity. We also contrast recent advances in the care of persons with hepatitis C with the lamentable rise in new infections associated with intravenous drug use. Finally, we highlight the impact of both conventional complicatio...
Source: Current Treatment Options in Gastroenterology - April 4, 2019 Category: Gastroenterology Source Type: research

Endoscopic Papillary Large Balloon Dilation Versus Endoscopic Sphincterotomy for Treatment of Bile Duct Stones
AbstractPurpose of reviewTo review the current literature focusing on the indications, efficacy, and safety of endoscopic papillary balloon dilation (EPBD) and endoscopic papillary large balloon dilation (EPLBD) with or without endoscopic sphincterotomy (EST) in the treatment of bile duct stones.Summary/recent findings• EPBD without EST is associated with a higher risk of post-procedural pancreatitis and lower rate of stone clearance than EST alone.• EPBD without EST should be at least 2 min in duration, and placement of a pancreatic stent and other measures to reduce pancreatitis risk should be considered.&...
Source: Current Treatment Options in Gastroenterology - April 3, 2019 Category: Gastroenterology Source Type: research

Predictors of Progression in Barrett ’s Esophagus
AbstractPurpose of reviewTo review recently published data on factors that predict the risk of progression of Barrett ’s esophagus (BE) to high grade dysplasia (HGD) or esophageal adenocarcinoma (EAC).Recent findingsComputer models have been developed that could help predict the risk of progression with greater accuracy. The progression of BE score (PIB) is one such model based on clinical and endoscopic features, while a second uses automated image analysis of formalin-fixed and paraffin-embedded tissues looking for morphologic features and immunostaining patterns for molecular markers. Panels of genes such as those...
Source: Current Treatment Options in Gastroenterology - February 22, 2019 Category: Gastroenterology Source Type: research

Endoscopic Retrograde Cholangiopancreatography in Pediatric Populations
(Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - February 12, 2019 Category: Gastroenterology Source Type: research

Optical Diagnosis of Colorectal Polyps: Recent Developments
AbstractPurpose of reviewOptical diagnosis of diminutive colorectal polyps has been recently proposed as an alternative to histopathologic diagnosis. Recent developments in imaging techniques, new classification systems, and the use of artificial intelligence have allowed for increased viability of optical diagnosis. This review provides an up-to-date overview of optical diagnosis recommendations, classifications, outcomes, and recent developments.Recent findingsThere are currently seven major classification systems and three major society recommendations for quality benchmarks for optical diagnosis of diminutive polyps. T...
Source: Current Treatment Options in Gastroenterology - February 12, 2019 Category: Gastroenterology Source Type: research

Overlap Between GERD and Functional Esophageal Disorders —a Pivotal Mechanism for Treatment Failure
AbstractᅟRefractory GERD is very common, and while many different underlying mechanisms have been identified, the main focus has remained on residual reflux (acidic or non-acidic). Recently, Rome IV introduced two new concepts with important impact on patients with refractory GERD. They include the introd uction of the reflux hypersensitivity group and the proposal that GERD can overlap with a functional esophageal disorder. Recent studies have demonstrated that the latter affects approximately three quarters of the GERD patients who failed PPI once daily. (Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - February 8, 2019 Category: Gastroenterology Source Type: research

Colorectal Cancer in Young Adults
AbstractPurpose of reviewRoutine screening for colorectal cancer (CRC) in adults>  50 years of age has led to overall reductions in CRC incidence and CRC-related mortality. Yet CRC incidence among young adults age
Source: Current Treatment Options in Gastroenterology - February 2, 2019 Category: Gastroenterology Source Type: research

New Developments in Esophageal Motility Testing
AbstractPurpose of reviewThe purpose of this review is to present the latest developments in esophageal motility testing and summarize the current paradigm of esophageal motility disorders.Recent findingsWhile high-resolution esophageal pressure topography interpreted according to the Chicago Classification represents the gold standard to evaluate esophageal motility, recent studies highlight the additional value of novel manometric applications. Novel applications include provocative measures to assess for obstructive physiology at the esophagogastric junction (EGJ), esophageal peristaltic reserve, and rumination and supr...
Source: Current Treatment Options in Gastroenterology - February 2, 2019 Category: Gastroenterology Source Type: research

New Developments in the Diagnosis and Treatment of Eosinophilic Esophagitis
AbstractPurpose of reviewEosinophilic esophagitis (EoE) is a chronic, allergen-driven, immune-mediated disease of the esophagus that progresses to esophageal fibrostenosis if left untreated. The aim of this review is to provide a concise update on recent clinically relevant advances in the development of diagnostic and therapeutic approaches for EoE.Recent findingsCurrent diagnostic and disease monitoring protocols for EoE rely on repetitive endoscopic evaluations and esophageal tissue acquisition for histopathologic analysis. Recent advancements in EoE diagnosis include endoscopic functional lumen imaging probe (FLIP), tr...
Source: Current Treatment Options in Gastroenterology - February 1, 2019 Category: Gastroenterology Source Type: research

New Advances in the Treatment of Acute Pancreatitis
AbstractPurpose of reviewDespite the increasing incidence of acute pancreatitis, the overall mortality of AP has decreased.Recent findingsThe findings of recent studies on fluid therapy, analgesics, antibiotics, and enteral nutrition as well as the management of AP complications have led to improvements in clinical care. However, there are still no pharmacologic treatment(s) for AP.SummaryExperimental studies have revealed many potential therapeutic targets, but these will need to be further developed and tested before they can be assessed in randomized controlled trials with important clinical endpoints. (Source: Current ...
Source: Current Treatment Options in Gastroenterology - January 30, 2019 Category: Gastroenterology Source Type: research

Esophageal Third Space Endoscopy: Recent Advances
AbstractPurpose of the reviewThe novel concept of third space endoscopy was first applied to humans in 2008 for the management of achalasia through peroral endoscopic myotomy (POEM) procedure. Over the ensuing 10  years, this revolutionary procedure, which started in Japan, has been adopted and mastered by surgeons and gastroenterologists across the globe. In this article, we review the recent innovations and applications of third space endoscopy in the management of esophageal disorders.Recent findingsWith experience and innovation, the application of third-space endoscopy has extended beyond achalasia, and currently...
Source: Current Treatment Options in Gastroenterology - January 26, 2019 Category: Gastroenterology Source Type: research

Advances in the Diagnosis and Treatment of GERD: New Tricks for an Old Disease
AbstractPurpose of reviewGastroesophageal reflux disease (GERD) is a common diagnosis encountered by both primary care providers and specialists, but despite its prevalence, there are limitations in the current diagnostic tests for GERD. Once an accurate diagnosis is made, treatment options can be offered, and this field continues to burgeon with options. In this review, we seek to review the recent advances in GERD diagnostics and subsequent treatment options.Recent findingsNovel impedance markers and novel techniques (mucosal impedance testing, salivary pepsin, high-resolution manometry, and narrow-band imaging) have sho...
Source: Current Treatment Options in Gastroenterology - January 25, 2019 Category: Gastroenterology Source Type: research

Advances in Therapeutic Drug Monitoring for Small-Molecule and Biologic Therapies in Inflammatory Bowel Disease
AbstractPurpose of reviewTherapeutic drug monitoring (TDM) is increasingly utilized as a strategy to optimize inflammatory bowel disease (IBD) therapeutics. As management paradigms have evolved towards treat-to-target strategies, there has been growing interest in expanding the role of TDM to guide drug optimization for achieving objective endpoints. This review summarizes the evidence for using TDM with biologic and oral small-molecule therapies, evaluates the role of reactive versus proactive TDM in treatment algorithms, and identifies potential future applications for TDM.Recent findingsAchieving therapeutic drug concen...
Source: Current Treatment Options in Gastroenterology - January 25, 2019 Category: Gastroenterology Source Type: research

Challenges in Endoscopic Therapy of Dysplastic Barrett ’s Esophagus
AbstractPurpose of reviewBarrett ’s esophagus (BE) is the only known measurable factor associated with esophageal adenocarcinoma. The development of endoscopic eradication therapy (EET) has transformed the way BE is managed. Given the fairly recent development of EET, its role in BE is still evolving.Recent findingsThis paper discusses the challenges that endoscopists face at the preprocedural, intraprocedural, and postprocedural stages of BE management. These include challenges in risk stratification, dysplasia detection, ablation methods and dosimetry, choice of resection technique, and management of refractory dis...
Source: Current Treatment Options in Gastroenterology - January 19, 2019 Category: Gastroenterology Source Type: research

The Gut Microbiome as a Target for IBD Treatment: Are We There Yet?
AbstractPurpose of reviewThis review aims to highlight recent research on the gut microbiome in IBD and the application of microbiome-modulating therapies for the treatment of IBD including the use of the microbiome as an indicator for disease severity and treatment response.Recent findingsDespite the high number of gut microbiome studies and emerging evidence supporting the gut microbiome ’s involvement in disease pathogenesis, no single microorganism has been identified as a pathogenic agent in IBD. Retrospective studies and meta-analyses on antibiotic use in ulcerative colitis and Crohn’s disease and long-te...
Source: Current Treatment Options in Gastroenterology - January 19, 2019 Category: Gastroenterology Source Type: research

Gastroduodenal “Dysbiosis”: a New Clinical Entity
AbstractPurpose of reviewLike the rest of the gastrointestinal tract, the small intestine is colonised by microbes, but how this “microbiome” affects the immune system and digestive functions has largely been overlooked, especially in the “omics” era. Here, we present recent findings that show that the diversity, density and interactions of these microbes in the small intestine can play an important role in the pathog enesis of a number of gastrointestinal and extraintestinal disorders.Recent findingsChanges in the small intestinal mucosa-associated microbiota (SI-MAM) have been shown to occur with ...
Source: Current Treatment Options in Gastroenterology - November 12, 2018 Category: Gastroenterology Source Type: research

Helicobacter pylori Infection: New Facts in Clinical Management
ConclusionClinical aspects ofH. pylori infection have evolved over time and the therapeutic management requires continuous adaptation. A vaccine is still a non-fulfilled promise. The future will tell us more about the role ofH. pylori in interactions with the gut microbiome. (Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - November 10, 2018 Category: Gastroenterology Source Type: research

The Role of Botulinum Toxin Injections for Esophageal Motility Disorders
AbstractPurpose of reviewThe advancement of high-resolution esophageal manometry has led to improvement in the diagnosis of esophageal motility disorders. We reviewed the recent medical literature regarding the use of botulinum toxin (BTx) injections in the esophagus and the indications, current outcomes, and reported complications of this therapy.Recent findingsThe response rates of BTx injection therapy vary depending on the esophageal motility disorder. Studies have shown that response is transient in achalasia patients and given the more effective therapies available, it is only recommended in patients who are not surg...
Source: Current Treatment Options in Gastroenterology - November 8, 2018 Category: Gastroenterology Source Type: research

The Role of Botox in Colorectal Disorders
AbstractPurpose of reviewTo overview the current medical literature on the efficacy of botulism toxin treatment (BTX-A) for lower gastrointestinal disorders (GIT).Recent findingsBTX-A was found to have a short-term efficacy for the treatment of dyssynergic defecation. Surgical treatment was found to be more effective than BTX-A for the healing of chronic anal fissures, and BTX-A can be considered when surgery is undesirable. Data regarding the effects of BTX-A injection for the treatment of chronic anal pain is limited. Beneficial effects were observed only in a minority of patients. BTX-A treatment was found to be effecti...
Source: Current Treatment Options in Gastroenterology - November 5, 2018 Category: Gastroenterology Source Type: research

Which Patient-Related Factors Determine Optimal Bowel Preparation?
AbstractPurpose of reviewAdequate bowel cleansing before colonoscopy is a simple concept but the high rate of inadequate or incomplete bowel cleanliness and its consequences have been the subject of many studies, guidelines, and meta-analysis. The complexity resides in all the factors surrounding preparation intake such as type and regimen of bowel preparation, diets, compliance, and also patient-related factors that all influence quality of the bowel preparation. The purpose of this review is to focus specifically on patient-related factors and their challenges. Patients with lower GI bleeding are excluded from this revie...
Source: Current Treatment Options in Gastroenterology - November 3, 2018 Category: Gastroenterology Source Type: research

Endoscopic Full-Thickness Defects and Closure Techniques
AbstractPurpose of ReviewGastrointestinal transmural defects are defined as total rupture of the gastrointestinal wall and can be divided into three main categories: perforations, leaks, and fistulas. Due to an increase in the number of therapeutic endoscopic procedures including full-thickness resections and the increase incidence of complications related to bariatric surgeries, there has been an increase in the number of transmural defects seen in clinical practice and the number of non-invasive endoscopic treatment procedures used to treat these defects.Recent FindingsThe variety of endoscopic approaches and devices, in...
Source: Current Treatment Options in Gastroenterology - October 31, 2018 Category: Gastroenterology Source Type: research

Opioid-Induced Esophageal Dysfunction: An Emerging Entity with Sweeping Consequences
AbstractAdverse effects of opioids on the gastrointestinal tract are well known. However, with the rising epidemic of opioids, its detrimental effects on esophageal physiology are now being increasingly recognized. In this commentary, we briefly review the current evidence behind opioid-induced esophageal dysfunction with potential pathophysiology and treatment options. (Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - October 31, 2018 Category: Gastroenterology Source Type: research

Timing of Endoscopic Necrosectomy Following Transmural Stent Placement for Pancreatic Necrosis
AbstractPurpose of the reviewPancreatic walled-off necrosis (WON) may require adjunctive direct endoscopic necrosectomy (DEN) following transmural stent placement. DEN is performed immediately or delayed in relation to index endoscopy. There is currently no consensus on the optimal timing of DEN. We review the most recent literature addressing each practice.Recent findingsSome expert opinion prefer delayed DEN; however, recent data reveal immediate DEN may reduce the number of endoscopic sessions required for successful clinical resolution of WON.SummaryFuture studies are needed to determine the optimal timing for DEN foll...
Source: Current Treatment Options in Gastroenterology - October 27, 2018 Category: Gastroenterology Source Type: research

Potent Acid Suppression with PPIs and P-CABs: What ’s New?
AbstractPurpose of the reviewAcid suppression treatment has revolutionized the management of the acid-related disorders since the introduction of the H2-receptor antagonists (H2-RAs) and the proton pump inhibitors (PPIs). However, there has been increasing identification of needs for improvement in antisecretory therapy, especially in gastroesophageal reflux disease (GERD), the eradication ofHelicobacter pylori (H. pylori), protection from aspirin (ASA) and non-steroidal inflammatory drug (NSAID) injury and the management of upper gastrointestinal (UGI) bleeding. There have also been increasing publications addressing safe...
Source: Current Treatment Options in Gastroenterology - October 25, 2018 Category: Gastroenterology Source Type: research

Migraine, Cyclic Vomiting Syndrome, and Other Gastrointestinal Disorders
AbstractPurpose of reviewCyclic vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder characterized by episodic nausea and vomiting and is diagnosed using Rome IV criteria. CVS is being recognized more frequently in adults with a prevalence of 2%. It is associated with several functional disorders like autonomic dysfunction, anxiety, and depression, but the strongest association is with migraine.Purpose of reviewTo elucidate the close relationship between migraine and CVS and briefly discuss its association with other gastrointestinal disorders.Recent findingsWe highlight similarities in pathophysiology...
Source: Current Treatment Options in Gastroenterology - October 25, 2018 Category: Gastroenterology Source Type: research

Parkinson ’s Disease and Current Treatments for Its Gastrointestinal Neurogastromotility Effects
AbstractPurpose of ReviewGastrointestinal disturbances are seen in nearly all patients with Parkinson ’s disease and lead to impaired quality of life, affect drug pharmacodynamics, and potentially worsen patient’s existing motor fluctuations, leading to further disability. Recent evidence links abnormal accumulations of α-synuclein aggregates in the periphery (gut) as seen in the cortex which c auses dysfunctions impacting every level of the gastrointestinal tract from the esophagus, to the stomach, small bowel, colon, and rectum and can even predate the onset of the central neurologic disorder itself. Ma...
Source: Current Treatment Options in Gastroenterology - October 25, 2018 Category: Gastroenterology Source Type: research

Gastric Cancer: an Evolving Disease
AbstractPurpose of ReviewPrevalence ofHelicobacter pylori, the primary risk factor for gastric cancer, is declining globally. Paralleling this trend, gastric cancer incidence is also decreasing. Historically, the populations most affected by this neoplasia have been males, Asians, and groups with low socioeconomic status. This review provides an update on recently published literature regarding changes in gastric cancer epidemiology.Recent FindingsGastric cancer incidence trends vary by age, sex, race/ethnicity, and tumor anatomical location. Overall incidence appears to be leveling off among young birth cohorts in Western...
Source: Current Treatment Options in Gastroenterology - October 25, 2018 Category: Gastroenterology Source Type: research

Update on the Prevention of Post-ERCP Pancreatitis
AbstractPurpose of reviewEndoscopic retrograde cholangiopancreatography (ERCP) is a commonly performed procedure to manage pancreaticobiliary disease. Post-ERCP pancreatitis (PEP) is the most common adverse event of ERCP with a significant burden of morbidity and cost.Recent findingsAppropriate indication and counseling is mandatory especially for patients at increased risk for PEP such as those with suspected sphincter of Oddi dysfunction, pancreatic indications, and a prior history of PEP. Guidewire-facilitated deep cannulation is favored over contrast injection. High-quality trials support the use of rectal administered...
Source: Current Treatment Options in Gastroenterology - October 18, 2018 Category: Gastroenterology Source Type: research

Update on Vaccinating the Patient With Inflammatory Bowel Disease
AbstractPurpose of reviewPatients with inflammatory bowel disease (IBD) are at increased risk of infectious diseases independent of their immunosuppression status, and yet, studies suggest that this population is not receiving standard vaccinations at the same rate as the general population. This review seeks to understand why IBD patients may not be receiving recommended immunizations and to provide guidelines on vaccinating this vulnerable population.Recent findingsInactive vaccines are recommended for patients with IBD regardless of immunosuppression status due to the increased risk for many vaccine-preventable illnesse...
Source: Current Treatment Options in Gastroenterology - October 6, 2018 Category: Gastroenterology Source Type: research

Botulinum Toxin as a Treatment for Refractory Gastroparesis: a Literature Review
AbstractPurpose of reviewGastroparesis (GP) is a disorder of gastrointestinal motility which leads to delayed gastric emptying in the absence of mechanical obstruction. Treatment is limited as many patients are refractory to dietary modification and the use prokinetic medications carry significant adverse risks. These limitations necessitate more research into experimental therapies. The purpose of this article is to summarize the known information and guidelines on the diagnosis and management of GP and to review the latest literature on experimental treatments.Recent findingsBased on the current available literature, the...
Source: Current Treatment Options in Gastroenterology - September 26, 2018 Category: Gastroenterology Source Type: research

Selection of EMR and ESD for Laterally Spreading Lesions of the Colon
AbstractIntroductionColonic laterally spreading lesions (LSL) are increasingly managed using endoscopic methods that comprise two main techniques: endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD).Purpose of ReviewIn this review, we aimed to review the most recent literature on selection of the best endoscopic technique in the management of colonic LSL.Recent FindingsEMR and ESD are complimentary techniques in the management of patients with colonic LSL.SummaryEMR is safe and effective in most patients with LSL, except for cancers with submucosal invasion in whom R0 resection is favored. (Source...
Source: Current Treatment Options in Gastroenterology - September 21, 2018 Category: Gastroenterology Source Type: research

Recurrent Acute Pancreatitis: Current Concepts in the Diagnosis and Management
ConclusionWith a focused approach and appropriate investigations, the etiology of RAP can be identified in a significant proportion of patients. Therapeutic options are limited and future research is needed to improve understanding of the disease. (Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - September 19, 2018 Category: Gastroenterology Source Type: research